Workers’ Comp Needs Changes

I, personally, do not practice in the area of workers’ compensation. Richard Irwin, of Heiting & Irwin, however, is certified specialist in workers’ compensation for the last 20 plus years. I get to see how hard he works for his clients and how frustrating the workers’ compensation system can be.

I’ve been following the complaints of the lack of responsiveness of the County of San Bernardino to the workers’ compensation claims and need for treatment for the victims of the terror attack of December 2, 2015. Just recently the State Division of Workers’ Compensation, in commenting on their investigation into the San Bernardino County’s handling of cases involving those victims, said that denials for treatment have been rare and that delays were mainly attributed to doctors failing to submit the appropriate information. Is this a case of the fox watching the hen house? Many who are caught in the workers’ comp system say the workers’ compensation system is broken, inadequate, and fraught with delays and lack of treatment and attention that are unacceptable.

People who have been hurt on the job should be able to expect that they will get the treatment and attention necessary to cure and relieve the effects of the injury as soon as possible and to receive those benefits that they are entitled to in a timely manner. They need to buy food and pay their rent or mortgages and car payments, and provide necessities for their kids. Too often, though, workers’ comp insurance carriers and workers’ comp self insured entities like the County do not provide adequate treatment, attention, or benefits. They claim that, even though doctors order certain tests and/or treatment, they need to review the orders and requests and determine for themselves whether they feel they are appropriate. This requires submittal to other, undisclosed, evaluators who many times deny the requests, even without disclosure of their reasoning.

According to one recent article, the investigation into the complaints against the County of San Bernardino concluded that, “as claims matured, the County increased its scrutiny of treatment requests, leading to modifications and denials.” (Press Enterprise March 3, 2017). They blamed the treating doctors failing to document or fully explain their requests for the employees who were still suffering. The outcry was so bad against the County of San Bernardino that, in December, the Board of Supervisors set aside $100,000.00 to hire an outside company “to expedite” the claims; yet the frustrations and criticism continue.

And what about all of the rest of California’s injured employees that are subject to the workers’ compensation rules and processes? Nobody has paid $100,000.00 for their claims to be expedited; but they have just as great a need and get the same or worse treatment than the County employees have gotten.

I could go on for a very long time, specifying the treatment limitations and procedures/policies specified in legislation, often unrealistic in the real world, and often denying the injured any realistic chance of full recovery, especially in a timely way.

The workers’ compensation processes, rules and laws must be reviewed and changed if this is ever going to be put right. (In the meantime, effective and attentive representation by a workers’ comp attorney specialist is the best route for the injured worker).