Disability

Court Questions Decision to Fire Injured Nurse

A hospital fired an injured nurse. Now it faces a disability discrimination complaint.
By: | July 24, 2017 • 4 min read

Is an injured nurse a threat to patient safety? That’s what New Jersey-based Saint Clare’s Health System believed.

The nurse in question came back from workers’ comp and disability leave only to be fired. The hospital admitted that the termination of the nurse was directly related to her disability, stating that she could not perform the essential duties of her job.

Further, the hospital argued, she was a danger to other patients because her injuries could prohibit her from completing tasks.

The court disagreed.

Shouldering the Burden

Registered nurse Maryanne Grande worked for Saint Clare’s for seven years before she suffered her first work-related injury in 2007. While moving a patient, Grande injured her left shoulder, resulting in surgery and three months of physical therapy before returning to work on light duty. Grande returned to regular duty one month later.

Advertisement




In November 2008, Grande reinjured her left shoulder lifting the legs of an overweight patient. She underwent a second surgery and returned to regular duty two months later.

Finally, in 2010, Grande incurred her most recent injury. A patient was attempting to walk around his bed but lost his balance. Grande caught the patient, but feared she had injured her shoulder again.

An MRI showed she’d injured her cervical spine instead. Another surgery and four months of recuperation under her belt, Grande returned to work for two hours before tapping out. She finally returned two weeks later on light duty.

In August of 2008, Saint Clare’s human resources department led a hospital-wide job system analyses for various nursing positions.

The analysis helped the hospital determine what frequency with which job duties were performed and which tasks were essential to each position. For RNs like Grande, an essential task was frequently lifting 50 pounds from waist to chest.

Though cleared to light duty work in July 2010, Grande was informed by the hospital that she would need to undergo a physical test set up by Saint Clare’s. Grande reported to Kinematic Consultants, Inc. (KCI), for a functional capacity evaluation.

KCI determined that Grande “demonstrated maximum effort” and said she could return to work but would need certain accommodations. The report noted that final determination for return to work deferred to her own physician. Grande was re-examined by her doctor, and was cleared to work with certain restrictions, including occasionally lifting items up to 50 pounds instead of frequently lifting that weight and only transferring patients with assistance.

The next day, Saint Clare’s fired Grande.

Back and Forth in Court

Grande filed a two-count complaint against Saint Clare’s: the first for unlawful discrimination based on a disability and the second for unlawful discrimination based on a perceived disability. Saint Clare’s filed for a summary judgment to which Grande filed a cross motion. Summary judgment was given to Saint Clare’s based on Grande’s inability to show she could perform her job in a way that met hospital standards.

Grande brought her case before an appellate division panel that reversed the summary judgment, stating that the case contained several disputable facts that only a jury could resolve. Saint Clare’s appealed.

The case was brought before the New Jersey Supreme Court. There, Saint Clare’s argued that because Grande was on light duty at the time of her discharge, and both her physician and KCI reported that she needed certain accommodations to complete her duties, Grande could not prove she was capable of performing her RN duties as outlined by the hospital.

Advertisement




Additionally, Saint Clare’s held that because the KCI report provided evidence that Grande’s continued employment was hazardous to her own safety, her work performance could jeopardize the safety of other employees and patients.

Grande countered that the hospital admitted to firing her due to a perceived disability—a prime example of discrimination, she said.

The New Jersey Association for Justice and the National Employment Lawyers Association of New Jersey filed amicus briefs with the Supreme Court in support of Grande. They argued that Saint Clare’s discriminated against the nurse, improperly assumed that Grande would incur another injury and believed that Saint Clare’s should not have carte blanche to decide the essential functions of a nurse’s job.

The Final Word

Under New Jersey law, employers are prohibited from terminating a disabled employee because of their disability. In this case, the court found that Grande presented a viable discrimination claim.

“When terminating a disabled employee because of an inability to abide by [safety] standards, an employer must prove that its standards relate to the employee’s duties and that no reasonable accommodation exists that will allow the employee to continue in her position,” wrote an associate justice.

The court ruled in favor of Grande, allowing for the nurse to take her trial to court.

Cite: Maryanne Grande, RN, v. Saint Clare’s Health System

Autumn Heisler is the digital producer and a staff writer at Risk & Insurance®. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

Advertisement




That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

Advertisement




Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]