Workers' Compensation — An Important Right

The system of Workers’ Compensation was established in the early part of the 20th century. It was a compromise. Workers were guaranteed some compensation and coverage of medical costs if they were injured on the job, regardless of whom was at fault. In return, workers gave up their right to sue their employer for a work-related injury. Workers’ Compensation became the “exclusive remedy” — the only method for workers or their families to be compensated for the worker’s lost ability to work.

Over the past 15 years business groups, led by the insurance industry, have mounted strong campaigns in nearly every state to “reform” Workers’ Compensation. There are certainly many areas of the system that need reform. Employers’ insurance carriers routinely delay payments and authorization for medical treatment without penalty. Claims are arbitrarily challenged without good cause. And benefits, which are supposed to be approximately _ of the average weekly wage, have generally not kept pace.

Unfortunately the “reforms” sought by business groups have weakened workers’ protections and rights. Among commonly sought changes are laws which

1. Limit the time workers can receive benefits, even if they are disabled for life,
2. Classify certain injuries as “non occupational”,
3. Eliminate workers’ right to choose their own doctors instead of the employer’s doctor and,
4. Use inappropriate medical guidelines to decide whether and how much a worker is disabled.

Fraud
Much has been written about claimant fraud. We have all seen the supposedly disabled worker who is out on comp but is caught on film playing sports or working in the yard. Yet the insurance industry’s own studies confirm that worker fraud is a very minor part of the problem, accounting for only three to four percent of compensation fraud. Employer “premium fraud”, misrepresenting jobs and under reporting payroll, are much more significant factors. Unfortunately the stigma of fraud prevents many workers from filing for benefits they are entitled to.

As Workers’ Compensation systems around the country have become more unfriendly for claimants, more workers are going elsewhere for treatment of their work-related conditions. As a result, costs which should be paid by the employer’s insurance carrier are being borne by the workers themselves, their health insurance, union health funds or the taxpayers through Social Security Disability and Medicare.

Despite the delays and difficulties, there are several important benefits injured workers have through these programs:

Medical care related to treatment of the injury is free. There are no premiums; the coverage goes with you from job to job and continues after retirement.

An injury may cause problems long after it occurs. Benefits may be difficult to obtain if a case was not established when an injury first happens.

You don’t have to stop working to receive full Worker Compensation medical benefits.

Prevention
The best way to reduce Workers’ Compensation costs is to prevent injuries and illnesses at work. This can be done through effective health and safety programs that give workers and their union representatives a meaningful role in the process. And there is no reason why workers and their families should not receive compensation for lost ability to earn a living. Workers’ Compensation is an important right.