How workers’ comp failed injured nurse

 I am a Registered Nurse with more than 35 years’ experience caring for patients. I always loved my work caring for the injured, ill and disabled. Little did I know that when I became disabled myself, my employer and its workers’ compensation insurance carrier would care so little about me.

In 1998, I was working as an operating room nurse at Kaiser Foundation Hospital in San Diego, when I was injured at work.  I had worked at Kaiser for 12 years without any problems, until I tripped and fell over a parking lot barrier. Kaiser treated my injured knee, but later ignored four doctors’ reports that I had also injured my neck and back. Kaiser denied that those injuries were from the fall.

Little did I know that when I became disabled myself, my employer and its workers’ compensation insurance carrier would care so little about me.

For years, doctors’ recommendations were delayed or denied by Kaiser’s insurer, Sedgwick Claims Services. All they would approve were painkilling drugs, but not the treatment I needed for the underlying medical issue. These drugs’ side effects caused additional medical problems. In 2010, my teeth began breaking off at the roots.

Sedgwick denied the dental treatment I needed, so I took them to court.  In February 2013, the judge ordered Sedgwick to provide this urgent medical treatment. To this day, they have refused to do so, and have instead defied two judge’s orders to provide urgently needed dental treatment.

By July of this year, my doctor sent me to the emergency room, and 25 of my teeth were removed. I spent the entire month in the hospital, in agony, and on painkillers. Due to the delays in approving medical care, I’ve now lost my teeth. Little did I know that when I became disabled myself, my employer and its workers’ compensation insurance carrier would care so little about me.

 Why does the State of California allow workers’ compensation insurance companies to further damage patients like me through delaying and denying medical care and disability compensation?

Insurers’ Utilization Review (UR) routinely delays and denies doctors’ legitimate requests for appropriate medical treatment. This is unnecessary and expensive, and has got to change. Anyone watching can see evidence of out-of-control delay and denial in the 15,000 denials of recommended medical care in just the month of August.

Why does the State of California allow workers’ compensation insurance companies to further damage patients like me through delaying and denying medical care and disability compensation? Sedgwick faces a relatively small monetary penalty for ignoring the court order, which means little to a huge corporation.

It’s time to bring UR to heel, and stop insurance carriers from using it as a routine roadblock.
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Ed’s Note:  Debbye Mazzucca, R.N., who was injured in the operating room, lives in La Mesa.