A national study by the Rand Corporation is urging changes to the workers’ compensation system. The study was commissioned by the US National Institute for Occupational Safety and Health (NIOSH) and approaches necessary improvements inorder to make the nation’s workplaces safer.
Showing posts with label reform. Show all posts
Showing posts with label reform. Show all posts
Monday, October 1, 2018
Thursday, August 9, 2018
A Deviation Off-Premises Bars Claim
The “Coming and Going Rule” has always been a grey area in determining compensability in the workers’ compensation arena. A bucket full of cases and statutory modifications have tried to establish clarity.
Thursday, December 21, 2017
Cries of High Costs and Fraud – Watch for Reforms
Today’s post comes from guest author Kit Case, from Causey Wright, Seattle, Washington..
There is always discussion, in every state, about the expense of workers’ compensation insurance to employers. It is common to hear stories of corruption and fraud when employer costs run high. This discussion can lead to cries of fraud, usually with fingers pointed towards claimants and often tied into efforts to reduce benefits to injured workers. As a recent example, take a look at the article published on July 23rd in the Fresno Bee, written by Dan Walters of CALmatters, titled “California workers’ compensation system plagued by high costs and fraud.” In the article, Mr. Walters points to Southern California as an area particularly afflicted by fraud, inserting the hot-button phrase “immigrant workers,” as follows:
There is always discussion, in every state, about the expense of workers’ compensation insurance to employers. It is common to hear stories of corruption and fraud when employer costs run high. This discussion can lead to cries of fraud, usually with fingers pointed towards claimants and often tied into efforts to reduce benefits to injured workers. As a recent example, take a look at the article published on July 23rd in the Fresno Bee, written by Dan Walters of CALmatters, titled “California workers’ compensation system plagued by high costs and fraud.” In the article, Mr. Walters points to Southern California as an area particularly afflicted by fraud, inserting the hot-button phrase “immigrant workers,” as follows:
Wednesday, February 8, 2017
Made by a robot...driven by a computer
The workers' compensation scheme is being challenged to potential extinction by the workplace in which it was created decades ago. Stressed by economic challenges that have been fueled by globalization and technology, workers' compensation benefit programs are now being dismantled by historic reforms that attack the core philosophical principles of its very existence.
The evolving dynamic of the world's automobile industry provides a focus on the new economy where goods are made by robots and operated by a computer.
Friday, April 8, 2016
The Difficult Task of the Florida Supreme Court
The Florida Supreme has before it a constitutional challenge once again concerning workers’ compensation. The scope of the controversy remains undefined and the ultimate impact equally uncertain. I have found over the years that one cannot predict the outcome of a case by merely watching an oral argument.
Thursday, October 10, 2013
California Workers' Compensation Reform: Is The System in a Ditch Now?
California is the sentinel jurisdiction for innovative decisional law, theory and statutory changes in workers' compensation. As goes California, so goes the nation. The changes to limit access are coming so quickly that perennial reform has become almost weekly now. The complexity is almost scary. Recent proposed modifications in the Independent Medical Review (IMR) process reflect what happens when statutory changes are not first vented with those who are major stakeholders, ie. injured workers and their representative. Commentary and analysis, continue to be kicked down the road as the system stalls and fails. Today's blog post is shared from http://blogs.sacbee.com.
[Click here to see the rest of this post]
Last year, the California Legislature -- with the blessing of Gov. Jerry Brown -- enacted its traditional, once-a-decade overhaul of the state's multibillion-dollar-a-year system of compensating workers for job-related injuries and illnesses.
Employers, insurers, medical care providers and other players in the workers' compensation system are still sorting through what the Legislature and Brown wrought. Generally, the overhaul, Senate Bill 863, raised some cash benefits but also tightened up eligibility for, or even eliminated, other benefits. This earned rare joint support from employer groups and labor unions, which had worked on the changes privately.  A new 16-state study of workers' compensation systems, covering 60 percent of the nation's workers, says it's too early to tell what the real-world effects of SB 863 will be, specifically whether its cost-saving provisions will offset the costs of increased cash payments, as its sponsors promised.Because the effects of the 2012 overhaul are still unknown, the study from the Workers Compensation Research Institute in Cambridge, Mass., concentrated its section on California on how it compared to other states during the years following the previous overhaul in 2004. It found that disabled California workers were receiving permanent partial disability payments more often than those in other major states and that those payments tended to be longer in duration -- thus confirming one of employers' complaints,... |
Saturday, August 24, 2013
Report Recommends Raising Workers' Compensation Premiums
Workers' compensation premiums in California should increase by 3.4% in 2014, according to a report by the Workers Compensation Insurance Rating Bureau, the Sacramento Bee's "Capitol Alert" reports.The report represents a non-binding recommendation for insurers (Walters, "Capitol Alert," Sacramento Bee, 8/12).BackgroundIn September 2012, Gov. Jerry Brown (D) signed into law a bill (SB 863) that overhauled the state's workers' compensation system.The law -- by Sens. Kevin de León (D-Los Angeles) and Jose Solorio (D-Anaheim) -- changed the formula used to calculate benefits for injured workers, increasing their compensation by an average of 29%. It also eliminated benefits for certain health conditions that often are subject to lawsuits, such as psychiatric problems, sexual dysfunction and sleep loss. |
Wednesday, August 21, 2013
Changes to California Insurance Don’t Help
| By Gordon Gibb | Fresno, CA: |
A California woman whose life has been described as “a living hell” blames the insurance underwriter, in association with her former employer, for leaving her high and dry with
denied disability insurance for the past eight years. Injured on the job in 2003, she was only paid benefits for two years. In spite of substantial evidence as to the woman’s disability, the insurer stopped payments, resulting in job loss and homelessness.
Guadalupe Ortega even had her children taken away from her, according to The Fresno Bee (8/6/13).
Ortega’s denied ERISA disability story is heart-wrenching. The one-time employee of Lyons Magnus of Fresno was injured on the job about 10 years ago, suffering injuries to her shoulder, neck and back. Her employer acknowledged that Ortega’s injuries were work-related and occurred on the job. Doctors having examined Ortega concur that the woman is 70 percent disabled.
Friday, August 16, 2013
Liberty Mutual FIles Suit in NY To Stop Elimination of Reopener Fund
An effort spearheaded by Liberty Mutual to thwart Governor Cuomo's effort to eliminate the NY State Insurance Fund's elimination. The Cuomo Administration has asserted that the move to close the Fund is necessary to save money and consolidate resources to avert unnecessary workers' compensation insurance premium increases.
"Liberty Mutual Group subsidiaries have filed a suit challenging New York’s decision to close a state workers’ compensation fund dealing with settled claims that are later reopened.
"The suit alleges that the decision by the governor and legislature, included as a component of the state budget for the next two years, will cost insurers and self-insured employers up to $1.6 billion in unfunded liabilities.
"However, an industry official experienced in the workings of the state’s workers’ compensation fund questions the viability of the suit.
Click here to read the complete article, "Liberty Mutual Group Subsidiaries Challenge Closure of N.Y. Reopened Cases WC Fund"
Read more about "NY workers' compensation" and reform
"Liberty Mutual Group subsidiaries have filed a suit challenging New York’s decision to close a state workers’ compensation fund dealing with settled claims that are later reopened.
"The suit alleges that the decision by the governor and legislature, included as a component of the state budget for the next two years, will cost insurers and self-insured employers up to $1.6 billion in unfunded liabilities.
"However, an industry official experienced in the workings of the state’s workers’ compensation fund questions the viability of the suit.
Read more about "NY workers' compensation" and reform
Mar 11, 2008
With Governor Spitzer now embroiled in a major scandal that may end in his resignation as Governor of the State of New York, all eyes in the workers' compensation arena are now focused on his reform efforts. On February ...
Aug 13, 2013
Note that following the 2004 reform, SB 899, defense fees skyrocket from $368 million in 2003 to nearly double at $642 million in 2006, while applicant attorneys, whose fees are largely pegged to permanent disability indemnity, lost some ground, but essentially remained flat. Things stabilize a bit after 2006 until 2011 when the lawyers on both sides, start ... N.Y. AG announces $600,000 agreement with masonry ... Plaintiffs' expert says lead paint abatement could.
Apr 23, 2013
Headlines screaming for “Workers' Comp Reform” are blaring in many states (CA,FL, NY, OH, NC, and most recently IL). In Illinois, the state's much-criticized system is under fire and legislation to totally dismantle the system is ...
Apr 13, 2011
Headlines screaming for “Workers' Comp Reform” are blaring in many states (CA,FL, NY, OH, NC, and most recently IL). In Illinois, the state's much-criticized system is under fire and legislation to totally dismantle the system is ...
Tuesday, August 13, 2013
Workers compensation hike on California employers proposed
Last year, the Legislature and Gov. Jerry Brown enacted a major overhaul of the state's multi-billion-dollar system of compensating workers for job-related injuries and illnesses, aimed at stabilizing its costs.
The Workers Compensation Insurance Rating Bureau, however, believes that premiums for insurance that most employers carry to cover claims for treatment and cash benefits still should rise next year.
The independent bureau announced that taking into account the legislation's changes, premiums should rise by 3.4 percent next year to an average of $2.62 per $100 of payroll.
The recommendation is not binding, and insurers in the highly competitive workers comp market can charge whatever they wish. State Insurance Commissioner Dave Jones also will weigh in with his recommendation.
The bureau also put another caveat on its recommendation - that it could be changed, depending on whether the state Division of Workers Compensation adopts a proposed new schedule of payments for physicians who treat job-related disabilities.
Last year's overhaul of the system, contained in Senate Bill 863, was a deal among most of the major stakeholders in the system, employers and labor unions most prominently. It followed a pattern of making major changes in the system roughly once a decade, usually after years of maneuvering by the major stakeholders.
The Workers Compensation Insurance Rating Bureau, however, believes that premiums for insurance that most employers carry to cover claims for treatment and cash benefits still should rise next year.
The independent bureau announced that taking into account the legislation's changes, premiums should rise by 3.4 percent next year to an average of $2.62 per $100 of payroll.
The recommendation is not binding, and insurers in the highly competitive workers comp market can charge whatever they wish. State Insurance Commissioner Dave Jones also will weigh in with his recommendation.
The bureau also put another caveat on its recommendation - that it could be changed, depending on whether the state Division of Workers Compensation adopts a proposed new schedule of payments for physicians who treat job-related disabilities.
Last year's overhaul of the system, contained in Senate Bill 863, was a deal among most of the major stakeholders in the system, employers and labor unions most prominently. It followed a pattern of making major changes in the system roughly once a decade, usually after years of maneuvering by the major stakeholders.
Sunday, July 28, 2013
The Oklahoma Opt-Out System is Bad Medicine for an Ill System
The newly enacted Oklahoma "Opt-Out" workers' compensation system has been urged by reformers as an effort to provide a more efficient and effective than its century old program enacted in the early 1900s. A comparison of the Oklahoma Opt-Out system to the New Jersey system reflects a limitation on litigation and a return to a more administrative program. Additionally, the opt-out system would provide for injured workers' choice of physician that ultimately could be blended into an employer based health program.
The changes are dramatic, and a major shift from the traditional based system such as New Jersey has followed since 1911.
Obviously the future statics will be reviewed by all stakeholders to determine if the Opt-Out System can really satisfy the concerns of all stakeholders or just a few.
Radical statutory changes to workers' compensation that have been limited to the interests of specific interest groups in the past have been met with disasters. The Opt-Out System of Oklahoma appears to be one of those programs, and has been bitterly contested by the advocates of injured workers.
In order for the creation of an optimal system of compensation to meet the socio-political-economic changes that are occurring in the world, all parties must sit at the table and work out a plan together. The Oklahoma Opt-Out system just appears to be bad medicine for a very ill system.
The Jersey System:
Case are heard by Compensation Judges nominated by the Governor and the system is administered under the Executive Branch of government. There are 50 Compensation Judges.
The Oklahoma Opt-Out System:
Starting on February 1, an administrative process with three appointed commissioners will replace the current court procedure with 10 judges for litigating workers’ compensation claims.
Temporary Disability Benefits
The Jersey System:
If an injured worker is disabled for a period of more than seven days, he or she will be eligible to receive temporary total benefits at a rate of 70% their average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20% of the SAWW. These benefits are provided during the period when a worker is unable to work and is under active medical care.The limit is 450 weeks. The maximum temporary disability rate for 2013 is $826.00.
Permanent Disability Benefits:
The Jersey System:
Partial Disability: When a job related injury or illness results in a partial permanent disability, benefits are based upon a percentage of certain "scheduled" or "non-scheduled" losses. A "scheduled" loss is one involving arms, hands, fingers, legs, feet, toes, eyes, ears or teeth. A "non-scheduled" loss is one involving any area or system of the body not specifically identified in the schedule, such as the back, the heart, the lungs. These benefits are paid weekly and are due after the date temporary disability ends.
Total Permanent Disability:
These weekly benefits are provided initially for a period of 450 weeks. These benefits continue beyond the initial 450 weeks provided that the injured worker is able to show that he or she remains unable to earn wages.
Wages earned after 450 weeks offset the weekly computation in proportion to the income at the time of the injury. Permanent Total benefits are paid weekly and are based upon 70% of the average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20% of the SAWW.
Permanent Total Disability is also presumed when the worker has lost two major members or a combination of members of the body such as eyes, arms, hands, legs or feet. However, permanent total disability can also result from a combination of injuries that render the worker unemployable.
The changes are dramatic, and a major shift from the traditional based system such as New Jersey has followed since 1911.
Obviously the future statics will be reviewed by all stakeholders to determine if the Opt-Out System can really satisfy the concerns of all stakeholders or just a few.
Radical statutory changes to workers' compensation that have been limited to the interests of specific interest groups in the past have been met with disasters. The Opt-Out System of Oklahoma appears to be one of those programs, and has been bitterly contested by the advocates of injured workers.
In order for the creation of an optimal system of compensation to meet the socio-political-economic changes that are occurring in the world, all parties must sit at the table and work out a plan together. The Oklahoma Opt-Out system just appears to be bad medicine for a very ill system.
New Jersey Traditional v Oklahoma Opt-Out
Hearing OfficialsThe Jersey System:
Case are heard by Compensation Judges nominated by the Governor and the system is administered under the Executive Branch of government. There are 50 Compensation Judges.
The Oklahoma Opt-Out System:
Starting on February 1, an administrative process with three appointed commissioners will replace the current court procedure with 10 judges for litigating workers’ compensation claims.
Temporary Disability Benefits
The Jersey System:
If an injured worker is disabled for a period of more than seven days, he or she will be eligible to receive temporary total benefits at a rate of 70% their average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20% of the SAWW. These benefits are provided during the period when a worker is unable to work and is under active medical care.The limit is 450 weeks. The maximum temporary disability rate for 2013 is $826.00.
The Oklahoma Opt-Out System:
Temporary disability payments will be reduced to 104 weeks instead of 156 weeks, with a cap at 70 percent of the state’s average weekly wage, about $540 per week.
Temporary disability payments will be reduced to 104 weeks instead of 156 weeks, with a cap at 70 percent of the state’s average weekly wage, about $540 per week.
Permanent Disability Benefits:
The Jersey System:
Partial Disability: When a job related injury or illness results in a partial permanent disability, benefits are based upon a percentage of certain "scheduled" or "non-scheduled" losses. A "scheduled" loss is one involving arms, hands, fingers, legs, feet, toes, eyes, ears or teeth. A "non-scheduled" loss is one involving any area or system of the body not specifically identified in the schedule, such as the back, the heart, the lungs. These benefits are paid weekly and are due after the date temporary disability ends.
Total Permanent Disability:
These weekly benefits are provided initially for a period of 450 weeks. These benefits continue beyond the initial 450 weeks provided that the injured worker is able to show that he or she remains unable to earn wages.
Wages earned after 450 weeks offset the weekly computation in proportion to the income at the time of the injury. Permanent Total benefits are paid weekly and are based upon 70% of the average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20% of the SAWW.
Permanent Total Disability is also presumed when the worker has lost two major members or a combination of members of the body such as eyes, arms, hands, legs or feet. However, permanent total disability can also result from a combination of injuries that render the worker unemployable.
The Oklahoma Opt-Out System:
Permanent disability payments will be reduced from 520 weeks to 350 weeks.
Choice of Treating Physician
The Jersey System:
The Jersey System:
None. Employer selected physician must be utilized.
The Oklahoma Opt-Out System:
Employees will be allowed to change treating physicians once so long as the selection is from a list of three doctors provided by the employer.
Arbitration or Alternate Dispute Resolution
The Jersey System:
None. All cases, including settlements, must be heard or reviewed by a Compensation Judge.
The Oklahoma Opt-Out System:
Employers can require arbitration as the exclusive way to settle claims and disputes with employees.
Tuesday, April 23, 2013
NJ Governor Christie to Propose Workers' Compensation Reform
The NJ Workers' Compensation system is in for a change. Governor Chris Christie of NJ is taking aim at reforming the NJ system.
In the past, unsuccessful major attempts to reform the State's workers' compensation
system have come from interest groups from outside of the State, ie. 1980's national insurance Industry (AIA) concerns. Now the focus is changing, and the proposals for reform will be coming from the the State's Chief Executive, a major coalition builder who has successfully tackled major legislative changes during his term in office.
In the past, unsuccessful major attempts to reform the State's workers' compensation
Historical efforts on workers' compensation reform in NJ have been:
-1974 Following the NJ State Commission on Investigation "Report of the NJ Workmen's Compensation System"
-1980's Following the WCRI Study attempt to adopt AMA Medical Guidelines
-1980's Following the WCRI Study attempt to adopt AMA Medical Guidelines
-1998 An attempt to increase the calculation of the State Average Weekly Wage, Dependency Benefits and Legislative Oversight
-2008 Following the NJ Star Ledger expose ("How NJ Fails Workers") on temporary and medical benefit issues
“'We’re going to be coming up with a package of proposals that’s going to work both sides of that,' Christie told a caller on his monthly NJ 101.5 FM radio show tonight.
'The employers who may not be stepping up and meeting their obligations and also the employees who are committing fraud on the worker’s comp system,' he said."
Click here to read the complete article: Christie to present plan to reform N.J. worker's compensation system (NJ.com)
“'We’re going to be coming up with a package of proposals that’s going to work both sides of that,' Christie told a caller on his monthly NJ 101.5 FM radio show tonight.
'The employers who may not be stepping up and meeting their obligations and also the employees who are committing fraud on the worker’s comp system,' he said."
Click here to read the complete article: Christie to present plan to reform N.J. worker's compensation system (NJ.com)
Sunday, December 2, 2012
The Hidden Cost of Jobs - Selling Fear
At great economic cost to taxpayers, governmental entities have desperately attempted to save jobs during the economic depression of our generation. The hidden costs to save jobs has been revealed in a story and database appearing in the NY Times today. The gamble in many jurisdictions just didn't payoff and now the taxpayers are subsidizing the costs.
"Over the years, corporations have increasingly exploited that fear, creating a high-stakes bazaar where they pit local officials against one another to get the most lucrative packages. States compete with other states, cities compete with surrounding suburbs, and even small towns have entered the race with the goal of defeating their neighbors."
"Over the years, corporations have increasingly exploited that fear, creating a high-stakes bazaar where they pit local officials against one another to get the most lucrative packages. States compete with other states, cities compete with surrounding suburbs, and even small towns have entered the race with the goal of defeating their neighbors."
Likewise, states have targeted workers' compensation insurance as a competitive giveaway incentive to industry, adding insult to injury for disabled workers, as a trade-off cost in order to save jobs. This has been an unfortunate experiment and has resulted in an unfortunately emsaculation of the entire workers' compensation benefit programs. The "giveaway," like the other governmental incentive efforts, has created more losers than winners, and and decimated workers' compensation.
Read the complete NY Times story Hidden Costs to Taxpayers As Companies Seek Tax Deals, Governments Pay High Price http://buff.ly/RtoiBk The Interactive Data
....
Read more about the "recession" and workers' compensation
Jon L.Gelman of Wayne NJ, helping injured workers and their families for over 4 decades, is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson).
Read more about the "recession" and workers' compensation
Feb 23, 2009
The present economic downturn has been compared to the Great Depression of the 1930's or the recession of the 1980's. The factors that existed during those financial cycles need to be compared to the present political and ...
Nov 06, 2009
Since the start of the recession in December 2007, the number of unemployed persons has risen by 8.2 million, and the unemployment rate has grown by 5.3 percentage points." "Among the marginally attached, there were ...
Jul 21, 2009
Compounding that predicament is the fact that the recession has eliminated 6.5 million jobs since 2007. Both higher levels of unemployment and a reduction in salary increases impact have a fiscal impact of the workers' ...
May 29, 2012
The Dewey & LeBoeuf bankruptcy was a long time coming as the firm simply failed to curtail its spending and partner dividends when clients were pulling back in the face of the recession. So I don't see Dewey & LeBoeuf as ...
Thursday, November 29, 2012
The Devil is in the Details California Style
When Workers Compensation was adopted in the United States after the European model of a benefit system for injured workers in the early 1900's, it was supposed to be a simple remedial system, The unfolding California regulatory process is highlighting, yet again, that the system is in major trouble, and that the glimmer of hope, in the name of reform, to revived it from live-support, is lacking credibility.
The administrative system of Workers' Compensation was built upon simplicity, efficiency, as a social insurance system, It was a process encouraged by Industry to avoid litigation in the civil justice system. Giving up the right to a trial by a jury was a big trade off for Labor back in early 1900's. The adoption of the system, through its poster child, the tragic Triangle Shirt Waist Fire in New York City, was emblematic of the need for a practical system to make things work, and preserve justice in doing so.
The California reform effort of this summer, SB 863, was pushed through by some elite and self-serving lobbying groups, to try to "level the playing field" in a State where economic upheaval forced it to the verge of bankruptcy. As it edged closer to its own fiscal cliff, it was about to take an ailing workers compensation program with it.
Those who practice workers' compensation law in California have just gotten used to complexity. They spend enormous time and effort navigating a a maze of bureaucratic regulations that are generated each reform cycle in the name of simplicity and efficiency.
The administrative system of Workers' Compensation was built upon simplicity, efficiency, as a social insurance system, It was a process encouraged by Industry to avoid litigation in the civil justice system. Giving up the right to a trial by a jury was a big trade off for Labor back in early 1900's. The adoption of the system, through its poster child, the tragic Triangle Shirt Waist Fire in New York City, was emblematic of the need for a practical system to make things work, and preserve justice in doing so.
The California reform effort of this summer, SB 863, was pushed through by some elite and self-serving lobbying groups, to try to "level the playing field" in a State where economic upheaval forced it to the verge of bankruptcy. As it edged closer to its own fiscal cliff, it was about to take an ailing workers compensation program with it.
Those who practice workers' compensation law in California have just gotten used to complexity. They spend enormous time and effort navigating a a maze of bureaucratic regulations that are generated each reform cycle in the name of simplicity and efficiency.
In promulgating Utilization Review Standards noted commentator David DePaolo, points out, "The fear of course is that regulations will end up either ineffective or unduly burdensome thus mitigating potential savings due to excess complexity."
The equation offered by the Rules simply just doesn't add up. They add more costs, fees and "independent extra-judicial parties," without time restrictions, to what is supposed to be a free and speedy process. Outsourcing justice is just taking another step away from the civil justice system and due process rights embodied in our Constitution.
After all these emergency regulations are promulgated, the California Legislature will again visit the system, and a new wave of reform will need to be considered. The devil in the details of the regulations will need to be reviewed. The next legislative cycle is anxiously awaited. Hopefully it will allow the legislature to be open to the suggestions and ideas of all stakeholders and a creatively new system will be entertained to handle medical delivery in the workers' compensation process.
....
Jon L.Gelman of Wayne NJ, is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson).
More about California and workers' compensation
After all these emergency regulations are promulgated, the California Legislature will again visit the system, and a new wave of reform will need to be considered. The devil in the details of the regulations will need to be reviewed. The next legislative cycle is anxiously awaited. Hopefully it will allow the legislature to be open to the suggestions and ideas of all stakeholders and a creatively new system will be entertained to handle medical delivery in the workers' compensation process.
....
Jon L.Gelman of Wayne NJ, is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson).
More about California and workers' compensation
Sep 13, 2012
Injured workers are voicing opposition to recently passed legislation in California to enact austerity measures to save the California workers' compensation from rising costs and expenses. The injured workers group is voicing ...
Aug 15, 2012
Rumors spread like wildfire this week as alleged secret back-room dealing continued in an effort to reform the failing California workers compensation system, yet again. The great trade-off of 2012 appears to be a major move ...
Sep 01, 2012
Tonight the California Legislature took an axe to its ailing workers' compensation system, as part of major election year austerity measures. Targeting both medical and legal costs of operating the program, at the ...
Jul 12, 2012
Insurance Commissioner Dave Jones today announced that a statewide joint task force in the fight against California's underground economy has netted contractors allegedly operating illegally, resulting in 104 enforcement ...
Saturday, September 1, 2012
California Takes an Austerity Axe to Workers Compensation
 |
| Governor Jerry Brown (Photo credit: Wikipedia) |
Click here to read: California Lawmakers Overhaul Workplace Insurance (Reuters)
Thursday, November 13, 2008
Workers' Compensation Medical Benefits are in Critical Condition
Now that Barach Obama is a going to be at the helm of the US, greater attention is being focused on the need for a national health care system incorporating workers’ compensation medical coverage. With private insurance companies failing, unemployment increasing, the cost of medical care soaring, more attention has now been placed on the elimination of medical care as a workers’ compensation benefit paid by Industry.
It is not all surprising that Dr. Peter Barth reported to the WCRI Conference in Boston, that workers’ compensation programs may be swept up into a national health care system. He reminds us that this was attempted in the Clinton proposal. The enactment of such a proposal looks even more urgent now.
The medical system overall is now being stressed by: an aging workforce; medical conditions manifested by stress and aging; consumerism in health care; the attempt to shift costs from major medical plans and CMS to workers’ compensation; new and expensive treatment modalities, procedures and pharmaceutical products,and the expansion of palliative and “end of life care.” It is anticipated that the average cost may amount to $500.000 per claim.
The workers’ compensation system just can’t deliver medical treatment quickly and cheaply enough. The systems are frough with administrative costs delay. It is adversarial requiring legal timetables of investigation, litigation, adjudication and appeals. The progress of disease is not subject to court rules or judicial administration. Immediate and emergent medical treatment protocols follow a biological timetable not a legal one.
National health reform that embodies workers’ compensation as an element is a long awaited solution to coordinate and advance the delivery of health care to all Americans. Old, inefficient and archaic systems need to be abandoned if progress is to advance. Moving forward to the inclusion of workers' compensation into a universal and nationalized program for health care is an important and innovative change. The change is crticial and necessary to advance with science, the economy and the social structure of America.
It is not all surprising that Dr. Peter Barth reported to the WCRI Conference in Boston, that workers’ compensation programs may be swept up into a national health care system. He reminds us that this was attempted in the Clinton proposal. The enactment of such a proposal looks even more urgent now.
The medical system overall is now being stressed by: an aging workforce; medical conditions manifested by stress and aging; consumerism in health care; the attempt to shift costs from major medical plans and CMS to workers’ compensation; new and expensive treatment modalities, procedures and pharmaceutical products,and the expansion of palliative and “end of life care.” It is anticipated that the average cost may amount to $500.000 per claim.
The workers’ compensation system just can’t deliver medical treatment quickly and cheaply enough. The systems are frough with administrative costs delay. It is adversarial requiring legal timetables of investigation, litigation, adjudication and appeals. The progress of disease is not subject to court rules or judicial administration. Immediate and emergent medical treatment protocols follow a biological timetable not a legal one.
National health reform that embodies workers’ compensation as an element is a long awaited solution to coordinate and advance the delivery of health care to all Americans. Old, inefficient and archaic systems need to be abandoned if progress is to advance. Moving forward to the inclusion of workers' compensation into a universal and nationalized program for health care is an important and innovative change. The change is crticial and necessary to advance with science, the economy and the social structure of America.
Sunday, October 7, 2007
California: Did Workers' Comp Reform Go Too Far?
Friday October 5, 2007
Did Workers' Comp Reform Go Too Far?
By Alan J. Wax
California employees have borne the entire brunt of the Governor's 2004 Workers' Compensation Reform (SB899). Studies by state agencies confirm that the benefits have been reduced by 50 to 70 percent. Even the U.S. Chambers of Commerce reports that California's benefits are among the lowest in the nation. The average maximum weekly permanent disability benefit for the nation is $595, compared to California, which is $270. Weekly benefits for permanently disabled workers in California are the fourth lowest in the nation. Balance this with the fact that California's cost of living is one of the highest in the nation. The insurance industry reports their profits for the last three years exceed the cost of all benefits combined. (Based on the Workers' Compensation Insurance Rating Bureau July 2007 Rate Filing and Summary of March 31, 2007 Insurer Experience)-
Here are some examples of California's ranking among the lowest in the nation compared to other states:
Loss of an eye: California ranks lowest in the nation!
Hearing loss in one ear: California ranks lowest in the nation!
Loss of a foot: California ranks second lowest in the nation!
Loss of a leg at hip: California ranks sixth lowest in the nation!
Loss of a thumb: California ranks seventh lowest in the nation!
(Source: "Analysis of Workers' Compensation Laws," U.S. Chamber of Commerce)
In a special hearing regarding the Reform, Senator Sheila Kuehl had admonished the then, Administrative Director Andrea Hoch by stating that there was no legislative intent to reduce "whole hog" the overall benefits, the then Chairman Richard Alarcon, stated it was his understanding "that [SB899] should not reduce benefits to injured workers." In fact, Governor Schwarzenegger was quoted as saying, "I never wanted to hurt any one of the workers or the people that get benefits," (Sacramento Bee, November 19, 2003). However, that is exactly what is being done by this reform.
SB 936 sponsored by Senator Don Perata, would help restore fair and adequate in small measure benefits for those who through no fault of their own become permanently disabled as a result of a work related injury and will not require any cost increase for employers. As permanent disability benefits represent only 13 percent of total benefits. This measure has been passed on a virtually unanimous vote of Senate and Assembly Democrats. This remedial bill partially corrects unintended 50 to 70 percent cuts in permanent disability compensation to injured workers. There are many problems with the workers' compensation reform dealing with limits on reasonable medical treatment, temporary disability benefits and vocational retraining. SB 936 would be a first step in trying to restore modest compensation to California's injured on the job.
Alan J. Wax, a Certified Specialist by the State of California in the area of Workers' Compensation Law, and a member of Board of Governors of the California Applicant's Attorney's Association is a partner with the law firm of Wax & Wax. He can be reached at (661) 255-9585. His column represents his own views, and not necessarily those of The Signal. "Business Law" appears Fridays and rotates between members of the Santa Clarita Valley Bar Association. www.SCVbar.org.
Did Workers' Comp Reform Go Too Far?
By Alan J. Wax
California employees have borne the entire brunt of the Governor's 2004 Workers' Compensation Reform (SB899). Studies by state agencies confirm that the benefits have been reduced by 50 to 70 percent. Even the U.S. Chambers of Commerce reports that California's benefits are among the lowest in the nation. The average maximum weekly permanent disability benefit for the nation is $595, compared to California, which is $270. Weekly benefits for permanently disabled workers in California are the fourth lowest in the nation. Balance this with the fact that California's cost of living is one of the highest in the nation. The insurance industry reports their profits for the last three years exceed the cost of all benefits combined. (Based on the Workers' Compensation Insurance Rating Bureau July 2007 Rate Filing and Summary of March 31, 2007 Insurer Experience)-
Here are some examples of California's ranking among the lowest in the nation compared to other states:
Loss of an eye: California ranks lowest in the nation!
Hearing loss in one ear: California ranks lowest in the nation!
Loss of a foot: California ranks second lowest in the nation!
Loss of a leg at hip: California ranks sixth lowest in the nation!
Loss of a thumb: California ranks seventh lowest in the nation!
(Source: "Analysis of Workers' Compensation Laws," U.S. Chamber of Commerce)
In a special hearing regarding the Reform, Senator Sheila Kuehl had admonished the then, Administrative Director Andrea Hoch by stating that there was no legislative intent to reduce "whole hog" the overall benefits, the then Chairman Richard Alarcon, stated it was his understanding "that [SB899] should not reduce benefits to injured workers." In fact, Governor Schwarzenegger was quoted as saying, "I never wanted to hurt any one of the workers or the people that get benefits," (Sacramento Bee, November 19, 2003). However, that is exactly what is being done by this reform.
SB 936 sponsored by Senator Don Perata, would help restore fair and adequate in small measure benefits for those who through no fault of their own become permanently disabled as a result of a work related injury and will not require any cost increase for employers. As permanent disability benefits represent only 13 percent of total benefits. This measure has been passed on a virtually unanimous vote of Senate and Assembly Democrats. This remedial bill partially corrects unintended 50 to 70 percent cuts in permanent disability compensation to injured workers. There are many problems with the workers' compensation reform dealing with limits on reasonable medical treatment, temporary disability benefits and vocational retraining. SB 936 would be a first step in trying to restore modest compensation to California's injured on the job.
Alan J. Wax, a Certified Specialist by the State of California in the area of Workers' Compensation Law, and a member of Board of Governors of the California Applicant's Attorney's Association is a partner with the law firm of Wax & Wax. He can be reached at (661) 255-9585. His column represents his own views, and not necessarily those of The Signal. "Business Law" appears Fridays and rotates between members of the Santa Clarita Valley Bar Association. www.SCVbar.org.
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