The Stench of Fraud, Continued

In The Stench of Fraud: Why Workers’ Comp Can No Longer Be a Closed System, I briefly mentioned the plight of one individual, who I called “Ms. X”.

I called her that because her case is still winding through the medico-legal system in her state, and I do not want to prejudice her case, or add to her woes by embarrassing her, even though she herself is bringing light to her situation by using all resources available to her,

But I felt that once I mentioned her in my previous post, it was alright to expound on the subject of fraud, and discuss her case without identifying her personally.

According to her own words to me [bracketed below] and in her correspondence to others, this is how her nightmare began:

I am an injured worker who was maimed by the medical providers in the insurance carrier’s network of medical providers. Mine is a long story that began December 12, 2011 when I was hurt at work.

[A herniated lumbar disk from working in a sitting position in excess of 65 hours one week and during that week, picking up boxes of banking and files from time to time. I began to feel discomfort in my lower back, went home, took it easy over the weekend, went back to work on Monday, worked for approx. an hour or hour and a half, got up, went to the copy machine, made my copies, bent over to pick them up and then that is when the disk herniated.]

On the day that I was hurt at work, the human resources manager told me that she was going to call the insurance carrier to find out what to do or where to send me. When she returned, she wanted me to sign a “release letter”. I had just gotten that job on November 16, 2011. I got the message that someone there didn’t want me to file a WC claim by virtue of the effort to induce me to sign a release letter. I needed that job and hoped that my back would feel better. I didn’t sign a release letter but I did write a letter indicating that I was hurt at the copier but that I didn’t want to go to their Doctors. I asked if I could go home. At some point, the HR manager gave me a couple of Advil and water for the pain. I had gone home from there – Monday, 12/12/2011. By Thursday, 12/15/2011, my back did not improve, so I placed a call into the HR Mgr. and said that I need to see their Doctors… the HR Mgr. responded by saying something to the effect “Why, you don’t have any money to go to your own Doctor?” (Not verbatim). I was taken aback by this. She knew I was hurt at work. She continued by saying, “We have a release letter signed by you!”. I responded by saying something to the effect that I never signed a release letter. We argued… and so on.

She goes on to say in her correspondence that:

…former employer who fired me less than 3 months after I filed a WC injury. On the very day that I filed a WC claim, my employer placed an ad on Craigslist to replace me. I didn’t learn until sometime in May 2012 that my former employer lied to the insurance carrier about the circumstances of my injury and what I had said. For the record, I was hurt at work and due to the working conditions and surroundings, including my desk and number of hours that I had to work, 65-66 hours the previous week. Our office had very little storage, therefore, myself and the other Escrow Officer, had to pack up boxes of files for closings and banking. We lifted these boxes weekly and sometimes daily due to the lack of space.

Because of what has happened to me, I have been upfront with Doctors outside of the workers comp system. At one of the Doctors, a pain management Doctor that I went to see in early 2014 – March or so, one of the female investigators that I had seen near my apartment on prior occasions (or was her twin) showed up and was placed inside a room before I was, I arrived first, was placed inside the room next to her. During that visit to the Doctor after being placed in the room next to the investigator, the receptionist from the front desk asked me several times if I did recreational drugs and had I ever done recreational drugs. Clearly, a continued effort to create a negative review of me and/or my history. Another Doctor who I visited to get a referral to an orthopedic Doctor insisted that what I describe does not happen. She said that there are no instances in the US of a person being forced under anesthesia. Further, she said that I was delusional and that I should see a psychiatrist, and that the pain that I have is psychologically driven and not real pain.

She was given three epidurals, and this is what happened to her after the first epidural, which went without incident:

I was forced under anesthesia for simple lumbar epidurals. At the 2nd epidural procedure, after objecting to anesthesia, I was told I had no choice, that it was the policy of the surgery center (_____ ___ Outpatient Surgery Center) that all patients must undergo anesthesia. I awakened from that with severe neck pain and slight left arm pain. My Doctor had injected my neck, left side of my spine, left leg with some sort of chemical that tingled and popped like Alka Seltzer. In fact, the tingling went from my lower left lumbar down my left leg all the way up my back and felt like a popping sensation in my head. I was there to receive a lumbar steroid epidural injection and “trigger point shots” in the left side lumbar area.

The next epidural procedure, I made it clear I that I did not want to be placed under anesthesia not only on the phone (a day prior to the procedure) but also before the procedure in pre-op and I re-stated the same in the operating room for everyone to hear. I restated that I was to get a local pain blocker (just as I had during the first lumbar epidural). Instead, my Doctor abruptly shoved the needle into my back without any pain blocker whatsoever. I could feel the needle going through the textures of my back (not precisely or with care into the spinal area where the disk is). My head flew up as I screamed “Wait!” or “Stop!”. He would not relent! As my head hit the operating room table (where a towel and prop to lay my head was), he moved the needle inside me to the nerve in my back next to my spine and held it against the nerve! The pain was so excruciating that I bit into the towel that was for my head to rest on and screamed with the towel in my mouth. Pure agony! He would not stop! I had no choice once again but to give into anesthesia. When I awakened, I thought to myself, Oh my God, they didn’t! I had injuries now throughout my back, neck, shoulders and arm. I could feel the nerves firing all over my back and next to both sides of my spine from the injections of some sort of chemical (the Alka Seltzer feeling again) that over the coming months, burned and corroded the ligaments in my spine, tendons and muscles in my back. It felt as though I was being burned from the inside out. PAIN from burning, PAIN from damage and maiming! I can now and then could feel that some of the tissue/muscles were pushed away from my spine creating the feeling of divots or holes on both sides of my spine. I could feel what seemed to be a muscle pushed away and hanging down on to the right mid side of my person. The ligaments that are in my neck and run up into my skull feel damaged, sore. My spine felt “chiseled” in specific areas most prominently in the top of my back and neck and the bottom near the lumbar sacrum area. I now have instability in my spinal column. I can feel the vertebrae in my spinal column moving not in sync with the other vertebrae…

There is a lot more detail to her case that is beyond the scope of this blog to address, but I am sure my readers have gotten a clear idea of what she has gone through. As a former Claims Examiner and Claims Administrator for a wrap-up insurance program, I have never seen, nor heard of such abuse inflicted upon an injured worker.

This poor woman, who was just doing her job, was taken advantage of by a broken, corrupt and dysfunctional workers’ compensation system that makes the injured worker seem like the guilty party, when it is the providers and legal system who are guilty of injuring and maiming the worker.

To illustrate just how they are characterizing this woman, here is another part of her correspondence regarding an attempt to make her out to have a psychological problem:

The insurance carrier and/or it’s attorneys are working hard to impair my credibility. Several attempts to have me include a psych claim ,since I finally realized that I was being maimed, have been made. Even the AME has placed a notation in his last report that is false – saying that I have ongoing psychological “???”. For the record, I haven’t any history of psych issues. This is a lie that is meant to bode well in favor of the defense. I have never before had a psychological condition. I did mark on a form that I was depressed but that was due to the pain! Not anything else.

In my insurance career, I came across another poor soul who suffered from depression due to the pain he suffered as a result of his injury. At the time, I was the No-Fault Claims Supervisor of the NY office of an automobile insurance company that insured Black Car limousines (Owner and Owner and Another). A Coptic Christian gentleman from Egypt cried in my office before he was seen by our medical consultant. Recognizing that my job was to limit the amount of money we paid to this individual, I did speak to our consultant just prior to the examination. It was the least I could do for this person. So reading what Ms. X has written does not surprize me in the least.

A letter Ms. X forwarded to me from a defense attorney even stated that her epidurals were harming her and not helping. This letter was part of a plan to get her to settle for a few thousand dollars. The lawyer’s text is as follows:

Additionally, the applicant appears to not be benefitting from the treatment, in fact, the treatment by both the employer’s physician and your physician [addressing claimant’s former attorney] appears to be harming rather than helping the applicant.

She also stated in her correspondence that she discovered that:

…some of my medical forms, surgery reports, paperwork had been falsified, changed over and above my signature and due to the anesthesia form (copy handed to me) was marked differently than the first page that I signed and more.

Finally, to make matters worse, she received a letter from a law firm representing her workers’ comp primary physician, demanding her to cease and desist from making false and libelous statements on the internet about their client. From what I understand, this is the physician who the defense attorney said above was harming her. It is no wonder that by mistreating Ms. X this workers’ comp doctor prompted her to take the actions she did to warn people about his conduct.

As I mentioned in the last post on this subject, Ms, X would have been homeless if it was not for her sister. She was subsequently fired from her job as a Manager of her department by her employer after filing the workers’ comp claim.

The events and actions discussed by Ms. X and disclosed here by me, further elaborates just how much the stench of fraud and abuse in the system has become unbearable. These words that I have quoted are but a small part of the whole story Ms. X has told people about, but it is clear that there is something rotten in the state of CA, if not in the state of Denmark, paraphrasing Shakespeare. And we all know that when something is rotten, the stench is overpowering.

Yet, the medico-legal system is arrayed against Ms. X, and the end result, I am afraid will be that she loses, and her work comp settlement will be liened against by the primary physician’s attorney, or the case will be decided in the insurer/employer’s favor, and Ms. X will be unable to go back to work, and will be forever marked as someone who brings attention to herself and not in a positive light. And furthermore, she may be marked as having a psychological issue, when in reality, she is only trying to get the proper treatment for her herniated disk. This psychological defense strategy smacks of something the Soviets used to do to political dissidents.

One gets the feeling that even though the Soviet Union is no more, we are more like the Soviet Union and other authoritarian states, in that the individual is powerless against the power and prestige of physicians, hospitals, lawyers, the courts, and other medical providers, and the system itself.

If ever there was a more clearer case of why we need to transform workers’ comp from the broken, corrupt and dysfunctional system I have been describing these past two years, this case is it.

How different Ms. X’s life would have been if she had gone to an honest and reputable treating physician, received the proper medical treatment, and if necessary, gotten back surgery to repair her herniated disk, even if she received the surgery from her employer or insurance carrier in another country, as a medical tourism option.

And how different her life would be if she did not have to be threatened with a lawsuit from a shyster law firm that is representing a shyster physician, as well as being misrepresented by bad attorneys, so that I had to ask someone I knew if he could help her. There is a saying, “a fish rots from the head down”, and in this case, the stench of the fish called ‘Workers’ Comp fraud’ is taking down the entire system.

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13 thoughts on “The Stench of Fraud, Continued

  1. Irene Padilla

    After talking with an injured who worked for SCIF-state fund insurance fund, the CA Quasi state insurance agency, has stated to me that money from the fund is primarily given to top state employees called civil servants. When he made this discovery among some other fraud & corruption, he was targeted with severe beatings by the state’s own law enforcement in the CA, SCIF office(1987) building where he worked. A whistle blower’s award. I suspect that rather than get story this out, to the public on the fraud & corruption, he was given his workers compensation for the rest of his life, unlike most who are injured for life, The story is that it Worker comp judges and law enforcement will get their benefits but not lower level employees because they indoctrinated by the state to be pro business. The trade off. So yes the stench is from the rotting head of the fish and it does start at the top. What I have seen in legislation, commissions, worker comp hearings is that the reforms were to cut off as much as possible since 1989 with at least 5 reforms and that since then most CA. injured workers will hardly ever receive medical treatment or not much of anything else. Vocational Rehabilitation was stripped starting in 1993 and really no longer exists The plan is to get us to Social Security & Medicare as soon as soon as possible, to pick up the tab and neither program worries about the taxpayers picking up the employers responsibilities. It is amazing that the “professionals” like doctors, attorneys, judges, police, corporations & unions, the worker compensation insurance ilk, look human (especially when they wear suits & ties, robes and white coats) but are in fact nothing more than savages, raking in the money at any cost to the injured worker, money that belongs to the injured workers and taxpayers/premium payees. Insure that employers create safe & healthy work environments, get rid of the “professional middlemen” , treat employees employees with dignity & respect and the human & financial costs to us all will freatly decrease.

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    1. Transforming Workers' Comp Post author

      You can thank Pete Wilson and Ahrnold for this mess, but blame also goes to the liberals in CA who gave away the store to too many people…I once heard on TV that by some future date, CA will have 50 million residents. Can you imagine what would happen if many of these residents filed for work comp? Small businesses for sure would go out of business, and others would flee, or get the system changed.

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      1. Irene Padilla

        It actually started with Deukmegian, 1989, the Ist reform but certainly when writing to both Pete & Arnold about whatever problems we mentioned, they both made those problems worse in their next reforms. Most were liberals that signed onto Arnold’s 2005-SB899 (Pete did have a hand in this one too where pain was no longer a limitation, cut temp disability to two years(the usual prior to) and mold not causing illness and the current “liberal” Governor Jerry Brown with 2013-SB863 sealed the deal to eviscerate what ever there was left. Practice makes perfect after they keep doing illegal stuff and then it is legitimized by legislators via another reform. I’ll go another step further and say the CA workers compensation system is nothing more than a sadistic and parasitical system because it sure does hand over 80% plus of the many billions that do not go to the injured. Just 17.1 % go to all injured workers (2005-WCIRB) and over 50% to “medical providers”, just like the ‘ medical provider” that used & moved a needle to force Ms X under anesthesia only to do further harm her to where she’ll never work again and become the one who is discredited. This QME holds a license as an M.D. & also a state certified license as a Qualified Medical Examiner-Medical legal examiner, including sub-rosa but who’s watching him as he holds this woman hostage with a needle in her large backside nerve to hold her hostage again via forced anesthesia and held her hostage again, to get injected with unknown chemical agent or agents to completely disable her? It sure is a conflict of interests to wear those two hats, first do no harm and then harm her during a treatment with an evaluation her calling her nuts? Obviously he wasn’t conflicted when he got paid by the insurer when he hurt her like he did and he has the unmitigated gall to threaten her via a law suit for slander? Another tactic to get her to back off, in the calling for justice
        Where are the law enforcement including the fraud county DA’S WHO state that there are no penal codes to charge the doctor with? A crime less crime? DA’s that receive about 33 million a year to prosecute less than 700 people a year? Since 2005, one smaller corporation got caught with fraud, but why would the DA’s bite the and that feeds them and file fraud or any criminal charges against corporations that give them the 33 million a year?
        5 billion a year to the illegal NICB to collect all insurance info on you forever ( an illegal nice gift that keeps on giving to use against you when you file any future claims). Now your comp claims are all based on car accidents that happened many years ago even though the employer takes you as you are and there really are no lasting injuries prior to the comp claim. This is part of the ME’s job, to write a report that excludes your work related injury(albeit large omissions and alterations of your or a real doctors medical facts and not TO repeat in a report as to what really happened at your work place that caused those injuries and then blamed it all on your child hood, your past accidents, your prior medical conditions even though they no longer exist or weren’t there in the first place. Basically your whole life to which you were really fine until you filed a worker comp claim. Just imagine you were perfectly physically & mentally well UNTIL you filed a worker claim.
        The ME’s get paid to write felonious perjury evaluation reports.They are also boiler plated by the ACOEM/ADA. Just change the name & the claim #.
        The insurance industry’s sub rosa kicks in to commit more illegal acts against the injured worker like stalking with undue and obvious intimidation, ( following you across the country at every twist and turn, all to stop you from trying living what is left of your life) and which also includes the hijacking of your U.S. mail, sending you threatening letters from attorneys, hijacking your electronic digital devices so you cannot say what is happening to you and your case, illegal entry & theft of your home and car, causing car accidents to further injure you, slashing your tires and or cutting and draining your brakes to further injure you or worse. This is the use of the NICB, 5 billion dollars of premium money per year and now the FBI using tax payer dollars every year as well. So who are the real criminals here and all with the permission of all law enforcement who’s own benefits are all insured.
        This is the result of the injured workers vs the insurance industry or as I call it, the insurance cartel.
        At one time, not too long ago about 1 million were injured every year here in CA.. According to some, it is now about 440,000 a year but those maybe just the ones that file WC claims. Many other workers folks will not file for fear of ending up like their family or friends. Hurt, sick, broke or dead. This does not count agricultural workers who have it the worst.
        And don’t forget the unions part in all of this, where it seems it’s only job is to collect initiation fees, union dues and organize more future injured workers, only to hand it all over to attorneys for the employers and then sent to the even more savage and torturous worker comp court called the WCAB.
        BTW, the icing on the cake, so to speak is that in the CA worker’s comp court , we have no due process which makes the CA WCAB, what many others in the system have called it, a kangaroo court. With the higher judicial courts, no matter the type of real case you have, say for instance, discrimination’s or whistle blowing cases, these real judges where do process is supposed to exist, will remand you & your civil cases to the worker comp court. I would say that with pure confidence that is was a thorough orchestration for many employers with the legislators, judges, unions, attorneys, certain M.D.’S to ( the bottom feeders) to in fact keep the revolving door to continue making sure labor is kept cheap, except for these WC “labor” . That many of us, our lives, our families, we’re the profit cog in the wheel of corporations. A truly carnivorous machine to insure the “have’s” vs more “have not’s”.
        There is no justice here whatsoever and certainly there is no humanity in the CA workers comp system and that this is what voters get when they vote for the so called “leadership” legislators. Workers compensation is unconstitutional on its face because it was never voted in by the citizens and “our legislative leaders” keep enacting more unconstitutional reforms that violate the federal mandate which was the right to real medical care, wage compensation, vocational rehabilitation and partial or total disability compensation in lieu of tort claims (master/slave) all to save millions in the new industrial age back in the early 1900’s.
        At 17.1% of billions of dollars per year, it is more than fair to say that the federal mandate has been violated for at least several decades when worker compensation reform took place by Nixon (1972 ) and when worker compensation specialists attorneys were created.(1978). The start of the rotting head of the fish.
        Since the system is so well rigged so voters can only vote the least of two evils, that with all of this, IT IS STILL AN EVIL.

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  2. Irene Padilla

    One more issue to think about, is how, does one get the system changed? I know that many folks hate regulations but it needs to happen but yet again with all of the fraud & corruption that permeates the WC system and that it is perpetuated by our legislators, it does appears to be impossible at this time.
    One little twinkling of hope though, since the Pope of the Catholic Church, which has over 1 billion members, is changing the way the church Curia (Administration) performs & also making the necessary changes in its own Bank of Italy, then just maybe cutting out the rotting fish head of the comp system is possible. One can only hope that change IS possible AND I’ll keep praying for this to happen.
    Thank you for posting on what is needed to be said.

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  3. Transforming Workers' Comp Post author

    What I meant was that the business community would get the system changed so that they would not have to pay for high cost work comp benefits, which is exactly what they did. Unfortunately, the reform was no reform, and that is why there are people being hurt by it. When you don’t believe in a social safety net, this is what you get…we are only now learning what the other side is all about. We never thought these people would take us backward, but it is our own fault for not realizing how far and how fast we were pushing government to spend money to help people in need, especially the poorest and working class.

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    1. Irene Padilla

      There are many who paid for those safety nets including the govt FICA & pension & health care retirements and for decades and then those nets disappeared ALMOST overnight and why those who paid into those disappeared nets are now on the govt dole, their own FICA, much sooner rather than later, through no fault of their own and the business community did that with their voracious appetite for greed. It is as that simple!
      When some who think they, the self anointed, figure they really are not, then just maybe and only then maybe they’ will fully realize that it is about fairness and equality, especially when actually getting decent pay and a good work environment while actually working for a living. The working/business attitude/paradigm was much different years ago. So, when you ask for a big decrease somewhere, it increases somewhere else and it usually ends up being a negative for most. The law of physics. It is working today against us just as it is for Ms.X. She like so many others lost everything and the business community of today created that problem because they wanted all the safety nets for themselves. Corporations are after all the citizens while us real people are not, so they win for now..

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  4. Irene Padilla

    I just needed to add THAT as I have found out recently, that when injuries or illnesses are totally permanent, whether by the job or with “a lack of medical care or or the wrong medical, that Ms X. endured -making sure we never go back to work again in any case, that the injured worker WILL BE automatically sent to social security & Medicare. UNION heads with employers brought in the SSA to pick up the tab for both wage replacement (if you can call the least of the least owed to you from the SSA) from SSA & Medicare paying for the injuries or illnesses that weren’t tended to or created by the insidious & sinister comp system.
    It takes about two years from the onset of the injury or illness. Most seriously ill or injured workers were on temporary disability for 2 years before it became actual CA law in 2005. The SSA goes directly to the insurance adjuster for the wages received while on comp , not the actual earned wages that should be applied within the SSA laws.
    1. The highest paid year from within application of SSA. 5 years from 1st application
    2. The average of the last highest of 3 of years of working when filing for SSA benefits, 5 years of first application
    3.. Over the life time of working.

    I was told by an SSA reviewer that my benefits would be adjusted-off setted because
    a.I was married,
    b.then it was over 20 years(I worked 30),
    c.then it was over 30 years.

    My amount was less, starting with an amount that was around 150.00 dollars per month less than those who never worked at all but who were disabled who receive SSI and on the letter to the adjuster by the SSA did indeed say SSI.
    In essence I received less than those who never worked at all. My highest year was 21,700(1991) and according to when I applied, I was to receive benefits with THE FIRST but with the 80% offset, the amount came to 1510.00 a month. In other words, my total of any wc monthly benefits & SSA could not exceed 80% o the 1510. I don’t know how the monthly amount came to be and I am still going to the SSA OIG on 3-17-2014-3-18-2014 & Congressmember with a complaint I made in June-2-14. I was told by a SSA tech adviser that is first it would be within 30 days but then I was told after me calling again, that it would be up to 6 months for the review, this is after I filed a complaint of their policy of process review on 3-17-2014
    The SSA IS in with unions & employers, that this was an orchestrated plan because the SSA is to review the worker comp cases (those who injured on the job) to correct any further offsets AND the SSA does not review any comp claims for any total permanent disability so that the SSA isn’t paying out more than it should. This leaves another fact as to why IW’s were never going to receive their owed comp benefits, that with the employers & unions ( this is a relationship that certain pols claim this is adversarial & contentious one but certainly not when it comes to denying comp & SSA benefits) and the SSA, that injured workers were NEVER going to receive ANY WC total permanent disability by employers or their insurance cohorts. the TPA’s. the self-insured employers hire, but that Injured workers were only going to receive the least of the SSA benefits.
    The other issue is that injured cases can grow old and moldy for decades as mine has done.(1988)and a case still sits at the WCAB.
    This is were is gets really dicey for the orchestrated plan of more fraud & corruption, it is still unknown as to whether the amount injured workers receive on SSA benefits ARE the real amount that should be allocated to them. Along with this, the insurance adjuster gives out the same QME reports from their QME’s that denied the injury or illness in the first place for total disability. These same falsified reports are used by the SSA to deny or delay SSA benefits and the claims for the medical or mental issues are given by SSA but not comp even though our attorneys had us file for mental claims as well, all to hide all of the physical injuries and the SSA does the same thing. The SSA will give benefits on mental issues but not physical, so our word against the employer’s wrong doing in the workplace, will never be credible again
    The other issue in SSA is that their reviewers have no problem in actually changing the application date as they did mine and now lied to the SSA OIG. Another delay process while one waits for their meager (orchestrated) amount of SSA benefits. It is also well know that unions send their injured or ill members to the applicant attorneys who also handle the very same injured workers SSA claims. SO, the Injured workers own attorneys get two fees, one for a C& R & one for the SSA.
    The CA WCAB knows that these totally injured workers will end up on SSA and help the defense for the insured employer to give out as little disability benefits for totally ill or injured workers. So there are lot of civil servants (state) who are in the business of protecting the employer’s best interest and not ours, the injured workers and the tax dollars pay for all of these civil servants to help destroy more workers. Why, IT IS cannibalistic, that other workers eat their own, all because of money-greed-avarice!.There is a lot of tax payer money used to continually harm & hurt workers all the time and it doesn’t stop because injuring workers is a trillion dollar industry. This is going on decade after decade with no ending in sight.
    BTW, I have 17 QME reports with additional reports where the some of QME’s never saw me but stated I was okay to go back to work. I also have my own doctor reports that were not used by either defense or applicant attorney in my trial in 1999-2000 or used by the QME’s. I have never seen so many lies, character assassination’s and no medical care for so many years that these many QME’s (all but one) falsely wrote, all to deny me what was owed to me by the simple virtue of the constitutional worker’s compensation laws here in CA. that I was to be compensated and given medical care and vocational rehabilitation and it did not happen. The SSA is supposed help the disabled as well and it does not, so there is further proof that we were never intended to get our due compensation nor would we ever be able to go back to work again. The fix has been going on for almost 3 decades with no legal help around, no one to fight for us, those of us who suffered so many civil rights abuse by a worker compensation court right here in ca and others.
    Exclusive remedy is actually a denial of due process AND the ability of the EMPLOYERS worker’s compensation to just keep harming over & over & over again with impunity.
    With what happened in Ferguson Missouri, it occurred to me that at least one disenfranchised group of society made it into the national news. But what is going on to injured workers, with all of the fraud & corruption, is still invisible.

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  5. Irene Padilla

    To add great insult to injury, that when an injured worker goes directly from temporary disability to social security & medicare benefits, ( it is intentional that any worker will not receive worker’s compensation total disability) that after paying for both via earnings for decades, that the IW also HAS to pay well over 140.00 A MONTH & now close to 200.00 a month, out of their meager SSA benefits. Now, that tops it all, putting people in the poor house, and the injured workers are paying for their own care & compensation… paying for it all via their decades of work F.I.C.A. benefits. When the Injured or ill finally get their retro money from SSA, remember that their same WC attorney get’s up to 25% of the first SSA $10,000, just like with a WC C&R 15-20% for about 20,000, (for a total work related injury or illness) thus releasing the employer of all liability even when more injuries are made by medical folks or lengthy litigation, so it behooves the same attorney to let SSA claims drag on just as they let drag WC claim drags on in the workers compensation kangaroo court & get two bites of the same apple doing nothing.
    Defense attorneys are paid directly out of an expense account out of each claim number, (4) which are regular attorney fees. I received 5600.00 for whole body injuries & the defense got almost 25,000 up until 2000. That is not counting their fees after 2000 when I fought my cases all the way to the CA. Supreme Court.
    The QME’s got about the same 25,000.
    Many of my doctors are still owed well over 150,00.00
    I was fired in 1993 after my 2nd time out, getting fired after 1 year again (1989) while on WC.
    In 1994 did get started with 538.00 per month with SSA & my husband’s medical care is paying for my care, and that is limited at best.
    Thank you Kaiser, Athen Jenkins, TPA, Mullen & Fillipi, Grancell Lebowitz..etc, the CA WCAB, 3rd Appellate court , CA Supreme Court , 2nd fed Appellate court, SEIU & the SSA!
    Dina J. Padilla

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