Tuesday, September 25, 2012

SB 863 is the medical-legal equivalent of last night's officiating blunder at the Seahawks-Packers fiasco

Once in a while we get to review medical-legal blunders with the same gusto  ordinarily reserved for football blunders like the Packers-Seahawks officiating error of Monday night, 9/24/12

We'll spare readers the details of the officiating blunder that led to the Seahawks 14-12 declared win last night.  We're confident that it'll be subject to review for years to come. We're also confident that SB 863 will be reviewed as the fiasco that it is, i.e., a method that conceals the names of  Independent Medical Review (IMR) doctors while at the same time rendering them practically immune from legal appeals from even the most egregiously wrong decisions, much akin to the NFL standing by the blunders of its replacement referees.

As matters stand now, the IMR doctors who'll replace the current Utilization Review system can only be challenged based on bias, fraud, or conflict of interest. That's the genius of the California Labor Federation, Grimmway, and Governor Brown, all of whom must have skimmed this part of the bill with about as much insight as the NFL replacement referees used last night.  They seem to have overlooked how difficult it is to accuse someone of bias, fraud, or conflict of interest without knowing the name of the alleged perpetrator.

If a spirited appeal is to be mounted against SB 863, it should start with repeal of the IMR section of SB 863 or with a restraining order against it.

Then we can test other sections of SB 863, for instance, to what extent were the new lien processes or the Medicare RBRVS improperly composed as intentional  encumbrances to the legitimate rights of injured workers.


  1. Sadly the state of CA IS not for ordinary citizens, only pro employers & FAR worse for injured workers. The state should be held to the highest standard of protecting all of its citizens & that hasn't happened since I became aware of the first reform back in 1989.
    Steve Poizner, the previous DOI comm, wanted UR-Utilization Review out of the picture because UR was actually siding more with IW's which proves that the state of CA. is NOT PRO EMPLOYEE, On or of the job(injured). The workman's compensation system has been fraudulent and corrupt at every level & state employees like judges WC boards, FAC, CHS&WC, and unions(they have not done anything for workers but send them to applicant attorneys for almost 30 years). I personally believe that when legislators create harm for any constituent & now in the millions, that are unprotected, should be looking for another place to work if not incarcerated for deliberately causing more harm. Injured workers have provided enormous amounts of damaging information on the corruption & the sanctioning of that corruption at WC boards, fac, DIR & CHS&WC, & legislative hearings(Although, what IW's get to speak by unions & legislators WERE limiting IW's to two minutes and regarding SB863, not even that.
    The RAND Institute would have all of that data, since it is their job to gather all government information on its activities. What is the reason to shaft so many employees? Keeping employer costs down including the the state of California employees. Our first amendment rights were denied as well as violation of the BROWN ACT! Where exactly is our representation? Only employers are protected from their own fraud & corruption & has been since 1989!
    Thank you for your much needed supportive report.
    Dina J. Padilla
    President of VOICES/B.E.S.T.CA.Chapter

  2. Dina Padilla, unfortunately, is on target. In their eagerness to connive with Gov. Brown re SB 863, the unions that cooperated with the Governor allowed "alternative dispute resolution" to sneak into the law. Rank-and-file union members will not be told about this plank. They'll find out about it later, the hard way, when it's too late. Likewise, the clock is already ticking on conflicts within this mean-spirited legislation that gives increased permanent disability to injured workers with one hand while taking a large chunk of it away with the other hand (dyssomnia secondary to chronic pain, sexual dysfunction from spinal injuries, etc). Injured workers won't be told about this concession, either, not until too late for the permanently injured. What smells worst in this careless legislation is the provision to limit appeals about Independent Medical Review to bias, fraud, and conflict of interest while simultaneously keeping the names of the IMR doctors secret! SB 863 was a political trade by the California Labor Federation in conjunction with big business led by Grimmway Farms. All the same, there's no denying Gov. Brown's skills as a Governor who intends to govern, the devil take the hindmost, as he did in this case.

    -- Robert L. Weinmann, MD, Editor, www.politicsofhealthcare.com

  3. Military M.D.'s , Orthopedic and psychiatrists were the only two specialists that any injured worker saw regardless of the many other diseases, exposures or other injuries were reported to the employer or even CAL-OSHA and that became clear in 1988. Many of these were out of state military doctors were under the auspices of the CA. state licensed QME's. SO! What happened through the years with each reform is the legitimacy of using anybody with a license, maybe and via the military.The USCode1010 prohibited that military doctors could only diagnose and treat in a national emergency and now the USCode 1010 does not exist. But the military docs were making oodles of money writing the "same" fraudulent reports on just about all injured workers. Since only injuries were reduced to and of orthopedics and pysche, orthopedic injuries were combined with pysche component by interested parties. The ortho injury then became "its all in your head" with the pysche becoming the ONLY injury and the employer never did pay for those orthopedic injuries, they just "poof", disappeared via military doctor reports. Social security only acknowledged the mental illness too and both lawyers & military docs who write the same reports for many injured workers(they do get some facts wrong on skin color, age, which shows the sameness in the reports on injured workers) and make money on both! Other injuries or illnesses were never acknowledged! Now, the mental illness, pysche injuries caused by orthopedic are erased. VOILA! NO MORE INJURIES ON THE JOB! that is the idea to save & protect employers, isn't it? The truth will come out someday really soon on the monumental inhumanity that involves the big players to disenfranchise and dismiss workers as a way to pay for the big players real needs.
    I cannot express enough the monumental fraud & harm that has been committed to workers. That we are an end to a means. It took me 25 years to figure the real reasons to disenfranchise any who works for a living at jobs that no longer pay very much, are without benefits and now with out any protection of being injured on the job.

  4. It takes many players to keep the fraud going. WC comp fraud IS NOT any different then what happens to innocents who are exploited in churches but yet it is the best kept secret exposing innocent workers to any injury, illness, all for employers with their actors to continue to harm for profit!
    CBS startlingly aired episodes on one of their soap operas about employer abuse, low wages, no medical benefits, dangerous working conditions and employers not having WC coverage.
    Maybe all is not lost and they finish the episode with workers receiving justice and restitution, unlike real injured workers! Millions of injured workers in the last 20 ears alone! And yet no justice or restitution. Speak volumes, doesn't it.
    To let you know. I've assisted hundreds if not more to acquire the knowledge that I have OF AND FOR the REAL Workmans' Compensation system, nationwide!