04:30 PM CST on Tuesday, January 4, 2005

The WFAA-TV investigative series State of Denial revealed a Texas workers' compensation system in crisis. Reporter Brett Shipp and Producer Mark Smith found state regulators often fail to enforce labor laws and penalize those insurance companies that unjustly deny benefits and medical treatment to injured workers. As a result, many of the most seriously injured Texas workers go untreated and remain unable to work, ultimately turning for support to public welfare.

The series has earned Shipp and Smith, along with photographer/editor Kraig Kirchem and executive producer Nann Goplerud, a prestigious duPont-Columbia University Award.

Shipp and Smith found state regulators may have lost sight of their assigned role: "Ensure appropriate and efficient health care for all injured employees." Instead, in an effort to control health care costs, state regulators and insurance carriers developed a shockingly cozy relationship.

Several stories detail possible fraud or questionable actions practiced by at least several major insurance carriers, but ignored and unpunished by regulators. The WFAA-TV series has revealed how some insurance companies send peer review doctors medical files "stripped" of records important to the possible approval of workers' comp claims. Those peer review doctors who routinely deny care receive lucrative contracts, while those who approve care fail to be rehired.

STORY ARCHIVE

Sufferers detail worker's comp woes (12/30/04)

Injured workers say doctor siding with insurance companies (12/28/04)

Doctor faces scrutiny by worker's comp commission (12/15/04)

End may be near for embattled workers comp system (10/07/2004)

Compensation denied without physical exam (06/25/2004)

Workers' comp patients being denied payment for pre-approved surgery (06/24/2004 )

Injured workers continue to wait for medical care (06/11/2004 )

Injured workers' comp patients voice complaints to lawmakers (05/18/2004 )

Report: Changes to Texas worker's comp system needed (04/28/2004 )

Senators probe workers' comp issue (04/26/2004)

Workers comp investigation begins (1/23/04)

Insiders: Doctors profit from denied claims (1/2/04)

Carriers denying treatment to worker's comp patients (12/23/03)

Worker's comp complaints voiced in Austin (12/18/03)

Worker's comp patients face shrinking doctor pool (12/17/03)

Doctors: Insurance carriers violating worker's comp rules (12/10/03)

Doctors, patients may march to protest worker's comp system (12/04/03)

Grant raises suspicion of conflict in workers' comp system (11/21/03)

Worker's comp system on the verge of collapse? (11/18/03)