INJURED WORKERS SUE TO KEEP THEIR DOCTORS:

Taking Away Injured Worker's Doctor Delays Healing, Costs Public

SACRAMENTO - Injured workers and their advocates today filed a lawsuit in the Third District Court of Appeal to stop the State of California from taking away their treating doctors. "Taking away my doctor disrupts and delays my treatment, recovery and return to work," said San Francisco Police Officer DeMarco Foster. "It also costs taxpayers more, making them pay for delays in recovery from injuries." Foster has been seeing a psychiatrist since he was shot on duty while stopping a dog from attacking a young child. Foster has been unable to sleep since he was shot, and is fighting the State's new workers' compensation regulations, which could force him to leave his own doctor and seek medical care from a doctor of his employer's insurance company's choosing. "If I were forced to stop seeing my doctor and start seeing another doctor, it would delay my recovery. It takes me a long time to open up to a doctor, so all of the time it took to establish a new rapport would be more time away from work. I am not sure I could recover as well with another doctor. I trust my doctor and am making progress. That might not happen with a new doctor."

Injured workers blasted the State's move to take them away from the doctors they have been seeing. Joanne D'Amato, a single mother from Encinitas who had been holding down two jobs to support her family, told reporters how she slipped and fell while working as a food server and cocktail waitress. After four years of being treated by one set of doctors, her condition had radically deteriorated to the point that D'Amato could not drive, nor lay down to sleep. At one point, she was confined to a wheelchair. One doctor told D'Amato she could not return to work, but D'Amato insisted that she had to work to support her family. D'Amato returned to her office manager's job for two years, but while recovering from surgery, one of her doctors told her employer she could no longer work. The employer fired D'Amato. At that point, D'Amato petitioned to be allowed to choose her own doctors. She won, a choice that would be lost under the Administration's proposed workers' compensation Medical Provider Network (MPN) regulations.

After choosing her current doctors, D'Amato told those attending the Capitol news conference, her condition improved dramatically. "My surgeon is my hero," said D'Amato. "The difference between my relationship with these doctors and my previous doctors cannot be overstated. My current doctors' willingness and ability to understand and treat me are essential for me to recover and live a decent life. My former doctors did not ask questions or take the time to listen to me. One yelled at me for not taking the pain medication he had prescribed, but he didn't try to understand how badly my body reacted to it. My current doctors listen, and notice my symptoms even before I do. Isn't that how it's supposed to be?"

"It took me more than five years to find doctors who could give me some relief from my pain and injuries. I am improving," said D'Amato. "I can use my right arm again. It is far less likely that I will ever work again if I am forced to leave the care of my current doctors. I believe it is far less likely that I will ever work again if I am forced to leave the care of my current doctors."

David Schwartz, president of the California Applicants' Attorneys Association (CAAA) and a plaintiff in the lawsuit, told the news conference, "This lawsuit was filed so that hundreds of thousands of injured workers can continue to see their own doctor to receive treatment for their work injuries. The purpose of the suit is to overturn a new regulation adopted by the State that will allow insurance companies and employers to force these workers to stop seeing their own doctors. The workers' compensation legislation enacted lat year, SB 899, does not give the State the right to terminate existing doctor-patient relationships for all these workers. And rather than saving money, forcing every injured worker to switch to a doctor selected by the insurance company would increase costs by prolonging treatment and delaying the worker's return to work. It's one thing for workers injured next year to be forced to see a company doctor. But it's absolutely ridiculous for the State to rip a patient away from his or her doctor in the midst of treatment."

Schwartz pointed out that the lawsuit filed today will have "absolutely no impact on next year's workers' compensation insurance rates. Insurance rates for 2005 are based exclusively on the estimated cost of injuries that will occur next year, and networks will be in effect for all those injuries. Injuries from prior years, like those of DeMarco Foster and Joanne D'Amato, have no role in setting rates for next year. Their employers already paid for the cost of those injuries when they paid their insurance premiums the year the injury occurred. Forcing these workers into a network and cutting their care will only add to the already high profits of the insurance companies, and won't reduce insurance costs for employers at all."

Schwartz also noted that "there is overwhelming public support for injured workers choosing their own doctor. Far from saving money or providing better care, forcing injured workers to leave their doctors only delays good care and adds costs as the new doctors are forced to go through all of the original steps of taking the patient's history, reading through possibly thousands of pages of medical reports and then getting to know the patient."