Tag Archives: ProPublica

‘Workers’ Comp Industrial Complex’ Cost-Containment Measures Harm Workers

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The National Workers' Compensation and Disability Conference & Expo in November featured a party with an acrobat, Hummer limos and a live alligator named Spike. Another workers' comp conference in August hosted a concert by Joan Jett & the Blackhearts. (Clockwise from top left: Michael Grabell/ProPublica, Artemis Emslie via Twitter, Tom Kerr via Twitter, Jamie Gassmann via Twitter)

The National Workers’ Compensation and Disability Conference & Expo in November featured a party with an acrobat, Hummer limos and a live alligator named Spike. Another workers’ comp conference in August hosted a concert by Joan Jett & the Blackhearts. (Clockwise from top left: Michael Grabell/ProPublica, Artemis Emslie via Twitter, Tom Kerr via Twitter, Jamie Gassmann via Twitter)

It is the beginning of a new legislative year in the United States. State legislatures will face the latest versions of “reforms” to workers’ compensation laws from business and insurance interests. They will renew their annual claims that the proposals benefit workers while coincidentally lowering or containing costs for employers and insurers. I wish these people would be honest about their real intentions. Cut the **** or to quote Monday Night Football: “COME ON MAN!”

A recent expose on the “workers’ comp industrial complex,” is a must read for all who care about injured workers and their rights. ProPulica author Michael Grabell describes the   “workers’ comp industrial complex” as a loose association of insurance and business groups and cost-containment companies, which are being bought and sold for billions of dollars in profits. Meanwhile, workers and their representatives fight endless legislative battles to prevent more benefits reductions and added obstacles to collecting those benefits. 

“… Over the past two decades, a cottage industry of middlemen has emerged, which some have dubbed the ‘workers’ comp industrial complex.’ Even private equity firms have bought in, seeing profit opportunities in employers’ and insurers’ quest to contain spending.

“The middlemen offer an array of services, from managing claims to negotiating medical bills, all promising to reduce costs — although critics say some actually raise them, as well as the burden on those hurt on the job.”

This ProPublica article shows the HUGE business opportunities some see in workers’ compensation. But these efforts will not help the injured worker, because cost containment means reduced benefits, stalling, denied claims, and working the system to delay, all at the expense of the injured worker and often his or her long-term health.

Respected workers’ compensation commentator David DePaolo, writes a column called “DePaolo’s Work Comp World” at workcompcentral.com, a website that bills itself as “Workers’ Compensation Education, Courses, News and Information.”

One of his recent articles, titled “Stop The Fantasy,” takes the notion of cost containment to task, and he also writes his views on the state of how “the media” cover workers’ compensation.

“Workers’ compensation should not be mysterious, should not be hiding, and should be exposed to the public good or bad, because it is for the public – each and every person that works in this country should be afforded reasonable work injury protection. It’s good social policy. It’s good economic policy.”

This focused quote from DePaolo’s commentary regards the “workers compensation industrial complex” that ProPublica took to task, where DePaolo really questions the need for and philosophy of this part of the workers’ compensation system.

“Cost containment is an apt term if we, as an industry, are willing to accept its definitional reality – that the intent of cost containment is to save money for those who are paying it out,” DePaolo wrote in his article.

“Let’s stop with the fantasy that cost containment is for the benefit of injured workers. It’s not. Otherwise it would be called something else. That cost containment paradoxically results in medical treatment that should cause better outcomes is not the paramount reason for these businesses.

“We all know that – so let’s stop trying to pretend that it is something which it is not.

“If the services are intended to benefit injured workers then there should be a better term for those services that should reflect that beneficial treatment,

“Maybe we’re misunderstood. Maybe our good intentions aren’t appreciated.

“But maybe cost containment really is an accurate term – and at whose expense?” 

Cost containment appears to be both big business and big money, from the extensive ProPublica article. Here are two paragraphs that explain the spoils that people could win or received at just one of the “more than 150 workers’ comp conferences a year.” 

“… For three days in November, hundreds of vendors wooed insurers and employers with lavish after-hours parties, giveaways of designer handbags, photos with Olympic gymnast Kerri Strug, and free rides in orange Hummer limousines. … Vendors gave away Apple watches, bottles of bourbon, and a Vespa scooter. There were free massages and shoeshines, a superhero caricature artist, more than one mentalist, and a live alligator named Spike.”

After all this excitement, the ProPublica article explains how much of workers’ compensation premiums that insurers in California spent on overhead – 36 percent – and how “the amount of money that insurers spend on medical cost containment programs has more than doubled from $197 million in 2005 to $471 million in 2014, according to the state workers’ comp ratings bureau.”

Some people involved in the fancy exposition included the following, quoted from ProPublica.

“There were companies that provide networks of doctors and companies that review medical bills, firms that provide expert medical opinions and firms that specialize in complex claims. There were defense lawyers, data processing firms, rehab facilities, surveillance companies, outside claims shops, occupational medicine clinics, pain management services, translators, schedulers, headhunters and associations promoting other conferences.

“There were labs that test injured workers’ urine for illegal drugs. There were even labs that test urine to ensure workers are taking the prescribed drugs instead of selling them.”

Now, because of the profit potential in “cost containment” (this is a phrase that should make people groan, as I did), “private equity firms have gone on a buying spree,” according to ProPublica, resulting in little-known players outside the workers’ compensation system becoming “powerful players in determining the future of how injured workers are treated.” 

“Increasingly, though, decisions to deny care aren’t being made by workers’ employers or insurers, but by these myriad claims administrators, managed care companies and cost-containment firms. Some industry observers say the firms have added a layer of cold bureaucracy to an already complicated system,” according to the ProPublica article.

I could provide more quotes and details from the articles, but as I wrote initially in this post, both the ProPublica and DePaolo’s articles are essential reading material for those who care about workers, how society treats workers, and who helps workers, especially when they’re injured. Because the system that’s supposed to help those who get hurt at work, workers’ compensation, is often bloated, confusing, and full of those (like folks working in cost containment) whose focus isn’t necessarily to either help injured workers heal, get back to work, or move on with their lives, but muddle the process instead.

We cannot match the resources of the “workers’ comp industrial complex,” but our cause to serve injured workers by getting them the prompt, quality medical treatment they need and deserve is just, and we must keep fighting the good fight!

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Insurance, insurance regulation, Money, Workers' Compensation, Workers' Compensation Reform and tagged , , , , , , .

States with Opt-Out Workers’ Comp System are Strict on Injured Workers

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Dallas attorney Bill Minick (Photo credit Dylan Hollingsworth for ProPublica)

Today’s post was written by guest author Hayes Jernigan, from The Jernigan Law Firm in North Carolina. In 2015, ProPublica and NPR have done a great service to the public by making in-depth reports on workers’ compensation systems in many states. Their most recent focus was looking at the opt out systems implemented Texas and Oklahoma. These similar systems essentially strip workers of the protections that workers’ compensation gives, stacking the deck dramatically toward employers and their insurance companies.

Fortunately, Nebraska is not an opt out state yet. But many Nebraska employers, especially those who are self-insured for the purposes of workers’ compensation, have adopted many tactics from opt out states. I think the most prevalent tactic is hoodwinking employees into filing for short- or long-term disability when an injury should be covered by workers’ compensation. Employees often unknowingly agree to this in situations where the work duties aggravated an old injury or pre-existing condition or if there is some minor delay or defect in reporting the injury. If you sign up for private disability insurance, you are often asked to deny that your disability is work related. That can doom any possible workers’ compensation claim in the future. If you are being asked to sign up for long-term or short-term disability for a medical condition that may have been caused by work injury, contact a workers’ compensation attorney.

Texas and Oklahoma have both adopted an “opt-out” system for Workers’ Compensation. ProPublica along with NPR recently published an in-depth look at the results in these two states. Under this system, employers can opt-out of state mandated workers’ compensation insurance by creating their own policy for injured workers. These employer-written policies give employers 100% control over the terms, the benefits, and even settlements.

Specifically, ProPublica and NPR found that these employer-created policies generally have strict 24-hour reporting requirements or even require an injury to be reported by the end of a shift. This means, if an employee does not report their injury within their shift, or within 24 hours, they are prevented from bringing a claim at all. Period. End of discussion. Employers can also dictate how much benefits will be paid and some employers have capped death benefits for employees who are killed at work at $250,000. Whereas under the State Workers’ Compensation system, if a deceased worker leaves behind minor children, they will continue to receive benefits until they turn 18 (which could easily end up being well over $250,000 when you factor in lost wages until the worker would have been 65). This is potentially detrimental to a young widow or widower who is left with very young children.

This morning we tweeted a recent ABC news article that a worker was killed when he fell at a construction site in Charlotte. I’d hate to think that his or her family would be limited to recovering only $250,000 in the event the worker left behind dependent family members and young children. Money can’t begin to replace someone who is lost to us too early from an accident at work, but $250,000 would hardly cover a lifetime of income that the family will lose, especially if young children are left behind.

 

To read more on how the Opt-Out system is affecting injured workers in Texas and Oklahoma, go to: ProPublica: Inside Corporate America’s Campaign to Ditch Workers’ Comp.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Government, Legislation, Workers' Compensation and tagged , , , .

Workers’ Compensation ‘Reforms’ by State Have Costs, Too

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This ProPublica/NPR series should be required reading for all who care about workers’ compensation and how the process really works – or doesn’t work – for those who are injured on the job. The series shows the very real cost to loved ones when the system doesn’t hold up to the workers’ compensation “grand bargain” that was entered into more than a century ago in many states, including Nebraska. Families are hurt economically, and necessary role changes occur when a spouse and/or children become caretakers, which is often the case. 

Today’s blog post is focused on an excellent and informative, but very sobering, interactive chart that looks at how workers’ compensation “reforms” by state are occurring.

I found the introductory paragraph for the chart enlightening and honest:

“Over the past decade, states across the country have been unwinding a century-old compact with America’s workers: A guarantee that if you are injured on the job, your employer will pay your medical bills and enough of your wages to help you get by. In all, 33 states have passed laws that reduce benefits, create hurdles to getting medical care or make it more difficult to qualify for workers’ comp.”

When benefits are reduced and medical care is denied, the burden of caring for injured workers shifts to taxpayers through social programs because the workers’ compensation system has all too often come up short. This results in taxpayers subsidizing injured workers on the local and state levels through healthcare and the social safety net. At the same time, workers’ compensation insurance premiums for businesses are at their lowest rate in 25 years, partially because the “reformed” workers’ compensation systems can save businesses money while avoiding the costs of caring for these hurt workers.

I urge you to spend some time on the interactive graphic and see where your state stands in its support of injured workers. Although the firm’s lawyers are licensed in Nebraska and Iowa, we work with many who are injured in other states as the need arises and have an extensive network of lawyers who we work with on workers’ compensation, especially focusing on representing truck drivers.

This blog will feature continued commentary and analysis on the ProPublic/NPR report, as was first addressed last week. But if you have specific questions about an injured worker’s situation and need help or are unsure what the next steps are, please contact an experienced workers’ compensation attorney like those at Rehm, Bennett & Moore.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Workers' Compensation Reform and tagged , , , , , , .

Examining Workers’ Compensation Costs to Employers

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Source: Bureau of Labor Statistics National Compensation Survey 1991 - 2014 (Credit: Sisi Wei/ProPublica)

Source: Bureau of Labor Statistics National Compensation Survey 1991 – 2014 (Credit: Sisi Wei/ProPublica)

Business and insurance interests are bombarding state legislatures every day of the week to take workers’ rights away by complaining how most states’ workers’ compensation systems are too expensive.

Recently, ProPublica and NPR produced a very detailed explanation of the state of workers’ compensation, focusing, rightly so, on injured workers. This article, which was the first in the series, included an interactive graphic that showed that even though business are complaining about rising premius, workers’ compensation insurance coverage is generally at its lowest rate in 25 years, “even as the costs of health care have increased dramatically,” according to the article.

As examples, using the average premium cost to the employer per $100 of workers’ wages, Nebraska employers paid $1.93 in 1988, while they actually paid $.15 less for the premium in 2014, for a total of $1.78 per $100 of workers’ wages, according to the chart. Iowa was more dramatic, with the price of workers’ compensation insurance $2.79 per $100 of workers’ wages in 1988. It went down $.91 to $1.88 per $100 of workers’ wages in 2014.

By scrolling down in the article, a person finds another graphic that shows how employer costs have risen for other categories, but have fallen for workers’ compensation. Most notably, the cost of workers’ compensation insurance coverage (per $100 of workers’ wages) went from $2.71 in 1991 to $2.00 in 2014. During the same timeframe, the cost of health insurance went from $8.55 to $12.52 and the cost of retirement benefits went from $5.50 to $7.29, all per $100 of workers’ wages, according to the chart in the article.

The offices of Rehm, Bennett & Moore and Trucker Lawyers are located in Lincoln and Omaha, Nebraska. Six attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 90 years of practice representing injured workers and truck drivers in Nebraska and Iowa in state-specific workers’ compensation systems. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers’ Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), and the Nebraska Association of Trial Attorneys (NATA).  We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Government, Iowa, Legislation, Nebraska, Workers' Compensation, Workers' Compensation Reform and tagged , , , .