Waitress Violet Day slipped and fell in a restaurant walk-in freezer two years ago, injuring her lower back and shoulder. She filed a workers' compensation claim in January 1987, but has yet to receive full payment for her injury. Her odyssey through California's byzantine workers' compensation system has turned out to be more disturbing than her original injury, she says.
Ms. Day's employer disputed her claim and the case entered the system's clogged adjudication process. According to state law, a case must be set for hearing within 30 days after the plaintiff's attorney declares readiness to go to trial. Ms. Day's hearing, however, was delayed for a year.
Even after she signed a $10,500 settlement with her employer, she received no money because the agreement required approval by a workers' compensation judge. Judges' caseloads are so heavy, there are long delays even to approve settlements.
Unemployed and having sold off her car to pay for rent, Ms. Day became desperate. ``I had to beg them to give me an advance,'' she says. So far she has received about $5,600.
Yesterday, Ms. Day, two other workers and two unions filed a class-action suit charging that the workers' compensation system consistently misses deadlines because of inadequate staffing and other administrative problems. They want the system to adhere to its legislatively mandated deadlines.
Many states face long delays and other serious problems in their injured worker programs, says Melvin Witt, former head of the California Workers' Compensation Appeals Board, a state court of limited jurisdiction that resolves workers' compensation disputes. If the California class-action suit succeeds, it could lead to similar litigation elsewhere.
But the backlog in California is so bad, charges plaintiff attorney Ralph Abascal, that ``for the first quarter of 1988, there were 384 feet of unopened mail'' in workers' compensation offices statewide.
Ronald Rinaldi, who heads the California agency that oversees the workers' compensation system, responds to the shortage of judges and staff by saying, ``we're willing to talk resources, but we want to talk overall reform. We are being very aggressive in trying to improve productivity and automation.''
The California legislature established one of the nation's first workers' compensation systems from 1911-18 as part of a wave of progressive working-class reforms. Previously, employers had maintained that all on-the-job injuries were the workers' fault.
Workers' compensation was the nation's first ``no-fault'' insurance system. Employees were to receive prompt payment for injuries, while employers could avoid potentially costly litigation.
In the late 1940s the state mandated that all claims must be set for trial 10 to 30 days after the workers' attorney declares readiness for trial. But in recent times, as the number of injuries has grown, the governor's office has failed to expand the workers' compensation administrative apparatus, creating huge backlogs.
From 1970 to 1986 workers' compensation cases increased by 150 percent, but the number of hearing officers or judges rose by only 24 percent.
For the last several years, the Democrat-controlled legislature voted money to increase the number of judges and staff, but Republican Governor George Deukmejian vetoed it.
Attorney Abascal says the governor's veto was an attempt to force through other changes in the workers' compensation system.
The governor is sensitive to employers' and insurance companies' complaints that the system costs them too much, says John O'Hara, an attorney appointed by the Governor to mediate the issue. Employers and insurance companies maintain that employee fraud, unnecessary litigation, and a large increase in stress-related claims have driven up the cost of workers' compensation insurance premiums.
Employers and unions also agree that benefit payments are too low. Benefits have not been increased since 1981. Maximum benefits for temporary disability are $224 per week and only $140 a week for permanent disability.
Labor unions and applicant attorneys complain that the system forces workers to settle prematurely, and that it is difficult to litigate cases of obvious employer negligence.
In March the state senate and assembly held joint hearings in an attempt to resolve the controversy, but failed to agree on legislation. Gov. Deukmejian formed an advisory group which is scheduled to make its report in August, but it's not clear if the members can reach a consensus.
The legislature will reconvene only for the month of August, so a potential overall reform bill has remote chances of being passed this year.
The class-action lawsuit seeks to speed up payment of claims, while the debate continues on a comprehensive overhaul. Abascal predicts that the case will win easily because the state is ignoring its own legislatively mandated deadlines.
How the courts might choose to enforce the deadlines is another matter. In the early 1970s the courts issued contempt citations and imposed fines against various state governments for failing to meet deadlines in welfare cases.
Abascal hopes that California courts will do the same, thus forcing the state to increase staffing and pay benefits to workers such as Violet Day.