The LA County Observer

Observations of a LA County Resident

Workers’ Compensation medical care versus your private insurance medical care

Written By: raconte - Jan• 02•17
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The other day I read an interesting post written by Dr. Kathleen Kozak a physician from Hawaii who has a column in Honolulu Civil Beat. Her column, which can be read here bolstered my own personal theory that has been germinating for quite some time now. I’ve often wondered over the past many years if we looked objectively at both care models, Workers’ Compensation and the private, which model would have the injured worker back to pre-injury condition (or at least as close to it as possible) faster? Based on my own experience (both nursing and personal) I think we’d find that an injured person would “recuperate” more quickly if provided care through their private insurance.

I think this story from Hawaii illustrates the problem quite well. Reading about Bonnie Chan’s struggle to get appropriate care for her work-related injury struck a chord with me, especially in her fight to get timely care. When I underwent ankle bone graft and partial fusion/surgery, I suffered an unexpected outcome and consequently developed Complex regional pain syndrome (CRPS) and though my orthopedic surgeon made numerous requests for physical therapy, which by the way is one of the treatment of choice for CRPS his request were continually denied. At least one of the reasons given was that I had already had the maximum number of physical therapy allowed by our state’s WC regulations. While I had had physical therapy, it was ordered for my elbow as part of my recovery post-surgery elbow surgery. To this health professional it makes little sense that the physical therapy ordered for my ankle would be denied because I had “used” up my allotted physical therapy on my elbow. One would think that if physical therapy is the treatment of choice then that should supersede some arbitrarily set limit.

But then again we are talking about WC, a bureaucratic, governmental system that by definition is not always known for being logical. All thanks to the self-insured Adventist Health (that religious hospital/healthcare corporation).

More to follow. . .

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