Fighting The “HIPAA Police,” Accessing Your Client’s Medical Records

Episode Notes

Transcript

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Intro: Workers Comp Matters, the podcast dedicated to the laws, the landmark cases, and the people that make up the diverse world of workers’ compensation.  Here are your hosts, Jud and Alan Pierce.

Judson Pierce: Hi, and welcome to another edition of Workers Comp Matters.  My name is Judson Pierce of Pierce, Pierce & Napolitano in lovely Salem, Massachusetts.  We are here today to discuss issues relative to the workers comp system.  As we often do, we have a guest on, and the topic today concerns HIPAA, the Healthcare Portability Act, which was signed into law 27 years ago, if you could believe it, and the problems that it causes, attorneys and the clients that we protect and advocate for and are undying, seeking to get medical records and medical notes to make our cases.

So, our guest today is very active in that arena.  His name is Jared Vishney.  Jared Vishney is a technologist and entrepreneur with over 30 years of domestic and international experience with Fortune 500 enterprises, as well as small to medium sized companies.  He holds a dual economics and business degree from UCLA, and his involvement in the healthcare and legal industry began 14 years ago when he founded Arctrieval, a business providing health information management software to hospitals and doctor’s offices.  So, Jared, without any further ado, welcome to Workers Comp Matters.

Jared Vishney: Thank you, Judson, thank you so much for having me on today.  I look forward to hopefully sharing some information that will be valuable to your audience and help tackle some of those issues that they’re having to advocate for their clients and the blockage and the roadblocks they face because they can’t get the medical information to substantiate a claim or case.  So happy to be here.

Judson Pierce: Absolutely.  When I knew that you were coming on, I asked some attorneys in our office about the lengths of time that they encounter in their record requests.  They just shook their heads and they said, 30 days is awesome, 90 days is quite often the case, 60 is kind of the norm.  How do you do it?  How does the company gather records and get them to a lawyer’s office in 30 days or less?

Jared Vishney: I think the first point is to set the stage that obtaining the medical and billing information to substantiate a claim or case is critical.  And it’s the Achilles heel of workers comp claims and cases, as well as personal injury claims and cases, that it just takes too long, takes too much effort, and it costs too much.  And the problem that you’re facing is most firms, and we’ve talked to over a thousand, 75% of them wait more than three months to get records, over 50% wait more than four months. And it’s really not their fault, because as you mentioned back in 1997, when the HIPAA rules were first passed, it was like a great new world.  It was designed to unify things and streamline things and get information flowing faster to authorize people.

Well, it kind of had the opposite effect, because everybody became super risk adverse, because the penalties for making a mistake are high, and they’re significant.  So rather than opening things up, it clamped things down.  The problem is everybody says, oh, 30 years ago, prior to the HIPAA hip authorization, was the wild, wild west of getting records, and you had to fill out different forms for different hospitals.  Some didn’t, some had them, others didn’t.  And HIPAA came along and unified that, and everybody said, “Okay, how do I get my records?”  Well, you got to fill out this HIPAA authorization.

The problem with the HIPAA authorization that we’re all used to, is it’s part of the HIPAA Act from 1997, and it relates to 45 CFR 164.508.  And what it says is it defines how a request needs to be structured in the authorization, how it needs to be structured.  The problem with that is, there’s no guidelines or mechanics or timeframes associated with that third party HIPAA authorization.  The providers are in control of the process.  They can take as long as they’d like and even states that have requirements for entities to respond to a specific timeframe, they’re often ignored because there’s real no enforcement action.  The key is to use a different part of the HIPAA privacy rule.  It’s section 164.524, and it’s referred to as a patient access request or individual right of access.  And what it states is, I, Jared, for example, can tell you or tell not you, but tell the healthcare provider, I want you to send an electronic copy of my records to Judson.

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They have to do that in 30 days.  If they don’t, now they face potential investigations and fines and penalties from the Office of Civil Rights for not complying with the individual right of access that I issued.  It is my right to access this information.  It is my right to have this delivered to a designated third party.  And that’s really the key.  We’re moving away from a permission-based model, that’s permissive that leaves the provider in control, and fundamentally to a directive model where the individual has the right to direct that covered entity to do what they’re supposed to.  That’s really the key in the approaches.  And the methodology is to stop using those third-party HIPAA authorizations and start using individual right of access requests, which are enforceable and carry some pretty nasty fines and penalties from the Office of Civil Rights if the providers don’t do what they’re supposed to.

Judson Pierce: Fascinating.  I didn’t know of that specific part of the Act that would allow for an individual to really maintain his or her rights, which is probably one of the main reasons this law was passed in the first place.  Right?

Jared Vishney: Well, it was.  I mean, it goes back — it was contemplated that we need to provide access and there shouldn’t be blocks.  So, for example, and it has real teeth to it.  Banner Health here in Arizona was fined $200,000 and put on a two-year corrective action plan for not complying with two of these individual right of access requests.  They basically dragged their heels in providing this information to the designated third party and got slapped with a huge fine and not just –

Judson Pierce: How long was that delay, do you know?

Jared Vishney: I think it was — they were initially notified.  I’d have to go dig it out specifically, but if I recall, they were 30 days late.  They were notified by the Office of Civil Rights to comply.  They still didn’t comply.  And then after 90 days, they were slapped with the — they did the investigation, but they were 90 days late on providing the information.  So, it’s got real teeth to it.

Judson Pierce: Yeah.  The Office of Civil Rights, you mean it’s a federal agency that would pursue this right, not a state?

Jared Vishney: Correct.  It’s federal level.  So, Office of Civil Rights is a department within the Department of Health and Human Services.

Judson Pierce: Department of Health and Human Services.

Jared Vishney: Exactly.  So, it’s not just a regulatory issue of commerce, it’s a civil rights issue because it is the individual’s rights to do that.  And that’s really the key and fundamental difference between what we see other firms doing and what we’re doing and what we are doing to help educate and change the landscape and unlock access to those, really the overarching term is protected health information, which could be records or bills or anything related to the past, present, or future care of the individual, as well as any of the financial transactions around that care.

Judson Pierce: Part of the reason for this law was also right, that it’s a privacy law.  It’s to protect people’s private medical information.  In this age that we’re living in now, where there’s so much instant access to medical records, even on your own personal devices through healthcare portals, one can possibly get his or her office visit note from their PCP within minutes after the office visit.   How does that change the model of what you all are doing?

Jared Vishney: Well, there’s two parts of it.  My background, just so you know, in addition to what you said to folks is, I ran a release of information company for 10 years, and we were working in hospitals providing the information out to people who needed it, whether it be insurance companies, attorneys, other doctor’s offices.  And I have personally seen both sides of the equation.  And what you’re looking at is the information that comes through the patient portal is not necessarily the full legal medical record for the individual.  It’s like you said, a summary of the care.  It might be lab reports, it may be notes, but it may not.  In most cases, it is not the full legal medical record.  In some instances, the information that comes through the portal is sufficient to justify a claim or case, and that’s all you may need.  In other instances, you need the full clinical notes, and you don’t want to miss anything.  You want the full legal medical record.  And that’s really where the portals are different.

The portals are designed for continuity of care, and somebody being able to take that information going to the next provider and saying, “Hey, look, here’s my basic information.  Here are my lab reports.  Here’s what the last doctor said.” Okay, great. They may still want more information that’s not necessarily available through those portals.  So, there is a difference in the information set itself.

Judson Pierce: That’s interesting.  All right, why don’t we, at this point, take a quick break for a word from one of our sponsors, and we will be right back with Jared Vishney.

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Judson Pierce: And we’re back.  At this point in our conversation, Jared, I’d love to ask you a little bit about the disconnect between document management technology and legislation governing medical record production.  What’s happening on the state and federal levels to correct the issue?

Jared Vishney: Well, I think to understand what’s happened, a quick history lesson makes sense and not so much of a history lesson, but if you go back 30, 40 years ago, most records and information were stored on paper documents stored in charts, stored in file rooms and that’s how people primarily stored medical records as individual files.  And if you needed something, you would take it out, and then you would look at it.  And then along came technology and now we’re starting to store things in systems.  Initially it was just images of those paper documents, and that’s evolved into a full electronic health record or medical record system, where it’s more than just clinical notes.  There’s a tremendous amount of information.  What you’ve seen, though, is what used to be documented on a, let’s say, three-page nursing flow sheet with a lot of checkboxes is now 300 pages of records within an electronic medical record system.  So, you’ve seen an explosion of how the data is stored and also the amount of data.  It used to be telemetry data like temperatures and vitals were done every half hour or whatever.  Now you have continuous monitoring of those vitals, and that can lead to an explosion of information as well.

So, what used to be documented, say, in an ER visit for, let’s say somebody was injured on the job and they cut themselves and they had stitches, and they were sent home to recover recuperate or let’s say they had a minor orthopedic issue with a fracture that might be 20-30 pages of ER notes when they were written on paper.  Now, that same ER visit is 200 to 300 pages.  So, you have this proliferation of documents and information.  Well, what was going on initially is, again, it was the wild, wild west of charging for records is one hospital will charge dollar page, this other hospital charge something else.  And the states, for the most part, legislated rates for, okay, you’re not going to have predatory business practices in charging for copies of these records.  It’s silly that you’re charging $50 for a single page.  So, they normalized it.

And that was based upon the paper records back in, most of the legislation came in mid 80s-ish, early 80s to kind of corral this.  And then what happened is the technology advanced, we’re storing these things.  And to get a copy of those records, somebody physically had to get up from their desk, go back into a dirty file room, potentially.  Well, it wasn’t that dirty because they were medical records.  Get the file, take it apart, photocopy it, reassemble it, and then send that copy to somebody else, mail it out.  That kind of made sense that it was 50 cents, 75 cents per page, and then it might be $20, $30, $40 for that chart.  Well, when you start applying that to 200 or 300 pages, it gets expensive very quickly.  And what you’re doing is people are no longer physically working with this information.  It’s all electronic now.

Now there’s still work involved that they got to find it, they got to search for it, they got to check it, but the amount of labor involved is significantly reduced.  So, you have a situation where legislation is still based upon those paper records, but they’re applying it to electronic data and that’s where these disconnects are, where you may have a 15,000-page chart and a copy service will want, or a hospital will want $10,000 for that.  So, what we’re seeing is, we’re seeing on a federal level, there was a notification to modify the HIPAA privacy rule that would have enforced a cap on the production of medical records being delivered to a third party.

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That has been delayed and delayed and the current final date for the final action is now December 2024, with effective sometime in June of 2025.  In the meantime, what’s happening is a lot of these states, and it’s a lot of the trial lawyer associations say, hey, this is silly.  We shouldn’t be paying $500 for records that are coming to me on a CD or downloaded from a website.  So, we’re starting to see states take up the cause and see legislation enacted to control the cost of the medical, electronic copies and medical records.  For example, Nevada recently enacted a law back on October 1 that limits the copy of an electronic record to not more than $40.  Ohio put a similar law on the books, that it’s $50, and Utah has one that limits it to $150.  Arkansas is $75.  So, we’re starting to see these caps come in and people realizing that the cost of the records are crazy, especially in some cases.  In workers’ compensation cases, sometimes the records come from industrial commissions or they’re required to provide them from the employer.  So, you don’t face some of these issues, but they’re still dragging their feet.  You may not have the cost, but I’ll get to it when I get to it.  So that’s where it ties back into that individual right of access, saying, hey, you still got to do this in 30 days.  Even though they’re free, you need to give them to me.

And there’s some penalties that are starting to be, how do we say it, legislated on the state level as well.  But really the biggest penalty comes from the federal level, where the office of Civil Rights may come in and potentially investigate and levy a fine against you.  Even if there’s no fine, the providers don’t want the office of Civil Rights looking at what they’re doing, because just responding to an inquiry is 20 or 30- or 40-man hours of labor to get everything done.  So, they’d rather just, okay, yeah, we’re just going to get you the record.  So, it’s a little bit of the squeaky wheel gets the oil, and especially if you know what you’re doing and they know they’ve done something wrong, they’re quick to remedy it so they don’t have to deal with a potential investigation.  Was that helpful?  I hope.

Judson Pierce: Yeah, it absolutely was.  It shed a lot of light on the issues that we see.  Some of our providers actually use vendors, third party vendors, I think one’s called, like, Citrix or Psyocs(ph).  And that makes things even longer in terms of how long it takes to get them.  And the provider’s offices that we call, they’re like, well, we can’t send them to you.  We outsource that, and then it’s up to that vendor company to charge what they want to charge for them.

Jared Vishney: In some cases, yes, that outsourcing is a critical component.  And the way we work is we advocate always that individual right of access request goes directly to the provider.  If the provider chooses to outsource because it was issued to them, fine, they’re more than welcome to outsource it.  But they are ultimately responsible for the production of those records and the copy in the timely manner.  It’s not Psyocs, Sharecare, MRO Verisma, IOD any number of those release of information providers that are going to get in trouble.  It’s the hospital that’s going to get investigated, because they are ultimately the covered entity that’s responsible to comply with the HIPAA privacy rules as well as enforcing compliance with their business associates.  And that excuse is, no.  If I’m not going to go out, we don’t deal with Psyocs.  We deal with the providers.  Your staff has done something wrong.  And it’s also a lot of these outsourced companies, if you call them, unfortunately, there’s a call center somewhere.  The people are not well trained.  They’re not incentivized to solve the problem.  Going back to the provider, and especially taking up the issue with the director of medical records or the chief privacy officer and when they see that, oh, yeah, we’re out of compliance, that’s what makes things happen.  That’s when you see movement.  But if it’s just the general vendor calls, you’re not going to see it and that’s what people experience.  It’s like you’re paying excessive amounts of money and getting poor service when neither should be happening.

Judson Pierce: Well, let’s take our final break of the program, and we’ll be right back with Jared Vishney of Arctrieval.

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Judson Pierce:  And we’re back with Jared Vishney of Arctrieval.  The differences between, say PI cases in workers’ comp.  Do you as a company notice those differences?  I mean, it’s a particular area of the law that we concentrate in.  Whereby, you know, the injury has to be on the job and there’s a defined benefit system that’s statutory.  Each state is a little bit different.  How do you all, as a company dealing with many different states handle those differences?

Jared Vishney:  Well, I think when you look at it, and I’m not an expert in all the rules and procedure for all the different states.  We focus on medical records and billing records and protected health information.  Ideally, you want the information related to that injured party to whoever’s advocating for them, whether it is a worker’s comp case or Social Security Disability or public benefits claim or personal motor vehicle accident and medical malpractice mass work(ph).  You need information to advocate on behalf of that client for their claim or case and the idea is to restore them to their status prior to whatever injury happened to him.  Whether somebody else is responsible for that restoration, or they have their own insurance for that restoration and really call that is to put them, like it never happened as much as possible and the information gets blocked.  Whether it’s a worker’s comp case and the industrial commissions in each state will often dictate who gets the records?  How you get the records and where they’re located?  There’s still that fundamental right of access.  If you’re not getting what you need, you can always issue a request directly to the provider that provided the services to the individual because that individual is entitled to a copy of their protected health information.

The provider has to give it to him.  Now, oh, well they paid for it, so and so paid for, we don’t do this, we don’t do that.  And sometimes that comes into play but the bottom line is, hey I’m the individual.  I’m telling you I want you to send a copy of my records either to me or to my designated third party.  I don’t care who’s paying for it.  So that can kind of help with cut through some of the red tape and roadblocks when it comes to workers comp and it depends also it could be on the state level what those rules are.  But if you’re getting issues or you’re having issues to obtain this information.  It is my right as an individual and that’s really the core of what we’re establishing and to make sure that those records flow and these issues the same it doesn’t really matter what type of case or claim it is that access to the protected health information because it’s often locked up in a vault guarded by the HIPAA police, which I like to call them, that it really is.  They view their job as, oh we’re going to get in trouble as much as they hate their jobs.  They don’t want to lose it.  It’s really weird sometimes but they really are it’s like well, I have to make sure that this doesn’t go to the wrong person and this and that and all these other pieces.

If they spent half as much time as making sure the right information got to the right person.  It means so much better, but it’s really a risk adverse culture.  They’re looking for things that are wrong.  So, my advice and this goes to anyone that’s representing somebody and needs medical information to substantiate the claim or case is be clear conspicuous and specific in what you’re looking for, make sure there are no errors in the request that you send.  And in some cases, HIPAA authorizations are fine.  People are used to them.  They know what to do with them.  They’ll provide.  They’ll get the records but you’re at the mercy of the provider.  Individual right of access has that 38-time frame is a little more aggressive and then finally ultimately if you’re not getting what you need.  There’s always the subpoena process if you have to take file and action or suit in whatever jurisdiction you happen to be in and then subpoena the records.

One tip down subpoenaing record is a lot of times folks will issue them in the name of the facility.  And if you’re having problems getting records.  Issue the subpoena in the name of the chief executive officer of the chief legal officer or the chief privacy officer and have them served instead of the facility.  It’s amazing how fast the records will appear when the CEO get subpoenaed to deliver medical records and the medical records department isn’t doing their job.  It’s truly is a thing of beauty when that gets sorted out.

Judson Pierce:  That is a pro tip right there, folks.

Jared Vishney:  Absolutely.

Judson Pierce:  Couple of quick follow-ups for you Jared before we end.  Money, I’ve often heard that your records are your records.  If you want your records in their entirety, you don’t have to pay for them.  You’re the person whose records they belong to.  Is that true and only the lawyer would have to pay for them?  Can a plaintiff his or herself gather all their records for free?

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Jared Vishney:  Yes and no.  So, the records are not your records.  The information, it’s about you.  So, you have a right to access the information.  The information is technically property of the healthcare provider because they’ve assembled and they’ve created it even though it’s about you and everybody thinks.  Well, those are my medical records.  I should be able to take a copy and do what I want with it.  No, they’re not, it’s about you but it’s not your property, so to speak.  Now, what’s happened—

Judson Pierce:  Work product.

Jared Vishney:  It’s essential.  Yeah, and so but individuals have rights to access that information in most of it’s done very inexpensively.  If you want a copy of your records in paper format, there’s a cost of production for that and you’ll be charged for that.  It’s not to get the information but it’s for the act of producing that information.  If you get it electronically and you haven’t sent to yourself electronically, then the maximum that a facility can really charge is, let’s say upwards of $20.00.  Let’s just leave it at that.  If I, Jared request records from Good Samaritan Hospital and have them sent to me.  I might be looking at a $20.00 fee.  In most cases, most facilities will provide the records free or for a very minimal charge when they’re coming to the individual.  If they’re going to another health care provider.  Like I would say I, Jared wants Good Samaritan Hospital to send this to my primary care physician.

That continuity of care those documents are transmitted at no cost.  As soon as the third party gets involved, that’s where the cost come in and the logic is, well that attorney or insurance company is going to make a lot of money off these records in this information.  Therefore, we should charge them a lot.  That’s really doesn’t hold water.  It was because it took effort to go photocopy of 50-page chart 30 years ago and you had labor costs and that’s what it was supposed to cover.  It was not designed to be a supplemental revenue stream or a source of income for a provider or facility.  It’s a cost of doing business and it should be cost recovery based, nonprofit based in with this disconnect again between legislation and the type of system used to store the records is introduced to this arbitrage system where, oh I can charge paper rates for electronic records.  I can make a ton of money on this and that’s really where we’ve gotten to and we need to get away from that.

We need to get back to, okay, a reasonable charge makes sense because there is a cost of providing it but it’s not supposed to be a profit center.  Those records were paid for in the course of providing treatment and care to that individual.  It doesn’t require extra effort on the part of the doctor, the clinician or anybody else to create copy of the records.  It does take some minor labor from a clerical staff to search, find and produce it in the PDF file, but it’s not $10,000.00 for 15,000 pages that took somebody 20 minutes to compile into a PDF file.

Judson Pierce:  And what facilities do you have access to?  What facilities don’t you have access to?  When a law firm employs your company to help them and gathering records.  Are you sometimes at the mercy of who will abide and who won’t?

Jared Vishney:  Well, I think the biggest thing is we’re not a copy service.  We are a technology company and we provide a software tool to the in-house staff to help them obtain and manage the medical records as such our costs are very minimal.  It’s a monthly subscription fee starts at $139 a month to issue and manage an unlimited number of requests.  So, access to the information, there is no restricted access through our methodology in the software.  It is simply, it’s federal law.  You have to supply it.  You can’t say no to the individual right of access request and for us, it’s an entirely different way of doing this.  It’s empowering the teams with better information better tools to become more efficient and get their jobs done faster with less effort and quite frankly, eliminating all the time.  They’re having to spend on the phone calling a medical provider, going where these records.

Judson Pierce:  Right.

Jared Vishney:  We’re eliminating 80% of that time and although its sales plug I’ll give is that folks that use the individual right of access methodology combined with the software automation tool in this case are retrieval(ph).  They’re getting 90% of their records back in 30 days without having to make all these follow-up calls because providers know they have to do it.  It’s not optional.  It’s not our fault or more importantly the injured party’s fault that some hospital providers inefficient in providing this information.  They should not have to suffer any more than necessary because somebody didn’t give them medical records and that’s what we’re really out to solve that problem.

Judson Pierce:  And what about human error?  If someone in our office says it’s a right shoulder we’re looking for records on and it was really the employees left shoulder that he or she injured.

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Is that going to delay it because we inputted it wrong or also there are certain times where medical records releases need to be a little bit more extravagant, say it’s psychological notes. There’s got to be initials on certain lines. How does it work with the system like yours when there are issues of human error and extra things on medical releases that need to be filled out?

Jared Vishney: Well, the human error part is going to be introduced into anything that you ever do because we’re humans and we’re not perfect. We are an imperfect species so but ask you want left shoulder versus right shoulder. I would not be that specific in request. I would say I want the radiology studies and exams from these dates of service. Send me everything you have in that timeframe.

When you start getting things like specific body parts, it actually is counterproductive for the request itself because a lot of the medical records department, they’re not in a position to review the records. They can’t — their staff is not trained to separate right shoulder, left shoulder. Just request medical records for that particular incident and that date of service and if so they found something else like there was a cut on the right leg, which you’re really not interested in, they’re not going to be able to separate those things out of those records and that causes problems at the fulfillment stage.

So I would avoid that. I would be specific but general in the sense that I want radiology reports, I want radiology images. I want whatever pieces that are involved in order to get the information I need. So that’s part one for the human error, and if there’s an error, we-re request it. Because we’re not dealing with HIPAA authorizations, the individual right of access requests are single-use document. If there’s an error in it, reissue it, and they got to fulfill it because you’re still looking at a 30-day timeframe versus 90 or 120.

So that’s that piece. With respect to special provisions, the nice thing about the individual right of access request is it applies to all medical information and there’s only one small carve out. The carve-out is and this has already been demonstrated. There was a case with Riverside Psychiatric Hospital in California that they said oh, we’re mental health institution, behavioral health. The HIPAA individual right of access request doesn’t apply and they came back and they were fined by the Office of Civil Rights for not sending the information.

Anything related to the past, present and future care is subject to the request. There is one and only one carve out which is psychotherapy session notes. So the actual clinician’s notes where they will diagnose somebody and say, “Hey, Joe is crazy.” Whatever that happens to be. They don’t want that to get to Joe. Joe sees that and says, “My doctor says I’m crazy. I’m going to go down there, beat him up and show him I’m not crazy”. That’s to protect the welfare and safety of the mental health workers. But everything else, assessments, medical, anything medically related, individual right of access.

In those cases where the psychotherapy notes are needed specifically the session notes, then you would issue a traditional third-party HIPAA authorization and each states a little bit different but they may, as you mentioned, they may need it witnessed or notarized but that information goes to a designated third party. That information does not come back to the individual again to protect the safety and well-being of the mental health worker that may have a potentially dangerous client.

Judson Pierce: Very helpful information. We have come to the end of our program today. I’d like to thank very much our guest Jared Vishney of Arctrieval. I guess you said you’re in Arizona, but you represent and help out firms all over the country. Right?

Jared Vishney: Well, yeah, and yes, and I appreciate that. We have firms in almost 40, over 43 states now using the platform because it is based upon federal law and it is the log land and it helps to normalize things and it really helps to create roadblocks and what I would tell people is come spend, if you’re interested, come spend 20, 30 minutes with us on a demonstration.

Not only — it’s not just to show you what we’re doing but we’re happy to share additional tips and tricks that we didn’t get into here our job as I view it is their attorneys and their clients they are representing that have been injured are waiting way too long to get the medical records. It wastes enormous amounts of time for the staff to get the records. The records cost too much and all that does is denies justice for that injured party because somebody in medical records doesn’t want to do their job.

I view it as our mission to solve that problem and ethically build a business in the process. And that’s what we’re up to and we’re just going to keep going down that path.

Judson Pierce: Thanks so much Jared and thank you for all the help you’ve done for lawyers and their clients.

(00:34:57)

If you want to know more about Jared and his firm Arctrieval, you can visit arctrieval.com, that’s arctrieval.com. And for all of us here at Legal Talk Network Workers Comp Matters, thank you for listening and go on and make it a day that matters. Take care.

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