• Report: #1120685

Complaint Review: State Compensation Insurance Fund

  • Submitted: Mon, February 03, 2014
  • Updated: Wed, February 12, 2014

  • Reported By: Dave Poole — Alamo California
State Compensation Insurance Fund
P.O. box 8291 Pleasenton Ca 94588 , Select State/Province USA

State Compensation Insurance Fund Sandra Crossly claims adjuster for SCIF The State of California has passed laws that protect employers, insurance companies, and doctors from law suites. I am an injured worker who has been waiting for corrective knee surgery for two years. State Compensation Insurance Fund (SCIF) uses bad faith insurance practices and plain old fraud to deny medical treatment. I have documents that clearly show how this fraud works. I have seen four well respected Orthopedic surgeons who clearly state that my knee replacement was installed incorrectly. SCIF approved my total knee replacement which was performed in March 2011. Additionally SCIF approved for me to get second opinions which all doctors concur that knee revision surgery is needed. Now that I have a doctor willing to do the knee revision, they use a doctor at CID Management a company used by SCIF for medical review, to deny my need for surgery. CID representative Dr. Karp in Sarasota Florida calls my doctor in Fremont California at 10:30 PM to ask about the need for surgery. Since My doctor wasn't in his office at 10:30 PM to answer questions, Dr. Karp denied the need for surgery on my right knee . I feel that exposure on this situation is one that should be heard. Thank You, David P Pleasanton California

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The State of California has passed laws that protect employers, insurance companies, and doctors from law suites. I am an injured worker who has been waiting for corrective knee surgery for two years.  State Compensation Insurance Fund (SCIF) uses bad faith insurance practices and plain old fraud to deny medical treatment.  I have documents that clearly show how this fraud works. I have seen four well respected Orthopedic surgeons who clearly state that my knee replacement was installed incorrectly.  SCIF approved my total knee replacement which was performed in March 2011.  Additionally SCIF approved for me to get second opinions which all doctors concur that knee revision surgery is needed.  Now that I have a doctor willing to do the knee revision, they use a doctor at CID Management a company used by SCIF for medical review, to deny my need for surgery.  CID representative Dr. Karp in Sarasota Florida calls my doctor in Fremont California at 10:30 PM to ask about the need for surgery.  Since My doctor wasn't in his office at 10:30 PM to answer questions, Dr. Karp denied the need for surgery on my right knee. I am disabled because of this, and Dr. Karp could care less and has never even seen me. 

     There are now approximately 75,000 injured workers that have been denied health care and are having their cases reviewed by Maximus Federal Services a company contracted by the State of California.   This is all because of a new law signed into affect July 1, 2013.

     I have been in contact with Senator Mark DeSaulniers office to see if they can help. This has been less than fruitful since SCIF is a quasi government agency.  They have enacted new laws to cut costs, and innocent and injured employees are paying the price for this misjudgment.  My private medical insurance will not cover any surgery to my knee since it is a Workers' Compensation case.  I feel that exposure on this situation is one that should be heard.  

 

Thank You,

 

David P

Alamo, CA 94507

925-xxx-xxxx (home)

925-xxx-xxxx (cell)

(((REDACTED)))@yahoo.com







This report was posted on Ripoff Report on 02/03/2014 10:09 PM and is a permanent record located here: http://www.ripoffreport.com/r/State-Compensation-Insurance-Fund/Select-StateProvince/State-Compensation-Insurance-Fund-Sandra-Crossly-claims-adjuster-for-SCIF-The-State-of-Cal-1120685. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year.

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