David Zaniroli was a Lieutenant at Folsom Prison. His work injuries are numerous, and he has 8 significant scars from his surgeries alone. David has a unique appreciation of the discrepancy between being treated through work comp vs through traditional health insurance. For his first few work injuries, he opted for treatment through his regular family doctor, and he used his health insurance rather than work compensation just to make matters easier on himself. (His family doctor said she didn’t want to deal with work comp insurance, and at the time, he was amenable to simplifying things for the sake of efficiency.) But as his work injuries added up and he realized he was likely going to need to be placed on medical disability because of his work injuries, he sought treatment through the work comp channel.
Whereas his non-work comp doctor said he was a very good candidate for surgery, the work comp doctors, without exception, refused to acknowledge surgery as a potential solution and would simply prescribe pain pills (with all their side effects) as a permanent solution. Once, when an upper-extremities specialist approved him for surgery, work comp insurance then sent him to another doc under the auspices of “making sure the surgery was viable.” David complied, but when he arrived at the doctor’s office, he discovered that the physician they’d sent him to was a plastic surgeon. Incredulous, he asked the doctor why they’d send him there when he’d already seen an eminent surgeon with the proper specialization to relieve his painful condition. The plastic surgeon replied quite frankly, to David’s utter shock: “I don’t know, but I’ll keep taking their money.” The plastic surgeon, of course, later determined that his surgery was “not medically necessary”.
Every one of David’s requests for care over the past 5 years has been denied. He waits through the appeals process for sometimes 6-8 weeks each time; he’s in pain all the while, but time doesn’t hurt the insurers as much. He believes that their goal is to make it so difficult for you to receive treatment through work comp that you resort to using your health insurance or another way to pay, just to make your life livable.
Further, David wonders if work comp insurers are getting kickbacks from the pharmaceutical companies. He’s noticed that they switch brands of similar medication often. When one drug that’s been working just fine stops being approved, and another brand-name medication with almost exactly the same ingredients is substituted, one begins to sense an unsettling note of truth to his theory.
One fact is undeniable: when the inmates at Folsom prison get better medical care than David does –(as a work comp patient who spent his career protecting the public from such inmates)– something is terribly wrong.