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Published: Monday, 12/18/2006

BWC scandal riles claimants; injured workers see millions lost as they fight for help

BY JAMES DREW AND STEVE EDER
BLADE STAFF WRITERS

COLUMBUS Greg Switala watched with fascination as the investment scandal unfolded at the Ohio Bureau of Workers Compensation.

People at the bureau handed out money like it was candy to their friends, he said.

Mr. Switala has an intense personal interest in the agency, which sets rates and collects premiums from employers to pay medical bills and lost-wage benefits to more than a million injured workers in the state.

He is among the injured workers who claim that beyond the big headlines of the bureau s scandal is a 16-year effort by two Republican governors to deny treatment and retraining to claimants so businesses can lower their costs.

They call it the Bureau of Workers Compensation, but I think it has become the Bureau of Business Protection, said Mr. Switala, who suffered severe shoulder injuries after years of working at a distribution warehouse in Lima.

It s no secret that Ohio s government has been in the hands of the reactionaries since the 1990s.

A decade after then-Gov. George Voinovich referred to the workers compensation system as the silent killer of jobs, many injured workers say their frustration about not being able to return to work is aggravated by bureaucrats and managed-care companies focused on making big bucks.

The bureau pays nearly $2 billion a year in medical benefits and lost wages to injured workers, and more than $170 million in fees to managed-care organizations, which handle the claims of injured workers.

In 2005, Sarah Shick, 27, was working as a bartender in Cleveland Heights when she fell through a trapdoor in the bar. The 10-foot fall onto a cement surface injured her head, neck, back, and liver, according to claims documents.

Since the accident, Ms. Shick said she has found herself fighting the bureaucracy for her benefits as she tries to adjust to a new lifestyle.

The bottom line is that this is an employer-based service, said Ms. Shick. It s not really about the people. It is not really about the injured workers.

The bureau did not make William Mabe, its administration-CEO, available for an interview, but spokesman Nancy Smeltzer said the agency is focused on quality and efficiency for the injured workers.

Several injured workers interviewed by The Blade said the bureau s privatized managed-care program, which debuted in 1997, has prevented them from receiving job retraining.

A counselor for a vocational rehabilitation firm concluded that Mr. Switala had failed to make 15 face-to-face job contacts per week over three months.

When I was in the job search, I had chronic pain, said Mr. Switala, 52. It wasn t always possible for me to get out there and look as diligently as they wanted me to. I freely used the Internet. I freely used the mail, and I freely used the telephone to contact prospective employers, but they did not consider those as valid job contacts.

As a result, Mr. Switala said he enrolled at a Dayton-area college to get an engineering degree.

But in 2002, the bureau agreed with the conclusion of the vocational rehabilitation firm overseeing his case. As a result, Mr. Switala said he lost his workers compensation benefits and had to drop out of college.

Ronald E. Jones, Sr., injured in 2003 while working as a mechanic, says he suffers depression and can no longer work in his chosen field, yet has received no BWC retraining assistance.

Ronald E. Jones, Sr., injured in 2003 while working as a mechanic, says he suffers depression and can no longer work in his chosen field, yet has received no BWC retraining assistance.
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Ronald E. Jones, Sr., a Toledo resident who was injured while working as an auto mechanic in 2003, said he never received any retraining through the bureau. He said he has not worked since December, 2004, and now suffers from depression.

I can no longer be an auto mechanic. It was my labor of love, and my hobby at home, he said.

When the scandal over the bureau s investment of $50 million in a rare-coin fund created and managed by GOP fund-raiser Tom Noe broke in April, 2005, after it was reported in The Blade, bureau officials and their backers in the legislature stressed that the amount lost would not affect injured workers.

If someone is injured in Ohio, they re going to be taken care of through workers compensation, said state Sen. Robert Schuler (R., Cincinnati) in June, 2005. Lawmakers were debating bureau reforms, including a ban on investing in rare coins.

To say there s a culture of corruption is just ridiculous, Mr. Schuler added.

But last month, as a Lucas County judge sentenced Noe to 18 years in prison for stealing from the bureau s rare-coin investment, Tom Wersell, chief of the bureau s investigations unit, delivered a different message about the investment scandal, which grew to include a $215 million loss in a Bermuda-based hedge fund.

BWC became synonymous with the terms pay-to-play and a culture of corruption While we know today that the [State Insurance Fund] is safe and will provide for the injured workers of Ohio, investigating and verifying the solvency of the fund cost millions of dollars, dollars that should have been used for the injured workers, Mr. Wersell said.

Phil Fulton, a workers compensation attorney in Columbus, said the investment scandal has worsened the relationship between injured workers and the bureau.

Game-playing alleged

According to bureau statistics, about one of 10 state-fund claims were disallowed or dismissed in 2005-2006, with 1.6 million open claims and about $850 million paid for medical benefits and about $1 billion paid for lost wages. The bureau would not provide data covering the 1990s.

But many injured workers say it s the game-playing that the bureau engages in after a claim is approved that illustrates the problems with the system.

Ms. Shick said she has seen the human toll.

I ve met people in therapy rooms and doctor s offices who are losing their houses, who can t afford to buy clothes for their kids, who are struggling to eat and going to food pantries when before they had $50,000-a-year jobs because they don t have good lawyers and they are intimidated by the system, she said.

Bureau critics say that the plight of injured workers has deepened because two Republican governors, George Voinovich and Bob Taft, have thrown the system out of balance to reward their business backers.

Mr. Taft had the opportunity to appoint his own bureau administrator-CEO when he took office in 1999, but he chose to keep James Conrad, whom Mr. Voinovich picked after persuading the GOP-controlled legislature to hand over control from an independent board to the governor.

Taft did not have the sense or the backbone to get rid of Conrad, said Henry Eckhart, a board member of Common Cause-Ohio, a watchdog group. The claimants have suffered. That is what the employers liked, and the employers are the big contributors. They supported Voinovich and Taft. They wanted a pro-business BWC and Conrad was it.

Mr. Conrad, who was brought down by the rare-coin investment scandal, resigned in 2005. He did not respond to an e-mail seeking comment.

Mark Rickel, Gov. Bob Taft s press secretary, said when Mr. Voinovich ran for governor in 1990, the last year of Democrat Gov. Richard Celeste s final term, the bureau was an inefficient, expensive, and a customer-unfriendly agency.

It was unresponsive to injured workers and employers both. Despite the significant issues with the investments, the bureau has vastly improved for all of its customers, Mr. Rickel said.

It s broken right now

The bureau should continue to focus on keeping its premiums down. Workers comp premiums are highly relevant to job creation and retention, Mr. Rickel added.

Ms. Schick, the former bartender from Cleveland Heights, said she feels fortunate there is a workers compensation system in Ohio to assist injured workers. But, she said, the system is corrupted, and it s broken right now.

I don t think it needs to be thrown away; it needs to be cleaned up, said Ms. Shick, who hopes to eventually return to college and retrain for a job that fits her disability. She added that she believes the system is broken because there s too many political influences and too much money to be made.

Ms. Shick said her experience has caused her to see the biggest problems with the bureau s 9-year-old program to use private firms to managed injured workers medical care.

There s a lot of money motivating these [managed-care organizations], she said.

Dr. Bruce Siegel, a pain-management specialist from Cincinnati, worked as a doctor for the bureau until the mid-1990s. He said he is an outcast from the bureau because he was too much of an advocate for injured workers.

Doctor intimidated

In almost two decades of working with and against the bureau, Dr. Siegel said he has endured what he characterized as an often threatening and intimidating bureaucracy that cares little for patients and strips doctors of their integrity.

Now, as a doctor who consults with injured workers at the request of their attorneys, he says he can speak out about what he sees as the agency s mistreatment of injured workers.

They do not give a darn whatsoever what happens to the worker. They will pay their doctors to say whatever is necessary to postpone payment, to deny payment, or to put it off as long as possible. I ve seen some ridiculous responses from them, he said.

Dr. Siegel said the managed care-organizations make money for the company and nobody else at the expense of the patients health.

Society has an obligation to take care of injured workers, said Phil Fulton, a workers compensation attorney in Columbus and former president of the Ohio Academy of Trial Lawyers.

They have nowhere else to go, he said.

Diane Ferro, a 58-year-old from Akron, describes her dealings with the bureau as often frustrating and sometimes hopeless.

In 2004, Ms. Ferro tripped over a paperweight used to hold a door open at a hotel where she worked as a housekeeper. The fall caused extensive damage to her ankle and knee, causing her to need surgery and rehabilitation.

In addition to her physical injuries, Ms. Ferro said she has suffered financially and emotionally as a result of her struggles with the bureau.

In October, Ms. Ferro told a counselor that she was severely depressed because of her lack of income and the pain in her ankle.

I m in quicksand and I m afraid I m going to be evicted, she said, according to bureau records.

Ms. Ferro said the bureau does not provide a proper safety net for workers like herself.

Unless I call and raise hell, nobody gives a damn, she said. I m a proud woman, but I m not too proud to ask for help and fight for what I think is right.

Contact James Drew at: jdrew@theblade.com or 614-2210496.



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