Too fatigued for a cute post title, or, Why Yetis are Lousy at Canasta

Friend Schell, are you OK? I hope that the lawyer has given you some options. We're worried about you!

I'm pretty sad & fatigued tonight. Just a hard day, I guess.

The discussion on the community blog about For Better or For Worse is fascinating. Why do we become emotionally involved with a comic strip? Or for any fiction for that matter? Are we somehow escaping Mr. Reality? Is that a bad thing to do anyway? Well, I wish I had something profound to say, but I don't. All I have are questions.

Hubert Humphrey was a very compassionate guy. He said in speeches all the time that the measure of a society was how it helped the people at the sunrise (the young), the people at the sunset (the old), and the people in the shadows (the disabled and truly disadvantaged.) I've been thinking a lot about disabled people today, this morning in a rather abstract way. There are costs to society and to the individuals from disability. To society, we lose a productive member. (Now, there are lots of working people who are not contributing to the productive bottom line. For example, the entire security industry produces nothing. But in our time, it's certainly necessary.) It is not callous (at least I don't think it is) to consider the economic impact of disability on society. It would be callous to ignore the effect on the individuals. I see a lot of these folks, since I represent people who are injured and disabled in the various legal systems that provide to a greater or lesser extent for them. These people feel frustrated, worthless, angry, depressed, and are leading lives where they live with physical pain every moment and know that they are simply waiting idly and in pain until they die. (I am reminded of a Dilbert cartoon, where Dogbert comments that people are really organic pain receptors rushing headlong into Oblivion.) I was wondering this morning what we can do for these people as a society that we aren't doing. How can we help them to be marginally productive, to regain some self-respect and to give them something other than pain to look forward to in the morning? We have a very few "sheltered workshops," where the mostly-mentally disabled can do simple physical tasks without the stress of production quotas, but very few of those people can be accomodated by what we have. Is there anything useful that we can create that will be something like revenue neutral? I just don't know. I'm more of a one-on-one guy in my profession, not a systems guy. But it all bothers me. In the interests of saving money, the care that we have for these people is often subordinated to financial interests. For instance, few insurers or workers' comp carriers will pay for pain medication long-term. They claim that it isn't necessary, which is utter bullshit in many instances, and that it is often abused, which is absolutely true. So do we erect an even more cumbersome monitoring system to identify the people who really need long-term pain meds? I just don't know. We are so materialistic. When I bought my car, I was in the get-a-nice-car-and-have-fucking-status mode. What a dumb-ass. It's still a good car, now 10 years old, and I think that the materialism/status thing is much lessened in my heart.

It was something coincidental that I was musing on these things this morning, because this afternoon, I had a face to put to the problem. I talked with Mary P., a 40 year old woman who rode 4 hours to get to No. 3 because she couldn't find a lawyer any closer who would even talk to her about workers' comp. (Definition: Workers' Comp is a collective term for the wage-replacement, medical cost and permanent injury compensation given to injured workers who were hurt on the job. It is not very valuable at best, but on the other hand it is liability-neutral, that is, a worker can recover the benefits even if s/he was negligent in causing his/her own injury.) In 2004, Mary was working for an out-of-state temp agency which placed her in a factory. (Of the whole temp agency ills, another post, another day.) She was doing heavy lifting, and had a sudden "pop" in her mid-back, and immediate onset of severe pain. She had zero prior back problems. She went to a family doc, who diagnosed her with thoracic sprain-strain, and put her off work for a while. The pain continued, so the family doc sent her to an orthopedic doc, who ordered an MRI. There was a delay in getting the MRI because they cost $750 and the Workers' Comp carriers hassle the doctors to try to get them to withdraw the request. The MRI occurred a couple of months later, and showed a herniated disk at T-10-11. (I don't know if an explanation is necessary here - this is in the mid back and the disks are made out of a gelatinous substance which cushions the interfaces between the vertebra. When a disk bulges or herniates, it doesn't provide that protection and may itself press on nerves thus causing pain.) Her doctor asked the Comp carrier to amend the diagnosis, and they ignored that request, and it was forgotten for a time. She was sent for an IME (independent medical examination, i.e., to a comp doctor on behalf of the insurance company.) Since the disk was not an "official" diagnosis, that doc didn't rate it or pay attention to it. She got a lawyer, protested the denial of the diagnosis update, and went through the cumbersome litigation process on that issue. In the meantime, her lawyer was getting 20% of her rapidly ending checks. An administrative law judge denied the diagnosis change, saying that she had a very bad disk injury causing disability, but hadn't proved that it was caused by the work injury. (In the record were several reports of doctors who treated her saying that the disk obviously was caused by the injury, but the ALJ relied on the opinion of the Office of Medical Management, which consists of doctors who sit and review records all day, and who never met Mary.) The Board of Review agreed with the ALJ. Her lawyer bowed out, and didn't appeal to the Supreme Court, but I can't criticize her for that, because the Court wouldn't have helped. So, this lady has no income from Workers' Comp, even though it is idiocy to say that the disk wasn't caused by this injury. There is a doctrine called res judicata, one of the first things you learn in law school. Essentially, it says that once a decision is made, it's final and forever unless a higher court/authority changes it. So we cannot go back and change the diagnosis now, and I had to tell her that there was nothing at all I could do for her. (And I am going to have to determine what to do when people call with these problems, and that bothers me as much - I spent 1-1/2 hours with Mary to go through the file, knowing at the outset that it probably wasn't going to be a case, but the rent and salarires and other costs at No. 3 continued to accrue unchecked.) Well, I told her that the only option she had was to file for Social Security Disability, and to make sure she was OK with that, I called the local Social Security office, got them to bring Mary up on the computer and tell me if she had coverage. One has to have contributions of a certain amount for roughly 5 out of the last 10 years. (Actually, 20 of the last 40 quarters.) (I know that this administrative stuff is dry and uninteresting - but it determines where Mary will get the money to pay her electric bill in the future.) It turns out that she didn't have coverage because much of her work was in-home health care for cash for several years, and SS taxes were not paid. (I can hear the voice of conservative condemnation here. If she had gotten a real job . . . Working under-the-table is a fact in our economy, and often isn't the worker's decision, rather it is the employer's because they don't want to pay withholding taxes and do the paperwork. Ann Coulter, take note.) So the only Social Security that she could possibly get is SSI, which is a needs-based program, that is, for disabled very poor people. An SSI check is approximately $550 per month. Mary isn't qualified for that, either, because she receives $600 per month in child support for her 3 children who live with her. Sooooo, she is totally screwed. There is nothing that I can do to help her. Her life is going to be economic hell for however long she lives. In America. In America. God, this is sad.

Before Mary left, I called my former partner to "staff" the case, that is, to ask for a second opinion in case I was missing something. She couldn't offer any other ideas, either. There is a considerable cost to calling my former partner, because my wounds from that relationship are still open.

Let's see - new term of Court started this week. Tomorrow morning will be taken up by "docket call," where the trial court judges "call the docket," and set cases for the next 4 months. It's a very traditional thing not done very many places any more, and sort of formal, like the Red Mass. It is a coming together, and for me a reminder of the isolation and specialization of my profession. Then in the afternoon, I have to drive way the hell down to the center of the state to a regional jail, where they have moved Tina the Crack Dealer, since we received her Pre-Sentence Report, which is great. I may have pulled a rabbit out of the hat and have a way to get a sentence less than the 10 year mandatory minimum. I'm keeping my (and her) hopes up. There is a big factory outlet strip mall a mile from the jail, so my mom is going with me to shop while I'm at the jail. That'll be nice to get her out and about.

Oh, and I don't have a clue why yetis are lousy at canasta, but trust me when I say that they are.

Mizpah. Pippa passes.

R