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EMPLOYMENT ISSUES UNIQUE TO JEHOVAH'S WITNESS EMPLOYEES
JEHOVAH'S WITNESS EMPLOYEES
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"On June 25, 2001, in order to obtain information as to Plaintiff’s level of activity, Defendant hired Dempsey Investigations, Inc. to conduct visual and video surveillance of Plaintiff. During the surveillance, Dempsey captured Plaintiff for 14.5 minutes performing
the following activities:'loading 7 bags of groceries, 2 one gallon jugs of water, 24 [soda] can box from shopping cart to the back seat of the vehicle, lifting grocery bags two at a time, lifting one gallon jug and 24 [soda] can box from bottom of cart on one occasion, bending into back seat area without hand support with above items, entering/exiting a motor vehicle with no difficulties, running errands, wedding, placing a sun guard up against from windshield and twisting upper body from sitting position.'In his report, the investigator noted that at no time during his surveillance did Plaintiff 'exhibit any apparent physical limitations'.”
"Plaintiff argues that because the medical records submitted by various physicians indicated that Plaintiff’s fibromyalgia, CFS and other medicinal problems rendered her disabled and unable to engage in any sustained work activity, Defendant’s decision to terminate Plaintiff’s benefits was wrong. However, based on the evidence before Defendant at the time of its decision, this Court does not agree with Plaintiff’s assessment. There does not appear to be any dispute as to whether Plaintiff’s suffers from fibromyalgia or CFS. What is disputed and had to be demonstrated by Plaintiff to Defendant at the time her claim for benefits was being considered was whether Plaintiff’s conditions rendered her totally disabled as defined under the Plan. Based on a review of the evidence in the record, this Court cannot say that Defendant’s decision to deny Plaintiff continued benefits under the Plan was de novo wrong. Defendant thoroughly gathered and reviewed all medical information, including that information provided by Plaintiff, concerning Plaintiff’s condition. Pursuant to the Plan, in order to continue receiving LTD benefits, Plaintiff, as a direct consequence of her disability, had to be 'so prevented from performing one or more of the essential duties of any occupation for which she was qualified.' Nothing in the record indicates Plaintiff was so prevented. As such, this Court will not disturb Defendant’s determination."
COFFMAN v. METROPOLITAN LIFE INSURANCE CO. was a 2002 West Virginia federal lawsuit involving a Jehovah's Witness named Frank H. Coffman, II. Coffman (age 53) was formerly a territory representative for Wyeth-Ayerst Laboratories, a division of American Home Products Corporation. Coffman's duties included visits to health care professionals, pharmacies, and others. He also distributed samples, sold AHPC pharmaceutical products, and maintained account records. Coffman earned a bachelor's degree in psychology and a master's degree in rehabilitation counseling. Prior to serving as a Wyeth-Ayerst territory representative, he worked for two years as a Disability Claims Examiner for the West Virginia Division of Vocational Rehabilitation. While at Wyeth-Ayerst, Coffman participated in the Employees Group Insurance Program, which included short-term and long-term disability coverage through Metropolitan Life Insurance Company.
In November 1996 Coffman ceased work after returning from a cruise with his wife. On December 19, 1996 Coffman executed a Statement of Claim for STD benefits. In April 1997, Coffman sought LTD benefits while review of his STD benefits claim was in progress at MetLife. On his Statement of Claim, Coffman asserted he was unable to engage in any gainful employment and could not return to work "until an effective treatment for my condition is found." The attending physician's Statement of Functional Capacity of May 2, 1997 listed Coffman's primary disabling condition as Chronic Fatique Syndrome and a secondary diagnosis of vertigo. Coffman and MetLife went back and forth vigorously, but on September 30, 1997, MetLife reversed itself and approved Coffman's claim for STD and LTD benefits up to September 30, 1997. The total amount of benefits received amounted to $7800.00 for STD and $14,678.39 for LTD.
MetLife requested additional medical information to support the continuation of benefits after September 30, 1997. Thereafter, Coffman vigorously pursued his claim, and MetLife vigorously investigated such, including surveilling Coffman. The court record includes details of Coffman's travels out of the home to shop and attend Jehovah's Witness meetings and Conventions:
"MetLife placed him under video surveillance to document his physical activities. InPhoto Surveillance observed Coffman on September 24, 27, 28 and 29, and October 12, 1997. ..., on September 28, ... Coffman left home by 9:40 a.m. and drove himself and his wife the 14-minute trip from his house to the Charleston Civic Center to a church activity. The report notes Coffman "parked on the third level of the adjacent parking garage in a handicapped parking space next to the elevators." ... Coffman carried two tote bags into the Civic Center, where he remained for more than seven hours. At 5:07 p.m., Coffman returned to his car carrying the same two bags over his shoulder, along with a small cardboard box. He appears in no apparent discomfort, able to bend and very mobile. At 5:17 p.m., after driving himself and his wife to a restaurant 10 minutes away, he quickly walked through the rain into the restaurant, holding the door for his wife. Surveillance was discontinued at this point. ... On October 12, 1997 more surveillance was taken. Coffman left his house at 10:01 a.m. driving with his wife accompanying him as a passenger. Coffman traveled for 10 minutes to the Kingdom Hall of Jehovah's Witnesses. Once parked, he is seen bent over his vehicle and lifting a large brief box, which he carried into the building. He left two hours later with the same brief box. He traveled to a local Captain D'sTM, where he and his wife had lunch for about 45 minutes. He is seen standing in line to order, gets his food, eats and converses over lunch. He then left the restaurant and drove the car to Charleston Area Medical Center."
The end result was that MetLife concluded that Coffman was able to resume performing the duties of a territory representative. During this same period, Coffman had also pursued SSI Disability, which was initially denied, but later granted. As requested by Coffman, the employer exercised its oversight authority as plan sponsor to review MetLife's earlier claims decision. A request was made for MetLife to again fully review the claim. The memorandum recommended that the employer's "Retirement Committee" deny the appeal for lack of evidence of disability. On January 27, 1999 the Retirement Committee deferred its determination pending further review by the Employee Benefits and Law Departments and outside legal counsel. On April 6, 1999 the Retirement Committee upheld MetLife's determination. On August 20, 1999, after reviewing the information in the appeal file, MetLife also upheld its prior termination decision. On January 10, 2001 Coffman instituted this action. His four count Amended Complaint asserted claims against both AHPC and MetLife for (1) wrongful denial of benefits (Counts I and III); and (2) violation of the West Virginia Unfair Trade Practices Act (WVUTPA), West Virginia Code Sections 33-11-1 et seq. (Counts II and IV). Counts II and IV were previously dismissed as preempted by ERISA. See Coffman v. Metropolitan Life Ins. Co., 138 F. Supp.2d 764, 766-67 (S.D.W. Va. 2001).
In the end, this USDC ruled in MetLife's favor: "Based on the present record and the parties' submissions, and accounting for an asserted conflict of interest, the Court cannot conclude Defendants acted unreasonably or lacked substantial evidence upon which to base their respective decisions. Accordingly, the inquiry ends. This action is DISMISSED ... ."
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RICHARDSON v. METROPOLITAN DISTRICT COMMISSION was a 2003 Connecticut federal lawsuit filed by a African-American Jehovah's Witness named Tammy Richardson. Richardson alleged that her employer MDC unlawfully discriminated and retaliated against her on the basis of her race, religion, and sex. Richardson worked as a clerk in MDC's accounting department.
In September 1997, Richardson was involved in a non-work-related automobile accident that resulted in a 22% disability of her lower back. Richardson was out from work from September 20, 1997 through December 8, 1997. On several occasions between 1998 and 1999, Richardson took medical absences because of the injuries sustained in the accident. In October 1998, Richardson received an evaluation that rated her performance as unsatisfactory, based in part on her absences from work, and her annual increment was withheld. MDC placed Richardson on a six-month probationary period. All Richardson's prior evaluations were satisfactory. On March 31, 1999, Richardson left work on a medical leave of absence. On July 1, 1999, Richardson attempted to return to work, but her supervisor sent her home. On July 1, 1999, Richardson's chiropractor faxed a "Return to Work" form to MDC that explained that Richardson could return to regular duties with a few limitations: she could not lift or carry more than ten pounds; she should work half-days until further notice; and she requires chiropractic care twice a week. On July 9, 1999, when she returned from the March 31, 1999 medical leave, MDC reduced Richardson's responsibilities at work and elevated a less qualified white employee to her position. Richardson filed another "Return to Work" form on July 13, 1999 that stated she should only work part-time until July 23, 1999. On July 23, 1999, Richardson attended a Jehovah's Witness Convention. Richardson had requested the day off in March, and the supervisor approved the use of vacation time. On the day before the convention, the supervisor informed Richardson that he revoked his approval. When Richardson returned to work on July 26, 1999, MDC suspended her for two days without pay for her absence on July 23 and part-time attendance from July 12 through July 21. On August 6, 1999, Richardson filed a complaint with the Connecticut Commission on Human Rights and Opportunities. Because of her medical absences, Richardson's six-month probationary period extended until August 1999. On August 30, 1999, MDC reviewed Richardson's performance and concluded that it continued to be unsatisfactory. Accordingly, MDC denied Richardson a step increment. Richardson took a medical absence for injuries from the accident and job-related stress on November 3, 1999, until her voluntary resignation on December 7, 1999, to accept another position elsewhere.
Richardson thereafter filed this lawsuit for money damages and equitable relief brought pursuant Title VII of the Civil Rights Act of 1964, the Family Medical Leave Act of 1993, and the state common law of intentional infliction of emotional distress. Richardson alleged that the Metropolitan District Commission unlawfully discriminated and retaliated against her on the basis of her race, religion, and sex. On August 7, 2002, the district court granted partial summary judgment for the defendants on some of the plaintiff's claims. However, the case went forward on the issue of discrimination and retaliation on the basis of her sex. No further info is available, but at that point, defendents likely pursued a settlement.
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SHAFFER v. CORNING were two federal lawsuits (1998 and 2001) which involved a Jehovah's Witness named Edward J. Shaffer, Jr. Shaffer was employed by Corning from 1991 through 1999. In April 1998, as a result of depression and anxiety he was placed on a company approved short-term disability leave by his treating psychologist. In October 1998, 20 days before his leave expired, Shaffer filed a federal lawsuit alleging that Corning violated his civil rights by failing to accommodate his Jehovah's Witness religious beliefs. Pursuant to a collective bargaining agreement, Shaffer remained out of work on unpaid disability leave, while at the same time retaining his seniority benefits.
In August 1999, Shaffer enrolled full-time in college. In December 2000, Shaffer's first lawsuit was summarily dismissed. In January 2001, Shaffer received notice that he was terminated effective December 27, 1999. Corning did such despite his official unpaid sick leave status due to Corning's belief that enrolling full-time in college violated the terms of the leave. This action terminated Shaffer's health coverage and other seniority benefits. Thereafter, Shaffer filed a second federal lawsuit under Title VII of the Civil Rights Act of 1964, this time alleging "retaliation". Corning's motion for summary judgment was denied, but trial outcome is unknown.
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"In determining whether a claimant has the residual functional capacity to perform her past relevant work, the ALJ must review the medical evidence regarding the claimant s physical limitations as well as her own descriptions of her physical limitations, including her subjective pain complaints. ......"Although the ALJ found that Hill suffers from the severe impairments of fibromyaglia [Curiously, fibromyaglia is extremely common among Jehovah's Witnesses females; so much so, that the WatchTower Society has published articles on the topic in its religious magazines.] and chronic lumbosacral strain, he rejected her contention that the pain produced by these conditions was so severe as to be disabling. ......"An ALJ is not free to disregard a claimant's subjective pain complaints merely because they cannot be corroborated by objective medical evidence. ......"Additionally, the ALJ overlooked evidence potentially relevant to several other factors. With respect to medication, for example, the record is replete with references of different medications prescribed to alleviate Hill's pain, such as Dolobid, Cyclobenzaprene, Lodine, Tylenol with Codeine, Relafin, Xanax, and Amithriptyline, that were all unsuccessful. ...
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HARRIS v. SOCIAL SECURITY ADMINISTRATION was a 1998 Texas federal case involving a Jehovah's Witness named Johnny Harris. Harris worked as a tree trimmer, and after a fall in 1991, he applied for disability benefits, but was repeatedly denied by SSA, which lead to Harris's filing a federal lawsuit. Not surprisingly, the record contains conflicting evidence as to the extent of Harris's physical injury. Somewhat surprising is Harris's introduction into the case of alleged "mental" problems: "Plaintiff asserts a mental impairment which, in combination to physical impairment, renders him disabled. Plaintiff's asserted mental impairment is the result of what he characterizes as a low IQ, depression, and migraine headaches. In fact, plaintiff's motion applauds plaintiff for attaining the position of foreman despite plaintiff's IQ of 77, and his having failed 3rd grade. ... Plaintiff's IQ results in what he terms an over-simplification of more complex issues and an inability to reflect or properly analyze questions. Plaintiff claims these deficiencies were apparent during the administrative hearing and in discussions with doctors or family members. ... Such a lack of intellect, plaintiff asserts, is a disability in itself, or, at a minimum, creates a disability in light of plaintiff's physical impairments."
The USDC affirmed in part and remanded in part, with these remarks: "Since May 6, 1992, the medical evidence indicates that plaintiff's condition does not meet the listings of 1.05(C). While plaintiff complained of pain, he did not experience the other symptoms necessary to meet 1.05(C). Moreover, except Dr. Corley, each of his doctors consistently concluded that his fusion remained intact. Further, Dr. Corley's opinion only supports the conclusion that plaintiff is disabled from strenuous physical work, not from light or sedentary work activities. Substantial evidence supports the ALJ's conclusion. Plaintiff's assertions of a mental disorder and anxiety suffer from the same flaw: there is simply no medical evidence in the record to substantiate such a conclusion. Plaintiff claims he has a mental disorder meeting sections ... The ALJ also considered the combined effect of plaintiff's physical impairments with his asserted mental condition. The ALJ noted that: He has alleged an inability to work due to back pain for which he takes medications. He testified he can stand a long time, walk up to three blocks at a normal pace, has no problem using his hands, can lift books and clothes, but it hurts to stand and wash dishes. Since his release from his doctor, he mows his yard, one acre, using a riding mower, helps clean house, folds clothes, studies photography, reads, conducts Bible study with his family, and is a part-time lay preacher for the Jehovah's Witnesses. He is not paid for church work. Back in 1991 and 1992 he saw a psychiatrist for depression but stopped going because he felt he was[not] being helped and because he had a bad reaction to medication. He has never been in a hospital for a mental problem and took Prozac for only about three months. Every now and then he lifts something too heavy, such as a chair or end of a table or tree limb. He drives once per day to either preach or just to ride and helps his wife with cleaning. The evidence as a whole supports a capacity to perform light work activity but not his past work as a tree trimming working foreman. His daily work activities further supports a light work capacity. There is substantial evidence that Harris' alleged mental impairment combined with his physical impairments would not be expected to interfere with his ability to work, considering his age, education or past work experience. A careful review of the ALJ's decision reveals that he found that Harris' physical impairments left him capable of engaging in light physical work activities, and that his alleged mental impairment was non-severe and did not prevent him from performing jobs in that range. That Harris could act as a lay preacher and regularly mow his lawn and engage in domestic duties support this conclusion."
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BLANCHARD v. FEDERAL EXPRESS was a 1995 Louisiana state Worker's Compensation case involving a Jehovah's Witness named Rodney Blanchard. Blanchard injured his back while loading and unloading packages as a part-time employee of FedEx. He was treated by Dr. Charles Strange for two herniated disks and released in April 1992 for light to medium level employment on a full-time basis. The hearing officer found that after January 27, 1993, FedEx did everything within its power to help Blanchard return to the labor market, but the evidence indicates and Blanchard's own testimony established the fact that he voluntarily removed himself from the labor force, not because of any disability, but because he simply did not wish to return to full-time employment.
Blanchard testified that he was a member of the Jehovah's Witnesses, and that he had time consuming obligations as an Elder in his Kingdom Hall. He stated that he spent approximately one hour in door-to-door "canvassing" and two more hours performing other church-related duties every morning, five days a week; that he had "shepherding" duties from 7:30 to 9:30 p.m. on Tuesdays and Thursdays; and that he also had church obligations on Saturdays, Sundays, and sometimes on other weeknights. Plaintiff testified his job with Federal Express was part-time. He accepted and held the job because it did not conflict with his church obligations. Since the medical evidence did not support the conclusion that he continued to be totally disabled, either partially or permanently, the state court affirmed the state's discontinuance of benefits.
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IN THE MATTER OF DAVID GARCIA was a 1993 Florida court decision. In January 1993, 30 year-old mechanic David Garcia, Of Lake Worth, Florida, was severely injured when a tire he was changing exploded. The explosion ripped off one arm and did severe damage to the rest of his body, including his face, all of which required extensive skin and muscle grafts. Arriving unconscious at St. Mary's Hospital, Garcia was unable to communicate then, or afterwards due to heavy sedation. David's wife, Jane Garcia, informed the hospital that David and herself were Jehovah's Witnesses, and that blood transfusions would not be permitted. David was suffering from excessive blood loss, and would not survive without transfusions before, during, and after all the many surgeries his severe injuries would require.
David Garcia's parents and siblings, who were NOT Jehovah's Witnesses, were outraged. They immediately obtained legal counsel and petitioned the local court for guardianship and authorization to consent to all medical care necessary to save David's life. At the hearing, during which Jane Garcia did her best to fight against blood transfusions, David's family testified that David was NOT a Jehovah's Witness, had never joined the Jehovah's Witnesses, and had told them that he only attended WatchTower meetings to keep his JW wife happy. Doing such nearly cost David Garcia his life. The court granted Garcia's own father guardianship, with power to authorize all necessary medical care. Outcome unknown.
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IN RE BARTO TECHNICAL SERVICES was a 1995 Pennsylvania federal bankruptcy case in which certain debtors were objecting to the claim of a Jehovah's Witness named Christine Lawrence. Limited details. Christine McNeil Lawrence's deceased husband, Donald E. Lawrence Sr., 39, of Harrisburg, had reportedly been killed in an on-the-job accident at Bethlehem Steel Corporation's Steelton, Pennsylvania plant in January 1991. A subsidiary of Barto apparently had manufactured the piece of equipment involved in his death. Apparently, after collecting all available insurance, Work Comp, government benefits, etc., this JW family (sons, Donald E. Lawrence Jr., and Ryan Lawrence, and two daughters, Lauren Lawrence and Erika Lawrence) were also going after "damages" from anyone else that could be linked to the death of Donald Lawrence. Outcome unknown.
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SIMMS v. SULLIVAN was a 1989 D.C. federal appellate court decision. Roscoe C. Simms was a 40 year-old Jehovah's Witness who lived in the Washington D.C. area. Having only an 11th grade education, Simms had worked various manual labor jobs, despite having lost a hand and forearm in a "hunting accident" when he was 15 years-old. Simms also claimed that he had injured his back on-the-job in 1977. Prior to filing for "total disability" with the Social Security Administration, Simms last worked in 1984, at a Hospital, where he acted as a supervisor in various maintenance departments.
As a Jehovah's Witness, Roscoe Simms admitted that he regularly performed recruiting activities for the JWs, including visiting homes and conducting home bible studies. Yet, he applied for "total disability benefits", and SSI, by claiming that he was unable to perform any job.
Simm's claim was denied at every SSA level. A vocational expert testified that Simms had "transferrable skills including supervising, record keeping, and dispatching" that enable him to do certain kinds of "other work." The expert took into account Simm's "residual functional capacity for light work activity," the amputation of his left forearm, and his "inability to write for more than 15 minutes" with his right arm. With these limitations in mind, the expert offered several examples of work that Simms could perform: "service station manager, auto station attendant (without repairs), auto rental clerk, dispatcher of motor vehicles and security guard dispatcher." Even if limited only to "sedentary exertion," the expert said, Simms "would still be able to perform the work as an auto rental clerk and dispatcher."
Thereafter, Roscoe Simms filed this federal lawsuit. The USDC granted the SSA's motion for summary judgement. On appeal, the USCA reversed and remanded with direction for the court to more fully develop the record as to Simm's disabilities and available occupations, if any.
Industrial Indemnity has directed our attention towards inconsistencies in the employee’s testimony. We find that, in the hearing, the employee flatly contradicted her deposition testimony concerning whether her ankle had been injured in her foot accidents at work, about her lucidity and her use of narcotic medications during the deposition, and about the medical advice she may have received concerning her use of a crutch. We also find the employee’s hearing testimony concerning the work-relatedness of her claimed disability flatly contradicted her legal documents in her claim against Reno Air. We are particularly troubled by the employee’s testimony that she had her son surreptitiously complete portions of her psychological testing during her evaluation by Dr. Detrick. We are compelled to find the employee is not credible. AS 23.30.122.
Ms. Edwards testified inconsistently concerning the employee’s plans for a trip to Disneyland during for her California medical consultation in 1995. Also, the uncontradicted evidence in the record indicates Keith Pleasure completed portions of the employee’s psychological testing, deceiving Dr. Detrick. We must also find these two witnesses are not credible under AS 23.30.122.
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KNIGHT v. ATLANTIC MARINE INC. ET AL was or maybe still is a 2003-5 Florida worker's compensation case under the federal Longshore Act and the jurisdiction of the United States Department of Labor. This case involves a Jehovah's Witness named Casper A. Knight, who was employed as a shipfitter in Jacksonville, Florida. On May 8, 1995, Casper Knight was working aboard a ship then under construction, when he fell off a ladder striking his left knee against a bulkhead.
Knight experienced pain and swelling in the knee, and was initially treated with only a few sessions of physical therapy. The pain and swelling persisted, so Knight was referred for an orthopedic consultation and further tests. An MRI, administered on May 26, 1995, revealed a moderate knee joint effusion and bone bruise. On May 31, 1995, Knight was cleared to return to light duty work indefinitely. Knight continued to complain of pain and swelling in his left knee, so Knight was examined and treated by an orthopedic surgeon on June 14, 1995. Dr. Hardy diagnosed an effusion and administered injection treatments. When Knight's condition failed to improve, Knight returned to Dr. Hardy on June 21, 1995. Dr. Hardy performed arthroscopic surgery on June 30, 1995. Knight was returned to light duty work on July 10, 1995, with the anticipation that he would be able to return to full duty by the end of July. However, the surgery did not seem to help Knight's knee. On September 7, 1995, Dr. Hardy noted that Knight had made no progress in physical therapy. Dr. Hardy decided not to provide Knight with new medications, because none that he had prescribed made "any real difference."
Although Dr. Hardy's notes following the surgery contain no mention of swelling or pain migrating to other area of Knight's body, by September 28, Knight was reporting a stabbing pain on straight leg raising. On October 26, Dr. Hardy observed that the degree of pain that Knight was reporting was "unusual compared to the pathology," and he referred him to Dr. Tandron, also an orthopedic surgeon, who examined Knight on October 31, 1995. At the time of this referral, the medical notes of Knight's pain complaints reveal that his problem was located in the area of the left knee and nowhere else.
Not until November, 1995, did Dr. Hardy note that Knight complained of pain beyond the left knee itself. Even then, the pain that Knight reported was still around the left knee area and nowhere else. On October 26, 1995, Hardy observed that the degree of pain that Knight was reporting was "unusual compared to the pathology," so Hardy referred Knight to a Dr. Tandron, who was also an orthopedic surgeon.
Tandron examined Knight on October 31, 1995, and noted that Knight was experiencing sharp pain under the kneecap, was using crutches, and reported that the sheets at night "bothered the anterior aspect of his knee". These and other complained symptoms caused Tandron to suspect that Knight was possibly suffering from "Reflex Sympathetic Dystrophy", or RSD.
In response to Tandron's input, Hardy referred Knight to an anesthesiologist to have a sympathetic block treatment. Two blocks were performed, but they produced only a "minimal" response. Dr. Hardy deemed these results highly significant. In Hardy's opinion, this test "is the most certain test for RSD," and its lack of affect on Knight, according to Dr. Hardy, ruled out RSD by definition. Hardy ordered a bone scan on March 27, 1996. Although the bone scan was not normal and showed increased uptake, neither the scan nor the block, in Hardy's opinion, revealed results consistent with any variant of RSD he had seen. In Hardy's opinion, Knight had either complex regional pain syndrome (CRPS), or a psychological problem, or both. Hardy felt there was little else he could offer him, and therefore, recommended a pain management program.
Hardy and Tandron referred Knight to Genesis Pain Management Group, so that Knight could receive a multi-disciplinary approach with experts in different areas of pain management. On March 4, 1996, Dr. Wittmer performed a psychological examination; Anita Davis performed a physical therapy exam; and Dr. Jawed Hussain performed a medical examination.
Wittmer testified that he diagnosed a pain disorder with both psychological factors and a general medical condition, and deferred rendering an opinion on the presence of a histrionic personality disorder. Knight's multi-dimensional pain inventory suggested to Dr. Wittmer similar pain severity as other patients with chronic pain, although the degree to which it interfered with Knight's life was much higher than the average person with pain. He assessed Knight's emotional distress was average compared to other chronic pain patients, and his general activity level as poor in comparison with the average chronic pain patient. Knight's coping strategies questionnaire indicated to Dr. Wittmer very poor self-management skills for dealing with pain and suggested that Knight perceived that the various behavior or cognitive strategies are not effective at controlling or decreasing his pain symptoms. Wittmer interpreted Knights profile as likely consistent with a histrionic style, but he specifically testified that he did not diagnose Knight with a histrionic personality disorder. Wittmer opined that a diagnosis of chronic pain syndrome rendered by an orthopedic surgeon predating Knights on the job injury could possibly be an indication of another feature of a histrionic personality disorder, and could re-dispose him potentially to chronic pain with other injuries. Wittmer testified that Knight was looking for medical treatment as opposed to rehabilitation and had very limited motivation for comprehensive rehabilitation services. Wittmer expressed reservations that surgery or further invasive procedures, such as spinal chord stimulation or a drug administration system like the morphine pumps, would obtain a positive outcome. In Wittmer's opinion, Knight's profile complicated the outcomes of those types of procedures. Wittmer recommended a limited physical therapy approach, which did not equire Knight to suspend taking medications.
Anita Davis, a physical therapist at Genesis, participated with Wittmer in the comprehensive pain evaluation. At that time, Knight was walking with crutches and was not using a wheelchair. Davis noted that Knight exhibited minimal pain behaviors and demonstrated less pain intensity behavior than other patients she had served. Davis testified that Knight attended one physical therapy session in April, 1996, and she did not hear from him again. By April 17/8, 1996, Knight had refused to participate further in the pain management program. Dr. Hardy informed Knight that he continued to recommend the pain management program and that if he refused to participate, then Hardy would have "nothing further to offer Casper."
Later in 1996, Knight saw a Dr. Harry Koslowski, who specialized in neurology, rehabilitation, and pain management, and treated patients with RSD. Koslowski's tests and treatments seemed to rule out both RSD and CRPS, so recommended that Knight again seek traetment at Genesis.
In November 1996, Knight began seeing Dr. Claudio Vincenty, who was a Board Certified anesthesiologist and specialist in the field of pain management at the Jacksonville Spine Center. Vincenty treated Knight for RSD, but eventually refused to treat Knight due to Knight's "manipulative behavior".
Dr. Jacob Green initially evaluated Knight on June 30, 1997, and remained Knight's treating physician. Green was Board Certified in Neurology and pain management. In his initial report, Green noted that Knight complained of burning pain from hips to toes at level 7-8, and "problems with chest, arms, and shoulders." Green detected left leg atrophy and found that Knight's left leg was whiter and cooler than the right leg. Green diagnosed RSD; recommended "aggressive therapy" involving a number of other doctors.
Despite the fact that the therapy recommended by Dr. Green was approved by the Insurer on July 11, 1997, Dr. Green reported that on July 17 that Knight asked him for Dr. Kovorkian's phone number, which prompted Dr. Green to counsel Knight against suicide, and refer him to Dr. Lucas, a psychologist.
Thereafter, Knight saw Dr. Green and several other doctors recommended by Green. In August 1998, a Dr. Lord removed from Knight's left hand a cyst which was likely due to the use of crutches. A Dr. Hooshmand had recommended against the cyst surgery, because he wanted Knight to stop using crutches. In July 1999, a skin rash was biopsied by a Dr. Bruce Paley. By February 2001, Green reported that Knight's pain was still at level 8, and concluded that Knight suffered "total body impairment." In October 2001, Green described Knight's condition as static for about three years, and that "there is little else we can do except keep giving him medication and hope for the best." By then, Knight was telling Dr. Green that he was suffering from memory loss. Dr. Green continued to prescribe physical therapy, a high voltage galvanic unit, a motorized wheelchair, a spa, chiropractic treatment 3 times per week for 6 months, and wheelchair access for his personal residence.
Dr. Deborah Fralicker, a Chiropractor, first saw Knight in July 1997, on referral from Dr. Green. She diagnosed Knight with RSD due to his work-related injury, assessed him at MMI with deterioration from crutches to wheelchair, and in need of home aid. In her opinion, Knight was permanently and totally disabled, cannot sit in one position for more than ten to fifteen minutes, and "he also has very poor concentration due to his pain level as well as weakness." Fralicker treated Knight with gentle manipulation, infrared photon stimulation, and acupuncture. She recommended that he be given a jacuzzi spa at home, and recommended physical therapy three times a week, including moist heat, electrical muscle stimulation, strengthening exercises for the calf and left quadricepts, massage for 30 minutes three times a week.
During the five-year period Drs. Green and Fralicker treated Knight, he reported pain levels above level 7 which, over time, spread from his left knee to other areas of his body including low back, mid back, fingers, sternum, shoulders, neck, hip, hands, head, and skin, while his condition deteriorated from crutches to a wheelchair. Usually by Green's recommendation, Knight saw several other doctors and received other treatments too lengthy to continue summarizing. Between 1995 and 2003, Knight's medical expenses and "temporary-totally disability" benefits amounted to nearly $1,000,000.00 paid by the Employer's insurance company. The Insurer suspended benefits from September 20, 2001, to January 4, 2002 (not sure why for only that brief period). In this 2003 lawsuit, Knight sought compensation and other benefits for when benefits were suspended, plus Knight also demanded various other benefits including, new or modified living quarters, 32 hours of home attendant care per week, and an in-home jacuzzi spa. Knight also claimed that his disability status should be downgraded to "permanent-total disability", effective February 23, 1998.
The Employer's Insurer contended that Knight's benefits had been suspended because Knight failed to cooperate with an IME it wanted him to attend at the Cleveland Clinic, which was the premier pain clinic in the U.S. The Insurer denied that Knight needed the additional benefits which he was then seeking. In addition, Employer contended that Knight had failed to follow the recommendations of the health professionals who had been treating him. The Employer argued that it had approved the physicians and treatments that Knight had selected, "but after six years and nearly a million dollars in medical benefits, Knight was worse off in 2003, than he was several years ago." His then current treatment provided only temporary relief, and the prognosis of his physicians anticipated no improvement. The Employer argued that the care Knight was then presently receiving was not in his best interest, and it cited a body of medical evidence in the record indicating that Knight needed a multi-disciplinary pain management approach to his care, which was formulated by a team of health professionals who are expert in treating CRPS. The Employer therefore sought an order authorizing changes in the care and treatment regime Knight was receiving. Employer also interposed a defense under Section 8(f) of the Longshore Act in the event Knight was found permanently and totally disabled.
In 2003, the ALJ ruled that Knight would receive reimbusement for all expenses and benefits for the period that the Insurer had suspended such, plus some other incident treatments/benefits were to be provided by the Insurer. However, per Insurer's request, the ALJ ordered Knight to be admitted to the Cleveland Clinic in Cleveland, Ohio, in order to be examined, evaluated, and treated by a Dr. Michael Stanton-Hicks. Stanton-Hicks was a professor and head of pain services at the Cleveland Clinic, and was one of the world's most renowned experts and prolific writers on RSD. The ALJ ordered that after such examination that the Insurer would not have to pay for any treatments, medications, etc. which were not prescribed by Dr. Hicks.
Knight was evaluated by the Cleveland Clinic in June 2003. Stanton-Hicks diagnosed derangement of the left knee, with "questionable symptoms of superimposed CRPS", and recommended a course of treatments which could be prescribed by Dr. Green back in Florida. Neither Knight nor Green agreed with everything Stanton-Hicks recommended, and apparently, additional treatments were followed, which the Insurer refused to reimburse per the 2003 ALJ Order. Those additional expenses were the subject of a second (or possibly more) ALJ hearing in 2005, which for the most part ruled in the Insurer's favor.
The following Excerpt from 2003 ALJ Order should be very educational for employers, insurers, physicians, etc, because it demonstrates many JWs' opinions about mental health professionals. The WatchTower Society had a history of doing everything it could, short of excommunication, from dissuading JWs from seeking the help of the mental health industry. It has been only within the past couple decades that JWs could seek the help of mental health professionals without being ostracized or even shunned by their fellow JWs. Why the change? Necessity. Depending on the type of mental illness involved, Jehovah's Witnesses have higher incidents of illness than does the general population -- ranging from 150% to 300% for various types of mental illnesses. See the book linked at the bottom of the page: JEHOVAH'S WITNESSES AND THE PROBLEM OF MENTAL ILLNESS.
Psychological Evaluation
Now, one aspect of the pain clinic model which is likely to cause some difficulty, as this record demonstrates rather clearly, is the consideration of the factors which may involve the services of a psychologist. Drs. Hardy, Koslowski, Tandron, Rowe, Pulley, Eichberg, and Barsa all believed that Knight would benefit from a pain management team approach including a psychological component, and Dr. Hooshmand indicated that he would have no objection to an evaluation of any potential psychological aspects of Claimant's condition. Yet, Knight remains adamantly resistant to the notion that there may be a psychiatric or psychological component to his present condition, and except to the extent discussed below, his objections are unreasonable.
Thus, Knight was asked at the hearing whether he would willingly undergo psychological evaluation and treatment. He testified;
"No, because I grew up, my uncle is a psychologist and I'm well experienced. I studied psychology all through school and I'm quite familiar with it and I have, you know, an understanding of what it's based on. And a lot of it is not based on science. It's not based on fact. That's why a psychologist can not prescribe medicine. Only a psychiatrist can. And it's like some of the things that Dr. Willmer or Wittmer said I totally disagree with. His attitude was that if I came from a, I'll use the term dysfunctional family, then I'm potentially going to be a dysfunctional person the rest of my life, no matter what, no matter what I want to be. That's like saying that once somebody, you know, shows any personal character flaw at all, it can never change, that they can never be a better person, even if they desire to. Well, that's just silly.And my bible based education [JW buzz phrase referring to the "education" that the WatchTower Society provides Jehovah's Witnesses via its' literature and "meetings".] tells me that there's much more value in other types of therapy. And no doctor has recommended that for me."
Although several doctors have recommended a team approach to his problem, including the involvement of a psychologist, Knight, based upon his high school study of psychology, seemed inclined to self-diagnose his condition and report:
"I don't see any need for that because there's no problems that are based in that area, you know... ."
Other experts are not so sure.
I am mindful that Knight also suggested that, as a Jehovah's Witness, he had religious beliefs which conflicted with certain aspects of psychological or psychiatric treatment and stated that OWCP advised him that if his "beliefs disagree with that, you don't have to submit to the treatment..." Knight explained that some forms of psychiatric and psychological care "violate his religious beliefs."
As previously recognized, however, to the extent that a particular aspect of mental health evaluation, counseling, or treatment is inconsistent with the religious convictions of the Jehovah's Witnesses, Knight reasonably may refuse to cooperate or participate in that specific aspect of the examination or treatment modality. Any such refusal, however, must be grounded, in good faith, upon the tenets of the Jehovah's Witnesses. Beyond that, Knight's general objections to the involvement of a psychologist or other mental health professional in his evaluation, care, or treatment, based upon his high school studies or his personal misunderstandings about the science and theories of psychology or his belief that "there are no problems in this area," are not reasonable and do not justify a refusal to cooperate.
...
Footnote 23. The record shows, for example, that Knight was reluctant to, and in fact did not, meet with Rick Robinson, the vocational expert, in part because he thought that Robinson was a mental health counselor. Knight testified:
"... the letter he sent to me had one, I think one set of initials next to his name, you know, like a credential abbreviation, but the letters he sent to my doctors that he referenced today, he sent them some questionnaires, he had like six abbreviations of credentials, including one that said, I think it's LMHC, which is supposed to stand for licensed mental health counselor and that was a concern because I didn't really agree with that type of counsel and I wasn't sure if that's what I was being sent there for because they had misrepresented to me a couple of times... ."
The following excerpt is from the section of the 2003 ALJ Order directing Knight to be admitted to the Cleveland Clinic. No surrounding explanation was given in the ALJ Order, but readers should first read the PEDROZA v. CINTAS CORP, GROESSLER v. CINEMARK USA, and the "Gregory West" summaries all posted on the Miscellanous Lawsuits I page.
"For purposes of this visit, Claimant will not be authorized to tape record, either audio or video, any aspect of his evaluation, care, or treatment at the Clinic unless such recording is consistent with Clinic policies applicable to other patients. Further, if Claimant wishes to travel with a companion, he may do so at his own expense; however, a visitor or companion may accompany Claimant to any evaluation, examination, or treatment session at the Clinic only to the extent that the presence of a third party is consistent with Clinic policy applicable under similar circumstances to other patients."
First, some JWs like to tape record -- audio or video -- other people. The problem is that such JWs do not always ask permission or even disclose that they are doing so.
Second, many JWs distrust orthodox medicine and regular physicians, and they will often take other JWs with them to medical consultations, treatment sessions, etc. as "witnesses". I know of one incident when one JW female took a second JW female to a surgery consultation, rather than her own husband, because the husband was not a JW. That surgeon threw the two JWs out of his office; telling his JW Patient that if she wanted him to operate on her, then she should return with her husband, rather than the know-nothing know-it-all church busy-body she had brought with her.
It should be further noted that the WatchTower Society has a long history of advocating unorthodox medicine, and even quackery, while denigrating orthodox medicine and physicians. Simply "google" the keyterms of Jehovah's Witnesses and medicine for a couple of hours of hilarious, entertaining reading.
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RECOMMENDED READING:
Jehovah's Witnesses and the Problem of Mental Illness
Blood Transfusions: A History and Evaluation of the Religious, Biblical, and Medical Objections (Jehovah's Witnesses perspective)
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