My State Fund Story

Workers' Comp News

State Fund reformer was paid a salary of $450,000 a year, plus perks

Was United States Senator Dianne Feinstein mislead by Governor Schwarzenegger office?

In September of 2009, she was assured that someone in the governor’s staff would "work hard" to help the injured firefighter with his endeavors.

The senator cannot call for an investigation into why the governor’s staff did not follow through on their assurance about helping the firefighter, if no one is willing to contact her office.

The governors office has also not responded to a request made by Congressman Adam Schiff, the request was in regards to a another problem with SCIF's claims handling.

Does Governor Schwarzenegger know about this Firefighter's situation?

Governor Arnold Schwarzenegger
State Capitol Building
Sacramento, CA 95814
Phone: 916-445-2841
Fax: 916-558-3160

As a public service to the firefighter, his family, and the public that is served by your firefighters, I am doing what I can to provide a forum for his story. It is imperative for you to share his story with your elected officials, friends and co-workers. These stories are shining examples of what is to come if the public stands by idly and does nothing.

Click here to listen to who wanted this website blocked.

In My Opinion

I read another great article in Workers’ Comp Executive. Titled: SCIF to Attempt Rebranding Its Tarnished Image

SCIF management hopes to give its employees a boost in morale with new language and a new way of looking at SCIF's role in California's economy.

Apparently SCIF employees’ morale is down. If this is indeed true, what could be the cause? According to the article, SCIF employees have been subjected to a barrage of negative media about the organization due in large part to the malfeasance of some top SCIF management, which were removed last year.

As a public service I wanted to find out what other things could be causing such a drop in morale. My research turned up some interesting information. I found an article in the L.A Times, Millions wasted by State Fund, by Marc Lifsher.

According to the article, a state audit uncovered some very startling facts. SCIF spent some $300 million on technology and had to pay out some $20 million in penalties for delays in processing of medical bills and disability benefits for injured workers.

So why didn't SCIF get these payments made on time? With all the technology they bought there should be no reason, or is there? These late payments to injured workers and treating doctors were going on in the early 90's. My family was forced into poverty by the way SCIF is allowed to operate.

SCIF is being forced to have more oversight by the state legislature. SCIF has become very concerned about the need to protect sensitive information regarding their claims handling. How they handle claims is a big mystery. One of the reasons is the need to protect injured workers’ health information under the federal law, HIPAA. If you click on the audio link at the upper left hand side of this page you will hear what a computer security specialist that worked inside SCIF had to say about the protection of peoples private medical records.

The culture of corruption can not be cleaned up with new words or slogans. It can only be cleaned up by positive action of management. Honest management, not business as usual management.

Frequently Asked Questions

Q:If you were contacted by state officials, or State Fund, in regards to a possible settlement would you be willing to enter into settlement negotiations?

A:Yes, in fact the California Department of Justice has suggested I contact State Fund.

Q:Would you like to see the breakup of State Fund?

A:No, I would like to reach a settlement and be assured that there will be some real oversight put into place to protect other injured workers and their families.

Q:Does State Fund think you will eventually give up?

A:I do not know what they are thinking at this point. All I know is that the longer this continues, even more people will realize that I was right and see that I am not the only victim. State Fund should be aware, I will not simply give up and go away and, that there are people who are prepared to continue my fight should something happen to me.

Q:Do you believe that you might be a victim of retaliation?

A:At times I feel that way, particularly when no one in any Department within the State that knows about this case and has the authority to step in and help me or at least provide me with some sort of assistance will do so.

Q:Why did the L.A. District Attorney take the case then drop it?

A:Besides the fact that it is Insurance Company money that funds that unit (through the Fraud Assessment Commission). There had also been personnel changes. Lauren weis was forced to take a postion in the Workers' Comp. Fraud Unit in retaliation for supporting Steve Cooley's opponent Gil Garcetti. Lauren Weis was so displeased with the transfer that she even filed an official grievance. Kristie Hutchinson, who was the driving force behind getting the case investigated, left her postion as Special Assistant for the Workers Compensation Fraud Unit.
So between State Fund's influence (via FAC money), Lauren Weis' 'Eye-for-an-Eye', and Kristie Hutchinson's leaving. Justice went out the window.

Q:Are you really injured, and if so then how are you able to stand out there protesting?

A:Yes, I am injured. Unfortunately scar tissue in the lungs and an irregular heart beat is not something that can be seen by someone who doesn't have a set of x-rays and the proper equipment. If my injury wasn't internal, had my arm been sheared off and the bloody stump laying inside a machine at my employers, there would be no question.

However my exposure to plastic smoke/fumes/fires is well documented, see State Fund's own Job Site Report, which has this rather damning paragraph:
"Fumes are emitted when this occurs though the ceiling fan is designed to prevent this. In fact there is a visible cloud coming off the front of the machine near the operator."

Now take into account what plastic is made from and what happens when it is heated or burned, and you'll see that prolonged exposure to carcinogens and nerve agents is not good. Now, how am I able to protest? Well, you'll notice that I'm not out there every day or for very long. I have good days where my heart behaves and I cough just a few times, and I have bad days where my heart will race and skip beats willy-nilly and I can't catch my breath, or I'll have coughing fits.

Q:In light of the fact that State Fund's own documents provided more than enough evidence, why is it that no one in the State government is willing to hold them accountable?

A:I get asked this question over and over. From what I have learned, people are intimidated and don't want to take on State Fund for fear of damaging their careers. It is about money and power. If you read this letter that I was asked to write, it will become quite clear what is going on in the Workers' Compensation system.

Q:What do you think was State Fund's motive for what they did to you and your family?

A:Their motive was simply to save a little money. After their own investigation, State Fund realized that they were obligated to award me with a 100% payout, including lifetime medical. With my heart and lung problems, it could have cost State Fund well over a million dollars. Instead, they intentionally falsified the documents to prevent the payout.

Q:Do you think your case is just a fluke, or the tip of the iceberg?

A:If State Fund did not condone the actions taken on my case, they would have turned over the files on my case, gotten rid of the people committing the fraud, and cleaned up their system. Instead, State Fund hired lawyers from high-power law firms to keep the files sealed and get their own in-house attorneys off the hook.

A fire fighter's story of pain and suffering, in his own words.

Why is an injured firefighter forced to live in excruciating pain?

State Compensation Insurance Fund, a government insurance carrier, continues to deny repeated requests for an FDA approved Pro Disk (Artificial Disk) replacement for this injured firefighter. The Doctor's request to perform an FDA approved spinal surgery was denied because it is NOT ALLOWED by the ACOEM guidelines.

In 2004 the California legislature passed SB899 and the Governor signed it into law. SB899 now re-defines "Cure and relieve" to only be treated in accordance with ACOEM guidelines.

Why did the state legislature stop allowing the Treating Doctor to have the final say on how the injured worker should be treated? After all the TREATING DOCTOR would have the best idea on what level of care an injured worker will be needed to give him the very best chance to heal and return to the job.

"You will be glad to know that I had already looked at your website the first time you wrote and I commend you for your commitment to this issue." - California Senator Bob Huff

I complied with the senators’ request and wrote to the insurance commissioner as a public service. To date I have not received any reply from the commissioner, because I believe the commissioner is being kept in the dark so he will have no knowledge that SCIF, a state agency is allowed to save money on my injury claim, by violating state and federal laws.

Links

Pay Billy New

Rell Smells New

Almost Broken

Is a State Fund Claims Adjuster A Serial Killer?

Read Cathy Nign's letter to Insurance Commissioner

As seen on America’s Most Wanted, convicted rapist and alleged serial killer of possibly 30 people, John Floyd Thomas Jr., a 20 year employee of State Compensation Insurance Fund as a claims adjuster. Could he have worked on your case?