Response from the Governator...
 

On Jul 9, 2007, at 4:50 PM, governor@govmail.ca.gov wrote:

Thank you for contacting me regarding workers' compensation. I appreciate hearing from people who care about the important issues facing our state.

As Governor, I am committed to ensuring quality health care for injured workers and improving California's business environment. Workers' compensation costs were skyrocketing before I took office, and my reforms have lowered costs and ensured that objective medical standards are used to compensate workers based on the extent of their injuries. As a result, premiums have fallen dramatically since 2003 and saved businesses billions of dollars that they have used to hire more workers.

These efforts have helped to restore prosperity to our economy, creating more than 650,000 new jobs in California, improving accountability in the system and reducing costs by providing for prompt, effective medical treatment. The reforms also created medical provider networks and a new permanent disability rating schedule and reward employers who return workers to their jobs.

Again, thank you for taking the time to write. I welcome any ideas and comments that can help improve the future of California.

Sincerely,


Arnold Schwarzenegger

Well, welcome to Arnie's " New Vision of California"...

WC is ALL about saving money for the Insurance Cos and the Employers, by REDUCING BENEFITS to injured workers, in both treatment AND permanent Disabilty Awards.

Arnie basically "held a legislative gun" to the heads of the Legislators in approving his reforms on the basis that if they appoved the reforms, and subsequently their were "unintended consequnces" (i.e. BIG MISTAKE), they could be easily remedied. If the legislature did NOT appove the reforms, they would be subject to a BALLOT INITIATIVE, subject to the voting process, hence California Constutional LAW, which is infinitely a more lengthy, complicated to UNDO.

What has resulted is a total MESS. Rather than stream-lining the system in order to ensure a timely benefit-delivery to "cure and relive the effects of the industrial injury", Sb899 has resulted in a questionable Utilization Review Process by "Doctors", some of which do not even have credetials to practice medicine if California, retired Podiatrists denying autho on Brain-injured injured workers, etc. Unreasonable delay/denial of treatment is " the norm", for the penalties have been signifantly REDUCED to 10-25%, based on the "approved" amount of the specific cost or treamtnet that has been requested.

The Primary Treating Physician no longer has the 'presumption of correctness"--THE VERY MS. who is REQUIRED to evaluate the injured worker at LEAST every 45 days.

So, if the Insurance Carrier DISPUTES the diagnosis, treatment recommendations. level of pemanent disability etc., there is no longer the "duelling QME process", whereby the injured worker can pick from a panel of QME's as HIS expert examiner to counter the QME that the Insurance Co haspicked as THEIR expert. Now, the shift is for the parties to pick an "AME", an Agreed Medical Examiner", who is SUPPOSED to be "neutral and objective", and is the SOLE Doctor who opines on diagnosis, treatment recommendations, and ultimate level of Pemanent Disability.

A is so happens, the MAJORITY of Defense QME's "saw the writing on the wall" with SB899, KNEW that their previously lucrative roles were being phased out, and all of a sudden, "jumped on the bandwagon" and marketed themselves to Applicant Attorneys and Defense Attorneys as to their "abilty and availabilty" to act as AMES.

Gosh, what a SURPRISE the Iw gets, when this AME "splits the baby"--in order to make BOTH applicant attorneys and defense attorneys "happy" (thus ensuring a continual stream of referrals), the AME will "opine" that the IW does indeed have carpal tunnel and ulnar compression, but does NOT have "evidence of RSD" on their 5 minutre exam.

When it comes time to determine the level of Permanent Disabilty, the "new reforms" have slashed this as well, quite significantly, using the AMA 5th Guidelines of OBJECTIVE factors ONLY.

Previously, if anb IW was restricted to sedentary work, lifting/carrying restrictions and had PAIN, these were ALL considered "factors of disability".

An IW with bilateral upper extrmity disability (CTS/Ulnar/RSD) with a five pound wight restriction, no repetitive use of either hand/arm, moderate pain could EASILY rate out at a LEAST 70%, which would ALSO entitle the IW to the Life Pension.

Under the NEW rating schedule, compliments of Arnie, that SAME IW would rate out as 14-22% "Whole Person Impairment" at BEST.

The DIFFERENCE in the monetariy value of these ratings is over 70,000, depending on the age and occpation of the IW, NOT including the Life pension OR Future Medical (which of course, the AME, who TRRUMPS the PTP, severely minimizes..."Patient would NOT benefit from x,y, z, so would not allow).

Obviously, this is DEVESTATING to an IW, paricularly for RSD sufferers, who are mis-diagnosed by the AME, and essentially deprived of TREATMENT, both current and future.

Approcimately two weeks ago, Arnie stated that irf ANY bills from the legislature came across his desk that would INCREASE benefits to the IW, he would SUMMARILY VETOE THEM. PERIOD.

Isn't that IRONIC, given that Arnie HIMSELF was the BENEFICIARY of Workers Comp Benefits in the early '80s when HE filed a WC claim for injuries during the filming of "Conan the Barbarian"?

Perhaps Arnie takes his acting roles a little to LITERALLY...

Thank you for allowing me to "expound"--this truly was not intended as a "rant"--merely the "FACTS" as they currently exist in California.

<Sincerely,

The Other Brokenwings

+

hehehe desi...the real curious here...:D

screennames can be real close. if a * is added or a number or ~. i checked. yep...we have a (brokenwings) and a brokenwings. :o

back to our regularly scheduled topic. :p

Hi Desi! Thanks for figuring that out! I haven't posted for quite a while due to flare ups (both RSD and FOREST FIRE)...thought maybe it affected my eyes and I was seeing double!;)

So, now that there are two of us, I thought I'd just start calling my self the "other" brokenwings whie I sign my posts!

The Other Brokenwings

Changes are a commin.. Soon I hope!
 

BC Canada has also since 2003 used the AMA guidelines (though they don't tell you that) and do not take into account HOW the injury affects your life.

I have full body RSD and have to use a scooter to get very far and cannot work I was "awarded":confused: 123.73 a month!!

Here is a link to the JAMA site where they explain that there are problems and what they are doing about it:

http://jama.ama-assn.org/cgi/content/abstract/283/4/519

The AMA guidelines were never meant to be used alone but in conjunction with another assesment to rate the impact the injury has on your life:

http://www.environmentaldiseases.com...ing-guide.html

It's no wonder they save so much money they are putting us on the streets!

Sory me rant for today I just lost the apeal for my disability amount yesterday. and I just am soo upset about this travesty of justice:mad: :eek: :mad:

:grouphug:

awww sandel...i'm sorry to hear that. :( :mad:

:hug: :hug: :hug:

Oh, Sandel, that is TERRIBLE..but is there ANY WAY that you could appeal to a Higher Court? Well, I sure can sympathize with you...and so many others who are truly being, well (as delicately as I can say on a public Forum) being SCREWED...

My thoughts and prayers are with you...I know it is HARD, but try and relax so your RSD doesn't go off on a really bad flare.:hug:

The Other Brokenwings

thank you I needed the hugs..
 

I have one more level to appeal it.. I also only had one docs note then and now I have 3 docs saying that I am unable to work.. WCB had a problem with the one I had sent in because aparently I can only be disabled by my right foot injury, my doctor had also mentioned the other symptoms bodywide and they think that is not compensable. dumb people..

I feel so helpless with all this I have no lawyer and this is the last of 3 that I have lost.. the next step is WCAT for this one and as usual I think I have it beat.. but I have been wrong before :( I have decided that if I loose with the WCAT appeal I am going straight to the News Papers.

My pain levels are very high today I think WCB's trying to make me quit as alot of people do here, I would if I could but this is my life and if I don't look after it nobody will.

Thanks for listenin..