01:00 AM EST on Sunday, November 21, 2004

Jim Casale, a Cranston firefighter, was driving a rescue truck to a fire scene on Aug. 9 when he was struck by an SUV driven by a woman who has since been charged with drunken driving and driving in reckless disregard for the safety of her passengers.

Casale suffered a dislocated right elbow and cervical damage in his neck. He takes a lot of medications and wears a special glove on his right hand to control swelling. He wasn't able to put on his pants without help until a few weeks ago. He still has a hard road ahead before he's back on the rescue truck.

So Casale was injured on the job. It couldn't be clearer, right? He's driving the rescue wagon to a fire, with lights and siren announcing his presence, and gets hit by a vehicle driven by a woman suspected of drunken driving.

Except Casale wasn't injured on the job. Not in the eyes of Cranston city officials. Instead, he is on sick leave and his sick days run out early next month. Representatives of the firefighters' union will go before the City Council tomorrow night and ask for emergency sick leave for him so the city will be spared the embarrassment of having one of its own, injured while doing his duty, face a job without a paycheck.

The union reps expect the emergency sick leave to be approved by the council. It's never been turned down. But they also expect it to be rejected by Mayor Steve Laffey.

Any way you look at it -- and not everybody looks at it the same way -- this is nuts. This is playing games with people's lives.

By any reasonable standard, Casale should be listed as injured on duty. But, unfortunately, he has been the victim of more than one wreck. There's the wreck of the rescue truck. And there's the wreck of the relationship between Cranston and its firefighters.

It leaves Kirsten Casale very, very angry. She is dealing with the situation that every spouse of a police officer or firefighter fears.

"When I got the call that my husband had been in a serious accident, I didn't know if I would find him dead," she says.

She sits at one end of the kitchen table. Her husband sits opposite her in the one chair in which he can be comfortable. Hagop Jawharjian, their lawyer, and Paul Valletta, president of Local 1363 of the International Association of Fire Fighters, sit with them.

Kirsten has notebooks -- big, thick notebooks. They contain the ongoing history of her struggle to get answers and find someone, anyone, who can impose some sanity and common sense. Among other things, she tells of the times when treatments for her husband, including crucial MRIs, were delayed or denied coverage because of the lack of Injured On Duty (IOD) status. She also points out that they have had to pay thousands of dollars in insurance copayments.

Under IOD status, the city assumes all expenses for the injured employee.

"All we should be focusing on is his getting well," she says. "We shouldn't be fighting for what he is contractually entitled to."

At the heart of the dispute is a new medical release form that the Laffey administration introduced earlier this year and that firefighters refused to sign. Casale's refusal to sign is the reason he's being denied the Injured on Duty status. Valletta points out that the form is almost an exact replica of the one used by the Police Department for prisoners.

"No American in his right mind would sign this waiver," says Valletta.

The union filed a grievance over the form. It is due to go to arbitration next month. It could be months after that before there is a decision. It leaves open the possibility that Casale will be months without a paycheck.

The Cranston City Council approved a resolution last month asking that the Laffey administration reinstitute the previous medical release required for IOD status until the legality of the new form is determined. The resolution carries no legal weight, and the Laffey administration has not adopted it.

The firefighters' main objection to the new form is that it opens up their medical histories to far more and far wider scrutiny than is necessary. They take issue particularly with the fifth and final section:

"I have read carefully and understand the above statements and do herein expressly and voluntarily consent to disclosure of the above information and/or medical records (including alcohol and drug abuse, records of my condition and HIV test, psychiatric notes and/or venereal disease and/or other sensitive or confidential related information)."

Valletta is right. No American in his right mind would sign this waiver. And the Rhode Island Affiliate of the American Civil Liberties Union has written to Paul Grimes, Cranston's director of administration, to say that requiring firefighters to sign the form raises a number of concerns under the state's Confidentiality of Health Care Communications and Information Act and its intent to protect the privacy of health-care information. The ACLU also suggests that the practice may violate federal laws that protect the confidentiality of health-care information.

Grimes says the union's refusal to sign the form has put the city in a tough position. There is procedure to be followed in applying for IOD status, and that procedure includes a medical release form.

Grimes says that Beacon Mutual, the company that administers the city's health-care plan, requested that the city tighten its procedure, and the new medical release form is part of complying with that request.

"We're establishing administrative protocol for considering IOD," says Grimes.

Grimes also points out that the Cranston police have agreed to the medical release form.

"We have to release medical records relevant to an injury," says Grimes. "The employer is going to own this injury, maybe for the rest of the employee's life."

Valletta says the police approved the form only after being allowed to remove some objectionable provisions.

Meanwhile, Jim and Kirsten Casale and their two children sit right smack in the middle of this face-off. They wonder about refinancing their home. They feel badly used.

The firefighters' union is taking a reasonable stand and making a reasonable request. The new medical waiver form intrudes far too much on rights of confidentiality and privacy. And, while the legality of the form is being determined, Jim Casale should have his medical costs completely covered by the city because he was seriously injured while serving the city.

For Cranston to desert one of its own at such a trying and uncertain time is despicable. And what makes it even more so is the feeling that this hideous new medical release form is less an attempt to tighten up procedure than to further put the squeeze on a union that won't fall into line. It is a grubby piece of work.

"Where is the moral responsibility?" asks Kirsten Casale.

It's sure not at City Hall.

But there is an upside to this whole seedy incident. Jim Casale has found a source of extra income.

"When I go to court to testify [about the accident] I get paid overtime," he says. "It's city business."

Bob Kerr can be reached by e-mail at bkerr [at] projo.com.