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• Warren Schneider
• Marjory Harris


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I returned from a legal convention to find the sky filled with turkey vultures.
I watched them land awkwardly in the branches of a big stand of blue gums, then circle in the air and descend onto my neighbor's property, where they were consuming a dead deer. Several at a time would pick at the carcass while several more would stand nearby on the ground. When they returned to the trees, another bunch would descend to feed.

As I watched this nature drama, I was reminded how fractionalized workers' comp had become, with various “vendors” providing dubious services, frittering away the comp dollar as they fed on the injured worker. It used to be that the comp dollar was primarily spent on services that directly benefited the injured worker, medical treatment and indemnity payments. The claims adjusters knew their cases, knew the doctors, knew a lot about medicine, and had the authority to make decisions.

Then came the “reforms” of 1989 and the next few years. In an attempt to standardize claims administration, legislative and administrative micromanagement turned a fluid system that could deal with the myriad situations occasioned by work injuries into a concrete and unwieldy bureaucratic system. Comp became a minefield riddled with statutes and regulations filled with mind-numbing minutiae. This encouraged the growth of specialized vendors. It wasn't long before the claims administrator had less and less say-so and ultimately became a clerk with a huge caseload, little authority to make decisions, and ineffective in dealing with the micro crises so common to people needing relief from the physical, emotional, and financial havoc wreaked by their injuries.

Increasing specialization of tasks related to comp management had the unintended consequence of increasing inefficiency and delays. With every change in the law, new services sprang up, to capitalize on the obscurity of the new “reforms” and to get their piece of the comp carrion.

To the nurse case manager were added the personnel of utilization review and the bill reviewers, “clinical validation services” and the like. Aren't these tasks that could also be done by a nurse case manager? But why streamline when you can make something absurdly complex?

And when you get a report from a forensic evaluator like an AME or QME, why not spend some more of the comp dollar to have another vendor critique the report to reduce the paltry WPI even further? And since the other vendor’s report is not admissible, why not try to get the original report writer to reduce the WPI to an even paltrier amount by hiring a defense attorney to take the doctor’s depo?

But wait, I have gotten ahead of myself. Before we get to this point, we need to look into every nook and cranny of the injured worker’s past to find “other factors” causing permanent disability. We need surveillance videotapes showing the injured worker going about his ADLs. We need to do many evaluations to rule out or in sleep disorder, erectile dysfunction, etc. We need to get a DFEC report, to show how off the mark the PDRS actually is.

We need so much more than we used to need to administer a claim, even though we pay out so much less in indemnity and services to the injured worker. Or maybe I should say, we need all this more effort and expense so that we can justify paying so little that would actually benefit the injured worker.

And because this “reformed” system is so inefficient, unlike the deer’s carcass, which is disposed of quickly by the efficient turkey buzzards, flies fester in the lives of those Injured at work. The maggots of anxiety and depression eat away at them as they face uncertain economic survival. But all those vendors get paid for their services. And sometime in the not so distant future, the reformers will cry, “The system is broken! It doesn’t work! We need reforms!”


Marjory Harris began practicing law in 1974 as a defense attorney and later became an applicant's attorney and a certified specialist. She continues to represent injured workers in the San Francisco Bay Area and Inland Empire and mentors attorneys on big cases.

Reach Marjory at (888) 858-9882 or email to
MHarrisLaw@verizon.net
www.workerscompensationcalifornia.com


Comp Administration,
Soup to Nuts


The Editor’s Rant on Reforms
Editorial opinion by Marjory Harris

> New PDRS & DFEC
> ACOEM, AMA Guides & FCAs
> Defense Perspective: Settlement
> Computer Corner: Analyzer
> Case Status Spreadsheet
> Carving up PD
> Comp Admin., Soup to Nuts