California’s workers’ comp system is getting some bad press.
I’m referring to the news that a year after the San Bernardino terrorist massacre, victims who worked for the county are having trouble getting their treatments approved.
This story broke after the San Bernardino Press Enterprise published a piece featuring interviews with victims who were having trouble getting medications and other treatments. Workcompcentral picked up the story, and other media outlets are doing the same.
Apparently the county has held group meetings with some of the survivors to discuss the problems. The Chairman of the San Bernardino Board of Supervisors, James C. Ramos, has issued a statement of concern which in part blames the medical providers treating the workers for providing inadequate documentation to support the requested treatments. Ramos also announced that “Based on concerns expressed by the Board of Supervisors, the county will hire a firm whose sole function will be to expedite the process for our employees.”
I’ve heard rumblings that these problems have greatly irritated some legislators and that we may see legislative efforts to address some of the bottlenecks experienced by terror victims.
Supporters of the MTUS, UR and IMR system status quo will undoubtedly argue the old maxim that hard cases make bad law. And it may be, as I’ve noted in other posts, that there is a lot of “friction” in California workers’ comp due to treating doctors who are unwilling or unable to understand how the treatment guidelines and request for authorization schemata is structured.
But the reality is that the problems getting treatment experienced by the San Bernardino terror victims are problems encountered by many other workers in California.
The situation is yet another wake-up call reminding us that no matter how well the system may be performing in bland, clinical data studies, there is a human cost.
In this instance the county is hiring a firm that will apparently be a liaison between the workers and doctors and the claims administrators. That’s an extra cost for employers. And it’s a service that is being provided only because of the magnitude of the Islamist terror event and the political sensitivity surrounding it.
But perhaps it is an idea worth looking at. Should there be some sort of ombudsman process where workers can go to, in Ramos’ words, “expedite the process”? Some informal ombudsman procedure?
In taking most treatment disputes out of the hands of WCAB judges, we’re left with a situation which is neither expeditious nor fair in the minds of many workers.
At a mimimum, the San Bernardino situation should be fodder for detailed study by CHSWC. What has gone wrong in the handling of those claims? Who is to blame? What can we learn from this?