I’m a traveling nurse. I tripped and fell in a patient’s room. The insurer delayed and denied the doctor’s treatment plan. I was terminated after my injury. My unemployment and temporary disability insurance ran out. I owe rent to the hotel where I live. I’m an insurance
About Me: My name is Althea Hart. I’m 61 years old, and I live in Bakersfield.
About My Family: I am married, with 3 children and 4 grandchildren. I’m from Alabama, and that’s where my family lives.
My Job and What Happened: I have been a Registered Nurse (R.N.) for 37 years. I was working for Flagstaff/US Nursing, a national company that recruits nurses for care needed by patients in many states. I was on assignment in Bakersfield, caring for patients at Bakersfield Memorial Hospital. In August 2011, I tripped over the monitoring cords in a patient’s room and fell. I suffered a concussion, a torn rotator cuff, injured my back and my knee. The hospital terminated my employment and stopped paying the housing cost that is part of my travel compensation. I have spent three years fighting for care. There is no dispute that my injuries happened on my job. The Qualified Medical Examiner has rated me as being 45% disabled. Yet, I can’t get care approved.
What this has meant to my life: I cared for patients for 30 years, and now I am denied care for my injuries at work. I am trapped in a hotel in Bakersfield. I can’t go home to Alabama, where I have family to help care for me, because no doctor there will treat California workers’ compensation cases.
I have no money and am swamped with debt. I get no transportation to medical appointments and have no car. I worked for Dignity Health, but have lost my own dignity to insurer mistreatment. Five of my family members back home have died while I’ve been trapped in California.
How Utilization Review (UR) Delays and Denials Affect Me: The hospital’s insurance company, Gallagher-Bassett Insurance, has delayed and denied the care the doctors recommended. I have spent three years fighting to get the insurance company’s own doctor’s recommended care approved. I finally got approval for shoulder surgery, but I still need knee replacement surgery, and care for the injured disc in my back. Because Temporary Disability is capped at two years, the delays have exhausted my Temporary Disability. Yet, I still can’t work with my untreated injuries. The insurance company refuses to approve care recommended by their own chosen doctors.
How Workers’ Comp was supposed to help me: Workers’ Compensation was supposed to help me: Workers’ Compensation insurance is supposed to provide medical care to cure or relieve the effects of my work injury, and Temporary Disability support while I heal. I’ve had to fight for treatment. One doctor told me I’d die before the insurer approves his treatments. I need a total knee replacement, and suffer migraine headaches, nightmares and insomnia from a concussion. I’ve developed heart problems and stress symptoms. How can a nurse like myself, injured treating patients, be denied care?