Insight, analysis & opinion from Joe Paduda

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Nov
1

Kafka was a work comp attorney

Yes, it’s true. And if he wasn’t a half-bubble off plumb when he started, he certainly was after spending a few years behind his desk at a workers comp insurer.
Franz Kafka worked for the Workers Accident Insurance Company, and is credited by no less a personage than Peter Drucker with invention of the hard hat. (with perhaps little support for that assertion)
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For anyone who slept thru, or has been trying to forget those weird, more-than-slightly bizarre stories of man-waking-up-as-a-cockroach, or Trials held in low-ceilinged-rooms with death as the inevitable result, it may be time to dust off the college English anthology and revisit once again Kafka’s world.
Why?
Kafka can’t be any stranger (sorry, Camus fans) than today’s work comp world.
Kafka’s literary ‘angle’ has been discussed and debated for decades. Some think his work focuses on people’s tendency to invent their own struggles. Others interpret Kafka differently, believing much of his work describes the futility of existence, the hopelessness that comes from a complete lack of control over one’s own future.
Perhaps most believe Kafka was more interested in the absurdity of bureaucracy and law, the overwhelming focus on process and following rules, no matter how ridiculous or pointless, and the primary importance of the process over the outcome, the proveeding over the result. Several of his writings centered on, or included significant reference to, legal proceedings – the Trial the most obvious.
Today, we have workers comp – supposedly designed to remove lawyers from occupational injury and reimbursement for same – heavily influenced by lawyers for plaintiffs, defendants, and myriad other legal hangers-on.
– We have lawyers, for reasons known only to themselves, pushing drugs on their clients.
– We have employers neglecting to, or actively discouraging – the reporting of occupational injuries.
– We have medical fee schedules that discourage certain types of treatment while wildly overpaying for others.
– We have court hearings that drag on, and on, and on, marked by discussions seemingly unrelated if not completely foreign to the subject at hand.
– We have judges deciding that contracts signed by providers aren’t legal, even though the language was clear and the providers didn’t have any guns pointed at them at the time of signing.
– We have managed care contracts that reward managed care vendors, and managed care execs for sending injured workers to providers that bill a lot – and often.
– We have payers arbitrarily denying coverage for procedures one day, and approving the same procedure, for a claimant with similar injury the next.
And that’s just what I can think of in a few quick minutes; there are many more instances that amplify the absurdity inherent in this industry.
But, if nothing else, we can thank workers comp for helping Franz Kafka become one of the last century’s most creative fiction writers. Yet one has to wonder, who in the industry will become the next great author? Who has both the literary talent and has experienced enough career-provided absurdity to become the ‘next’ Franz Kafka?


Joe Paduda is the principal of Health Strategy Associates

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A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.

 

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