“The Fallout of Workers’ Comp ‘Reforms’”: The impact of benefit rollbacks on injured workers

March 26, 2015

"The Fallout of Workers’ Comp ‘Reforms’”, a summary of ProPublica findings

Gary Fury tore his rotator cuff and ruptured his bicep at work in July 2012 and didn’t receive the surgery his doctor recommended “ASAP” until January 2013.

 

“They just don’t know how much pain I sat for six months in waiting to get surgery,” he said.

 

In this latest installment of ProPublica’s in-depth report about the dire state of workers’ compensation, the stories of individuals who have felt the impact of so-called workers’ compensation reforms are featured in harrowing detail. Injured workers don’t just battle to regain their health or adjust to living with new disabilities – they also have to battle a system that is heavily stacked against them.They are forced to survive on a fraction of their previous wages, wait extended periods of time for benefits without another source of income, and have essential medical treatments postponed as their cases are reviewed by multiple doctors.

 

Temporary benefits leaving workers in poverty

 

There are 22 states that have set time limits on workers’ comp benefits for temporary injuries, meaning after a set amount of time benefits will stop even if the injured worker hasn’t recovered. In Fury’s case, he was struggling to make ends meet when his benefits stopped and he was still recovering from his injury while out of work.

 

“It got down to the point where I had to go get help, like from what they call welfare,” Fury said. “That was so embarrassing for me. You know, you’re used to working all your life. I raised two kids and never had to be on there. Sometimes, it really degraded me to go to a grocery store and you had to pull out your card instead of pulling out your cash — all because you’re an injured worker.”

 

Placing the blame on pre-exisiting conditions

 

Source: ProPublica

Source: ProPublica

 

A huge trend in workers’ comp has been the increased use of pre-existing conditions to limit or deny care after workplace injuries. Even when medical and empirical data strongly indicates otherwise, insurance companies have pressed hard to have work injuries unjustly misfiled as pre-existing conditions. ProPublica found that 10 states since 2003 have increasingly allowed insurance carriers to deny claims of injuries that have aggravated pre-existing conditions. In Florida, injured workers may have to pay up to 49 percent of their medical costs if their insurance carrier deems that they had a pre-existing condition, even if their injury was work-related.

 

Limiting access to your own doctor

 

 

New laws have limited workers’ abilities to choose their doctor, and what care they can receive. There are 18 states that allow employers to select doctors to treat injured workers initially and 19 states that require workers to choose from a list of doctors their employer provides.

 

Christopher Carter required a simple cortisone shot to reduce pain in his injured foot, according to the first doctor he saw. Three doctors and two years later, he still had not received the shot because in Montana insurance companies can transfer injured workers to new doctors at any time. This further exemplifies that workers’ compensation system throughout the U.S. is not focused on providing workers with quality medical care.

 

Read the full article here.

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