WC Claim Frequency

[josephlopez]

I was hurt at work in 2004. CCMSI has been the TPA that provides adjusting for my medical claims related to the work injuries. At first, it seemed like my adjuster would listen to arguments that a thing was compensable when they initially denied the claim. However, now, it seems to be a "deny first, litigate second" strategy to keep injured workers from getting timely care and medicines, therby saving money for their clients. Once the legislative lobbying of the insurance industry took hold of our extant laws, they were able to run claims from another State, which was previously illegal.

This change has had a negative effect on the provision of services that are supposed to be guaranteed once documented properly. Instead, CCMSI is taking me to court each time I ask for things that are related to my injuries and are standard practices in the VA or other similar providers for people with PTSD, a Traumatic Brain Injury (Mild) and ongoing care for my eye which was cut open during the series of attacks I endured as a whistleblower. It is further confounding that they open themselves up to the optics that they are actively retaliating against a person who brought a corrupt principal to justice, and who was attacked by criminal agents of that principal both on and off school grounds as Danny Moon was slowly arrested and tried for RICO and 63 predicate felonies that I told Al Wesson of Internal Audit about. My sister was denied a claim, which has required surgeries, and her only route to get compensation that is supposed to be automatic upon proof of worksite injury, is to litigate.

No wonder the number of paid out claims is decreasing. Injured workers are being put through a hoop jumping process that CCMSI manifested with its influence on our laws. They run things from Chicago now, and New Mexico school employees are suffering needlessly and taking on expenses that they claim are savings through good management, not the manipulation of our laws to allow for "deny first, litigate second" status.