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Reflecting On a System That Needs Fixing

On December 2, 2015 about 80 employees of the Inland Regional Center in San Bernardino attended a workplace training event/holiday party that ended after 14 of them were killed and 22 were seriously injured in a mass shooting. One year later, many of the injured find themselves victims again—this time of the Workers' Compensation system.

As reported in the Los Angeles Times, "In interviews and at a recent public meeting, employees described struggling to cope with a callous county bureaucracy that provided little comfort as they tried to heal. Instead, they were left scrambling for help and tangling with a county-administered Workers' Compensation program that has led to delays and denials of needed medication and treatment…."

A similar scenario has played out throughout the state to injured workers, including in Rialto, Stockton and San Jose, where firefighters feel abandoned by the Workers' Compensation system when they are injured in the line of duty. Injured workers' rights to receive adequate and humane treatment for injuries have been jeopardized by cost-cutting efforts and a misapplication of the law.

The injured workers in San Bernardino

"The rights of injured workers to receive appropriate medical treatment were severely affected in 2013 with the passage of Senate Bill 863," explains attorney Richard Felton, a partner at Gordon, Edelstein, Krepack, Grant, Felton & Goldstein, LLP (GEK). "This legislation took the medical decision-making process out of the hands of the treating physician and into the hands of the employer's insurance company, leading to a significant increase in denials of treatment. And although there is a purported safeguard in place through the Independent Medical Review (IMR) process, it is basically an exercise in 'rubberstamping' the denial."  

There is always hope that positive change is in the future, which is why GEK attorneys participate actively on the legislative  frontlines in Sacramento, and work with colleagues of the California Applicants' Attorneys Association (CAAA) to ensure that a more just system will become a reality.
"Upon reflecting on a Workers' Compensation system that needs fixing, it is clear that our legislative involvement is vital, but the solution doesn't stop there," says GEK partner Steve Scardino, who is on CAAA's Board of Governors and is a member of the organization's Public Safety and Labor committees.  "For instance, skilled legal counsel can help develop a medical record to be sure that it complies with the law, and as a result  there is a better likelihood of getting  the medical care approved even in a treatment review system that is stacked against employees. In addition, in some cases the courts can still play a role in forcing an insurer to authorize medical treatment. And, by educating physicians in the Workers' Compensation system on how to comply with all the rules necessary to properly report and request authorization for medical treatment, we can help prevent delays and denials in medical care.

"Those who were hurt in San Bernardino are now—a year later—suffering physically and psychologically, with the county seemingly turning a blind eye.  And the firefighters in Central and Northern California are victims to a system that doesn't consider the sacrifices they make every day to ensure the safety for all the public they serve.

"We at GEK will never give up on the fight for justice for the injured."

 

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