Monthly Archives: February 2011

Illinois Speaker of House joins clamor for investigation; Washington state’s system may face bankruptcy

In Montana, workers’ comp reform is leaning toward reducing benefits for injured workers

As a follow-up to our preceding post,  we see that a top-ranking legislator in Illinois has joined with other lawmakers calling for an investigation of the state workers’ compensation program.

According to a Feb. 26 article at, “Illinois House Speaker Michael Madigan has introduced a bi-partisan resolution calling for an audit of the Illinois Workers’ Compensation program ‘as it applies to state employees.’

“The resolution, H.R. 131, was filed Thursday and is co-sponsored by state Reps. Tom Holbrook, D-Belleville; Dwight Kay, R-Glen Carbon; and Frank Mautino, D-Spring Valley.”

Resolution calls for a deep dig into the workings of the system

The overall resolution comprises eight sub-parts, extending the audit to include, but not be limited to:

  • the roles of three separate agencies, including the Attorney General’s office and the Illinois Workers’ Compensation Commission in processing, reviewing, determining, and paying on workers’ compensation claims filed by State workers
  • the number of claims filed by State workers during the last 4 years, including a classification of the types of alleged injuries, employing unit, disposition, and claims payments.

The other six areas range from reviewing the settlement process and  analyzing fraud policies to analyzing arbitrator caseloads and reviewing conflict of interest practices. Besides the audit, calls also have been made for a federal probe.

From emergency hikes to peeks at bankruptcy in Washington

Another story we’ve been following is the fight in Washington state over workers’ comp, which The Seattle Times calls “one of the most contentious issues in the legislative session.” In February, an emergency rate hike was pushed through, and in January the governor was being praised for a “bold plan” to revamp the system.

Now, despite progress on different bills, officials are saying hard choices loom ahead, with chances of having a bankrupt system within five years, according to a Feb. 26 piece in the Seattle Post Intelligencer, which reports that the governor, “the head of the state Department of Labor and Industries and the state auditor have all said the system is heading toward bankruptcy. In a December report, the auditor’s office said the state’s fund for workers compensation has a 95 percent chance of becoming insolvent in the next five years.”

The Seattle Times story says, “Workers compensation is closed-loop insurance system in which businesses pay payroll taxes, and the state invests the money. But the state’s accident fund is in the red for $275 million.”

Pensions…and the governor’s plan

As in a variety of states around the country, pensions are a sticking point in this fight.

According to The Olympian, “Gregoire and L&I’s proposals include House Bill 2002, which labor supports. It is an Oregon-style approach that pays an incentive to small businesses of up to 50 percent of a worker’s wage if they let the worker return for limited duties while mending from injuries.

“But Gregoire and L&I also want to limit lifelong disability pensions. Business groups have complained about those costs for years, but they haven’t persuaded the Democrat-controlled House and Senate to give them relief from what they contend are expensive pensions.”

L&I director Judy Schurke told the paper that  “the system could save $720 million over four years if all four elements of the governor’s reform are approved. ‘All I can tell you is the governor is very committed to it,’ Schurke remarked at the time.”

Montana’s injured workers could be a casualty in reform battle

In another follow-up, the battle in Montana seems to have simmered down–at a cost to injured workers. A Feb. 23 report from a news site in Kalispell, MT, says that “The Montana House of Representatives on Wednesday put the final stamp of approval on a bill aimed at reforming the workers compensation system.

“Legislators brought two competing bills this session. State Senator Ryan Zinke (R-Whitefish) is carrying the first bill which saves money by cutting provider rates. State Representative Scott Reichner (R-Bigfork) is carrying the other bill which saves money by cutting benefits to injured workers.”

The former died in committee; Reichner’s bill passed.

Party lines–again

According to a Feb. 25 account in the Great Falls Tribune, the bill is partisan, a GOP product:

The House passed a bill this week that they say will lead to a 20 percent reduction in costs to employers by July, and an up to 45 percent decrease over three years.

Democrats said the workers’ compensation bill, which passed on a party line vote, is “broke.”

“It doesn’t do what it needs to reform the system. It takes the biggest chunk out of the hide of the worker, and it did not address the true cost problem,” [House Minority Leader John Sesso, (D-Butte)] said.

He said that under the GOP workers’ compensation bill, providers and insurance companies are not asked to “pay their fair share to bring the system back in line with economic reality.”

Frequently enough, a worker’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Injury on the job

Filing a claim

Illinois arbitrators suspended as workers’ comp scandal grows to include calls for state, federal investigations

The workers’ comp case involving former Illinois state trooper Matt Mitchell and the WC arbitrator assigned to his claim has skyrocketed into a bone fide scandal with federal implications. We first reported on the the case back in Sept. 2010; our most recent follow-up, posted on Feb. 11, describes reports of the arbitrator’s  getting caught trying to hide what should have otherwise been a public hearing.

However, it seems as though arbitrator Jennifer Teague was not as concerned about the general public’s attendance nearly so much as she was worried about increasing scrutiny from reporters at the Belleville News-Democrat, a  print and online news outlet of the McClatchy chain, a major U.S. news provider. One of a series of stories concerned the News-Democrat’s analysis of thousands of e-mails obtained via Freedom of Information requests; in one of the messages, Teague indicated intent to reschedule “on the sly with no press” a December hearing in Mitchell’s case.

Teague denies Mitchell claim–just before getting suspended herself

The latest report, at another site, the online version of the St. Louis Post-Dispatch says: “Former Illinois State Trooper Matt Mitchell isn’t entitled to workers’ compensation for injuries from a crash that killed two Collinsville sisters because the crash was the result of ‘quasi-criminal’ driving by the trooper, a state arbitrator ruled this week.

“Mitchell ‘simultaneously drove at speeds in excess of 120 miles per hour on a highway replete with holiday traffic, wrote e-mails on his car computer, and took a personal phone call lasting almost four minutes long,” state workers’ compensation arbitrator Jennifer Teague wrote in the opinion.

“The five-page opinion rules that Mitchell’s actions ‘were a substantial and unjustifiable risk resulting in a gross deviation in the standard of care in his duties as an Illinois State Trooper. (His) conduct was … egregiously outside the scope of employment” with the state.”

Did public outrage affect the ruling in the case?

The opinion also raises the question of why Teague wanted a December hearing in the case to be held “on the sly.” Regardless of whether her opinion holds up, if Teague had been leaning toward the “quasi-criminal” finding, it seems at least somewhat likely that would have squared up with those in the community who were dismayed over the possibility of awarding workers’ comp benefits to Mitchell, who pleaded guilty to two felony charges that resulted in a 30-month probation deal.

Another twist in the story comes from a Feb. 18 piece from the News-Democrat at its site, which says the denial of Mitchell’s claim was “one of [Teague’s] final acts before she was placed on paid administrative leave” on Feb. 15–as was her co-worker John Dibble, another arbitrator. (According to records, Mitchell spent nearly two years suspended from duty, but also on salary.)

Teague and Dibble among eight arbitrators who filed for or received benefits

According to the story, Teague and Dibble share another factor: “Teague, 37, was one of eight of the state’s 32 arbitrators who has filed or received workers’ compensation awards, including John Dibble. Dibble, who was also placed on paid administrative leave Tuesday, received $48,790 for injuries he sustained in a fall while walking up the steps at a hearing site in Herrin. His claim was settled through the mail, without appearing before an arbitrator.”

A Feb. 12 account at has details about Teague’s own workers’ comp claim:

Illinois workers’ compensation arbitrator Jennifer Teague offered to accommodate an assistant attorney general by setting a special hearing date in a difficult case during the same conversation in which she asked for help in speeding up resolution of her own personal injury case, according to a three-page report from the Office of the Executive Inspector General for Attorney General Lisa Madigan.

According to the report, submitted to the Attorney Registration and Disciplinary Commission, Teague said she was “really cash-strapped right now and has two mortgages.”

“According to these (Office of the Attorney General) employees, arbitrator Teague has linked the settlement of her personal workers’ compensation claim to setting a hearing date in an unrelated case handled by the OAG and pending before her,” the report stated.

News-Democrat calls for suspension after revelation of agency report

A Feb. 15  opinion piece at questioned why Teague was still on the job: “After reading a formal complaint about workers’ comp arbitrator Jennifer Teague, you have to wonder: Why are the taxpayers still paying her a salary?

“The complaint was made to the Attorney Registration and Disciplinary Commission four months ago in October by Attorney General Lisa Madigan’s office. According to it, Teague offered to speed up a hearing on an unrelated case if she could get help getting her personal worker’s comp claim settled more quickly. When she didn’t get what she wanted, she took a furlough so she wouldn’t hear the other case.”

The piece ends by calling for the workers’ comp commission chairman to at least temporarily suspend Teague–without pay–until an investigation can be completed.

State senator calls for federal probe

By Feb. 17, that idea had gained enough traction for the Decatur Tribune to report: “Questions raised by recent media reports about the truthfulness of the filing, handling and processing of hundreds of workers’ compensation claims in Illinois has prompted State Sen. Kyle McCarter to seek an investigation by the U.S. Attorney’s Office and/or the F.B.I.”

The article quotes McCarter as recognizing  the dual administrative leave placements of Teague and Dibble. He goes on to say, “We need an independent investigation.”

State rep seeks accounting from auditor general

On Feb. 18, the Springfield Journal-Register reported:

On Thursday, Rep. Dwight Kay, a Glen Carbon Republican, introduced a resolution that Illinois’ auditor general audit the workers’ compensation commission with special, but not exclusive, attention to possible collusion between that panel and public safety officers in the Mitchell case.

“The integrity and trust relating to the daily operation of the Illinois Workers’ Commission is questionable,” Kay wrote in statement Thursday, adding that “not keeping records of uncontested claims and holding private hearings which are supposed to be public should not be tolerated.”

Frequently enough, a worker’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Injury on the job

Filing a claim

Secondhand smoke could be workers comp case in Missouri; despite prank, California court rejects lawsuit

Secondhand smoke is entering the workers’ compensation arena–by backing its way into law.

According to a Feb. 9 brief in the Southeast Missourian, “The [state] Senate approved final amendments to a bill revamping the state’s workers’ compensation programs on Wednesday that could allow for claims to be made for illnesses arising from exposure to secondhand smoke.”

Toxic exposure better suited to court system

What’s strange is is that the provision is an exception to broader legislation that stops workers from making workers’ comp claims over “prolonged exposure to chemicals or inhalants.” State Sen. Jack Goodman (R-Mt. Vernon) sponsored the bill, contending that toxic exposure cases are better served by the court system because of the potentially long period before manifestation of symptoms.

A Feb. 9 post at (which also includes a link to an audio file of floor debate on the bill) says that “One issue is whether the employee knows that there are inherent dangers in the job should be able to sue the employer if those dangers make them ill or lead to their death. Goodman says the workers’ compensation remedy is ‘adequate’ for employees who assume the risks of their jobs.”

Senator: Some cases should not be restricted to workers’ comp relief

But the senator also recognizes that some cases should not be limited to workers’ comp restrictions: “. . . Goodman also says workers whose employers knowingly do not keep employees safe should be able to demand compensation outside of the worker’s comp system. He cites a series of lawsuits filed by employees of a southwest Missouri popcorn company who claimed the company allowed substances in the factory air that eventually led to severe lung problems.”

State Sen. Robert Schaaf (R-St. Joseph) pushed the amendment to retain secondhand smoke provisions in the workers’ comp system.

Workers’ comp & exclusive relief

On December 19, we wrote about situations in which an injured worker might be able to sue a co-worker or another third party–but still not be able to bring a personal injury suit against the insured employer. However, a case involving a prank that resulted in injury has been limited to the workers’ comp system by a California appellate court.

According to a Feb. 10 account of a ruling issued a few days earlier, “In California, a worker injured by a coworker’s prank is limited by the exclusive remedy provision of the workers’ compensation law.”

Prank with cane leads to knee injury

A copy of the ruling is at, including the following summary, about Raymond Garcia, who was hurt in August 2008 while on the job for the Los Angeles Department of Water and Power (DWP):

Appellant was a DWP employee. His complaint, filed on August 21, 2009, alleged that on August 22, 2008, he was recovering from a knee injury which necessitated the use of a cane. He was trying to wean himself from the cane, and while at work that day he left it behind when he walked away from his desk for a brief errand. When he next used the cane, he lunged forward and reinjured his knee. He then noticed that the cane had been shortened.

Plaintiff suspected that one of three employees (Vargas, Johnson, and Troschak) had shortened the cane. All were Electric Trouble Dispatches (EDTs) who were seated near him. He told the EDTs that his knee hurt, that the cane-shortening “wasn’t funny,” and that “you guys should not mess with anyone’s handicap aids . . . because it’s not funny.” None of them said anything.

On August 24, plaintiff was again at work. He asked Vargas who had shortened the cane. Vargas answered that he was not the culprit, and that he knew who had done it but could not tell. Plaintiff had a similar conversation with Johnson. On August 27, 2008, plaintiff asked Troschak, who admitted that he had shortened the cane. He apologized and asked whether he was in trouble. Plaintiff responded that he did not know, but that if he continued to feel pain in his knee, he would seek medical attention.

Suit alleges DWP created atmosphere of horseplay

Garcia’s suit named DPW and Troschak as defendants, charging that Troschak was on duty and that the DWP  “condoned pranks, jokes, and horseplay and failed to deal appropriately with pranks, jokes, and horseplay, creating the atmosphere which allowed Troschak to believe that he could engage in the subject behavior.”

Specific complaints included:

  • assault, battery, intentional infliction of emotional distress, and vicarious liability and respondeat superior;
  • causes of action against the DWP titled hostile environment, failure to prevent harassment under Government Code section 12940, subdivision (k), negligent hiring, training, retention, and supervision, discrimination based on disability in violation of the Labor Code, Civil Code section 51.9, and the Fair Employment and Housing Act, and violation of the Fair Employment and Housing Act.

Defendants demurred, citing doctrine of exclusivity

However, California law still allows a certain kind of pleading known as a demurrer, which can accomplish what in other states requires a motion to dismiss. In this case, the defendants demurred, citing several grounds, but basically asserting that “that all causes of action were barred by the doctrine of workers’ compensation exclusivity.”  The trial court agreed, sustaining the demurrer, “without leave to amend.” In other words, the suit was tossed out, leaving Garcia the chance to appeal but not to amend his complaint.

‘No matter how rough or thoughtless’

The appeals court denied every argument of the complaint, notably finding that Troschak was acting in the scope of employment, which was acknowledged in the complaint itself. Other highlights include “horseplay injuries to both participating and nonparticipating employees are within the course and scope of employment when the employer condones the horseplay,” and “This is horseplay, no matter how rough or thoughtless, or even cruel, and is part of the workers’ compensation bargain.”

Frequently enough, a worker’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Injury on the job

Filing a claim

NFL’s workers’ comp issue just keeps growing; Florida tries a new tack with proposed bill

An ongoing issue in the NFL concerns injured players who file for workers’ comp benefits in states where they played games rather than in the state where the team is based. We first covered the issue last year here and here, describing what was originally known as “the Bengals’ situation,” which expanded to the point that hundreds of retired, injured players were filing in California because of its unique circumstance.

The California system vs. newer contracts

We quoted from an April piece from The New York Times: “California provides the only workers’ compensation system that allows retired pro athletes to file claims for long-term injuries sustained on playing fields years or even decades before. Quietly, hundreds of football players have received awards or settlements worth at least $100,000 and 700 more players are pursuing claims, many of them by satisfying California’s unique requirement that they played at least one game within state borders.”

By last spring, teams that were watching or fighting similar actions included at least the Bengals, Dolphins, Saints, Titans and Rams. The Titans and Bengals had already begun inserting specific language into player contracts restricting workers’ comp actions to their home states.

The battle expands

Now, the Miami Dolphins are fighting on another front. According to a Feb. 14 article in the Pittsburgh Post-Gazette the workers’ comp issue has become part of “the war” between owners and players:

Kendall M. Newson caught just two passes in his National Football League career, but now the former Miami Dolphin is the star of a legal battle, fought Downtown last week, in the war between the teams and players.

Lawyers for the Dolphins asked U.S. Magistrate Judge Lisa Pupo Lenihan to put the kibosh on Mr. Newson’s workers’ compensation case related to a 2005 knee injury, sustained in a preseason game at Heinz Field, that ended his career. They said the claim should be decided by an arbitrator, not by Workers’ Compensation Judge Pamela L. Briston.

Lawyers for Mr. Newson and the NFL Players Association countered that there was no legal precedent for a federal judge stopping a state workers’ compensation case and added that such a measure would be especially damaging due to the current contract dispute between the league and players.

In other words, the scenario is escalating. For Newson, prevailing under Pennsylvania law would mean the difference of nearly $4,000 a year plus medical benefits that his attorneys say are better than those available in Florida. Dolphins’ management wants the case to be settled via arbitration in Florida: one player’s benefits may not seem like much, but increased benefits for hundreds of players, over time, add up significantly.

Florida’s new workers’ comp bill

An unrelated issue in Florida is a new bill that is designed to:

  • modernize and set standards for certain underwriting ratings
  • create a new position within the Office of Insurance Regulation, called the Worker’s Compensation Administrator, which would
  • reduce overlap among current responsibilities spread over several offices.

According to a Feb. 10 piece at, “In 2003, lawmakers created a new subplan D that was designed to provide coverage to small employees with 15 or fewer employees and non-profit organizations. Primarily, the subplan was provided as a safety net for small contractors after lawmakers ended workers’ compensation exemptions in the construction industry. Unlike the other three subplans that had actuarially sound rates, subplan D rates were capped at a small percentage above rates charged in the voluntary market and were assessable policies. The subplan quickly ran up a deficit and in 2004 lawmakers appropriated money from the state’s Workers’ Compensation Administrative Trust Fund to retire the shortage. They also eliminated the subplans in favor of a three tier rating plan.”

In other words, the former “fix” for small contractors didn’t work out. Reportedly, this bill is on a fast-track to becoming new legislation. We’ll keep tracking it and report as developments are known.

Frequently enough, a worker’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Injury on the job

Filing a claim

Montana battle escalates; Illinois arbitrator caught trying to pull off a secret hearing

Today we’ve got some surprising–even unsettling–follow-up on cases we’ve discussed.

Most recently, we took a look at increasingly heated controversy over proposed legislation to change the workers’ comp system in Montana (final item here, “In Montana, the dust is flying”).  In September, we discussed the case of Mitch Mitchell, a former state trooper who was seeking benefits for injuries sustained in a car crash that killed two teenage girls. In January, we found a mention of the workers comp arbitrator in the case, in another story about the number of workers comp workers seeking their own benefits packages; now we learn Ms. Teague is making news for trying to hide a crucial hearing in the Mitchell case.

House Bill 334 ‘undermines’ a better bill?

According to an early January piece at Big Sky Business Journal, “A newly crafted workers’ compensation bill cleared a legislative hurdle Wednesday, but not without criticism from opponents who said it was unfair to employees and undermined a bill much longer in the making.

“House Bill 334 by Rep. Scott Reichner, R-Bigfork, is one of two major proposals for workers’ compensation reform working its way through the Legislature. Montana is ranked as having the worst workers’ compensation rates in the country and paid nearly $400 million in workers’ compensation rates last year, officials said. Lawmakers say while on the campaign trail they consistently hear from business owners that the high rates are keeping them from expanding their business, paying employees better or forcing them to move out of state.”

A Jan. 10 piece at elaborates: “The plan is supported by Republican leaders and many business interests as the most effective way to quickly lower Montana’s work comp insurance rates, which most agree are among the most expensive in the nation.

Labor groups favor the alternate measure

“But a Senate committee on Wednesday was reviewing a different compromise bill four years in the making. Labor groups and Gov. Brian Schweitzer’s administration support it, but doctors don’t like how it reduces payments to them. Doctors, hospitals and insurance companies favor the House Republican plan.”

Among the highlights in the 37 pages of the proposed measure, according to Big Sky, are “are ending medical benefits 60 months after the day the injury occurred instead of the last time medical services were used and it also creates a list of doctors that injured workers can see rather than letting them request their personal doctor.”

Proponents of the bill praise it for its potential savings (estimated at $84 to $183 million), but opponents characterize it as making Montana’s workers comp system “the most restrictive” in the nation, if passed.

A stab at secrecy in Illinois

The Belleville (Illinois) News-Democrat has done some bang-up reporting on the Jennifer Teague-Mitch Mitchell case being handled by the Illinois Workers’ Compensation Commission (IWCC). At its online site,, there’s a Feb. 8 piece by reporters Beth Hundsdorfer and George Pawlaczyk with the following lede:

A state workers’ compensation arbitrator who will decide whether former Illinois State Trooper Matt Mitchell should be compensated for his injuries wanted to keep the public hearing secret, according to e-mails between the arbitrator, Mitchell’s lawyer and an assistant attorney general, who represents taxpayers.

“We are going to do it on the sly with no press,” wrote Illinois Workers’ Compensation Commission arbitrator Jennifer Teague in an e-mail to her court reporter. Thousands of Teague’s e-mails were obtained by the Belleville News-Democrat under the Illinois Freedom of Information Act.

‘More than willing’ to schedule unknown place & time

A day later, the St. Louis Post-Dispatch reported:

Mitchell’s hearing, originally was scheduled for Dec. 20 in Belleville, was pushed up to Dec. 17 and relocated to a Collinsville office without public notification. A decision on compensation has yet to be made.

“There is nothing I can do to keep them (reporters) out of a public hearing, but will be more than willing to do a special setting and an unknown place and time!” Teague wrote to Mitchell’s lawyer, Kerry O’Sullivan, on Oct. 18.

O’Sullivan, in a November reply to Teague with a copy to Assistant Attorney General Bill Schneider, suggested an “off-docket trial of this matter to prevent or reduce media attention.”

Tip leads reporter to hearing

According to the News-Democrat, one of its reporters was tipped off that the hearing date had been changed.  After arriving at IWCC regional office in Collinsville a few minutes after the hearing had begun, the reporter knocked on a closed door and was subsequently admitted into the room.

The story began in 2007, shortly after Thanksgiving, when Mitchell was on duty and en route on I-64 to the scene of an auto accident. According to court documents, Mitchell was using his cell phone to send messages while driving at speeds as high as 126 mph. Subsequently, his state trooper vehicle crossed the median and “bisected” the the oncoming vehicle of sisters Jessica and Kelli Uhl, killing both.

After spending nearly two years suspended from duty while drawing a salary, Mitchell eventually pleaded guilty to two counts of reckless homicide in a deal that netted him 30 months’ probation. By September 2010, the request for workers’ comp benefits had been filed, seeking an award for injuries sustained in the line of duty.

Opinion piece asks some tough questions

Given the reportage, perhaps it’s only fitting that the News-Democrat ( seems to be the only news organization we’re aware of that has a public, editorial stand on this case, as witnessed by this Feb. 10 opinion piece, headlined “It’s no secret what to do on Mitchell worker’s comp hearing ploy“:

As for Teague, the Workers’ Compensation Commission needs to fire her. The commission’s credibility is already in doubt because of many questionable awards to Menard prison workers. It cannot keep an arbitrator on the payroll who either doesn’t understand, or doesn’t care, that her job is the people’s business.?

Now, here’s the really, really big question: Given the Mitch Mitchell case, how is it that the state can deny any knowledge of  Menard?

Basically, what we’re asking is, “Exactly, what is going on?”

Frequently enough, a worker’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Injury on the job

Filing a claim

Actions in three states exemplifies need for workers to have access to trained, experienced counsel

Do you work for a contractor? Are you a contractor? Have you had liens filed against you? Are you considering filing a lien? These are all questions worthy of answers in the world of Workers’ Compensation

Last time we looked at California and Utah trying to tighten up regs on contractors who try to game the system. Today we’ll resume with California, where liens also affect the workers’ comp system, plus current affairs in Washington and Montana. The liens have been described as “choking” the system in California. In Washington, an ad hoc rate hike has been declared official.

How to strangle? Use liens, says one report

According to a recent post at, “Liens are ‘choking’ California’s workers’ compensation system, with employers and insurers spending roughly $200 million per year on loss adjustment expense to handle medical liens claims, according to a new liens report [from the California Commission on Health and Safety and Workers’ Compensation (CCHSWC)].

“In the Golden State’s workers’ compensation system, a lien is a direct claim against the defendant for a benefit which is not otherwise payable to the injured worker. ‘The rationale is that the lien claimant has furnished medical treatment or other service that the employer was required to provide, so the lien claimant is entitled to payment from the employer. A medical provider must accept the payment allowed by workers’ compensation and must not collect from the patient unless the claim turns out to be noncompensable. A lien is the medical provider’s vehicle for contesting the employer’s determination of the amount payable for medical goods or services. Unlike conventional liens, these are not obligations of the injured worker,’ according to the California Commission on Health and Safety and Workers’ Compensation.”

A ’cause and a result

It may even be worse than that. According to the commission’s report, not only is the current system abjectly inefficient but also may involve coercion, all to the detriment of injured workers and taxpayers:

Liens are both a cause and a result of serious distress in the California workers’ compensation system.

As a cause, liens are choking the system.

The Presiding Judge of the Los Angeles office estimates that liens consume about 35% of the court’s calendar and would consume even more if the calendar slots were not being rationed. Lien hearings take away time for the court to deal with the claims of injured workers.

California employers and insurers are spending roughly $200 million per year on loss adjustment expenses to handle medical lien claims. The volume of liens provides an environment where indefensible delays and denials by claims administrators and fraud and abuse by lien claimants can thrive, side by side. As a symptom, the billions of dollars in dispute reflect both obligations that should have been paid but which may eventually have to be compromised in order to obtain any payment, and claims that should not be paid but which may eventually have to be compromised in order to obtain closure.

The volume of liens forces the courts to encourage settlement, almost to the point of coercion. The necessity of settlement rewards both unjustified claims and unjustified refusals.

The prevalence of liens is unique to California. Other states we have contacted have nothing comparable. One national insurer commented that it writes 22% of its business in California but receives 87% of its liens in this state.

Sounds like a helluva problem, and we’ll definitely keep following this situation.

Emergency rate hike goes mainstream

Something else we’ve been following is the goings-on in Washington state,  recently discussed here.

What I termed an ad hoc decision, Insurance Journal is calling a decision made on an “emergency basis.” Hedzup, everybody who might be affected–this is yet one more reason to get educated about the system and to consider hiring a competent, trained, experienced attorney: “Washington’s Department of Labor & Industries (L&I) has approved an increase to the state’s workers’ compensation premium rates by an average 12 percent or 6.5 cents per hour for 2011.

“The new rates already took effect on Jan. 1 on an emergency basis while the state held public hearings on the matter. Individual employers could see their rates go up or down, depending on their recent claims history and any changes in the frequency and cost of claims in their industry.”

In Montana, the dust is flying

Now, in Montana, which we’ve written about, this recent post at informs us that, “The battle lines over competing workers’ compensation reform plans crystalized Monday at a hearing for the Republican reform plan, as workers made it clear they don’t like a bill partially written by the insurance industry.

“Construction, timber, oil companies all made up parts of the business community that aligned with the medical community in backing a Republican proposal aimed at cutting rates by as much as 40 percent. One eastern Montana oil business said it could save more than $600,000 in work comp costs alone if it moved its headquarters across the border to North Dakota.

“That proposal was also viewed more favorably by the insurance companies.”

Regardless of whether you have an ongoing workers’ comp case, it’s informing to understand that state governments and major insurance companies are in the midst of redefining the boundaries of the rules and regulations.

Frequently enough, a worker’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Injury on the job

Filing a claim