Illinois’ workers’ comp system finds new way to make news: deny a cheap headset
Longtime California residents may be wondering “What the heck happened to our state?”
Who could blame them, given one public scandal after another, for years on end?
Funds voted toward California fraud probes
A recent piece in the North County Times addresses worker’s comp fraud:
Funding to fight workers’ compensation fraud slightly increased this year despite a tough state budget climate and a limp economy.
On Tuesday, State Insurance Commissioner Dave Jones recommended a grant of $4,861,584 to investigate and prosecute workers’ compensation fraud for San Diego County’s district attorney office. That’s about $36,000 more than what the county received last year, according to Dave Lattuca, the chief of the insurance fraud division for the San Diego County District Attorney’s Office.
Riverside County will receive a grant of $1,463,732.
This year’s grant to San Diego County is the second-highest funding level recommended to a district attorney’s office in the fiscal year that began July 1, according to Jones’ office.
The state urged $5.7 million for Los Angeles County to fight workers’ compensation fraud —- the most of California’s 36 counties. Riverside County ranked No. 6 with its award.
In total, the state insurance commissioner announced $32 million in grants to fight fraud throughout California —- slightly higher than last fiscal year’s total of $31 million, according to Dave Althausen, a spokesman for Jones.
Revised contract: a ‘brawl’ between providers and carriers?
A July 11 report from Insurance Journal calls into question whether injured workers are the focus that they should be:
A controversy in the California workers’ compensation market over a revised provider contract threatens to erupt into an all-out legal brawl as doctors for injured workers and applicants’ attorneys take aim at the state’s largest carrier.
The nonprofit State Compensation Insurance Fund, California’s carrier of last resort, has drawn intense criticism over its newly implemented medical provider network (MPN) contract.
State Fund, as the carrier is known, has stood by the recent changes, saying patients will benefit from the contract revisions, all of which it says were made following state law.
However, the California Society of Industrial Medicine and Surgery (CSIMS) and the California Applicants’ Attorneys Association (CAAA) decry the contract as fraught with legal deficiencies and ethical issues that pose harm to employees at workplaces operated by State Fund’s roughly 180,000 policyholders.
CSIMS, which represents doctors who treat workers’ compensation patients, described the State Fund MPN contract as a “heavy-handed” attempt at contract medicine.
In expressing the organization’s “grave concerns,” CSIMS Executive Vice President Carlyle Brakensiek said the contract compels doctors to restrict injured workers’ right to treatment.
Illinois’ system back in the news
Regular readers know we’ve been covering the scandal-ridden Illinois workers’ comp system; among our more recent updates was this post about the Menard prison facility.
More recently, the Belleville News-Democrat has done it again, that is, scooped every other news organization, this time about a worker who was denied a simple set of cheap headphones. Gotta tell you, if I were the local, nearby AP Bureau Chief, I’d assign a reporter to this Illinois workers’ comp agency. The BND.com folks are likely to win beaucoup awards for this ongoing coverage.
OK, back to news from BND.com: “Prison clerk’s lack of headset costly to taxpayers — $128,424 in medical bills so far”:
Prison finance clerk Angela Grott complained to her supervisors that file drawers at her work station jammed, the computer keyboard was set too high and her chair was hard to move, according to state workers’ compensation records.
While Grott stated these factors contributed to pain in her neck and shoulder area, she testified during a Dec. 14 workers’ compensation hearing that it was primarily the lack of a headset for the telephone at her desk at the Menard Correctional Center that caused severe pain. She said this pain worsened because, not having a headset, she was forced to hold the telephone receiver in the crook of her neck for hours while typing on a keyboard.
Grott’s workers’ comp claim so far has resulted in a $128,424 medical bill that must be paid by public money because Illinois is self-insured.
While headsets were readily available close to the prison — one currently sells for $9.96 at the Chester Walmart — Grott testified at the hearing that her supervisors repeatedly rejected her requests to provide one or to ergonomically alter her work station.
Reached at her job at the prison, Grott said, “I have no comment.”
A spokeswoman for the Illinois Department of Corrections said officials are waiting for headsets to arrive. They will then be given to any employee who wants one.
As you might surmise from the preceding, workers’ comp cases can get very involved in government problems that have nothing to do with obtaining prompt, thorough treatment for an injured worker.
We can help you find an attorney
Frequently enough, a worker’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources: