"Every year there are more than 1 million injuries due to motor vehicle accidents in the United States. Many of these injuries are minor and go unreported. However, some injuries are serious enough to require extensive medical treatment, insurance and personal injury lawsuits.
There Is No Such Thing As An Independent Medical Examination
If you are injured from a motor vehicle accident, and make a claim against the driver who caused the accident, his or her insurance company has the right to have you examined by a doctor of its choice. This is variously called an ""independent"", ""adverse"" or ""compulsory"" medical examination. I refuse to use the word ""independent"" when referring to these exams, even though they are routinely referred to as IME's. I call them ""Insurance Medical Exams,""or better yet, DME's or ""Defense Medical Exams.""The bottom line is that these doctors are hired for one purpose and one purpose only - to either deny or minimize a claim.
Whatever it's called, the doctor who performs the exam will testify about your injuries for the insurance company. Make no mistake- the insurance company pays the doctor's fee. The doctor is examining you not for the purpose of treatment, nor to help you find relief from your injuries. Rather, it is the doctor's job to obtain information that will either allow the insurance company to terminate its obligation to pay your medical bills or to cast doubt on your claim of injury should your case go to trial.
This examination, and the doctor, are anything but independent. The insurance companies carefully and deliberately pick what doctors they want to perform specific evaluations. Most of these doctors have frequently done work for that insurance company and typically work for insurance companies exclusively. These doctors solicit business from the insurance companies by offering to do such 'independent' medical evaluations for them knowing that the insurance company will not refer patients to the doctor again unless the reports are favorable to the insurance company. This means that in order to stay in business, this 'independent' doctor, performing an 'independent' medical examination must be in the business of writing reports which negate injury claims, and serve only to bolster the insurance company's denial of your medical benefits. If this 'independent' doctor fails to write reports in accordance with the insurance carrier's specifications, then that doctor will not be referred any more cases to review from the insurance company.
Actions Speak Louder Than Words
Everything you do in the doctor's office will be observed and recorded by the doctor and his staff. The doctor often incorporates simple activities, such as sitting on the examining table or taking your shirt off, as part of their mobility testing. So, while you might think the doctor never saw you move, s/he did observe you take off your jacket and pull your shirt over your head, demonstrating certain mobility techniques. All of those observations are part of the exam, although not as obvious to you as other parts of the physical exam itself. Be particularly aware of surveillance persons in the waiting room. One particular insurance company, in a letter addressed to the IME physician preceding the exam, asked the doctor to ""watch"" you in the waiting room and document things such as opening up doors, sitting waiting for the evaluation, walking within the facility, etc. Sometimes the IME physician may even drop something on purpose to see if you bend to pick it up. Remain observant and watchful of everything you do when entering the offices of an IME physician. Stay seated and don't walk around.
Be On Time
Keep your appointment. Many insurance companies schedule exams through agencies that supply doctors who are willing to perform these exams for insurance companies. Your failure to attend the exam may result in your being responsible for payment of the doctor's fee or the suspension of payment of your medical bills.
Be Honest
Honesty is the best policy. The best way to ""connect"" with the doctor is to be polite, cooperative, and above all, truthful. If you lie or fake an injury during the exam, the doctor will recognize your deceit and mention it prominently in the report. Try to appear open and forthright by providing helpful and straightforward answers. Also, attempt to make eye contact whenever possible. Although you need to pay attention to the doctor's questions so you can answer them carefully, don't appear nervous. After all, you know the answers to the questions, so try to stay relaxed.
Prepare For The IME Exam:
Get organized! One way to strengthen your case and be more relaxed during the exam is to gather your thoughts so you can present your medical history in a logical and concise, but complete manner. Here are some topics you'll cover:
* Your medical history, including prior injuries;
* How the accident occurred;
* What areas of your body were injured;
* Your primary symptoms;
* When your injuries cause you pain;
* Movements or activities that aggravate your injuries and cause pain or discomfort;
* Treatment or medication that makes your injuries feel better; and
* Activities that have been affected or limited.
Review the summary before your exam, but do not bring the summary with you.
What the Doctor Looks For:
Once you are called in for examination the IME doctor will typically conduct a patient interview to learn the history of the accident and medical condition, and then conduct a medical examination. At some point in time, the IME doctor is also likely to consult other medical records provided before your arrival in relation to the plaintiff's (your) case. During this process, the IME doctor looks for a variety of factors about you, the injury victim, including:
General Appearance- The doctor will observe you not only during the examination, but while you walk in the examination room, how you stand, whether you have any difficulty climbing onto the examination table, whether you show any signs of distress while sitting on the examination table, how you dress and undress yourself, your weight and personal hygiene, and anything else that the IME doctor believes relevant to your injury or condition.
Meeting The Doctor- The IME doctor will ask questions to formulate opinions about your injuries. Be careful that you understand each question before you answer it. For
example, if the doctor asks, ""How do you feel now?"" you should find out if he wants to know how you feel that minute or at this point after the accident. You may feel pretty well at that particular moment, but may have had pain associated with your injury earlier in the day, so it's important to be specific and accurate in your answers. Take time to answer all questions carefully. If a question is unclear or confusing, don't be afraid to ask the doctor to explain or rephrase the question before you answer. If you make a mistake, correct it immediately. Avoid unnecessary elaboration. Remember that the doctor is hired by the insurance company to help its case. So, while you should always answer a question politely, honestly, and completely, don't ramble on or elaborate unnecessarily.
Signs of Deception- The IME doctor will typically be on high alert for any sign of deception or exaggeration, and can be expected to report any impression that you intentionally or unintentionally exaggerate any symptoms.
Objective Manifestations of Injury- The doctor will typically review any medical imaging studies, such as x-rays, MRI reports, CT scans, and EMG nerve conduction studies, to try to find objective manifestations of injury - that is, objectively measurable damage or injury to the plaintiff's body. The doctor will also evaluate whether your subjective symptoms of pain and discomfort are consistent with the objectively verifiable manifestations of the injury.
Subjective Manifestations of Injury- The doctor will often perform tests which require you to provide subjective indications of pain, discomfort, sensitivity or insensitivity. For example, a doctor examining for a lower back condition may have the patient perform a variety of movements which stretch or turn the back, and note the point at which the patient starts to report pain and the point where movement becomes limited by pain. The doctor may test the subjective manifestations in several ways, or at more than one point during the examination, to see if any claimed pain level or point of disability remains consistent.
Other Contributing Factors- The IME doctor can be expected to inquire about any other ailments or injuries, including any which have occurred prior to or since the accident, which may have somehow contributed to the injury, or aggravated the injury or impaired recovery since the time of the accident. The doctor will also likely address any lifestyle factors discovered within this process, such as drinking, smoking, overeating, and recreational drug use, which may somehow contribute to the injury.
What you should DO at an IME:
Be honest and cooperative with the doctor.
Be pleasant. At the same time, you should not behave in such a fashion that the doctor can say you were laughing during the examination.
Be concerned. Be serious. Be polite. Give the doctor accurate, but brief, history on how your accident or injury occurred.
Give the doctor an accurate history of your job details and what you do in terms of lifting, bending, stooping, carrying, and walking.
If the doctor asks you about any previous injuries or illnesses you had before the present one, be honest and tell him the nature of any injuries you had, and whether you had surgery in connection with those previous injuries. On the other hand, do not volunteer information.
If the doctor asks if you have had any previous injury claims, you should say to him, ""I've had previous injuries"" (if that is true).
If you are totally disabled, explain to the doctor that if there was any way you could be back at work, you would be there.
Keep copies of any document you fill out or sign at the IME's office. Don't assume the IME will keep your questionnaire. Many don't, and that may be the only proof you have that you told the doctor about some part of your medical history or injury. So keep your own copy.
This independent medical exam Doctor is going to ask you many questions in great detail. Keep in mind to answer his or her questions as simply as possible. Yes or no answers are the best you can give. Try not to elaborate on any subject. Never guess! If you are unsure or do not know the answer to a question, simply state ""I do not know"". If the physician is asking questions about your doctor, or your doctor's opinion, tell the exam doctor to look in the file that was provided to him or her, all that information should be in it. It is also ok, if you are uncomfortable, to tell the exam doctor that all of your injury information is also in the file. You can keep repeating this as much as needed. Independent medical examination physicians will try to get you to sing like a canary in hopes to get you to say something different.
Anytime this physician touches you or makes you do something that hurts tell him or her loudly! If you do not make it known that what is happening is causing you pain, the doctor will write in his or her report that the injured worker did not have any pain. Make your pain known!
Be aware that the doctor is sometimes performing the same test on you in more than one fashion and in more than one way. For example, the doctor may test your legs when you are sitting up and when you are lying down. This is the same test. Therefore, if you complain of pain inconsistently, the doctor is going to make note of it. Let the truth come out and you will obtain a more favorable report from the doctor.
Wear hand/arm braces and use any rehabilitative assistant devices like canes, walkers etc. at least two days before the exam, the day of, and two days after the exam. Be watchful and mindful you are likely to be under surveillance for these days as well. Look for strangers in your neighborhood or unfamiliar cars following you during that time period. If you are on good terms with your neighbors, ask them to alert you if they are contacted by anyone out of the ordinary. Insurance companies frequently use a ruse whereby they call you on the telephone and tell you they want to deliver some sort of mail or package. Be careful of strange phone calls.
During the course of your exam, without the doctor knowing it, keep track of the time the doctor spends with you and what is being done during each time period. For example:
2:00 p.m. Arrive at the doctor's office.
2:15 p.m. Appointment time
2:30 p.m. Go to examining room
2:40 p.m. Doctor arrives in examining room.
3:00 p.m. Interview ends, told to undress, doctor leaves
3:10 p.m. Doctor returns and begins exam
3:15 p.m. Examination over
3:20 p.m. Leave clinic
What NOT TO DO at an IME:
* Do not try to out-smart the doctor. They didn't go through all those years of medical school and residency to be fooled by someone who says ouch every time they move.
Those patients get less sympathy and even less credibility for their complaints.
* Do not volunteer any information not requested.
* Do not discuss who is at fault in your case.
* Do not discuss settlement of your case.
* Do not allow the doctor to take X-rays or conduct other diagnostic tests.
* Do not take any written tests.
* Do not go to any other doctors or facilities without your attorney's approval.
* Do not lie. That can undermine your whole case.
* Do not drive yourself to the visit. Try to have your spouse, friend or neighbor drive you.
* Do not talk about your accident, injuries, insurance company or case in elevators, common areas or doctor's waiting room.
* Do not wear dangling jewelry or earrings.
* Do not come to the doctor with hands that look they are dirty from working on a car or changing the oil.
* Do not come to the doctor with elaborately painted fingernails (especially if you are claiming carpal tunnel or any other type of chronic pain syndrome).
* Do not jump on and off of the examination table at the doctor's office.
* Do not come in tight jeans or cowboy boots. Men, don't come unshaven. Ladies, don't come with make-up on or wearing high heels.
* Do not leave the doctor's office in a running trot or quick walk and jump into your car, because the doctor is probably watching you from his or her window.
* Do not use medical jargon or fancy terminology when discussing your case or describing your symptoms. If you are complaining of a neck injury, don't twist your head back and forth when the doctor is moving about the room in an effort to follow his movements.
* Do not discuss money or any plans of retirement with the doctor.
* Do not discuss your marital situation. Your marital situation is not relevant to the present examination.
* Do not exaggerate your problems.
* Do not moan, groan and wince or grimace in pain every time the doctor touches you.
No matter how lightly or heavily the doctor may touch you, be natural.
* Do not ask the doctor for medication or pain pills.
* Do not talk to the doctor about the insurance carrier, attorneys or the adjusters.
If you have a bad back, don't bend down and untie your shoes. Wear loafers and kick them off/slide them on.
* Do not discuss with the doctor the amount of your claim or the amount of wages you used to make. Politely decline to do so by saying that the insurance company has that information.
* Do not discuss with the doctor whether you have any hearings coming up on your case.
* Do not discuss what you deserve for a settlement or your plans for spending the money you may get.
* Do Not Expect A Fair Report. While a few IME doctors are highly professional, and seek to actually provide an objective evaluation, the vast majority of them know that they are being paid by the insurance company, which pay their bills and expect that the position of the defense will be improved as a consequence of the IME report. If the IME doctor prepares a report you believe to be unfair, let your lawyer worry about it.
You need to be principally concerned with what your treatinghealth care providers tell you about your condition.
After the Exam Once the exam is over and you have left the doctor's office, prepare a written summary containing the following information in as much detail as possible:
* What the doctor said to you;
* What you answered;
* What, if anything, was dictated into a tape recorder by the doctor during the exam;
* What tests or procedures the doctor performed;
* How much time the doctor spent with you;
* What was done during each time period; and
* Any inappropriate or unusual questions or comments made by the doctor.
The doctor will prepare a report for the insurance company describing his examination of you, along with his findings and opinions. It is extremely rare for the doctor to determine that you were injured in the accident or recommend any further treatment
Try to remember what goes on during the exam in as much detail as possible, but don't take notes in front of the doctor or bring a tape recorder into the exam - that could make it appear that you are more interested in getting money for your injuries than in improving your health. It is extremely important to note the exact amount of time the doctor spends actually examining you because the doctor will prepare a detailed report regarding your injuries despite having only spent a short time actually examining you.
As soon as you are home, sit down and write down every detail you can recall of your exam(i.e. time spent with a nurse or doctor, questions asked by the doctor and your answers, tests performed by the doctor, etc.). We understand that you cannot remember everything, but do the best you can. Nonetheless, your attorney is most effective when he/she has as much information as possible regarding your case. You must provide that information to the attorney. He/she is your advocate, not your private investigator. You are their eyes and ears, so give them as much information as possible- after all, the insurance carrier is doing the same thing to opposing counsel."
Independent Medical Examinations (IMEs) - Not So Independent
Is the Supreme Court Really Supreme?
"President Obama and the Senate have confirmed Justice Sonia Sotomayor and Justice Elena Kagan to the Supreme Court. Gun owners, organizations like the NRA (National Rifle Association), and GOA (Gun Owners of America) were alarmed by these appointments and confirmations. The question is should they have been alarmed? Should any Sovereign American Citizen with Natural Rights be alarmed when a member of the legal BAR (British Accredited Registry) is confirmed to the Supreme Court? It does not seem to alarm us when Democrat and Republican attorneys of the BAR (British Accredited Registry) hold most of the positions in government, so what's the big deal surrounding who is nominated to the Supreme Court?
Allow me to explain why we should ALL be worried about the current legal system, which was implemented by Democrat and Republican members of the BAR in Congress. After the founding of our nation, the American people were supreme and sovereign. Fast forward a few hundred years; it is the attorneys in the executive, legislative, and judicial branches of government who appear supreme and sovereign. I don't know how you view these turn of events, but this ""change"" in sovereign status from ""We the people"" to ""Them the government"" does not seem good for America. Perhaps it is time we begin worrying about who sits on the Supreme Court and why they were placed there in the first place. Perhaps it is time the American people were supreme and sovereign again in the United States.
Mainstream Media and most government agents have convinced Americans the Supreme Court can ""change"" the Constitution by interpreting what it says to meet the needs of Special Interest groups and corporations. The Supreme Court cannot lawfully interpret the Constitution, but the ""perception"" they have the power to interpret the Constitution is why the NRA and GOA were alarmed when anti-Second Amendment Justices Sotomayor and Kagan were confirmed to the Supreme Court. In the United States legal Democracy, everything hinges on perception. That's why, in their legal Democracy, ""Truth is the perception of the Majority."" If governmental leaders still used the lawful Republic of the Founding Fathers, there would be no need for alarm when government agents take office. On the other hand, since we agreed to use the ""legal"" system created by the attorneys in the executive, legislative, and judicial branches of government, our freedom and liberty depend on uncovering the truth about the Supreme Court. Allow me to provide evidence of this all-important truth relating to the Supreme Court as well as our governments in general.
The power of the Supreme Court can be found in Article III Section 2 of the Constitution. It reads, ""The judicial Power shall extend to all Cases, in Law and Equity, arising under this Constitution, the Laws of the United States, and Treaties made, or which shall be made, under their Authority."" Article III Section 2 of the Constitution additional says, ""the supreme Court shall have appellate Jurisdiction, both as to Law and Fact, with such Exceptions, and under such Regulations as the Congress shall make."" The Founding Fathers did a good job separating the powers of government. What some of the Founding Fathers ""possibly"" failed to foresee is the separation of powers does not work when most governmental representatives in Congress and all Supreme Court Justices belong to the elite organization called the British Accredited Registry (BAR). Members of the BAR in the Supreme Court having the ""judicial Power"", and other members of the BAR in Congress having the ability to create ""Exceptions, and such Regulations"" to everything else could leave the American people with no ""lawful Justice"". Evidence and the state of our nation suggest Lady Liberty has been fed a lethal dose of ""legal Justice"" as America is controlled by members of the British Accredited Registry (BAR) at all levels of government...instead of controlled by the American people.
In his book, The Constitution That Never Was, Ralph Boryzewski points out the following (emphasis mine):
""The founding lawyers...had repeatedly seen juries refuse to convict their fellow citizens who were caught smuggling contraband goods to avoid paying the duties required by English law. The jury defied the supreme authority, the King of England. However, under their new constitutional system, the lawyers intended to put an end to such powers.
...They would continue to get themselves elected to the Congress...where they would enact the laws. They would continue as in England with Attorneys General and Districts Attorney to enforce the laws, and finally only lawyers could be judges who would interpret the law. With the power of the three departments in their hands, the lawyers could make themselves sovereign authority with better control over the people than the King himself.""
It appears Special Interest lawyers and attorneys have made themselves sovereign authority in the United States, ""with better control over the people than the King himself."" Because ""juries refuse to convict their fellow citizens"", we now have commercial ""Equity Law"" courts containing only Judges of the British Accredited Registry (BAR) with no ""Common Law"" jury present in court. Lack of a jury in court is a disturbing situation, but it might not be as bad as it seems. You see, the Special Interest controlled lawyers and attorneys in government and the Supreme Court have ""better control over the people than the King himself"" in their legal system using ""legal Justice"". Fortunately for the American people, our Natural Rights from God, the Universe, and Nature fall under the realm of ""lawful Justice"", which is outside the jurisdiction of Congress and the Supreme Court. Unfortunately for the American people, we have allowed Mainstream Media, government-controlled schools, and lying politicians with BAR cards to convince us our Natural Rights fall within their legal system. Please be aware there is a difference between the lawyers' and attorneys' legal system of equity used today and the Founding Fathers' lawful system of common law put in place when America was created. I won't go into the difference between legal laws and lawful laws within this article; I've written extensively on these issues in my book and Blog already.
The Constitution was written FOR governmental employees to follow when running the ""government"" of the United States of America, not FOR governmental employees to control the American people. It was not meant to be a document giving governmental employees ""better control over the people than the King himself"". Sadly, we've been brainwashed to believe it puts government over the people-especially when the Supreme Court is involved. Most of us have this erroneous belief because Mainstream Media and the attorneys in government want us to believe employees with British Accredited Registry (BAR) licenses control America...as they use the Supreme Court as the final RULING body. Look at all the Media hoopla when a new Supreme Court Justice is confirmed by Congress. I watched the beginning of C-SPAN's coverage of Supreme Court Senate confirmation hearings for Ms. Kagan with much amusement. One of my NOT so favorite Senators, Dianne Feinstein, said, ""the most powerful computer cannot tell us whether the Presidents power as commander in chief allows him to exceed the bounds of the Foreign Intelligence Act and other statutes in wartime; nor can they tell us congressional laws barring guns from the grounds of schools or implementing new Health Insurance requirements are within Congresses Article I powers."" Senator Feinstein is correct when she says computers can't decide these ""legal issues"". However, evidence suggests these ""lawful issues"" have already been decided in the Founding Fathers' Constitution. Feinstein wants you to believe the Supreme Court can lawfully RULE on ""congressional laws barring guns"" and Congress ""implementing new Health Insurance requirements are within Congresses Article I powers.""
Senator Feinstein is incorrect when she makes such legal, yet unconstitutional, allegations. Article I of the Constitution does not allow congressional laws barring guns; nor does it give government employees the power to force FREE Sovereign American Citizens to do anything that would violate our Natural Rights. Article I of the Constitution defines the powers of Federal Government to run the nation. It does not give government the power to violate our Natural Rights to be armed or force Americans to purchase government-controlled Health Insurance. That's why the attorneys in Congress need the attorneys in the Supreme Court to RULE in the government's favor when these issues are challenged in court.
As you can see, members of Congress wish to convince us the Supreme Court has ""better control over the people than the King himself"". Ralph Boryzewski was correct when he said, ""With the power of the three departments in their hands, the lawyers could make themselves sovereign authority."" Evidence suggests the Special Interest lawyers and attorneys have made themselves RULERS of America, but it's only a legal trick. For example, the Supreme Court knew it could not lawfully interpret the meaning of the lawful Second Amendment in the District of Columbia versus Heller and McDonald versus Chicago gun-control cases, so they gave us a legal interpretation instead. In the Senate confirmation hearing for Kagan, Senator Feinstein attempted to convince everyone watching the Supreme Court had the power to interpret the Constitution. She was very upset the current Supreme Court went against more than 70 years of anti-Second Amendment legal precedent in the District of Columbia versus Heller and McDonald versus Chicago gun-control cases. Feinstein didn't seem to care more than 70 years of anti-Second Amendment legal precedent to disarm Americans and cement ultimate control of the people violated your Natural Rights. Ultimate control of the people today is ""better control over the people than the King himself"" in the past because Americans owned guns to protect themselves from ""the King himself"" in the past. Senators like Feinstein would have the American people defenseless and helpless against their current legal government. That's why Feinstein wanted the Supreme Court to make the final RULE on gun-control, to disarm American Citizens, in the District of Columbia versus Heller and McDonald versus Chicago legal, yet unconstitutional, gun-control cases.
When dealing with the legal system, we must be aware none of the legal statutes passed by attorneys in government can violate our Natural Rights from God or override the Supreme Laws of the Land in the Founding Fathers' Constitution. Statutes violating our Natural Rights are unconstitutional, which means most legal laws legislated by government today are actually unconstitutional statutes. Why were most Gun owners, organizations like the NRA (National Rifle Association), and GOA (Gun Owners of America) alarmed by the appointments and confirmations of anti-Second Amendment Justices Sonia Sotomayor and Elena Kagan to the Supreme Court? They were alarmed because the lawyers working for the NRA and GOA went to the same law schools as the political attorneys attempting to RULE ""We the People"". Our current legal system of mostly unconstitutional statutes is the only game in town for lawyers and attorneys with BAR card licenses. These legal tricks have been implemented slowly over hundreds of years by certain elements within our government. The same government-controlled school curriculum teaching you government employees and Supreme Court Justices were sovereign over the people is brainwashed into lawyers and attorneys as well when they attend law school.
When lawyers and attorneys pass the BAR (British Accredited Registry) test and get their BAR license, the legal brainwash is complete. Most lawyers and attorneys in government no longer consider Americans possess lawful Natural Rights from God; these political attorneys in Federal, State, and Local government bestow us with man-made Civil Rights instead. If you have Civil Rights instead of Natural Rights, then the attorneys in the Supreme Court feel justified when they interpret the Constitution and RULE America from on high. Civil Rights can be RULED upon within the attorney's fictional realm, which was created by years of legal precedent setting court cases designed to give sovereignty to government while taking sovereignty from American Citizens. It's all a legal trick, but it works because lying politicians, the Mainstream Media, and government-controlled schools have conspired to hide the truth.
Congressional employees, like Senator Feinstein, wish you to believe the Kings and Queens sitting on the Supreme Court have the authority to decide all matters in controversy in the United States. The Special Interest controlled attorneys in Congress, like Senator Feinstein, want you to think the Supreme Court can interpret away the Second Amendment or any other Amendment in the Constitution. Do you believe the Founding Fathers would revolt against ""the King"" of Britain and later turn over control of America to attorneys of the Supreme Court with British Accredited Registry (BAR) card licenses from Britain? Most people think a person has to be a member of the British Accredited Registry (BAR) to sit on the Supreme Court. Of course, this is not the truth. Lawfully, normal American Citizens could become Supreme Court Justices, but don't hold your breath waiting for the attorneys in the Senate to approve your confirmation if you don't have a British Accredited Registry (BAR) license to RULE America using the legal mumbo jumbo that has replaced lawful law.
Can the Supreme Court interpret the Constitution and RULE on any issue? No way, the Supreme Court cannot lawfully interpret the Constitution; that would violate your Natural Rights and make the Supreme Court Kings and Queens of America. Still, there seems to be a real conspiracy afoot with lawyers and attorneys in government. Their plan to, ""continue to get themselves elected to the Congress...where they would enact the laws. They would continue as in England with Attorneys General and Districts Attorney to enforce the laws, and finally only lawyers could be judges who would interpret the law"" is being used to control our nation. I urge my readers to do your research. Look into the oaths of office sworn to by ALL members of government at the Federal and State levels-including the Supreme Court. This information can be found on the Supreme Court website. All our governmental agents swear an oath to uphold the legal Constitution of the United States of America, which is a different document than the Founding Fathers' lawful Constitution for the United States of America. This is yet another legal trick with Constitutions brought to us by most members of Congress, most Presidents, and most Supreme Courts over the last 100 plus years. These legal tricks were not designed to keep us safe; they were designed to take away our freedoms.
Evidence suggests Special Interest lawyers and attorneys have had much success making themselves the sovereign authority in the United States, ""with better control over the people than the King himself."" Members of the British Accredited Registry in Federal, State, and Local governments unconstitutionally control America using their legal system. If that's not horrific enough, Special Interest has the Supreme Court waiting in the wings to make a final RULING on our freedoms. The Founding Fathers did not create America to be RULED by nine Kings and Queens in the Supreme Court with British Accredited Registry (BAR) card licenses. The question is, now that you know the American people are the real Sovereign Kings and Queens of America, will you allow Special Interest attorneys and lawyers of the British Accredited Registry (BAR) to RULE America with legal laws that violate your lawful Natural Rights under God and the Universe? Allowing attorneys in government and Justices in the Supreme Court to keep their fictitious legal supremacy is leading the United States of America down the road to a form of legal slavery for its Citizens. The road to freedom demands the American people become supreme once more in America. Which road will you take now that you know the truth?"
Allow me to explain why we should ALL be worried about the current legal system, which was implemented by Democrat and Republican members of the BAR in Congress. After the founding of our nation, the American people were supreme and sovereign. Fast forward a few hundred years; it is the attorneys in the executive, legislative, and judicial branches of government who appear supreme and sovereign. I don't know how you view these turn of events, but this ""change"" in sovereign status from ""We the people"" to ""Them the government"" does not seem good for America. Perhaps it is time we begin worrying about who sits on the Supreme Court and why they were placed there in the first place. Perhaps it is time the American people were supreme and sovereign again in the United States.
Mainstream Media and most government agents have convinced Americans the Supreme Court can ""change"" the Constitution by interpreting what it says to meet the needs of Special Interest groups and corporations. The Supreme Court cannot lawfully interpret the Constitution, but the ""perception"" they have the power to interpret the Constitution is why the NRA and GOA were alarmed when anti-Second Amendment Justices Sotomayor and Kagan were confirmed to the Supreme Court. In the United States legal Democracy, everything hinges on perception. That's why, in their legal Democracy, ""Truth is the perception of the Majority."" If governmental leaders still used the lawful Republic of the Founding Fathers, there would be no need for alarm when government agents take office. On the other hand, since we agreed to use the ""legal"" system created by the attorneys in the executive, legislative, and judicial branches of government, our freedom and liberty depend on uncovering the truth about the Supreme Court. Allow me to provide evidence of this all-important truth relating to the Supreme Court as well as our governments in general.
The power of the Supreme Court can be found in Article III Section 2 of the Constitution. It reads, ""The judicial Power shall extend to all Cases, in Law and Equity, arising under this Constitution, the Laws of the United States, and Treaties made, or which shall be made, under their Authority."" Article III Section 2 of the Constitution additional says, ""the supreme Court shall have appellate Jurisdiction, both as to Law and Fact, with such Exceptions, and under such Regulations as the Congress shall make."" The Founding Fathers did a good job separating the powers of government. What some of the Founding Fathers ""possibly"" failed to foresee is the separation of powers does not work when most governmental representatives in Congress and all Supreme Court Justices belong to the elite organization called the British Accredited Registry (BAR). Members of the BAR in the Supreme Court having the ""judicial Power"", and other members of the BAR in Congress having the ability to create ""Exceptions, and such Regulations"" to everything else could leave the American people with no ""lawful Justice"". Evidence and the state of our nation suggest Lady Liberty has been fed a lethal dose of ""legal Justice"" as America is controlled by members of the British Accredited Registry (BAR) at all levels of government...instead of controlled by the American people.
In his book, The Constitution That Never Was, Ralph Boryzewski points out the following (emphasis mine):
""The founding lawyers...had repeatedly seen juries refuse to convict their fellow citizens who were caught smuggling contraband goods to avoid paying the duties required by English law. The jury defied the supreme authority, the King of England. However, under their new constitutional system, the lawyers intended to put an end to such powers.
...They would continue to get themselves elected to the Congress...where they would enact the laws. They would continue as in England with Attorneys General and Districts Attorney to enforce the laws, and finally only lawyers could be judges who would interpret the law. With the power of the three departments in their hands, the lawyers could make themselves sovereign authority with better control over the people than the King himself.""
It appears Special Interest lawyers and attorneys have made themselves sovereign authority in the United States, ""with better control over the people than the King himself."" Because ""juries refuse to convict their fellow citizens"", we now have commercial ""Equity Law"" courts containing only Judges of the British Accredited Registry (BAR) with no ""Common Law"" jury present in court. Lack of a jury in court is a disturbing situation, but it might not be as bad as it seems. You see, the Special Interest controlled lawyers and attorneys in government and the Supreme Court have ""better control over the people than the King himself"" in their legal system using ""legal Justice"". Fortunately for the American people, our Natural Rights from God, the Universe, and Nature fall under the realm of ""lawful Justice"", which is outside the jurisdiction of Congress and the Supreme Court. Unfortunately for the American people, we have allowed Mainstream Media, government-controlled schools, and lying politicians with BAR cards to convince us our Natural Rights fall within their legal system. Please be aware there is a difference between the lawyers' and attorneys' legal system of equity used today and the Founding Fathers' lawful system of common law put in place when America was created. I won't go into the difference between legal laws and lawful laws within this article; I've written extensively on these issues in my book and Blog already.
The Constitution was written FOR governmental employees to follow when running the ""government"" of the United States of America, not FOR governmental employees to control the American people. It was not meant to be a document giving governmental employees ""better control over the people than the King himself"". Sadly, we've been brainwashed to believe it puts government over the people-especially when the Supreme Court is involved. Most of us have this erroneous belief because Mainstream Media and the attorneys in government want us to believe employees with British Accredited Registry (BAR) licenses control America...as they use the Supreme Court as the final RULING body. Look at all the Media hoopla when a new Supreme Court Justice is confirmed by Congress. I watched the beginning of C-SPAN's coverage of Supreme Court Senate confirmation hearings for Ms. Kagan with much amusement. One of my NOT so favorite Senators, Dianne Feinstein, said, ""the most powerful computer cannot tell us whether the Presidents power as commander in chief allows him to exceed the bounds of the Foreign Intelligence Act and other statutes in wartime; nor can they tell us congressional laws barring guns from the grounds of schools or implementing new Health Insurance requirements are within Congresses Article I powers."" Senator Feinstein is correct when she says computers can't decide these ""legal issues"". However, evidence suggests these ""lawful issues"" have already been decided in the Founding Fathers' Constitution. Feinstein wants you to believe the Supreme Court can lawfully RULE on ""congressional laws barring guns"" and Congress ""implementing new Health Insurance requirements are within Congresses Article I powers.""
Senator Feinstein is incorrect when she makes such legal, yet unconstitutional, allegations. Article I of the Constitution does not allow congressional laws barring guns; nor does it give government employees the power to force FREE Sovereign American Citizens to do anything that would violate our Natural Rights. Article I of the Constitution defines the powers of Federal Government to run the nation. It does not give government the power to violate our Natural Rights to be armed or force Americans to purchase government-controlled Health Insurance. That's why the attorneys in Congress need the attorneys in the Supreme Court to RULE in the government's favor when these issues are challenged in court.
As you can see, members of Congress wish to convince us the Supreme Court has ""better control over the people than the King himself"". Ralph Boryzewski was correct when he said, ""With the power of the three departments in their hands, the lawyers could make themselves sovereign authority."" Evidence suggests the Special Interest lawyers and attorneys have made themselves RULERS of America, but it's only a legal trick. For example, the Supreme Court knew it could not lawfully interpret the meaning of the lawful Second Amendment in the District of Columbia versus Heller and McDonald versus Chicago gun-control cases, so they gave us a legal interpretation instead. In the Senate confirmation hearing for Kagan, Senator Feinstein attempted to convince everyone watching the Supreme Court had the power to interpret the Constitution. She was very upset the current Supreme Court went against more than 70 years of anti-Second Amendment legal precedent in the District of Columbia versus Heller and McDonald versus Chicago gun-control cases. Feinstein didn't seem to care more than 70 years of anti-Second Amendment legal precedent to disarm Americans and cement ultimate control of the people violated your Natural Rights. Ultimate control of the people today is ""better control over the people than the King himself"" in the past because Americans owned guns to protect themselves from ""the King himself"" in the past. Senators like Feinstein would have the American people defenseless and helpless against their current legal government. That's why Feinstein wanted the Supreme Court to make the final RULE on gun-control, to disarm American Citizens, in the District of Columbia versus Heller and McDonald versus Chicago legal, yet unconstitutional, gun-control cases.
When dealing with the legal system, we must be aware none of the legal statutes passed by attorneys in government can violate our Natural Rights from God or override the Supreme Laws of the Land in the Founding Fathers' Constitution. Statutes violating our Natural Rights are unconstitutional, which means most legal laws legislated by government today are actually unconstitutional statutes. Why were most Gun owners, organizations like the NRA (National Rifle Association), and GOA (Gun Owners of America) alarmed by the appointments and confirmations of anti-Second Amendment Justices Sonia Sotomayor and Elena Kagan to the Supreme Court? They were alarmed because the lawyers working for the NRA and GOA went to the same law schools as the political attorneys attempting to RULE ""We the People"". Our current legal system of mostly unconstitutional statutes is the only game in town for lawyers and attorneys with BAR card licenses. These legal tricks have been implemented slowly over hundreds of years by certain elements within our government. The same government-controlled school curriculum teaching you government employees and Supreme Court Justices were sovereign over the people is brainwashed into lawyers and attorneys as well when they attend law school.
When lawyers and attorneys pass the BAR (British Accredited Registry) test and get their BAR license, the legal brainwash is complete. Most lawyers and attorneys in government no longer consider Americans possess lawful Natural Rights from God; these political attorneys in Federal, State, and Local government bestow us with man-made Civil Rights instead. If you have Civil Rights instead of Natural Rights, then the attorneys in the Supreme Court feel justified when they interpret the Constitution and RULE America from on high. Civil Rights can be RULED upon within the attorney's fictional realm, which was created by years of legal precedent setting court cases designed to give sovereignty to government while taking sovereignty from American Citizens. It's all a legal trick, but it works because lying politicians, the Mainstream Media, and government-controlled schools have conspired to hide the truth.
Congressional employees, like Senator Feinstein, wish you to believe the Kings and Queens sitting on the Supreme Court have the authority to decide all matters in controversy in the United States. The Special Interest controlled attorneys in Congress, like Senator Feinstein, want you to think the Supreme Court can interpret away the Second Amendment or any other Amendment in the Constitution. Do you believe the Founding Fathers would revolt against ""the King"" of Britain and later turn over control of America to attorneys of the Supreme Court with British Accredited Registry (BAR) card licenses from Britain? Most people think a person has to be a member of the British Accredited Registry (BAR) to sit on the Supreme Court. Of course, this is not the truth. Lawfully, normal American Citizens could become Supreme Court Justices, but don't hold your breath waiting for the attorneys in the Senate to approve your confirmation if you don't have a British Accredited Registry (BAR) license to RULE America using the legal mumbo jumbo that has replaced lawful law.
Can the Supreme Court interpret the Constitution and RULE on any issue? No way, the Supreme Court cannot lawfully interpret the Constitution; that would violate your Natural Rights and make the Supreme Court Kings and Queens of America. Still, there seems to be a real conspiracy afoot with lawyers and attorneys in government. Their plan to, ""continue to get themselves elected to the Congress...where they would enact the laws. They would continue as in England with Attorneys General and Districts Attorney to enforce the laws, and finally only lawyers could be judges who would interpret the law"" is being used to control our nation. I urge my readers to do your research. Look into the oaths of office sworn to by ALL members of government at the Federal and State levels-including the Supreme Court. This information can be found on the Supreme Court website. All our governmental agents swear an oath to uphold the legal Constitution of the United States of America, which is a different document than the Founding Fathers' lawful Constitution for the United States of America. This is yet another legal trick with Constitutions brought to us by most members of Congress, most Presidents, and most Supreme Courts over the last 100 plus years. These legal tricks were not designed to keep us safe; they were designed to take away our freedoms.
Evidence suggests Special Interest lawyers and attorneys have had much success making themselves the sovereign authority in the United States, ""with better control over the people than the King himself."" Members of the British Accredited Registry in Federal, State, and Local governments unconstitutionally control America using their legal system. If that's not horrific enough, Special Interest has the Supreme Court waiting in the wings to make a final RULING on our freedoms. The Founding Fathers did not create America to be RULED by nine Kings and Queens in the Supreme Court with British Accredited Registry (BAR) card licenses. The question is, now that you know the American people are the real Sovereign Kings and Queens of America, will you allow Special Interest attorneys and lawyers of the British Accredited Registry (BAR) to RULE America with legal laws that violate your lawful Natural Rights under God and the Universe? Allowing attorneys in government and Justices in the Supreme Court to keep their fictitious legal supremacy is leading the United States of America down the road to a form of legal slavery for its Citizens. The road to freedom demands the American people become supreme once more in America. Which road will you take now that you know the truth?"
Why Men Lose in Family Court
"Like most individuals you have probably arrived at this article because you are looking for answers to a specific family law problem. Hopefully this article will help motivate you to take the necessary steps to resolve your issues.
The subject of this article is ""Why Do Men Lose in Family Court?"" I have spent the last 20 years attempting to answer this question. After considerable research, case evaluations and client interviews I believe I now have the answer.
Nineteen years ago I went through a brutal divorce. Actually, at the time of divorce we were very friendly with one another and agreed to settle out of court. My Ex-wife, through a paralegal filed for divorce and like most men I simply agreed to the terms. I walked away with nothing! I surrendered the house, ($40,000.00 in equity) the boat, the car, furniture etc. etc...Everything I had acquired in 13 years of marriage was suddenly gone. We had three children and I wanted them to have the benefit of these items. Although I didn't realize it at the time I could have and should have made better agreements that would have benefited all members of my family in a much greater way. Looking back I simply didn't know what a good agreement was or how to make the deal. I was so concerned about maintaining a good relationship with my ex that I avoided anything that might have resulted in a legal battle. I should have filed my response with the court and requested an equitable division of property, custody, visitation and a support order that was based on my Real income. In general I should have been more attentive to the legal issues. This was truly a mistake!
Like most men I had adopted the common belief that men always lose in divorce proceedings so why not just surrender everything now and avoid the inevitable. What I didn't realize at the time was that I wasn't doing anyone any favors by surrendering everything to my ex-wife. Ignorantly giving up my property caused my wife to develop a false confidence in the legal system that would soon allow her to sue me again and again and again. Like many women she understood the prevailing thought of men that they always lose in family court and she capitalized on this belief. Therefore it didn't matter any longer how much I had given to her the fact that I didn't know what I was doing was extremely obvious. Despite everything I had surrendered, ignorantly failing to make fair and equitable agreements at the time of my departure from the family home was a colossal mistake and was a personal invitation for her to sue me later. I would in time realize that money and property are no substitute for a well-written, fair and equitable agreement of ALL issues. Like the American Express advertisement declares ""Don't leave home without it!""
I had also surrendered a number of other rights simply because I was ignorant and wasn't aware of the significance of these rights. Mainly rights to my children. I had mistakenly believed that women always get custody of children and Dads always get the standard every other weekend visitation schedule. In fact I was so ignorant I actually thought this was the law! Little did I realize that even after I had given everything I had I would still have to give more.
About 2 years later I acquired a new love interest and our ""friendly divorce"" turned into a legal nightmare! She went to an attorney and was advised to take me back to court to increase child support, decrease visitation, contempt of court and a host of other issues. Not knowing any better I went to an attorney, paid a $3500.00 retainer fee and went to court. It was my belief that we had fairly resolved all of our legal issues in the beginning and I really didn't understand why she wanted more or how she could get more.
After 3 court hearings and an additional $3000.00 in attorney fees (total $6,500.00) later I had gotten my butt kicked! My attorney did absolutely nothing! He was worthless but certainly richer. On the way home from the courthouse I realized how unfair the family law system of justice was for men and began a search for answers. Further, I realized that just having an attorney does not mean there will be a successful resolution. A few days later I saw a newspaper advertisement for a Fathers Rights support group near my home. It sounded interesting so I decided to attend one of their meetings.
The following Friday I arrived at the meeting discouraged and without hope. As I walked to my seat I passed a number of tables with pamphlets and books and other written materials all directed at men with family law problems. Most of these materials were advocating political reform of the family law system. I grabbed one of everything!
Once in my seat the meeting began with a number of men sharing their stories of severe prejudice and bias in the family court. The first thing I realized was that I was not alone in what I had experienced in and out of court. After two or three testimonies a gentleman went to the podium and addressed the crowd. The subject of his speech was ""Why men lose in Family Court.""
The gentleman opened his speech with these questions: ""How many of you came here tonight because you are currently in a family law case and are looking for answers?"" Everyone in the room raised their hands. ""How many of you defaulted by not responding to divorce or hearing papers?"" Many raised their hands. ""How many of you are struggling to pay your child support?"" Again almost everyone raised their hands. ""How many of you are being harassed by the District Attorney (Child Support Enforcement) for child support?"" ""How many of you have had their driver's licenses suspended or taxes taken due to unpaid child support?"" Many raised their hands. ""How many of you only see your kids every other weekend?"" About half the room raised a hand. ""How many of you paid a large amount of money to an attorney to resolve your problems and still lost the battle?"" Again almost everyone raised their hands. Finally he asked, ""How many of you are happy with the outcome of your case?"" The room suddenly became quiet and no one raised their hands.
When the speaker had finished asking the questions it was very apparent that most of the men in the room, including me, didn't know the first thing about avoiding or resolving a family law problem! It was a moment of realization that we had each failed due to our own ignorance. These men, myself included were like lambs headed to slaughter. None of us had a clue as to what we had done wrong or how we could still resolve our own legal problems! What a pathetic group of men! This wasn't what any of us expected.
The speaker continued by explaining why men lose in family court. ""Yes there is bias, prejudice and discrimination in family court towards men. Yes the family court system is broken and needs reform. However, despite these problems most of you have failed because you didn't take the time to learn how the system works."" As he spoke he gave numerous examples of mistakes that men make. ""Men lose in family court because they simply don't do their homework and women do!""
Most men, myself included, believe they are capable of resolving just about any problem. Most have run businesses, negotiated purchases of homes and/or cars and have been successful resolving other large problems at work and home. Consistent with their success in other areas of their life, when their long-term relationship's end they believe they can ""cut a deal"" or somehow avoid a problematic legal case without making legally filed agreements. Call it male machismo or pride but in reality it's called arrogance! Failing to learn how the family law system works will doom your case. Like one leading motivational speaker has stated: ""Failing to plan is planning to fail!"" There is no substitute for correct information and knowledge.
The speaker closed the meeting with this exhortation: ""I want each of you to make a commitment. A commitment to your friends, family, to your children and to yourself! I want you to commit to learning how the family law system works. I want you to commit to changing the outcome of your case! This week I want each of you to go to a law library or bookstore in your area and read anything and everything you can on family law. Once you have acquired the needed knowledge set a goal, form a plan and don't give up until you get what you want and need!""
As I drove home from the meeting I was filled with mixed emotions about what the speaker had said. On one hand I was encouraged that I could take control of my case, learn how the system works and resolve my ongoing legal problems. On the other hand I was very discouraged when I realized I had caused my own legal problems. I had lost in court because I had failed to learn the ""rules of the game."" Like millions of other men I thought I could strike an easy out of court settlement and go on with my life. How wrong I was! This was a very hard lesson for me! I was a college graduate. I was fairly intelligent and should have known better. My Ex-wife wasn't to blame, I was! I did this too myself! My failure was her victory!
The very next morning I decided to make the commitment to resolve my legal problems. As the speaker instructed I went to the local law library and read numerous books and articles. The following day I went to numerous bookstores and read many self-help books on family law. In addition, I searched the Internet and read everything I could about divorce and Family Law. The more I read the more I realized how mistaken I had been.
Over the next six months I continued studying family law and attending the meetings sponsored by a local Fathers rights support group. In a matter of weeks my personal knowledge of law and family related legal issues began to flourish. In fact, I eventually became a board member of the statewide group. After a few months, I even enrolled in paralegal classes at a community college. A year later I was so committed that I enrolled in law school. Boy what a turn around!
My first year of law school I began offering self-help legal assistance and counseling to men. Also, I returned to court to resolve unfinished legal business. This time I was prepared for battle! I had done my homework!
On the day of court I discovered that my ex-wife had retained the same attorney she had used previously. When he saw me in the hallway I am sure he thought this would be quick and easy. After all I was so misinformed the first time. The attorney approached me and began telling me how ridiculous my request for hearing was and that he was going to ""stick it to me"" if I didn't drop the matter immediately. With confidence, I informed him I would not do so and would see him before the Judge. We did discuss the legal issues at hand and you could see that his attitude towards me was much different than before. The attorney made his routine offer of settlement that I promptly refused. He was now very concerned. He had recognized that something was very different.
About an hour later, we ended up in front of the Judge. Here's what happened: My child support went from $1,113.00 per month plus health insurance of $225.00 to $243.00 a month in child support and she paid the health insurance. Further, my visitation time-share with my kids went from 5% to 43%. It turns out that my ex-wife was earning over $100,000.00 a year. I had filed subpoenas with her bank and employers based on a rumor I had heard that she had a second job but I wasn't sure. The subpoenas revealed that she did in fact have a second job. She had not revealed this to the court. Even her attorney was unaware of this! In fact her ""second job"" earned her significantly more money than her regular job. Big mistake on her part! Needless to say I won the relief that I was seeking! My ex-wife may have won a previous battle but ultimately lost the war. Over the next six months there were other legal issues that I was able to resolve. I stopped her from moving out of state with the kids. In fact this did not even require a hearing. She accepted my legal explanation of what the court would in fact do and she decided not to move.
On another occasion the principal of the school that my children attended felt she had no obligation to provide me with copies of my children's report cards and other information. (Emergency medical contact information, Notice of parent-teacher conferences, transcripts etc. etc...) It's significant to note that my ex-wife's mother was the vice-president of the school board. The principal, vice-principal, teachers and school nurse were aware of this. No doubt that the decision to deny my parental rights was directly related to my mother-in-laws powerful position. Well, I filed a suit in civil court naming the principal, vice-principal, school nurse, the entire local and county school boards, and the California board of education.
At the hearing the County's attorney spoke with me and expressed regret that this matter had to be filed. He agreed that the schools position could not be legally supported based on the family code. He informed them that their position was in error and the policy of preventing a parent with joint legal custody from viewing his children's school records was illegal and should be instantly changed. The matter was settled in the hallway and never made it to the Judge and for good reason.
Here is the best part of this story: After successfully resolving the legal issues my ex-wife ""got the message."" She realized that I would never again allow myself to be used as a legal punching bag. There would be no more rolling over. No more defaults, no more passivity. I had become a pro-active participant. I had finally learned how the system worked and would vigorously defend myself in any future issue that might arise. And guess what? Once she understood she could no longer win automatically, Lo and behold we never had another legal dispute! Immediately following the last court hearing our conversations became civil but solely limited to the lives of the kids. Exactly the way it should be! (And should have been from the beginning)
My children are grown now and my personal family law struggles are over. I learned the hard way that what you do now will determine the quality of the relationship you will have with your children in the future. People forget that children are only in the custody of either parent for a relatively short time. After they reach the age of majority is when the real relationship begins! I was fortunate in that I discovered my failure in time. I was able to reverse a never-ending trend of court hearing after court hearing with no end in sight. It all changed that one evening after the meeting when I decided to commit to making needed changes in my attitude and approach to my case. I had learned a valuable lesson. Know the rules before you play the game! Once I discovered the rules of the game it all changed.
Finally, family law problems affect not only you but NEW wives, girlfriends, parents, grandparents, Aunts/Uncles, employer, friends and most significantly your children! Don't wait any longer! Don't wait until it's too late! Make a commitment now to change your life and the lives of all who are around you by learning how the family law system works. Do your homework first! You can bet your Ex has!
By Mike L. Weening, Esq."
The subject of this article is ""Why Do Men Lose in Family Court?"" I have spent the last 20 years attempting to answer this question. After considerable research, case evaluations and client interviews I believe I now have the answer.
Nineteen years ago I went through a brutal divorce. Actually, at the time of divorce we were very friendly with one another and agreed to settle out of court. My Ex-wife, through a paralegal filed for divorce and like most men I simply agreed to the terms. I walked away with nothing! I surrendered the house, ($40,000.00 in equity) the boat, the car, furniture etc. etc...Everything I had acquired in 13 years of marriage was suddenly gone. We had three children and I wanted them to have the benefit of these items. Although I didn't realize it at the time I could have and should have made better agreements that would have benefited all members of my family in a much greater way. Looking back I simply didn't know what a good agreement was or how to make the deal. I was so concerned about maintaining a good relationship with my ex that I avoided anything that might have resulted in a legal battle. I should have filed my response with the court and requested an equitable division of property, custody, visitation and a support order that was based on my Real income. In general I should have been more attentive to the legal issues. This was truly a mistake!
Like most men I had adopted the common belief that men always lose in divorce proceedings so why not just surrender everything now and avoid the inevitable. What I didn't realize at the time was that I wasn't doing anyone any favors by surrendering everything to my ex-wife. Ignorantly giving up my property caused my wife to develop a false confidence in the legal system that would soon allow her to sue me again and again and again. Like many women she understood the prevailing thought of men that they always lose in family court and she capitalized on this belief. Therefore it didn't matter any longer how much I had given to her the fact that I didn't know what I was doing was extremely obvious. Despite everything I had surrendered, ignorantly failing to make fair and equitable agreements at the time of my departure from the family home was a colossal mistake and was a personal invitation for her to sue me later. I would in time realize that money and property are no substitute for a well-written, fair and equitable agreement of ALL issues. Like the American Express advertisement declares ""Don't leave home without it!""
I had also surrendered a number of other rights simply because I was ignorant and wasn't aware of the significance of these rights. Mainly rights to my children. I had mistakenly believed that women always get custody of children and Dads always get the standard every other weekend visitation schedule. In fact I was so ignorant I actually thought this was the law! Little did I realize that even after I had given everything I had I would still have to give more.
About 2 years later I acquired a new love interest and our ""friendly divorce"" turned into a legal nightmare! She went to an attorney and was advised to take me back to court to increase child support, decrease visitation, contempt of court and a host of other issues. Not knowing any better I went to an attorney, paid a $3500.00 retainer fee and went to court. It was my belief that we had fairly resolved all of our legal issues in the beginning and I really didn't understand why she wanted more or how she could get more.
After 3 court hearings and an additional $3000.00 in attorney fees (total $6,500.00) later I had gotten my butt kicked! My attorney did absolutely nothing! He was worthless but certainly richer. On the way home from the courthouse I realized how unfair the family law system of justice was for men and began a search for answers. Further, I realized that just having an attorney does not mean there will be a successful resolution. A few days later I saw a newspaper advertisement for a Fathers Rights support group near my home. It sounded interesting so I decided to attend one of their meetings.
The following Friday I arrived at the meeting discouraged and without hope. As I walked to my seat I passed a number of tables with pamphlets and books and other written materials all directed at men with family law problems. Most of these materials were advocating political reform of the family law system. I grabbed one of everything!
Once in my seat the meeting began with a number of men sharing their stories of severe prejudice and bias in the family court. The first thing I realized was that I was not alone in what I had experienced in and out of court. After two or three testimonies a gentleman went to the podium and addressed the crowd. The subject of his speech was ""Why men lose in Family Court.""
The gentleman opened his speech with these questions: ""How many of you came here tonight because you are currently in a family law case and are looking for answers?"" Everyone in the room raised their hands. ""How many of you defaulted by not responding to divorce or hearing papers?"" Many raised their hands. ""How many of you are struggling to pay your child support?"" Again almost everyone raised their hands. ""How many of you are being harassed by the District Attorney (Child Support Enforcement) for child support?"" ""How many of you have had their driver's licenses suspended or taxes taken due to unpaid child support?"" Many raised their hands. ""How many of you only see your kids every other weekend?"" About half the room raised a hand. ""How many of you paid a large amount of money to an attorney to resolve your problems and still lost the battle?"" Again almost everyone raised their hands. Finally he asked, ""How many of you are happy with the outcome of your case?"" The room suddenly became quiet and no one raised their hands.
When the speaker had finished asking the questions it was very apparent that most of the men in the room, including me, didn't know the first thing about avoiding or resolving a family law problem! It was a moment of realization that we had each failed due to our own ignorance. These men, myself included were like lambs headed to slaughter. None of us had a clue as to what we had done wrong or how we could still resolve our own legal problems! What a pathetic group of men! This wasn't what any of us expected.
The speaker continued by explaining why men lose in family court. ""Yes there is bias, prejudice and discrimination in family court towards men. Yes the family court system is broken and needs reform. However, despite these problems most of you have failed because you didn't take the time to learn how the system works."" As he spoke he gave numerous examples of mistakes that men make. ""Men lose in family court because they simply don't do their homework and women do!""
Most men, myself included, believe they are capable of resolving just about any problem. Most have run businesses, negotiated purchases of homes and/or cars and have been successful resolving other large problems at work and home. Consistent with their success in other areas of their life, when their long-term relationship's end they believe they can ""cut a deal"" or somehow avoid a problematic legal case without making legally filed agreements. Call it male machismo or pride but in reality it's called arrogance! Failing to learn how the family law system works will doom your case. Like one leading motivational speaker has stated: ""Failing to plan is planning to fail!"" There is no substitute for correct information and knowledge.
The speaker closed the meeting with this exhortation: ""I want each of you to make a commitment. A commitment to your friends, family, to your children and to yourself! I want you to commit to learning how the family law system works. I want you to commit to changing the outcome of your case! This week I want each of you to go to a law library or bookstore in your area and read anything and everything you can on family law. Once you have acquired the needed knowledge set a goal, form a plan and don't give up until you get what you want and need!""
As I drove home from the meeting I was filled with mixed emotions about what the speaker had said. On one hand I was encouraged that I could take control of my case, learn how the system works and resolve my ongoing legal problems. On the other hand I was very discouraged when I realized I had caused my own legal problems. I had lost in court because I had failed to learn the ""rules of the game."" Like millions of other men I thought I could strike an easy out of court settlement and go on with my life. How wrong I was! This was a very hard lesson for me! I was a college graduate. I was fairly intelligent and should have known better. My Ex-wife wasn't to blame, I was! I did this too myself! My failure was her victory!
The very next morning I decided to make the commitment to resolve my legal problems. As the speaker instructed I went to the local law library and read numerous books and articles. The following day I went to numerous bookstores and read many self-help books on family law. In addition, I searched the Internet and read everything I could about divorce and Family Law. The more I read the more I realized how mistaken I had been.
Over the next six months I continued studying family law and attending the meetings sponsored by a local Fathers rights support group. In a matter of weeks my personal knowledge of law and family related legal issues began to flourish. In fact, I eventually became a board member of the statewide group. After a few months, I even enrolled in paralegal classes at a community college. A year later I was so committed that I enrolled in law school. Boy what a turn around!
My first year of law school I began offering self-help legal assistance and counseling to men. Also, I returned to court to resolve unfinished legal business. This time I was prepared for battle! I had done my homework!
On the day of court I discovered that my ex-wife had retained the same attorney she had used previously. When he saw me in the hallway I am sure he thought this would be quick and easy. After all I was so misinformed the first time. The attorney approached me and began telling me how ridiculous my request for hearing was and that he was going to ""stick it to me"" if I didn't drop the matter immediately. With confidence, I informed him I would not do so and would see him before the Judge. We did discuss the legal issues at hand and you could see that his attitude towards me was much different than before. The attorney made his routine offer of settlement that I promptly refused. He was now very concerned. He had recognized that something was very different.
About an hour later, we ended up in front of the Judge. Here's what happened: My child support went from $1,113.00 per month plus health insurance of $225.00 to $243.00 a month in child support and she paid the health insurance. Further, my visitation time-share with my kids went from 5% to 43%. It turns out that my ex-wife was earning over $100,000.00 a year. I had filed subpoenas with her bank and employers based on a rumor I had heard that she had a second job but I wasn't sure. The subpoenas revealed that she did in fact have a second job. She had not revealed this to the court. Even her attorney was unaware of this! In fact her ""second job"" earned her significantly more money than her regular job. Big mistake on her part! Needless to say I won the relief that I was seeking! My ex-wife may have won a previous battle but ultimately lost the war. Over the next six months there were other legal issues that I was able to resolve. I stopped her from moving out of state with the kids. In fact this did not even require a hearing. She accepted my legal explanation of what the court would in fact do and she decided not to move.
On another occasion the principal of the school that my children attended felt she had no obligation to provide me with copies of my children's report cards and other information. (Emergency medical contact information, Notice of parent-teacher conferences, transcripts etc. etc...) It's significant to note that my ex-wife's mother was the vice-president of the school board. The principal, vice-principal, teachers and school nurse were aware of this. No doubt that the decision to deny my parental rights was directly related to my mother-in-laws powerful position. Well, I filed a suit in civil court naming the principal, vice-principal, school nurse, the entire local and county school boards, and the California board of education.
At the hearing the County's attorney spoke with me and expressed regret that this matter had to be filed. He agreed that the schools position could not be legally supported based on the family code. He informed them that their position was in error and the policy of preventing a parent with joint legal custody from viewing his children's school records was illegal and should be instantly changed. The matter was settled in the hallway and never made it to the Judge and for good reason.
Here is the best part of this story: After successfully resolving the legal issues my ex-wife ""got the message."" She realized that I would never again allow myself to be used as a legal punching bag. There would be no more rolling over. No more defaults, no more passivity. I had become a pro-active participant. I had finally learned how the system worked and would vigorously defend myself in any future issue that might arise. And guess what? Once she understood she could no longer win automatically, Lo and behold we never had another legal dispute! Immediately following the last court hearing our conversations became civil but solely limited to the lives of the kids. Exactly the way it should be! (And should have been from the beginning)
My children are grown now and my personal family law struggles are over. I learned the hard way that what you do now will determine the quality of the relationship you will have with your children in the future. People forget that children are only in the custody of either parent for a relatively short time. After they reach the age of majority is when the real relationship begins! I was fortunate in that I discovered my failure in time. I was able to reverse a never-ending trend of court hearing after court hearing with no end in sight. It all changed that one evening after the meeting when I decided to commit to making needed changes in my attitude and approach to my case. I had learned a valuable lesson. Know the rules before you play the game! Once I discovered the rules of the game it all changed.
Finally, family law problems affect not only you but NEW wives, girlfriends, parents, grandparents, Aunts/Uncles, employer, friends and most significantly your children! Don't wait any longer! Don't wait until it's too late! Make a commitment now to change your life and the lives of all who are around you by learning how the family law system works. Do your homework first! You can bet your Ex has!
By Mike L. Weening, Esq."
Working Nonimmigrant Visas For the United States
"Aliens from all over the world coming to the United States to work as nonimmigrants may fall under H-1B, H-IC, H-2A, H-2B, H-3, (nonimmigrant working or training visa), R-1 (nonimmigrant religious visa), I (nonimmigrant media representatives visa), D crewperson (nonimmigrant landing permit), J-1 (nonimmigrant exchange, trainee)., A and G (nonimmigrant diplomatic visa), O and P (nonimmigrant entertainment visa), L-1 (nonimmigrant intra-company transferee visa), and TN (nonimmigrant visa for professional Canadians and Mexicans).
Whether an alien qualifies for a nonimmigrant working (or training) visa depends on whether the requirements of the particular visa can be complied with by the alien applicant or beneficiary.
Nonimmigrant Working and Training Visas: H-1b, H-1c, H-2a, H-2b, H-3, and J-1:
This category covers nonimmigrant working or training visas for business personnel of companies operating in the United States. It permits employment in the United States for longer duration and facilitates temporary residence for the duration of the allowed stay.
Each visa or status requires the prior approval of a U.S. employer's or trainor's petition, which states the qualifications of the alien beneficiary or trainee and the requirements of the position.
1. H-1B: Specialty Occupation:
The annual cap of 65,000 H-1B visas is reduced to 58,200 after deducting 6,800 H-1B1 visas for Chile and Singapore. H-1B employer can file the petition on April 01 of each year and even thereafter, if the annual cap is not used up.
The U.S. petitioner-employer is required to submit a Labor Condition Application (LCA) certification from the U.S. Department of Labor (DOL) that such application (ETA 9035E) in the occupational specialty has been electronically filed thereat and monitored at ICertPortal.
The filing fee for the Form I-129 petition to be paid by the employer totals $2,320 ($320 + $1,500) (or $750 if employer has 25 or less employees) + one time $500 fraud fee), payable to the Department of Homeland Security.
Not all occupations are specialty occupations, which require a body of highly specialized knowledge and the attainment of a 4-year bachelor's or higher degree in the specific specialty or its equivalent, as the minimum entry requirement for the occupation.
The employer must pay 100 percent of the prevailing wage now determined by the DOL National Prevailing Wage Help Center in Washington, D.C., at the time of filing the LCA. The employer is also required to maintain a public access file within one day after the LCA filing, and post notice of the LCA filing in two (2) locations for ten (10) days.
An H-1B petition may be approved up to three (3) years with extensions up to maximum of six (6) years, and beyond, if a Form I-140 employment-based petition has been filed and pending for at least 365 days prior to the 6th year limit.
2. H-1C: Foreign-Trained Nurses:
Limited (500 visas per year, 25 visas for State with nine (9) million or less population and 50 visas for State with over nine (9) million population) H-1C visas are issued to foreign-trained registered nurses licensed to practice in the State and to work temporarily at hospitals in designated Health Professional Shortage Areas (HPSAA), as defined by the U.S. Department of Health and Human Services (HHS) and determined by the DOL.
Initial period of stay is up to three (3) years and limited to three (3) years. But this classification had expired on December 20, 2009.
3. H-2A, H-2B, H-3 and J-1 (Agriculture/Seasonal/Trainees):
(a) H-2A visas are for foreign workers to perform temporary or seasonal agricultural work at the time and place where there are insufficient U.S. workers who are able, willing, and available to do the work.
The H-2A employer must obtain a labor certification determination from the DOL that the employment of an alien worker would not adversely affect the wages and working conditions of similarly employed U.S. workers, as well as provide housing and worker's compensation insurance.
(b) H-2B visas capped at 66,000 a year are for foreign workers to perform work for a one-time occurrence or a seasonal or peak or intermittent need in nonagricultural sectors of the economy.
An application for labor certification is likewise filed by the U.S. employer and approval obtained from DOL. And as in all H applications, Form I-129 is filed with the U.S. Citizenship and Immigration Services (USCIS).
Foreign workers are admitted initially for the time stated in the labor certification, with a maximum of one (1) year, subject to yearly extensions, to a maximum work stay of three (3) years, and a 6-month foreign residency requirement prior to another application.
(c) H-3 visas are designed for aliens coming to receive instruction and training not designed to provide productive employment, unless incidental and necessary to the training and pursuing a career outside the United States.
They are admitted for the duration of the approved training program for a maximum length of two (2) years, subject to a 6-month foreign residency requirement prior to a subsequent application for the same beneficiary alien.
The type of training program should not exist in the alien's home country or country of origin, and is not readily available in any other country.
(d) J visas are issued by U.S. Consuls abroad and meant for exchange visitors, foreign physicians, professors, students, teachers, bona fide trainees or interns, au pair youths, etc.; who have sufficient funds and are fluent in English.
A trainee program for agriculture, hotel, and tourism is limited to twelve (12) months with some exceptions. Other training programs may last eighteen (18) months. In order to get additional training, trainees should be outside the United States for the 2-year foreign residency requirement, unless a waiver thereof is granted by the USCIS.
Waivers may be based on:
(i) possible persecution in country of origin;
(ii) exceptional hardship on U.S. citizen or lawful permanent resident spouse or child;
(iii) no objection by country of origin; and
(iv) request by interested state or federal agency.
4. R-1, I, D, A and G Visas:
(a) R-1 visas are for religious workers (ministers, professionals in religious occupation [cantors, liturgical workers, broadcasters, etc.] or religious vocations [monks, nuns, etc.]) who: (1) two (2) years immediately before the filing of the application on Form I-129 has been a member of the religious denomination having a nonprofit religious organization in the U.S.; and (2) will be working for the U.S. religious organization or affiliate.
The R-1 status is initially for three (3) years, but limited to a maximum of five (5) years. The spouse and minor children may accompany or follow to join in R-2 status.
The R-1 religious worker may be eligible again for the same status after five (5) years, if he or she resides outside of the U.S. for one year, unless he or she is able to adjust to lawful permanent resident status as a special immigrant (Forms I-360 and I-485).
(b) I visas are for representatives of media (foreign press, television, radio, film, etc.) who will perform solely their vocation in the U.S. They may be employed by a branch, subsidiary, or affiliate in the U.S. of the foreign media company to perform activities for the benefit of the foreign media.
Their admission is for duration of status, which could be indefinitely. And they may adjust to lawful permanent residence without restrictions. Dependents designated also as ""I"" are required separate employment authorization to work in the U.S.
(c) D visas are for foreign crewmen who are coming to the U.S. to join and work on board a vessel. They include crewmen for the normal operation of the vessel as well as trainees, cooks, employees of concessions on board such as barbers, beauticians, and waiters on cruise ships.
They may be issued C-1 (transit) visas to join the ship in the U.S. Thereafter, they may be issued Form I-95 (landing permit) to be allowed in U.S. ports.
Initial admission is for twenty-nine (29) days. No extension nor change of status is allowed. If only on C-1 visa, they cannot adjust status to lawful permanent resident. If on D status, they cannot adjust even if married to a U.S. citizen, unless grandfathered under Section 245(i) of the Immigration and Nationality Act (a family or employment-based immigrant petition was filed on or before January 14, 1998, or the latest before April 30, 2001, [if the later applicant were physically in the U.S. on December 21, 2000]).
(d) A and G diplomatic and international organizations visas are for ambassadors, ministers, diplomats, officers, and their families (A-1), other officials and employees of foreign governments and their families (A-2), and personal employees and servants (maids) of A-1 and A-2 and their families (A-3), as well as resident representative, staff, and families of permanent mission of a foreign government to the U.N., I.M.F., O.A.S., etc. (G-1), other accredited representatives of foreign government, military officers, personnel, and immediate families (G-2), as well as G-1 and G-2 from foreign governments not recognized by the U.S. (G-3), officers and employees of international organizations and immediate families (G-4), and lastly attendants, servants, and personal employees of G-1 to G-4, who may be admitted for three (3) years with renewals (G-5).
5. O and P Entertainment Visas:
(a) O visas are for aliens who have ""extraordinary ability in the sciences, arts, education, business or athletics,"" who have demonstrated such ability ""by sustained national or international acclaim.""
They enter the U.S. to continue the type of work they do abroad, although the work in the U.S. does not require a person of extraordinary ability.
O-1 applicants cannot self-petition; they are petitioned through Form I-129 by U.S. agents or promoters of their artistic or athletic performances on special events, who submit itineraries with the application to USCIS.
Persons assisting O-1 applicants as integral part of their performances may be issued O-2 visas, and spouses and children of O-1 and O-2 beneficiaries may accompany or follow to join them on O-3 status.
O-1 and O-2 petitions are required to contain written advisory opinion from the proper union or guild, attesting to the beneficiary's expertise/skills and ""no objection"" to the performance(s) or event(s) in the United States, unless re-entering the U.S. to perform similar activities within two (2) years of obtaining consultation, or merely requesting for extensions of stay.
Initial admission is for the time the USCIS approves to perform the activities, but not exceeding three (3) years. Extensions of one (1) year increments may be granted for the same event(s) or series of performances.
(b) P visas are particularly for internationally-recognized athletes or group performers, such as musical groups or bands performing for at least one (1) year, (P-1A) as well as persons who are integral or essential part of an entertainment group who have had a sustained and substantial relationship with the group for at least one (1) year (P-1B).
International recognition and the one (1) year relationship may be waived for certain performers. P visa holders are allowed to stay temporarily to perform in competition or event or performance. Spouses and minor children may come accompanying or following to join as P-4.
As in O visas, consultation with a proper union or guild is required for P petition (Form I-129) approval. P-1 athletes may be admitted up to five (5) years with one (1) extension, while admission of a P-1 entertainment group may not exceed one (1) year. And spouses and children may be admitted for the duration of stay of the principal beneficiary.
6. L-1 and TN Visas:
(a) L-1 visas are for intra-company transferees, who are employed abroad as managers, executives, or persons with specialized skill for one (1) year of the past three (3) years by a parent, branch, subsidiary, or affiliate of a U.S. company, before the filing of its application (Form I-129).
The alien beneficiary enters to work in a managerial or executive (L-1A) capacity, or in work involving specialized knowledge (L-1B) for the U.S. company, which may be for profit or nonprofit. No prevailing wage is required as compensation, and the job need not be full-time.
Moreover, the parent and subsidiary companies abroad and in the U.S. need not be in the same business or occupation. Nor is there any capitalization requirement for the U.S. company.
Aside from the regular Form I-129 fee of $320.00, a one-time fraud fee of $500.00 is required for L-1 applications. If the U.S. company is a start-up, admission for L-1 is for one (1) year. Otherwise, managers and executives are limited to seven (7) years and those with specialized knowledge to five (5) years. Spouses and children may be admitted on L-2 visas for the duration of stay of the principal beneficiary.
Spouses of L-1 may be issued employment authorization (Form I-766) for the period of stay not to exceed two (2) years.
(b) TN visas are for citizens form Canada and Mexico coming to engage in professional activities for U.S. employers under the North American Free Trade Agreement (NAFTA), signed on December 08, 1993.
NAFTA defines ""activities at a professional level"" as requiring ""at least a baccalaureate (bachelor's) degree or appropriate credentials demonstrating status as a professional."" The regulations (8 C.F.R. §214.6(c)) list the professions covered by NAFTA.
No Form I-129 is required, nor a labor condition application (LCA), nor a labor certification approval, only documentation at a port of entry or station for Canadians. A TN visa is required for Mexicans, but likewise no approved Form I-129, nor LCA.
Form I-94 (Departure Document) is issued as a multiple entry for one (1) year and can be extended on Form I-129. No license to practice is required to enter as a TN, but licensure may be enforced by the state agency involved.
***This article does not constitute legal advice or a legal opinion on any specific facts or circumstances. Its contents are intended as general information only. The reader is urged to consult his/her own attorney concerning his/her specific legal questions.)"
Whether an alien qualifies for a nonimmigrant working (or training) visa depends on whether the requirements of the particular visa can be complied with by the alien applicant or beneficiary.
Nonimmigrant Working and Training Visas: H-1b, H-1c, H-2a, H-2b, H-3, and J-1:
This category covers nonimmigrant working or training visas for business personnel of companies operating in the United States. It permits employment in the United States for longer duration and facilitates temporary residence for the duration of the allowed stay.
Each visa or status requires the prior approval of a U.S. employer's or trainor's petition, which states the qualifications of the alien beneficiary or trainee and the requirements of the position.
1. H-1B: Specialty Occupation:
The annual cap of 65,000 H-1B visas is reduced to 58,200 after deducting 6,800 H-1B1 visas for Chile and Singapore. H-1B employer can file the petition on April 01 of each year and even thereafter, if the annual cap is not used up.
The U.S. petitioner-employer is required to submit a Labor Condition Application (LCA) certification from the U.S. Department of Labor (DOL) that such application (ETA 9035E) in the occupational specialty has been electronically filed thereat and monitored at ICertPortal.
The filing fee for the Form I-129 petition to be paid by the employer totals $2,320 ($320 + $1,500) (or $750 if employer has 25 or less employees) + one time $500 fraud fee), payable to the Department of Homeland Security.
Not all occupations are specialty occupations, which require a body of highly specialized knowledge and the attainment of a 4-year bachelor's or higher degree in the specific specialty or its equivalent, as the minimum entry requirement for the occupation.
The employer must pay 100 percent of the prevailing wage now determined by the DOL National Prevailing Wage Help Center in Washington, D.C., at the time of filing the LCA. The employer is also required to maintain a public access file within one day after the LCA filing, and post notice of the LCA filing in two (2) locations for ten (10) days.
An H-1B petition may be approved up to three (3) years with extensions up to maximum of six (6) years, and beyond, if a Form I-140 employment-based petition has been filed and pending for at least 365 days prior to the 6th year limit.
2. H-1C: Foreign-Trained Nurses:
Limited (500 visas per year, 25 visas for State with nine (9) million or less population and 50 visas for State with over nine (9) million population) H-1C visas are issued to foreign-trained registered nurses licensed to practice in the State and to work temporarily at hospitals in designated Health Professional Shortage Areas (HPSAA), as defined by the U.S. Department of Health and Human Services (HHS) and determined by the DOL.
Initial period of stay is up to three (3) years and limited to three (3) years. But this classification had expired on December 20, 2009.
3. H-2A, H-2B, H-3 and J-1 (Agriculture/Seasonal/Trainees):
(a) H-2A visas are for foreign workers to perform temporary or seasonal agricultural work at the time and place where there are insufficient U.S. workers who are able, willing, and available to do the work.
The H-2A employer must obtain a labor certification determination from the DOL that the employment of an alien worker would not adversely affect the wages and working conditions of similarly employed U.S. workers, as well as provide housing and worker's compensation insurance.
(b) H-2B visas capped at 66,000 a year are for foreign workers to perform work for a one-time occurrence or a seasonal or peak or intermittent need in nonagricultural sectors of the economy.
An application for labor certification is likewise filed by the U.S. employer and approval obtained from DOL. And as in all H applications, Form I-129 is filed with the U.S. Citizenship and Immigration Services (USCIS).
Foreign workers are admitted initially for the time stated in the labor certification, with a maximum of one (1) year, subject to yearly extensions, to a maximum work stay of three (3) years, and a 6-month foreign residency requirement prior to another application.
(c) H-3 visas are designed for aliens coming to receive instruction and training not designed to provide productive employment, unless incidental and necessary to the training and pursuing a career outside the United States.
They are admitted for the duration of the approved training program for a maximum length of two (2) years, subject to a 6-month foreign residency requirement prior to a subsequent application for the same beneficiary alien.
The type of training program should not exist in the alien's home country or country of origin, and is not readily available in any other country.
(d) J visas are issued by U.S. Consuls abroad and meant for exchange visitors, foreign physicians, professors, students, teachers, bona fide trainees or interns, au pair youths, etc.; who have sufficient funds and are fluent in English.
A trainee program for agriculture, hotel, and tourism is limited to twelve (12) months with some exceptions. Other training programs may last eighteen (18) months. In order to get additional training, trainees should be outside the United States for the 2-year foreign residency requirement, unless a waiver thereof is granted by the USCIS.
Waivers may be based on:
(i) possible persecution in country of origin;
(ii) exceptional hardship on U.S. citizen or lawful permanent resident spouse or child;
(iii) no objection by country of origin; and
(iv) request by interested state or federal agency.
4. R-1, I, D, A and G Visas:
(a) R-1 visas are for religious workers (ministers, professionals in religious occupation [cantors, liturgical workers, broadcasters, etc.] or religious vocations [monks, nuns, etc.]) who: (1) two (2) years immediately before the filing of the application on Form I-129 has been a member of the religious denomination having a nonprofit religious organization in the U.S.; and (2) will be working for the U.S. religious organization or affiliate.
The R-1 status is initially for three (3) years, but limited to a maximum of five (5) years. The spouse and minor children may accompany or follow to join in R-2 status.
The R-1 religious worker may be eligible again for the same status after five (5) years, if he or she resides outside of the U.S. for one year, unless he or she is able to adjust to lawful permanent resident status as a special immigrant (Forms I-360 and I-485).
(b) I visas are for representatives of media (foreign press, television, radio, film, etc.) who will perform solely their vocation in the U.S. They may be employed by a branch, subsidiary, or affiliate in the U.S. of the foreign media company to perform activities for the benefit of the foreign media.
Their admission is for duration of status, which could be indefinitely. And they may adjust to lawful permanent residence without restrictions. Dependents designated also as ""I"" are required separate employment authorization to work in the U.S.
(c) D visas are for foreign crewmen who are coming to the U.S. to join and work on board a vessel. They include crewmen for the normal operation of the vessel as well as trainees, cooks, employees of concessions on board such as barbers, beauticians, and waiters on cruise ships.
They may be issued C-1 (transit) visas to join the ship in the U.S. Thereafter, they may be issued Form I-95 (landing permit) to be allowed in U.S. ports.
Initial admission is for twenty-nine (29) days. No extension nor change of status is allowed. If only on C-1 visa, they cannot adjust status to lawful permanent resident. If on D status, they cannot adjust even if married to a U.S. citizen, unless grandfathered under Section 245(i) of the Immigration and Nationality Act (a family or employment-based immigrant petition was filed on or before January 14, 1998, or the latest before April 30, 2001, [if the later applicant were physically in the U.S. on December 21, 2000]).
(d) A and G diplomatic and international organizations visas are for ambassadors, ministers, diplomats, officers, and their families (A-1), other officials and employees of foreign governments and their families (A-2), and personal employees and servants (maids) of A-1 and A-2 and their families (A-3), as well as resident representative, staff, and families of permanent mission of a foreign government to the U.N., I.M.F., O.A.S., etc. (G-1), other accredited representatives of foreign government, military officers, personnel, and immediate families (G-2), as well as G-1 and G-2 from foreign governments not recognized by the U.S. (G-3), officers and employees of international organizations and immediate families (G-4), and lastly attendants, servants, and personal employees of G-1 to G-4, who may be admitted for three (3) years with renewals (G-5).
5. O and P Entertainment Visas:
(a) O visas are for aliens who have ""extraordinary ability in the sciences, arts, education, business or athletics,"" who have demonstrated such ability ""by sustained national or international acclaim.""
They enter the U.S. to continue the type of work they do abroad, although the work in the U.S. does not require a person of extraordinary ability.
O-1 applicants cannot self-petition; they are petitioned through Form I-129 by U.S. agents or promoters of their artistic or athletic performances on special events, who submit itineraries with the application to USCIS.
Persons assisting O-1 applicants as integral part of their performances may be issued O-2 visas, and spouses and children of O-1 and O-2 beneficiaries may accompany or follow to join them on O-3 status.
O-1 and O-2 petitions are required to contain written advisory opinion from the proper union or guild, attesting to the beneficiary's expertise/skills and ""no objection"" to the performance(s) or event(s) in the United States, unless re-entering the U.S. to perform similar activities within two (2) years of obtaining consultation, or merely requesting for extensions of stay.
Initial admission is for the time the USCIS approves to perform the activities, but not exceeding three (3) years. Extensions of one (1) year increments may be granted for the same event(s) or series of performances.
(b) P visas are particularly for internationally-recognized athletes or group performers, such as musical groups or bands performing for at least one (1) year, (P-1A) as well as persons who are integral or essential part of an entertainment group who have had a sustained and substantial relationship with the group for at least one (1) year (P-1B).
International recognition and the one (1) year relationship may be waived for certain performers. P visa holders are allowed to stay temporarily to perform in competition or event or performance. Spouses and minor children may come accompanying or following to join as P-4.
As in O visas, consultation with a proper union or guild is required for P petition (Form I-129) approval. P-1 athletes may be admitted up to five (5) years with one (1) extension, while admission of a P-1 entertainment group may not exceed one (1) year. And spouses and children may be admitted for the duration of stay of the principal beneficiary.
6. L-1 and TN Visas:
(a) L-1 visas are for intra-company transferees, who are employed abroad as managers, executives, or persons with specialized skill for one (1) year of the past three (3) years by a parent, branch, subsidiary, or affiliate of a U.S. company, before the filing of its application (Form I-129).
The alien beneficiary enters to work in a managerial or executive (L-1A) capacity, or in work involving specialized knowledge (L-1B) for the U.S. company, which may be for profit or nonprofit. No prevailing wage is required as compensation, and the job need not be full-time.
Moreover, the parent and subsidiary companies abroad and in the U.S. need not be in the same business or occupation. Nor is there any capitalization requirement for the U.S. company.
Aside from the regular Form I-129 fee of $320.00, a one-time fraud fee of $500.00 is required for L-1 applications. If the U.S. company is a start-up, admission for L-1 is for one (1) year. Otherwise, managers and executives are limited to seven (7) years and those with specialized knowledge to five (5) years. Spouses and children may be admitted on L-2 visas for the duration of stay of the principal beneficiary.
Spouses of L-1 may be issued employment authorization (Form I-766) for the period of stay not to exceed two (2) years.
(b) TN visas are for citizens form Canada and Mexico coming to engage in professional activities for U.S. employers under the North American Free Trade Agreement (NAFTA), signed on December 08, 1993.
NAFTA defines ""activities at a professional level"" as requiring ""at least a baccalaureate (bachelor's) degree or appropriate credentials demonstrating status as a professional."" The regulations (8 C.F.R. §214.6(c)) list the professions covered by NAFTA.
No Form I-129 is required, nor a labor condition application (LCA), nor a labor certification approval, only documentation at a port of entry or station for Canadians. A TN visa is required for Mexicans, but likewise no approved Form I-129, nor LCA.
Form I-94 (Departure Document) is issued as a multiple entry for one (1) year and can be extended on Form I-129. No license to practice is required to enter as a TN, but licensure may be enforced by the state agency involved.
***This article does not constitute legal advice or a legal opinion on any specific facts or circumstances. Its contents are intended as general information only. The reader is urged to consult his/her own attorney concerning his/her specific legal questions.)"
"Dangerous Dog Ordinances, Stevens County, Washington - Title 12 - Straight Talk - Know Your Rights!"
"Reacting to a series of dog attacks and problems in recent years in the Counties, both Stevens County and Spokane County in Washington State (and nationwide) have adopted new regulations for dealing with potentially dangerous and vicious dogs. Since I am a citizen of Stevens County, I will speak to the new Title 20 ordinance adopted in December 2007 by Stevens County.
Stevens County's new set of dangerous dog laws is designed to put the accountability on the owner and not just the animal. At this date, Stevens County does not have any designated animal control authority other than the Stevens County Sheriff. Under its new Title 20 ordinance, the Stevens County Sheriff's Office now has more authority to find that a dog is dangerous or potentially dangerous and impose corrective actions to protect the public. Owners are given further opportunity to appeal the Stevens County Sheriff's designation to the courts.
By definition under the newly adopted Title 20, a ""potentially dangerous"" dog is one that has a known propensity, tendency, or disposition to cause an unprovoked attack or to cause injury or otherwise threaten the safety of humans or domestic animals. A ""dangerous dog"" has caused unprovoked severe injury to a human being, or has killed a domestic animal while off the owner or keeper's property, or has previously been found ""potentially dangerous"" and aggressively attacks again or endangers safety. Both the ""potentially dangerous"" dog and ""dangerous dog"" designations under the Stevens County, Washington Title 20, carry similar consequences for owners and their dog(s). Stevens County has imposed more restrictive measures under the ""potentially dangerous"" dog designation than under current Washington State law.
If a dog is found to be ""dangerous"" or ""potentially dangerous"", the owner must register the dogs within 14 days of the County Sheriff's determination, and the registration will only be accepted if the owner agrees to placement of an identifying microchip inserted in the animal, payment of the first registration fee and an annual registration fee, and to keep the dog enclosed indoors or in a proper enclosure. Proper enclosure is defined under Title 20 as a kennel that contains an enclosed top as well as sides. If the dog is allowed outside the enclosure, it must be muzzled and restrained with a 3-foot chain with a 300 lb. tensile strength. An owner cannot sell or transfer ownership, custody or residence of the dog without notifying the County Sheriff and notifying the new owner of the dog's record with an acknowledgment signed by the new owner of the terms and conditions of his maintenance while in Stevens County, Washington. In extreme cases, presumably the County Sheriff as the animal control officer has the authority to decide if the dog must be destroyed. While I can understand the adoption of Title 20 and its ordinances and the ""dangerous dog"" designation and the purpose and merit behind its adoption, the ""potentially dangerous dog"" designation appears to be nearly impossible to regulate and this particular designation is ripe for abuse.
I am relatively certain many of us have experienced a difficult neighbor a time or two. For whatever reason, certain individuals seem to have nothing better to do than complain about their neighbors' pets, the broken down automobile, hobbies, or anything else that may annoy them at any given time. In fact for some people, they seem to make complaining their hobby. In rural Stevens County, Washington and other rural areas that are moving rapidly toward development, there will always be conflicts between country neighbors with differing views on a rural lifestyle. The Title 20 ""potentially dangerous"" dog designation provides these people with just one more avenue for conflict and additional ammunition for harassment. An additional danger for citizens is that the entire hearing process as applied through the Stevens County Sheriff's Office, under both designations, appears to be fundamentally flawed and unconstitutional.
I have spoken to several residents in the County where harassment by a nuisance neighbor, through Title 20, appears to have occurred to their detriment. The new Stevens County, Washington Title 20 ""potentially dangerous dog"" designation seems to make it particularly easy for a nuisance neighbor to harass another neighbor. Since the recent adoption of Title 20 in December 2007, I have discovered that several citizens have been struggling to defend against false and/or frivolous allegations about their companion dogs. One citizen found herself the target of a nuisance allegation by a problem neighbor and the Stevens County Sheriff concerning her ""potentially dangerous"" dogs, after her complaining neighbor's dog pulled her show dog through her own fence and killed it. Apparently a complaint was lodged by the nuisance neighbor against the deceased show dog as a preemptive strike. How many Stevens County citizens have simply forfeited their right to ownership of a companion dog because of nuisance allegations they could not afford to defend and unconstitutional actions being taken by Stevens County public officials? All a nuisance neighbor may now have to do is claim that a dog barked at them, and the dog's owner may be hit with a predetermined ""potentially dangerous"" dog designation, fees, an embarrassing public hearing and media coverage, and other severe restrictions on their dog by the Stevens County Sheriff.
I suppose the best part of the new Title 20 ordinance is the appeal process since a dog is already predetermined by the Stevens County Sheriff to either be ""dangerous"" or ""potentially dangerous"" prior to a hearing. However, many poor people do not have the resources to legally fight back against an initial and possibly frivolous determination by the Stevens County Sheriff in advance of a public hearing. Attorney fees, at a rate of $200 per hour to defend against this type of nuisance action, may be in the range of $2,000 - $40,000+.
There are other potential problems in carrying out the new Stevens County Title 20 ordinances. The problems I reference below, as well as others I have not highlighted in this article, have already emerged in other states and Washington State counties -- King and Spokane County, Washington, for example. The courts in King County and Spokane County have recently ruled upon the controversial dangerous dog ordinances and procedures. In King County, for example, in the recent dangerous dog case of Mansour v. King County tried by animal law attorney Adam Karp, where Mansour was found to have been denied due process, the Washington State Court of Appeals ruled: ""Due process essentially requires the opportunity to be heard at a meaningful time and in a meaningful manner"". . . ""An adequate standard of proof is a mandatory safeguard."" "" The standard of proof instructs the fact finder ""concerning the degree of confidence our society thinks he should have in the correctness of the factual conclusions"" . . .. While the Stevens County Sheriff continues to sit as the investigating official, the judge and jury in these potentially dangerous and dangerous dog cases, how much confidence can the public place in any factual conclusion made by the Sheriff's Office?
In Spokane County in a ""potentially dangerous dog"" case, Judge Austin of the Spokane County Superior Court ruled that Spokane's ""dangerous dog"" ordinance is unconstitutional because it denies pet owners the right of due process, and that as a matter of law the administrative procedures used in the City of Spokane regarding ""dangerous dog"" determinations and appeals from those rulings violate citizens' due process rights. In their current system, dogs tagged as ""dangerous"" by the city and its contractor, SpokAnimal, are deemed to be just that unless the owner can prove otherwise -- flying in the face of the notion of presumed innocence. The judge ruled that the City violated (in this case) Patty Schoendorf's rights by taking her property -- her dogs --and intended to destroy them after a hearing where she was not allowed to cross-examine or impeach witnesses involved in the dog's impoundment. She also wasn't given access to documents in the City's ""dangerous dog"" file, and the opportunity to rebut those allegations -- another denial of due process guaranteed by the Constitution. The judge not only ordered Spokanimal to immediately release the dogs, he also ordered the City of Spokane to pay legal bills for a team of attorneys - Robert Caruso, Richard Lee and Cheryl Mitchell, animal law attorneys.
While I would like to say that I trust the Sheriff's Animal Control Officers to ensure that there is a real danger to the public, the truth (and therein the problem) is that in Stevens County there is currently no separation of powers from the onset of the initial investigation, the Sheriff's determination of ""potentially dangerous dog"", and finally to the Sheriff's ruling following a public hearing that a dog is ""potentially dangerous"". The Stevens County Animal Control Authority (the Stevens County Sheriff's Office) sits as the investigator, judge and jury. Where is our guaranteed system of checks and balances in this process? The following is generally the procedure used under the Stevens County ""potentially dangerous"" dog designation:
(1) When a complainant calls to make a report, he makes it to the Stevens County
Sheriff's Office, the designated animal control authority in Stevens County;
(2) A Stevens County Sheriff's Officer may be dispatched to the scene to presumably thoroughly investigate the dog incident and take an incident report. A thorough and complete investigation may or may not occur, and in fact the dog's owner may not even be allowed to tell their side of the story to the Officer or see the complaint, the results of the investigation, and may not even be advised of the name of the complainant by the Sheriff's Office. The Sheriff's goal in these cases appears to be to hold back all relevant documents and evidence entirely from the accused pet owner until a day or two before the hearing, stating that the procedure is still in the ""investigational stage""-- similar to a criminal proceeding. The pet owner has no time to prepare a defense;
(3) After the Sheriff takes an incident report from the complainant, the owner of the alleged offending dog(s) is then promptly advised by a Stevens County Sheriff's Officer that he/she must submit to photographing of his/her dog(s), prior to the dog owner receiving any kind of a notice or citation from the Stevens County Animal Control Authority (the Sheriff). Notice of the alleged incident may simply be a Sheriff's Officer arriving on the doorstep or at your gate, and advising you that he is required to take photographs of your dogs as ""part of the hearing process"". At this point, you may not even have notice of any hearing. The photographing process may or may not involve a Stevens County Sheriff's Officer demanding entrance onto your private property or requesting entrance into your home, for the stated purpose of photographing your dog(s).
Citizens, please be aware that a dog is designated as ""personal property"" in the State of Washington and other states. The Washington State Constitution and U.S. Constitution protect individuals against unlawful searches and seizures concerning your personal property.
The simple act of entering onto private property for the purpose of taking photographs of personal property, without the direct or implied consent of the property owner and without a search warrant, is unlawful. Generally speaking, warrants are signed by judges or commissioners in criminal matters. At this point, this procedure is still considered a civil or administrative matter. There appears to be something inherently wrong with this process from the outset. (The rule that I have personally imposed is not to let anyone onto my property without my express invitation (or a warrant). My directive to this effect seems to work for most people.)
Of course, there are ""exigent circumstances"" exceptions under the law to the warrant requirement. Exigent circumstances generally arise when a law enforcement officer may have reasonable ground to believe that there is an immediate need to protect his life, the life of others, their property, or that of others, the search is not motivated by an intent to arrest and seize evidence, and there is some reasonable basis to associate an emergency with the area or place to be searched. None of these exigent circumstances is likely to exist in a Title 20 dangerous or potentially dangerous dog investigation which would allow a public official to trespass for the purpose of photographing dogs.
4) The owner of the alleged offending dog will then receive a certified letter or personal service by the Stevens County Sheriff', notifying the dog's owner that their dog has already been deemed a ""potentially dangerous"" dog or ""dangerous dog"" under their new Title 20 ordinance. The owner's dog is deemed ""guilty"" before tried, based generally only upon a report made by a complainant. That complainant could be made by anyone with ""axe to grind"". The dog is declared guilty in advance of a public hearing before the Stevens County Sheriff's Department. The investigating agency (the Stevens County Sheriff's Office) then amazingly plays the role of the judge and jury at this public hearing where the dog's owner is required to prove that his/her dog is not dangerous, or potentially dangerous. Please be aware that you (as the accused) are not required to prove anything. The burden of proof falls upon your accusers to make their case, and not you. Public testimony will be taken by the Sheriff, and you will receive a subsequent notice of his final ruling. This entire process usurps constitutional protections afforded each citizen under Washington State and U.S. Constitutions. Any hearing in a ""potentially dangerous dog"" or ""dangerous dog"" case should be set before an impartial judge or hearing officer. The Sheriff cannot rule on issues as a matter of law.
It is my understanding and belief that any public hearing conducted by a public official(s) in Washington State must follow the law and procedures under either the Washington State Open Meetings Act or Administrative Procedures Act. Since a dangerous dog hearing does not really meet the criteria under the Open Meetings Act, the hearing process should follow the Washington State Administrative Procedures Act. If you are not familiar with this Act, familiarize yourself with it and your rights under this Act. This law can be found in the public library under 34.05 RCW (Revised Code of Washington). Insist that any dangerous dog hearing you may be a party to comply with these lawful procedures.
Citizens, please take heed! The Stevens County Title 20 dangerous dog ordinances are dangerous to you in that they can potentially escalate into a criminal matter if you do not comply with the severe restrictions imposed on your dog, or if the dog is again the subject of a complaint. You must contest the letter/notice that you receive from the Stevens County, Washington Sheriff's Office and promptly return it via Certified US Mail or Delivery Confirmation. Also enclose your own letter stating you contest your dog's predetermined designation by the Sheriff, and that you demand a lawful hearing before a bona fide hearing officer conducted under the Washington State Administrative Procedures Act. If you do not sign and return the Notice from the County Sheriff, the ""potentially dangerous dog"" designation is automatically applied by the Sheriff to your dog through your inaction.
Once you have been deemed to own a ""potentially dangerous"" dog or ""dangerous"" dog, all regulations, restrictions, fees and other penalties under the new ordinances apply to you and your dog. The Title 20 regulations, restrictions, fees and other penalties have severe consequences for both you and your dog. If you do not comply with these new regulations following the final determination of your ""potentially dangerous dog"" or ""dangerous dog"", then you possibly may be issued a criminal citation. Potentially you may be thrust into the position of defending yourself as a criminal. Moreover, your homeowner's insurance may be cancelled or be prohibitively expensive in the future, and you may be forced to carry an expensive bond if you intend to keep your dog in the County.
The Title 20 dangerous dog ordinances can be dangerous to your health and welfare and your dog's health and welfare, particularly if you do not exercise your constitutional rights. I would highly recommend hiring an attorney, if you can afford one. Hire someone who specializes in animal law, for instance one of the attorneys mentioned in this article. If you cannot afford one and are low income, call CLEAR at their toll free number in Washington State to see if you can qualify for free legal assistance. Other possible sources of legal assistance are the Gonzaga Law School, or the Washington State Bar Association who may have a referral to a pro bono (free) attorney.
Please exercise your civil and constitutional rights and familiarize yourselves with this new set of laws under Stevens County, Washington - Title 20. Please do not allow your valuable rights to be trampled upon by public officials or you may lose them. Do not allow yourself to become their victim.
Last but not least, please recognize and be aware that you do not have to allow anyone onto your private property, in most cases, without a warrant. It surprises me that many citizens do not know this. If there is any doubt in your mind, please respectfully ask the person requesting permission to enter onto your private property ""do you have a warrant?"" Express to them that without a signed warrant, that person does not have your consent to enter onto your private property. This rule generally applies to most everyone, public officials included, unless they have an implied right to enter such as a meter reader. With respect to your private property rights, generally speaking, what applies to any other private citizen who wants entrance to your property applies to public officials as well. Post your gates and property with ""No Trespassing"" and ""Beware of Dog"" signs to protect yourself -- approximately every 50 feet. Also fence your property with at least a 5-6 foot fence if you own a dog, for additional protection. Electrify your fence, if necessary, if you are in a rural area. Fence chargers, including solar fence chargers, can be purchased for $30 and up and are quite effective as a deterrent to entrance and exit by animals.
I recognize that this article may not be ""politically correct"" in this climate as this is a sensitive issue right now. I am aware that it may anger those who are truly at risk or who have been victims of genuinely dangerous dogs. I agree that genuinely dangerous dogs are a threat to public safety. However, I submit that while the intent behind Title 20 and other dangerous dog laws is good and I agree with its intent, the process to apply and regulate under these laws has been poorly thought out and implemented in general by Stevens County, Washington and other counties around Washington State (and our nation) in trying to protect the public safety. In trying to protect the public health and safety, individual constitutional rights, due process, and privacy cannot be ignored. If you do not exercise your rights, you will forfeit those valuable rights guaranteed to you by the U.S. and Washington State constitutions. You also may be forced to relinquish your beloved family pet, euthanize it, move out of the County, or live with severe restrictions on the animal and very expensive insurance."
Stevens County's new set of dangerous dog laws is designed to put the accountability on the owner and not just the animal. At this date, Stevens County does not have any designated animal control authority other than the Stevens County Sheriff. Under its new Title 20 ordinance, the Stevens County Sheriff's Office now has more authority to find that a dog is dangerous or potentially dangerous and impose corrective actions to protect the public. Owners are given further opportunity to appeal the Stevens County Sheriff's designation to the courts.
By definition under the newly adopted Title 20, a ""potentially dangerous"" dog is one that has a known propensity, tendency, or disposition to cause an unprovoked attack or to cause injury or otherwise threaten the safety of humans or domestic animals. A ""dangerous dog"" has caused unprovoked severe injury to a human being, or has killed a domestic animal while off the owner or keeper's property, or has previously been found ""potentially dangerous"" and aggressively attacks again or endangers safety. Both the ""potentially dangerous"" dog and ""dangerous dog"" designations under the Stevens County, Washington Title 20, carry similar consequences for owners and their dog(s). Stevens County has imposed more restrictive measures under the ""potentially dangerous"" dog designation than under current Washington State law.
If a dog is found to be ""dangerous"" or ""potentially dangerous"", the owner must register the dogs within 14 days of the County Sheriff's determination, and the registration will only be accepted if the owner agrees to placement of an identifying microchip inserted in the animal, payment of the first registration fee and an annual registration fee, and to keep the dog enclosed indoors or in a proper enclosure. Proper enclosure is defined under Title 20 as a kennel that contains an enclosed top as well as sides. If the dog is allowed outside the enclosure, it must be muzzled and restrained with a 3-foot chain with a 300 lb. tensile strength. An owner cannot sell or transfer ownership, custody or residence of the dog without notifying the County Sheriff and notifying the new owner of the dog's record with an acknowledgment signed by the new owner of the terms and conditions of his maintenance while in Stevens County, Washington. In extreme cases, presumably the County Sheriff as the animal control officer has the authority to decide if the dog must be destroyed. While I can understand the adoption of Title 20 and its ordinances and the ""dangerous dog"" designation and the purpose and merit behind its adoption, the ""potentially dangerous dog"" designation appears to be nearly impossible to regulate and this particular designation is ripe for abuse.
I am relatively certain many of us have experienced a difficult neighbor a time or two. For whatever reason, certain individuals seem to have nothing better to do than complain about their neighbors' pets, the broken down automobile, hobbies, or anything else that may annoy them at any given time. In fact for some people, they seem to make complaining their hobby. In rural Stevens County, Washington and other rural areas that are moving rapidly toward development, there will always be conflicts between country neighbors with differing views on a rural lifestyle. The Title 20 ""potentially dangerous"" dog designation provides these people with just one more avenue for conflict and additional ammunition for harassment. An additional danger for citizens is that the entire hearing process as applied through the Stevens County Sheriff's Office, under both designations, appears to be fundamentally flawed and unconstitutional.
I have spoken to several residents in the County where harassment by a nuisance neighbor, through Title 20, appears to have occurred to their detriment. The new Stevens County, Washington Title 20 ""potentially dangerous dog"" designation seems to make it particularly easy for a nuisance neighbor to harass another neighbor. Since the recent adoption of Title 20 in December 2007, I have discovered that several citizens have been struggling to defend against false and/or frivolous allegations about their companion dogs. One citizen found herself the target of a nuisance allegation by a problem neighbor and the Stevens County Sheriff concerning her ""potentially dangerous"" dogs, after her complaining neighbor's dog pulled her show dog through her own fence and killed it. Apparently a complaint was lodged by the nuisance neighbor against the deceased show dog as a preemptive strike. How many Stevens County citizens have simply forfeited their right to ownership of a companion dog because of nuisance allegations they could not afford to defend and unconstitutional actions being taken by Stevens County public officials? All a nuisance neighbor may now have to do is claim that a dog barked at them, and the dog's owner may be hit with a predetermined ""potentially dangerous"" dog designation, fees, an embarrassing public hearing and media coverage, and other severe restrictions on their dog by the Stevens County Sheriff.
I suppose the best part of the new Title 20 ordinance is the appeal process since a dog is already predetermined by the Stevens County Sheriff to either be ""dangerous"" or ""potentially dangerous"" prior to a hearing. However, many poor people do not have the resources to legally fight back against an initial and possibly frivolous determination by the Stevens County Sheriff in advance of a public hearing. Attorney fees, at a rate of $200 per hour to defend against this type of nuisance action, may be in the range of $2,000 - $40,000+.
There are other potential problems in carrying out the new Stevens County Title 20 ordinances. The problems I reference below, as well as others I have not highlighted in this article, have already emerged in other states and Washington State counties -- King and Spokane County, Washington, for example. The courts in King County and Spokane County have recently ruled upon the controversial dangerous dog ordinances and procedures. In King County, for example, in the recent dangerous dog case of Mansour v. King County tried by animal law attorney Adam Karp, where Mansour was found to have been denied due process, the Washington State Court of Appeals ruled: ""Due process essentially requires the opportunity to be heard at a meaningful time and in a meaningful manner"". . . ""An adequate standard of proof is a mandatory safeguard."" "" The standard of proof instructs the fact finder ""concerning the degree of confidence our society thinks he should have in the correctness of the factual conclusions"" . . .. While the Stevens County Sheriff continues to sit as the investigating official, the judge and jury in these potentially dangerous and dangerous dog cases, how much confidence can the public place in any factual conclusion made by the Sheriff's Office?
In Spokane County in a ""potentially dangerous dog"" case, Judge Austin of the Spokane County Superior Court ruled that Spokane's ""dangerous dog"" ordinance is unconstitutional because it denies pet owners the right of due process, and that as a matter of law the administrative procedures used in the City of Spokane regarding ""dangerous dog"" determinations and appeals from those rulings violate citizens' due process rights. In their current system, dogs tagged as ""dangerous"" by the city and its contractor, SpokAnimal, are deemed to be just that unless the owner can prove otherwise -- flying in the face of the notion of presumed innocence. The judge ruled that the City violated (in this case) Patty Schoendorf's rights by taking her property -- her dogs --and intended to destroy them after a hearing where she was not allowed to cross-examine or impeach witnesses involved in the dog's impoundment. She also wasn't given access to documents in the City's ""dangerous dog"" file, and the opportunity to rebut those allegations -- another denial of due process guaranteed by the Constitution. The judge not only ordered Spokanimal to immediately release the dogs, he also ordered the City of Spokane to pay legal bills for a team of attorneys - Robert Caruso, Richard Lee and Cheryl Mitchell, animal law attorneys.
While I would like to say that I trust the Sheriff's Animal Control Officers to ensure that there is a real danger to the public, the truth (and therein the problem) is that in Stevens County there is currently no separation of powers from the onset of the initial investigation, the Sheriff's determination of ""potentially dangerous dog"", and finally to the Sheriff's ruling following a public hearing that a dog is ""potentially dangerous"". The Stevens County Animal Control Authority (the Stevens County Sheriff's Office) sits as the investigator, judge and jury. Where is our guaranteed system of checks and balances in this process? The following is generally the procedure used under the Stevens County ""potentially dangerous"" dog designation:
(1) When a complainant calls to make a report, he makes it to the Stevens County
Sheriff's Office, the designated animal control authority in Stevens County;
(2) A Stevens County Sheriff's Officer may be dispatched to the scene to presumably thoroughly investigate the dog incident and take an incident report. A thorough and complete investigation may or may not occur, and in fact the dog's owner may not even be allowed to tell their side of the story to the Officer or see the complaint, the results of the investigation, and may not even be advised of the name of the complainant by the Sheriff's Office. The Sheriff's goal in these cases appears to be to hold back all relevant documents and evidence entirely from the accused pet owner until a day or two before the hearing, stating that the procedure is still in the ""investigational stage""-- similar to a criminal proceeding. The pet owner has no time to prepare a defense;
(3) After the Sheriff takes an incident report from the complainant, the owner of the alleged offending dog(s) is then promptly advised by a Stevens County Sheriff's Officer that he/she must submit to photographing of his/her dog(s), prior to the dog owner receiving any kind of a notice or citation from the Stevens County Animal Control Authority (the Sheriff). Notice of the alleged incident may simply be a Sheriff's Officer arriving on the doorstep or at your gate, and advising you that he is required to take photographs of your dogs as ""part of the hearing process"". At this point, you may not even have notice of any hearing. The photographing process may or may not involve a Stevens County Sheriff's Officer demanding entrance onto your private property or requesting entrance into your home, for the stated purpose of photographing your dog(s).
Citizens, please be aware that a dog is designated as ""personal property"" in the State of Washington and other states. The Washington State Constitution and U.S. Constitution protect individuals against unlawful searches and seizures concerning your personal property.
The simple act of entering onto private property for the purpose of taking photographs of personal property, without the direct or implied consent of the property owner and without a search warrant, is unlawful. Generally speaking, warrants are signed by judges or commissioners in criminal matters. At this point, this procedure is still considered a civil or administrative matter. There appears to be something inherently wrong with this process from the outset. (The rule that I have personally imposed is not to let anyone onto my property without my express invitation (or a warrant). My directive to this effect seems to work for most people.)
Of course, there are ""exigent circumstances"" exceptions under the law to the warrant requirement. Exigent circumstances generally arise when a law enforcement officer may have reasonable ground to believe that there is an immediate need to protect his life, the life of others, their property, or that of others, the search is not motivated by an intent to arrest and seize evidence, and there is some reasonable basis to associate an emergency with the area or place to be searched. None of these exigent circumstances is likely to exist in a Title 20 dangerous or potentially dangerous dog investigation which would allow a public official to trespass for the purpose of photographing dogs.
4) The owner of the alleged offending dog will then receive a certified letter or personal service by the Stevens County Sheriff', notifying the dog's owner that their dog has already been deemed a ""potentially dangerous"" dog or ""dangerous dog"" under their new Title 20 ordinance. The owner's dog is deemed ""guilty"" before tried, based generally only upon a report made by a complainant. That complainant could be made by anyone with ""axe to grind"". The dog is declared guilty in advance of a public hearing before the Stevens County Sheriff's Department. The investigating agency (the Stevens County Sheriff's Office) then amazingly plays the role of the judge and jury at this public hearing where the dog's owner is required to prove that his/her dog is not dangerous, or potentially dangerous. Please be aware that you (as the accused) are not required to prove anything. The burden of proof falls upon your accusers to make their case, and not you. Public testimony will be taken by the Sheriff, and you will receive a subsequent notice of his final ruling. This entire process usurps constitutional protections afforded each citizen under Washington State and U.S. Constitutions. Any hearing in a ""potentially dangerous dog"" or ""dangerous dog"" case should be set before an impartial judge or hearing officer. The Sheriff cannot rule on issues as a matter of law.
It is my understanding and belief that any public hearing conducted by a public official(s) in Washington State must follow the law and procedures under either the Washington State Open Meetings Act or Administrative Procedures Act. Since a dangerous dog hearing does not really meet the criteria under the Open Meetings Act, the hearing process should follow the Washington State Administrative Procedures Act. If you are not familiar with this Act, familiarize yourself with it and your rights under this Act. This law can be found in the public library under 34.05 RCW (Revised Code of Washington). Insist that any dangerous dog hearing you may be a party to comply with these lawful procedures.
Citizens, please take heed! The Stevens County Title 20 dangerous dog ordinances are dangerous to you in that they can potentially escalate into a criminal matter if you do not comply with the severe restrictions imposed on your dog, or if the dog is again the subject of a complaint. You must contest the letter/notice that you receive from the Stevens County, Washington Sheriff's Office and promptly return it via Certified US Mail or Delivery Confirmation. Also enclose your own letter stating you contest your dog's predetermined designation by the Sheriff, and that you demand a lawful hearing before a bona fide hearing officer conducted under the Washington State Administrative Procedures Act. If you do not sign and return the Notice from the County Sheriff, the ""potentially dangerous dog"" designation is automatically applied by the Sheriff to your dog through your inaction.
Once you have been deemed to own a ""potentially dangerous"" dog or ""dangerous"" dog, all regulations, restrictions, fees and other penalties under the new ordinances apply to you and your dog. The Title 20 regulations, restrictions, fees and other penalties have severe consequences for both you and your dog. If you do not comply with these new regulations following the final determination of your ""potentially dangerous dog"" or ""dangerous dog"", then you possibly may be issued a criminal citation. Potentially you may be thrust into the position of defending yourself as a criminal. Moreover, your homeowner's insurance may be cancelled or be prohibitively expensive in the future, and you may be forced to carry an expensive bond if you intend to keep your dog in the County.
The Title 20 dangerous dog ordinances can be dangerous to your health and welfare and your dog's health and welfare, particularly if you do not exercise your constitutional rights. I would highly recommend hiring an attorney, if you can afford one. Hire someone who specializes in animal law, for instance one of the attorneys mentioned in this article. If you cannot afford one and are low income, call CLEAR at their toll free number in Washington State to see if you can qualify for free legal assistance. Other possible sources of legal assistance are the Gonzaga Law School, or the Washington State Bar Association who may have a referral to a pro bono (free) attorney.
Please exercise your civil and constitutional rights and familiarize yourselves with this new set of laws under Stevens County, Washington - Title 20. Please do not allow your valuable rights to be trampled upon by public officials or you may lose them. Do not allow yourself to become their victim.
Last but not least, please recognize and be aware that you do not have to allow anyone onto your private property, in most cases, without a warrant. It surprises me that many citizens do not know this. If there is any doubt in your mind, please respectfully ask the person requesting permission to enter onto your private property ""do you have a warrant?"" Express to them that without a signed warrant, that person does not have your consent to enter onto your private property. This rule generally applies to most everyone, public officials included, unless they have an implied right to enter such as a meter reader. With respect to your private property rights, generally speaking, what applies to any other private citizen who wants entrance to your property applies to public officials as well. Post your gates and property with ""No Trespassing"" and ""Beware of Dog"" signs to protect yourself -- approximately every 50 feet. Also fence your property with at least a 5-6 foot fence if you own a dog, for additional protection. Electrify your fence, if necessary, if you are in a rural area. Fence chargers, including solar fence chargers, can be purchased for $30 and up and are quite effective as a deterrent to entrance and exit by animals.
I recognize that this article may not be ""politically correct"" in this climate as this is a sensitive issue right now. I am aware that it may anger those who are truly at risk or who have been victims of genuinely dangerous dogs. I agree that genuinely dangerous dogs are a threat to public safety. However, I submit that while the intent behind Title 20 and other dangerous dog laws is good and I agree with its intent, the process to apply and regulate under these laws has been poorly thought out and implemented in general by Stevens County, Washington and other counties around Washington State (and our nation) in trying to protect the public safety. In trying to protect the public health and safety, individual constitutional rights, due process, and privacy cannot be ignored. If you do not exercise your rights, you will forfeit those valuable rights guaranteed to you by the U.S. and Washington State constitutions. You also may be forced to relinquish your beloved family pet, euthanize it, move out of the County, or live with severe restrictions on the animal and very expensive insurance."
Saturday, 5 May 2018
"Amidst all the turmoil of cancer diagnosis and figuring out how to beat it, you and your health care providers commonly forget that the odds are that you will survive your disease for many years to come. Loss of fertility is one of the most disheartening consequences of cancer treatment. This is a guide to all the young women and men diagnosed with cancer on how to preserve their ability to conceive after cancer treatment. Unfortunately, in the real world, you do not get timely information to be able to make an informed decision. Surveys of young women and men indicate that they are very interested in future fertility. Surveys of providers, however, points that in less than half the cases fertility issues are discussed or women are referred for consultation. Interestingly, when women inquire about fertility they are more likely to receive information about future fertility or referral to a specialist.
Call to Action: the notion that 'I / you got cancer and would be lucky to sort it out' should not stop young people and their physicians from planning for long term survivorship issues. It is really possible to lead quite a normal life after cancer treatment with thoughtful preparation and consultation with pertinent health care providers
Preservation of Fertility in Women
Who needs it and how its done?
Fertility is a key aspect of the quality of life for cancer patients of childbearing age.
Preservation of fertility is defined as the application of medical, surgical and laboratory procedures to preserve the potential of genetic parenthood in adults and children at risk of sterility before the end of natural reproductive lifespan (Gosden 2009).
Decrease or loss of fertility can take place due to exposure to medication (chemotherapy), radiation or surgery (e.g removal of the ovaries). The American Cancer Society estimates that cancer affects one in each 3 women living in the United States. Modern cancer treatment commonly involve exposure to chemotherapy and sometimes pelvic radiation. Cancer and its treatment though is not the only situation that affect fertility. Fertility can also be diminished by bone marrow transplantation and treatment of kidney disease usually due to lupus (lupus nephritis).
If you are a women or a man living in the United States and recently diagnosed with cancer or another condition that threatens your future ability to mother or father children, this lens is written with you in mind. The odds are you will beat your disease and survive for many years to come. Considering fertility-sparing options before starting disease treatment may greatly enhance your ability to conceive a biological child after cure.
Health Problems that Jeopardize Fertility
Who needs to consider fertility preservation?
a. In 2009 about 700,000 women will be diagnosed with cancer, about 10% of them under the age of 45. Breast cancer is the most common cancer affecting women. Each year bout 15,000 women will be diagnosed with breast cancer before 45 year. Women can also be diagnosed with leukemias, lymphomas, cancer of the colon, uterus, ovary, skin or thyroid gland. Treatment of all these cancers is associated with long term effects during the survivorship period including decline in fertility. The effects of cancer treatment go beyond the harm caused by the method of treatment itself to the time spent in treatment and time needed for follow up. This delay means women will probably attempt pregnancy several years later than they intended.
b. Women undergoing bone marrow transplantation for treatment of cancer, anemias (e.g sickle cell disease) and other diseases. The use of chemotherapy and radiation prior to transplantation is usually associated with fertility loss in the vast majority of patients.
c. Some women develop breast or ovarian cancers due to abnormality in breast cancer gene (BRCA1 & 2). Reducing the risk of future cancer may require removal of both ovaries with loss of fertility.
d. Women diagnosed with connective tissue disease (Systemic lupus, rheumatoid arthritis...) or autoimmune disease may have severe disease affecting their organs (e.g kidney). Chemotherapy is sometimes used to suppress their immunity which may lead to fertility decline. Moreover, the antibodies generated by the disease process may directly affect ovarian function.
e. Individuals exposed to accelerated loss of eggs due to genetic disease (e.g mosaic Turner syndrome) can also benefit from preservation of fertility
f. Fertility extension. Women delaying pregnancy for career or social reasons (no male partner at this time) can consider freezing their eggs or embryos (using donor sperm). This option was not studied in large population studies.
Effects of Cancer Treatment on Ovarian Function
In general the younger the woman, the more oocytes she harbors in the ovary and the higher the likelihood that some oocytes will remain in the ovary after treatment.
a. Chemotherapy and the Ovary. The use of chemotherapy can lead to fast loss of oocytes (eggs). Oocytes carry the genetic material that women pass to their children after fertilization by a sperm. The effect of these agents is variable depending on the drug, dose, frequency of administration, and age of the woman at the time of treatment. Cyclophosphamide is the most harmful agent for future fertility. These medication appear to cause loss of eggs through damage of its DNA and inducing spontaneous demise of the egg. There is no proven method that can prevent this loss.
b. Pelvic Radiation and the Ovary. Exposure of the ovary to radiation can damage the eggs and the remaining tissue of the ovary. The amount of radiation that leads to complete loss of ovarian function is dependent on the age. A dose of 1500cGy will sterilize the majority of women at age 30. Smaller doses will sterilize older women.
c. Time factor. Cancer treatment usually requires several months. For some cancers (e.g breast cancer) medical treatment (tamoxifen) is required for 2 to 5 years after surgery and chemotherapy. For others oncologists recommend a period of observation for 1 to 2 years. This will delay a woman's plan to start a family to a later age when fewer oocytes remain in the ovary. Actually the effect of cancer treatment on the ovary appears to be similar. Continuous loss of eggs from the ovary takes place in all women. Cancer treatment accelerates this loss so that the number of eggs in the ovary would correspond to older age.
d. Pelvic Radiation and the Uterus. Exposure of the uterus to radiation increases the risk of miscarriage, preterm labor and abnormal pregnancy outcome.
Evaluation of Ovarian Function after Cancer Treatment
Tests that reflects fertility potential (egg production) in women
Although many think that resumption of menstruation after cancer treatment indicates that the woman retains the ability to conceive, this is not true. Some women have regular menses with near exhaustion of the eggs in the ovaries. Thus, menstruation is not a reliable indicator of the ability to conceive.
The function of the ovary before after cancer treatment can be evaluated using hormone tests and ultrasound.
1. Cycle day 2 or 3 FSH (follicle stimulating hormone, normal is less than 12mIU/mL)
2. Inhibin
3. Antimullerian hormone (AMH). This is a new and promising marker and appear to be more accurate than the other markers.
4. Vaginal ultrasound to evaluate the number of small follicles visible in the ovary.
Although these markers are more accurate than menstrual history, normal markers after treatment does not mean that ovarian function is completely preserved after exposure to treatment.
Here is a study that I did in 2006. I compared the response to fertility medication in women cancer survivors that were exposed to chemotherapy to those that present for fertility preservation prior to cancer treatment. The number of eggs obtained from those exposed to chemotherapy was much less than those not exposed.
Methods Used to Preserve Fertility in Women
How it is done?
Methods used to preserve fertility in women are generally divided into three categories:
Modification of cancer treatment plan to reduce damage to the ovaries and uterus:
1. Preserving one ovary in women affected with early ovarian cancer.
2. Preservation of the body of the uterus with removal of the cervix in early cervical cancer.
3. Use of progesterone treatment instead of removal of the uterus in endometrial cancer.
Protection of the ovaries from the damage caused by cancer treatment:
1. Ovarian transposition is a surgical procedure to move the ovaries upwards, away from radiation field before pelvic radiation. Results are variable as some scattered radiation still reaches the ovaries.
2. Protection of the ovaries from the effect of chemotherapy. GnRH agonists are a group of medications that suppress the master gland in the brain, preventing the release of the hormones that stimulate development of follicles in the ovaries. Although suggested, there is no proof that they actually protect the ovaries and improve the chance of pregnancy after the use of chemotherapy.
Low Temperature Storage of Embryos, Oocytes or Ovarian Tissue:
1. Embryo freezing
2. Oocyte freezing
3. Ovarian tissue Freezing
Because they are applicable to all types of cancer, I will go through these in some detail.
Embryo Freezing
The standard method for women with a partner
This is considered the standard method for preservation of fertility. Its suitable for women with a male partner or accepting he use of donor sperm and when cancer treatment does not need to be started immediately.
This method entails stimulation of the ovary with medications and frequent monitoring of response using ultrasound and blood work. This stimulation usually requires 12 to 14 days.
The eggs are then removed from the ovary by an outpatient procedure under sedation. Egg retrieval requires passing a needle through the vagina into the ovary. Eggs are then fertilized in the lab and the resulting embryos are frozen 2 to 6 days later and stored for later use. Cancer treatment can start immediately after egg retrieval.
After cure, women can request to use their embryos, that are placed back into the uterus after simple preparation of the lining of the uterus. The transfer of two embryos into the uterus yields a pregnancy rate of about 30%.
Women diagnosed with an estrogen sensitive tumors (e.g. breast cancer, uterine cancer) require special attention to mitigate estrogen rise during stimulation.
Egg Freezing
Slow freezing and Vitrification
Egg freezing is considered for women with no male partner and declining the use of donor sperm. It requires stimulation of the ovaries and egg harvest as described earlier.
The human egg is unique. Its the largest cell in the body with high water contents. The membrane surrounding the cell is not very permeable. Moreover, its the only cell in the body where chromosomes are spread on flimsy structure called the spindle, rather than being enclosed inside the nucleus of the cell.
The egg requires special expertise to freeze. One of two techniques are used; slow freezing or vitrification (rapid freezing). The newer vitrification method has the advantage of minimizing the formation of ice crystals inside the egg and yields better survival of the egg at thawing.
The American Society for Reproductive Medicine still considers egg freezing experimental.
In Vitro Maturation
Growing eggs in the lab
In this method a very short ovarian stimulation for 3 to 5 days is performed followed by retrieval of immature eggs. Eggs are then matured in the lab, fertilized and the resulting embryos are frozen for later use. The efficiency of this method is lower than retrieving fully mature oocytes. About 50% of follicles punctured yield an egg. Approximately 70% of the eggs reach maturity in the lab and about 70% of those fertilize. This method is suitable for women demonstrating high response to stimulation to fertility medication.
Ovarian Tissue Freezing
Investigational method
This is an experimental method for preservation of fertility. In this method one ovary is removed, processed and frozen. After cure, the ovary is transplanted back in the pelvis (orthotopic) or under the skin (heterotopic). Processing of the ovary means that the outer 2-3mm (this is the part that contains the eggs-the cortex) is shelled out and cut into thin strips. So far the ovary cannot be frozen as a whole organ because its too thick for cryoprotectants (the substance that protects the tissue from damage caused by freezing) to diffuse into it before freezing. Removal of the ovary is performed using laparoscopy (minimal access surgery) or at the time of surgery for other indication.
The inner part of the ovary (does not contain eggs) is sent for tissue examination to make sure it does not contain any malignant cells. Since ovarian harvest can be accomplished in 1 to 2 hours, this method is used when there is no time to complete ovarian stimulation (2 to 3 weeks) or when stimulation of the ovary is not possible as in girls before puberty. Because of the experimental nature of the procedure, its offered to women with very high risk for ovarian failure after treatment.
Co-ordination of Cancer Treatment & Fertility Preservation
Multiple studies in the US surveying patients or oncologists found that discussion and referral for preservation of fertility takes place in less than 50% of patients. Referral was more likely when patients inquire about fertility issues.
This underlines the importance of educating women about fertility issues and the diagnosis of cancer and other allied diseases. Empowering women to ask questions appears to one of the most important initial steps to receive appropriate information about and possibly pursue preservation of fertility.
Collecting information and co-ordination of care between providers concerned with cancer treatment and those that deal with preservation of fertility can be a demanding task, especially at difficult and busy times. Here is a planning tool that aims at helping you organize your thoughts and collecting information about your cancer and to discuss this information with multiple providers.
If You Do not Read Anything Else Read This
Cancer treatment especially chemotherapy reduces the ability to conceive. If you were diagnosed, you deserve to get answers about long term issues including fertility. Preservation of fertility is possible and relatively easy. The standard method for women is embryo freezing."
Call to Action: the notion that 'I / you got cancer and would be lucky to sort it out' should not stop young people and their physicians from planning for long term survivorship issues. It is really possible to lead quite a normal life after cancer treatment with thoughtful preparation and consultation with pertinent health care providers
Preservation of Fertility in Women
Who needs it and how its done?
Fertility is a key aspect of the quality of life for cancer patients of childbearing age.
Preservation of fertility is defined as the application of medical, surgical and laboratory procedures to preserve the potential of genetic parenthood in adults and children at risk of sterility before the end of natural reproductive lifespan (Gosden 2009).
Decrease or loss of fertility can take place due to exposure to medication (chemotherapy), radiation or surgery (e.g removal of the ovaries). The American Cancer Society estimates that cancer affects one in each 3 women living in the United States. Modern cancer treatment commonly involve exposure to chemotherapy and sometimes pelvic radiation. Cancer and its treatment though is not the only situation that affect fertility. Fertility can also be diminished by bone marrow transplantation and treatment of kidney disease usually due to lupus (lupus nephritis).
If you are a women or a man living in the United States and recently diagnosed with cancer or another condition that threatens your future ability to mother or father children, this lens is written with you in mind. The odds are you will beat your disease and survive for many years to come. Considering fertility-sparing options before starting disease treatment may greatly enhance your ability to conceive a biological child after cure.
Health Problems that Jeopardize Fertility
Who needs to consider fertility preservation?
a. In 2009 about 700,000 women will be diagnosed with cancer, about 10% of them under the age of 45. Breast cancer is the most common cancer affecting women. Each year bout 15,000 women will be diagnosed with breast cancer before 45 year. Women can also be diagnosed with leukemias, lymphomas, cancer of the colon, uterus, ovary, skin or thyroid gland. Treatment of all these cancers is associated with long term effects during the survivorship period including decline in fertility. The effects of cancer treatment go beyond the harm caused by the method of treatment itself to the time spent in treatment and time needed for follow up. This delay means women will probably attempt pregnancy several years later than they intended.
b. Women undergoing bone marrow transplantation for treatment of cancer, anemias (e.g sickle cell disease) and other diseases. The use of chemotherapy and radiation prior to transplantation is usually associated with fertility loss in the vast majority of patients.
c. Some women develop breast or ovarian cancers due to abnormality in breast cancer gene (BRCA1 & 2). Reducing the risk of future cancer may require removal of both ovaries with loss of fertility.
d. Women diagnosed with connective tissue disease (Systemic lupus, rheumatoid arthritis...) or autoimmune disease may have severe disease affecting their organs (e.g kidney). Chemotherapy is sometimes used to suppress their immunity which may lead to fertility decline. Moreover, the antibodies generated by the disease process may directly affect ovarian function.
e. Individuals exposed to accelerated loss of eggs due to genetic disease (e.g mosaic Turner syndrome) can also benefit from preservation of fertility
f. Fertility extension. Women delaying pregnancy for career or social reasons (no male partner at this time) can consider freezing their eggs or embryos (using donor sperm). This option was not studied in large population studies.
Effects of Cancer Treatment on Ovarian Function
In general the younger the woman, the more oocytes she harbors in the ovary and the higher the likelihood that some oocytes will remain in the ovary after treatment.
a. Chemotherapy and the Ovary. The use of chemotherapy can lead to fast loss of oocytes (eggs). Oocytes carry the genetic material that women pass to their children after fertilization by a sperm. The effect of these agents is variable depending on the drug, dose, frequency of administration, and age of the woman at the time of treatment. Cyclophosphamide is the most harmful agent for future fertility. These medication appear to cause loss of eggs through damage of its DNA and inducing spontaneous demise of the egg. There is no proven method that can prevent this loss.
b. Pelvic Radiation and the Ovary. Exposure of the ovary to radiation can damage the eggs and the remaining tissue of the ovary. The amount of radiation that leads to complete loss of ovarian function is dependent on the age. A dose of 1500cGy will sterilize the majority of women at age 30. Smaller doses will sterilize older women.
c. Time factor. Cancer treatment usually requires several months. For some cancers (e.g breast cancer) medical treatment (tamoxifen) is required for 2 to 5 years after surgery and chemotherapy. For others oncologists recommend a period of observation for 1 to 2 years. This will delay a woman's plan to start a family to a later age when fewer oocytes remain in the ovary. Actually the effect of cancer treatment on the ovary appears to be similar. Continuous loss of eggs from the ovary takes place in all women. Cancer treatment accelerates this loss so that the number of eggs in the ovary would correspond to older age.
d. Pelvic Radiation and the Uterus. Exposure of the uterus to radiation increases the risk of miscarriage, preterm labor and abnormal pregnancy outcome.
Evaluation of Ovarian Function after Cancer Treatment
Tests that reflects fertility potential (egg production) in women
Although many think that resumption of menstruation after cancer treatment indicates that the woman retains the ability to conceive, this is not true. Some women have regular menses with near exhaustion of the eggs in the ovaries. Thus, menstruation is not a reliable indicator of the ability to conceive.
The function of the ovary before after cancer treatment can be evaluated using hormone tests and ultrasound.
1. Cycle day 2 or 3 FSH (follicle stimulating hormone, normal is less than 12mIU/mL)
2. Inhibin
3. Antimullerian hormone (AMH). This is a new and promising marker and appear to be more accurate than the other markers.
4. Vaginal ultrasound to evaluate the number of small follicles visible in the ovary.
Although these markers are more accurate than menstrual history, normal markers after treatment does not mean that ovarian function is completely preserved after exposure to treatment.
Here is a study that I did in 2006. I compared the response to fertility medication in women cancer survivors that were exposed to chemotherapy to those that present for fertility preservation prior to cancer treatment. The number of eggs obtained from those exposed to chemotherapy was much less than those not exposed.
Methods Used to Preserve Fertility in Women
How it is done?
Methods used to preserve fertility in women are generally divided into three categories:
Modification of cancer treatment plan to reduce damage to the ovaries and uterus:
1. Preserving one ovary in women affected with early ovarian cancer.
2. Preservation of the body of the uterus with removal of the cervix in early cervical cancer.
3. Use of progesterone treatment instead of removal of the uterus in endometrial cancer.
Protection of the ovaries from the damage caused by cancer treatment:
1. Ovarian transposition is a surgical procedure to move the ovaries upwards, away from radiation field before pelvic radiation. Results are variable as some scattered radiation still reaches the ovaries.
2. Protection of the ovaries from the effect of chemotherapy. GnRH agonists are a group of medications that suppress the master gland in the brain, preventing the release of the hormones that stimulate development of follicles in the ovaries. Although suggested, there is no proof that they actually protect the ovaries and improve the chance of pregnancy after the use of chemotherapy.
Low Temperature Storage of Embryos, Oocytes or Ovarian Tissue:
1. Embryo freezing
2. Oocyte freezing
3. Ovarian tissue Freezing
Because they are applicable to all types of cancer, I will go through these in some detail.
Embryo Freezing
The standard method for women with a partner
This is considered the standard method for preservation of fertility. Its suitable for women with a male partner or accepting he use of donor sperm and when cancer treatment does not need to be started immediately.
This method entails stimulation of the ovary with medications and frequent monitoring of response using ultrasound and blood work. This stimulation usually requires 12 to 14 days.
The eggs are then removed from the ovary by an outpatient procedure under sedation. Egg retrieval requires passing a needle through the vagina into the ovary. Eggs are then fertilized in the lab and the resulting embryos are frozen 2 to 6 days later and stored for later use. Cancer treatment can start immediately after egg retrieval.
After cure, women can request to use their embryos, that are placed back into the uterus after simple preparation of the lining of the uterus. The transfer of two embryos into the uterus yields a pregnancy rate of about 30%.
Women diagnosed with an estrogen sensitive tumors (e.g. breast cancer, uterine cancer) require special attention to mitigate estrogen rise during stimulation.
Egg Freezing
Slow freezing and Vitrification
Egg freezing is considered for women with no male partner and declining the use of donor sperm. It requires stimulation of the ovaries and egg harvest as described earlier.
The human egg is unique. Its the largest cell in the body with high water contents. The membrane surrounding the cell is not very permeable. Moreover, its the only cell in the body where chromosomes are spread on flimsy structure called the spindle, rather than being enclosed inside the nucleus of the cell.
The egg requires special expertise to freeze. One of two techniques are used; slow freezing or vitrification (rapid freezing). The newer vitrification method has the advantage of minimizing the formation of ice crystals inside the egg and yields better survival of the egg at thawing.
The American Society for Reproductive Medicine still considers egg freezing experimental.
In Vitro Maturation
Growing eggs in the lab
In this method a very short ovarian stimulation for 3 to 5 days is performed followed by retrieval of immature eggs. Eggs are then matured in the lab, fertilized and the resulting embryos are frozen for later use. The efficiency of this method is lower than retrieving fully mature oocytes. About 50% of follicles punctured yield an egg. Approximately 70% of the eggs reach maturity in the lab and about 70% of those fertilize. This method is suitable for women demonstrating high response to stimulation to fertility medication.
Ovarian Tissue Freezing
Investigational method
This is an experimental method for preservation of fertility. In this method one ovary is removed, processed and frozen. After cure, the ovary is transplanted back in the pelvis (orthotopic) or under the skin (heterotopic). Processing of the ovary means that the outer 2-3mm (this is the part that contains the eggs-the cortex) is shelled out and cut into thin strips. So far the ovary cannot be frozen as a whole organ because its too thick for cryoprotectants (the substance that protects the tissue from damage caused by freezing) to diffuse into it before freezing. Removal of the ovary is performed using laparoscopy (minimal access surgery) or at the time of surgery for other indication.
The inner part of the ovary (does not contain eggs) is sent for tissue examination to make sure it does not contain any malignant cells. Since ovarian harvest can be accomplished in 1 to 2 hours, this method is used when there is no time to complete ovarian stimulation (2 to 3 weeks) or when stimulation of the ovary is not possible as in girls before puberty. Because of the experimental nature of the procedure, its offered to women with very high risk for ovarian failure after treatment.
Co-ordination of Cancer Treatment & Fertility Preservation
Multiple studies in the US surveying patients or oncologists found that discussion and referral for preservation of fertility takes place in less than 50% of patients. Referral was more likely when patients inquire about fertility issues.
This underlines the importance of educating women about fertility issues and the diagnosis of cancer and other allied diseases. Empowering women to ask questions appears to one of the most important initial steps to receive appropriate information about and possibly pursue preservation of fertility.
Collecting information and co-ordination of care between providers concerned with cancer treatment and those that deal with preservation of fertility can be a demanding task, especially at difficult and busy times. Here is a planning tool that aims at helping you organize your thoughts and collecting information about your cancer and to discuss this information with multiple providers.
If You Do not Read Anything Else Read This
Cancer treatment especially chemotherapy reduces the ability to conceive. If you were diagnosed, you deserve to get answers about long term issues including fertility. Preservation of fertility is possible and relatively easy. The standard method for women is embryo freezing."
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