Report: Reforms Gut Workers’ Compensation Programs Nationwide

Workers’ compensation began as a kind of revolutionary agreement in the modern world: Employees would forfeit their right to sue their employer, if in turn they are guaranteed their on-the-job injury would be compensated with coverage of medical bills and enough wages to help them sustain while they recovered.
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And for a long time, the system worked well.

However, a series of state-level reforms occurring over the last 10 years have resulted in numerous states dismantling these protections one-by-one, in many cases resulting in workers waiting years to receive necessary surgeries, prescriptions and other care, while battling with insurers and plummeting into poverty. This phenomenon was tackled in-depth by reporters at NPR and ProPublica, whose joint investigation – “The Demolition of Workers’ Comp” – was published this month.

The state-level changes have been enacted under the guise of “reform,” and unsurprisingly have been backed by insurance companies and large corporations who have asserted falsely that costs associated with workers’ compensation programs are out-of-control.

Here’s the reality: Companies today are paying the lowest rates for workers’ compensation insurance since the 1970s. What’s more, insurance companies had their most profitable year in a decade in 2013, raking in a return of 18 percent.

So this is not – and never was – a matter of making tough decisions. It’s about insurance companies and employers doing right by workers who, though no fault of their own, are hurt on the job – sometimes to a devastating degree. Workers who have lost limbs or the ability to walk should not have to fight battles for years just for basic compensation – especially when they don’t have the option to sue. The forfeiture of the right to sue is part of the exclusive remedy provisions of workers’ compensation law, which unsurprisingly, remain intact despite all the other changes.

Employers are instead pushing workers toward social safety nets, such as Social Security Disability Insurance, Medicaid and Medicare to recover medical expenses and lost wages. These are funded by taxpayers, which leaves companies off the hook. But those programs are not automatic either, and workers may spend years fighting to secure SSDI or other coverage.

What the recent investigation uncovered is that in the last 12 years, there have been 33 states that have passed workers’ compensation laws that reduce benefits under workers’ compensation, or alternatively make it tougher for those with certain kinds of injuries or diseases to collect. This has led to an extremely disparate system, where the loss of an arm in one state can result in a payment of $262,000, but the same loss in another state will only garner $27,000 in compensation.

Both North Carolina and South Carolina have reduced benefits since 2002.

In a lot of states, not only have workers’ compensation payments been reduced, they may be cut off totally after exceeding some arbitrary limit. This limit does not take into account whether the worker has recovered.

Additionally, employers and insurers are controlling medical decisions to an increasing degree, including whether a worker can receive surgery. Choices that were once between patient and doctor now inherently involve one’s bosses. There are 37 states in which workers cannot choose their own doctor, and are strictly limited to a pre-determined set of providers.

And in at least once state, insurance companies now have the ability to re-open older cases in order to retroactively deny medical care on the basis of opinions provided by doctors who never saw the patient. Amazingly, those physicians don’t even have to be licensed to practice in that state.

Those who push these measures say they are necessary to attract and keep strong business. which put people to work. However, the fact that these changes have been coined “reforms” is, as workers’ advocates note, “a real insult to workers.”

If you have been injured at work, contact the Lee Law Offices at 800-887-1965.

Additional Resources:
Injured Workers Suffer As ‘Reforms’ Limit Workers’ Compensation Benefits, March 4, 2015, By Howard Berkes, NPR and Michael Grabell, Pro lica

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