The Postal Service has notified [PDF] the APWU that it has established a relationship with Align Networks to provide physical therapy services for employees with work related injuries and illnesses. APWU strongly discourages member participation.
It is our understanding that as a contract provider, Align Networks and their therapists can share information with the USPS that would otherwise be protected by doctor-patient confidentiality, including information that is unrelated to workplace injuries.
In addition, Align Networks strives to achieve reduced costs for its payor companies.
A quick visit to the Align Networks’ Web site exposes how savings might be achieved and several other issues that are cause for concern. Employer services listed on the site include: aggressive management of visit attendance and compliance; notification to employing agencies when employees miss appointments; support in determining medical necessity; assistance in continuance-of-care dispute resolution; help with therapy claim closure; and, probably the most egregious, providing employers with “documentation of Worker’s Compensation Clinical Guidelines comparison for treatment frequency and duration based on condition to allow employers to determine the appropriateness of continued care.”
Therapists should provide medical services based on patient needs, in cooperation with the claimant’s treating physician. Based on the information contained on the Align Web site, it appears the company may be allowing employers such as the Postal Service to interfere with that process.
The good news is participation in this program is strictly voluntary. Employees cannot be forced nor should they be pressured or misled into using Align Networks for any treatment services.
According to the Postal Service, every employee who has an open approved claim and workers with new traumatic injury claims that are pending adjudication are eligible to use the program. Employees who complete a job-related injury claim (Form CA 1) will be provided an application for physical therapy [PT] through Align Networks, as well as contact information, and other information [PDF]. It is important for employees to keep in mind that they have the right to elect a therapist of their choice – they can refuse Align Network services.
In cases where the employee submits a claim for an occupational disease (Form CA-2), an Align Networks card will be issued to the employee by first-class mail once the claim has been accepted. Physical therapy appointments will be scheduled by Align with one of the Networks’ therapy providers and the injured worker if the worker chooses to participate.
In an effort to compel injured workers to use the program, the USPS has started distributing posters [PDF] and has supplied supervisors, managers and postmasters with mandatory service talks that are to be given to all postal employees. In our opinion, the campaign is somewhat deceptive and flagrantly preys upon employee frustrations.
The USPS claims there are advantages for employees who utilize Align Networks for physical therapy services. Employees will not need to obtain prior approval from the Office of Workers’ Compensation Programs and they will not have to pay for out of pocket expenses. Align boasts a more efficient, accurate and timely processing of therapy requests and a large, expanding network of providers. The APWU warns members not to be swayed by the overstated benefits of the program.
The reality is all employees who sustain on-the-job traumatic injuries and provide notice within seven days of the incident must be issued Form CA-16 “Authorization for Examination / Medical Treatment” [PDF] by the USPS within four hours. The “16” authorizes conservative medical care for up to 60 days without obtaining prior authorization from OWCP. This includes physical therapy services. For employees who aren’t entitled to receive Form CA-16, once their claim is approved, authorization for services can be expedited by ensuring the medical provider is enrolled in ACS and uses the proper international diagnosis and treatment codes. It has also proven helpful for claimants or their providers to regularly follow-up with ACS until their request for medical treatment is approved.
In addition, union members should understand that a condition is not considered a workers compensation injury until the claim is approved by OWCP. This means health benefits can legally be used to procure treatment for on-the-job injuries or illnesses with minimal expense to the employee. Once a claim is approved, out-of-pocket expenses can generally be recovered. It has also proven beneficial for treating physicians to provide OWCP with a brief narrative that explains how delaying treatment would have hindered recovery and been detrimental to the employee’s well being. If finding a physical therapist has been difficult, most treating physicians can usually refer claimants to therapists that accept OWCP cases. OWCP’s Provider Search could also be a useful tool.
We recognize workplace injuries and illnesses are fraught with frustrations that might make it tempting to try a service that appears to be trouble-free and effortless, but these are hardly reasons for claimants to subject themselves to a company that is employed to be an advocate for the Postal Service. The perils of using a contract provider are real. Members need to recognize they can access the treatment they need for recovery by using medical providers who work on their behalf and who are concerned with their health and welfare.
Members who have questions or concerns about Align Networks or their OWCP claim should contact their local or state APWU representative. Representatives seeking additional information or guidance should contact the Human Relations Department.