Firefighters file lawsuit over denied worker's comp claims - | Lufkin and Nacogdoches, Texas


Phoenix firefighters file lawsuit over denied worker's comp claims

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A group of Phoenix firefighters is suing the company that manages the city's worker's compensation program.

A bill being heard in the House Insurance Committee on Tuesday could eliminate "bad faith" as a reason someone could sue for workers compensation.

HB2455, if passed, would instead empower the Industrial Commission, which could investigate and give a maximum $10,000 fine to be paid to the state and a $5,000 fine for the aggrieved party.

No matter how much money was lost by an injured worker, $5,000 would be the maximum fine recovered if the insurance company denied coverage.

In August 2013, the group of Phoenix firefighters said their valid claims have been denied time and time again.

"All we as firefighters want is to be taken care of when we get hurt, because the nature of our job is not if we're gonna get hurt, it's when you're gonna get hurt," said Brian Dimas, a 14-year veteran of the Phoenix Fire Department.

He is one of nine firefighters named in a lawsuit against York Risk Services Group.

The lawsuit alleges the worker's compensation program that York manages has been nothing short of a scam when it comes to paying out earned benefits.

"I was stepping off a (fire) truck," said Dimas as he described his workplace injury. "I twisted, and when I stepped off, my knee popped. As the shift went on, the pain started to get greater."

So Dimas did what he was supposed to do.

He saw a doctor and filed a worker's compensation claim.

"When my specialist told me that he thought my injury required surgery everything got twisted, and my claim was denied at that point," Dimas said.

He told CBS 5 News his claim was denied after he met with another doctor, one handpicked by York.

"These folks put their lives on the line and protect our community, and when they needed help and they needed protection, York wasn't there for them," said Kevin Wein, an attorney for the plaintiffs.

The lawsuit filed in federal court states the firefighters were defrauded of benefits owed to them, because of injuries suffered on the job and that the so-called independent medical examiners used to deny the claims are in York's back pocket.

"We believe they're doctors that are being used by York to reach favorable opinions," said Wein. "I should add that in each one of these cases, the Industrial Commission of Arizona found that the doctors' opinions were wrong, that, in fact, the injuries did occur at work and were compensable under the worker's compensation system."

The lawsuit also states claim denials and delays resulted in financial hardship for many of these firefighters.

But Dimas said they're not just looking to recoup their losses; they want York to do what's right.

"Everything comes back to money," he said. "So if monetarily they see no advantage in doing what they're doing to us, then hopefully, they'll stop."

CBS 5 News has reached out to York and the City of Phoenix for comment.

Copyright 2014 CBS 5 (KPHO Broadcasting Corporation). All rights reserved.

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