The October issue of the American Journal of Industrial Medicine confirms what our clients have been experiencing since the California legislature began “reforming” medical treatment access in 2003: the system fails to provide appropriate care for non-catastrophic injuries. (See Franklin, G., et al., “Workers’ Compensation: Poor Quality Health Care and the Growing Disability Problem in the United States,” American Journal of Industrial Medicine, October 2014). The reforms, which include reliance on “evidence-based” medicine and utilization review, often results in increased permanent disabilities and a shift of compensation to Social Security, Medicare and other state and federal disability systems.
The authors note a 75% increase in those receiving Social Security Disability benefits for working age people during the period 2000 and 2012. The basis of the inability to work has shifted from cardiovascular to musculoskeletal, arguably injuries that could have been prevented with safer work practices.
Our experience at Fraulob, Brown, Gowen & Snapp is consistent with these findings. Just today, one of our client’s reported that the expert medical evaluator in his case, agreed to by the insurance company, advised him that had his neck surgery been approved when his doctor requested, rather than going through the utilization review process, he would have had less residual disability. This of course does not even address the pain and suffering he endured waiting for approval; pain and suffering which is not paid by workers’ compensation.
The only way to change this system is through legislation. Which means that people need to vote and need to make it their mission to contact their legislators and the governor with their horror stories.
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*Melissa C. Brown is a frequent lecturer at legal conventions and seminars. Ms. Brown has been recognized in America’s Top Attorneys for over 20 years. She has studied Mediation at the World Intellectual Property Organization in Geneva, Switzerland.Ms. Brown is a certified specialist in Workers’ Compensation as well as a national expert on Social Security Disability , Elder Law, Health Care Planning and decision-making. She is a law professor and published author.
Her practice includes serving as a court appointed and agreed upon Arbitrator for Workers’ Compensation matters. Her legal treatise, Advising the Elderly or Disabled Client, is utilized by law schools throughout America as well as Elder Law, Disability and Personal Injury attorneys. She been retained as an expert witness by the NFL Players association regarding compensation for brain and other serious injuries sustained by professional athletes.
