 For the rest of the story on the Alaba Fire, we need to talk about one other topic that generally gets overlooked. That is, the protocol that should be in place to deal with burn injury victims. Grant Gifford and Josh Lang were transported after the shelter deployment on the Alaba Fire to a small medical facility in Hot Spring, South Dakota. They were stabilized and then moved to a regional hospital in Rapid City where Josh was treated and released and Grant was checked in for observation. What happened next was the beginning of a tedious paperwork process and a long road to recovery. I knew that I had some second degree burns to my hands and leg and arm and some on my face and is what ended up, my left hand was true second degree and I actually had third degree on my right hand and I knew that my right hand was by far worse but that point in time I didn't really, to me everything was okay because I was alive and I was able to see my family. I wasn't really concerned about my burns. I knew that none of them were fatal and I was going to make it through it. Grant was at Rapid City Regional Hospital for four days battling a 104 degree temperature. He was assigned to a plastic surgeon to care for his burns. Then they released me and they want my wife to change my dressings and to breed me daily and we already have three kids and we're about ready to have our fourth child and to me that wasn't an option. So they set it up that our local family practitioner could debride my wounds and change me every day which was good because it was very painful and I don't know how to describe how much pain you get when somebody is scrubbing on your burns to try to clean up and then rewrap and took quite a bit of morphine every day to go through that process. About three weeks into it, every week, once a week I had an appointment with the plastic surgeon to check. My last appointment with him, when I arrived at his office my right hand had completely locked out. I could not move my right hand, not even wiggle my fingers. At that point in time I started to get pretty actively engaged in my own recovery and then he only spent about five minutes in the room and he left and we made the nurse bring him back in and I had some pretty specific questions for him that, you know, do I need to start physical therapy? No. I wanted to know when this wound was going to be healed and when I'd be able to go back to work and he kind of laughed at me and said maybe next year and he walked out of the room and at that point in time that's when I realized that this guy has no clue what I'm going through and doesn't know burns well enough to be treating me. I was afraid that if I wasn't having something done immediately on my right hand I may lose all movement of it for the rest of my life and that hit home pretty quick and at that point I called the forest FMO, Todd Pechota and told him what had happened and told him that I needed to get to a verified burn center. So the next day we left for Denver and once I got into the burn center there's several doctors there, you know, the primary surgeon and his residents and a specialized physical therapist that deals with burns on a daily basis and I spent about the next eight hours being evaluated and the physical therapist was, you know, torturous but she freed up my hand and the big concern was, you know, with the severity of the burn on top had I messed up tenons due to heat damage and that's what they were really evaluating is what was the internal damage to my hand from the burns and just getting it freed up and moving it again because, you know, three weeks they were both bandaged up, couldn't move them and that's the way they stayed. Another burn victim we talked to was Mariah Lucian. Mariah sustained burns when she was trying to outrun a rapid increase in fire behavior as her crew was burning out the top of a ridge line on the Po Cabin fire this last summer in Idaho. During her escape the fire crested the ridge and blew over her location. Mariah was transported with two other injured firefighters to the emergency room in Boise, Idaho. And then all this was blistered up and then there's a big blister here. It was basically all of this and up and along here and then all that was blisters. The entire night this was a very uncomfortable night and just coming out of the burn is you can smell yourself burning and it's disgusting but they just popped and refilled. I don't know how many times they did it for quite a while. They just popped and refilled until they were finally scrubbed down at Harborview. And you might just think well those are just blisters or get popped, heal up, no big deal. It's just like something on my foot but it's not that way at all. They need to heal from the inside out. One of the reasons I wanted to get to a burn center so much was the fact that I'm an EMT and I know that at least that burns, you know, they're sterile for the first 24, 48, 72 hours after that the risk of infection is huge and you need to get treatment for them. You know I thought I could give the system a chance to let it work. I had originally when I was at Rapid City Regional the first time I talked to this plastic surgeon I asked about a burn center and he laughed at me and said that, you know, there's no burn center in the US that would take you. Well I learned otherwise from that. Talking with this burn surgeon he said, you know, if it's not bad enough to treat EMT we have outpatient therapy. We'll take care of you. He says I look at bad send burns. That's my job. Because it was three weeks after the fact. He told me that if I would have been there I probably would have had skin grafts done and been admitted right away to my right hand. In Mariah's case she was released from the emergency room and flown to her family in Spokane, Washington. The doctor admitted he released me from the emergency room on the condition that I sought to see a burn center in two days. So from there my primary objective was I wanted to go home and see my family. What I thought about that night, I guess I thought that the forest, I guess I was kind of naive in the process that I thought the forest was going to, it would be covered. Everything would just go smoothly. It's not exactly a smooth process at all. Generally taking into the fact that OWCP and the U.S. Forest Service and all this is a separate thing that works separate and it wouldn't be a smooth process going through it. I pretty much figured that all the paperwork would be, you know, I wouldn't have to deal with any of that stuff. I'd go to the burn center and do it, you do it the burn center. You wouldn't have to deal with it. I pretty much figured that, and there is a Forest Service liaison for this stuff, but I basically, she gave me the OWCP name, representative name, and I went and I basically did all the phone calling and all the groundwork to get myself to that burn center. Whereas it seems like the two, you're the person that's hurt, you shouldn't be doing that stuff. You're supposed to be recovering and going through mentally and emotionally physically what you need to heal, not going through paperwork. So I guess I figured that all that stuff was handled and in no way it was. Amount of paperwork, like I say in the National CA-1, CA-16, the referral to the Denver Burn Center, and then you're talking about travel to and from having to write down your travel voucher, medical expenses. Here you are driving from Custer to Denver now, and your bandage is leaking and you've got to change them. You've got to buy bandages. So you've got to keep all these receipts, keep the miles on your personal vehicle, motel receipts, food bills, everything has to go back in just to fill out, just like typical travel assignment with going to a fire. So all that paperwork's there. The OWCP claim number, your file claim number. You've got to have it when you check in at the Burn Center. You're going to have to have it when you get prescription medication and documentation of what the prescription was, what doctor assigned it to you. I found out in the latter part that held back part of my travel voucher. I was told that I was cleared to travel under 500 miles to the Denver Burn Center and then my travel voucher was denied. They said, well, you traveled outside the 500 miles, which wasn't true. It was 483 miles from my address to the front door of the Burn Center. But all this stuff, it's just this huge sinkhole, it seems like, that you get buried under. And then after three or four months, in comes all the medical bills that you thought these hospitals were sending it to OWCP. I don't know. I get a letter from Blue Cross insurance telling me, hey, were you injured at work on this or what? Do we need to pay the claim? Because they had already submitted it to my personal insurance. And then you get to hospital bills looking for you to come pay the bill. The radiology bill, the ER bill in Hot Springs, the ER bill at Rapid City, the hospital stay, the plastic surgeon appointments, the doctors that were changing my bandages and custer, everybody's billing you. The Burn Center is billing you. And just knowing what avenue to take with all those bills and who to fax it to with your clean number and say, hey, this is your guys' deal. You take care of it. I'm sick of getting hounded by bill collectors. And that's where, as an agency, we need to ensure that person has a point of contact and they stay on top of the bills. You know, why should somebody that's been burnt, that's trying to recover, have to be dealing with that? Getting an injured firefighter to a qualified burn center is fairly simple if the request comes from the emergency room attending physician. The transfer and transport are included in the initial emergency care. But if the patient is released from the emergency room, the process can get a little more complicated. One of the four programs administered by the Department of Labor's Responses of Workers' Compensation, or OWCP, is the Federal Employees' Compensation Program. When a federal employee gets injured on the job, this is the program that provides workers' compensation coverage for lost wages, medical care, and rehabilitation assistance. Now, as valuable as this program is, it is at this point that an agency can really help an injured firefighter by assigning someone to help the firefighter deal with this paperwork process. It's important to understand the OWCP process and how it's supposed to work. To help us explain this, we talked to Karen Nichols, a human resource specialist from the National Interagency Fire Center. A COMP coordinator should always be involved in your OWCP claim. They will facilitate getting that paperwork to OWCP. They can answer a lot of your questions that you may have, and they can assist you in the process that is required by OWCP. However, ultimately, it is always the employee's responsibility to ensure these things are done and to provide the required information. If once you've been released from the emergency room physician and you require follow-up care for your injury, you should go to a primary care physician and be referred to whatever specialist you need to be seen by. If the emergency room physician refers you to a specialist, that is all that's necessary. The best-case scenario would be you have a serious burn injury, you go to the emergency room, they recognize that this is a serious burn injury. They refer you to the burn center and you continue treatment. It's from there. That is all covered under the initial CA-16 and you would still do your follow-up with whoever is designated as your primary care physician. But those medical expenses would be covered straight from the time you went to the emergency room all the way through. Recovery. In the case of Mariah, she was released from the Boise ER under the condition that she would see a burn center within 48 hours. Because she was officially released, she was now unknowingly required under the OWCP process to get a referral from a primary care physician. This was Tuesday night, so Wednesday and Thursday. Thursday I got the OWCP claim number and called that rep. That rep then told me that I needed to go to a primary care doctor in order to get admitted to a burn center. I really don't have a primary care doctor because I live in two to three places during the year. We spent the entire morning on the phone trying to find a primary care physician that would want to see me because I wasn't a regular there. I wasn't exactly content with that because I was supposed to be seeing the burn center today. I didn't know how far this was going to be drug out and I'm going to see the primary care doctor on Friday. We got a week in coming up. I didn't know how they operated. I'm seeing eventually seeing the burn center on Monday or Tuesday of the following week. I wasn't really going to have any of that. My dad and I went up to the medical clinic and basically told them that if there was someone worse off than me that they could treat them, but we weren't leaving until they treated me. We filled out the paperwork and within 15 minutes the doctor was looking at me and the silly part is he looked at me and he said he didn't have any experience with burns that he was calling Harborview. He called Harborview five minutes later. He came back and said the Harborview wanted to see me and they wanted to see me tonight. Another avenue for assistance comes from a nonprofit organization called the Wildland Firefighters Foundation. Their main focus is to help families of fallen firefighters and assist firefighters and their families when they are injured. Where we've been able to intervene is to get families to the bedside, into the burn centers, into the hospitals. We have been able to educate some of the Forest Service staff on the intensity of the burns where they need to make decisions to help support get those kids to the burn centers. We've been able to get money to those families. We've been able to fly families and firefighters immediately. We make that stuff happen immediately. From that point we called Wildland Firefighter Foundation and Vicki had a ticket in two and a half hours to Seattle and we were admitted within five minutes at Harborview and the care at the burn center was phenomenal compared to Boise ER or the primary care place. I had a chest X-ray within two minutes and residents and doctors all around me helping me out. By 11 o'clock that night they had me drugged up and scrubbing down and debraiding all my blisters. The other thing is, is the avenue out there, Vicki, called the Wildland Firefighter Foundation. There's a ton of support there that she has that we don't. Just in supporting you with travel to actual, in my case I had to call her and get advice about OWCP and she has lawyers on retainer that know the system in and out and were able to advise me on what path I needed to take to get some of this cleared up. As a supervisor if I had somebody burn that's the first call I'm making to get done with our agency administrator is to Vicki because I know she'll be there to support the families on the other side of the table not just the firefighter. It is our hope that listening to this section has enticed you to look into your agency's protocol when dealing with a firefighter that has experienced a burn injury. Burns are different and we need to see to it that these injuries are handled by true specialists. It is also important, before an injury occurs that we have identified who the compensation claims specialist is on our local units that can help these firefighters through the process immediately after the injury and all the way through the recovery process. Burns are completely different. They can't be treated to level one trauma center or locally. They don't have the knowledge or the tool skill set. To me that speaks of itself. You can go anywhere in the U.S. and you're not going to get the treatment that you need for burns other than a verified burn center. Until we realize that we're going to have people that leave an E.R. because some doctor doesn't think that they're critical and it's going to cause them to have a longer road of recovery.