Job-Injury Claims Spur Investigation by Schools

Spurred by a rash of workers’ compensation claims, Santa Monica-Malibu Unified School District officials have called for an investigation of all job-related accidents and have promised action against employees who file false claims.

Michael McCarty, director of business services, said the district’s insurance premiums have been increased by $110,000 to $742,922 to cover claims of $694,320 paid in the 1984-85 school year.

“We will be investigating every claim more thoroughly, but in no way does that mean that people who have legitimate accidents will be penalized,” McCarty said. “We understand that accidents on the job happen and those who are injured are entitled to their benefits, but we don’t want it abused, either.

“If we do suspect fraud, we are going to pursue it very aggressively, more aggressively than we did in the past.”

A Factor in Budget Cut

The increased premium was one of the factors that led the district staff recently to recommend the elimination of eight teaching and administrative positions in the 1986-87 budget.

Because of its high losses, the Santa Monica-Malibu district pays the highest premium of the eight districts in its insurance pool.

The pool, called Schools Linked for Insurance Management and founded in 1979, recently announced the premiums for the 1986-87 school year. The Santa Monica-Malibu district, which joined the pool last year, will be charged about $616 for each employee. Las Virgenes Unified’s premium is about $596 per employee; La Canada’s, $543; Beverly Hills’, $472; Burbank’s, $333; Glendale’s, $304, and Culver City, $275. Glendale Community College pays $282.

Mark Facer, a La Canada Unified School District official who is the president of the insurance pool, said that the premiums of all members in the group have increased because the state raised benefits. He said advertisements by attorneys encouraging workers to file suits for workers’ compensation have contributed to the increase.

Legal Fees Are Covered

California law provides that an employee who is injured on the job may be compensated for his medical expenses, loss of time at work, wages and legal fees.

Most school districts have been hit with higher insurance premiums for workers’ compensation, but school officials in the Santa Monica-Malibu district question why their district’s losses are so high.

“I was surprised to hear that we are having high losses,” board member Della Barrett said.

School board member Bob Holbrook said, “The problem is, we are getting a higher number of claims than normal, which suggests there may be abuse.”

Holbrook said he believes that most of the claims were legitimate, but he said he also suspects that some were not.

“I think part of the problem has to do with low morale,” he said. “People sometimes have aches and pains that they ignore when they feel good about their job, but if they don’t feel good about their job they might look for a way not to work.”

Most district officials cautioned against drawing the conclusion that the high losses in the Santa Monica-Malibu district indicate that there have been widespread abuses by workers.

McCarty said the district staff is trying to determine whether there was a problem and that he would report his findings to the Board of Education. He said the district staff will determine whether unsafe conditions exist for employees and whether workers need to be better informed about safety procedures. “We want to see what we can do to prevent accidents,” he added.

Rory Livingston, former Santa Monica-Malibu business administrator who recently left his post to work in the San Luis Obispo school district, said the answers are not hard to find.

“The primary reason that there are so many claims in Santa Monica is that every time someone gets injured they go visit an attorney,” he said. “Every day, people hear it on the radio, the same message: ‘If you are injured you have rights and I will represent you for free until you get a settlement.’ ”

Livingston said that examples of abuse would be a worker who says he can’t work because he suffers psychological stress from his job or a worker who complains of back problems. Such cases are usually hard to disprove.