Survivors of the Dec. 2 terrorist attack in San Bernardino say they’re being cut off from anti-depressants, anti-anxiety medication and counseling shortly before the one-year anniversary – making an already traumatic time even more distressing.

On Friday, Nov. 18, several survivors – who all work for San Bernardino County’s Environmental Health Services division – said they’re being denied the medication and counseling they desperately need approaching the first anniversary of the mass shooting by coworker Syed Rizwan Farook and his wife, Tashfeen Malik.

County Risk Management Director Ken Hernandez insisted survivors are getting all the medical care they need.

Fourteen people were killed and 22 were shot Dec. 2, 2015, during a holiday party/training event at the Inland Regional Center. Most of the 57 survivors are struggling with post-traumatic stress disorder.

Santa Ana workers’ compensation attorney Geraldine Ly, who represents eight survivors, said she’s angry that four have been cut-off cold turkey from anti-depressants or anti-anxiety medication or both. Counseling has been denied or “stalled” for three.

“I’m just appalled at the lack of sympathy that the county has for their employees who’ve been injured,” she said.

Survivors say the denials are part of a year-long struggle to get help from self-insured San Bernardino County, which administers its own workers’ compensation program, and a California workers’ comp system not designed for terrorist attacks.

Hernandez said the county sends doctor’s requests for prescriptions and other proposed treatment through utilization review, with other physicians weighing in on whether that’s medically necessary.

“We’re not denying any medication or any treatment that’s been approved,” he said. “If it’s non-certified through utilization review, that’s not the county denying any medication.”

The county may say approvals are out of their hands, but they’re not, Ly said. County risk management can authorize prescriptions, counseling and other needs without sending claims to utilization review, which uses “rigid” standards to find any reason to deny, she said.

Three survivors told county officials about the problems in a tense meeting Thursday, Nov. 17. About 20 to 25 survivors attended the meeting, while at least 16 remain on leave.

Program specialist Sally Cardinale returned to work part-time, but her doctor put her out on medical leave Friday after she began feeling more angry during withdrawal from anti-depressants and anti-anxiety medication denied in mid-October.

Last month, a workers’ comp utilization review board sent a letter saying she was authorized for more medication but was going to be weaned off it. But when she went to refill it, her pharmacy said the medicines were no longer authorized.

“On paper, they said they were doing it safely. But in real life, they just cut it off,” said Cardinale, 35, who couldn’t afford to pay $300 to $400 out of pocket. “With anti-depressants, you’re not supposed to just stop taking them.”

When asked why survivors would be “weaned off” medicines right before the anniversary, Hernandez said that’s decided by utilization review.

“If doctors determine they need to wean off, that’s their decision. Not mine,” he said. “I’m just administering the program based on the doctors’ reports.”

Survivors Ray Britain, the Environmental Health Services division interim chief on Dec. 2, and lead environmental health specialist Hal Houser get private counseling with victim compensation funding arranged by the San Bernardino District Attorney’s office because survivors couldn’t get counseling through workers’ comp quickly enough right after the attack.

On Friday, Houser nervously drove to a Rite Aide to see if prescriptions for medicines to treat PTSD from his private psychiatrist would be filled.

He had only eight days’ worth left – not enough to get through Dec. 2 – after a utilization review board denied prescriptions from a workers’ comp psychiatrist in mid-October for a “lack of history showing the need” – at the same time the doctor diagnosed him with PTSD and put him on medical leave.

Houser’s new prescriptions were filled later Friday.

“It’s that fight, that battle, to get healed. That’s what’s causing the anxiety,” said Houser, 55.

Britain was denied high-blood pressure medicine.

Ly said the denials are now making survivors worse.

“Without the medication they need, the support from the county and the sympathy from those who are involved in the workers’ compensation claims process, they are unable to mentally heal,” Ly said.

Contact the writer: 951-368-9444 or shurt@scng.com