Insight, analysis & opinion from Joe Paduda

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Oct
3

The Department of Labor’s report on workers’ comp

Is set for release at a public meeting in Washington this Wednesday, October 5, at 10 AM. While the content has been closely held, sources indicate topics  include:

  • increasing inadequacy of benefits,
  • restrictions on medical care for injured workers,
  • new procedural processes and hurdles for claimants, and
  • the effect these trends have had on Social Security Disability Insurance.

There will also be a discussion of Opt-Out; DoL’s Employee Benefit Security Administration has been looking into opt-out alternative plans and their compliance with ERISA.

We do not yet know what the report will say about these topics, however a close reading of OSHA’s March 2015 report provides some clues.  Actually, the title alone may be predictive:

ADDING INEQUALITY TO INJURY: THE COSTS OF FAILING TO PROTECT WORKERS ON THE JOB

A paragraph from the report’s Executive Summary follows:

The costs of workplace injuries are borne primarily by injured workers, their families, and taxpayer-supported components of the social safety net. Changes in state-based workers’ compensation insurance programs have made it increasingly difficult for injured workers to receive the full benefits (including adequate wage replacement payments and coverage for medical expenses) to which they are entitled. Employers now provide only a small percentage (about 20%) of the overall financial cost of workplace injuries and illnesses through workers’ compensation. This cost-shift has forced injured workers, their families and taxpayers to subsidize the vast majority of the lost income and medical care costs generated by these conditions. [emphasis added]

Another paragraph speaks to under-reporting of workplace injuries and illnesses:

While the estimate of three million serious work-related injuries each year may seem extremely high, it is undoubtedly only a fraction of the true number. Numerous studies provide documentation that many, and perhaps the majority, of work-related injuries are not recorded by employers, and that the actual number of workers injured each year is likely to be far higher than the BLS estimate

The meeting, entitled the State Workers’ Compensation Forum (you can attend or sign up for the video feed by registering here) will include representatives from the National Academy of Social Insurance and the Social Security Administration (I am a member of NASI but have had no involvement with this initiative).

Suggestions and observations. 

  1. Remain calm.
  2. It’s important to read the entire report.
  3. Have an open mind.
  4. Under-reporting of claims is good news for the workers’ comp “industry” as it creates:
    1. more incentive for safety and loss prevention,
    2. more opportunities for vendors,
    3. more premium for workers’ comp insurers, and
    4. likely better outcomes due to professional management of injuries and illnesses by work comp payers.

 

 


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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