Project Results

To view the Evaluation Project results for the UNITE Occupational Health/Workers' Compensation Program,  click here .

Public Policy Goal:

To improve access and quality of medical care by providing medical care to workers whose occupational disease claims have been denied or delayed.

Project Objective:

To develop a model program that provides a basic level of diagnostic testing and treatment to UNITE members regardless of Workers' Compensation claim status, in hopes of minimizing functional disability and promoting a speedier return to work.

Project Description:

UNITE, in collaboration with the Union Sanatorium Association, a comprehensive primary care center located in New York City, and the Mount Sinai Center for Occupational and Environmental Medicine devised new methods for providing UNITE members with access to basic medical care for cumulative trauma disorders without regard to claims status or claim controversy. This addressed an important problem-the inability of workers with occupational illnesses, whose claims for workers' compensation benefits are frequently contested, to receive prompt diagnostic and medical treatment. A model system was developed that provides a basic level of diagnostic testing and treatment regardless of claim status, in hopes of minimizing functional disability and promoting a more speedy return to work. The project included a study to evaluate the effectiveness of this model that was undertaken by investigators from Mt. Sinai Medical Center and the Health Policy Research Center of the New School University. (See UNITE Occupational Health/Workers' Compensation Program- Evaluation Project)

Key Findings and Accomplishments:

• By disseminating information about the project, the problems it seeks to address, and the progress, public awareness of the difficulties faced by injured workers who try to obtain medical treatment for occupational diseases was heightened.
• The project coordinated services, programs and care for patients using the Union Health Center and put into place a system for injured workers with third party insurance that would allow them to receive timely medical care for services not available within the Health Center.
• This project changed the way Union Health Center and the UNITE Benefit Funds handled workers' compensation health care; coordinated health care data; and allowed for a more systematic method to collect, track and organize medical and legal data on workers compensation claimants who were patients at the Health Center.
• This project was conducted among a predominately female (76.1%), immigrant (93.66%), non-English speaking, low wage population, of which 57.67% of the workers were totally disabled at the time they filed claims and 39.15% were partially disabled.
• This project depended heavily on a statute enacted by the New York legislature that permits group health insurers to pay for medical care and subsequently to be reimbursed by the workers' compensation carrier. It proactively implemented this statute for the benefit of injured workers.
• Barriers to the implementation that were overcome included adding a Spanish speaking staff member on the project and negotiating an agreement on which schedule of fees would apply to medical treatment (workers' compensation reimbursement rates were higher and did not contain any deductibles or co-insurance payments).

Tools Developed:

• " Workers' Compensation Prospective Study - Contact Sheet for Baseline Interview ." UNITE Workers' Compensation Initiative, fielded February, 1998 to present.
• " Workers' Compensation Prospective Study - Contact Sheet for 6 Month Follow-Up Interview ." UNITE Workers' Compensation Initiative, fielded August, 1998.
• " Workers' Compensation Prospective Study - Contact Sheet for 12 Month Follow-Up Interview ." UNITE Workers' Compensation Initiative, fielded January, 1999.
• " Workers' Compensation Retrospective Study - Contact Sheet for Retrospective Interview ." UNITE Workers' Compensation Initiative, fielded February, 1999 through present.

Reports and Publications:

"Healthcare That Works for Working People." UNITE Union Health Center, 1999.

Herbert, Robin, MD. "Expanding Access to Workers Compensation Health Care of Low Wage Immigrant Workers: The Unite Union Health Center Workers' Compensation Project."

Integrated Benefits. Edited by MG Stefanchick, 1999 Workers' Compensation Managed Care Sourcebook. New York, NY: Faulkner and Gray, 1998.

"NYCOSH Bi-Weekly." New York, NY: The New York Committee on Occupational Safety and Health, 1999.