Injured Worker, Juan MoraI want to die. This is no life. The insurance company has spent four years fighting to keep me from getting treatment for my stroke and the psychological trauma from the injury.  They’ve ignored court orders without penalty...

Juan Mora
UR Denied - 2013-2014

 


About Me:  My name is Juan Mora. I am 64 years old, and I live in Oxnard, in Ventura County.

About My Family:  I have 2 children, 3 grandchildren, and 2 great-grandchildren.


My Job and What Happened: I worked as a Parts Delivery Driver for Crown Dodge for 2 1/2 years. In July 2010, I was talking to the shipping and receiving clerk. When I stepped back, I tripped over a box with a car bumper in it. I fell backwards over the box and landed on my head, shoulder and hip on the concrete floor. I injured my brain, neck, and leg in the fall. I didn’t realize how badly I’d been hurt, and finished my shift that day. When I woke up the next morning, I could barely walk, I went to work and they sent me to the doctor. An MRI confirmed that I had suffered a stroke.

What this has meant to my life: I have no life, compared to before the injury. I used to play golf - even scoring in the mid-80s - go dancing, to baseball and football games, and on bus trips to Vegas and Laughlin. I can’t do much of anything anymore, as I can barely walk, have poor balance and have fallen scores of times since the injury. I fear if I fall and hit my head again, I’ll die. The medical effects of my head, neck and other injuries, and the stroke, have been many and severe. I suffer from many neurological problems, as well as physical injuries, such as an injured shoulder. I can’t drive for more than 10 minutes because the stroke causes muscle spasms in my left leg. With the injuries and the refusals to provide needed treatment, I began to feel that my life was no longer worth living. Despite an URGENT request last October, and again in January, for a psychiatric evaluation, I STILL have not been able to receive that treatment. I am in constant pain. The treating doctor can’t prescribe medication without a psychological evaluation, which the insurer has failed for months to provide.

How Utilization Review (UR) Delays and Denials Affect Me:  The insurance carrier has delayed and denied recommended treatments by a neurologist, psychiatrist and shoulder specialist. They’ve refused to provide transportation to my medical appointments, even though they know I can’t drive to LA. I have had to take the insurance carrier to court repeatedly. In court, they agree to provide treatment and transportation, but still don’t provide treatment authorization. When they finally agreed to the doctors’ appointments, the doctors were no longer available.


How Workers’ Comp was supposed to help me: Workers’ Compensation was supposed to help me: Workers’ Compensation is supposed to provide medical treatment to heal my work-related injuries. Instead, I have been given the runaround for four years: repeated delay and denial of medical treatments recommended by their own chosen doctors. I’ve taken them to court, where they agree to provide treatment and transportation. Then they fail to do so. There are no effective penalties or sanctions for their bad faith refusals to provide treatment and transportation.


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For more information, contact Steve Hopcraft, 916/457-5546; steve@hopcraft.com; www.caaa.org