Injured Workers Will Lose in California Workers Comp "Reform"

There's little doubt that California's $29 billion workers compensation system is in trouble. It charges California employers among the highest premiums in the country but provides workers with disability benefits that rank among the nation's lowest. But often forgotten beneath the dollars and debates are the injured workers.

While politicians downtown haggled over a workers' comp system that everybody agreed could use a fix, Jodi Greggs rested her aching back in the crowded waiting room of a nondescript office five miles away.

"I went to school, worked hard to get a degree so I could support myself, and then I wind up in a situation where I'm so broke it's ridiculous," said Greggs, who hasn't been able to work since the back injury she suffered five years ago. "I shouldn't have to feel like I'm a welfare recipient because I got hurt at work."

Although nobody disputes the severity of Greggs' injury, or that it was work-related, or that she is entitled to permanent disability benefits, her case has remained mired in the workers' compensation system for five years. Most of the squabbling has been over her medical care and treatment prescribed by doctors that insurance attorneys think is excessive.

Before her injury, Greggs said she enjoyed "a pretty decent life." She was "madly in love" with the man she'd married a year earlier. (They are still married.) She liked to hike and bike and practice amateur photography. She had a good job with a big company.

These days, she doesn't do much of anything except stay in bed. When she gets up, it's usually to go to the doctor, or to the pharmacy, to fill a cornucopia of prescriptions to relieve her physical and psychiatric pain.

She gets mad at the suggestion by advocates of workers' comp changes that cases like hers might be milking the system for unnecessary benefits.

"They don't know what my life is like," Greggs said. "They don't understand how hard it is. They need to be put in my shoes for a day. They need to come into my home and live this life."

Scharzenegger has made workers comp reform one of his top priorities. Funny thing though, all of his proposals seem to go against injured workers.

Under the Schwarzenegger plan, injured workers would lose the right to be treated by their own doctor unless the employer agrees to it. They would be entitled to no benefits if their occupation was responsible for less than 50 percent of their injuries. Their injuries would have to be objectively verifiable, through X-rays or range-of-motion tests or other exams. Medical treatment would be based on a doctor's definition of "necessity," rather than whether treatment provided the injured worker with "cure and relief." And a new system of "independent medical review," in which outside doctors who never see the injured workers -- including claimants with issues like Jodi Greggs' -- would resolve disputes over treatment.

Juliann Sum, coordinator of the Labor Occupational Health Program at the University of California at Berkeley, characterized the Schwarzenegger package as "sweeping changes that are all in favor of the employers."