San Bernardino survivors still face workers' comp delays, denials

Some survivors of the San Bernardino terrorist attack are still having trouble getting medical treatment through the workers' compensation system, nearly two months after county officials pledged to do more to ease their access to care.

The county Board of Supervisors said on Nov. 28 that it would hire an outside firm to expedite the claims process for survivors of the Dec. 2, 2015 attack at the Inland Regional Center that killed 14 and wounded 22. On Dec. 20 the county said it had finalized an agreement with IW Care Connection. But a group of county employees say the firm was slow to contact them, and even after it did, they have continued to face delays and hurdles in getting their medications, therapy and treatments.

"We do believe that there have been problems with a very small group" injured in the attack, says county spokesman David Wert. But the problems are not "widespread," he adds.

"We originally had 88 claims filed, we have 54 open cases right now and there are maybe five to 10 where people are having problems getting their treatments, getting their medications," he says. 

Amanda Gaspard, 32, was shot multiple times during the attack; one bullet went through her knee. She says she can't stand for more than five or 10 minutes and still struggles to walk. She says she needs a bone graft, but this week she learned a utilization review board employee had denied her doctor's request to perform the surgery.

She says the reviewer tried contacting her doctor on Jan. 17 to request "peer-reviewed journal articles about the safety and efficacy of bone grafts." She says her doctor was out of the office most of last week and the reviewer rejected the request on Jan. 20.

"If you're a physician sitting on a utilization review board," says a frustrated Gaspard, "and you don't understand that a bone graft is needed for someone that was shot in a terrorist attack … what type of doctor is that?"

The utilization review board's denial of the surgery, which her own doctor deemed medically necessary, is, "unethical, it's unconscionable, it's un-American … and I'm in pain every single day," she says.

Since the hiring of the outside firm, at least two more survivors have had difficulty accessing their medications, according to a press release from the employees' group, San Bernardino Survivors Speak Out. Another says she has had to undergo lengthy mental examinations and a fourth says she's being forced to switch psychologists.

Gaspard believes there are others who have experienced these frustrations, but are afraid to speak out for fear of losing their jobs. 

Wert says the county is not at fault. "In virtually every case, it's not the county holding it up, it's their treating physicians, who aren't submitting enough information to the county for the utilization review doctors to make any kind of informed decision," he adds.

Gaspard disagrees. "The delays and denial are fully within the hands of the county," she says.

The county announced Dec. 20 that IW Care Connection would provide enhanced nurse case management and system navigation services to employees injured in the attack. Wert acknowledges that it took until Jan. 13 for the firm to contact all of the survivors, but says there are several reasons why. 

For example, he says San Bernardino was delayed in sharing employees' contact information with IW Care Connection because the county first had to redact protected personal data. Some employees have hired attorneys, who have to give permission for IW Care Connection to talk to their clients. In other cases, the outside firm had difficulty reaching employees, says Wert.

"Some of the issues came with the case management firm, some of the issues fell with the county, and some of the issues fell to the clients or their attorneys," Wert says. "There was enough blame to go around."

An IW Care Connection spokesman says the company is "not authorized" to comment on the San Bernardino situation.

This story has been updated.