Overview

The FDNY Bureau of Health Services (BHS) serves other functions besides medical exams and monitoring of members who are sick or injured. Physicians employed by the BHS are given the honorary Medical Officer rank of ‘Battalion Chief’, and should be afforded every respect as such. BHS doctors examine and monitor members’ medical treatment, and also treat members, with the objective of restoring them to good health and back to full duty. Members are initially ordered to appear at the BHS soon after they call in sick and periodically thereafter until back to full duty. Also, all annual company medical exams are conducted by the BHS. Its other arm, the Counseling Services Unit (CSU), is based in a separate location and has facilities at multiple places to provide services. The CSU has helped many members and their families going through difficult times with the objective of restoring them to a healthy state of mind. This Chapter answers your questions about the Medical Office, such as medical leave, postponements, LOD injuries, exposures, documentation, discipline, light duty, annual medicals, counseling and much more. Lastly, it addresses matters such as punitive actions, and defending yourself against actions that may be taken by the BHS or the Department which may be inappropriate, unethical, or against Dept policy, our Collective Bargaining Agreement, or the law.

Respectfully and fraternally,
Eric DioGuardi
UFA Recording Secretary

Address – Hours – Directions

Office Hours & Location

Citywide Medical Leave Desk & Light Duty Desk are located at 9 Metrotech Center, Brooklyn, NY 2nd floor. The hours are 8am. to 1pm, 7 days a week. Members typically get there much earlier, as service is mostly on a first come-first serve basis. You must sign in no later than 1pm. If the office is crowded, it is possible that you may end up staying much later. Certain specialists do schedule appointments with individual members by time slots, including for Pulmonary and Orthopedic Treatment. These appointments may also be during other hours. In general, two or more medical officers shall be on duty daily for the purpose of treatment or examination—without charge. Members reporting to the Bureau of Health Services may wear civilian attire.

Directions

1. By Subway: N-R to Lawrence Street (MetroTech); N-B-M to Willoughby Avenue and Bridge Street; A-C-F to Jay Street and Borough Hall; 2-3 to Hoyt Street and Fulton Street; Q-D-M-N-R to Dekalb Avenue and Flatbush Avenue.
2. By Bus: B54 – Get off alongside 9 MetroTech (Myrtle Ave & Duffield Street); or take any of the following busses: B54, B57, B61, B67, B73 & B26. Get off at Myrtle Ave & Jay Street.
3. By Car: BQE South to Tillary Street exit. Go 1 block to Flatbush Avenue and turn left. Go 2 short blocks to Tech Place (on the right). From Manhattan: FDR to Brooklyn Bridge. Left on Tillary St. in Brooklyn. Turn right onto Flatbush Ave. Go 2 blocks on Flatbush Ave. to Tech Place (on the right). The entrance to the building is inside the MetroTech Center complex (9 MetroTech Center), not on Flatbush Ave.
4. Parking: Free parking was previously available under the BQE at the Tillary St. exit. Not anymore (Jan 2005). The DOT has been towing vehicles that are parked there. Municipal parking for a fee is on Livingston St. at Bond Street. There are other public parking lots in the area for a fee. It is almost impossible to find free street parking in the vicinity of the Medical Office.

Time Policies (Sick Leave & Light Duty)

Never Self-Diagnose

Tell the doctor where it hurts or how you feel, and no more. Do not allow anyone other than a doctor to diagnose you. Let them decide what condition is causing your problem. When on the phone with BHS or Car 32 or 33 (Dept Doctor’s vehicle), insist on speaking with the doctor when discussing your condition. Anyone else, no matter how well meaning, is unqualified to discuss or diagnose your condition. However, other issues may be addressed by other medical office staff.

Confinement to Residence on Medical Leave

It is a violation of a Federal Court Stipulation if any member is instructed by the Dept. to remain confined in residence when calling to postpone a Medical Office appearance. The March 24, 1996 Stipulation Of & Order Of Settlement and Discontinuance recorded in U.S. District Court prohibits confinement to residence while on medical leave as follows: “All members, unless they have been placed on SMLP, are not restricted to their residence, are exempt from any home visitation or telephone calls while on medical leave…”

See Medical Leaves & Abuse & Penalties section later in this chapter, which notes the criteria and penalties the Dept may impose if you exceed certain medical leave limits.

A.W.O.L.

Any member who is missing from a scheduled BHS appointment, medical, or appearance will get AWOL charges, if there is no reasonable explanation, as determined by the Chief Medical Officer.

Calling Sick from Home

In accordance with PA/ID 1-2003, off-duty members must call the FDNY Automated Citywide Medical Leave System (which will prompt you to provide certain identifying info) at 718-330-2204, which is available 24/7, at least two hours before your next tour start. You must also notify a supervisor from your unit within the same time frame. You are required to appear at the BHS Clinic on the day scheduled through the Automated Medical Leave System. After your medical examination, you must pick up your duty determination record before leaving. Make sure you read it. (If you do not agree, get the issue resolved immediately while still at the BHS Medical Office.) You must also notify your unit/officer of duty status and the next date you are scheduled to visit the BHS. Don’t work while injured or ill. When you get hurt, go sick! See Medical Leaves & Abuse & Penalties section later in this chapter, which notes the criteria and penalties the Dept may impose if you exceed certain medical leave limits.

Calling Sick from Work

In accordance with FDNY Regulations 17.12, members who call in sick while on duty are granted leave for the remainder of the tour, if requested. Make sure an entry is made in the Company Journal. This will not count as a medical leave-nor will you be penalized under the SMLP program. The BHS automatically returns many members back to full duty at the end of that tour, unless you call in sick again at least one hour prior to the end of that tour (one tour = a 9×6 or 6×9, not a 24). If you are taking the remainder of the first half or your 24, you will automatically be put back to full duty for the second half of the 24 unless you call in sick again. If you do call in sick at that time, you must immediately report to the BHS, in accordance with instructions provided by Car 32/33 or the FDNY Automated Citywide Medical Leave System. This sick call may count towards the SMLP program. If you are not scheduled to work the second half of a 24 but are still not feeling well before you go home-do not call in sick at that time. You should call in sick again only if you are still not feeling well within two hours of your next scheduled tour. Call in sick at that time and not sooner!

‘Remainder of Tour’ Granted Off Injury

As explained in the above and below paragraphs, medical leave taken for the remainder of any single tour does not count on your record as medical leave, nor is it charged to any other leave you have.

LOD Injuries – Minor, Time-Lost & No-Time-Lost

Per FDNY Safety Bulletin 7

1. Minor Injuries – an injury, not requiring a rest period or a medical leave. Notification to the Medical officer on emergency duty is not required. Your officer makes an entry in the Company Journal and a CD-72 is prepared. You remain on duty. Minor injuries may include, but are not limited to:

• • small abrasions
  • minor burns
  • mild conjunctivitis
  • minor contusions

The following shall not be considered minor injuries:

• • burns, other than minor
  • chest pains
  • foreign body in eye, already removed
  • lacerations, not requiring sutures
  • Minor sprains and strains (no swelling or discoloration)
  • sprains or strains, other than minor
  • any injury resulting in fainting, blackout, or loss of memory

1. No Time-Lost Injuries – an injury requiring a medical leave of less than one calendar day, not including the day of the injury. This includes “remainder of the tour” and “R & R” granted by a Medical Officer. An example: a member is injured on the 13th day of the month. The medical Officer grants medical leave until 1800 hours on the 14th. No Time-Lost medical leave does not count as sick leave on your record.
2. Time-Lost Injuries – an injury requiring a medical leave of more than one calendar day, not including the day of the injury.

NOTE: Though you may be granted the Remainder of Tour off for a severe cold, fever, etc., or other illness that occurs while on duty in accordance with Safety Bulletin 7, it will not be considered Service Connected. Also, this illness will not count as a medical leave call towards the SMLP count, unless you miss an additional tour.

Postponements – Too Ill / Injured to Report to BHS

Although the medical staff at the Bureau of Health Services must honor any medically valid request for postponement, we sometimes receive reports from firefighters who have been denied and ordered in. They have been told that unless they appear as ordered, they will be considered AWOL. In many cases, these instructions are not accurate. Stick to your guns and follow all the below instructions:

1. Unsafe Orders: The UFA wants to make it clear that firefighters are required to obey all legal orders from the Bureau of Health Services. However, a firefighter is not required to obey an order that will unnecessarily endanger his/her health or safety. Accordingly, if you reasonably feel that you are too ill or injured to travel or report to the Medical Office, you should express that to whomever you speak to at the Postponement Desk (718-999-1918/19/20). If necessary, request to speak to a Dept Doctor. You should be ready to explain why you are unable to appear. Postponements are for YOUR medical condition, not for other family members’ conditions or needs. Your reason may well be that traveling to the Medical Office may endanger you and others, that you have an excellent medical leave record and that there is no reason to compel your immediate appearance. You cannot be denied the right to postpone if it may be hazardous to your health and well-being. If you are too ill or injured to travel and are instructed that you can’t postpone, do the following:
   1. Ask for a Department ambulance to pick you up, transport you to the BHS, and transport you home.
   2. If this is denied, ask for a BHS doctor to examine you at your home.
   3. If both requests are denied (2005: we are currently informed they will be denied), inform the BHS that you “are postponing and will try again tomorrow.”
   4. If on the next day you are still medically unfit to travel and believe it worsen your medical condition, you can postpone again.

You can also call your firehouse to ask for Company Journal entries be made to document your postponement.

1. Get a Doctor’s Note: It is recommended that you obtain a note from your private physician, your local medical center or Emergency Room confirming your illness and the inadvisability of your traveling to Brooklyn. This will help validate for the Department your reason for postponement. Dept. PA/ID 2-87 states that Medical Office appearances may only be postponed “if the member is non-ambulatory” (unable to travel). It is not sufficient to assert that you have family obligations, i.e., you have to pick up your children, you need to get your car fixed, etc. Those reasons are not acceptable and will not withstand scrutiny. For each day you are really too ill to travel and you don’t want to worsen your medical condition, you can postpone again via the same procedure.If you postponed due to an acute but short-term illness for one day (such as a bad case of the runs, a severe migraine headache, etc.) that also prevented you from visiting a private doctor on that day, and you are ready to report to the BHS on the next day, but do not have a doctor’s note yet-what should you do? Contact the Postponement Desk and inform them that you can come in but obviously do not have a doctor’s note yet. Tell them if you are required to visit a doctor to get a note today or tomorrow, then you will need to postpone it again. Be guided by their instructions and document as described below. You may be instructed to report to the BHS without a note and see a BHS physician.
2. Document All BHS Correspondences: The UFA recommends that you keep a record of any conversation with the Medical Office staff to confirm exactly what both you and they say and write down the date, time, and name of the person(s) you speak with. You can also call your firehouse and have Company Journal entries made to document what instructions you were given. We further recommend that if you believe you are not receiving proper medical care or consideration, you should immediately notify the W UFA Health & Safety Officer / Sergeant-at-Arms or the Trustee-On-Duty of the specific facts of your case by immediately calling 212-683-4832.

When to Return to Full Duty?

1. When to Return to Full Duty? Easy answer – after you have healed and not a minute sooner. Protect yourself and protect any possible future disability case (which is never anticipated at the time). Stay out on medical leave until you are completely well enough to return to work. For members who are already on medical leave and are presented with the same offer from BHS as noted in the above paragraph, this applies equally as important. If you attempt to prematurely go back to work, are unable to, and must tap out again –

you have just created two separate medical leave calls against your medical leave folder/printout, even though it was for the same sickness or injury.

1. Re-injury: Worse yet; what if you return to work while not quite fully healed, catch a job, and compound the injury to the point that it is now even worse than before?? So don’t try and guess that you will be better in 3 days (ie: put me on full duty as of…). get better first, make a return visit to the medical office, and then go full duty. A premature return to full duty may end up with you prematurely ending your career.

RSOT Carry Over—Due to LODI Medical Leave

Firefighters on LODI medical leave may carry over unused RSOT into the new calendar year, but not into the year beyond that, as per Section 9 of PAID 1/90. Make certain your officer forwards an RSOT Carry-over report before

January 15, or you will jeopardize your guaranteed right to be offered these hours. If not eligible for a Carry-over request, you must work any rescheduled RSOT (as per PA/ID 1/90, Addendum 4) before January 1st. It is important

to document RSOT rescheduling request denials by having the Battalion Aid fax your request to DSCO. DSCO will fax back your request either approved or denied. You may need several verified denials to help you keep your RSOT rescheduling entitlement in the next year-especially for non-LOD Injuries. It is your proof that the Dept denied you! See FDNY Book (Overtime Chapter) for additional circumstances for RSOT Carry-over, including due to light duty assignment.

Light Duty

Any duty recommended by an FDNY Medical Officer for members unable to perform full duty. Light Duty (LD) is a duty status determination indicating a member is incapable of firefighting or fire investigation duties, but is capable of performing other tasks. (Excerpts/summary/interpretation of Mayoral Directive 78-14, Regs. Ch. 1 & AUC 322 (AUC 322 held in abeyance per DO 71/97)

1. Temporary: LD is a temporary assignment to duties which a temporarily unfit member is capable of performing. These are temporary assignments and should not exceed one year’s duration except under the most unusual circumstances. It is a transition between the time when you are partially disabled and the time when you either return to full duty or leave City service if the disability will not permit a return to full duty.
2. Extra Departmental Employment (EDE): LD members may work EDE only with the approval of the Fire Commissioner and Chief Medical Officer, in accordance with PA/ID 12-67.
3. Physical Therapy Release Time: In most cases, LD members will be accommodated in order to attend physical therapy. See Light Duty & Disabilities section later in this chapter for specific policies.
4. Boarding: Generally, after six months in disability status, light LD members are reviewed by a panel of BHS physicians to make an immediate duty determination, which is usually referred to as “Boarding”. (This is not to be confused with the 3-physician 1-B Medical Board, which determines if you are eligible for disability retirement for pension purposes. The 1-B Medical Board is independent of the BHS.) The purpose of the BHS Board is to determine which of the following three categories an injured or ill member falls under:
   • Fit-for-Duty: Eligible for return to full duty.
   • Unfit Temporarily: Temporarily unable to perform full duty and subject to re-evaluation at a later date.
   • Unfit-for-Full-Duty: Permanently unfit for full duty and recommended limited service (light duty continued). In other words, you most likely be forced to retire.

Notify your Delegate if you are told by the BHS Board that you are Permanently Unfit-for-Full-Duty.

1. Forced Retirement: Make sure you contact the UFA Disability Pension Consultant prior to appearing before the 1-B Medical Board. No Light Duty member is guaranteed a position beyond one (1) year in disability status since the member is incapable of performing the tasks for which he/she was initially hired. Once the BHS Medical Board determines that you are Unfit Permanently, your paperwork is forwarded to the Chief of Personnel. If after one (1) year in disability, a determination is made that the member should be retired via Fire Commissioner’s application, a letter shall be forwarded to the member and the member’s unit from the Bureau of Personnel indicating that retirement processing will commence. The member or supervisor shall have five days to respond. Failure to respond will ensure retirement processing goes forth.

Appeals will be evaluated based on Department needs only. Members with Commissioner’s Application will be processed for retirement via the (3 physician) 1-B Medical Pension Board and the ‘12 man’ Pension Board of Trustees. Once a member is found disabled by the 1-B Medical Board, the member must be retired unless granted a stay of retirement by the Fire Commissioner.

1. Limited Service Members (LSS): Also known as LSS assignment. The LSS designation has been replaced with the BHS term ’Unfit-for-Full-Duty”, which means you are permanently unfit for full duty (will be processed for disability retirement). Members whom the BHS Medical Board has certified as Unfit-for-Full- Duty from injuries or illness are disqualified from performing active fire duty and are assigned to some form of “Light Duty.”
2. Reasonable Accommodation per Americans with Disability Act (ADA): The ADA defines Disability as “someone who has had a physical or mental impairment which substantially limits one or more major life activities; or has a record of such physical or mental impairment; or is regarded as having such a physical or mental impairment.” Disabled persons have certain employee rights under Federal Law. This also applies to

FDNY members who are Permanently ‘Unfit-for-Full-Duty’. See Legal Book (Americans with Disability Act section) for more info.

Maternity Leave

1. Leave with Pay—Dept. Policy: “Special Leaves of Absence for personal business or other reasons shall be applied for well in advance of dates on which leaves are desired. All pertinent information indicating the necessity for such leaves shall be included.’’ (DO 15 of 1995, Sec 2.4) Any member may request leave with pay immediately prior to or immediately after the birth of his or her child. You will be allowed to utilize unused vacation time or even accrued vacation entitlement. Forward Requests to the Chief of Personnel via Form BP-605. Female FFs should refer to PA/ID #1/89 for specific medical leave and light duty entitlements if you are pregnant. If there are any problems, special conditions, or unusual circumstances, feel free to call the UFA to guide you in the right direction.
2. Leave without Pay—Family Leave Act: In accordance with Federal Law under the Family and Medical Leave Act 1993 and DO #138 of 1993 members are entitled to 12 work weeks of unpaid leave during any 12-month period due to a new birth, major illness of dependents, in accordance with certain definitions. See Legal Book (Family Leave Act chapter) for more specific info and additional maternity leave entitlements.
3. Leave without Pay—Dept. Policy: Members may take up to a one-year leave of absence without pay to take care of a newborn child. (Ensure you refer to PA/ID 2/89 & 1/89)

Stress Leave

See Counseling Services & Counseling Services Unit Section, later in this chapter.

Difficulties at the Medical Office?

Though most members receive quality professional medical services at BHS, not all members report this to be the case. This section will show you the best way to resolve issues when you do not agree with a Medical Officer’s decision. If you follow these directions, in most cases your issue can be easily resolved while you are still at the Medical Office. It is always important to be on solid ground and not have unreasonable expectations. If these steps do not work out, this section will also show you other effective remedies you can take after –the fact with the assistance of the UFA.

While at BHS or in Emergencies

1. Avoiding a Certain Doctor: If you seem to have personal difficulties with a certain doctor, and you are his/her next patient, simply wait for the other doctor to become available. It’s a simple remedy if you don’t have an appointment with a specific doctor. Just because you are next in line doesn’t mean you can’t voluntarily wait for the doctor next door.
2. Be Polite: Never get into a confrontation with BHS doctors or personnel. The Doctors are not our enemies. You should calmly explain to the doctor any legitimate reasons you disagree with their determination, especially if your health or safety will be endangered.
3. Help at BHS: There are times when you may not agree with the decision of the BHS doctor or feel that you want to take the problem to the next level. Your first avenue of resolution if you have a problem at the Medical Office will be the uniformed officers in charge. During clinic hours 7 days-a-week as per BHS policy, there are always 1 or 2 uniformed officers assigned to BHS who work hard to resolve problems or to smooth out disputes. They can usually resolve the issue or differences to satisfactorily address your specific problem. You can also see them if you believe you are being ordered to do something that is against Dept policy or our Collective Bargaining Agreement. If you strike out with both the treating doctor and the uniformed officer, you should speak with the BHS Chief Medical Officer or Deputy Chief Medical Officer. If all else fails, then call the UFA Health & Safety Officer/Sergeant-at-Arms or the UFA Trustee-on-Duty. Let the switchboard operator or answering service know if it is a BHS emergency. The Chief Medical Officers and UFA recommend that you take all these steps before BEFORE you leave the Medical Office rather than having continued problems down the road caused by not addressing your issue on the spot.
4. Danger/Emergencies: If you feel that your life or health may be, or is about to be, harmed or endangered by actions taken, to be taken, or not taken by any health care provider assigned at or by the BHS, or at a Hospital for an on-duty injury or illness, contact the UFA Health & Safety Officer/Sergeant-at-Arms or the UFA W Trustee-on-Duty IMMEDIATELY—if the above steps do not correct it.

Documenting Problems ‘After the Fact’ with the UFA

1. Final Disagreement with BHS: Be polite and do not get into a confrontation. Document everything: date, time, doctor, your present duty status, who you spoke to and the circumstances surrounding the event. Documented information should be forwarded to the UFA Health & Safety Office for action by UFA and our attorneys, if warranted (see below). Call the UFA Health & Safety Office first for guidance as to what you should do next and what you need to forward.
2. UFA Health & Safety Office: If you run into issues at the Medical Office or Counseling Services Unit that are not resolved, you should report and document it with the guidance of the UFA Health & Safety Office (see below steps). A phone call alone will not document your problem. After speaking with your Health & Safety officer, written documentation to the Health & Safety Office is the key to resolution. Often, what members perceive and say may differ significantly from what the written documentation shows or proves. Remember, a quick call may be needed, but written documentation is absolutely necessary!!!

Filing Forms/Documentation:

1. Via Web: This is the preferred method and makes it much quicker for the UFA Health & Safety Office to follow up. UFA Forms are user-friendly and can be submitted electronically. When you log on to www.UFANYC.org, click on Health & Safety to fill out a form. The information automatically goes into the UFA database file. This file doesn’t immediately appear on the website until the UFA Health & Safety Office reviews it. If there are questions they will follow-up. The site is updated regularly to keep everyone informed as to the Department’s progress at resolving issues. Members can also print out a receipt thanking them for their input, and summarizing their submission if they want to keep a record.
2. Info You Supply: You will be asked to supply your name, phone number, Social Security number, and e-mail address. This information will be kept strictly confidential and is for verification purposes only by the UFA Health & Safety Office. Your name will not appear on the website. The complaint forms allow for reporting when the Department was first made aware of the problems, and how many times overall the problem(s) were reported. It also provides space for members to briefly describe the complaint(s) in their own words. Members will also be asked if they have documentation of past reports.
3. Company Folder Documentation: Your complaints are then filed in the UFA Health & Safety Office in your company’s folder and also in Medical Complaint Project Folders for use at Medical Practice Review Hearings, in accordance with the UFA Collective Bargaining Agreement.
4. Via Fax, E-mail, or U.S. Mail: The same information may be provided on the UFA Medical Office Incident Report form. It can be found in the Forms Section at the back of this manual and can be output from the W UFA Website. Mail, e-mail or fax it to the UFA Health & Safety Office. These methods are generally slower than via the UFA Website.

• • Web Posting for All to See: After review and editing for clarification by the UFA Health & Safety Office, complaints will be available for viewing (by members, the Dept, public & media) until they are remedied. The listing will not be removed until the Delegate from the firehouse or the Trustee tells the UFA’s Health and Safety Office that the problem is resolved. This will give the people at the top levels of the administration an opportunity to see how well mid-level managers are doing at resolving problems. No one will be able to say that they were unaware.

Documenting Medical Misconduct & Malpractice with NYS

See Health Book (NYC Health Plan Chapter: Documenting Professional Misconduct) for additional info & specific instructions. The following info is provided by the NYS Dept of Health (DOH).

If you feel that any doctor (FDNY or private) treating you has not practiced honestly or competently, you may be able to file a complaint with the N.Y. State Dept. of Health, which investigates all professional misconduct by physicians or physician assistants. If there is sufficient evidence, it may result in a hearing before a committee of the Board for Professional Misconduct. The Board consists of physicians and consumer members. The Board has the authority to revoke, suspend or limit a physician’s license, issue a censure and reprimand, order education and/or retraining, levy a fine or require community service. The Board cannot direct a physician to change a diagnosis or alter an opinion. Medical Misconduct is different than Medical Malpractice. (Malpractice cases are heard in civil court and seek financial awards for patients or families who claim harm by a physician.) Contact the W UFA Health & Safety Officer /Sergeant-at-Arms and/or the UFA General Counsel if you believe you have a legitimate case. See examples cited below.

1. What is Not Misconduct? Complaints about a physician’s attitude, communication skills or rude behavior are not considered misconduct and therefore are not under state jurisdiction. While the State D.O.H. does not condone uncaring behavior, such actions do not, by themselves, constitute misconduct. (Examples are provided by the NYS DOH)
2. What is Professional Medical Misconduct? Examples include (but are not limited to): practicing fraudulently, practicing with gross incompetence or gross negligence; practicing while impaired by alcohol, drugs, physical disability or mental disability; being convicted of a crime; willfully filing a false report; guaranteeing that treatment will result in a cure; refusing to provide services because of race, creed, color or ethnicity; performing services not authorized by the patient; willfully harassing, abusing or intimidating a patient; ordering excessive tests; and abandoning or neglecting a patient in need of immediate care; failing to make X-rays or records available to the patient or another physician, upon a patient’s request. (Examples are provided by the NYS DOH)
3. Medical Misconduct Examples: The examples are provided by the NYS DOH. Willfully harassing, abusing or intimidating a patient; neglecting a patient in need of immediate care; willfully making or filing a false report; failing to make X-rays or records available to the patient or another physician, upon a patient’s request; or practicing the profession fraudulently, through gross incompetence or gross negligence; and more.

Annual Medicals & Other BHS Care

Annual Company Medicals

1. Company Delegate Excusal: Company Delegates are not required to attend company medicals on days of Union Meetings. Refer to the Union Book (Delegate & Battalion Delegate Chapter) for the procedure.
2. 9 Month Rule: If you have received a company medical within the last 9 months, you will not be allowed to report to the unit’s scheduled Medical Day at BHS. You will be included as part of the manpower pool and detailed to another company and must follow the same reporting for duty procedures as for Education Day or RSOT tours.
3. Calisthenics at Company Medicals: It’s the occupational-related exercise regimen that BHS Medical Officer Dr. Prezant briefed UFA Delegates during a previous UFA Delegate Educational Seminar. It is an individual barometer of how well you compare to your previous health record from one year to the next. So, relax and do the best you can. Your performance will not have a negative impact or punitive effect on your work status. However, you should be aware that your “Maximum Heart Rate,” and will be measured after the stair mill. This is the only thing that will affect work status—but only if a life-threatening reading is reached at that point.

While on Medical Leave:

1. Less Than 9 Months Since Last Exam: If you are on medical leave and had your previous annual exam within the prior 9-month period, do not allow BHS officials to keep you for another company medical. Explain your situation and give details. It does NOT benefit the members in the field when you take this exam prematurely while on medical leave or light duty. If BHS is uncooperative, see ‘Disagreement with BHS’ below.
2. More Than 15 Months Since Last Exam: If you are on medical leave and it has been greater than 15 months since your last company medical, the Dept. may possibly hold you for an annual medical if you are medically fit to take it. However, Annual Medicals are on Dept. time, not your time. If you are held for a medical ask for a FS 260 Form (Other Overtime) signed by the medical officer for the additional time you are at headquarters.
3. If On Light Duty: In general, you will only be asked to take your Annual Medical or receive training if you are on Light Duty. If the Medical Office places you on Light Duty immediately before your Annual Medical, you will not be entitled to OT. If the results of the Annual Medical determine you are not fit for light duty, you will be returned to Medical Leave (but not entitled to OT for the Annual Medical time).
4. Training on Medical Leave: If you miss your annual company medical because you were on medical leave, the Dept. says it will give you your annual medical/physical as soon as you are medically fit to do so. It is within its rights to do this while you are on medical leave. However, the Dept has NO RIGHT to tell you to remain at headquarters for the remainder of the day for classroom training—including for the “fit test” for blood-borne pathogens mask protection. You are on medical leave! After your clinic visit and make-up company medical/physical — you may leave the building if still on medical leave. Do not engage in any training activities. You do not have to stay for training if you are not getting paid. If you are refused, see ‘Disagreement with BHS’ below.
   1. Disagreement with BHS: Be polite and do not get into a confrontation. See ‘Difficulties at Medical Office?’ section: ‘While at BHS’ & ’Documenting Problems After the Fact’ subsections, which are a few pages earlier in this chapter.
   2. WTC Lung Problems: Members are also tested for lung capacity. If you show a significant decrease from your previous year’s tests, it may result in further testing, and possible placement on Light Duty. This has been especially true for many members who worked at the WTC after 9-11-01 who have been forced to retire with a Line-of-Duty disability pension. Others have remained in limbo, where the Medical Office does not let them go full duty and the State 1-B Medical Board denies their disability. If you find yourself in this situation, contact the W UFA Health & Safety Officer or your Borough Trustee. You may also request to speak with the UFA Special Pension Consultant.

Probie 5th Grade Medicals

See FDNY Book (Overtime Chapter) for more info.

1. OT for the Entire Day: The Dept currently (2005) orders probies to take Fifth-grade firefighter medicals on their own time. The UFA’s position is that probies are to be compensated for when ordered to appear for their 5th Grade Medical. All Delegates are instructed to ask their officer to record a TPR Code for ‘Other OT” when this occurs. If Payroll denies payment, assist your probies in filing a TPR Inquiry Form, adding the OT under “Other OT.” If the inquiry is denied, fax a copy of the denial and any other available documentation to the UFA Recording Secretary’s office.
2. Training on OT: The Dept currently orders probies to take Fifth grade firefighter medicals on their own time. If a probie is ordered to stay for any reason beyond this, including for training, see ‘Training while on Medical Leave’, which is a few paragraphs before this. Also, these probationary firefighters are entitled to overtime for the hours spent between the conclusion of their medical and the time they were excused at the end of the day. The Department has acknowledged a previous mistake regarding this and that it will not be repeated. File a TPR Inquiry Form adding your OT under “Other OT.”
3. Fit Test for Blood Born Pathogen Mask: There remains some disagreement about members remaining 15 minutes longer than the medical to receive a “fit test” for blood borne pathogens mask protection. The UFA’s position is that probies may leave BHS after the medical is complete. The “fit test” has absolutely nothing to do with a medical examination and the FDNY has no authority to hold members longer than necessary. The “fit test” is required by Federal Statute (29CFR1910.134) to be given before a member can go on-line to respond for fire or medical emergencies, and it must be given on Department time (also by Federal law). In other words, this test must be given before the probie works his/her first tour in the firehouse. There must be no training or classroom instruction following the probie 5th grade medical without overtime compensation. All Delegates are instructed to remind their probies that they are to leave BHS after their medical. If probies are refused, see ‘Difficulties w/Medical Office Personnel section: ‘While at BHS’ and ’Documenting Problems After the Fact’, which is a few pages earlier in this chapter.

Immunizations & Inoculations

The Department’s immunization and inoculation program is an excellent free benefit that can save you and your family from severe illnesses and high medical costs. The BHS administers tuberculosis tests and updates other needed immunizations at no cost, including tetanus and Hepatitis B. The BHS maintains your immunization & inoculation records in its computer system and will provide any written documentation you request. You may want to bring your UFA Locker Medical Monitoring Card with you for your Annual Medical. The BHS will enter any inoculation dates into its system for you so the BHS can automatically remind you of needed boosters, etc. whenever you take your Medical.

Inoculations may also be for biological or chemical agents in response to terrorist attacks. These are often done on a schedule or by emergency announcements in various firehouses.

Hepatitis inoculation is a series of 3 or 4 injections that protect you and your family. It has been reported that the most accurate results (to see if you are protected from Hepatitis) are measured if the testing is done after a three month wait (after your last shot). About 20% of those taking the series require the 4th shot. Currently (2005), all newly hired firefighters are offered Hepatitis B inoculations. BHS Nurses will be sent to Probie School to administer the first two inoculations for Hepatitis B-if a probie is not immunized already. Probies will also receive inoculations for measles, rubella and mumps, if needed. Their third Hepatitis B inoculation is administered at their 5th Grade Medical or next Annual Medical. Booster inoculations will be administered to any member whose immunity levels are too low. If you are concerned about the prevention of these illnesses, contact the BHS to see if/when any program is active. It’s a generous benefit. Make sure you take full advantage of it!

Line-of-Duty Injuries (LODI)

Serious Injuries (Confidentiality)

When members are seriously injured, keep the following in mind:

• Don’t Talk: Do not release an injured member’s name to anyone who calls, even if the caller seems to be a firefighter or department official. You do not want a seriously injured member’s name released in the media before the family is notified. One way to verify the caller is on official business is to hang up, call the unit they claim they are calling from and ask for the officer on duty to verify the identity, then transfer your call to that person.
• Family Notification: If the injured member is conscious and able, it is usually best if the injured member personally calls his or her family as soon as practical. It is more reassuring for the family to first hear their loved one’s voice so they know for sure that he or she is OK. If the injured member is unable to personally make the notification, ensure that this matter is discussed with your immediate supervisor and members in your company who are close to the injured member’s family—before family notification decisions are made.
• New Members: If you have a rotation, temporarily detailed or newly transferred member working in your house, make certain that after the immediate family is notified, that you notify their other companies if they are seriously ill or injured. They often participate in home company diner-dances, trips or sports. It would be unfortunate for them to hear about it in the news. It will also create more assistance, if needed, from those units. Make the calls!

Authorization for Line-of-Duty Medical Bills & Drugs $$

Diagnostics, Specialists & Prescription Drugs

• Medical Treatment: Who Pays? The FDNY pays directly for any medical services active members receive in connection with a LODI—but ONLY if you receive prior approval. Always get written authorization from BHS before you go for outside consultation or medical treatment for a LODI Injury. If you seek your own treatment without prior written authorization and then attempt to have the bill paid by the FDNY—don’t waste your time, trouble, phone calls or stamps—because all your attempts at reimbursement or payment will prove fruitless! Do it right the first time, as follows:
  • Active: You must have prior written authorization (except for emergencies) from the FDNY’s Bureau of Health Services (BHS) if you expect the FDNY to pay for any treatment of a LODI. If you have authorization, the Dept pays 100% of all authorized treatment and diagnostics for LODI injuries for active members. Medical services for LODI are NOT covered by your NYC Health Plan while you are an active member!
  • Give FDNY Address: Never provide your personal or FH info information (SS#, home or FH address, DOB, home or FH telephone number), other than your name, to any health care or medical diagnostic provider. Only provide them with the following, if they ask:
    • First, last name, age (not DOB)
    • FDNY address: FDNY Compensation Desk, 9 Metrotech Center, Brooklyn, NY 11201
    • FDNY Compensation Desk Inquiry Phone Number: 718-999-1838 or 1839
    • Necessary medical information to assist in accurate diagnosis and safe treatment
  • Retired: Medical services for LODI are NOT covered by the FDNY after your retirement date! The moment you retire, the Dept will no longer pay for your LODI treatment. Instead, your normal NYC Health Plan will cover it, subject to your plan’s limitations. In other words, your LODI coverage will most likely not be as thorough once you retire.

Getting Authorization for Medical Treatment

1. Initial Referral: In accordance with FDNY Regulations, Section 31.3.18, any member injured in the Line- of-Duty who requires treatment, examination, or follow-up by an outside physician for a Line-of-Duty Injury (LODI) must FIRST secure the proper written authorization from a BHS medical officer. The BHS compensation desk will refuse to process paperwork to pay the associated bills if prior written authorization has not been attained. This means that YOU will become responsible for payment of the medical bills.
2. Follow-up Treatment: Be careful not to be unintentionally misled by the outside physician once authorization for an initial visit has been granted. Written permission for examination or treatment is issued for a limited period of time or set number of visits. Any further treatment such as follow-up visits MUST BE preceded by a written report from the member’s physician specifying the type of treatment necessary, the number of follow-up visits and/or the duration of same. Bills for unauthorized treatment will NOT be honored by the Fire Department.

LODI Prescription Drug Payment: UFA Drug Card: Never use your SBF drug plan for any line-of- duty injury (LODI) drug prescriptions—ever! If you do this, the cost comes directly out of the limited money the City contributes annually into your SBF dental, optical, prescription drug, anesthesia, hearing aid, and other supplemental health benefits plan. It’s your money. Don’t waste it—the Dept is required to pay it! Here’s how the LODI prescription drug reimbursement program works:

1. FDNY Must Pay: Whenever you are prescribed drugs for a Line-of-Duty Injury, the FDNY physician or nurse at the BHS (Medical Office) will give you a LODI Prescription Reimbursement Instruction Sheet. The Dept. has assured the UFA that the BHS will automatically hand it to you. You should never have to ask. If you are not given the Reimbursement Instruction Sheet, contact the Trustee-on-Duty immediately.
2. Filling the Prescription: If you are given a prescription for a LODI from the FDNY medical officer, the Emergency Room or a treating consultant, fill your prescription with any local pharmacy, pay for it out-of- pocket, and obtain a written receipt. Authorizations will be written for medications that correspond to the LODI.
3. Reimbursement Submission: Make a copy of the receipt for future use if needed. Submit your original receipt, injury date, and Box Number as follows:
   • In person: Bring your receipt on your follow-up BHS visit to either the medical officer seeing you at BHS, or to the nurses on duty.
   • By Mail: deliver to FDNY Bureau of Health Services, Justine Lashkow, Head Nurse, 9 Metrotech Centre, 2nd floor, Brooklyn, NY 10012. Include with your receipt, the Box Number and date of injury.
   • LODI Prescription Drug Reimbursement instructions are usually listed each year on the back of your UFA Workchart Calendar for easy reference.
4. Time to Reimbursement: The BHS Reimbursement Instruction Sheet notes that payment will take a minimum of 3 months. Note: most members report reimbursement takes 4 to 6 weeks. The UFA is currently addressing the lengthy reimbursement time issue through Labor Management sessions2.

Documentation/Reporting of LODI

1. Medical Monitoring Locker Card:
   • Keep track of how many medical leaves you have taken in any 12 consecutive months, so you will be aware if you are approaching the danger level for any particular FDNY medical leave penalty level. Cross off ML dates that are over 1 year old.
   • Keeps a running calendar day count so you may verify with your W-2 form how many calendar days you have accumulated towards your LODI tax deduction at the end of the year.
   • Record your Tetanus boosters, which need to be done every 10 years
   • Record any other tests or immunization doses you may receive.Note: You may want to bring your UFA Locker Medical Monitoring Cards with you for your Annual Medical. As per the Chief Medical Officer, the BHS will enter any inoculation dates into its system for you so the BHS can automatically remind you of needed boosters, etc. whenever you take your Medical. The Dept will provide an official report for you on request.

     Keep the Card taped inside of your locker so you can quickly enter any above info when it happens, instead of relying on recollection days, weeks or months later. When full, post another card, and keep the completed cards as a part of your permanent personal medical records. It will save you future aggravation, and may also save your hard-earned money or prevent a future serious health problem.

2. Doctor’s Report: All members reporting to the medical office should make a copy of that visit’s doctor report (you are entitled to this) and all medical records that come into your possession in case FDNY records are lost or misplaced, to save for future documentation to dispute possible SMLP inclusion. Otherwise, a visit to headquarters and the medical office on your own time will be needed to get copies.
3. LODI Income Tax Deduction Documentation: You are entitled to deduct all calendar days that you are on LODI medical leave (not Light Duty) from your annual taxable income. This is automatically calculated by FDNY Payroll and should be reflected on your W-2 statement. The normally publishes a special 65-2 each January or February that lists the Per Diem deduction for FFs. This allows you to verify the accuracy of the W- 2 to insure you are receiving the proper deductions. See Financial Book (Tax Chapter) for more info.
4. LOD Injury Report (CD-72): Make sure EVERY line of duty injury is documented with a CD-72, which is the FDNY’s initial record of injuries that occur while on duty. Do not feel that any on-duty accidental injury does not warrant the submission of a CD-72 5-part form. No matter how slight the injury it’s never known whether it will be disabling or if you’ll suffer permanently. Most often CD-72’s are the basis of claims for accidental (3/4) disability. When initially going sick, sometimes we neglect to be seen by a medical officer by reporting the injury by phone, or we are seen by the FDNY doctor but don’t go to a hospital emergency room for an examination. When you are injured, make sure you are examined at the nearest hospital emergency room. Do not self-diagnose. Indicate where you have pain. Let the doctor determine if it is broken, torn, sprained, bruised, etc.
5. Be sure to file a completed CD-72, for every line-of-duty injury. See that the appropriate journal entry has been made to document your incident. Far too often the CD-72 injury description is vague and imprecise. Simply stating that an accidental injury happened while performing firefighting duties is incorrect.
6. Injury with No Time-Lost: When injured while on duty, in accordance with FDNY Safety Bulletin #7, you may be given the remainder of that tour off without it counting on your medical leave record. See ‘Time Policies’ section, which is earlier in this chapter.
7. Accident for LODI Pension Purposes? An “accident” has been defined by the Court of Appeals as an incident which is a “sudden fortuitous mischance, unexpected, out- of-the-ordinary, and injurious in impact”, and which happens while a member is in city-service. However, the Courts have also determined that not every line-of-duty injury constitutes an “accident”. If the injury is sustained in the performance of routine duties, it is not an “accident”, and the resulting disability does not entitle a member to an accident disability retirement. If, however, the injury is the result of an unexpected event which is not the risk of the work performed, then the injury is an “accident”, and the resulting disability entitles the member to accident disability retirement.

Ensure you see FDNY Book, FD Operations Chapter & Financial Book, Pension Planning & Retirement Chapter for more very important info, and specific CD-72 preparation instructions.

Hazardous Environment Exposure Reporting (CD-73 & MD-X3)

1. Notification: Immediately notify your Officer if you are exposed to a hazardous environment, such as chemicals, blood-borne, airborne pathogens or body fluids. Even if you are wearing all your protective equipment, you may still be susceptible to contamination.
2. CD-73 Member Exposure Report: It is absolutely crucial that a CD-73 is prepared for each and every exposure you have. The CD-73 5-part form is used to report an exposure to a hazardous environment noted above. Be as precise as possible in describing the type of exposure to which you were subjected. Many hazardous materials, such as chemical, radiological, PCBs, PVC, diesel and hydrocarbon fuel fumes can have an accumulative effect. If you were to become ill with an exposure related illness now or later in your career, this form is the only way to document that it is LOD related—especially for disability pension purposes. Keep in mind that exposure can occur even when protective clothing is properly worn.
3. MDX-3 Biological Exposure Report: If you are exposed to blood-borne or airborne pathogens (including HIV, TB or Hep B), in addition to a CD-73, an MDX-3 and a Pre-hospital Care Report (PCR) must both be prepared. A copy of the PCR should be given to the ambulance.
4. Medical Officer Notification: It is critical that your Officer immediately fax the completed MD-X3 to the Medical Officer on Emergency Duty at 718-999-0035. If your Officer is unable to complete transmission via fax, or if telephone confirmation of receipt of the MD-X3 is not received within a very short time, the Officer must notify the Bureau of Health Services at 718-999-1849/1850. A doctor should call back or visit the exposed member to obtain information concerning the exposure during your tour—before you go home! The doctor will make a determination as to whether the exposure requires tests or treatment and provide consultation pertaining to the exposure. If it is near the end of your tour, and no doctor has called, the officer should then beep or call the on-duty Medical Officer. You must speak to a doctor before the end of your tour. The Infectious Disease Control Unit will attempt to track the victim you were exposed to in order to determine his/her infectious disease status.
5. Medication: If you are given medication, do not wait to find out if the victim has an infectious medical condition. Start medication immediately.

Ensure you see FD Operations Chapter for more very important info and specific CD-73/MDX-3 preparation instructions.

Dept Vehicle Accidents

Any members on medical leave for 30 continuous calendar days or longer due to any accident with any fire department vehicle while on-duty are entitled to be paid 80% of your average monthly OT for each 30-day period on medical leave (not Light Duty). This is in addition to the normal income tax deduction for all days on LODI medical leave. See FDNY Book (Overtime Chapter) & Financial Book (Tax Chapter) for more info.

Overtime $ for LODI

Make sure your officer prepares your TPRs to reflect your overtime. File a TPR Inquiry Form for OT if you do not receive it in your check. If it is denied, fax a copy to the UFA Recording Secretary’s Office.

1. If you are injured, and call sick from a job and are told to report to the medical office right away-and if that trip takes you into the following tour-you are entitled to overtime until the medical office puts you on medical leave, per Regs 17.12.9.
2. If the Medical Officer “orders you to remain” beyond the end of your tour at the firehouse or emergency room to await a return call from BHS or the arrival of Car 32 or 33, “overtime will be authorized” per Regs 17.12.9. (TPR Code 1464/1465). You do not have to wait unless ordered.
3. If you are injured or ill and, in the hospital, or en-route to the medical office and your duty status is still in question for the next tour (but the tour has not started yet), then the manning spots must be filled with MMOT members. The Department may not reduce manning in another company to fill your spot. Inform the UFA Trustee-on-Duty immediately if you become aware of the Department violating this regulation. If you don’t, other companies will be starting the next tour understaffed!!! This is dangerous. Make the call!

Transportation, Benefits & Other Help

Ambulance, TV & Phone Assistance—Welfare Fund

Helps cover costs for hospitalized LODI members for TV & telephone use. It will assist non-LODI members with its own ambulance or private ambulance service. See Heath Book (Insurances, Help & Free Benefits Chapter; Health/Medical Help—Free Section) for more info.

Second Medical Opinions Free—Pro Bono Medical Panel

For Non-Service Connected Medical Conditions Only: This group of highly regarded independent physicians, who are experts in their specialties, will render a second opinion to our members and their immediate families, without charge. The initial consultation will be provided free to uniformed members with non-service connected medical conditions and their legal spouses or minor children. (DO #53 of 1992) See Heath Book (Insurances, Help & Free Benefits Chapter; Health/Medical Help—Free Section) for more info.

Free Family Transportation—Fire Family Transport Foundation

The FFT vehicle is intended to ensure that members who are seriously injured in the line of duty have their families transported to medical institutions in a way befitting their special needs. The FFT vehicle was donated to the Fire Department by the Fire Family Transport Foundation, Limited, a non-profit corporation founded by members of the Department. See Heath Book (Insurances, Help & Free Benefits Chapter; Health/Medical Help—Free Section) for more info.

Light Duty & Disabilities

Light Duty (LD) is a duty status determination by an FDNY Medical Officer indicating a member is incapable of firefighting or fire investigation duties, but is capable of performing other tasks. You will usually be assigned the 5 consecutive day 9am to 5pm chart (you may work weekends). 25 group Workchart spots are only assigned if available. (Excerpts/summary/interpretation of Mayoral Directive 78-14, Regs. Ch. 1 & AUC 322 (AUC 322 held in abeyance per DO 71/97)

Temporary

LD is a temporary assignment to duties which a temporarily unfit member is capable of performing. These are temporary assignments and should not exceed one year’s duration except under the most unusual circumstances. It is a transition between the time when you are partially disabled and the time when you either return to full duty or leave City service if the disability will not permit a return to full duty.

Extra Departmental Employment (EDE)

LD members may work EDE only with the approval of the Fire Commissioner and Chief Medical Officer, in accordance with PA/ID 12-67.

Physical Therapy Release Time

On days when physical/medical therapy (PT) is scheduled while working the 5 consecutive day Light Duty chart 9am to 5pm (0900 to 1700), members must work a half day, i.e., 0900-1300 hours or 1300-1700 hours, and will be released to attend physical therapy for the other part of the tour for service-connected injuries. Inform your LD Officer in advance. You must provide written confirmation from your therapist to your supervisor prior to each visit. If you are working the 25-group chart, PT release arrangements must be worked out with your LD assignment officer. (per DO #108/02 & Labor Management meeting in 2003—Chief of Operations Cassano, UFA Recording Secretary Miccio). Non service- connected injury PT is attended on the member’s own time. However, ask your LD supervisor for assistance if your work schedule makes it impossible to attend PT. Contact your Delegate if this becomes a problem that interferes with your treatment and recovery.

Boarding

Generally, after six months in disability status, light LD members are reviewed by a panel of BHS physicians to make an immediate duty determination, which is usually referred to as “Boarding”. (This is not to be confused with the 3- physician 1-B Medical Board, which determines if you are eligible for disability retirement for pension purposes. The 1-B Medical Board is independent of the BHS.) The purpose of the BHS Board is to determine which of the following three categories an injured or ill member falls under:

• Fit-for-Duty: Eligible for return to full duty.
• Unfit Temporarily: Temporarily unable to perform full duty and subject to re-evaluation at a later date.
• Unfit-for-Full-Duty: Permanently unfit for full duty and recommended limited service (light duty continued). In other words, you most likely be forced to retire.

Ensure you inform your Delegate if you are told by the BHS Board that you are Unfit-for-Full-Duty.

Forced Retirement

Make sure you contact the UFA W Disability Pension Consultant prior to appearing before the 1-B Medical Board. No Light Duty member is guaranteed a position beyond one (1) year in disability status since the member is incapable of performing the tasks for which he/she was initially hired. Once the BHS Medical Board determines that you are Unfit Permanently, your paperwork is forwarded to the Chief of Personnel. If after one (1) year in disability, a determination is made that the member should be retired via Fire Commissioner’s application, a letter shall be forwarded to the member and the member’s unit from the Bureau of Personnel indicating that retirement processing will commence. The member or supervisor shall have five days to respond. Failure to respond will ensure retirement processing goes forth. Appeals will be evaluated based on Department needs only. Members with Commissioner’s Application will be processed for retirement via the (3 physician) 1-B Medical Pension Board and the ‘12 man’ Pension Board of Trustees. Once a member is found disabled by the 1-B Medical Board, the member must be retired unless granted a stay of retirement by the Fire Commissioner.

Limited Service Members (LSS)

Also known as LSS assignment. The LSS designation has been replaced with the BHS term “Unfit-for-Full-Duty”, which means you are permanently unfit for full duty (will be processed for disability retirement). Members whom the BHS Medical Board has certified as Unfit-for-Full-Duty from injuries or illness are disqualified from performing active fire duty and are assigned to some form of “Light Duty.” See “Boarding”, which is a few paragraphs earlier in this section.

Reasonable Accommodation per Americans with Disability Act

The Americans With Disabilities Act (ADA) defines Disability as “someone who has had a physical or mental impairment which substantially limits one or more major life activities; or has a record of such physical or mental impairment; or is regarded as having such a physical or mental impairment.” Disabled persons have certain employee rights under Federal Law. This also applies to FDNY members who are Permanently ‘Unfit-for-Full-Duty’. See Legal Book (Americans with Disability Act section) for more info.

Light Duty Assignment OT $$

Many members are assigned to Light Duty (LD) effective the very next day after they call in sick (if they are not put on medical leave). The LD chart is the next 5 consecutive days, 9am to 5pm, and then two days off. The same two days off repeat each week. In accordance with AUC #184 (and the UFA Collective Bargaining Agreement (CBA)), members assigned to a new group are entitled to OT if the change results in any of the below situations.

Make sure your officer prepares your TPRs to reflect overtime to conform with these Department Policies:

1. AUC 184, Section 4.0: “Group changes shall be made so that member works as close to 144 hours per 25- day cycle as possible. If the group change contemplated would exceed the 144 hours in a 25-day cycle, the member would receive overtime for the additional hours.”
2. AUC 184, Section 4.1 (A): Members are entitled to forty-eight hours of leave after their group is scheduled for two 9×6 tours, and seventy-two hours leave after their group is scheduled for two 6×9 tours.
3. 2000-2002 CBA, Art. 12, Sec. 7: “Before commencing duty with a new group, a FF who has completed working two 9-hour or two 15-hour tours and who is entitled to a 48-hour or a 72-hour leave shall be permitted to complete the full 48-hour or 72-hour leave.”

Make sure your officer prepares your TPRs to reflect overtime to confirm with AUC 184 and our CBA.

Workchart Law Violation

The UFA filed a grievance in 2004 against the Department for Violation of the NYC Administrative Code FDNY Workchart Law for assigning members off the 25-group chart for Light Duty. (This is a separate grievance from the 2004 Award which prohibits the Department from ‘Involuntarily Detailing Members off the Chart for Training’ without first negotiating the issue with the UFA – which it has not yet complied with and is in contempt of court.). Until this issue is resolved, members must follow all orders from officers or face discipline. (Feb 05) Check with your Delegate regarding the latest status of this issue if you are being detailed off the chart.

Medical Leave Abuse & Penalties

History

Prior to our 1996 victory, under a program formerly known as PMLA (Possible Medical Leave Abuse), members on medical leave were confined to their homes, and not permitted to leave without Dept. permission. Members had to call and request each and every time it was medically necessary to leave their residence. Permission was granted only for medical necessities and for certain emergencies. In other words, members were prisoners in their own homes. There were also other draconian provisions. In the spring of 1993, the UFA filed a federal lawsuit against the FDNY, claiming that “the (Fire Commissioner) and various employees of the (Department) have by the acts set forth herein conspired to deprive NYC firefighters and UFA members as a class of their constitutional rights.” A variety of problems were documented (by participating firefighters) and shown as examples to prove each of our points. After many depositions, delays and numerous meetings between the UFA and FDNY – and under a judicial ‘threat’ of a ruling against the Dept.—a settlement was reached in 1996. This would never have been possible without the lawsuit. Members are no longer prisoners in their own homes! This section gives a brief summary of the SMLP and Chronic Absenteeism programs. (Refer to PA/ID 3-96 and PA/ID 2-95 for complete info.)

Credit and thanks must always be given to the ten participating firefighters who allowed us to use their individual cases and who volunteered their own time for the benefit we all enjoy today. They are: Richie Bevers L-132, Al Diemer E-328, Greg Horan L-143, Jim Johnson E-60, John Koller L-38, George Marlow L-134, Jim Perrin E-314, Mickey Ridge E-259, Paul Rut E-262 and George Wolznski E-314.

SMLP Program (PA/ID 3-96)

1. Current Penalty Criteria: As a result of the UFA’s 1993 federal lawsuit, PMLA was replaced with SMLP (Supervised Medical Leave Program), which only applies to members who fall into the following criteria:
   1. 5 or more ML calls during any preceding 12 months. The Dept must first send the member a warning letter informing him/her that he/she has 4 ML calls, and that one more call will place him/her on SMLP.
   2. LODI burns, fractures, lacerations & contusions do not count.
   3. ii. A 1-day sick call is viewed the same as a multi-day call. In certain cases, 2 calls for the same illness/injury may be viewed as one call, but this is not guaranteed—and is not easy to prove.
2. Penalties/Restrictions: If a member fits the above SMLP criteria, the following penalties apply:
   1. Restricted to your residence when on Medical Leave (ML). However, members are permitted specific 4- hour daily time blocks (8am – 12noon or 1pm – 5pm) to leave residence for all personal business. You must call when leaving & returning.
   2. Subject to home visitation and/or phone calls to verify you are home when on ML.
   3. No 24 hour tours and self-mutuals
   4. May lose transfer points
3. Inclusion & Appeal Procedure: In order to be placed under SMLP, the Dept must do the following:
   1. Absence Control Unit (ACU) must send each member with 4 medical leaves, within the running 12 month period, a warning letter (after excluding LODI burns, fractures, lacerations, or contusions). If your warning letter contains discrepancies, you should argue your points with ACU and notify your Delegate and Borough Trustee.
   2. Physician Review: If a member fits the 5-ML call criteria, an FDNY Physician will review your computer generated medical leave profile and entire folder, then forward a written report to Chief of Operations, who will also review your unit’s workload (# of runs & OSWs), and then make the SMLP inclusion determination.
   3. Member Notification: Your notification will include a statement from the Chief of Operations stating reasons, and a copy of the Chief Medical Officer’s written medical report.
   4. Appeal: A member must file a written appeal request, through channels, within 15 calendar days of his/her receipt of SMLP inclusion notification. It must include an explanation and any documentation. The Chief Medical Officer, Chief of Operations & Fire Commissioner will review the appeal and make a determination. You will not be put in the program until your appeal is denied. Immediately notify your Delegate and Borough Trustee for assistance, if you intend to appeal. Your Trustee will guide you on how to properly document your appeal. If you don’t immediately contact us, don’t expect miracles.
   5. Denial: If the appeal is denied, the Chief of Department will briefly state reasons, and ACU will notify you of effective date of inclusion.
   6. Grievance: Any non-compliance with the above outline is grounds for a grievance.
4. Discontinuation of SMLP: SMLP ends or continues based on the following:
   1. Initial Period: six months. At the end, if you have not used any medical leave, or have used only one medical leave with *objective medical findings, or have used medical leave only for LODI burns, fractures lacerations or contusions, you will automatically be removed from SMLP.
   2. Continuation: Members not meeting the above criteria may continue in SMLP for successive three – month periods, until meeting the above criteria.
   3. Appeal: To appeal continuation, follow initial SMLP appeal procedures.*For members who have used medical leave other than for line of duty burns, fractures, lacerations or contusions, the Chief Medical Officer will prepare a written report. The Chief of Operations will review the report and determine if the member is to continue in SMLP for another three months, or be removed from the program.
5. SMLP Avoidance:
   1. ALL members should tape a UFA Locker index card (see LODI Injury section in this chapter) on the inside of their locker door. On this you will record every medical leave, both non-service connected and LODI from the field. Once a date falls beyond one year’s time, you may cross it off. You will now always know when you are approaching the danger zone, and will not be caught by surprise.
   2. All members reporting to the medical office should make a copy of that visit’s doctor’s report (you are entitled to this), to save for future documentation to dispute SMLP inclusion. Otherwise, a visit to headquarters and the medical office on your own time will be needed to get copies. The FDNY Physician may need your assistance in pointing out a particular record. They are only human—and you may have a very thick folder!
   3. Stay out on medical leave until you are completely well enough to work. Don’t try to guess when you will be better by telling the FDNY Physician to “put you on full duty in three days.” GET BETTER FIRST, make a return visit to BHS, then go full duty. If you attempt to prematurely go back to work, are unable to, and must tap out again – you may have just created 2 ML calls (for the same injury/illness) towards the 5 calls required for SMLP inclusion.

Chronic Absenteeism Policy (excerpts from PA/ID 2/95)

1. Criteria: This policy will not affect members seriously injured in the line of duty who require extensive medical leave. It is focused on members with attendance problems that indicate he/she may be incompetent. This policy is not part of SMLP, though a member who fits this category may also be in SMLP. A member is presumed to be chronically absent if medical leave/light duty meets any of the following:
   1. Averages six (6) incidents per year for the previous five-year period (an incident is any episode you go from either a full or light duty to a ML status and then return to light or full duty thereby closing out the episode), or
   2. Averages 50 calendar days per year for the previous three-year period, or
   3. Exceeds 100 calendar days in any one-year period.
2. Excluded Medical Conditions: Members with “objective medical leave findings” may have such incidents or calendar days lost excluded from the average or count. Objective medical leave categories include: All Second/Third Degree Burns, Aortic Valvular Heart Disease, Arteriosclerotic Heart Disease, Arrhythmia, Fibrillation, Mitral Valvular Heart Disease, Myocardial Infarction, Syncope, Vaso Vagal, Chest Pain, Other Cardiovascular Disease, Ulcerative Colitis, Brain Cancer, Lung Cancer, Lung Carcinoma, Other Neoplasm, Leukemia, Pregnancy, Skull Fracture, Rib Fracture, Humerus Fracture, Radius, Ulna Fracture, Carpal Bones Fracture, Metacarpal Bone Fracture, Phalanges of Hand Fracture, Femur Fracture, Patella Fracture, Tibia, Fibula Fracture, Ankle Fracture, Tarsal, Metatarsal Fracture, Phalanges Fracture, Other Fractures
3. Review/Termination: Records of members fitting chronic criteria will be reviewed to identify mitigating factors, which will include the member’s medical profile, performance evaluations, workload considerations and any other relevant factors. If the review indicates the member is incompetent and unable to perform the full FF duties, proceedings may be instituted to terminate the member as provided by Section 75 of the Civil Service Law. The member will be served with formal charges of incompetence and will be entitled to a Section 75 hearing before the NYC Office of Administrative Trials and Hearings.

Counseling, Treatment & Counseling Services Unit

Counseling Overview

The Counseling Services Unit (CSU) is a unit of the FDNY Bureau of Health Services (BHS). Its purpose is to assist members and their families with the intention of restoring them to a healthy state of mind, and so members may perform their duties safely. If you are experiencing any problems that you feel may be interfering with safely performing your duties, or causing a danger to your health, the CSU is there to help, and if needed, can get you the required leave time to address a particular issue. Under these circumstances, you may wish to take advantage of these free services by calling the CSU at 212-570-1693. The CSU has assisted many members work their way through some of the following debilitating issues: dealing with serious injuries, death or serious illness of loved ones or colleagues, marital problems, trauma stress, feeling down, suicidal thoughts or other mental issues affecting you or your family, referrals to therapists, and addressing substance/alcohol problems. However, despite confidentiality laws, keep in mind that substance/alcohol use under certain circumstances is against Dept. policy and/or the law, and may possibly lead to termination, in accordance with AUC 202. See Legal Book for more info on issues related to Dept. Policies on substance/alcohol use. However, it has not been the Commissioner’s policy, in accordance with PA/ID 1- 84, to terminate members who voluntarily refer themselves to the CSU for help with alcohol or controlled substances, unless they failed to follow the prescribed treatment and program guidelines. Please read on…

Don’t Want FDNY or UFA to Know?

You can contact either the FDNY CSU or the UFA Health & Safety Office first. You should not contact the Medical Office or BHS for stress or counseling issues. The FDNY CSU and the UFA Health & Safety Office have programs available through Project Liberty, and other sources, where no person in the Dept, CSU or UFA will have any ability to know you are going for treatment. If you do not want to personally make the call for help, you can have your Delegate (or a concerned friend or family member) contact the CSU for you, or your Trustee contact the CSU on your behalf, in order to determine what confidential help is available to you, and how to go about getting it— without ever giving your name or personal info to the Dept, CSU or UFA!

Stress Leave: If you decide to request the Dept to grant you special leave time off due to your stress issue, the FDNY Chief Medical Officer will need to know some relevant info from your counselor in order to approve your request. It is still your choice, but the Dept is within its rights if you are requesting special leave.

Treatment for Member Problems

Substance Abuse & other Situational Stress (excerpted from PA/ID 1-84): The FDNY recognizes that problems with substance abuse and other situational stress can affect members and their families both on and off duty. The Department will continue to provide counseling assistance to members of the uniformed force and their families as necessary to promote their good health and welfare. For voluntary referrals, your CSU counselor will be the only person to know the details of your circumstances and treatment, and your record in the system is only permitted to have the notation “Situational Stress” or “Family Stress” and not anything else. Referral procedures are predicated on cooperation among labor and management. The Commissioner retains the discretion to apply or not apply the following policy, depending upon the facts and circumstances of the individual case and upon the needs of the Department. O No provision of any Dept policy, regulation or AUC 202R issued by the Fire Commissioner is in any way preempted by PA/ID1-84.

1. Definitions: The below definitions will help you better understand the descriptions later used under this policy, and how it may affect you:
   1. Situational Stress: Situational stress syndrome describes a variety of conditions that interfere with your ability to function on the job or in family and societal relationships, including substance abuse, temporary depression caused by a variety of problems, and mental illness.
   2. Substance Abuse: The use of any substance (including alcohol, illegal drugs and prescribed drugs used for other than lawfully prescribed) that interferes with the ability of an employee to function on the job. This includes off-duty use of any substance that adversely affects an employee’s relationships, socialization, health, legal responsibilities, or ability to function safely in society.
   3. Confidentiality: Your right to privacy in counseling is protected by federal and state laws. It applies to oral communications & written records. Under NYS law, however, counselors must notify specific authorities of suspected child abuse. In addition, if an individual is a serious threat to self or to others, the counselor must notify specific authorities or affected individuals. FDNY Medical Officers (who are licensed medical professionals) are entitled to review your confidential record under certain circumstances it if is necessary to evaluate or to determine certain courses of treatment, or if you are requesting special leave due to your condition. You have a right to know specifically who is seeing your medical information.
   4. Release of Info: Clients generally have the right to control the information exchanged about the details of their treatment, except when a court order directs that the information be provided. Under a supervisory referral, the Department or referring individual will be informed whether the employee is evaluated as having a problem needing treatment and whether the employee is in compliance or non-compliance with the recommended treatment. Under both voluntary and supervisory referrals, if it is necessary to put the client on medical leave or administrative duty status, sufficient information will be communicated to the Chief of Health Services or his designee so that the Department can administratively account for the client.
   5. Voluntary Referral: A member who seeks counseling on his/her own or with the assistance of a union Delegate or Trustee without being ordered by a supervisor or manager is classified as a voluntary referral.
   6. Supervisory Referral: A supervisory referral occurs when:
      • An employee is ordered to C.S.U. by a superior officer or manager. The administration or referring individual will be informed whether the employee is evaluated as having a problem needing treatment and whether the employee is in compliance or non-compliance with the recommended treatment.
      • An individual with a previous voluntary referral seeks assistance for a second time within a three (3) year period. In order to receive treatment, the employee must execute a release of information for the commanding officer concerned or the Commissioner’s designee, depending upon the specific facts of each situation.
   7. Treatment Plan: An individualized plan of care designed by a professional counselor to assist the member to cope effectively with a disease or personal problem.
   8. Ongoing Care: A follow-up plan designed by a professional counselor with the member to meet the individual needs of the member after initial treatment.
   9. Substance Abuse Treatment Policy: The substance abuse treatment policy of the FDNY provides for the following referrals to the Counseling Service Unit. Treatment under each referral begins with evaluation by a counselor.
      • Voluntary Referral: If evaluated as having a substance abuse problem, a treatment plan will be developed specifically for that individual. This treatment plan may include in- patient treatment, out- patient treatment and/or referral to a self-help group. All treatment plans will include a commitment to follow-up in outgoing care for the period of time deemed necessary by the CSU.
      • Supervisory Referral: A treatment plan will be developed for the employee’s specific needs following evaluation by a counselor. All treatment plans will include a commitment to follow-up in ongoing care for the period of time deemed necessary by the CSU.
      • Tests Prior to Returning to Full Duty: An employee’s duty status will be evaluated prior to return to full duty. This exam will include a substance use test.
2. Failure to Accept Treatment Program
   1. Voluntary Referral: If a voluntary referral fails to comply with the treatment program, but notifies CSU and returns to BHS for an exam to determine duty status on the next working day after leaving treatment, no action will be taken and the medical exam will not include a substance test unless the medical officer deems it necessary. If the employee leaves the treatment program, fails to notify CSU and fails to report to BHS for an exam, he or she will be reported AWOL from BHS and will be subject to a substance test upon eventual return to BHS.
   2. Supervisory Referral: Any member who receives a supervisory referral and fails or refuses to comply with the treatment program recommended or approved by CSU will be deemed:
      1. To have disobeyed an order to comply with the treatment plan recommended;
      2. to have exhausted this treatment opportunity, and
      3. the employee will be sent to the Bureau of Health Services for a duty status evaluation that will include a substance test. The employee’s noncompliance will be reported to the Bureau of Investigation and Trials (BITS). The member will be subject to appropriate disciplinary action, including the possibility of suspension and/or termination.
3. Other Situational Stress Referral Policy: In addition to substance abuse, situational stress covers other problems that may include temporary depression due to recent bereavement, family difficulties, money problems and the like, as well as mental illness. Mental illness manifests itself in many different forms, ranging from single short attacks with complete permanent recovery, to repeated short attacks with periods of well-being in between, to severe incapacitation that lasts for a very long time.
   1. Self Referral: The CSU encourages members to contact the CSU if they are experiencing difficulties as a result of a recent tragedy or serious personal problem. A friend, family member, union delegate or supervisor can also seek the assistance of CSU on behalf of a member. The Counseling Service Unit will evaluate the member’s situation and develop a treatment plan if appropriate. This may entail a modified duty assignment. Failure to comply with the whole treatment plan may affect the member’s opportunity to be treated by CSU a second time for the same problem.
   2. Supervisor Referral: If a supervisor believes that a member is exhibiting abnormal behavior, a referral should be made to the Chief Medical Officer. Based upon the findings of the physical examination, the member may be evaluated by a consultant in psychiatry to determine whether a mental illness exists and how it may affect the member’s duty status.
   3. Medical Finding’s Impact of Member: The findings of the psychiatrist will determine the next step; the BHS will attempt to ensure that the member is referred to proper treatment. If the member is diagnosed as having a mental disability that interferes with the member’s ability to perform the duties of the job, the member’s duty status will be reviewed. If appropriate, the member may be referred for disability retirement and/or leave without pay pursuant to Section 72 of the Civil Service Law. No report will be made to the referring supervisor except notification of any change in duty status, confirmation of whether a problem that interferes with the member’s ability to perform full duty does or does not exist, and whether the member is in compliance or non-compliance with the recommended treatment.

Bereavement Counseling for LOD Death Families

Counseling Services Unit: The CSU offers a range of services to meet the special needs of the families of the deceased. Confidential counseling as well as bereavement groups for wives, parents, and siblings of firefighters lost on September 11th. Recognizing the special needs of children who lost their fathers, CSU has partnered with three child bereavement specialists offering free confidential expert services in a convenient location. Appointments for individual, couples, family, and phone counseling are available. Special counseling groups are established for: Spouses, Parents, Siblings, Fiancés & Significant Others and Brothers of Brothers. Make sure that all family members of deceased members know that the CSU is available to help. See FDNY Book, Death Chapter for more info on available services when a member passes away.

LOD Death Family Assistance

Family Assistance Unit: Its purpose is to help families of Line-of-Duty deceased members. The Family Assistance Unit, in particular, can cut right through any red tape and bring the problem directly to the person who can take care of it. When your company runs into a roadblock regarding any LOD Death family matter, or if the family itself makes you aware of an unresolved problem, make sure the Family Assistance Unit is contacted. See FDNY Book, Death Chapter for more info on available services when a member passes away.

Member Crisis Team Response

1. Crisis Team Response Program: In order to facilitate immediate response to member emergencies, the Fire Commissioner, Chief of Department, Chief of Operations, or the City-Wide Tour Commander (during non- business hours of Fire Headquarters), have the authority to initiate a response by the Crisis Team, per AUC 308 of 1994. When approval is granted, the Notification Desk will contact the Crisis Team Coordinator. The coordinator is available on a twenty-four hour basis. Examples of incidents which may typically lead to notification of the coordinator are:
   1. Death of an on-duty member.
   2. A life-threatening injury of an on-duty member.
   3. The sudden death of an off-duty member.
   4. The suicide of a member.
   5. An apparatus accident resulting in a fatality.
   6. Any incident considered to be unusually traumatic, such as one involving numerous civilian fatalities, or unusual circumstances.
2. Crisis Coordination: Typically, the Coordinator and other pre-designated Department personnel would rendezvous at the company quarters of the affected members and provide appropriate assistance. For example, the team may warn members of possible adverse reactions that may occur as a result of the incident, and/or provide psychological support. The team will also evaluate the possible consequences of the event on the affected members and the need, if any, for additional follow-up.
3. Critical Incident Stress Debriefing Program: Critical Incident Stress Debriefing (CISD) is the most widely used group technique in the world for the prevention of post-traumatic stress disorder among high-risk emergency personnel. A CISD is a confidential group meeting or discussion about a traumatic event, or series of traumatic events. A CISD requires approval by the Chief of Department, whose decision will be based upon the recommendations of the Crisis Team Coordinator. .Its objective is to mitigate the psychological impact of a traumatic event, per AUC 308 of 1994. Elements of a CISD are:
   1. The debriefing usually is conducted within 3-10 days after the event.
   2. Attendance is voluntary.
   3. Specially trained peers (Uniformed Members) serve as discussion leaders. The members are chosen from a pool of volunteers who have completed, and received certification for, formal CISD training.
   4. The debriefing is conducted with professional oversight and guidance (e.g., FDNY Counseling Services Unit).
   5. A debriefing lasts an average of 2-3 hours.
   6. The debriefing is conducted at an accessible, comfortable facility.

Contacts Section

FDNY – N.Y.C. Fire Department

9 Metrotech Center, Brooklyn, NY 11201

FDNY Automated Citywide Medical Leave System: 718-330-2204

• prompts you to provide certain identifying info (available 24/7)

FDNY Postponement Desk: 718-999-1918/19/20

FDNY Chief of Personnel, 9 Metrotech Center, Brooklyn, NY 11201

FDNY Compensation Desk (for LODI Medical Bills)

• FDNY Compensation Desk, 9 Metrotech Center, Brooklyn, NY 11201
• Inquiry Phone Number: 718-999-1838 or 1839

FDNY Bureau of Health Services (BHS)

• Bureau of Health Services General Number: 718-999-1849/1850.
• LODI Prescription Drug Reimbursement:
  Justine Lashkow, Head Nurse, 9 Metrotech Centre, 2nd floor, Brooklyn, NY 10012

FDNY Medical Officer on Emergency Duty Fax: 718-999-0035

FDNY Counseling Services Unit (CSU): 212-570-1693

FDNY Family Assistance Unit Hotline: 718-999-1473

UFA – Uniformed Firefighters Association

204 East 23rd Street, New York, NY 10010

UFA Website: www.UFANYC.org
UFA General Number & Emergencies: 212-683-4832 (212-683-4UFA) General Fax: 212-683-0710
UFA Trustee-On-Duty for Emergencies: 212-683-4832 Trustees Fax: 212-683-0690
UFA Health & Safety Officer/Sergeant-at-Arms
Emergencies: 212-683-4832
Non-emergencies: 212-545-6965 or 6964
Fax: 212-683-4768
Email: Health&Safety@UFANYC.org

UFA Recording Secretary: 212-683-4832 Fax: 212-683-4359 Email: RecordingSecretary@UFANYC.org
UFA Disability Pension Consultant: 212-683-4359 (Lou Sforza)
UFA General Counsel: 212-732-9000 (Mike Block)