Dear Nicole,
I am in the home health business and I have a wonderful employee who has been with us for several years.  This care giver has daily contact with our patients and has never disclosed any personal medical issues to us.  Recently, this employee has decided to cut back on her work hours and as a result some of her patients had to be reassigned to other care givers.  When our office called to notify one of her clients that they would be sending a new employee from now on, his response was, “okay because she has an infectious disease anyway.”  What are my rights and responsibilities as the employer? - Signed, Worried

Dear Worried,
This can be a sticky situation.  Because a client has provided you with this information, you can go to your employee and let her know that a client has informed you that this is the case.  If she denies the information is true, your hands are pretty much tied.  However, if she confirms that she does in fact have this infectious disease, you can ask her to provide you with a medical release stating that is okay for her to safely perform her job duties.  You might also provide her with a job description of her duties to take with her to her doctor’s appointment.  If her doctor is unable to give her medical approval for this, you may have to let this employee go or move her into a position that is more suitable for her condition, one that would not include any patient care.  - Signed, Nicole

Dear Nicole,
As an employer, I was under the impression that if my employee was injured on the job, and they had a pre-existing condition that they had disclosed to me, the claim would be denied because they had previously injured that same body part.  However, I recently had an employee sustain an injury on the job to a body part that he had previously injured and you accepted the claim. - Signed, Confused

Dear Confused,
Although a Pre-existing condition is definitely considered in the acceptance of a claim, it is not automatic grounds for denial of a claim.  If a pre-existing condition becomes aggravated, accelerated or exacerbated by a work related injury the workers’ compensation carrier is usually responsible for the increased disability of that injured worker.  If your employee sustains a work-related injury to a previously injured part of their body, regardless of whether the previous injury was work-related, their claim is not going to be automatically denied.  If they have an accident that aggravates their pre-existing physical condition, such as arthritis, a back condition or a prior surgery, they are still entitled to all the rights and benefits provided by the workers’ compensation law in the state of Nevada.  If you do have a claim that is accepted on a body part that was previously injured we may be able to recover some or all of the costs of the claim through the Subsequent Injury Account (SIA).  This is a fund set up by the State of Nevada that a portion of all workers’ compensation assessments go to.  This recovery of funds would happen at the end of the claim, so the claim would go along like all claims and once the claim comes to an end and we know the total claims costs, we then attempt to recover those costs through this account. - Signed, Nicole