Virginia Beach officer's painful wait for workers' comp

Posted to: Local Government News Virginia Beach

VIRGINIA BEACH

Jason Lee had always dreamed of becoming a police officer.

His wife wasn't so sure. Why would you want to take a $15,000 pay cut to work long hours in a dangerous job?

She yielded, though, and in February 2003, Lee, a former Coast Guard petty officer first class, left his job as a network systems analyst at a tech company and joined the Virginia Beach Police Department. He excelled, and in 2007 he was named the city's Top Cop for his courageous response to a September 2006 shooting outside a nightclub.

Then the call came that Debbie Lee had been dreading, Her husband had been injured on the job.

On July 7, 2008, as he escorted a man in handcuffs down a flight of stairs, the man slipped. Lee grabbed his arm to keep him from falling and immediately felt a sharp pain in his back and groin.

Doctors eventually diagnosed a hernia in his groin and a ruptured disc in his spine. Three surgeries later, he's still in pain and has permanent nerve damage that makes his right foot go numb, causing him to fall.

The injuries eventually cost Lee his job and led to a lengthy battle with the city over workers' compensation benefits and medical expenses. During the dispute, he and his wife sold their home, drained their savings and relied on donations and generosity of family.

Their battle may have finally come to an end.

Ahead of a workers' compensation hearing scheduled for Tuesday, the city agreed last week to meet Lee's demands, said his attorney, Philip Geib. They've drafted an agreement to pay several months of withheld workers' compensation payments, reimburse him for all his medical expenses and cover all future costs related to his injury, he said.

The city will also start paying Lee the weekly workers' compensation stipend it has been withholding since he stopped working six months ago, Geib said. Before then, Lee had worked some light duty at the police department, but he had to stop because of his frequent falls, his pain level and his medications.

Lee estimates the city owes him about $24,000.

"I'm just happy the city did the right thing finally," he said. "It's a little late, but it's better to do the right thing now then never."

The Lees are still left with one question: Why did they have to fight so hard for so long?

For a while, Sedgwick Claims Management Services Inc., the private company that manages the city's injury claims, denied Jason Lee's benefits, questioning "if his alleged groin injury and/or hernia is related to his 7/7/08 incident," according to a workers' compensation denial form from the company dated April 2, 2009.

City officials declined to comment on Lee's case, citing privacy issues. Workers' compensation cases are complicated, said city Finance Director Patricia Phillips, who oversees the risk management department.

"We never try to purposely create a hardship on our employees," she said. "They work hard and they deserve our attention; however, every once in a while, you will have situations."

The city receives about 1,100 injury claims each year, said John Grook, the city's risk management administrator. Sedgwick manages the claims, but the city pays the bill, which totaled roughly $6.7 million last fiscal year, he said.

The city typically does a good job caring for injured police officers, said Officer Lucian Colley, president of the Virginia Beach Police Benevolent Association, a law enforcement union. He's had two back and knee surgeries, and the city covered everything, he said.

"The city has always taken good care of me," he said. "I'm very surprised what this young officer has gone through and there's no excuse for it."

Colley said he plans to conduct a survey to see whether other officers have had problems like Lee's.

 The past two years have taken a toll on Jason Lee, Debbie Lee and their two children - Katelyn, 11, and Thomas, 5.

With three major surgeries, about a dozen CT scans and MRIs and prescriptions for painkillers and other medications, the bills added up fast. Jason Lee had been the family's sole breadwinner because his wife is disabled from a shattered pelvis she suffered in childbirth.

They've scraped by, cutting out all the extras, like Thomas' soccer and Katelyn's school yearbook, and their school photos.

Because of his spinal injury, Jason Lee's right foot and leg often go numb, causing him to fall. Once he went to retrieve the mail and returned with bloody gashes on his knee, arm and forehead. Another time he fell on the stairs when his wife and children were outside playing. His foot got stuck and he shouted for help to get free, but they couldn't hear him outside. He ended up lying there until they returned.

"Now when we hear a thud upstairs, the kids run," Debbie Lee said.

They're hoping life will get a little easier now that payment is forthcoming. Jason Lee recently had a nerve severed in his spine to stop his back pain. He had a second procedure Friday. He'll still fall sometimes, but he shouldn't be in as much pain.

He's being administratively dismissed from the Police Department, where he'd risen to the rank of detective. He's bitter about the dispute.

"I'd sacrificed my family and everything for the Police Department or for the city, and when this happens, they just turn their back on me," he said.

Thomas says he wants to be a police officer when he grows up. That's OK with Jason and Debbie Lee, but they warn him about the risks.

"We don't discourage him," Debbie Lee said. "But we tell him."

Pilot researcher Maureen Watts contributed to this report.

Kathy Adams, (757) 222-5155, kathy.adams@pilotonline.com

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Sedgwick

I am being coerced to 'settle' out of court with Sedgwick due to an on-the-job injury. Once I settle, I give up a lifetime award of benefits for continued pain & the inability to work due to the accident.But,for every bill presented to Sedgwick, there is a battle & a good possibility they will not pay the bill anyway. They continually send you to their own doctors who say you are [surprise] perfectly healthy. My GP has been treating me for 11 years; my pain doctor since the accident in 2009. They both agree I cannot work because of pain & medication. I also fall down because of nerve damage. I am now in bankruptcy &have lost everything I own. Even if I settle,I may not have a place to live. Because of this, I may be homeless in 2 months.

Sedgwick Does it again

I am also an injured officer in the city of virginia beach. I have been off duty for 3 months now due to an on the job incident. Sedgwick just sent me my denial letter. they had me sheduled with their doctor, but decided to deny my case days before I was to meet with him. they know I also have a case but don't want one more doctor to give them the evedence of this. I have retained an attorney as well.

It's me, Jason Lee, The Officer in the article.

I'd like to make a quick clarification. The Virginia Beach Police Department did everything they could to assist my family and I. I received numerous donations and assistance from the Fraternal Order of Police Lodge #8, the Police Benevolent Association, the City's Commonwealth Attorney Office, Senator Stolle, and numerous individual officers donated money or time in assisting my family and I. I would also like to thank the community for your support and generous offers.

Police work is dangerous but its the greatest job in the world!

There are numerous Police Officers here locally and around the country going through the same thing with workers compensation and my prayers go out to them. The truth will always prevail.

Lee

Are you serious??

It amazes me how people can read what can at best be called a snapshot of the whole situation and immediately launch in to how the company who denied the claim initially ought to be investigated, etcetera. Did anyone read the article? Look at the photos? Trash all over, fast food containers and cups, animal cages...not a single piece of wall or floor appears clear of EXCESS yet there isn't enough money to pay for school photos, a yearbook or a child's activity? Hard to sympathize with a cause when the 'victim' has no problem displaying their priorities to the readership. The $25.00 for Subway could have paid for the yearbook. Just an observation.

the keyword

The keyword in a workman comp case is 'stall'. The next words should be 'get an attorney as soon as possible'....you will need it.

Rules

Aren't there rules one on workmen's compensation must follow? If so, and these rules were followed, would this person be in this position? As someone else said earlier, there are two sides to every story and all we'll hear is one side. That's a shame because I'm sure there is more to this than is printed here.

Rules

Yes, there are rules they must follow. The people who decide if the city's company is following the rules are in Richmond. In my case, when the city's company was NOT following the rules, my attorney had to continually send them notice and after so many notices, the worker's comp commission sets a hearing date in Richmond. As soon as the company received notice of this hearing date, they immediately did the right thing and followed the rules. The only reason they did that was to prevent having to go to the hearing. They don't want to go in front of that committee and get in trouble. As soon as they comply with the rules, the hearing is canceled. It's like a big scam. We'll get away with it until we get called to the committee.

They will deny you because that is how a corrupted system works

I have been helping a friend go thru this procedure and I am appalled at how the verification, authorization and denial of workmans comp and also disability status is decided, handled and executed. THe system is set up to deny, deny, deny, and stall the vast majority of claims being brought forth before commissioners and judges. TO say this system is corrupted is an understatement. Despite obvious physical impairment, scads of medical documentation and injury paperwork from employers, these people are left hanging with no income, no medical treatment and no way to collect unemployed (can't physically work - can't get unemployment.) This is repeated across the board everyday across this country. I pray the truth of this system gets out.

This is business as usual

This story is too familiar. This type of behavior by Workers' Comp companies goes on all over the country on a regular basis. I think the question everyone needs to ask, is why has nothing been done to change it? It is the same with Personal Injury Law. Only WE the people can make a change. In fact, demand a change. If our representatives don't take action to legislate laws to help their constituents, then we need to vote them out!

irresponsible journalism

The Pilot knows better.

The employee can reveal whatever he wants about his injury and hold back any details that he doesn't want made public.

Meanwhile, the city has its hands tied because of privacy concerns.

I don't know any of the people involved, but I think there is more to the story than meets the eye here. Unfortunately, we are getting only one version, the one that plucks at the heartstrings and that makes for good headlines.

Before the Pilot does another story like this, they should get the employee to sign an agreement that would allow the city to disclose all information.

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