Fifteen months after the most serious terrorist attack on U.S. soil since 9/11, many of the most seriously injured survivors in the December 2, 2015 San Bernardino terrorist attack are still being denied proper medical and pyschiatric treatment as well as physical therapy, thanks to California’s hopelessly flawed worker’s compensation system.
Because the attack happened at a workplace, instead of being covered by regular health insurance or even catastrophic insurance, the survivors of the attack were forced to file claims with California’s Worker’s Compensation system in order to obtain medical treatment.
Physical injuries from a terrorist attack are inherently different from workplace injuries—and yet the survivors are being forced to deal with the least efficient claims system in California, and perhaps the country.
California’s Worker’s Compensation system has been designed and re-designed to deny coverage in order to weed out fraudulent worker claims, not to deal with combat wounded survivors whose wounds have more in common with battlefield trauma than workplace injuries.
To add insult to injury, the survivors and their advocates were forced to plead their case again at a San Bernardino County Board of Supervisor’s meeting on Tuesday.
A number of the most seriously wounded survivors who need the most treatment have been left behind and denied care by a system that was never designed to deal with something as traumatic as a terrorist attack.
According to a November report just before the one-year anniversary by 89.3 KPCC Radio, San Bernardino County — which is self-insured when it comes to worker’s compensation insurance — denies the problem is serious.
“We do believe that there have been problems with a very small group” injured in the attack, county spokesman David Wert told KPCC. But the problems are not “widespread,” he adds.
“We originally had 88 claims filed, we have 54 open cases right now and there are maybe five to 10 where people are having problems getting their treatments, getting their medications,” he added in the interview.
ABC News interviewed Ray Britain, who was the interim Division Chief for the Division of Environmental Health Services. Britain contradicted Wert, stating that “right now, the process is denying everybody medication, therapy and surgeries.”
“These are people that were shot. A lot of the things that we’re talking about —we’re talking about people having to fight for surgeries, for physical therapy to try and learn to walk again,” he said.
Asked about these allegations by ABC News, Wert said, “our county has not denied care to anyone,” and “denials are rare. When they occur, the county shares in the employees’ frustration.”
Denials are based on a “utilization review” performed by a third party — an outside panel of doctors.
Around the same time the county was blaming the “utilization review” process, the New York Times reported that “[o]fficials with the California Department of Industrial Relations, which oversees workers’ compensation, told county officials . . . that they could, in fact, provide care beyond what the law required, said Christine Baker, the department director.”
According to the same KPCC Radio story, one survivor, “Amanda Gaspard, 32, [who] was shot multiple times during the attack; one bullet went through her knee . . . says she can’t stand for more than five or 10 minutes and still struggles to walk. She says she needs a bone graft, but [just recently] she learned a utilization review board employee had denied her doctor’s request to perform the surgery.”
She told KPCC that the reviewer tried contacting her doctor on Jan. 17 to request “peer-reviewed journal articles about the safety and efficacy of bone grafts.” She says her doctor was out of the office [during that week] and the reviewer rejected the request on Jan. 20.
“If you’re a physician sitting on a utilization review board,” a frustrated Gaspard told KPCC, “and you don’t understand that a bone graft is needed for someone that was shot in a terrorist attack . . . what type of doctor is that?””
Tim Donnelly is a former California State Assemblyman.