Paul D. Stutrud
P. O. Box 2205
Rohnert Park CA 94927
(707) 585-2421
copprfst@jps.net
23 April 2000
CONFERENCE COMMITTEE ON S.B. 996
JOHNSTON, Chair
24 April 2000; 8 a.m. to 10 a.m.-
California Room (4203)
S.B. No. 996 Johnston. Workers' Compensation
Senators:
I hope that you can appreciate that I and my two compatriots (Armando Crespo and Linda Berg) left Petaluma in Sonoma County at 6:00 am this morning to attend this hearing after only learning about it last Thursday 20 April.
Each of us is an injured worker who have run the gauntlet of this very corrupt system. I have been in the system more than ten years. Linda Berg is homeless as a result of this system and Mr. Crespo is facing deportation as a green card alien after being convicted for allegations of Workers Comp. Fraud. Mr. Crespo is appealing the conviction after going through some very tenuous efforts to disentangle the series of events that led to his false conviction.
I am not very happy about learning about Senate Bill 996 only a couple of days ago. I am appalled that Senate Bill 996, as it was originally introduced has gone from two pages to 81 pages of very complicated language that does not appear to be related to the original bill and its intent.
In my opinion, this bill looks like it was written by an insurance company lobbyist rather than in reflection of the sorry state of the insurance industry in California. I would like to know who the authors are of this amendment. A first case in point is found on page 4, paragraph (10) regarding indemnity payments; payable immediately as the present law calls for or to capitulate to the "excuse" the "check is in the mail -- because the bank is delaying payment."
In my opinion, this bill should be scrapped and replaced by more specific and separate bills. What in the world does automobile insurance fraud have to do with Workers Comp? (See page 7 paragraphs (b), (c ) and (h) of Section 1871 of the Insurance Code.
In regards to amending Section 1872.83 of the Insurance Code, I think more emphasis should be placed on defining the real perpetrators of Workers Comp. fraud -- which is vastly over exaggerated as being done by injured workers. The real fraud in this system is being done by the insurance industry itself in its activities to deny and delay lawful and timely medical care, rehabilitation therapy and vocational rehabilitation to qualified injured workers.
Further definitions need to be given to district attorneys about their priorities of pursuing allegations of Workers Comp. Fraud cases against injured workers. I have found that between having over-zealous Assistant DA’s acting to reach convictions against injured workers and very careless and cruel actions by insurance adjusters and defense attorneys to create appearances of Workers Comp fraud by injured workers, this system has reached an all time low in being nasty.
Mr. Crespo’s case is a good example. He was left high and dry by the insurance company and his employer in regards to providing timely medical care, response to being declared permanent and stationary, and then giving Mr. Crespo no indication if he was clearly terminated of both his employment and his Workers Comp case. After being left outside for more than a year, he assumed that his case was finished. He attempted to make himself a job and, voila!, the insurance company paid a handsome price for two private investigators to do video surveillance of Mr. Crespo. If you viewed this tape as a disinterested party you would see nothing wrong with what Mr. Crespo was doing. He was not exceeding the weight limits imposed upon him because of his injury. You would not see him performing any acts that a reasonable person would consider out of line for a man who had surgeries on his back and knee for his injuries. You would not see that Mr. Crespo would have to spend several hours of "down time" if he did any exertions that taxed his injuries.
Mr. Crespo’s video tapes led to the filing of a complaint in San Francisco Superior Court. Mr. Crespo was arrested by an eight man SWAT team from Petaluma with his two little girls crying and hanging onto his legs as their father was hauled off to jail.
Mr. Crespo’s story is sordid! He spent many hours driving back and forth between his home in Petaluma and San Francisco Superior Court for delay after delay of his case. He retained an attorney who turned out to be a buddy of the Assistant DA and they worked out a deal without any participation of Mr. Crespo and put him in a position of having to "plead guilty or go to jail!" Unwittingly, Mr. Crespo pleaded guilty, was convicted of Workers Comp Fraud (even though he was actually cited under the wrong section of the Penal Code) and was never provided with a translator at anytime during the proceedings.
We have been able to file for an appeal and Mr. Crespo’s former criminal defense attorney has agreed to write an affidavit regarding his misconduct and mishandling of Mr. Crespo’s case. But in the mean time, the I.N.S. is breathing down his neck, waiting for the conviction to be upheld. Mr. Crespo has lived in this country, gainfully employed for 20 years. He is married and has two young daughters and a mortgage on a home. He is a hard worker and not a shirker. He was the victim of an employer who did not follow safety rules and of the very corrupt Workers Comp system.
To reiterate, I would question the statistics of insurance fraud and pay a little more attention to how the insurance companies are carelessly acting to allow fraud by not having competent adjusters and investigators. I would like to see an analysis of how the insurance companies come up with their statistics for fraud and an explanation of how alleged perpetrators are able to get as far as they do in collecting "false" claims.
Referring to the section on the State Compensation Insurance Fund, I would like to see the amendments for this section in a separate bill with more in-depth analysis and a more clear description of what State Compensation Insurance Fund is all about.
On page 26, line 24, paragraph (d), I would like to see provisions for a format of consulting with the workers to be included with the Labor Commissioner’s annual report.
However, I do believe this is yet another section of Senate Bill 996 that should be done in a separate bill, with appropriate analysis.
I would also like to see Labor Code Section 139.6 as discussed commencing on page 39, starting at line 32 to be discussed under a separate bill and after the study that is being done by the University of California at Berkeley’s Labor Occupational Health Program on 13 May 2000.
I also believe that the matters of medical determinations starting at page 44, line 18, "Sec. 42" should be a basis for a separate bill that is well researched. I can recite the experiences of myself and many others who have been denied medical care, have been given an inappropriate rating or who have had to pay for private medical care and diagnosis’ because the employer or employer’s insurance representatives have simply said "No!" In other words, we have insurance adjusters practicing medicine without a license.
On page 54, (d) "The employer shall not be liable for the cost of any comprehensive medical evaluations obtained by the employee other than those authorized pursuant to Sections 4060, 4061, and 4062." This needs to be reviewed. There are many cases that I am aware of where an employee’s personal physician is ignored or denied for requests of very appropriate and timely medical evaluations, when they may be critical to the injured person’s recovery of their health and abilities to return to gainful employment. Again, I would urge that this be the basis of a separate bill that is researched, with consultations with injured workers.
Page 62, line 24, paragraph (b) -- there should be no excuses allowed for any delay in payments to an injured worker, including applications of state or federal banking laws. Insurance companies can certainly anticipate payments and provide for them out of accounts that are instantly accessible.
I was up until after midnight trying to plow my way through this amended bill and I don’t think it should be allowed to proceed in its present state. It needs to be broken down into more digestible and separate bills that can be adequately researched and reviewed.
In my more than ten years experience in the Workers Comp. loop, I have seen a lot of things that need to be changed.
I was delayed and denied appropriate medical care which I believe caused me permanent damage. I was denied completion of vocational rehabilitation after it was found by an investigation by the office of Postsecondary and Vocational Education that the school I was sent to for voc-rehab was not licensed, certified or capable of providing employable skills.
I was also denied a refund of the tuition refunded by this school (more than $10,000 paid to the school), as well as being wrongfully terminated. I lost more than a half-million dollars of income because my employer terminated me, refused to provide reasonable accommodation and then vocational rehabilitation.
My employer was a multiple violator of Labor Code Section 5814. The WCAB judge (Hendy) likewise was long overdue in making decisions and didn’t allow for oral hearings and never had a court reporter at his hearings.
My employer was permissibly self-insured and essentially thumbed its nose at the Workers Comp system. When I called the state agent in charge of permissibly self-insured employers and told him what was wrong, he laughed in my face and told me to save my breath. Nothing could be done.
I would like to see the Senate hold public hearings to take testimony from injured workers before they consider any further changes in the Labor and Insurance Codes.
I think a review of insurance company practices should be made a priority because I have learned that there is yet another aspect of insurance that is very comparable to Workers Compensation. That is the issues of shoddy workmanship and defective construction issues with new homes.
The patterns of delays and denials and stalling tactics are as rampant with the defective construction as they are with Workers Compensation and it all gets down to insurance adjusters denying claims and resolutions while the homeowners are made victims of years of litigation and stalling.
Thank you for your attention
Paul D. Stutrud
