Bad Worker’s Compensation Reforms

Categories: workers' compensation, Workers' Compensation Hearing DecisionAuthor:

You might have heard the recent series which was  broadcast on National Public Radio and published by Pro Publica http://www.propublica.org/article/the-demolition-of-workers-compensation about the many recent changes in state workers’ compensation laws that have reduced benefits to claimants. We are pleased that the Vermont legislature has generally protected workers’ interests in the Vermont Workers’ Compensation Act.

Nationally, however, many states have reduced benefits or introduced procedures that are hostile to injured workers.

The article explains that over the past decade, state after state has been dismantling America’s workers’ comp system with disastrous consequences for many of the hundreds of thousands of people who suffer serious injuries at work each year.

The cutbacks have been so drastic in some places that they virtually guarantee injured workers will plummet into poverty. Workers often battle insurance companies for years to get the surgeries, prescriptions and basic help their doctors recommend.

The changes, often passed under the banner of “reform,” have been pushed by big businesses and insurance companies on the false premise that costs are out of control.

In fact, employers are paying the lowest rates for workers’ comp insurance since the 1970s. And in 2013, insurers had their most profitable year in over a decade, bringing in a hefty 18 percent return

All the while, employers have found someone else to foot the bill for workplace accidents: American taxpayers, who shell out tens of billions of dollars a year through Social Security Disability Insurance, Medicare and Medicaid for lost wages and medical costs not covered by workers’ comp

ProPublica and NPR investigation has found:

● Since 2003, legislators in 33 states have passed workers’ comp laws that reduce benefits or make it more difficult for those with certain injuries and diseases to qualify for them. Florida has cut benefits to its most severely disabled workers by 65 percent since 1994.

● Where a worker gets hurt matters. Because each state has developed its own system, an amputated arm can literally be worth two or three times as much on one side of a state line than the other. The maximum compensation for the loss of an eye is $27,280 in Alabama, but $261,525 in Pennsylvania.

● Many states have not only shrunk the payments to injured workers, they’ve also cut them off after an arbitrary time limit — even if workers haven’t recovered.

● Employers and insurers increasingly control medical decisions, such as whether an injured worker needs surgery. In 37 states, workers can’t pick their own doctor or are restricted to a list provided by their employers.

● In California, insurers can now reopen old cases and deny medical care based on the opinions of doctors who never see the patient and don’t even have to be licensed in the state.

On top of reducing benefits or capping the time injured workers can receive them, states have found another way to cut workers’ comp costs: shifting control over medical decisions from workers and their doctors to employers and their insurers.

Thanks to a 2011 reform in Montana, for example, once insurers accept claims, they can choose workers’ doctors and change them at any time. In 2013, Georgia ended the promise of lifetime medical care for workers’ injuries, capping it at eight years for all but the worst cases. As a result, workers who have had hips or knees replaced because of workplace accidents may be out of luck when the devices wear out.

Other states, like Illinois and Delaware, have enacted more subtle changes, such as placing strict caps on payments to doctors and hospitals through medical fee schedules. The measures help control costs, but, critics say, they also cause some doctors to stop taking workers’ comp patients.

North Dakota — like California and Texas — has increased its use of outside medical reviewers who can deny recommended treatments or rule that injuries aren’t work related after only brief exams or by merely reading medical records.
At Shoup Evers & Green we are proud to help injured workers get the benefits to which they are entitled under the Vermont Workers’ Compensation Act. If you have questions about your claim, call Michael Green or John Schraven at (802) 861-6666 or contact us through our website. There is no charge or obligation for our initial consultations, and we will be pleased to answer your questions.

For more information on our workers’ compensation page and to search our workers’ compensation case database head to our workers’ compensation services page.

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