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Workers Compensation Reform

Workers Compensation Reform
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Various states have undertaken efforts to reform their workers' compensation system, usually with assurances that the changes will be beneficial to businesses and to workers. But as these examples prove, that's rarely the case.

California

Beginning in 2000, skyrocketing workers' compensation insurance premiums forced legislators in California to consider reforming the state's workers' compensation system. In 2002 and again in 2003, then-governor Gray Davis signed two reform bills that increased benefits, changed the rules for medical treatment and lowered vocational rehabilitation costs.

But insurers resisted lowering their rates, and Arnold Schwarzenegger campaigned on a platform that more reforms were needed. He was strongly supported by businesses, and after taking office, he won legislative support for his harsh reform package.

The resulting reforms have been mostly favorable to the insurance companies. Workers' compensation premiums in California remain the second highest in the nation, and injured workers have seen dramatic reductions in benefits available to them.

According to a report released by the California Labor Federation in 2007:

  • Frequency of workers' compensation claims has dropped almost continuously over the last 15 years. Workers' compensation changes that have made it harder for injured workers to access benefits have pushed the frequency of claims even lower.
  • Deregulation of the insurance market caused the crisis in workers' compensation. The repeal of the minimum rate law in 1993 resulted in predatory pricing and the insolvency of 32 insurance companies. Employers skyrocketing costs, beginning in 2000, resulted from insurers' irresponsible pricing after deregulation.
  • Insurers are now making historic profits. In 2005, their loss ratio was 30%. That is, for every dollar collected in premiums, insurance companies are only paying out 30 cents in benefits. Companies have never enjoyed such large profit margins.
  • Employers are saving $11 billion to $12 billion a year in workers' compensation costs out of a total system cost of $29 billion.
  • Permanently disabled workers face 50 percent cuts in permanent disability benefits. Total permanent disability dollars have been slashed by two-thirds.
  • Temporarily disabled workers face strict time limits on their benefits. They are being forced to rely on group health insurance and state disability insurance, a benefit they pay for themselves.
  • Medical treatment is being delayed and denied by insurance companies applying utilization review and strict interpretations of medical treatment guidelines. These reviews of employer chosen doctors are creating more friction and costs for the system and delaying care for workers.
  • Incentives to return injured workers back to work are inadequate.

Texas

In 2005, the Texas legislature approved a sweeping overhaul of the state's workers compensation, the first reform in 14 years. The changes were spurred by employer complaints about skyrocketing medical cost and rising insurance premiums.

Texas is the only state that doesn't require employers to buy workers' compensation insurance, and slightly more than a third have opted out. Those that do, however, face unlimited legal liability when an employee is injured on the job.

The 2005 reforms in Texas resulted in these changes:

  • The six-member Texas Workers' Compensation Commission was eliminated and replaced by the Texas Department of Insurance through the Division of Workers Compensation.
  • The Office of Injured Employee Counsel was created to serve as an advocate for injured workers.
  • The new law allowed employers to dictate where injured workers could receive treatment. Under the Texas system, employers can designate a medical provider network, which employees must use for workers' compensation medical care. Employers do not have to designate a medical provider network.
  • The waiting period for Temporary Income Benefits was reduced from four weeks to two weeks.
  • Tougher eligibility standards for Supplemental Income Benefits. To be eligible to receive benefits, injured workers must prove that they are actively involved in a vocational rehabilitation, actively searching for work through the Texas Workforce Commission or provide copies of job applications
  • Elimination of the Hazardous Employer Program. Previously, the state identified employers with high injury rates and required them to hire a state-approved consultant to help reduce the number of workplace injuries.

Florida

In response to business complaints about high workers' compensation costs, Florida enacted a workers' compensation reform bill in 2003. At the time, Florida's workers' comp costs were the second highest in the nation.

In the five years since the reforms took effect, those costs have dropped by more than 50 percent. Florida's workers' comp costs are now 45th in the nation, and they continue to drop - 18.4 percent in the last year alone.

However, the cost reduction has come with a huge cost that in essence victimizes injured workers.

One of the most controversial provisions of the 2003 Florida reform package involved capping fees for attorneys who handle workers' compensation cases, no matter how many hours they put in. Previously, judges in Florida had discretion in determining fees and typically based them on the number of hours that the attorney had worked on the case.

Now, when a client wins a workers' compensation claim, the attorney may collect a fee equal to 10 percent to 20 percent of that award. Because of this, attorneys are turning away legitimate cases because they are too costly and too time consuming to take on. Some injured workers have literally been denied the right to have an attorney represent them in the workers' compensation claims.

The issue has been brought to the attention of the Florida Supreme Court, which has been asked to overturn the section of the state's workers' compensation statutes that limit attorneys' fees.

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