When a police officer is shot in the line of duty, you would expect the state to go to extra-ordinary lengths to help the wounded officer.
But the I-Team discovered more than one case where police officers have faced long battles with workers comp as they fought to get medical care.
Investigators with Ohio's Bureau of Workers Compensation cracked nearly three thousand fraud cases last year alone -- saving more than 100 million dollars.
But greater Cincinnati police officers -- seriously injured in the line of duty -- say, because of a general suspicion of fraud, they were treated as guilty until proven innocent.
West Chester police officer Jeff Duma had survived a gun battle in March of 2007. But the fight of his life was just beginning.
"This whole thing, the worst thing to go through was dealing with workers comp." said Duma while on patrol in his police cruiser.
Officer Duma's claim file with Ohio's Bureau of Workers Compensation is a stack of paper 800 pages high, spanning a year and a half of medical forms, exams, treatment denials and appeals. Ironically, the stack of workers comp paperwork is thick enough to stop the same 40-caliber bullet that nearly ended his career.
"I could have took a disability and got it without any questions asked." he says.
But in Ohio, police disability pensions and workers comp are completely separate systems. Officer Duma wasn't going to let a gunman or a bureaucracy keep him from returning to work.
"You didn't take a risk for a guy who was just going to give up." Duma says. "I wasn't going to give up."
Steven Dyer, regional manager for Ohio's BWC, says the state paid for the surgery to rebuild officer Duma's shoulder.
The dispute began when the officer sought physical therapy to get back in uniform. "Denied." "Insufficient Evidence." "BWC denies the treatment" -- were some of the rejection notices Duma got from BWC despite a warning from one of his original surgeons.
This is a direct quote from the medical report the day Duma was shot: "The severity of the injury is likely to take up to a year to know the residual impact it may have on the future function of the shoulder."
So the natural question for BWC is why would physical therapy be denied?
"The process is also there to protect to the injured worker to make sure they're getting the appropriate medical care and they're not being over-treated." says Dyer.
Duma says he was getting a very different tone from a company hired by BWC to oversee his case.
"Very sarcastically and very nasty," he says, 'we just don't understand why it's taking you so long to get back to work.' "
That was the word from the state's sub-contracted managed care organization -- or mco -- one of many acronyms between injured workers and their medical care. Because officer Duma was stuck in the middle of this workers comp flow chart, his doctors refused to treat him.
"I kept saying, 'you know I was shot on duty, you know this is going to get approved, it's not going to get dis-approved. It didn't matter." Duma told the I-Team.
Another officer has a similar story.
"I looked over my shoulder and I just seen this black SUV vaulted.." says Mason police officer Scott Miller who was injured in a car accident while investigating another accident scene.
"When I couldn't wear my gunbelt -- gunbelt's between 15 and 20 pounds -- and as soon as I strapped that on, I mean it took my legs out from under me.' he says. "They finally figured out, 'hey your back's broke.' "
Officer Scott Miller also has a thick workers comp file.
"It's so much bureaucracy and code and if you don't do this. I saw three doctors off their list." he says.
All three doctors agreed: The Mason police officer needed surgery to repair his broken back. But officer Miller kept running into the same response from workers comp that sidelined officer Duma in West Chester: Denied.
"Now we need an independent opinion. We're going to send you to one of our own.", Miller says was the response from BWC. "and I'm like what were the first three?"
"There were some pre-existing type of conditions there." explains the bureau's Dyer.
Workers comp says a doctor's review discovered officer Miller had a never-before-diagnosed, pre-existing back problem and the violent crash in police cruiser could have been a coincidence.
"How do you dispute those facts?", says Miller. "How do you dispute the fact that I wasn't hit by a car?"
"He was definitely injured on the job.", says Dyer.
"But then when three separate doctors say he needs bone fusion, the bone fusion was denied. Why?", asks I-Team reporter Brendan Keefe.
"The evidence spoke to that condition being pre-existing the actual injury." Dyer says.
Officer Miller was prescribed all kinds of prescription painkillers. The same kind he saw on the street turn patients into junkies. He says a workers comp supervisor told him the appeals could take eight months and ordered him to take the pain pills.
"If you're telling me it's going to be several months, I'm not going to take a pain pill every four hours of every day for the next several months.", Miller says. "I said I'm not going to trade one problem for another. I can deal with the pain -- if I need to take it, I'll take it. 'well maybe you're denying treatment.' "
Then officer Miller found Dr. Atiq Durrani. His miracle procedure at the Christ Hospital's Spine Institute involves screws and hooks attached to either side of the fractures on the broken vertebra -- instead of fusing two vertebrae together.
"If he had the fusion now then returning to full police activity would be difficult." explains Dr. Durrani.
Remember even the fusion was already denied. Dr. Durrani has 50 successful cases with children -- but never tried his procedure on an adult. There was no way workers comp would approve the only surgery that would get officer Miller back on his police motorcycle.
"Any experimental surgery probably would not be approved.", explains Dyer.
"Nothing's going to stop me from getting back out there and doing what i want to do.", Miller responds. "No one is going to tell me I can't or deny my treatment like it seems they been doing. If I gotta pay for it myself, I'm gonna pay for it myself."
The city of Mason stepped up and offered to pay for the surgery. After four hours of delicate work on his spine -- officer Scott Miller was given a good prognosis from surgeon -- and Mason resident -- Dr. Durrani.
"Something that he loves to do that is return back to the streets and protect all of us.", says Durrani.
Miller is now walking around his neighborhood -- pain and pill free. Soon, like officer Duma in West Chester, he will be back on the beat with little thanks to workers comp.
"You fight harder to get back to work than you do to stay alive. You shouldn't have to do that.", says Duma.
Miller adds,"The last thing a police officer needs to do is worry about whether he's going to be taken care of if he's hurt in the line of duty."
One Cincinnati officer told the I-Team that he broke his finger while handcuffing a suspect...But so notorious is Ohio's workers comp system among local police, he told his doctor he was injured at home. Regular health insurance immediately covered the treatment, and the officer took a couple of sick days.
But workers comp treats police shot in the line of duty the same as office workers complaining of carpal tunnel from using a computer mouse.
Remember in both cases we showed, the officers could have much more easily taken a disability check for the rest of their lives.
