When a business has something good and people like it, you can bet on testimonials from customers. In the Internet age we look for reviews of products or services before we buy, hoping to capitalize on the experience of others so we either make the same great choice or avoid a poor decision.
A WorkCompCentral Forum thread recently popped up that is a sad commentary on our system because the people that are actually in the system providing goods and services have very little faith in workers' compensation to do what it is supposed to do.
And that is a sad state of affairs indeed.
|Bowzer won't run into the Wall of Comp again...|
I wonder, if I was an employee of a company, suffered a potentially severe and life changing injury, would I report it to the employer and file a claim. Or, if I had decent medical insurance, say through my spouse, would I simply seek all treatment through my private medical coverage? Knowing what I know about the nature of medical care received through today's workers comp insurance carriers, with the inordinate delays, arbitrary and consistent denials of treatment, generally poor treatment when compared to the private sector, and the adversarial relationship with the carrier, would I really put all of that on the line and stay within the system? What would I recommend to a loved one or friend facing the same questions?
I have asked myself the same question. As an adjuster, I see the whole picture, medical care, wage replacement, permanent disability, and the need to interact with the injured employees, attorneys on both sides, and some liens thrown in.
I am not sure that I would file a claim, unless it happened right in front of my manager, or something. In that instance, if I felt that I needed better or different treatment than what I was getting, you bet I'd self-procure.
I would only file a claim if I did not have STD and LTD that covered everything. But we speak from a position of privilege in that most of the people who post here have group health and the opportunity and means to purchase disability insurance. So some people have no choice.
There are a few injured workers forums and one on this site where injured workers ask this question regularly. Many who have been through the system tell others to not file the claim and use their private insurance. This is due to delays in medical treatment they have been victims of and receiving sub standard medical treatment in the workers compensation system. I have seen many instances that an injured worker actually becomes disabled further due to delays in treatment.
My response is if the injury is minor, no I would never claim it. If the injury was catastrophic... I am still pondering if I would claim it from the knowledge I have now of what happens to injured workers in California.
No I would not file a claim, knowing what I know now about the California workers compensation system. I think the medical treatment with delays and denials is sub-standard and can cause a person with a treatable injury to become disabled for life. Dealing with UR and now IMR... I and would not wish this upon anyone. My only question would be is it fraud to not file a workers compensation claim for an injury that occurred at work? If so then I would most likely file the claim. I have read conflicting responses to this some stating it is fraudulent not to file a claim when the injury occurred at work, while others have stated you have a choice.
I have had a lot of QME cases where the original orthopedic injury was treated by a private insurance MD who did not report it as a work injury when the worker told them it was a work injury, and kept treating it as non-industrial as it filled billable time and procedures and helped make the doctors house payment.
Isn't it illegal to NOT report an industrial injury.... ?? .... but I think it happens all the time.
When when a WC claim was finally filed, it totally messed up the case. The insurance company can easily say, 'oh look, his private insurance treated it so it is clearly non-industrial"
Perhaps what is being said above reflects declining claim frequency in most geographic areas (except of course the greater Los Angeles area, but we've all seen the latest news stories about atypical behavior coming out of various ne'er-do-wells that seems to account for the volume there) though increasing indemnity claims with attorney involvement.
I've asked myself this question throughout the years of my professional life in work comp. I used to have faith in the system and would have had no qualms about seeking care through the work comp system.
Now I would answer in the negative.
And that really is a sad testimonial.
If you don't have faith in the own system you work in, how can anyone else?
And what is the point in having a mandatory system of insurance if no one uses it?
The Walt Kelly comic strip from the 1960s and 70s, "Pogo," is most famous for this singular quote: "We have met the enemy and he is us."