Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains Common Ways that Social Workers Endanger Their Licenses

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Social workers frequently work with their community’s most troubled and marginalized populations, often working closely with people suffering from addiction, poverty, and abuse to accomplish their goals. But these necessary aspects of the social worker’s job frequently expose social workers to accusations of misconduct. Because social workers often work one-on-one with clients, these allegations can be tough to defend.

If you are a social worker in Kansas or Missouri facing an investigation into your conduct, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Do not agree to speak with an investigator without an experienced attorney by your side. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot navigate alone.

Most Frequent Allegations Against Social Workers 

Boundary Violations—allegations of boundary violations arise when a social worker’s relationship with a client extends beyond a therapeutic relationship. Sexual and romantic relationships are clear boundary violations, but even a perceived friendship or connection on social media can give rise to allegations. With the rise of social media, I advise clients to have a strict rule that they will have no virtual or social media relationship with their clients.

Failure to Maintain Client Records and Case Notes—social workers often struggle under oppressive caseloads. Clients’ immediate emotional and safety needs can seem more important than paperwork. But maintaining client records is a vital and mandatory aspect of the social work profession, and a failure to keep up with case notes results in an inability to communicate across the therapeutic team. Have a system for documenting client interactions at the time those interactions occur or soon after. I frequently see social workers find themselves in the midst of an administrative investigation when they have tried to catch up long after a client meeting or when they created false records long after a client interaction has occurred. 

Working Outside the Scope of Practice—while social workers are all compelled to help those in need, that compulsion can result in licensure issues when the social worker wanders outside his or her area of competency. If you are trying to develop a new competency, seek and document mentoring, supervision, training, and education. The problem with working outside the scope of practice is that, without mentoring and training, you can easily make mistakes and not be aware you are making them, even when you are otherwise conscientious. 

Failing to Keep Up with Continuing Education Requirements—many disciplinary actions start with an allegation that a social worker was unable to keep up with required continuing education requirements and grow from there. Keep up with your continuing education requirements and document your compliance so that this issue never arises. 

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your social work license to lose it because you failed to adequately document your compliance with continuing education requirements or some other housekeeping issue.  An inquiry from a licensing board regarding your professional actions and decisions means that your livelihood as a social worker is in jeopardy. As the investigation progresses, you will need help in gathering and organizing evidence, hiring expert witnesses, cross-examining witnesses, among other tasks.  Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your clients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.

 

 

 

 

Missouri Professional Licensing Attorney Danielle Sanger Explains Missouri Dental Board Complaint Process

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Dentists enjoy tremendous respect from their patients and community because they are professionals providing a valuable service. The vast majority of dentists go through their career without any disciplinary issues, so they are often entirely unfamiliar with the complaint and discipline process here in Missouri. There are many reasons why these otherwise rule following dentists receive notices of complaints, which I will detail below. I will also describe the two different complaint resolution processes and what you should do if the Missouri Dental Board contacts you about a complaint.

If you are a dentist in Missouri facing an investigation, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Do not agree to any resolution process, speak to an investigator, or agree to any temporary suspension without the assistance of a licensing attorney. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot navigate alone.

Why Good Dentists Get Accused of Misconduct

As I said earlier, most dentists here in Missouri are law-abiding, rule-following pillars of their communities.  While some commit severe lapses in judgment that result in discipline, such as sexually abusing a patient or self-prescribing, others are accused of misconduct when they have done nothing wrong. I see an increase in cases linked to the nation’s opioid crisis. People are addicted to these drugs that may have been legitimately prescribed to them at some point. Others go to the dentist with phantom symptoms to convince the dentist that opioids should be prescribed. Either way, when the dentist stops filling out prescriptions for opioids, the patient often uses the Missouri Dental Board Complaint process as a tool to leverage more drugs. If the dentist refuses to prescribe more opioids, a complaint ensues.

The Missouri Complaint Process

In Missouri, a complaint to the Missouri Dental Board can be handled two different ways, either through the Peer Review Program or the Missouri Dental Board complaint process.

Peer Review provides an alternative dispute resolution mechanism, at no cost to either party. Peer Review is a where other dentists review and attempt to resolve dental treatment problems and misunderstandings through mediation. The process may involve merely talking through a complaint or may require a clinical review of the accused dentist’s practice. One important point to note is that you may not be represented by counsel in the Peer Review process.

The Missouri Dental Board process is more formal and operates more like a court. The dental board will notify the dentist of the complaint, investigate the complaint, and offer a hearing. The Dental Board will have legal counsel, and the accused dentist is well-advised to have counsel as well.  A licensing attorney is an asset before the Board, as few dentists know how to cross-examine witnesses, challenge evidence’s credibility and relevance, and understand how to proceed strategically through the administrative process.

What You Should Do if You are Contacted About Misconduct

Because most attorneys are law-abiding and rule-following members of their communities, they all-to-often believe that “coming clean” and admitting misconduct is the right thing to do when they are accused of misconduct. While that is an admirable worldview, it rarely results in the favorable outcome that the dentist intends. Let me be clear, I want my clients to tell the truth and to be forthcoming, but I want them to do those things strategically.  If you just admit to misconduct without accompanying legal advice, you are more likely than not hurting your case, not helping it. I advise clients to exercise their rights to remain silent and simply say that they will be happy to speak with an investigator once they have an opportunity to consult with an attorney. Having worked for boards myself, I know that this statement is never taken as nefarious by investigators; they also know that this is the best course to take.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your dental license to lose it because you failed to attain competent legal advice when you needed it.  If you are a Missouri dentist and you have received a notice of complaint from the Missouri Dental Board, you need to know that this is a dire situation and that the process could result in a loss of licensure.

An inquiry from a licensing board means that your livelihood is in jeopardy. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your patients or clients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Provides an Overview of the Nursing Complaint Process

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I have seen nurses’ lives and careers devastated because they agreed to a “voluntary suspension” of their nursing license or to speak to an investigator without the assistance of an attorney while the nursing board investigated allegations of misconduct. While the nurse under investigation believed that “playing ball” or helping the investigators would help their case, this seemingly positive action had tremendous negative consequences.

If you are a nurse in Kansas or Missouri facing an investigation that jeopardizes your professional license, call attorney Sanger today at 785-979-4353 to schedule a free consultation.

What Should You Do If an Investigator Contacts You?

If you are a licensed nurse in Missouri or Kansas and have been contacted by a state nursing board investigator, it means that a complaint was made against you. More troubling, it indicates that the state nursing board believed that the complaint had some merit and was worth investigating.  Former patients, former coworkers, or an employer can file a complaint against you. The complaint can be based on procedural grounds—you made a mistake or were negligent in treating a patient—or on ethical grounds.  Ethical grounds cover behavior within and without the treatment context, such as having an inappropriate relationship with a patient or getting charged with a crime.

What Can I Expect Now That an Investigator has Contacted Me?

If a nursing board investigator contacts you, the board has found enough evidence of wrongdoing to warrant further inquiry into your conduct. The investigator’s job is to find out the facts by interviewing witnesses, requesting documents, and reviewing treatment records. They will request a meeting an interview with  you. They commonly require that you submit a written statement describing the incident that led to the complaint. For each of these stages, you will benefit from having the assistance of an experienced licensing attorney’s help. I previously advised these boards and have seen how poorly drafted statements and incomplete records resulted in devastating results for nurses who tried to “go it alone.” Even small improvements based on years of experience can mean the difference between a dismissal and a finding.

What Happens After the Investigator Finishes His or Her Inquiry?

An investigation takes several months to conclude, depending on the complexity and availability of evidence. When the investigation ends, the investigator submits a summary report. Further action, including discipline, is decided based on the summary report. Discipline may include:

Dismissal– This is the best outcome. This results when the nursing board determines that the behavior alleged does not rise to the level of a violation.

Private Caution Letter– This outcome is not as good as a dismissal, but is favored over discipline. A caution letter involves the board privately admonishing and warning the nurse under investigation that his or her conduct—while not warranting discipline—was imprudent or unwise. The board will remind the nurse under investigation of applicable rules and laws governing the profession.

Formal Complaint –This outcome should be avoided at all costs. It involves the board finding a regulatory or statutory violation. The nurse under investigation often has the option to sign a consent agreement or may refuse to sign the consent agreement and instead request a full hearing before the board. If the nurse signs a consent agreement, he or she agrees that a violation occurred and to a set penalty. If the nurse goes before the board, they have another opportunity to challenge the investigation’s validity and to contest the investigator’s findings.  The board will then punish the nurse as they see fit.

As the above process indicates, the investigator’s findings and recommendations will determine the course of action in your case. The matter could be resolved quickly and favorably or may be drawn out. Having an attorney with experience before the board is invaluable at this step. Do not let an investigation ruin what you have worked so hard to build. If a state nursing board investigator has contacted you, seek the help of an experienced licensing attorney immediately.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your nursing license.  If you are a nurse under investigation, do not agree to any suspension of any kind or speak to an investigator without an attorney to defend you. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot navigate alone. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your patients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney prepared to guide you through your with licensing issues.

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains the Kansas Pharmacist Complaint and Investigation Process

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Given the opioid crisis occurring in the United States and the uptick in complaints against pharmacists, I have recently defended pharmacists accused of violations here in Kansas. As someone who actually provided legal advice to medical boards in the past, I can also tell you that I have seen well-meaning professionals have their lives destroyed because they decided to try to represent themselves. No matter how seemingly inconsequential your case seems, attempting to represent yourself is a massive mistake. Because I have seen a rise in the number of chiropractor complaints over the years, I wrote the following blog post and attached a Kansas Board of Pharmacy overview for your review.

If you are a chiropractor here in Kansas facing an investigation that jeopardizes your professional license, call attorney Sanger today at 785-979-4353 to schedule a free consultation.

You Have a Constitutional Right to Due Process

The Kansas Board of Pharmacy is an administrative arm of the State of Kansas. So when the Kansas Board of Pharmacy begins actions that could result in the loss of your license, that is the state acting to take your property from you. Any time the government acts to restrict your life, liberty, or property it must first provide you with “due process,” a legal term that means you must have an opportunity to know the allegations against you, to review the evidence underlying those allegations, and to have an opportunity to “confront” that evidence in a meeting with an investigator.

While you could probably struggle through an investigation on your own and could likely even sit through a hearing, you want someone by your side that has been through hundreds of proceedings like yours. A licensing attorney can challenge the state’s evidence and can even have it excluded. Similarly, a licensing attorney can effectively cross-examine witnesses and access expert witnesses that can help your case.

The Initial Stage of an Investigation

Most reports received by the Kansas Board of Pharmacy come from consumers as formal complaints, but there are a host of other sources.  Some complaints originate with employers, the court system, law enforcement, neighbors, relatives, or other agencies. Once a complaint comes in, an investigator is assigned to begin gathering facts and evidence. It is vital that you remember that you have the right to legal help throughout the investigative process.

What Does an Investigation Look Like?

State investigators from the Kansas Board of Pharmacy will review medical records, personnel records, agency records, and records of discipline on licensing from other states. They will conduct interviews of witnesses and take their statements. It best if you have documents ready and organized for the investigator’s review and do not make them search for them; obviously, this promotes an air of transparency that can only help your case.

You will also have an opportunity for an interview. It is crucial that you have an experienced licensing attorney help you prepare for your interview and be by your side as it is conducted. This is also an opportunity to provide exculpatory and mitigating evidence to the investigator, and your attorney will help you collect the evidence that is most persuasive.

The investigative process takes six to nine months to complete. Factors such as the availability of evidence, cooperativeness of witnesses, and case complexity influence how long an investigation will take.

What Happens After the Investigation?

The investigator’s work is not complete once the investigation is complete.  The investigative summary and file are forwarded to the Kansas Board of Pharmacists and is reviewed by the Investigative Member of the Board, who decides what disciplinary action should be taken.  Options include, but are not limited to 1) revocation, 2) probation, 3) monetary fines, 4) non-discipline probation agreements, 5) agreements to obtain specific CE courses, and 6) referrals to the impaired provider program.

The Kansas Board of Pharmacy will notify you once they decide your discipline. The Board must approve whatever disciplinary action is recommended against you. While this may seem like the end of the road, it isn’t. You still have an opportunity to appeal this decision to the Kansas courts. However, agency decisions such as disciplinary decisions are given great deference by the courts, so it is more effective and much cheaper to work with an experienced licensing attorney to reduce your discipline at the investigation or Board level.

Contact an Experienced Kansas Licensing Attorney Now

You have worked too hard to attain your pharmacy license.  If you are under investigation, do not agree to any suspension of any kind or speak to an investigator without an attorney to defend you. Your livelihood is at risk, and the challenge facing you is one you cannot navigate alone. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your clients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney prepared to guide you through your licensing issues.

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Provides a List of Tips for Nurses Under Investigation

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Receiving a certified letter from your state licensing board indicating that they are opening an investigation into your performance as a nurse is a harrowing experience. Most nurses I know go through several stages of emotion—terror, embarrassment, anger, and fear are all common. I have helped hundreds of similarly situated nurses through this process and can assure you that many of those representations, while stressful, had positive outcomes. While I cannot provide specific legal advice for every possible situation in a blog-post, I thought it would be helpful to give an overview of general counsel that I regularly offer nurses who call me frantically upon opening a letter indicating that they are about to be investigated.  The list of general tips follows.

If you are a nurse in Kansas or Missouri facing an investigation, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Do not agree to speak with an investigator without an experienced attorney by your side. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot navigate alone.

Advice for Nurses Receiving Notices of Investigation

  1. Hire an experienced licensing attorney immediately. The biggest mistake you can make now is trying to “go it alone” or to “work with” the investigators. Both of these are horrible strategies that routinely result in catastrophe.  Hire an expert to help you gather evidence, deal with investigators, and present the best picture of your actions.
  2. Focus on telling the truth and being transparent. Like most things in life, it is far more serious to be caught lying than caught making a mistake. Given the extensive record keeping in most medical facilities, it is extremely unlikely that you will get away with any lie you tell, and the ramifications of lying are usually significant.
  3. If you have one, contact your professional insurance carrier. If you do not have one, it is too late to attain insurance for whatever conduct is being investigated.
  4. Keep silent. As you have seen on television, “anything you say can and will be used against you.” This is a serious situation and is no time for posting about your problems on social media. All too often I see my clients’ unfortunate statements, written in a period of anger or frustration, come back to haunt them as admissions in administrative hearings. Do not speak about your case with coworkers or friends either; any of these people can be called as witnesses to testify about your statements.
  5. Do not copy patient records, even if you need them for your defense. A licensing attorney can attain the documents you need when the time comes to put on your defense. Making copies of or otherwise improperly accessing patient records is likely a HIPAA violation and will further harm your case.
  6. Do not speak to investigators, former patients, or family members of former patients. These folks are likely fishing for information from you; speaking with them hurts your case.
  7. If an investigator contacts you, refer the investigator to your attorney and do not make any statement.
  8. Remain professional. You are a member of a profession honored for its professionalism. While you may have every right to be frustrated or angry, now is not the time to give investigators the impression that you fail to meet the standards of your profession.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your nursing license.  An inquiry from a licensing board means that your livelihood is in jeopardy. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your patients or clients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.

 

 

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains: Most Common Reasons for Chiropractor Discipline

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Chiropractors are a vital part of the medical community. That said, like any other medical professional, they face scrutiny from licensing boards and have false allegations made against them from time to time. They are obviously human as well and are susceptible to mistakes in judgment. I have much enjoyed my representation of chiropractors, and am often asked by my chiropractor clients about what the most common reasons that their peers find themselves before the state licensing board. I have drafted this post to answer that question.

If you are a chiropractor in Kansas or Missouri facing an investigation that jeopardizes your professional license, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot work your way through this alone.

Most Common Reasons for Chiropractor Discipline

Insurance Fraud: Medicare fraud is the most common reason chiropractors lose their licenses. Insurance fraud can be committed by engaging in fictitious billing for services that were not rendered and prescribing unnecessary procedures.

Negligence/Malpractice: An allegation of negligence/malpractice arises when a patient alleges that a chiropractor failed to meet the standard of care for a procedure and the patient suffered an injury as a result.

Criminal Convictions: A criminal conviction may result in a licensure action, but it often depends on the type and severity of the conviction. For example, a conviction for reckless driving is unlikely to have any effect on a chiropractor’s license, but a conviction for illegal drug distribution most likely will.  Similarly, any conviction that suggests that the chiropractor may not be safe with the public or the public’s money, such as convictions for sexual assault, domestic violence, or fraud, may trigger a suspension action.

Sexual misconduct: Chiropractors should not have a sexual relationship with a patient.  This is strictly enforced. What I commonly see is a consensual relationship that started gradually and in conjunction with treatment. When the relationship was going well, the chiropractor thought there was no harm in pursuing it; however, when the relationship was discovered or ended, a complaint arose.

Illegally Prescribing Medications: There is an opioid epidemic in the United States right now, and some of its cause is medical professionals who overprescribed addictive drugs or provided prescriptions to drug-seeking patients who were already addicted. Be scrupulous in your prescription practices to avoid allegations of misconduct.

How Can a Chiropractor Prevent License Suspension or Revocation?

While an allegation may have been made against you, that does not mean that you will be suspended. Before you can have any disciplinary action taken against you, you must receive “due process,” meaning that you must receive the specific allegations against you, the evidence supporting those allegations, and an opportunity to prevent your version of events and evidence at a hearing. With the help of an experienced licensing attorney, you can often have the allegations against you dismissed or reduced. Going through this process alone is foolhardy.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your chiropractic license.  An inquiry from your licensing board means that your livelihood is in jeopardy. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your patients or clients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains Why Physicians Should Think Twice About “Voluntary Suspensions” of Medical Licenses

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I have seen physician’s lives and careers devastated because they agreed to a “voluntary suspension” of their medical license or a restriction on their license while the medical board investigates allegations of misconduct. While the physician under investigation believed that the voluntary suspension would be brief and that it would put them in a good light with investigators, both assumptions were incorrect. In fact, the suspension lasted far longer than initially hoped, and agreeing to the voluntary suspension ended up having a host of negative consequences.

If you are a physician in Kansas or Missouri facing an investigation that jeopardizes your professional license, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Do not agree to any suspension of any kind or speak to an investigator without an attorney to defend you. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot navigate alone.

Expect Suspensions to Last Longer Than Promised

Physicians under investigation are sometimes asked to sign an Interim Stipulated Order (ISO) or Interim Consent Order (ICO) accepting a voluntary restriction on their license or, even worse, suspending their practice pending the outcome of the investigation. These requests are usually accompanied by a suggestion that the suspension will be brief. However, these investigations often take a year or longer, especially in the case of physicians. Additionally, there are other ramifications of a “temporary suspension,” such as:

Reports to the National Practitioner Data Bank (NPDB)

If you consent to an interim restriction on your license, that restriction will be reported to the National Practitioner Data Bank (NPDB). You will have to deal with any consequences of the report to the NPDB on your career, even though no allegation has been proven.

Withdrawal of Board Certification, Credentialing, and Employment

If your medical license is temporarily suspended, you should anticipate that your board certifications will also likely be withdrawn. The suspension of the license and withdrawal of board certification will frequently result in an employer terminating the employee as well. Accordingly, a voluntary suspension ends up being a death sentence for your career.

DEA Registrations

If you are a prescribing physician, you must also consider the serious impact of a restricted license on your DEA Registration. To hold a DEA Registration, the Drug Enforcement Administration (DEA) requires every DEA Registrant physician to possess a medical license granting state authority to prescribe controlled substances. So if you agree to a restriction on your prescribing privileges or consent to voluntarily withdraw from your medical practice while you await the outcome of an investigation, you should anticipate a request to surrender your DEA Registration. 

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your professional license.  If you are a physician under investigation and your licensing Board requests that you consent to restrictions on your medical license, you need to know that the restriction will probably last more than a few months and there are numerous other consequences to consider depending upon your type of practice and level of licensure.

An inquiry from a licensing board means that your livelihood is in jeopardy. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your patients or clients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.

 

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains the Effects of a DUI or DWI on Your Career as Medical Professional

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In Kansas, it’s called a DUI. In Missouri, it’s called a DWI. Either way, it can spell big problems for your career as a medical professional. I have helped many medical professionals through the licensure and employment issues associated with an arrest for driving while impaired and can help you as well. But too many professionals fail to attain the help of an experienced licensing attorney when they receive a notice of investigation or violation.  This failure ends up making the state’s job far too easy. Because I get so many calls asking about the career effects of a DUI/DWI conviction, I wrote the following blog post to explain the many ramifications.

If you are a professional in Kansas or Missouri facing an investigation that jeopardizes your professional license, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot work your way through this alone.

The Effects of a DUI/DWI

There is no question that a DUI/DWI conviction can have a significant impact on your life. While for some people it is a sign that they have a drinking problem, for others, it signifies a one-time mistake in judgment. Regardless, it has a greater impact on those in the medical field than those in other professions, as medical professionals have a heightened responsibility to appear free from intoxicating substances and often have state licensing boards that look unkindly on any criminal conviction.  Having advised countless medical professionals regarding their recent arrest for DUI/DWI, here are the most common effects:

Professional Licensure Loss, Suspension, or Discipline– A medical professional often has to report an arrest and usually must report a conviction to his or her licensing body. You will want to consult with an experienced licensing attorney before making the report. You want to avoid doing more damage than you have to in making this report, and an experienced attorney that has a relationship with the board can help you frame the issue in a light most favorable to the license holder.

Contractual Requirements—Many medical employers see a DUI/DWI arrest or conviction as a signal of an employee with a substance abuse problem. Many hospitals and clinics require employees to disclose any arrest within a certain amount of time. Again, this is the sort of disclosure you want to make with the help of an experienced licensing attorney. Having worked with many medical professionals on similar issues, a skilled attorney likely knows how to disclose in a way least harmful to your career.  That said, some employers make criminal charges a ground for suspension or even termination, so you will want to review your employee handbook with your attorney as well.

Lack of transportation—While your DUI/DWI is pending, you will likely be prevented from driving for a period, often months. This is an inconvenience and makes getting to and from work difficult. It can also be independent grounds for termination if your position requires a valid driver’s license.

Leave Issues—An arrest for DUI/DWI will likely require your presence at least one or two hearings. If you go to trial to contest your case, you will likely spend another few days in court. If you are convicted, you may have to serve days or weeks in jail depending on the severity of your case. Even if you accept a plea agreement, that too will require a hearing. In the end, you may have to miss several days of work, which your employer may not look upon warmly.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your professional license.  Whether it is a medical, counseling, nursing, accounting, veterinary or any other type of license, a DUI/DWI can mean that your livelihood is in jeopardy. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your patients or clients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains: Is My Licensure Case Criminal or Civil?

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Medical professionals often come to my office for a consultation and one of the first questions they ask is “is this a criminal or civil?” I don’t blame them for being confused, as depending on the conduct in question, it could end up being civil, criminal, or both. Because I so often get questions about the intricacies of these matters, I have written the following blog post to explain the difference between civil and criminal matters and the legal implications of your disciplinary board matter.

If you are a professional in Kansas or Missouri facing an allegation of misconduct or an investigation, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot work your way through alone.

The Difference Between Civil and Criminal Matters

To start the basics, a civil matter is one where the state seeks to take some “property” from you.  Now, you may think of property like physical property such as a car or land, but you also have a property interest in your license as a medical professional. You also have a property interest in your good name and reputation. You’ll remember from the U.S. Constitution’s 5th Amendment that the federal government cannot take your life, liberty, or property without due process of law.  The same holds true for state governments.  As a result, the state cannot take your professional license or your interest in your reputation without “due process.” Due process means an opportunity to know what the accusations are against you, an opportunity to review the evidence against you, and a hearing where you and your attorney can confront or attack those accusations and evidence with your own evidence. A civil matter may result in having some property—like your license—taken or suspended or having a fine imposed.

Criminal matters involve having your liberty taken by the state—they result in the accused going to jail if he or she is convicted.  A district attorney files a criminal matter in court, and you would usually learn of the charges by being served by a police officer or by being arrested. Because a loss of liberty, incarceration, is viewed as a more severe deprivation, more due process is required.  The standard of proof—beyond a reasonable doubt—is higher in a criminal case, a jury usually judges guilt or innocence, and the hearing or trial is much more formal.

If you receive a letter in the mail from a state administrative agency indicating that a licensure action or investigation has initiated against you, that administrative matter is civil in nature and not criminal. The letter signals that the state is starting your due process rights and alerting you to your opportunity to engage in that due process.

When Criminal and Civil Matters Overlap

If you have watched any amount of television, you have probably seen a crime drama where the criminal being arrested is given his Miranda warning of, “you have the right to remain silent, everything you say can and will be used against you in a court of law.”  While the crime drama may be just television, those rights are real.  That warning is relevant to you as well.

Take as an example, a pharmacist who is giving his relatives opioids for their pain without a prescription. If the state pharmacy board is alerted to this practice, the pharmacist will likely receive a notice of accusations in the mail, initiating his due process rights. That letter is a civil matter. If he is found to have violated the pharmacy regulations by a preponderance of the evidence—by a likelihood of at least 51%—he will have a civil penalty such as a fine, suspension, or license revocation. However, distributing opioids without a prescription is also a crime.

If the pharmacist in the above example admits in his civil hearing before the pharmacy board that he has been distributing opioids, that information can be used against him criminally. A statement made in a civil hearing, like any statement, can be used against you. The Assistant Attorney General who prosecuted the pharmacist’s licensing issue can simply hand the transcript of his admission to an Assistant District Attorney who can then charge the pharmacist with drug distribution.

As I stated above, the burden of proof in a criminal case is “beyond a reasonable doubt,” which is much higher than the civil hearing’s “preponderance of the evidence” standard. But if the pharmacist has admitted to distributing the opioids, that unequivocal admission will likely meet either standard.

As a result, a civil matter can easily turn into a criminal one if the conduct alleged violates both the state regulations that govern your medical field as well as the criminal statutes. While the example above dealt with opioid distribution, I have also seen civil cases transform into criminal ones in cases alleging sex with a patient, boundary violations, and financial transgressions.  Accordingly, it is a massive mistake to think you can handle your civil hearing alone or that you can play along with the investigation to make things go away. You are just digging yourself into a deeper hole and playing into the state’s hands when you attempt that sort of foolish strategy.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your professional license.  Contacting an experienced licensing attorney to help you through the misconduct hearing process, explain the criminal implications of any allegations against you, and can mean the difference between getting back to helping your patients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with nursing licensing issues.

 

Missouri Professional Licensing Attorney Danielle Sanger Explains Issues Surrounding Fifth Amendment Self Incrimination

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Professionals sometimes come to me with questions about “pleading the Fifth” in their hearings before licensing boards in Missouri. This concept comes into play when testifying truthfully might subject the testifier to criminal charges. While the U.S. Constitution guarantees all citizens the right to protect themselves from self-incrimination, Fifth Amendment protections are not a panacea. Deciding whether or not to testify is a complex decision and should not be made lightly. If you are even thinking about exerting your Fifth Amendment rights, you must seek expert legal help immediately.

If you are a professional in Missouri facing an investigation, call attorney Sanger immediately at 785-979-4353 to schedule a free consultation. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot work your way through this alone.

The Fifth Amendment

The Fifth Amendment of the United States Constitution guarantees that a person cannot be forced to testify against themselves in a criminal matter. Basically, a prosecutor cannot call a defendant to the witness stand and ask him or her whether they committed a crime. Importantly, a jury or court cannot hold that decision to remain silent against a defendant.

A hearing before a licensing board is not a criminal trial, however. While not a criminal prosecution, the United States Supreme Court held in Lefkowitz v. Turley, 414 US 70 (1973), that a person cannot be forced to testify in a civil matter such as a licensing hearing when the testimony could later incriminate them criminally:

A witness’ privilege against self-incrimination `not only protects the individual against being involuntarily called as a witness against himself in a criminal prosecution but also privileges him not to answer official questions put to him in any other proceeding, civil or criminal, formal or informal, where the answers might incriminate him in future criminal proceedings.’

 

Accordingly, you can “plead the Fifth” in a Missouri licensing hearing, meaning that you can refuse to testify. But is that a good idea?

Implications of Pleading the Fifth in Missouri

Remember, when you plead the Fifth, you are saying that your testimony may implicate you in a crime. While that tactic may be a wise one to avoid criminal prosecution, it is likely to be held against you in a licensing case.  That is a significant difference between a criminal and civil proceeding; your silence cannot be held against you in a criminal proceeding, but a civil proceeding such as a licensing board hearing can draw a negative inference from your refusal to testify.

Imagine you are a nurse and are alleged to have distributed opioids to family members illegally. In your licensing hearing, it would be wise to plead the Fifth Amendment to avoid serious criminal charges related to drug distribution. That said, in a civil matter, your decision to plead the Fifth may be used against you and will likely be taken as an admission by the licensing board. This adverse inference by the licensing board will likely cost you your license. Accordingly, taking the Fifth is a good way to avoid criminal prosecution, but is a strategy that will likely lead to negative consequences in the licensing context. It is never a decision to make lightly or without the help of experienced licensing counsel.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

If you are a professional facing criminal prosecution, you are likely also in jeopardy of losing your professional license.  Whether it is a medical, counseling, nursing, accounting, veterinary or any other type of license, an inquiry from a licensing board means that your livelihood is in jeopardy. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your patients or clients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.