“Sedgwick delayed and denied the care I need for my work injury. They treated me like a criminal, not an injured professional hurt doing his job. Despite a court order finding my injury was work-related, Sedgwick has refused to provide any medical care. How can they get away with that?”

Injured Worker - Juan Jose Gonzalez

My name is Juan Jose Gonzalez.

I’m 63 years old, and I live in Perris, in Riverside County.

I’m married with two grown children: a daughter, 18, who is in college; and a son, 17, who is finishing high school.

I went to school and studied to become a Radiologic Technologist.

I loved my job, taking x-rays and other important tests for patients, and I excelled at it for 25 years.

I worked at several hospitals, and they all loved my work.

Until I was injured.

Then, everything changed.

Sedgwick Claims Services, the workers’ compensation insurance company for the hospital, treated me like a criminal, not an injured professional hurt doing his job.

Sedgwick has delayed and denied needed medical care, pushing me into poverty.

They are experts at giving injured workers the runaround, and have delayed my care for more than 5 years.

On October 16, 2008, I was moving an x-ray machine, with many tubes connected, and I tripped.  I didn’t want to damage the x-ray machine equipment, so I twisted awkwardly so as not to fall and knock over the x-ray machine.

As I twisted, I bent over awkwardly, injuring both of my shoulders, my left elbow, my finger and my middle and lower back.

I immediately contacted my house supervisor, who sent me to the emergency room.

The emergency room doctor ordered x-rays and CAT scans of my lumbar spine, gave me a pain medication prescription, and suggested that I go to the industrial medicine provider for work injuries.

I did see that doctor, but I also wanted to see my own personal physician of many years, whom I trusted.

The hospital refused to give me the form to request to see my own doctor.

The hospital refused to fill the pain medicine prescription their own doctor wrote.

I was put on work restrictions, diagnosed with a back sprain and rotator cuff tear. I continued to work on light duty while waiting for approval for medical treatment.

One day, I got a call to go to a building at Inland Valley Hospital, where an investigator for Sedgwick was waiting for me.

He said he wanted me to replicate the accident so he could film it.

I had received no notice of this interview, and it made me very concerned.

I was very reluctant to try to do what I’d been doing when I had injured myself.

I told the investigator I couldn’t re-enact the injury, as I was concerned about further injuring myself.

He told me I was refusing, and that it would have “serious consequences in your case. You don’t want to cooperate.”

A few days later, Sedgwick denied my case for refusing to “cooperate” with their investigator.

 

Even though the MRIs showed labrum and rotator cuff injuries, Sedgwick refused to provide needed medical treatment.

I took Sedgwick to court, and they agreed to a judge’s order finding my injury was work-related. Yet they have refused all medical treatment.

So I was left on my own.

It has been a nightmare for my family and me.

I’ve had to get what care I could outside Sedgwick’s network.

I’ve had three shoulder surgeries, all on my group health plan, and still need more.

I’m in pain from my back injury.

 

How did I go from being a valued and trusted employee of 15 years at Mercy and Scripps and Sharp Hospitals, to being painted as a monster?

I’m not a quitter, and I went to school to be a productive provider for my family.

I achieved that goal, and then Sedgwick refused to accept and treat my work injury.

It has been a fight for the last 5 years, and has affected my finances and my family.

I used to be very active with my family.

Now, my children have to take care of me, and I can’t afford to meet my family's needs.

I did my job faithfully, and was injured through no fault of my own.

Workers’ compensation insurance is obligated to provide temporary disability support, needed medical care and permanent disability compensation.

I have received none of these.

How can insurance companies get away with not meeting their responsibility?


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