How to Keep Up with Your Medical Care During the COVID-19 Shutdown

Individuals with ongoing medical needs may be concerned about obtaining medical care during the COVID-19 pandemic. Any patient seeking medical care should know that medical offices are essential businesses and are exempt from Kentucky Gov. Andy Beshear’s order closing all non-life-sustaining businesses.

Medical professionals are expected to practice safety protocols, such as social distancing. You can get the medical care you require in Kentucky without unnecessary risk of exposure to the COVID-19 coronavirus.

At Morgan, Collins, Yeast & Salyer, our attorneys represent clients who have suffered a personal injury or workplace injuries, and for whom receiving ongoing medical care is often a necessity. The Kentucky personal injury and workers’ compensation lawyers of Morgan, Collins, Yeast & Salyer stand beside you during this trying time with the Kentucky Courage we bring to the table as your attorneys. If you need our help, don’t hesitate to contact us at (877) 809-5352 or online.

What to Expect from Doctors During the COVID-19 Shutdown

The Centers for Disease Control and Prevention (CDC) has issued guidelines for all U.S. healthcare facilities to respond to community spread of the COVID-19 coronavirus. “Community spread” refers to the presence of the virus in a specific area, including among some people who are not sure how they became infected.

The CDC reaffirms that maintaining a functioning healthcare system is of paramount importance. “It is critical for healthcare facilities to continue to provide care for all patients, irrespective of COVID-19 infection status, at the appropriate level, whether that involves home-based care, outpatient treatment, urgent care, emergency room care, or hospitalization.”

The CDC is advising medical offices to explore alternatives to face-to-face triage and visits. This includes:

• Instructing patients to use available patient portals, online self-assessment tools, or to call and speak to an office/clinic staff member if they have coronavirus symptoms, such as fever, cough, or shortness of breath.
• Identifying staff to conduct telephone and telehealth interactions with patients. Medical offices are to develop protocols so staff can assess patients quickly.
• Determining measures to identify which patients can be treated by telephone and which patients will need to be seen at the doctor’s office or at emergency care.
• Instructing patients that if they have respiratory symptoms they should call before they leave home, so staff can be prepared to care for them when they arrive.

The Kentucky Medical Association is urging physicians to follow guidance from the CDC and the Kentucky Cabinet for Health and Family Services. A major initiative of the KY Cabinet is to promote the adoption of telehealth services across the Commonwealth.

‘Telehealth’ Technology Increases Remote Medical Care Options

“Telehealth” is the use of electronic information and telecommunications to support long-distance clinical health care, patient and professional health-related education, and public health and health administration. Technologies include videoconferencing, store-and-forward imaging, streaming media, and wireless communications.

In normal times, telehealth can connect patients who live in rural areas to services offered by distant providers. This capability enables patients to receive care in their communities and avoid long travel times. Today, telehealth allows all of us to stay at home and receive care we need without exposure to COVID-19.

Many healthcare organizations are already set up to provide telehealth. All a patient needs to use telehealth services is a stable internet connection and a computer, tablet or smartphone. Hospitals, clinics, doctors’ offices and other healthcare providers are all bound by the same requirements as in face-to-face visits to keep your health information safe.

Medicare, Medicaid, and the Kentucky Department of Insurance have authorized the increased use of telehealth services under COVID-19 prevention protocols. Medicare has specific services that may be offered via telehealth. The Kentucky telehealth law requires Medicaid and managed care organizations (MCOs) to cover medical services provided via telehealth to the same extent they cover medical services provided in-person.

The KY Department of Insurance prohibits insurers from requiring that a patient have a prior relationship with the provider in order to have services delivered through telehealth, if the provider determines that telehealth would be medically appropriate.

Under emergency rules, the following services are permissible as telehealth services or as a telecommunication-mediated health service:

• Applied behavioral analysis
• Behavior supports and counseling services
• Case management
• Certified alcohol and drug counselor (CADC) counseling
• Comprehensive community support services
• Day treatment
• Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit services
• Group outpatient therapy
• In-home services, such as personal care or homemaking
• Intensive outpatient program services
• Mobile crisis services
• Partial hospitalization
• Peer support services
• Physical, occupational and speech therapy
• Prosthetic and orthotic services
• Service planning
• Supported employment
• Therapeutic rehabilitation program.

The U.S Department of Veterans Affairs is also expanding its telehealth services for veterans during the COVID-19 pandemic.

Support Yourself During Social Distancing, Quarantine and Isolation

This is a stressful time for all of us. Everyone reacts differently to stressful situations, and no one truly knows what to expect from an infectious disease outbreak that requires social distancing, quarantine or isolation.

Here are some tips for coping from the CDC and from the Substance Abuse and Mental Health Services Administration (SAMHSA):

• Stay up to date on what is happening. Look to credible sources for information on the infectious disease outbreak, such as the CDC or the official Team Kentucky source for information concerning COVID-19.
• Take care of your physical health. Try to eat healthy and well-balanced meals, exercise regularly and get plenty of sleep. Now and then, stop to take deep breaths and stretch. Avoid alcohol and drugs.
• Stay connected to others. Use the telephone, email, text messaging, and social media to connect with friends, family, and others. Talk “face to face” with friends and loved ones using Skype or FaceTime.
• Take breaks from watching, reading or listening to news stories, and especially from social media. Hearing about the pandemic repeatedly can be upsetting.
• Arrange for your needs. Inform health care providers of any medications you need regularly and work with them to ensure that you continue to receive those medications. Ask your health care providers about telehealth capabilities, or social distancing and other safety protocols if you are to make office visits. Provide your employer with a clear explanation of why you are away from work, if necessary.
• Reduce financial stress. Contact your utility providers, cable and Internet provider, landlord or mortgage banker, and other creditors as soon as you realize you may have a problem making payments to explain your situation and request alternative arrangements.
• Reach out. Call SAMHSA’s free 24-hour Disaster Distress Helpline at 1-800-985-5990 if you feel lonely or need support. If you need to connect with someone because of an ongoing alcohol or drug problem, and are not already in a 12-step program, consider contacting a local Alcoholics Anonymous or Narcotics Anonymous

The COVID-19 hotline at (800) 722-5725 is a service operated by the healthcare professionals at the KY Poison Control Center who can provide advice and answer questions. Because the phone line is likely to be extremely busy, check online for the answer to general questions before calling.

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Coal Miners and Coronavirus

As many Americans stay home to wait out the coronavirus pandemic, Kentucky coal miners still go down to the mines, deemed an essential business, where the virus is one more potentially deadly threat coal miners face each working day.

Coal miners may be especially vulnerable to the coronavirus because of the working conditions and the significant incidence of lung damage from years of exposure to coal dust, silica and diesel exhaust, said the Washington Post, quoting medical researchers.

First identified in a Kentucky resident March 6, the coronavirus is spreading as incidences of black lung disease, lung cancer and COPD continue to rise among U.S. coal miners. Working and retired mine workers who have black lung or other pulmonary disease are seen as being at greater risk of becoming very ill if exposed to the coronavirus. The coronavirus is spread through respiratory droplets produced when an infected person coughs, sneezes or talks, according to the Centers for Disease Control and Prevention (CDC).

UMWA Seeks Protection Against COVID-19 for Coal Miners

The United Mine Workers of America (UMWA) has asked federal regulators to set uniform, enforceable guidelines to help protect coal miners from contracting COVID-19. In a letter dated March 24, UMWA President Cecil Roberts asked the Mine Safety and Health Administration (MSHA) to require mine operators to:

• Ensure that miners have access to N-95 respirators
• Set procedures for disinfecting equipment between shifts
• Provide extra personal protective equipment (PPE)
• Create disinfectant strategies for bathhouses and other communal gathering places.

“Our miners work in close proximity to one another from the time they arrive at the mine site,” Roberts said in the letter. “They get dressed, travel down the elevator together, ride in the same man trip, work in confined spaces, breathe the same air, operate the same equipment, and use the same shower facilities.

“Many miners are also old and suffer from various underlying health conditions, such as pneumoconiosis, which the UMWA believes will greatly exacerbate the severity of the symptoms related to COVID-19; heart disease – a condition that in itself suppresses the immune response, leaving the afflicted more susceptible to harmful pathogens; and compromised immune systems.”

Roberts added that these high-risk miners often live in rural communities and have less access to medical care than is available in urban areas.

UMWA spokesperson Phil Smith told the Ohio Valley Resource that while some mines are voluntarily taking precautions to protect workers, the efforts are not uniform across the industry.

Blackhawk Mining, a Kentucky coal company operating nine mining complexes across three states, voluntarily shut down operations from March 23 through April 5 because of the pandemic. Its workers were not paid but kept their benefits, including health care, while on furlough.

As of this writing, the MSHA’s COVID-19 recommendations echo the CDC’s, which include avoiding close contact.

“MSHA is abiding by the President’s Coronavirus Guidelines for America, which are based on the CDC Interim Guidance for Risk Assessment and Public Health Management of Persons with Potential Coronavirus Disease,” the website says.

Of about 5,200 people in Kentucky who work in the coal industry, about 3,200 are underground miners and another 1,000 work in surface mines.

Kentucky Coal Miners at Risk Just for Breathing

Pulmonary disease is common among coal miners because of the air they breathe on long work shifts in and around the mines. Exposure to coal dust causes various respiratory diseases, including coal workers’ pneumoconiosis (CWP), aka “black lung disease” or “miner’s lung,” and chronic obstructive pulmonary disease (COPD).

Coal miners are also exposed to crystalline silica dust, which causes silicosis (a type of pulmonary fibrosis), COPD and other diseases.

Black lung disease causes inflammation of lung tissue, coughing and fibrosis, which is thickening or scarring of lung tissue. There is no cure, but treatment can help improve quality of life through management of symptoms. Black lung disease can lead to such complications as chronic bronchitis, which is a long-term inflammation of the breathing tubes, or lung cancer, as well as COPD.

COPD is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus production and wheezing.

Each of these lung diseases can lead to impairment, disability and premature death.

While it is generally thought that it takes many years of coal mine work to develop severe respiratory problems, two studies presented in 2019 said black lung, COPD and other nonmalignant respiratory diseases appear to account for a greater proportion of death in the younger generation of miners.

Recent reports have pointed to an unexplained increase in the occurrence of progressive massive fibrosis (PMF) in recent years, most likely attributable to excess exposure to crystalline silica, according to the studies. Crystalline silica is a basic component of soil, sand, granite, and most other types of rock.

An increase in the incidence of black lung disease in recent years has been potentially attributed to changes in mining technology. The new technology allows extraction of higher volumes of coal and surrounding rock in a given time period and creates finer dust particles than can be inhaled deeply into the lungs.

How Can A Coal Mine Workers’ Compensation Attorney Help Me?

If you have become ill or been injured while working in the Kentucky coal industry, you should be eligible for workers’ compensation benefits, including reimbursement of medical costs, partial replacement of lost wages and, if needed, disability stipends.

If you are having difficulty obtaining workers’ compensation benefits, the Kentucky workers’ compensation lawyers of Morgan Collins Yeast & Salyer will fight for the full workers’ comp benefits you deserve. It takes Kentucky Courage to fight for comprehensive workers’ benefits while also battling a debilitating illness. Kentucky coal miners show courage every day. Our attorneys are ready to bring Kentucky courage and help you stand up for the full benefits available by law. Contact the experienced workers’ comp lawyers at Morgan, Collins, Yeast & Salyer today for a review of your case that is free, has no strings attached, and is available from the safety of your own home.

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