Guiding illegal immigrants injured on the job to appropriate medical care requires workers compensation case managers and claims handlers to take on the role of social worker, detective and translator.

Even delivering indemnity checks often presents additional challenges when injured workers reside in the country illegally, the claims and case managers say.

Still, experts say, comp claims for illegal immigrants must be managed effectively to ensure that treatment is delivered before medical conditions worsen and drive up claims costs, and before attorneys become involved.

Claims managers say they face numerous hurdles when they try to contact illegal immigrants injured at work. Fraudulent Social Security numbers are common, home addresses are wrong, and the workers and their families often are distrustful and unwilling to provide necessary information, fearing immigration authorities may become involved.

Laws in most states, however, mandate that illegal immigrants injured on the job receive the same care and benefits as legal workers.

One common challenge, say nurse case managers who specialize in helping catastrophically injured workers, occurs when assisting undocumented workers return home from a hospital stay.

"You are trying to work on discharge to a particular address and it doesn’t exist or it’s not the address they are actually living at," said Marlys Severson, president of SCM Associates Inc. and a network manager for Paradigm Management Services L.L.C., a Concord, Calif.-based catastrophic case management company.

"It makes it really tough to try to pull everything together to make for a smooth transition and good medical care," Ms. Severson said.

Impoverished living conditions can make returning patients home medically impossible, said Mary Hawkins, a bilingual catastrophic nurse case manager in Atlanta for Intracorp, a unit of Philadelphia-based unit of CIGNA Corp.

"If they have been living 12 (people) to an apartment, sleeping in shifts on the floor, you can’t send someone home with an infection and an open wound," she said. "You can’t send someone home who is a new paraplegic (under those conditions.) You can’t send someone home who is an amputee."

Catastrophic nurse case managers’ responsibilities include visiting the residences of injured workers to verify their home accommodations will be safe for recuperation after leaving treatment.

"I’ve had instances where I’ve gone to the house and there are 15 to 20 people who happen to be living with no furniture and you have an injured worker who’s laying on the floor on a blanket," Ms. Severson said. And the workers don’t have access to social resources available to legal workers.

Living conditions may impede healing and require medical case managers to spend more time educating patients about caring for themselves, said Adolfo Arsuaga, branch manager in Reston, Va., for the Hispanic Resource Center, a unit of Genex Services Inc., a disability management company.

"They do require a little bit more handholding," Mr. Adolfo said.

Providing illegal immigrants with disability payments can present challenges because they don’t have appropriate documentation to open a checking account, he said.

In some cases where injured workers’ accommodation is not appropriate for their medical condition, insurers pay to rent a new apartment. But finding one can be difficult because some apartment owners demand proof that the injured worker is in the country legally, case managers say.

"Half the time you end up literally having to put them in a hotel room (with accommodations for disabled guests) month after month because they can’t sign a lease," Ms. Hawkins said.

Workers comp insurers say they do not ask whether someone is undocumented and claim forms don’t require such information. But case managers and claims managers say there are several clues.

The use of multiple Social Security numbers for a single claimant is one tipoff for claims examiners, said Darrell Brown, workers comp practice lead for Sedgwick Claims Management Services Inc. in Long Beach, Calif.

Others agree that multiple Social Security numbers are common.

"We have seen undocumented workers having multiple (Social Security numbers). One for the job, one for the third-party administrator, and one for the health care facility," said Thomas Newman, marketing analyst in Nashville, Tenn. for Alternative Service Concepts L.L.C., a claims management company.

Establishing addresses also can prove challenging for case managers. Financial instability often forces undocumented workers to move frequently. Or they provide false addresses because of their fear of immigration authorities.

Illegal immigrants change telephone numbers frequently, or they may not have a telephone, so case managers visit their homes more regularly to ensure they follow through with treatment.

"There (are) a lot of scenarios involved, but it just makes it really difficult for (health care) coordination (and) getting them to and from their therapy, being able to get them to and from their doctor’s appointments, being able to provide them adequate care," said Ms. Severson.

The additional hurdles to providing care to illegal immigrants increases the likelihood that their medical outcomes will not be as successful, claims managers say.

Sometimes the outcomes are heart-wrenching, nurse case managers said.

One worker returned home to Mexico rather than stay in the United States and undergo surgeries that could have restored the sight he lost in one eye, Ms. Severson said.

Distrust and a desire to return home when injured is common, she added. Some undocumented immigrants fear that flying across state lines to medical centers of excellence could expose them to immigration officials so they choose to forgo the specialized care, Ms. Severson said.

Ultimately, resolving claims filed by illegal immigrants requires that claims examiners and others build a trusting relationship with them, said Kimberly George, vp and managed care practice lead for Sedgwick in Chicago.

But earning trust and building a relationship can take "a lot more time, energy, effort and teamwork in order to provide good care for them," Ms. Hawkins said.

"You have to be an investigator, a social worker, a spiritual adviser, a medical coordinator and a translator," said Ms. Hawkins of Intracorp. "You have to speak English, Spanish and medical."

Source

 By Joe Guzzardi

The countdown to VDARE.COM’s Fifth Annual Worst Immigration Reporting Award is underway. It comes at a time when a new attack on “Hate Speech”—a.k.a. free speech, the honest discussion of what I’ve called “hate facts”—is looming.

Within the next thirty days we’ll announce who during 2008, among the dozens of candidates, has consistently written the least professional immigration stories on America’s most important topic.

Because we have so many rotten reporters to choose from, VDARE.COM will not bestow its award more than once to any journalist.

And that must disappoint Newsday’s Bart Jones, [e-mail him] the 2006 co-winner with his equally unprincipled colleague Mae Cheng. [e-mail her]

Based on Jones’ coverage of the recent murder of illegal alien Ecuadorian Marcelo Lucero, he could easily qualify were he not an earlier honoree.

If I didn’t know better, I’d bet that Jones’ stories, as well as the entire Newsday treatment of the Lucero incident highlighted by its character assassination of Suffolk County executive Steve Levy, could have been written and edited by La Raza’s Janet Murguia.

I hate to disappoint Jones. So let’s take a moment to have a little fun at Jones’ expense by picking apart his cornerstone sob story. [Lucero’s Family Hosts Mass at Home He Helped Build, Bart Jones, Newsday, November 17, 2008]

Jones, who filed from Ecuador, loves the Mass angle, mentioning it five times in his 800-word story intending to build sympathy for more illegal immigration. (Aside: Newsday still hasn’t recovered from its circulation scandal of two years ago. Advertising revenues remain soft. Company layoffs and buyouts have been ongoing since 2004. Yet, it foots the bill to send a reporter to Ecuador?)

To re-emphasize his point that the Lucero family is religious, Jones also included two references to the deceased’s wake. Religion is one of many common denominators in MainStream Media illegal immigration stories. The objective is to hammer home the message: illegals good; Americans bad!

In addition to the curious coincidence that such a high percentage of immigration stories involve deeply religious illegal aliens, there’s another statistical oddity: the high incidents of critical illnesses among the protagonists.

In the case of the Luceros, Marcelo’s father died of a heart attack and his mother survived a cancer scare.

I know that being cynical about their faith and skeptical about their health makes me appear insensitive, especially to readers less hardened than myself.

The reality is, however, that over the last fifteen years, it has been one of my jobs to read mainstream media immigration stories—first for Californians for Population Stabilization, then for NumbersUSA.Com and now for VDARE.COM

Having now read several thousand putrid stories, I’ve developed a tough stomach. And after a few years, I’ve been struck by the amazing quirk that such a large number of aliens are so religious and so sickly.

Somewhere out there must live an illegal alien who’s a heathen. And with all the free health care they receive, somebody should be in good physical condition.

Back to our “Worst Annual Immigration Reporting” award. Jones’ story caught my eye because since 2003 when we first introduced our contest, the stakes have gotten higher.

Five years ago, we had a two-fold objective:

• To raise awareness among the general public on just how shoddy immigration coverage is.

   

• And, helpfully, to educate reporters and editors that better stories evolve from fair and balanced copy.

We did well on the first part of our mission. Every single patriotic immigration reform proponent knows exactly how dismally the media presents our issue.

Of course, on our second goal, the odds against us were too long to achieve total success.

Still, we soldier on.

But today, instead of a didactic crusade, we’re fighting a defensive battle to preserve our First Amendment rights.

Brenda Walker wrote last week about the New York Times and its ratcheting up efforts to squash any immigration points of view it doesn’t cotton to.

The Newsday/Jones/ Lucero case is an excellent example of what we’re up against.

In a follow-up story to Jones’ piece, Newsday reporter Juliann Vachon stacked the deck against Levy [Civil Rights Leaders Denounce Levy, Media After Slaying, By Juliann Vachon, Newsday, November 25, 2008]

To save you time and trouble, I’ll fill you in on the details:  

• By “civil rights leaders”, Vachon means La Raza and Janet Murguia.

   

• By “media”, Vachon means Lou Dobbs—not the Times.
  

Murguia charged that Levy has taken:

"…A notably hard line against immigrants in his county, and has been lauded by cable hosts like Lou Dobbs as a folk hero. Suffolk County is a particularly good example of elected officials stoking the fires of anti-immigrant sentiment.

She added that:

“For two years we have urged politicians and members of the media to show some restraint in echoing the damaging rhetoric that demonizes our communities."

Lucero’s murder, Murguia said, is the latest “wake up call.”

Representatives from other “civil rights groups”—as they refer to themselves— joined Murguia in her attack on Levy: the Asian-American Justice Center, the Anti-Defamation League, the National Urban League, the NAACP, the Mexican American Legal Defense Fund, Suffolk County Human Rights Commission and the Educational Fund and the Leadership Conference on Civil Rights.

In his defense, Levy made the perfectly logical observation that:

“It is reprehensible that anyone would suggest that the tens of millions of Americans who favor secure borders are necessarily intolerant or bigoted. Since when is enforcing the law seen as something negative and inflammatory?”

But that’s exactly where the argument is. If you speak out against immigration, even illegal immigration, the civil rights groups come after you and the MSM backs them up every inch of the way.

Think about that—self-appointed civil rights groups opposed to free speech!

This isn’t a new trend, but it’s a growing one.

So far, Americans still have First Amendment rights…technically.

Murguia and others like her have done a good job at chipping away at them. The press glorifies her while it marginalizes Levy (and ignores VDARE.COM) for defending our country’s laws.

Today, no American can speak frankly about race, religion, or sexual orientation in the US and keep his job. Multiculturalism demands that every characteristic of any of the ethnic groups must be accepted uncritically or not mentioned at all.

If we aren’t careful, and with the Fairness Doctrine looming, the U.S. might end with soft totalitarianism, up like our neighbor to the north, Canada, or the once-proud Britain and France.

It can happen here. Heaven help us—and America—if it does.