How a Workers’ Compensation Adjuster’s Intentional Delays Killed a Man

How many times could a company with a homegrown, wholesome name like Ralph’s Grocery Co. turn a blind eye to the medical needs of an injured employee? According to the California Workers’ Compensation Appeals board, 11 is the lucky number.

Sedgwick-CMSThe trouble began in December 2003, when Charles Romano sustained an injury to his left shoulder and cervical spine while stocking the shelves of Ralph’s Grocery Co. in Camarillo, California. Two years after the initial injury, Romano finally received the authorization required to proceed with surgery. Romano’s shoulder was healed, but he contracted a serious staph infection as a result of the procedure. Once healthy and hardy, Romano suffered both pulmonary and renal failure, followed by partial paralysis.

And what did Ralph’s Grocery Co. and its third party claims adjuster do once they realized that Romano had contracted an antibiotic-resistant staph infection, more commonly known as MRSA? As Romano suffered from this debilitating, multi-system illness, Sedgwick CMS delayed eleven requests for authorization and reimbursement.

But wait–it gets worse. Not only did Sedgwick CMS fail to deliver fair reimbursement in a timely fashion, they also ignored a judge’s direct order to provide Romano with the intensive care that he needed until his medical bills had reached a grand total of $24,000 a day.

Charles Romano was 47 years old when he died from cardiorespiratory arrest, respiratory failure, and pneumonia resulting from an untreated MRSA infection. In the years prior to his death, Romano was treated at five separate facilities; Sedgwick CMS either delayed or refused to pay any of the accompanying medical costs, even after Romano was awarded further medical treatment by the California Workers’ Compensation Appeals Board. This appalling conduct continued up until Romano’s death, when Sedgwick CMS denied authorization for his final stay at Community Memorial Hospital.

Perhaps most distressing is the fact that Sedgwick CMS contends that they cannot be penalized for eleven instances of “unreasonable delay” because the applicant is now deceased. This attitude certainly conflicts with the heartfelt, apologetic statement made in response to the threat of prosecution.

After the untimely death of Ralph’s Grocery Co. employee Charles Romano, friends and family have rallied to his cause. In June 2013, longtime friend Sid Freeman joined forces with several members of the Central Coast Chapter of the California Applicant Attorney Association. After going public with a brief news conference, Freeman went on to file a letter with District Attorney Greg Totten pushing for the criminal prosecution of the third party claims administer Sedgwick CMS.

At Moebes Law, we are outraged by this blatant disregard for employee health and welfare. If you suffer from a workplace injury, don’t let your case get swept under the rug — contact us for a free consultation today.

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