For those of you that read this blog regularly, you will know that I speak to Police, Fire and DA’s Office Employees from all over the state. I also talk to an array of Staffers, Consultants, Lobbyists and elected leaders. I hear a lot. I filter even more information.
I have also come to detest the Worker’s Comp System that has been set up for municipalities.
You will never understand the nightmare that is the Bureaucracy in the County or City until you are an injured employee
I sell Worker’s Comp Insurance. Insurance Carriers could NEVER get away with what “self-insured” government programs get away with.
Deny all claims at first receipt. This is a trick that slimy insurance carriers do (and I have seen a few) as it is a proven fact a certain number of claimants will drop off. Another trick is paperwork “errors” or “coding” mismatches. Medical billing and coding is its’ own subculture and I see government entities abuse this in an attempt to forestall claims payments or treatments. If a private carrier did either of these, it would be front-page headlines and massive payouts in a personal injury lawsuit.
I have been told by sources in more than just Riverside and Placer County that there are bureaucrats all over governments that hate cops. I’ve been told about one such bureaucrat that still infests Riverside County HR and to this day is still messing with claims. It is my belief that one of the now permanently disabled sources I referenced in my previous post would not be disabled today had treatment been rendered in a timely manner.
I am aware of multiple complaints against Placer County and a lawsuit that may well exceed $5 Million against Riverside County.
Without getting in to the nightmarish details – it is accurate to say that the system is adversarial and that the bureaucrats have almost total control over weather claims get paid or not.
These include rejecting medical opinions based on technicalities.
Using doctors that are patsies for the county
Micromanaging a diagnosis
Playing doctors off against each other
Deliberately taking several days to respond to calls or voicemails and/or deliberately waiting until 4PM on a Friday to respond
Waiting until the statutory deadline to settle a claim post successful lawsuit or arbitration
Treating all claimants like they are lying until proven true
I am not sure how the County Supervisors could provide any oversight on the abusive system that has been set up. Knowing insurance as I do, Municipalities seem to resent the civil service protections employees have and appear to retaliate against them via abusing their legal protections they have under employee benefits. Private insurers do not get to behave this way at all.
What is the solution? – make local governments buy Worker’s Comp Insurance and eliminate the bureaucracy of abuse. Fat chance of that happening in California.
Sign up to receive RightOnDaily updates sent to your inbox.
I filed a Worker’s Comp claim on my back and heart when I retired. My attorney told me I was assigned a back doctor who is favorable to the injured, but a heart doctor that almost 100% of the time goes in favor of the county. Attorney’s pretty much know the outcome of your case when the doctors are assigned. True to this, my back settled and heart was denied although evidence of heart related issues and high blood pressure. Appealing heart decision. I understand the county because I have seen numerous bullshit worker’s comp claims over the years, as have all of us. I’ve talked to several retirees since I retired and they have filed Worker’s Comp claims on every ache and pain, in-grown toe nail, they’ve ever had. One asked me why I didn’t file for everything and I told them because my back and blood pressure were my only issues. So the county see’s these countless B.S. claims and has to fight back somehow. Game of chess. Worker’s Comp is ripe for fraudulent claims. Two-way street.