Worker comp provider defends practices

By Jason Kosena

And the beat goes on.

The Interim Committee to Study Issues Related to Pinnacol Assurance — known as the “Pinnacol Hearings” to some in the Legislature — held its third daylong session Monday at the Capitol.

As in the committee’s second session, when witnesses testified that the firm’s high salaries and lobster dinners for associates were extravagant, Monday’s hearing offered a lineup of more than a dozen injured workers who proclaimed their discontent with the state’s last-resort workers’ compensation insurance firm.

The 16-member panel was created by Senate Bill 281, a piece of last-minute legislation, and was charged with the task of exploring future options for Pinnacol, a quasi-governmental agency with a large cash surplus. Some lawmakers had hoped to use that cash to bridge the state’s massive budget gap. The attempt to use $500 million of Pinnacol’s reserves eventually died after Gov. Bill Ritter said he would not support the measure.

The panel — which is composed of 10 state lawmakers from both parties and six civilians, including Pinnacol CEO Ken Ross — is charged this summer with coming up with a list of recommendations for the 2010 legislative session. Possibilities include leaving Pinnacol alone, privatizing it or taking control of the firm and its $700 million surplus.

Monday’s parade of witnesses took time to detail their work-related injuries and the way in which Pinnacol denied them what they said was necessary medical coverage.

Radean Hahn, a 57-year-old woman who was hurt on the job after a desk fell on her leg, said she has lived with chronic pain since her accident and that acupuncture is the only form of treatment that has been helpful.

“I can’t tell you how much it helped. I finally had hope,” Hahn testified. “(But,) I was horribly shocked that Pinnacol denied authorization for anymore acupuncture.”

Hahn said her Pinnacol assigned doctors approved the treatment before blasting the insurance company for its lack of service to the injured.

“When I read in the newspaper that Pinnacol has a $700 million surplus, I knew why,” Hahn said. “They aren’t trying to provide care. If they can find any little reason not pay out a claim, they will do it.”

Former firefighter Steve Stahl said after he was injured, Pinnacol had him followed by a private investigator, whose job, he said, was to discredit his injury.

Stahl testified that his lawyer told him Pinnacol had surveillance video of him picking up his infant daughter and was beginning an investigation into his workers’ compensation claim.

“I became paranoid of my friends, my parents, anyone I had contact with,” Stahl said, adding that Pinnacol’s investigators contacted his family and friends to tell them he was being investigated for fraud.

“My life had become one big fight against the big bad insurance company,” he said.

Pinnacol CEO Ross offered only a prepared statement to the committee, calling it inappropriate for the insurance company to directly question patients it is working with now or has worked with in the past.

“When workers are injured on the job, we are committed to ensuring that they receive timely and appropriate medical care and are safely returned to work,” Ross said.

Monday’s testimony extended beyond injured workers, however.

John Hughes, M.D., the chairman of the Colorado Medical Society Workers’ Compensation and Personal Injury division, told the committee that Pinnacol’s use of independent medical examiners creates problems for many patients.

“The use of independent medical examinations in complex long-term cases — where medication prescriptions might be off-label or under an experimental protocol — an independent medical examiner might be ignorant to those (kinds of things) and suggest that care be shut down,” Hughes said. “That has emerged as a problem ... a big problem for us.”

Despite that claim, when asked by Ross how Pinnacol compares to other insurance companies, Hughes called Pinnacol one of the better companies to work with.

“I think there are some self-insured that have done the best, but among insurance companies in Colorado, I see Pinnacol’s process to be the most fair and the most transparent,” Hughes said. “The (medical) reviews are not going to be done by someone in Arkansas — which is happening with other companies.”

Despite the often-solemn tone of Monday’s testimony, there was one brief moment of laughter.

Before Stahl testified, he told the committee that he was nervous and asked listeners to bear with him if he faltered.

After he finished a very clean and uninterrupted speech, Sen. Sean Mitchell, R-Broomfield, raised his hand indicating to the committee’s chairwoman, Sen. Morgan Carroll, D-Aurora, that he would like to comment.

“You said that you were nervous, but your testimony was (strong),” Mitchell said. “If anybody else in the audience is nervous, sometimes when I am in committee and I am feeling nervous, I try and picture the chairwoman in her underwear.”

The committee room aroused in laughter.

“I do not suggest that,” Carroll said.