In November 1999 it was brought to the BMWE's attention that Burlington Northern Santa Fe Railway was distributing a Medical Help Desk card to emergency care physicians that implied that in order to receive payment for any treatment they provided, a physician must follow BNSF's protocols and complete a BNSF form. Specifically, it says "to ensure complete and expedient payment for your services by BNSF, please follow the BNSF Medical Department Emergency Care Protocols and complete the BNSF Medical Status Form."

The card also states, "providers are asked to defer decisions on work restrictions until a BNSF Preferred Provider sees the employee the next day" and "if time away from work is indicated," providers are asked to "please approve lost time only until the next day follow-up care."

Shortly after becoming aware of the use of the card, the BMWE contacted the Federal Railroad Administration and requested that the FRA advise the BNSF to stop using the card immediately because it interfered with the medical determinations and treatment provided by attending physicians rendering emergency care to injured BNSF employees. Use of the card was also in direct conflict with the BNSF Safety Assurance and Compliance Program (SACP).

The SACP Committee (comprised of management, labor and FRA members) had recently reached an understanding that prohibited supervisory personnel from being in an examining room while an injured employee is being treated unless the injured employee specifically consents to the supervisor's presence. The intent of this understanding is to end the practice of BNSF officials questioning or interfering with a doctor's medical determinations or prescribed treatment for the purpose of keeping the injury non-reportable under FRA criteria.

In February of this year, the FRA advised that it had completed an investigation of the BNSF Medical Help Desk card and the underlying protocols and expressed surprise at BNSF's use of the card since the FRA has discouraged the use of similar cards on other railroads. The FRA determined that the three statements printed on the card referred to above "have the potential to interfere with professional medical treatment of injured employees."

Although "the card and the separate 'protocols,' in and of themselves, do not constitute a violation" of FRA regulations because there is no required "instant case of an accident, injury, or occupational illness," the FRA advised that it shared concern with the BMWE over the use of the card. Therefore, they contacted the BNSF in early January and indicated the instructions on the card were in noncompliance with the intimidation and harassment prohibitions in FRA regulations and informed BNSF of their need to take prompt action to rescind the card.

FRA has also issued instructions to all FRA Operating Practices Inspectors to make them aware of the past use of this card and to monitor BNSF for compliance. For any intimidation and harassment complaints that come to their attention, inspectors have been informed to inquire whether this card was delivered by a BNSF supervisor to the medical treatment facility personnel in relation to the injured employee's case. If the card was delivered, inspectors have been advised to gather sufficient evidence to enable the recommendation of civil penalties against the railroad in each such case for noncompliance under FRA regulations.

BNSF indicated they would immediately rescind the cards and instruct all department heads that managers are not to deliver the Medical Help Desk card to any medical treatment facility.

If any member becomes aware of BNSF's continued use of the Medical Help Desk card, they should inform their system office and/or the Grand Lodge Safety Department.