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Workers' Comp News
State Fund reformer was paid a salary of $450,000 a year, plus perks
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
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. |
In His Own Words; A Fire Fighter's Story
"Where do I start to say how horrible State Fund is and the care they provide is so inept that I am going insane. I am a firefighter paramedic who fell through a floor during a fire on April 17th 2008. I have been fighting for going on 1 ½ years to get the treatment I need to get on with my life. It took six months to get an MRI that the surgeon wanted. I have had to file 2 expedited courts hearings just to get the doctors and test. I eat out of depression, stress and anxiety. I have gained 35 lbs, my knee is starting to have problems and my blood pressure is now at dangerous levels. Now on top of my pain meds and muscle relaxer meds I get to add blood pressure meds. I have to get my blood pressure down before I can have a very painful disco gram test. This is one of my personal favorites. When the medical review board denied my surgery they requested that my doctor make a request for a disco gram test, from the same medical review board who decides the medical treatment I can have. They didn’t just approve it and let me have the test they chose to take a route that would extend my suffering and pain by months. Thanks State Fund for all the unnecessary pain and suffering. I also lost my job because State Fund is denying me the treatment I need to get back work. I was unable to return within the allotted time. When I do get to go back to work I won’t have a job. I will have to go find a new job as a firefighter paramedic that is if I get to go back to my previous career. The injuries suffered to my back will probably keep me from returning to my previous career. So I will need to go back to school for 3-4 years. So I’ll probably be 40 by the time I get to go back to work. How much more time lost from my family do I have to suffer through? I almost forgot it took me a year to get a psychologist to talk to. They kept trying to give a psychologist about an hour away when I can’t sit longer than 10-20, so how am I to drive an hour when I can’t sit that long? My wife is working she can’t take me. When I asked for a ride they balked and Wow! found a shrink next to my other doctors. When I do go somewhere that’s longer than what I can drive my wife must take me. I have to lay the car seat back as far as it will go. I also can’t drive a lot of times because of the mind altering effects of the medications I am on. I don’t think I will have surgery this year. I am looking at 3 years and probably more of my life gone because STATE FUND reuses to treat my injuries. I have strong evidence and 3 surgeons saying I need a disk replacement surgery and microdisectomy surgery. Yet that is not enough evidence for State Fund, they just DENY, DENY, DENY. Had State Fund fixed me in a timely manner I would have been out of work for about year, but instead I am looking at 3 plus years. My pain is so bad that without pain meds I can’t sleep, sit, or lay down. I would pace through my house until I passed out from pure exhaustion. On several occasions I paced for over 30 hours. That was the only thing that helped my pain. The worst thing about my story is how my 3 year old son says daddy I’ll fix your back and he then kisses my back and takes his hands and pretends to fix me. It makes me cry that my 3 year old son has more compassion than a system that was designed to take care of the injured workers. One last thing when your son looks at you and says daddy when you get fixed cans you take me to Disneyland, camping and the beach, TRY NOT TO CRY. I need to get the treatments needed for my injuries. They denied my surgery saying it is experimental yet it has been approved by the FDA"
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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.
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
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? |
