Yes, I did ask readers to send me their horror stories involving the
workers' compensation mess Gov. Schwarzenegger claims to have fixed.
But you can stop now.
I've got enough material to keep me busy until I'm eligible for Social Security, if it hasn't gone belly up by then.
The responses ran the gamut, as was to be expected.
I got employers saying their premiums have fallen, but far more saying their premiums have jumped.
Some readers crucified me for taking a few pokes at Schwarzenegger, who
was only trying to straighten things out, as they see it, even if he
did go easy on insurance companies that stuffed his pockets with
campaign money.
Some employers, including Jeff Kavin of
Greenblatt's Deli, wondered why I don't write about fraud and abuse by
attorneys, doctors and employees who "skim so much money out of the
system" that premiums soar for business owners while "the worker with a
real devastating injury is left with very little."
Well, of
course that's part of the problem, and it always has been. Lest you
doubt it, consider this week's series on the creative energy at
King/Drew Medical Center. Employees there filed 122 claims in 10 years
for falling off chairs, collecting a cool $3.2 million for their tragic
falls from a frightening height of about 18 inches.
But by far,
most of the responses I fielded on the workers' comp morass were from
doctors, lawyers and injured employees telling me about treatment being
delayed, denied or discontinued.
I've heard from a retired El
Segundo teacher, 80 years old, who is suddenly being grilled (by mail)
by a doctor she never met, part of a workers' comp conspiracy to cut
off her medication for a longtime disability.
I've spent a day
and a half playing amateur arbitrator in the case of a jockey who was
thrown from a horse, had hip surgery, and claims the home healthcare
agency frequently failed to show up at her house, where she was alone
and immobile.
"Insurance companies have stopped cutting checks
… period," says West L.A. physician Lauren Papa. "I have patients who
should rightfully receive benefits and aren't…. They're going on
welfare, being evicted, using food stamps, etc. Worse, it's Christmas.
Do these idiots think my patients don't want to work?"
Bruce
Traney, a workers' comp attorney, warns that it will get worse in
January, when more of the impact of the governor's "reform" package
kicks in.
"If you're a worker in California and get hurt in the
next year," Traney says, "you're not going to be a happy person. You'll
be human flotsam thrown to the curb."
One of the readers who
got hold of me was a gent who claimed he had no ax to grind, which
always makes me suspicious. But I called him anyway.
"I am the
president and editor in chief of WorkCompCentral.com — a news and
information service for the work comp industry," he said. "We don't
take sides. We just publish the facts."
And what are they? I asked David DePaolo, the boss man and a lawyer who used to represent insurance carriers.
As DePaolo sees it, Schwarzenegger wanted to make good on his campaign
promise to deliver a workers' compensation reform measure, especially
since so many of his supporters in the business world were complaining
about rising premiums. He delivered the package, DePaolo says of SB 899.
But not the fix.
"There are too many inconsistencies and loopholes. That's the bottom line," DePaolo says.
"The governor said relief was on the way. That's the way they played it
— that you were going to see some immediate relief. But nobody in the
industry believed that. Everybody thought it was pie-in-the-sky
statements made for political reasons."
The simplistic
legislative "remedy" was no match for the forces that drove up workers'
comp rates nationwide, says DePaolo. It gets pretty complicated, but he
blames the stock market crash and a multibillion-dollar fraud in the
international insurance market. In lay terms, we're talking about a
Ponzi scheme and bad stock gambles.
And in California, we ended
up with a "reform" package that seems to have been designed to help
recoup those losses for the insurance industry.
Sure, there
were obvious abuses by injured workers. Some of them received medical
services that exceed anything they would get from standard health
insurance companies.
But do the state reforms swing the pendulum too far in the other direction?
"I would say that based on what I've seen, there is a great increase in the denial of medical treatment," DePaolo says.
Great news, of course, if you're an insurance company.
"Financially, insurance companies are doing fantastic right now because they're bringing in more money and paying out less."
And the sweetest part of the deal, as I noted in the last column, is
that SB 899 doesn't require them to pass on the savings to employers.
Large companies might see a decrease in workers' comp costs because
they're self-insured and don't get gouged by a middle-man, DePaolo
says. Smaller companies might see a temporary decrease, but he expects
the real impact of SB 899 to be slower price increases rather than big
discounts.
"And," DePaolo predicts, "we'll be in a crisis again in seven to 10 years."
