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Would you want your family covered by Opt Out?

Today’s WorkCompCentral brings an editorial on the “trend” in some state capitals towards plans legitimizing opting out of workers compensation.  Friend and colleague Peter Rousmaniere has done more research and investigation of opt-out programs than anyone else I know.

He knows of what he speaks, and his view of opt out is one we work comp folks should carefully consider.  His reporting on Oklahoma, overall trends, and progress to date are clear evidence of Peter’s expertise.

Among Peter’s concerns are:

  • the requirement that employees report injuries within 24 hours.  Peter notes there’s no good reason for this requirement.
  • Very low wage replacement levels, so low that higher-compensated employees may well be discouraged from filing claims
  • plan documents that are indecipherable
  • documents pertaining to individual claims that prohibit injured employees from sharing the document with anyone.
  • opt out plans being considered in several states may well violate ERISA.

It is important to note that many employers opting out in Texas are doing so responsibly, however the new efforts promoted by AAWC are anything but.

The net is this – would supporters of these programs want their family members covered by these plans?

Pro Publica published an extensive review of opt out; it is damning however in my view it suffers from a lack of credibility coming from its biased, slanted, and in many cases patently false “reporting” on workers comp.

What does this mean for you?

AAWC’s opt out promotion smacks of continuing a race to the bottom, adding yet another insult to working people.  If AAWC is really interested in doing right by workers it sure has a strange way of showing it.


4 thoughts on “Would you want your family covered by Opt Out?”

  1. “the requirement that employees report injuries within 24 hours. Peter notes there’s no good reason for this requirement.”

    I’d think the reasoning for this would be so that you can more safely conclude that the injury occurred at work. Is that not reasonable? It seems reasonable to me, but maybe I’m missing something.

    1. Brian – thanks for the note.

      The issue – as I understand it – is it is not always possible to report an injury within that time period. The injury may appear slight but get worse over time, the worker may go home for the weekend hoping to be better by monday only to discover s/he isn’t, the reporting process itself can be flawed, the injury may be due to repetitive motion, it may be an occupational disease, the injury may be catastrophic so the worker may be incapacitated, and myriad other reasons.

  2. I think Brian’s point is that there are plenty of good reasons for the 24 hour requirement. Joe’s point is that there are exceptions, and they seem valid.

    Isn’t it easy enough to come up with a policy that requires 24 hour reporting of injuries and allows for exceptions, and then list them?

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Joe Paduda is the principal of Health Strategy Associates



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