Last December, dozens of county workers were killed or injured when gunmen opened fire in a terrorist attack at an office holiday party. As they look back on that event, many of the survivors are still struggling with the shock and trauma as well as suffering physically. To add to the misery, some victims are now learning that certain workers' compensation benefits were not approved because of the system California uses for assessing the kind of care to dispense.
The review process is outsourced to companies contracted by insurance carriers. The companies approve or reject requests for medical care using a uniform set of guidelines. Injured workers and their doctors feel that individualized, common sense treatment is being replaced by mandated rules. This is especially harmful when dealing with mental health issues such as post-traumatic stress.
Some local leaders defend the decisions made by the review process. They explain that many patients did not receive certain treatment or medications they requested -- particularly those for dealing with mental trauma -- because their doctors failed to send the appropriate documentation. County officials in California assured injured workers that they would strive for better communication between physicians and claims adjusters to improve the level of care for injured workers.
When workers are hurt on the job, either through accidents or third-party injuries, there are avenues they can pursue to get the funds they need for recovery. However, if one's trauma or injury makes it difficult to do the most basic tasks, fighting for workers' compensation benefits may be too overwhelming to imagine. Fortunately, there are experienced attorneys who understand how the insurance business works and who are willing to do the heavy work so the victim can focus on getting well.
Source: NBC Bay Area, "San Bernardino Shooting Survivors Fight for Medical Treatment Workers' Comp Denied", Liz Wagner, Dec. 2, 2016