Fewer than a quarter of BCSO MP’s COVID-19 benefit claims approved

SAN ANTONIO – Detention officers and sheriff’s deputies in Bexar County who have applied for COVID-19 workers’ compensation benefits since the start of the pandemic have been denied more than 75% of the time, records obtained confirm by KSAT Investigates.

Sheriff Javier Salazar called the process “frustrating” and blamed much of the blame on the county’s third-party administrator.

“They deserve much better treatment than what they sometimes get and I think that gets lost in this process,” Salazar said, referring to members of his agency whose health has been affected by the deadly virus.

Since March 2020, nearly 1,200 BCSO staff have tested positive for COVID-19: 771 on the detention side and 401 on the law enforcement side, according to figures provided by BCSO officials to the end of last month.

Of BCSO’s 33 first responders who subsequently applied for COVID-19 workers’ compensation benefits, only eight were approved, according to county records provided through a public records request.

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Benefits denied for MP who went into a coma and lost 100 pounds

BCSO Deputy Johnnie Rodriguez has spent part of the past four decades proudly serving the county.

But in early January, halfway through a patrol shift, he started feeling ill and was sent by a supervisor to get tested for COVID-19.

Rodriguez’s wife Sharon, herself a former BCSO MP, said the test came back positive and her husband began quarantining at home.

Within days, Johnnie Rodriguez woke up with difficulty breathing and was taken to a hospital near his home.

Sharon Rodriguez then insisted that he be moved to University Hospital after his breathing problems intensified.

Johnnie Rodriguez’s condition worsened, according to his wife, who said he fell into a coma and could not breathe without the aid of machines.

“They told me several times every morning, ‘you know, he’s not going to make it,’ to ‘get your financial house in order’. And I refused,” Sharon Rodriguez said.

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Sharon Rodriguez, wife of MP Johnnie Rodriguez. (KSAT)

In March, amid the couple’s medical nightmare, Sharon Rodriguez received confirmation that the county’s third-party administrator had denied her workers’ compensation claim.

“We, CCMSI, have reviewed your claim for workers’ compensation. Based on the facts we have about your claim, we will not pay medical benefits or income,” the March 17 denial letter reads.

The two-page letter specifically states that Johnnie Rodriguez’s symptoms began before he returned to work in late December.

Sharon Rodriguez, who ran for Bexar County Sheriff in 2020, and Salazar dispute that claim.

Salazar said BCSO went so far as to shoot body-worn camera footage showing Johnnie Rodriguez at work during the time in question.

“He came to work, showed up to work, clocked in, did his shift,” Salazar said.

Johnnie Rodriguez, who weighed about 240 pounds when he caught COVID, lost 100 pounds while hospitalized and was only able to regain about 15 pounds.

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Since being released from medical care to return home last month, after six months in hospital, Johnnie Rodriguez has been on 24-hour oxygen and continues to have severe lung and heart problems, his wife said. .

BCSO Deputy Johnnie Rodriguez pictured at the hospital earlier this year. (KSAT)

Johnnie Rodriguez has difficulty walking and continues to use a wheelchair to help get around.

She said they’ve received bills for medical tests like X-rays and CT scans totaling more than $100,000, but she expects that number to skyrocket in the coming months.

Sharon Rodriguez said the family have been responsible for around $50,000 in medical bills so far, but her husband’s doctors’ bills or extended hospital stays have yet to arrive.

“When they are sick or injured or even worse, as we have seen in some cases, they lose their lives defending this county, we owe it to them to support them and their families. And in this case, it just doesn’t seem like it’s done and yes, I’m frustrated. I’m pissed about it,” Salazar said.

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Reached for comment, a county spokesperson said they could not specifically discuss Johnnie Rodriguez’s claim for benefits, but did provide general information about the workers’ compensation claim process:

A worker’s compensation claim must meet the following conditions to trigger coverage:

  • Injury/illness occurring during and in the course of employment and

  • The injury sustained by the employee is the mechanism that triggers the coverage.

  • Under pre-pandemic conditions, COVID-19 would have been considered an “ordinary disease of life” because it is airborne. Anyone can contract it and it would be very difficult to isolate the point of contraction. However, during the COVID-19 pandemic, Senate Bill (SB) 22 passed:

    • This is a measure intended only for first responders to create an eligibility that did not exist before.

    • First responders receive coverage for a COVID-19 illness through their medical insurance. Therefore, there is no actual hedging gap, but rather a possibility of subsequent hedging.

    • SB22 outlines how coverage requirements can be met or how to restate a previously denied workers’ compensation claim involving a COVID-19 illness so that coverage can be invoked.

    • SB22 allows rebuttals or questions. The criteria to pave the way for secondary coverage under SB22 are:

Senate Bill 22, which was signed into law by Texas Governor Greg Abbott in June 2021 after garnering strong bipartisan support, makes COVID-19 a suspected illness for some first responders, including detention officers and sheriff’s deputies.

The county remains engaged in an ongoing legal battle with the widow of the first BCSO MP to die of complications from COVID-19, MP Timothy De La Fuente.

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While the county has publicly honored De La Fuente’s memory on several occasions, his widow’s claim for benefits stemming from his April 2020 death has been denied.

Pauline Pezina De La Fuente reflects on one of the many honors her husband received after he passed away from complications from COVID-19 in April 2020. (KSAT)

Twice last year, an administrative judge sided with Pauline Pezina De La Fuente, forcing the county, a self-insured entity, to cover the cost of $1,922 to cremate De La Fuente’s remains and to pay his widow weekly death benefits.

The county, according to court records made public earlier this year, appealed both decisions.

At first instance, an appeal panel overturned the decision and remanded the case for a contested second hearing.

After the administrative judge again ruled in late September that Pezina De La Fuente was entitled to death benefits and reimbursement of cremation costs, the county again appealed the case.

In late January, the county filed a lawsuit against Pezina De La Fuente in state district court, asking a judge to overturn the decisions of the administrative judge and the second appeal board.

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Pezina De La Fuente said if she were deprived of benefits, which amount to less than $4,000 a month, she would be forced back into the workforce.

“The fact that the county continues to deny this claim is shameless, it is disgusting. It’s like my husband doesn’t exist,” Pezina De La Fuente said earlier this year.

In an email to a county claims specialist earlier this year, Salazar called the legal filing “reprehensible” and “insulting” to De La Fuente’s memory.

Copyright 2022 by KSAT – All rights reserved.

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