MINUTES OF THE
SENATE COMMITTEE ON COMMERCE AND LABOR
Sixty-seventh Session
February 11, 1993
The Senate Committee on Commerce and Labor was called to order by Chairman Randolph J. Townsend, at 8:15 p.m., on Thursday, February 11, 1993, in Room 205/206 of Cashman Field Center, Las Vegas, Nevada. Exhibit A is the Meeting Agenda. Exhibit B is the Attendance Roster.
COMMITTEE MEMBERS PRESENT:
Senator Randolph J. Townsend, Chairman
Senator Sue Lowden, Vice Chairman
Senator Ann O'Connell
Senator Mike McGinness
Senator Raymond C. Shaffer
Senator Leonard V. Nevin
Senator Lori L. Brown
GUEST LEGISLATORS PRESENT:
Assemblyman Lynn Hettrick
STAFF MEMBERS PRESENT:
Brian Davie, Senior Research Analyst
Linda Krajewski, Primary Secretary
Sheri Asay, Committee Secretary
Frank Krajewski, Senior Research Analyst
OTHERS PRESENT:
James Cashman, Director, Las Vegas Chamber of Commerce
Mark Smith, President, Las Vegas Chamber of Commerce
Bill Champion, Lobbyist, Employer Coalition of Southern Nevada
Blackie Evans, Executive Secretary/Treasurer, Nevada State American Federation of Labor/Congress of Industrial Organizations (AFL/CIO)
Danny Thompson, Political Director, Nevada State American Federation
of Labor/Congress of Industrial Organizations (AFL/CIO)
Jack Jeffrey, Secretary/Treasurer, Southern Nevada Central Labor
Council, and Southern Nevada Building Trades Council
Frank Caine, President, Southern Nevada Building Trades Council
Dan Richvalsky, Injured Worker and licensed Workmans' Compensation Representative
Judy Burke, Showboat Casino Employee
Steven Cowart, Ironworker
Phillip Dahn, Nevada Injured Worker Advocate, Iron Workers Local #433
Robert Miller, Cook, Sante Fe Casino
Theresa McGuire, Member, Culinary Workers Union
Scott Dickinson, Nevada Association of Independent Businesses
Susan Harrelson, James Truss Employee
Charles Nort, Nevada Administrators
Lynn Grandlund, President, Grandlund, Watson, Clark and Associates
Steve Bova, Injured Ironworker
John Lofty, Injured Worker
Bob Steffan, Employee Representative, Public Employees
Carl Johnston, Injured Worker Advocate
Kenneth Cottell, Iron Workers Local #433
Richard Wellman, Injured Ironworker, Iron Workers Local #433
Arthur Galgani, Union Laborer, Local #872
Danny Williams, Private Citizen
Barbara Williams, Injured Worker
Donald Cox, Sr., Injured Worker
Dawn Cox, Private Citizen
Chairman Townsend opened the meeting and announced that Mr. Champion and his group would speak initially, followed by Mr. Evans and any group representing the board, and that they would conclude with public testimony.
James Cashman, Director, Las Vegas Chamber of Commerce, and a member of Nevadans Concerned Coalition of Businesses, indicated they had previously presented their suggestions to both this committee and the Governor. Mr. Cashman noted that, as payers of the premiums, they are most interested in having the reform necessary to keep the system prospering. He said they have prepared a synopsis of where the two positions conflict, and that Bill Champion and Mark Smith would present the explanation.
Mark Smith, President, Las Vegas Chamber of Commerce, indicated they applaud the Governor's statement that he would veto anything that did not show major reform. He said they have some questions regarding their position, and Bill Champion, their lobbyist, would discuss those.
Bill Champion, Lobbyist, Employer Coalition of Southern Nevada, identified two exhibits provided to each committee member: Nevada Unified Business Coalition (Exhibit C) and Summary of Nevada Unified Business Coalition's Positions on Governor's W. C. Bill (Exhibit D). He prefaced his discussion by saying they are generally very supportive of the Governor's position, differing in some places in terms of methodology and inclusion.
Chairman Townsend asked Mr. Champion to cover those items that they oppose and cite reasons for the opposition.
Mr. Champion agreed saying generally they support the committee's position that the State Industrial Insurance System (SIIS) should be run like an insurance company, and should be governed by a board of the policy holders. Regarding Number 13, he questioned the amount of support an advisory council would provide if there was a good board.
Number 19, holding an employee's job for 3 years is impractical because 3 years is too long. A worker would have to be displaced, and many of their supporters do not have light duty work. He noted that there may be other methods, but they oppose the terms listed, not necessarily the intent.
Number 26 mandates a $400 deductible by employers for every SIIS claim. He noted that SIIS could offer that as a premium reduction method, or a premium inhibition mechanism, but their position is that it should be optional with the employer.
They support Number 33, the tests for drugs following an injury, but they think that the "within 2 hours" may be impractical because of transportation problems in the state. Also, they think that any illegal drugs in the system should be presumptive of a causal modality. Mr. Champion indicated it also has a sociological impact. He stated that California reduced their drug abuse from 35 percent to 10 percent positive after instituting pre-employment testing, and testing following injuries.
Relative to Number 39, Mr. Champion said their supporters feel that the investigatory function should remain with SIIS because they are familiar with workers compensation claims, and they have all of the files and materials in their offices. He noted that increasing the penalties for the fraud abuse to felonies would encourage prosecution. He said a more practical effort would be for SIIS to perfect the case, and then hand it over to the attorney general for prosecution.
Mr. Champion stated they were undecided about the hearing officer level. They know that something serious has to be done. He indicated that the committee has some excellent recommendations in mind, and that people are working with the trial lawyers and with members of the committee to find a practical solution.
Mr. Champion said rehabilitation, Numbers 48 to 49, has gotten out of hand and has to be reformed. Their simple proposal is that rehabilitation applies only if the American Disability Act (ADA) does not.
Mr. Smith noted that SIIS had a board meeting that afternoon and both management and labor gave unanimous agreement on a stress bill.
Mr. Champion asked if Mark Smith had language on what they believe is their stress position?
Mr. Smith indicated they would have it the next day.
Mr. Cashman concluded saying the conflicts of their position and the Governor's position were fairly minor in scope and they are amenable to working with the committee, the legislature, and the Governor to make needed changes.
Senator Townsend thanked them and called on Mr. Evans and his group to testify.
Blackie Evans, Executive Secretary/Treasurer, Nevada State American Federation of Labor/Congress of Industrial Organizations (AFL/CIO) introduced Danny Thompson, Political Director, Nevada State American Federation of Labor/Congress of Industrial Organizations (AFL/CIO); Frank Caine, President, Southern Nevada Building Trades Council and; Jack Jeffrey, Secretary/Treasurer, Southern Nevada Central Labor Council and Southern Nevada Building Construction Trades Council.
Mr. Evans said they wanted to make sure they understood what has been voted on, and to ask some questions. They understand it has been voted and passed by this committee that the current board of directors would be eliminated and would be replaced by six policy holders and one from the general public.
Senator Townsend pointed out that the bill has to be drafted and then they will vote on it. He noted that many of the things that were addressed may have a substantial impact on whether those provisions stay in the bill, or stay in the bill as the committee recommended.
Mr. Evans indicated he hoped that was the case. With reference to the proposal to eliminate the state industrial insurance attorney who represents the injured workers, he asked if there had been any action taken or going to be taken, regarding the Governor's recommendation of a $2,500 cap on attorney fees?
Senator Townsend replied that it was proposed during Mr. Craigie's presentation, but no action had been taken on that particular item.
Mr. Evans indicated concern with the elimination of the appeals officer, and going directly from a hearing to district court. He asked if there had been any consideration of who would pay for additional district court judges if the court system got overloaded. He understood that action was taken by the committee to reduce temporary total disability, permanent partial disability, permanent total disability, and survivors benefits by using net pay for benefits. Without debating this issue of how much those benefits should be reduced, he agreed it called for reduction under the system, but it also called for the largest reduction from the people who make the least money, $15,000 or less.
Senator Townsend noted that those numbers have been recalculated and the new numbers will give a different focus.
Danny Thompson, Political Director, AFL-CIO, reminded the committee of the problems resulting from trying to alleviate divorce proceedings. He said that if the proposal on the appeals officer is passed as is, the courts would be flooded with people unhappy with the arbiters decision. He noted this be a very costly item in which every taxpayer in the state would have to share.
Jack Jeffrey, Secretary/Treasurer, Southern Nevada Central Labor Council, stated he understood that at least one of the proposals called for non-binding arbitration. He suggested removing appeals and going directly to district court because, if it is non-binding, nobody is going to agree. He said, "If you're going to have arbitration it should be binding." He indicated his concern was with the process noting they had been talking about concepts for a month. He requested that when the bill is finally drafted and introduced that it go back to the committee for hearing so they can have a chance to address their concerns. Mr. Jeffrey also expressed concern over hearing that the bill will be introduced and passed the same day without hearings.
Senator Townsend pointed out he hoped that when they return to Carson City they will have a bill draft request (BDR) that can be introduced as a bill, and then have it sent back to the committee. He said disagreements, technical problems and misunderstandings would have to be ironed out as soon as possible.
Mr. Thompson said, "To clarify then, when the bill does come back to committee there will be a public hearing where we can raise our objections."
Senator Townsend stated it would be their standard kind of work session, an interactive session, where everybody is brought to the table, and every item is discussed. He said Tuesday morning, barring problems, they will work on the bill.
Senator Brown noted that the purpose for doing what the committee did was because there were so many proposals, that drafting every one of them would have made the process take forever.
Mr. Evans expressed his concern with the provision for the suspension of compensation if an injured worker is not recovering because of a non-industrial injury. He indicated he thought it was bad legislation, would not be upheld in court, and they oppose the legislation.
Senator Nevin noted that in their revised BDR, there was provision to handle these cases through an administrative court rather than district court, because the district courts are too busy, and do not want to handle them. He indicated he thought that would resolve Mr. Evans' concerns.
In response to Senator Nevin, Mr. Jeffrey said he thought we had an administrative court now. He stated that 90 percent of the problem is taken care of at the first step, the hearing officer level, leaving 10 percent to go to appeal. He said he thinks the present system is practical and he does not see anything wrong with it.
Mr. Evans replied what they were concerned about was that everybody wants to spend trust fund money except the employers and employees, whose money it is. He asked if the self-insured, and everybody else would participate or is it going to come from just SIIS. His group strongly agrees with the fraud units. He continued, "If you've got a claimant out there that's fraudulently receiving compensation, we want you to prosecute him, convict him, and put him in jail. But next cell over we want you to find that employer that's not paying true premium, that is not reporting correctly on his income, and have him in the next cell. And the third cell over there, we want the providers that are out there billing the system for things they don't do, overbilling and all the other problems that they have from providers."
Mr. Thompson stated one of the things that disturbed him was that currently the system does not investigate anything but claimant fraud. He continued saying the other two kinds of fraud, employer and provider, were the worst kind. He surmised the amount of money lost to be substantial.
Relative to provider fraud, Senator Townsend noted that two of the key people who would be prosecutors in the fraud unit are currently employed by the attorney general, and are the most successful prosecutors of Medicaid fraud in the west coast.
Mr. Thompson agreed but noted that there are providers who have been charged or convicted of fraud that are still providing SIIS provider care.
Senator Townsend indicated fraud is a felony in Medicaid, but it is a misdemeanor in SIIS. He noted they are hoping to change it so that it is a felony in both instances.
Senator Brown stated she had asked whether they could get information as to who has already been convicted, so they will not be allowed on their willing providers list.
Mr. Evans called attention to the problem of non-insurers who feel paying a fine of $10,000 is cheaper than yearly insurance payments. He said they think it is part of the cost of doing business. He believes they should not only be prosecuted, but their business license should be taken away.
Senator O'Connell indicated employers feel the same way, and that they have taken care of the situation.
Senator Townsend indicated that over the years some of the concentration has been dissipated and put it into other state agencies. He stated that the Department of Administration is in charge of hearings and appeals, but whenever one uses a managed care organization, the medical component deals with those disputes. He said that leaves approximately 20 percent of disputable claims for the hearing and appeals level, which are heard within the system.
Mr. Evans confirmed the statement.
Senator Townsend asked Mr. Evans if he wanted that dispute mechanism back under SIIS system and out from the Department of Administration.
Mr. Evans said, "Yes."
Senator Townsend asked Mr. Evans if he could think through "how do we do it" so it could be discussed on Monday.
Mr. Evans replied, "Sure." He continued stating the system needs to be streamlined and simplified. He said the Governor's reorganization plan is really what he is looking at for SIIS. "Bring them back together." He urged that they have one individual or a board who is responsible. He then stated he wanted to discuss some other topics. He indicated they have agreed with the coalition committee on some restriction of reopening rights. They do not agree with the limitation of 5 years as the Governor recommended, and they certainly do not agree with 3 years as recommended by this committee. However, they do agree that there are problems, and they have agreed to a formula. The flat limitation of 3 years is going to cause all kinds of trouble. They are really concerned about the transfer again of SIIS rehabilitation to the state Bureau of Vocational Rehabilitation (BVR). He asked what happens to the rehabilitation center that was paid for by the employers' trust fund money for the injured workers in this state. They are concerned about again another state agency sending SIIS a bill for services performed.
Mr. Evans indicated that he had met that afternoon with SIIS staff and they had some questions. The auditors expressed concern with the Governor's proposal to move the auditors from SIIS to the Department of Taxation. Mr. Evans stated this was again, send the bill to SIIS, and let someone else appoint and supervise them. He reminded the committee of the two major ingredients of the workers' compensation system: Employers that pay the bill and employees who give up the right to sue in order to get benefits for their injuries. Mr. Evans said he talked with management about stress claims. They do not think it is right to eliminate all stress claims nor do they think one only has to show that 10 percent of the cause is related to the job for one to be eligible for a stress claim. He said that labor and management have worked out language that would be submitted to the committee. Mr. Evans continued stating managed health care is not something that organized labor can easily agree to, but they have agreed, because there has been a 487 percent increase in medical costs in the last 8 years, and something needs to be done with the system, and for the benefit of the workers. Another concern expressed by Mr. Evans is the need to pass laws that prohibit chiropractors and medical professionals from referring people to facilities that they own.
Frank Caine, President of Southern Nevada Building Trades Council, indicated that when a worker gets injured the worker wants to pick his treating physician. But, he indicated they would give that up if it would save a lot of money as long as there was some selection. Mr. Caine said he has been representing injured workers for 25 years on the hearings level, and they have always gone in knowing it was a no fault system. They did not have to go there and prove and fight that something that was actually wrong with them. " But," he said, "we also want to be able to pick our trading position and be treated fairly at the SIIS."
Mr. Evans related some positive information. He told of a counselor who went to work 2 years ago with 486 files on her desk. Today it was 19. This was due to increased hiring during the last 6 to 8 months. They are working now to get their average loss time to 7 to 8 weeks which will solve a lot of their problems.
Mr. Thompson asked if the proposal still includes a requirement to give every claimant a drug and alcohol test?
Senator Townsend said, "No." He indicated that what is there is that there has to be reasonable cause in order to test an individual. Mr. Thompson asked that the bill not be fixed on the "backs of the injured workers."
Senator Townsend indicated his reason for moving the bill as quickly as possible was to provide the assembly with as much time as possible.
Mr. Dan Richvalsky, Injured Worker, and a licensed workmans' compensation representative stated his concern related to page 9, number 8, the abolishment of the office of the Nevada Attorney for Injured Workers. He indicated the attorneys are of help to those injured workers who are not attorneys and do not understand the system. He asked that the Nevada Attorney for Injured Workers be retained.
Judy Burke, Showboat Casino Employee, asked that, under probable cause, would they reconsider the drug testing. She described the current program at the Showboat Casino, and indicated that it works well.
Steven Cowart, Ironworker, expressed his concern about receiving reasonable and adequate care. He described his problem, noting the long period of time involved, the incompetence of the doctors, the denial of help from SIIS, and the difficulty of getting another doctor.
Senator O'Connell indicated the committee shared the concerns relating to lost papers and failure to get doctor appointments. She emphasized they are tying to pool the system into smaller units of 500 cases with doctors that will work within the system, if necessary, on Saturdays and during the evening. She emphasized the committee's concern is getting the injured worked back to work.
Phillip Dahn, Nevada Injured Worker Advocate and retired member of Iron Workers Local Number 433, stated he has been an Injured Employee Advocate for the last 4 years, assisting Frank Caine. He said abolishing the office of the Nevada Attorney for Injured Workers meant disenfranchising a lot of people that will have no representation. He stated the people at the lower end of the scale would not be able to afford an attorney. His second concern related to non-binding arbitration. He noted the end result will be many injured workers will be on welfare, overburdening the system. His final issue related to making the board of directors all policyholders. He emphasized that it is in the policyholder's interest to save money, thus the injured worker is the loser.
Robert Miller, a Cook, Santa Fe Casino, indicated he felt the committee should be addressing the disease of the problem not the symptoms, by strengthening the state occupational safety regulations and enforcement. Through the use of pictures, he noted the following safety problems: (Exhibit E. Original on file in Research Library.)
1. A pot room where they wash pots and pans showed a floor wet from a leaking sink which had been reported months ago and was still not repaired.
2. Grease and debris on a floor that was not cleaned during an 8 hour shift.
3. Several pictures of debris on the floors of walk-in coolers.
4. Grease, water, and build-up on the floor in front of the chef's office with a wet floor sign laying underneath a sink.
5. Trash and boxes laying around in front of the chef's office.
6. A steamer used for heating and preparing foods that had been out of operation for 7 to 10 days and still had water leaking from it.
7. A cold box where cold salads (oil based) are kept, showing debris on the floor.
Mr. Miller indicated the walk area where the steamer and the chef's office are located is the direct area that people have to travel to perform their work duties.
Senator Townsend asked if he had reported these to either the health department or the state Occupational Safety and Health Act (OSHA)?
Mr. Miller replied that he had first personally met with management and was told it would be resolved. Then he and his coworkers met with management to resolve the problem. He said that outside of a couple of days of some cleaning, maintenance on the floor, and picking up trash, nothing was really done and he does not think the problem has been addressed. He stated that workers are responsible to be as safe as they can on the job, that management is responsible to provide a safe working environment, and the state is responsible to enforce the proper working conditions. He noted that though he wears the proper footwear, he has slipped on the floor on numerous occasions. He explained his experience with safety conditions and inspectors when he worked in a coal mine. He suggested that the state impose high enough fines so that companies would take safety seriously and would not make unsafe environments cost effective for the companies.
Theresa McGuire, a member of the Culinary Workers Union, read from prepared text (Exhibit F).
Senator Townsend interrupted her testimony to request that she not make reference to any committee people.
Ms. McGuire replied, "Senator, a person on this committee voted on something which I believe to be a conflict of interest, and I believe that, as a chairman of the committee, you should be concerned about that."
Senator Townsend responded that "every member has a right to make that decision for themselves. We're trying to deal with policy here. Everyone has acted appropriately tonight, we're getting very important information. Let's try and keep it that way, please."
Ms. McGuire said, "Senator, I do believe that this is important information. I do believe that a conflict of interest should be of concern to every member of this committee, just as it is to the majority of the people in this room, and to the majority of the voters in this state. And I believe you have an obligation to hear my public testimony tonight."
Senator Townsend answered, "I do, but I want to keep it impersonal, please"
Ms. McGuire responded, "Senator, a conflict of interest cannot be impersonal."
Senator Townsend said, "Well, let's get on with the issue."
Ms. McGuire concluded reading her testimony. She then added, "I believe that should be public information, Senator, since she had ran for public office knowing that she was a casino representative and that we have a right to know if there is a conflict of interest when she is making drastic changes that are going to affect most of the workers in this state."
Scott Dickinson, Nevada Association of Independent Businesses, discussed items 3 and 8 on page 9 of the proposal. He said he wholeheartedly agreed with their proposal that the people paying the premiums should make up the majority of the board of directors. Regarding item 8, he said an insurance company to whom businesses pay premiums should not have on their staff an attorney whose job it is to sue the company paying premiums. He indicated he also agreed with their proposal to abolish the office of the Nevada Attorney for Injured Workers.
Susan Harrelson works as both an employer and employee for the James Truss Company. She spoke in defense of employers and employees who do not take advantage of the system. She indicated that if they could save money on their workers' compensation premiums, they would put that money into raises, better wages for their workers, and better benefits, health, disability, dental than they now have.
Charles Nort, Nevada Administrators, indicated he agreed with Mr. Evans that there would be a problem if the hearing officer step was eliminated and the case would go directly to the district court. He also agreed that if the system goes to a hearing process and it is non-binding arbitration, and the system is forced to go to district court level, there has to be a record on appeal. Further, he said he was in agreement with the process whereby there is some change in the hearing officer and the decision making process. He noted that there is a very fine body of hearing officers right now, and they hear a large caseload on a daily basis. He said the problem is not the workload, but the process they have to go through. He indicated he would like to see some changes on that. He also agreed that if the hearings are returned to the State Industrial Insurance System, then he agreed with labor that there will be a process whereby there is no independent agency hearing it, and the workers will not get a fair shake.
Lynn Grandlund, President, Grandlund, Watson, Clark and Associates, asked the committee to look closely at how the formula identified on page 3, number 3, is going to be computed. She cited a client who was able to reduce his modifications factor from the mid 1.23 to .93 which for a convalescent center is very good. However, she noted when the formula was applied, the center ranked as the highest risk employer in the southern part of the state.
Steve Bova, Ironworker, indicated SIIS claims went up 12 years ago when OSHA conditions went down. He urged putting pressure on President Clinton for a comprehensive health plan, keeping SIIS the same, and suing the federal government for negligence, because they didn't keep OSHA up the way they should have.
John Lofty, Injured Worker and member of the local labor union, agreed with Steve Bova regarding safety hazards. Mr. Lofty was injured 3 times in a 3 week period because of the safety hazards at his job. His employer, now a state employer, did not file the required C-3 form until a month later instead of in the required 6 days. SIIS laughed at him and told him that the legal $1000 per day assessment was just a scare tactic. He also felt that abolishing the representation for the injured worker was not fair. He pointed out that attorneys charge 35 to 40 percent for workers hurt on the job, compared to 33 percent for auto accidents.
Bob Steffan, Employee Representative, Public Employees, said the employers in the state are leaving SIIS and that private industry is insuring the best and most profitable agencies and businesses. He stated this leaves the smaller businesses, that can not afford private insurance, stuck with the higher premiums. He indicated that the government is a business, and if it is in the business of protecting workers who give up their right to sue employers, then SIIS has the obligation to protect the worker in return for giving up that right. Mr. Steffan continued, stating if county tax dollars are going to a private insurer, he would rather see them go to a system that benefits all workers in the state, and national health care is the answer. He noted that Senator O'Connell mentioned the appeals rate as being her benchmark for how good or bad the system is. He cited North Carolina when a poultry plant exploded and 25 workers were killed, and several were injured, the company filed bankruptcy and the workers were left "holding the bag." The state OSHA official said they have a very low complaint rate. He indicated that the average employee who is earning $5 or less an hour never appeals, and those statistics are never included in the 1 in 500 appeal rates.
Carl Johnston, Injured Worker and Advocate, requested the committee consider retaining the hearing officers, indicating the problem with SIIS was the attitude of some of the people at SIIS, and the "ripping off of the system" by some of the professionals. He cited letters not being answered for months, if at all; the need to go to the chief medical officer to obtain emergency assistance for an injured worker; and his personal knowledge of many cases involving mental evaluations, costing $3,000 to $4,000, where the evaluation papers were the same with only names changed and a few different words. He stated that many workers would not have the funds to go and hire an attorney in order to go to court.
Kenneth Cottell, Iron Workers Local #433, Injured Iron Worker, stated his back was broken on May 31, 1990 and it was September 1992 before he had his operation. He cited the problems and delays he encountered with the system, and indicated the need for SIIS to expedite cases, getting them resolved as quickly and efficiently as possible.
Richard Wellman, Injured Iron Worker, Iron Workers Local #433, and still in the system made the following points.
1. Page 1, Determination of Benefits, requesting notification of serious accident only. Mr. Wellman pointed out every accident should be reported to protect both the employer and employee in the event a claim is filed. However, initial reporting paper work should be simplified.
2. Page 2 - item 4 - Compensation of Benefits. He said this is based on net pay not gross pay, and he disagreed completely.
3. Item 6 - Revising the method of calculating benefits for temporary total disability. Mr. Wellman indicated he did not understand it. He said if it means reduce benefits, then combined with item 4, it is a double hit.
4. Item 7 - Under Nevada Revised Statutes 616.607 (NRS) you are required to inform a claimant of this information before he accepts a lump sum.
5. Mr. Wellman noted restricting claim reopenings to 5 years will not work in all cases. He cited two cases as examples.
6. Regarding the hearing officer level, Mr. Wellman indicated that they are supposed to handle the administrative part of an appeal, such as a misread regulation, or time elements, and that is currently done expeditiously. At the appeal officer level, the appeals officer can not only hear what is precisely before the court, but anything relevant. He indicated it was important to keep these levels since a judicial review requires that all material be reviewed.
7. In the managed care section, he stated that there has to be a screening process for doctors. He suggested that when an operation had to be redone, that the original doctor who performed the surgery be required to reimburse SIIS for the cost.
8. Mr. Wellman asked who is going to have input for the worker if the board is composed of employers under the control of the Governor?
Arthur Galgani, Union Laborer, Local #872, said he hurt himself in October 1992. The company said he was not hurt on the job, and he was immediately put under investigation even though people on the job witnessed the accident. After 65 days and two phone calls to his employer, he indicated he is faced with reduced benefits and three surgeries. He noted he is barely making it now on the benefits he receives.
Danny Williams, Private Citizen, said since he last testified he has had a chance to go over the proposals. He said he does not feel that managed health care is really health care because the number of doctors who can see injured workers has been narrowed down.
Senator O'Connell interrupted Mr. Williams to say that it is not the intention of the committee to narrow the number of doctors. She stated that it is a willing provider and anybody who is interested in meeting the circumstances put out, is a provider.
Mr. Williams then asked about managed care and freedom of choice, indicating that he felt that they had been narrowed down to a select group that is strictly controlled. He further stated that "the doctors that the system has now already abuse us." He continued noting that the doctors SIIS sent him to did not address his pain, and that it took him going to another state to get proper diagnostic testing in order to find out what was going on. He also indicated that he did not agree with the 3 or 5 year reopening because an injured person does not necessary know within what time span he will need to reopen his case.
Senator O'Connell replied that it is not limited so long as there is sufficient medical evidence.
Mr. Williams asked if that was within the lifetime. Senator O'Connell replied in the affirmative.
Senator Nevin added that if a person is in the system, he will still receive care. He stated they want to be sure the injured person is covered.
Mr. Williams noted that he filed his first letter with the Department of Industrial Relations (DIR), indicating that he usually takes care of it himself. Immediately after filing, he said an investigator was following him. First the investigator went to employers where he was applying for work, and one employer told him that the investigator used "gestapo tactics." When he brought this to the attention of the system, via a letter, another investigator started watching everywhere he went. The next day, Mr. Williams said his truck was not running so he had to take a rental car, and the investigator stayed out at his house in the desert for 2 days watching his other car thinking that he was at home. One of his neighbors got upset with the investigator nosing around with his binoculars and camera, and confronted him. The investigator told the neighbor that he was taking pictures of mining equipment, and that he could not give his name. Mr. Williams said there needs to be accountability in the system. He stated if the system is given immunity then there is no accountability.
Senator Townsend asked which proposal he was reading from.
Mr. Williams cited the Claims Administration and read "provide immunity from liability from insurers for bad faith." When Senator Townsend asked him what page he was reading from, he replied, "first page on list of remaining workers' compensation proposals."
Senator Townsend stated, "Those are the things yet to be determined."
Mr. Williams stated that when he was injured, his employer was uninsured from out-of-state. He said the working conditions were unsafe. He fell 12 feet backwards with about 200 to 300 pounds of steel catwalk in his arms. When he went to the system he was given three choices: private insurance, work it out with his employer, or join the system. He chose to work it out with his employer who agreed to pay for the doctor bills and worked out a fair wage. Mr. Williams was paid a weeks wage, and then did not hear for 2 to 3 weeks. When he checked, his employer told him that SIIS had called and said for a $500 fine he "was off the hook." Mr. Williams expressed the opinion that the system interfered with his election of remedy and indicated that there was something illegal there. Finally, Mr. Williams addressed checks and balances. He indicated that the Governor's proposal for the board to be all the same entity was not a balance. He proposed at least one injured worker; one neutral person, possibly voted in by the people; three people from management; and two from union-labor.
Ms. Barbara Williams, Injured Worker, indicated accountability, and checks and balances are what is missing from SIIS. She described her injury, the rudeness of the lady at SIIS, and the help she received from a lawyer not associated with SIIS. She spoke about the doctor who "messed up" 40 women before the state got involved, and of the many injured workers now on drugs, prescribed by SIIS doctors, some of the workers are now in jail.
Donald Cox, Sr., Injured Worker, described his injury and his experiences with SIIS. He referenced the report from Steinberg Diagnostic Medical Imaging (Exhibit G) indicating his broken back is not healing and the bone is not growing. SIIS sent him to vocational rehabilitation, refused him help, and cut off his medical payments. Mr. Cox had to reopen his case before he could receive additional medical treatment. SIIS required him to get Comprehensive Integrated Work-up (CIW) report. (Senator O'Connell has a copy.) He requested an appointment with Dr. Peeks, but instead was sent for a rating which indicated that he was not ratable. The case worker refused him more medicine. Since he felt he was getting nowhere with the system, Mr. Cox when to Long Beach Memorial and Scripps for a diagnosis. The diagnosis indicated a rib would have to be cut, discarded, a lung deflated, and his heart moved over. Mr. Cox was told that it was going to have to be done sometime in the future, if he did not have it done now. He returned to SIIS and they informed him he was not on medical anymore. He was never notified of this. He's been rated 10 percent and he still has his broken back and carpal tunnel. He said the 5 year restriction can not apply here because this might take 20 years.
Senator O'Connell asked if Mr. Cox had an appointment with Mr. Spinello.
Mr. Cox replied he did, that Mr. Spinello took the paper work, and he has not heard anything from him. He reiterated he never has any notification.
Senator O'Connell asked Mr. Cox to give Scott Young, Legal Counsel, SIIS, his papers and Mr. Young would get some information for him.
Dawn Cox, Private Citizen, wife of Don Cox, reviewing the events from 4 years ago indicated that Mr. Cox went to over eight SIIS doctors who kept telling him they could not fix his problem, to go home, and live with it. He was sent to physical therapy, and after 2 1/2 years, one of the therapists told him he had a big knot on his back, which was not normal, and refused to treat him anymore. Mr. Cox went to Billy Carter who sent him to Dr. Peeks in Long Beach. When Dr. Peeks looked at the first CatScan that had been taken, he said Mr. Cox had a broken back, the spine was totally separated from the vertebrae, and was cracked on one side. Dr. Peeks performed the surgery and things went well for 8 months then Dr. Peeks prescribed a discogram. His case worker, Nora Olson, refused the request and indicated he was to go to a CIW instead. Mrs. Cox stated six doctors tested her husband and said his problem was not correctable, that they wanted him rated, and returned to work. They said he could carry 50 pounds. Mr. Cox was forced into rehabilitation, and made to drive daily from Pahrump to Las Vegas. He was in so much pain he had to lie on the floor as he could not sit in a chair.
Senator Townsend indicated that Mr. Young will get back to Senator O'Connell in the next day or so after he has completed his investigation, and Senator O'Connell will get hold of Mr. Cox.
There being no further business, the meeting was adjourned at 10:10 p.m.
RESPECTFULLY SUBMITTED:
Mavis Scarff,
Committee Secretary
APPROVED BY:
Senator Randolph J. Townsend, Chairman
DATE:
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Senate Committee on Commerce and Labor
February 11, 1993
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