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Opinion: Let’s restore choice of doctor, end discrimination in Workers’ Comp

When someone gets hurt on the job and loses time from work, there are two things they want: to get healthy and to get back to work as soon as they can. But on Gov. Schwarzenegger’s watch, an injured or disabled worker had no assurance of either. The governor sided with big business and the insurance companies over injured workers. Gov.-elect Brown has a chance to change that.

Gov. Schwarzenegger promised not to hurt injured workers or reduce their medical care or disability compensation.  He broke that promise by pushing through legislation that reduced disability compensation by as much as 60 percent.  

Gov. Schwarzenegger lost sight of the fact that Article 14 Sect. 4 of the California Constitution was added when workers gave up their right to sue their employers for work injuries and, in return, were granted the Constitutional right to a no-fault workers’ compensation system:  “A complete system of workers’ compensation includes adequate provisions for the comfort, health and safety and general welfare of all workers and those dependent upon them for support to the extent of relieving them from the consequences of any injuries or death incurred or sustained by workers in the course of their employment,” and “full provision for such medical, surgical, hospital and other remedial treatment as is requisite to cure and relieve from the effects of such injury.”

We have witnessed a gradual deterioration of these guaranteed Constitutional rights and compensation.  

Gov. Schwarzenegger has taken away the right of the injured worker to choose his own physician.  In essence, he has allowed the fox to stand guard over the hen house by allowing the insurance industry and employers to handpick their doctors and then frequently deny the treatment recommended by their own doctors.   

Gov. Schwarzenegger has put a cap on temporary disability compensation, limited physical therapy to 24 lifetime treatments and has handcuffed the workers’ compensation Judges by taking away their power to order additional benefits when they deem it appropriate.  

Gov. Schwarzenegger has promoted discrimination against women, people of color and the elderly by requiring doctors to reduce the disability compensation of injured workers due to pre-existing risk factors and pre-existing conditions, even though these factors or conditions in no way affected the worker’s ability to perform his or her job.  Gov. Schwarzenegger has eliminated a number of workers’ compensation Judges positions and support staff, resulting in further delays in obtaining medical care and disability compensation for injured workers.  

The California Applicants’ Attorneys Association, whose members represent disabled Californians injured on the job, remains committed to making sure insurance companies provide the benefits that people pay for. Here are three simple things the governor-elect can do to balance the scales.

First, it is time to restore the choice of doctor to disabled Californians injured at work. It was a right that Governor Jerry Brown originally provided disabled workers.  It was Gov. Schwarzenegger who took away that right.

CAAA believes it is a basic civil right to decide for yourself who is going to lay their hands on your injured body and perform medical tests. A company doctor’s first allegiance is to the company that hired them, not to the patient.

Second, the Legislature has twice voted to stop insurance companies’ discrimination in disability compensation. Believe it or not, insurance carriers penalize women, seniors, and ethnic minorities for being who they are. They reduce the amount a person receives in disability compensation based on “risk” factors related to gender, race and age. In one case, an African American man lost half of his disability compensation after a heart attack because the insurer said men of his race are more susceptible to heart attacks than other men. This penalty had nothing to do with the individual, but was deducted solely because of his race.

Gov. Schwarzenegger has twice vetoed legislation to outlaw this outrageous discrimination. We are confident that after the civil rights community joins us in making the case to Governor Brown this discrimination will be outlawed.

And finally, we look forward to working with consumers to ensure that workers’ compensation insurance companies, and every other insurance company, pay legitimate claims fairly.
Workers’ compensation insurance is just like car or homeowners insurance. Workers’ compensation insurance provides disabled workers the opportunity to heal, knowing they won’t lose their home or drown in debt. But the number of workers’ compensation claims has been cut in half since 2004, but not the number of injuries.

Disabled Californians injured on the job routinely have their medical care delayed or denied, and their permanent disabilities are compensated less than in almost any other state. As a result, many injured workers are turning to group health policies, social security, disability and other public providers – because they can’t get medical care from the insurance companies.

It is in the interests of all stakeholders to have a fair and efficient system for getting workers healthy and providing care for those who are permanently disabled. CAAA understands that alone, we will not succeed.  But with others who represent and care about disabled Californians, women, and older workers of every color and ethnic background, we will succeed in restoring fairness to disabled workers.


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