Practically no one expects to get hurt at work; the perception is that is what happens to other people. But, you may find someday that it happens to you. If you are injured at work there are some things you need to understand. First, work place injuries can happen in two ways under California law. First, an injury can be termed "specific" in nature; for example, when a person is injured falling off of a ladder that is a specific injury. Alternatively, an injury may develop over time; such an injury is referred to as a cumulative trauma injury. For example, a beverage delivery truck driver who moves heavy kegs over and over for a long period of time might develop cumulative trauma to his/her low back or some other body part from the repeated heavy lifting. Often, such claims reveal themselves through chronic pain which does not stem from a particular injury event.
We have previously reported on the myriad ways in which workers' compensation carriers' procedures add costs to the system and thereby drive up insurance rates. Here is yet another example.
We work hard to be of service to our clients and are grateful when our service is recognized. I was in Hawaii last week working on a legal malpractice case. Our client who had been a longshoreman, had injured his back and could no longer do his job. When I went to his house, he insisted on giving me a gift. He said that in Hawaii it is a tradition to give a friend a gift the first time they visit their home.
The current state of affairs for medical treatment for injured workers is without a doubt rigged in favor of insurers who game the system to deprive workers of needed medical treatment and to push the costs of reasonable medical treatment off onto private health insurers, Medicare and MediCal. First, 80% of all workers injured at work are required to treat with doctors listed in the workers' compensation carrier's Medical Provider Network ("MPN"); the MPN is created and maintained by the workers compensation insurers. If a physician who is on the MPN recommends care which the insurer feels costs the insurer too much money, those physicians are weeded out by the insurer through economic profiling and taken off the MPN list. This means that doctors are reluctant to provide care which would otherwise would be reasonably medically necessary. We have had client's say that their doctor has said "I would prescribe 'X' treatment, but the carrier will bump me off the MPN."
"John Welder" gets something in his eyes while welding. He reports the incident immediately to his employer. There was no wash station, so the employer tells the welder to rinse his eyes with a bottle of water. When that does not solve the problem, John Welder says that he needs to see the doctor due to the ongoing pain. The welder's supervisor then yells at him, "damn it John, we better find that there is something in your eyes."