For my first post of 2015, I want to go back to a subject I wrote about last year, namely the fraud and abuse perpetrated against injured workers by their employers, by lawyers, by the medical profession and the insurance industry at large.
Wall Street hedge funds and private equity firms, in particular, who are taking an greater interest in the workers’ comp industry, and as has been written extensively about, are buying up various workers’ comp service providers, thus shrinking the industry and squeezing every last drop of profit from the claims process while cutting back on services, or even raising the price of those services.
I discussed the issue of fraud and the plight of an injured worker I called “Ms. X” in two articles; the first article, The Stench of Fraud: Why Workers’ Comp Can No Longer Be a Closed System, dealt with the use of phony or unapproved implants, the second article, The Stench of Fraud, Continued, described the ordeal Ms. X suffered after being injured at her place of employment.
Today’s article, also highlights the ordeal suffered by an injured worker, who I will call “Ms. A”. The following text below is the actual words written by Ms. A on her personal blog, with some minor editions by myself.
I will point out that Ms. A was an executive with a very large corporation, whereas Ms. X was an employee of a small firm, and was not an executive. This will give the readers some idea that the fraud and abuse is not confined to low income or clerical workers, but could be experienced by anyone, at any level of employment, so long as they are not the owners or managers of companies.
Here is Ms. A’s story:
January 9, 2015 marks 3 years since a witnessed slip and fall at _________ by ________________ in Big Bear, California and Traumatic Brain Injury. Still waiting for medical care and benefits. Thousands and thousands of dollars have been paid out in evaluations; very little in the way of ‘medical care’ requested by treating physicians.
Friends have suggested that since _________________________ and it’s Work Comp carrier, CNA Insurance,…refuse to provide medical care, and continue to refuse to reimburse nearly $30,000 in properly submitted medical expenses for mileage to their designated doctors and medically necessary treatment that they unlawfully denied, that GOFUNDME might help.
I lost professional credentials…. Hawaii Real Estate Sales License, California Real Estate Broker’s license, and California Notary license. Failures to provide medical care, disability benefits, and return to work opportunities! Thanks _______.
I was basically thrown out of a public CAREER NIGHT at ________________ Indio in December 2014, which was a public invitation to learn more about the company and working as a sales person. I was able to say hello to several co-workers while HR pondered on what to do with my attendance at their public event. The Project director advised that Human Resources said he could not talk to me, and… LOL, I was the only person from the “PUBLIC” who showed up for the event.
Social Security Disability has been denied twice, and Long Term Disability is at constant threat of being discontinued, despite the policy and fiduciary responsibilities.
Some say that upon diagnosis of anything to do with Brain Injury, Work Comp carriers fully and immediately breach fiduciary responsibilities and expedite 3D practices….”DELAY, DENY, DECEIVE” rather than to expedite immediate medical care to mitigate harm and risk.
The first year, I could hardly speak, and leaving the house was only ‘as necessary’ to various doctor evaluations. My speech is still ‘dysfluent’ but improved. I experience cognitive fatigue more often than I care to admit. There are other impairments, but being a sales person and personal-development-activist who has walked on fire and bent rebar at the throat chakra, I muddle along to the best of my abilities.
If you remember 286 computers and dial-up, no clip-board, no copy and paste then you have an idea of what it can be like living with a brain injury.
I am a “High IQ TBI and Work Comp Survivor” Some new and old friends say I am still brilliant, just different, and much slower.
Typing is still a strong suit. Different lobes govern different functions. The brain is an amazing organ. Neuroscience is truly the New Frontier. Ask a Veteran today!
One doctor, in 2012, advised to “never tell anybody you have a brain injury, as it has a stigma”….He wanted me to spend out of pocket $500 for a day-planner to conceal the impairments. I didn’t start screaming loudly about it until year two, when I could better grasp the extremely dangerous situation I was in as an Injured Worker in America. It became very clear what a corrupt and vile system Work Comp in America, and elsewhere, is. Consider Japan’s Nuclear Meltdown workers.
If you say Work Comp is none of your business, I must assume you are not part of the Human Race.
When I slipped on ice and fell backwards on 1/9/12 and conked my head really hard at Big Bear, I laid in the snow for what seemed to be about 5 minutes. I was asked if I was ok, and I said, “No, I hit my head really really hard.” I was dazed and confused, but eventually got up, dusted the snow off, and reported to the sales meeting. My colleagues had a great laugh about my fall, and one even said, ‘Ewwwwwwww, she has Fukushima radiation all over her now from the hot-snow!’
I gave a ‘timeshare tour’ at 9 am, and I was very apologetic for my extreme confusion and disorientation and they were grateful for a short tour, and a fast gift.
Around 10 am, the administrative manager asked if I was going to a doctor, and I asked if I had to see any special doctor. He said, “See any doctor that accepts work comp” and provided me with an incomplete DWC-1 form, that had no insurance info on it. I drove down an icy mountain after the last tour of the day, about 20 miles, then another 40 miles of flat desert. How? Dunno! Just did.
Nobody thought I might need a ride to a doctor, or a hospital, or even a 911 ambulance ride? I haven’t worked since, and I have spent more than $30,000 out of pocket to discover and obtain help for brain injuries. Had I received immediate and appropriate care, I am told I might have returned to work that first year.
Recently, after denied TTD and PD benefits for months, and years of failures to authorize medical treatments, the attorney for _______suggested that if I reviewed the situation, it would be clear that the failure to obtain medical care is all my fault, and he further asked why I believe I am entitled to any benefits.
He sent a nasty little note with his legal opinion on my medical conditions, suggesting a Court Appointed ‘Conservator’ to make my decisions, since I struggle so with the Work Comp system. It sounded to me like he was suggested I agree to let the Court appoint an insurance company goon to finish the kill? Yikes. The contempt and disdain is mutual.
That doesn’t even mention the insurance guy who called and after listening to me whine about no medical care for nearly 3 years asked, “….so when ARE you going to die?”
The insurance company and attorneys had me driving everywhere; I don’t know how I did it either. One doctor wanted me to drive with a brain injury, sleep deprived, over 100 miles for an ‘exam’ and that’s where I drew the line. I knew that was insane, and would be a danger to me and to the driving public. Where do they find those Work Comp neurologists? Haven’t met a smart one yet.
You can see from her description of her ordeal, there is something going on with her claim and the claims of so many other injured workers.
She is coping with this traumatic event the best way possible, but the system that was designed to care for people like her has failed time and again, and for no other reason than to protect the profits of those who are inflicting harm on her, after initially suffering an injury not her fault.
A wise man once said, “for what hath it profit a man if he gains the whole world, and loses his soul,” To me, it would seem that the workers’ comp system, the legal system, the medical profession, and the insurance industry has lost its soul on the way to gaining the world and profit.
As for Wall Street, two hundred years of lying, cheating, stealing, conniving, and manipulating has proved that they have no soul, only dollar signs where their hearts and minds should be.