As reported by BenefitsPRO, a new report from the California Department of Industrial Relations indicates that the state has saved $600 million more than expected due to reforms passed in 2012. That might be good news for employers who have been undoubtedly benefited from legislation that allows for greater scrutiny over workers' compensation claims—but what about our workers?
The ProPublica Report
The effects of California's controversial workers' compensation reforms have been the concern of many people for several years. Last year, ProPublica and NPR partnered for a series of investigative reports into the "dismantling" of workers' comp systems all over the country—including in California. What they found continues to be troubling in 2016 and for anyone expecting meaningful improvements in our workers' compensation system.
Take the case of Nicolas Mercado, 54, who was paralyzed after his commercial truck flipped over. In 2013, Mr. Mercado needed modifications to his home to accommodate his wheelchair. After receiving approval for those modifications, his insurer sought a second opinion which rejected some of the modifications. The dispute then went to an independent medical reviewer.
Since 2012, independent medical reviewers have been used in the California workers' compensation system to rule on disputes by looking solely at medical records. In many cases, like Mr. Mercado's, the review process is slow, inaccurate, and leaves claimants without the benefits they need. His insurer continued to appeal a judge's decision that all of the home modifications in Mr. Mercado's case were reasonable and only relented when a local TV station featured his story.
What Can Be Done?
Independent medical reviewers are not the only major issue facing California workers' comp claimants. Arbitrary limits on temporary wage benefits, limited choices in doctors, and stricter guidelines to reevaluate and deny care in old cases are also preventing countless claimants from the receiving proper care. There is currently a lawsuit that's been filed in Los Angeles that, among other things, claims that California's workers' compensation system often defines being a woman a "pre-existing condition."
So what can be done for current and prospective claimants who need to petition for workers' comp benefits? The best way to ensure that your claim stands the best chance of approval is to hire proven counsel ready to prepare and assert your filing. At our firm, we have 120 years of combined workers' compensation experience and solely work in this practice area. We're engaged with this industry and are well-versed in the ever-changing challenges our clients face.
Are you ready to file for benefits? Or need to contest a decision from your insurance provider? If so, the knowledgeable and proven Central Valley workers' compensation lawyers at Berry, Smith & Bartell, a Professional Law Corporation are ready to hear from you. Contact one our three office locations today. Se habla español.