February 2002

News

News
Supreme Court Narrows the ADA
A late-January ruling by the Supreme Court appears to be discouraging news for workers with disabilities, particularly those with repetitive stress injuries. The high court's unanimous verdict in the well-publicized Toyota v Williams case, which pitted injured assembly-line worker Ella Williams against the Japanese automaker, says that Williams is not covered under the Americans with Disabilities Act (ADA). The ruling further narrows the standard that workers must meet to be covered by disability-rights law, and could mean that companies may have less of a need for physical therapists.

"This could lead to employees feeling that they are not protected by this law," says Brewster Thackeray, a spokesman for the National Organization on Disability. "It's too early to say, but it certainly does not help the ADA."

When Williams developed her injury in 1996, Toyota initially tried to help her by moving her to a paint inspecting job, which required minimal use of her arms. But when the company later required her to sponge oil off the cars, her problems reappeared. Toyota refused to reassign her, and she stopped coming to work. Toyota then fired her, which is when she filed the suit.

The ruling states that work is not a major life activity, meaning a worker unable to do a specific manual task is not disabled if the task is not an important part of daily life. While too soon to predict the ramifications, it does appear to be a victory for big businesses, which have long complained about the number of lawsuits filed by people who they claim are not entitled to ADA protection. Still, Josh Ulman, an attorney for the US Chamber of Commerce, does not see major fallout. "Employers will not abandon workers with disabilities, nor will they stop providing ergonomic chairs and desks," he says. "This ruling simply means there is a higher standard for cases like this under the ADA."

However, Ulman says that the ruling was not conclusive, and it leaves the possibility open that Williams may win the case when it heads back to the US Court of Appeals for the 6th Circuit in Cincinnati sometime in February.

New Legislation Benefits PTs, Chiros
Under newly passed legislation, physical therapists will soon be able to receive additional pay for working Saturdays at Veterans Health Administration (VHA) facilities. The Deptartment of Veterans Affairs (DVA) Health Care Programs Enhancement Act of 2001 (HR 3447), passed recently by Congress and signed into law by President Bush on January 23, also mandates the establishment of a permanent chiropractic benefit within the DVA system, to encourage better long-term care for veterans. And though the bill is scaled back from an original draft that would have benefited chiropractors even more, representatives from both industries are pleased with the final version.

"We see this as a big victory," says Daryl Wills, president of the American Chiropractic Association. "Previously, veterans had to pay for treatment themselves. Now they will be reimbursed. It's also great because we had to fight various organizations to get it passed."

Similarly, physical therapists stand to benefit, according to Corrine Parver, JD, PT, an attorney with Dickstein, Shapiro, Morin, and Oshinsky in Washington, DC. "The Saturday premium pay, as it's known, is a significant provision," she says. "It will now allow PTs to get the same pay that registered nurses had been getting. That shows that parity is in place, and it makes working in Veterans' facilities more enticing for PTs."

The original bill, HR2792, would have established mandatory chiropractic care at all 172 VHA facilities nationwide. Instead, the modified bill establishes programs in at least one site for each geographic service area, of which there are only 22. "That is the only trouble," says Wills. "Some veterans live in rural areas and might have to drive more than 100 miles to a center. If we could have gotten individual doctors involved in the bill, it would have been even better."

Insurance Coverage Crisis Looms
Could the country's health care system be headed for the danger zone? According to a recent article by Los Angeles Times political correspondent Ronald Brownstein, conditions are brewing that would cause a jump in the numbers of uninsured citizens, similar to the crisis of the early 1990s.

In the recently published, "Health care fears are reigniting," Brownstein suggests that the growing health care problems are so bad that President Bush's 10-year, $1.35 trillion tax cut plan may have to be borrowed from to help pay for fixes.

The rapid erosion in health coverage in the late 1980s and early 1990s, which inspired former President Clinton's ill-fated restructuring efforts, had slowed by the middle of the decade, as insurers controlled costs by pushing workers into expensive managed care programs. Simultaneously, state and federal governments agreed on a 1997 partnership-the Children's Health Insurance Program (CHIP)-to fund insurance for children of the working poor. Such developments reversed the rise of the uninsured, a number that peaked at 44 million in 1998, and dropped to 39 million in 2000.

However, argues Brownstein, rising costs, reduced access, and mushrooming drug costs are once again driving up premiums, and Washington seems ill-equipped to respond. Prior to September 11, the Senate Finance Committee was preparing to spend billions to expand CHIP. But with that effort stalled, and recession, war, and tax cuts taking up a massive chunk of the federal budget surplus, a fix appears unlikely anytime soon.

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