Monday, July 21, 2014

My Industrial Injury

Well I did it.

I had an occupational/industrial "injury."

Thursday afternoon I arose from my desk, turned to one side in a slight twisting motion, and my 54 year old back let out a little "tick."

You know, that sort of minor catch where you get a bit of a twinge in the low back; where it doesn't really hurt just at that time. But I knew I would have some pain in the day or days to follow.

[One of my problems (yep, I have many) is that I have a high tolerance for pain. Part of that tolerance is due to the multiple injuries I have sustained "growing up" (if the stupidity to injury scale is utilized, I didn't really grow up until about age 48), part of that is due to my hyperactivity, and part of that is due to Mom's lack of empathy for my fatuity ("your shoulder is going to bother you for the rest of your life!" was the first thing I heard when I came home with a radical shoulder dislocation after a 35 mph skateboard fall).]

I carried on the for rest of the work day in a relatively normal fashion, partly aware of the increasing level of pain in my lower right back.

I didn't report it to my employer, and I didn't fill out any forms.
Bowzer: "Ooh .. that hurt..."

When I got home I did tell my wife about "pulling a muscle" in my back at work. The pain and tightness in the injury area had increased. She prepared an ice pack to help reduce the swelling and inflammation, and I had a beer.

Sleeping that night was fitful - the stiffness and soreness increased in the supine position. Laying on my stomach, though, was worse. Time for Advil.

The next day at work my movements were guarded and slow. Riding my bicycle in the morning before work didn't exacerbate the condition, and actually made it feel a little better.

At work I could get up out of my chair and walk, but the injury area was tender and more painful than the day before, and required guarded movements.

Still, I put on my game face, didn't report the injury to HR, didn't fill out any forms, didn't tell anyone.

Sing the following phrase in a descending baritone: "I'm too tough to care...".

Because I've experienced the "pulled back muscle" situation before, as I'm sure most of us over the age of 50, or even 40 have, I knew that this incident would resolve on its own eventually.

Sure enough, I awoke Saturday and the intensity of the symptoms had indeed decreased. Some minor vestiges of pain and soreness remained, but I cycled 73 miles with 4,600 feet of elevation gain, trimmed the hedge in the back yard (which includes using a ladder and power trimmer), mowed the lawn, cleaned the floors, washed the motorcycle, and did all sorts of other household chores involving medium to heavy physical activity.

But now I face a conundrum: I am admitting here, publicly, in this blog, that I have committed fraud on multiple counts.

I sustained a work injury. I was at work. I was doing my job. The injury, though minor, arose out of, and occurred in the scope of my employment. Perhaps it required only first aid, but who's to determine that? I didn't report the injury and I didn't fill out the required form. I didn't follow The Law. There are penalties for not following The Law.

Worse yet, as an employer I witnessed a work injury! But I didn't provide the employee with the injury claim form. I didn't complete the Employer's Report of Injury. I didn't tell the insurance company about it. I didn't refer the employee to medical care. As an employer I too didn't adhere to The Law, and likewise face consequences.

On both accounts I simply hoped that the incident would just go away.

And if it didn't go away I would probably just go to my personal general health doctor and tell him I experienced an unknown source of back pain at home anyhow.

Which is not, as it turns out, an unusual reaction from someone intimately experienced in workers' compensation.

In the panel session in which I participated at the California Coalition of Workers' Compensation 12th conference in Anaheim, CA last week, I asked the audience of over 400 work comp professionals by a show of hands if they would they seek treatment within the work comp system for any disease or injury, regardless of origin (industrial or not).

One hand went up, and I suspect that was from a self-insured, self-administered employer.

All other 399+ hands stayed down.

How can we put people through the work comp system if we, people that are intimate with work comp, professionals that deal with the system day in and day out and KNOW people within it to get things done, have no faith in it ourselves?

Was I wrong in not reporting my injury to my employer?

And as an employer who actually witnessed the injury, was I wrong in failing to provide a Claim Form for benefits or failing to get the employee to a physician?

What if this injury ends up being more than a sprain? Will I be denied benefits if I later claim an injury? Do I even want to bring this into the work comp system? And if I decide to stay out of the system, am I committing more fraud by telling the physician that I'm not sure how the injury occurred but that it happened at home? And is it even right that I knowingly shift the cost of this incident out of work comp and into the general health sector?

I'm guilty on so many counts.

When you send over the prosecutor please take it easy on me. My back hurts...


  1. I wouldn't wish the work comp system on anyone.

    I hope you feel better soon.

  2. Hey David, don't worry about it.

    There's very little risk of prosecution for fraud, work comp defense attorneys get away with it all the time. The District Attorneys look the other way, and Employers believe their insurance carriers have full impunity, and thereby protecting the Employers too.

    Here in California, the WorkComp judges won't even have the word spoken in the Courtrooms or Waiting rooms without stern warnings. 'No worries' ....

    Every now and then corporate media seems to tell a story about Joe or Jane Worker, just to keep the unsuspecting public off balance, and confused by the ol' stories that 'work comp is broken'...

    Rest and wait is a standard work-comp line, so take the afternoon off! :)

    Just get better. You don't really want to risk further injury by seeing a 'system' doctor.... or worse yet, denials of medically necessary treatment.

    As to WorkComp being broken, did you know that the CEO mOTAMED of CNA makes $10,600,000 a year, A 27 % INCREASE FROM 2011 according to Crane? Ha! There's a dude who KNOWS WORK COMP AIN'T BROKEN, HUH?

    I wonder how much Stephen Holmes, CEO of WyndhamWorldwide makes? Or Norin Grancell, CEO of Grancell, Stander, Reubens, Thomas and Kinsey?

    These are the Boyz responsible for more than 2.5 years of failure to provide medically necessary treatment to me, as their people apparently don't grasp that the brain is a body part located in the head.

    Heck, they don't think they have to even reimburse medical miles to the 45 day visit to the Orthopedic Surgeon handling the brain injury case, let alone reimburse more than $25,300 for said medical miles and additional self-procured medically necessary treatments that they refused to authorize. The Information and Assistance Officer repeatedly cheerfully supports their positions.

    You might consider joining NAIDW... National Association of Injured and Disabled Workers. Their slogan is "No Worker Left Behind".... You're not alone!

    So, I've been on the rest and and wait and wait and wait and wait program since 1/9/12...... The game is rigged. See your local chiropractor and acupuncturist and avoid Workers Compensation by any means necessary. THE GAME IS RIGGED!!!

    #InjuredWorkersUnited...SILENT NO MORE. ;D