The Los Angeles Times’ recent article on workers compensation unfairly used the actions of a few to put all public safety officers in a bad light. My story tells you why.
I was a police officer with the City of Montclair. I loved my job and would give anything to still be working as a police officer. During my tenure, I worked as a field training officer, narcotics investigator and worked as part of our honor guard team.
After suffering a neck injury while apprehending a bloody, naked suspect who was under the influence of PCP, amphetamines and benzodiazepines, I’ve experienced many delays in my medical treatment.
I’ve had three spinal surgeries thus far. The first surgery took approximately 15 months to get approved from my date of injury because of denials and delays by the insurance utilization review company.
My third surgery was delayed for approximately one year based on a forged medical review by the utilization review company. The City was alerted to this by my attorney after my surgeon discovered the fraud.
Months passed during these delays, all while I had to live with the constant pain, numbness in my hands and migraines. In addition, I was suffering from acid reflux and high blood pressure because of the chronic pain and medications. Even physical therapy after surgery was delayed, causing major hardships in my recovery.
Before my injury, I was very active. I played sports, owned a motorcycle, went whitewater rafting and skydiving multiple times. None of these things exist in my life now.
To make matters worse, medications were denied throughout this process, delaying my relief and forcing me to pay out of pocket. These were not cheap because I couldn’t get them from my personal insurance.
I was forced to medically retire, losing my career because of this on-duty injury. I have also been told that I may have permanent damage and pain.
I was single and owned my own home at the time I was injured. I had to sell my home to ensure I would be able to afford living with the pay cut that comes as a result of a job-related injury.
The vast majority of workers compensation claims are legitimate. Getting hurt on the job isn’t glamorous, nor is it something anyone wishes upon themselves. It usually means we can’t work as hard anymore, and we often lose our careers.
Is there fraud in workers compensation? Yes. However, a recent state audit found that only 2 percent of workers compensation fraud was attributed to employees filing false claims. The real fraud – nearly 84 percent – is attributable to medical and service providers bilking the system, as was the case with my utilization review. The Los Angeles Times never mentioned those facts.
While I’m sure well-intentioned, shining a light on a few fraudulent individuals and associating their actions as representative of the entire system is unfair to those of us who depend on workers compensation to live after being injured on the job.