Gov Moonbeam, a Democrat, seems to put his priorities in a disgusting order when it comes to certain issues. Take for example what he has shot down, aka veto’d, when it comes to protecting injured workers, like me, who depend on ‘the system’ when it comes to getting treatment for a valid work injury that has ruined my life forever. From an article at CA Progress Report by Sam Gold:
Meaningful Legislation That Saw The Round File
Governor Brown has spoken and has vetoed some important bills that relate to Workers Compensation. Let’s see what he simply wouldn’t sign into law.
AB584 which would force doctors who make Utilization review determinations to be licensed in California. Proponents of the bill believe that out-of-state utilization review physicians are making inappropriate decisions at least in part because there is no regulatory structure to hold them accountable to anyone. The bill is intended to ensure that there is a regulatory oversight body – the California Medical Board – that can discipline a utilization review physician in the event the physician violates practice standards which in many cases deals with making false and misleading statements to deny an injured worker the benefits due him under state law.
AB1155 which would not allow doctors to apportion disability caused by other factors such as race, religious creed, color, national origin, age, gender, marital status, sex, sexual orientation, or genetic characteristics.
These are only two among many other bills that will never see the light of day. And you have to ask yourself why! Workers’ Compensation is not about truth, justice, fairness, equity or even honesty, it’s about money, power and politics. It hasn’t been about workers for many years. They are simply an end to a means for big insurance.
The idiots on the Utilization Review Board are the bane of my existence. There is NO logic in how they determine what I need or do not need to lead a half-way normal life since I blew out my back over five years ago in a work-related incident. They have the last say when it comes to everything my back doctors want to do to help me…my medications, my surgeries, my treatment plan, etc.
Yet these fuckers are NOT licensed Doctors. WTF? Why would any self-respecting insurance company use idiots such as these to make important medical decisions?
Money…lots and lots of money-saving actions. Caring for me isn’t their primary concern, like ALL insurance companies, its all about makng or saving money for them..at MY expense.
Gov Schwarzenegger ‘overhauled’ the Workers Compensation laws whilst he was in office. Translated..that means he made the system and it’s rules and regulations “corporation-friendly” and made it extremely hard to hold these fuckers accountable when its as obvious as the nose on your face that they are denying something for no good reason other than a money-saving issue for them.
This problem isn’t just a California problem, its a national problem when it comes to injured workers. I thank my lucky stars that I have a wonderful, decent, caring claims adjuster that always backs me when the idiots at the URB (Utilization Review Board) deny something, hell they try to deny everything.
The favorite line used by the Workers Compensation insurance carriers is FRAUD. But when you actually look at the numbers of fraud cases found and prosecuted..they are fucking minimal. Yet the insurance carriers and their stooges at the URB will stop at nothing to fuck with me and my doctors when it comes to making my life ‘livable’ on even the most basic level. Again, from Sam’s piece:
By the insurance industry’s own admission, injured worker fraud is less than 1%, employer fraud is around 20-25%, so what about the remainder of the pie, over 70% that is provider fraud! Why don’t we hear about that? Why doesn’t the Department of Insurance go after them! After all, we are all accountable to the laws of this state, or are we? We seem to have a double standard in place that lets the real criminals go scott free!
We need a serious reform of these laws and not a repeat of the dog & pony show that former Governor Schwarzenegger put on for the benefit of his insurance industry contributors. This can happen to you. It doesn’t matter what you do for a living; doctor lawyer, Native American chief, you name the occupation; it can happen to you and you can end up losing everything that you have worked for in a lifetime!
I never thought I would be disabled so early in my working life. I really didn’t plan for such an action to happen to me and it’s frustrating as hell to deal with the fuckers at the URB every-friggin- time they refuse to allow a procedure, a medication or pretty much anything my licensed doctors want to do to make my life better or at least a little less painful to lead on a daily basis.
Back to Governor Jerry Brown..his goal, above all else evidently, is to lower the budget of the state of California. Even, apparently, if it means fucking over people who have been injured on the job by no fault of their own. My employers didn’t even attempt to fight my claim when I blew out my back..they knew they screwed up royally by demanding I work over 40 hours a week at a job that was very labor intensive. They actually broke their own rules in that regard as data collectors were never to work over 20-25 hours a week.
Yet they, and their insurance carrier, know they can fuck w/me via the URB and they do it, the mutha fuckas, every damn chance they get. A board that is made up of idiots apparently that are NOT licensed doctors. They have never talked to me, they have never even looked at an MRI or Xray of my back, they have never examined me. They go solely off the notes of one of my two doctors, or, more likely… their own whims, as their reasons for denying claims never make any sense medically when I ask my doctors or my claims adjuster to explain their logic in denying the latest claim for something…anything.
Which means I have to take them back to court, usually at least once a year, when I get tired of their fuckery of denying everything my doctors request. I represent myself and haven’t lost a case yet as thankfully, the judges can see the idiocy in their logic and have ruled for me every time so far.
But it’s stressful for me none the less, and at a time when I need as little stress as possible since I am fighting cancer now as well. And you know what really busts my chops: Its even more costly for the state as they have to pay for the court case to be heard by a judge..which in the long run, I find sadly very fucking ironic as the goal of both our current and former Governors was/is to SAVE money..not spend it.