WASHINGTON -A United States Postal Service (USPS) proposal that would reduce delivery of mail to five days could negatively impact the millions of Americans with chronic conditions who rely on the convenience and value provided by mail-service pharmacies, the Pharmaceutical Care Management Association (PCMA) said in letters sent to U.S. House Committee on Oversight and Government Reform Chairman Edolphus Towns (D-NY) and U.S. Senate Committee on Homeland Security and Government Affairs Chairman Joseph Lieberman (I-CT)
“About 1-in-6 prescriptions that are home delivered arrive on Saturday. Consumers count on getting their prescriptions at the right time and often can’t wait an additional two days, or even three days in the case of federal holidays that fall on a Monday,” said PCMA President and CEO Mark Merritt.
Government and independent studies have examined the increased savings, safety, and adherence provided by mail-service pharmacies. That research includes:
- Federal Trade Commission (FTC). The FTC found that mail-order pharmacies provide more savings than retail pharmacies.
- Pharmacotherapy: Official Journal of the American College of Clinical Pharmacy. Peer reviewed data found that highly automated mail-service pharmacies dispensed prescriptions with 23-times greater accuracy than retail pharmacies. The mail-service error rate was zero in several of the most critical areas, including dispensing the correct drug, dosage, and dosage form.
- Harvard University. Independent, peer-reviewed research conducted by Harvard University and published in 2004 by Health Affairs, analyzed some 670 million prescription drug claims and concluded that generic drug substitution rates at PBM mail-service pharmacies were slightly higher than at retail pharmacies.
- American Journal of Managed Care. Consumers receiving their prescription medications for chronic conditions through a mail-service pharmacy “were more likely to take them as prescribed by their doctors than did patients who obtained them from a local pharmacy,” according to the study. The study also found that 84.7 percent of patients who received their medications by mail at least two-thirds of the time stuck to their physician-prescribed regimen versus 76.9 percent who picked up their medications at “brick and mortar” Kaiser Permanente pharmacies.
PCMA represents the nation’s pharmacy benefit managers (PBMs), which improve affordability and quality of care through the use of electronic prescribing (e-prescribing), generic alternatives, mail-service pharmacies, and other innovative tools for 210-plus million Americans.
CALIFORNIA UNEMPLOYMENT INSURANCE APPEALS BOARD
(909) 987-XXXX
INLAND OFFICE OF APPEALS XXXX Arrow Rt, Bldg 19-A
PO BOX XXXX RANCHO CUCAMONGA CA 91729
GUILLERMO MOJARRO Claimant-Appellant
US POSTAL SERVICE c/o UCEXPRESS
Employer
Case No. XXXXXXX
Issue(s): 1256
Date Appeal Filed: 01/12/2010
EDO: XXXX BYB: 11/01/2009
Date and Place of Hearing(s):
(1) 04/12/2010 Rancho Cucamonga
Parties Appearing:
Claimant, Employer
DECISION
The decision in the above-captioned case appears on the following page(s).
XXXXXXXX XXXXXXXX, Administrative Law Judge
Case No.: XXXXXXX Inland Office of Appeals
CLT/PET: Guillermo Mojarro
Parties Appearing: Claimant. Employer
Parties Appearing by Written Statement: None
ISSUE STATEMENT
The claimant appealed from a determination disqualifying the claimant for unemployment benefits under Unemployment Insurance Code section 1256. The issue in this case is whether the claimant left the most recent employment voluntarily without good cause.
FINDINGS OF FACT
The claimant was employed as a Distribution Clerk. Level VI, for 22 years with the above-named employer earning $52,000 per year when his employee on October 30, 2009 under the following circumstances. The claimant resigned and accepted early retirement.
The claimant has a long, complicated history of grievances with his employer. The relevant portion of that history begins in February of 2007 when he was suspended for inappropriate conduct towards a co-employee. At the end of that brief suspension, the claimant informed the employer that he was not emotionally prepared to return to work. The claimant’s physician verified the claimant was unable to work because of his depression and anxiety. The claimant did not return to work before resigning on October 30, 2009 to accept his early retirement.
In February of 2009n the claimant requested to be returned to work. On March 26, 2009 the employer notified the claimant in writing that he was required to provide “objective and specific medical documentation sufficient to establish that you are able to perform the essential functions of your position, with or without accommodation…” before the employer could return him to employment. In response to this directive the claimant submitted a four-paragraph correspondence from his treating psychiatrist, Dr. Harry G. Lewis. The correspondence detailed the claimant’s condition, diagnosis and prognosis.
At the hearing the employer’s psychiatrist confirmed that this correspondence from Dr. Lewis “technically” satisfied the employer’s request for detailed medical documentation. Despite complying with the request, the employer did not return the claimant to his employment. Instead, it demanded that he submit to examination by the employer’s physicians. The claimant asserted his privacy rights and prevented the employer-appointed psychiatrist from sharing his
opinions with the employer. The employer refused to return the claimant to his position. The impasse was not resolved until the claimant became eligible for early retirement, which he then accepted.
REASON FOR DECISION
In Precedent Decision P-B-37 the appeals board held that in determining whether there has been a voluntary leaving or a discharge under section 1256 of the code it must first be determined who was the moving party in the separation. If the claimant left employment while continuing work was available, the claimant was the moving party. If the employer refused to permit the claimant to continue working, although the claimant was ready, willing and able to do so, the employer was the moving party.
An individual is disqualified for benefits if he or she has been discharged for misconduct connected with his or her most recent work. (Unemployment Insurance Code, section 1256.)
Absence caused by illness does not constitute misconduct. (Precedent Decision P-B-216.)
The department’s determination that the claimant was the moving party in this separation of employment is incorrect. The claimant had been out of work due to a psychiatric condition. The leave from work was approved by the employer. The claimant’s psychiatric issues were resolved according to the claimant’s treating physician, thereby opening the way for him to return to employment. The employer refused to permit the claimant to continue to work since it had not received a medical report from its own physician concerning the claimant’s medical condition. The claimant was ready willing and able to return to employment. Accordingly, the employer’s refusal to return the claimant to employment was the reason the claimant was forced to take early retirement, and thus the employer is the moving party in the separation.
The claimant was not discharged for misconduct connected with his most recent work. The absence from work was due to psychiatric medical condition. The employer approved the leave, and appropriately demanded medical verification that the claimant was capable of returning to his employment. According to the employer-appointed psychiatrist the claimant’s treating psychiatrist’s written release “technically” complied with the employer demand. Nevertheless, the employer refused to return the claimant to work.
The absence from work for a medical condition is not misconduct. The claimant was cleared medically by his own physician to the satisfaction of the employer’s written policy, and should have been returned to work. The employer’s refusal to return the claimant to work may have been for good cause. However, the decision not to return the claimant to his position was for reasons not amounting return the claimant to work may have been for good cause. However, the decision not to return the claimant to his position was for reasons not amounting to misconduct by the claimant. Accordingly, the claimant is not disqualified under code section 1256.
DECISION
The department’s determination is reversed. The claimant is not disqualified under code section 1256. and benefits are payable provided the claimant is otherwise eligible.
It’s only obvious that this was gong to happen… WAKE UP!!! (POTTER)MANAGEMENT!!! If you didn’t see this comming then it’s time to shit or get off the pot!! DON”T LET THEM CUT THE SERVICE AND MAKE THEM PUT THE BLUE MAIL BOXES BACK ON THE CORNERS!! THE PEOPLE ARE LOOKING FOR THEM!!! We need people in the USPS that have some NEW IDEAS who can make a difference! to ADD TO OUR SERVICE, NOT CUT THE SERVICE, LIKE POTTER WANTS… we can give our IDEAS as regular employees but they always get turned down get re-worded so it looks like someone else came up with it… and once in a while someone in management will do something with it but you better save your copy or it gets ripped off from you and they get the credit…