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The California Department of Industrial Relations is investigating delays in treatment for those injured in the San Bernardino terrorist attack in 2015, and a California lawmaker has proposed streamlining the workers compensation process for those injured in the attack or acts of workplace violence.
This follows recent public outcry that several individuals are suffering from not only the terrorist shooting, but also because of a lack of prescription refills and paid doctor visits, among a list of complaints documented in widespread media reports.
“We are diving deeper,” Christine Baker, Sacramento-based director of the Department of Industrial Relations, said Tuesday.
Fourteen people were killed and 22 seriously injured when an employee and his wife in a terrorist attack fired into a rented banquet room at the county’s Inland Regional Center on Dec. 2, 2015 during a holiday party.
Geraldine Ly, a Santa Ana, California-based attorney representing nine of the victims, many of whom reported to the press that their treatments have been denied or delayed regularly, did not return phone calls for comment.
David Wert, a spokesman for San Bernardino County, said in an emailed statement Monday that “96% of requested treatments have been approved” and that the delays are on the part of the providers.
“The county is finding that the vast majority of issues our Dec. 2 survivors have complained about involve paperwork not being submitted to the county by their providers,” he wrote, adding that “in the rare instances where treatment is denied, it is not the county denying the treatment but a reviewing doctor working under the state-mandated utilization review process.”
Ms. Baker said her initial investigation has led to that same conclusion.
Several health care providers have not taken all required steps to have medical needs met under the workers comp review process, she said, defending the medical review process, which ensures injured workers are not “exploited (or) overtreated” and that without the evidence-based medical reviews, workers can be exposed to unnecessary surgeries and too much medication.
The process works for most workplace injuries, she added, but the San Bernardino attack was “extraordinary.”
“We really need to take extraordinary steps in handling those claims,” she said.
In addition to a lack of information provided to the claims adjustors in the San Bernardino workers comp cases, claims adjustors have not been quick to respond or re-request information, she said.
“As we are digging deeper, in many cases it was the information that was necessary to secure an approval was lacking. (And) claims handlers have to reach out, too … There needs to be better communication. Communication is key (and) seems to be a little bit of the missing ingredient.”
Ken Hernandez, the county’s director of risk management, told Business Insurance in November that some delays have been caused by the magnitude of claims arising out of the incident and that “with the workers comp process, there are going to be delays.”
“Some people think it’s the county,” added Mr. Hernandez in that interview. “We are just here to administer the state program.”
Mr. Wert wrote on Monday that “in the rare instances where treatment is denied, it is not the county denying the treatment but a reviewing doctor working under the state-mandated utilization review process” and the county is now working with the department to improve the process.
Meanwhile, one California lawmaker is proposing a solution.
Assemblywoman Eloise Reyes, whose 47th District includes parts of San Bernardino, introduced a bill on Monday that would amend the labor code and “exempt medical treatment for employees or first responders who sustain physical or psychological injury as a result of an act of terrorism or violence in the workplace from the utilization review process and the independent medical review process, and would provide for an expedited proceeding before the Workers’ Compensation Appeals Board to resolve disputes regarding treatment.”
The changes would apply retroactively to the employees and first responders injured in the San Bernardino terrorist attack and any other employees or first responders injured by an act of terrorism or violence in the workplace that occurred prior to Jan. 1, 2018.
Ms. Baker would not comment on the proposed legislation.
California state Assemblywoman Eloise Reyes has introduced a bill that would expedite the workers compensation process for those injured in terrorist attacks or workplace violence.