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NPR Report Blasts CA Labor Officials For Selling Out And Betraying Injured Workers And WC

by repost
In an NPR report California labor officials are blasted for supporting so called "reforms" of worker compensation that have seriously harmed injured workers. CA Fed Secretary Treasurer Art Purlaski and Angie Wei who is legislative director of the California Federation of Labor colluded with the insurance industry to deregulate workers compensation and allowed insurance companies to harm seriously injured California workers.
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CA AFL-CIO Officials Art Purlaski and CA Labor Fed Official Angie Wei Helped Screw Injured California Workers
Injured Workers Suffer As 'Reforms' Limit Workers' Compensation Benefits
http://www.npr.org/2015/03/04/390441655/injured-workers-suffer-as-reforms-limit-workers-compensation-benefits
MARCH 04, 2015 5:04 AM ET

HOWARD BERKES
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MICHAEL GRABELL, PROPUBLICA
Dennis Whedbee, 52, lost half of his left arm in a drilling accident in North Dakota in September 2012. Several years later he's still fighting with North Dakota's insurance agency to get the help he needs.
Jeff Swensen for ProPublica
Dennis Whedbee's crew was rushing to prepare an oil well for pumping on the Sweet Grass Woman lease site, a speck of dusty plains rich with crude in Mandaree, N.D.

It was getting late that September afternoon in 2012. Whedbee, a 50-year-old derrick hand, was helping another worker remove a pipe fitting on top of the well when it suddenly blew.

Oil and sludge pressurized at more than 700 pounds per square inch tore into Whedbee's body, ripping his left arm off just below the elbow. Co-workers jury-rigged a tourniquet from a sweatshirt and a ratchet strap to stanch his bleeding and got his wife on the phone.

"Babe," he said, "tell everyone I love them."

It was exactly the sort of accident that workers' compensation was designed for.

Until recently, America's workers could rely on a compact struck at the dawn of the Industrial Age: They'd give up their right to sue. In exchange, if they were injured on the job, their employers would pay their medical bills and enough of their wages to help them get by while they recovered.

No longer.

Over the past decade, state after state has been dismantling America's workers' comp system with disastrous consequences for many of the hundreds of thousands of people who suffer serious injuries at work each year, a ProPublica and NPR investigation has found.

The cutbacks have been so drastic in some places that they virtually guarantee injured workers will plummet into poverty. Workers often battle insurance companies for years to get the surgeries, prescriptions and basic help their doctors recommend.

Now, 2 1/2 years after he lost his arm, Whedbee is still fighting with North Dakota's insurance agency for the prosthesis that his doctor says would give him a semblance of his former life.

The changes, often passed under the banner of "reform," have been pushed by big businesses and insurance companies on the false premise that costs are out of control.

In fact, employers are paying the lowest rates for workers' comp insurance since the 1970s. And in 2013, insurers had their most profitable year in over a decade, bringing in a hefty 18 percent return.

All the while, employers have found someone else to foot the bill for workplace accidents: American taxpayers, who shell out tens of billions of dollars a year through Social Security Disability Insurance, Medicare and Medicaid for lost wages and medical costs not covered by workers' comp.

ProPublica analyzed reams of insurance industry data, studied arcane state laws and obtained often confidential medical and court records to provide an unprecedented look at the unwinding of workers' comp laws across the country.

Among the findings:

• Since 2003, legislators in 33 states have passed workers' comp laws that reduce benefits or make it more difficult for those with certain injuries and diseases to qualify for them. Florida has cut benefits to its most severely disabled workers by 65 percent since 1994.

• Where a worker gets hurt matters. Because each state has developed its own system, an amputated arm can literally be worth two or three times as much on one side of a state line as on the other. The maximum compensation for the loss of an eye is $27,280 in Alabama, but $261,525 in Pennsylvania.

• Many states have not only shrunk the payments to injured workers; they've also cut them off after an arbitrary time limit — even if workers haven't recovered. After John Coffell hurt his back at an Oklahoma tire plant last year, his wages dropped so dramatically that he and his family were evicted from their home.

• Employers and insurers increasingly control medical decisions, such as whether an injured worker needs surgery. In 37 states, workers can't pick their own doctor or are restricted to a list provided by their employers.

• In California, insurers can now reopen old cases and deny medical care based on the opinions of doctors who never see the patient and don't even have to be licensed in the state. Joel Ramirez, who was paralyzed in a warehouse accident, had his home health aide taken away, leaving him to sit in his own feces for up to eight hours.
The scope of the changes, and the extent to which taxpayers are paying the costs of workplace accidents, have attracted almost no national attention, in part because the federal government stopped monitoring state workers' comp laws more than a decade ago.

The cuts have gone so deep in some states that judges who hear workers' comp cases, top defense attorneys for companies and even the father of the modern workers' comp system say they are inhumane.

Presented with ProPublica and NPR's findings, Sen. Bob Casey, D-Pa., one of the leading worker advocates in Congress, said the changes undermine the basic protections for injured workers.

The rollback "would be bad if it were happening in one state," he said. "But the fact that a number of states have moved in this direction is disturbing and it should be unacceptable to people in both political parties."
...

Anonymous Doctors Never See Patients

Unlike Whedbee, Joel Ramirez, a 48-year-old paraplegic in California, never even got to see the doctor who took away his medical care.

Last June — without examining Ramirez or even sending someone to assess his daily struggles — his former employer's insurance company terminated the home health aide he relied on.

<20141030_workers-compensation-propublica_fallon_0547_custom-22394fa1d5f9b19f5ff9222467ffa709c0187899-s1500-c85.jpg>
Joel Ramirez is helped onto a bed to receive an ultrasound with the aid of Francisco Guardado, his home health care giver, during a visit to the hospital in Rialto, Calif.
Patrick T. Fallon for ProPublica
Such cases underscore the consequences as states seek to streamline disputes and take more control of medical costs. But along the way, such provisions have tilted systems in favor of employers and stripped away fundamental protections that guaranteed workers the right to be examined by doctors and heard by judges.

A 2012 California law, supported by both business and labor, was intended to solve problems with an earlier reform that had left workers waiting months to see impartial doctors and months more for administrative hearings.

Under the new process, disputes are decided by independent medical reviewers chosen by a state contractor. These doctors, many of whom are licensed out of state, rely solely on medical records and remain anonymous. Their decisions can't be overturned except in limited cases.

Lawmakers also added a surprising twist: The medical dispute process wouldn't just apply to new cases, but retroactively. Suddenly every treatment request in the system — whether it be for surgery or a simple prescription refill — could now be subject to reviews by insurance company doctors and compared against more rigid medical treatment guidelines that might not have been in place when care was approved.

When the law took effect for old cases in July 2013, it quickly proved as problematic as the one it replaced — and insurance premiums went up. A process that was supposed to take less than six weeks has often stretched to six months.

And reviewers routinely rule against injured workers' doctors, denying treatment in 91 percent of disputes, according to preliminary data to be released this month by the California Workers' Compensation Institute, an insurance research group.

That's more than twice the denial rate for patients under regular group health plans, according to the California Applicants' Attorneys Association, which represents workers' lawyers.

Christine Baker, the state official who oversees workers' comp in California, said the number of claims that reach medical review is very low and the reform has provided an important check on costs. Most of the denials, she added, represent "inappropriate care," such as overprescribing addictive painkillers.

The reform is "speeding up the decision-making process," Baker said, noting that the initial backlog is now under control. "Workers are getting their treatment and a decision made about that treatment much quicker."

But in some instances, records and interviews show, injured workers have been denied treatment simply because the reviewer didn't have the right medical records.

Some of the harshest criticism of the new system is coming from a surprising source: the judges who hear workers' appeals.

"The only interest that's being protected here is industry," said Judge John C. Gutierrez, a workers' comp jurist for 22 years, in an interview a few hours after his retirement party in January. "I feel that their financial influence has had an impact on how this legislation came out."

Workers, he said, "are losing their voice."

In Ramirez's case, Travelers Insurance relied on the opinion of a doctor with no background treating spinal cord injuries who later withdrew his opinion and said he didn't know he was denying 24-hour home health care.

Ramirez had worked for 17 years at Kuehne + Nagel, the second-largest freight forwarder in the world, climbing his way up from temp worker to warehouse supervisor. One day in July 2009, his boss asked him to move a crate. Ramirez pulled it out with a piece of equipment called a pallet jack. But as he turned his back to operate the jack, he heard a whooshing sound. A nearly 900-pound crate loaded with boxes full of satellite dish mounting poles came crashing down on him.

The crate, which OSHA said had been unsafely stacked, folded Ramirez's body in half, crushing his spinal column and pinning his head between his feet.

"I started howling and yelling in Spanish and English," he said. As blood poured from his mouth, he managed to tell his co-workers he couldn't feel his legs anymore.

<20141030_workers-compensation-propublica_fallon_0253_custom-fc76b15c49e8cd1d48ec12709fb408c405032768-s1500-c85.jpg>
Lupita Ramirez dresses her husband, Joel, at their home in Rialto, Calif. Joel was paralyzed from the waist down after being crushed by a pallet when he was working in a warehouse.
Patrick T. Fallon for ProPublica
Travelers, the company's workers' comp carrier, began providing Ramirez with 24-hour home health care. In August 2012, a judge ruled him permanently and totally disabled and awarded him coverage for future medical care.

The system appeared to be working. But a month later, the governor signed the new law, making old cases like Ramirez's subject to the new review process.

According to medical and court records, in early 2014, Ramirez's physician submitted an unrelated request for additional care. Travelers sought a second opinion and then used what appeared to be only a slight modification to reassess the entirety of Ramirez's home care plan.

The decision to take away his support and leave him without a way to care for himself, Ramirez said, made him "feel like less than nothing."

Without his aide, the indignities for Ramirez began almost immediately. Unable to sense his bodily functions, he has at times been left soaking in his own urine or feces, waiting for his wife or children to come home from work, school or a trip to the pharmacy.

He fell several times trying to transfer from his wheelchair to the couch, lying helplessly as his wife and daughter struggled to pick him up.

His wife had to give up her job cleaning houses to care for him. His daughter quit college and works at a casino to help out financially.

In emailed responses, Travelers officials said they "sympathize" with Ramirez and his family and that the case was "unfortunate and complicated." But they insist Travelers did not use the new law to withdraw the aide, and only did so after a routine review of his care. A judge, however, said otherwise and ordered the company to restore the aide.

Told of Ramirez's situation, Baker said it was "terrible" and not how the system was intended to work.

The state workers' comp division is planning to update the home health care guideline after determining from a number of similar cases that it was too narrow and "does not meet what we want to have in California," said Rupali Das, the division's medical director.

On a recent afternoon, Ramirez lay on his couch in Rialto, Calif., after a long day traveling to doctors' appointments. Covering the wall were collage frames full of family photos — Ramirez holding an American flag the day he became a citizen, his daughter in a purple gown celebrating her quinceañera, and him and his wife dressed up when they used to spend the weekends dancing to Mexican and country music.

"We were really good at dancing together," he said. "Since my accident, I try to forget about music because I just get sad."

He breathed in and exhaled deeply.

In late October, Ramirez got some good news. Travelers reinstated his home health aide under orders from the state workers' compensation Appeals Board.

But Ramirez now feels doubly vulnerable, knowing how easily his critical support could be taken away.

Lying awake at night, Ramirez wonders what will happen when he gets older, when he and his wife have even less strength, when his kids have families of their own.

"Those moments, they make you think it's better to die before that happens," he said. "I don't want to live like that."

CA AFL-CIO Art Pulaski's Legislative Director And Supporter Of pro-insurance SB 863 Angie Wei Re-elected Chair Of California Commission on Health And Safety And Workers Compensation
Angie Wei Elected 2014 Chair of the California Commission on Health and Safety and Workers' Compensation
By WorkersCompensation.com
Oakland, CA (WorkersCompensation.com) - The California Commission on Health and Safety and Workers' Compensation (CHSWC) is pleased to announce the unanimous election of Commissioner Angie Wei as the Chair of the Commission for 2014. Ms. Wei, appointed by the Senate Rules Committee to represent labor, is the legislative director of the California Labor Federation, the state AFL-CIO Federation. Previously Ms. Wei was a program associate for PolicyLine of Oakland, California, and advocated for the California Immigrant Welfare Collaborative, a coalition of four immigrant rights groups that came together to respond to cuts in public benefits for immigrants as a result of the 1996 federal welfare reform law.
CHSWC, created by the workers' compensation reform legislation of 1993, is charged with examining the health and safety and workers' compensation systems in California and recommending administrative or legislative modifications to improve their operation. CHSWC was established to conduct a continuing examination of the workers' compensation system and of the state's activities to prevent industrial injuries and occupational diseases and to examine those programs in other states.

http://www.workerscompensation.com/compnewsnetwork/news/18000-angie-wei-elected-2014-chair-of-the-california-commission-on-health-and-safety-and-workers-compensation.html
§Angie Wei In Bed With Insurance Industry
by repost
wei__angie_ca_fed.jpg
California AFL-CIO Legislative Director Angie Wei who is also chair of the California Commission On Health And Safety and Workers Compensation has been colluding with the insurance industry to prevent injured workers from getting proper medical care and compensation.
§Stop Waterboarding My Wif
by repost
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Unite Here Local 2 & 2850 member David Mitchell's wife Bettye was terrorized by the workers comp system and the "reforms" put in place with the support of CA AFL-CIO Art Purlaski and Angie Wei
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