Three recent news items reflect the breadth and depth of disparity among the states’ regulations concerning workers’ compensation.

The first and third are from California and Florida, the second from Pennsylvania; taken together they reveal a shocking disconnect between treatment of perps and victims.

Roofer injured in 2003

According to a March 1 article in the Orange County (CA) Register, roofing contractor Michael Amzie Hollings “is expected to be sentenced to three years in state prison” after pleading guilty to various charges that boiled down to trying to hide workers, thereby paying nothing to the state’s workmen’s comp fund. No word from the Register on how long the scheme lasted, but it began unraveling in 2003 when a worker “fell from a roof and filed a workers’ compensation claim,” which resulted “in a denial of benefits,” according to prosecutors. The account also makes no mention of whether the injured worker ultimately received benefits–or even treatment.

On the one hand, the plea agreement shows how long such cases can slog through the system; on the other, even though Hollings faced a maximum sentence of 21 years and eight months, the expected three-year sentence should serve as a red flag for those who attempt to run similar schemes–at least, in California.

Agency owner dodges more than 1,000 counts

In another plea agreement reported today at pittsburghlive.com, 80-year-old William R. McCandless has apparently slipped through the system with a pretty sweet deal. Charged (along with his business) of “1,054 counts of failure to insure” from August 2006 through July 2009, McCandless “entered a general plea of no contest to a single count of failure to insure,” which is expected to net him a mere $3,000 fine plus probation.

One presumes the agency’s workers are now covered–and, of course, there’s no mention of anyone falling from a roof–but, still…more than a thousand counts? That must be one happy old guy.

Holdup victim awaiting surgery for more than a year

The next case is flat out tragic and has the father of an injured man taking on reform of Florida’s statutes, which were altered to prevent abuse by scam-running workers.

Posted March 01 at myfoxtampabay.com, this account tells the tale of Sam McGinnis, a drug store clerk gunned down during a holdup that netted $88 in Nov. 2008.

“We’ve all seen video of people caught on tape playing up their injuries and claiming benefits: people walking with a walker, and later walking just fine, or using or a cane where now you see it, now you don’t,” writes investifative reporter Doug Smith.

“But there’s nothing funny or phony about the video of Sam McGinnis, a clerk behind the counter at a drug store in Tampa, Florida on November 29, 2008. A camera inside the store shows a holdup.”

Cursed at by the robber and shot twice–for not moving fast enough–McGinnis still has a slug lodged in his back and remains “in constant pain,” with “[e]ven the simplest tasks . . . a challenge . . . and he says the workers’ compensation system is compounding his agony.”

Apparently, Florida’s worker-abuse reform went too far: Not only have the new regs have resulted in denial of surgery that would help McGinnis but also he’s been prevented from using his own private insurance–because he was hurt on the job.

“McGinnis hasn’t been able to get surgery that his doctors say could ease his pain because so far workers’ compensation won’t approve it. McGinnis says he had very good private insurance, but because he was hurt at work, he can’t use it.”

The article also says “McGinnis will need a lifetime of care.”

McGinnis’ father has begun a campaign to change the regs, creating a dual-track system, with one track for more routine on-the-job injuries and another for “for people who are catastrophically injured. . .” The father (Facebook profile here) has launched a Web site with a brief background and links to a youtube video and an online petition.

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Regardless of whether you’ve been hurt on the job, it’s wise to know the basics of workers compensation in case you, a friend or family member need to file a claim in the future. If you do get hurt, you should be aware of the first things to do or what to tell a co-worker who has been injured.

Sometimes an injured employee takes all the correct steps but still has trouble getting the claim taken care of; in that case here’s some information for problems with denial of benefits. If legal help is needed to help with the case, be sure to speak to a trained, experienced attorney.

California workers compensation law is similar to other state’s laws which provide medical benefits and lost wage compensation to California workers who sustain an injury at work while they are performing their normal job function.

Workers compensation or workman’s compensation is an insurance program created to provide immediate relief to employees without the employees having to file a personal injury claim for compensation. In exchange, California workers compensation law limits the amount of money which can be recovered from California employers.

Only work injuries or occupational diseases which are caused from the normal job requirements are covered by workers comp insurance. Work injury compensation is not provided to California workers who are injured while intoxicated, attempting to injure themselves or another employee or who are injured travelling to and from work.

There are a variety of occupational diseases and work injuries which are covered by California’s workers compensation. Some of the most common include:

• Back and neck injuries
• Abrasions and burns
• Amputations of arms or legs
• Concussions
• Heart attack or strokes on the job
• Carpel Tunnel
• Diseases caused by inhalation of chemicals or other toxins

California Worker’s Compensation Benefits

Californian workers comp insurance includes: medical benefits, temporary disability benefits, permanent disability benefits, vocational rehabilitation benefits and death benefits.

• Medical Benefits – California workers who sustain an injury at work are entitled to full medical benefits provided by their employer with no limits to time or money. The employer generally selects the first physician the employee is required to see and after 30 days the employee generally is allowed to choose their own doctor. Additional medical expenses are paid such as doctor’s visits, hospital stays and medications.
• Temporary Disability- California employees who suffer an injury at work are entitled to temporary disability payments which are 2/3 of their lost wage amount. California workers compensation outlines a maximum limit for lost wage compensation.
• Permanent Disability- California workers who suffer an injury at work and are unable to return to work are eligible for permanent disability. California workers who sustain an injury at work and can return to work but due to their work injury they can not make the same wage they could before the work injury, may be eligible for workers compensation benefits. California workers compensation will determine the amount for permanent disability based on a variety of factors including the worker’s age, occupation, work capacity and work injury date.
• Vocational Rehabilitation – California workers who suffer an injury at work and are not able to return to their job may qualify for vocational rehabilitation benefits including job retraining and job placement.
• Death benefits – Dependents of California workers who die from their work injury or occupational disease are entitled to death benefits to compensate them for the deceased worker’s lost wages. Burial expenses are also paid up to an established limit.

Do I Need a California Worker’s Compensation Attorney?

Workers compensation law can vary by state and can be complicated. Many insurance workers comp cases are settled easily and without dispute, but many are denied. Work injury lawyers can help California workers get the compensation they deserve and help fight employers and their worker comp attorneys if they are more concerned with saving money than helping the employee recover from their work injury.

Oakland, California, workers who sustain an injury at work may be able to receive a fixed monetary benefit through California’s workers compensation insurance. Workers compensation or workman’s comp was established to reduce the number of personal injury lawsuits filed by employees who were injured on the job. Workers compensation generally provides medical benefits and some type of lost wage compensation without the employee having to prove in court their employer was negligent. In exchange, the worker may forfeit some of the work injury compensation they may have recovered through a personal injury claim.

Workers comp insurance does not cover all work injuries but provides benefits to the employee only if the work injury occurred while the employee was engaged in their “normal” job duties. Work injuries caused by drug or alcohol intoxication, while travelling to and from work or from a worker’s intentional actions to injure themselves may not be covered.

The majority of Oakland employers, under California workers compensation law, are required to provide worker’s compensation insurance for workers who suffer an injury at work or who experience an occupational disease. Common conditions which may be covered can include:

• Back and neck injuries
• Abrasions and burns
• Amputations of arms or legs
• Concussions
• Heart attack or strokes on the job
• Carpel Tunnel
• Diseases caused by inhalation of chemicals or other toxins

Oakland Worker’s Compensation Benefits

Oakland workers comp insurance may provide a variety of benefits including: permanent disability payments, vocational rehabilitation benefits, death benefits for surviving dependents and medical benefits.

• Medical benefits – Oakland employees who are injured at work will receive medical coverage for the medical costs associated with their work injury. These benefits can continue indefinitely or until their medical doctor determines they are unnecessary. Expenses which are paid may include: doctor’s services, laboratory costs, prescription medications, chiropractic care and hospital stays.
• Temporary disability- Oakland workers who suffer an injury at work and are unable to work for at least 3 days may receive temporary disability payments which will include wage replacement. Worker’s compensation for lost wages will be 2/3 of the lost wage amount up to California’s worker compensation limit.
• Permanent Disability- Oakland workers who suffer an injury at work may receive permanent disability if their medical doctor determines their work injury is permanent. Workers comp insurance will determine the permanent disability payment amount by considering the age of the worker, the date of the work injury, the employee’s occupation and the employee’s remaining ability to work.
• Vocational Rehabilitation – Oakland workers who sustain an injury at work and are unable to perform their job may be eligible for vocational rehabilitation benefits which can include job training. Workers compensation law establishes a monetary limit for vocational rehabilitation.
• Death benefits – Dependents of Oakland workers who are killed from their work injury may receive workers comp death benefits. Worker compensation death benefits can include lost compensation and burial benefits.

Do I Need an Oakland Worker’s Compensation Attorney?

Many work compensation claims are resolved with very little difficulty, but others may be denied. An Oakland work injury lawyer can answer all of your questions, make sure your employer has your best interest in mind and provide you with the medical coverage and wage benefits you need to take care of yourself and your family.

If your work injury was caused by a defective third party product you may be able to receive compensation from the manufacturer of the product by filing a personal injury claim. Worker comp attorneys can also help if you have been demoted, fired, harassed or discriminated against due to your work injury.

San Jose workers who have suffered an injury at work may be eligible to receive paid medical care and lost wages under California worker’s compensation law. Workman’s comp or worker’s compensation provides benefits to workers who are injured at work if the work injury occurred while they were performing their job duties.

Workers compensation laws were created to reduce the amount of work injury lawsuits that would be filed and in exchange, injured workers are generally eligible to file a workers compensation claim and receive certain types of workman’s compensation without having to prove their employer was negligent in the accident, illness or injury.

San Jose workers compensation may allow for workers who have suffered an injury at work to receive medical care, permanent disability, temporary disability, rehabilitation or death benefits. Many illnesses and work injuries are covered, but some of the most common work injuries can include:

• Back and neck injuries
• Abrasions and burns
• Amputations of arms or legs
• Concussions
• Heart attack or strokes on the job
• Carpel Tunnel
• Diseases caused by inhalation of chemicals or other toxins

Work injury compensation may not cover injuries which occurred travelling to and from work or if the worker was off-site. Work injuries also may not be covered by workman’s compensation if the work injury occurred from the employee’s intentional action or while intoxicated from drugs or alcohol.

Worker’s Compensation Benefits in San Jose

San Jose’s workers comp insurance may provide the following work injury benefits for injured workers:

• Medical benefits – San Jose workers who suffer an injury at work may receive benefits for medical care. Medical care can include: dental care, hospital visits, doctor’s services, medications and chiropractic care.
• Temporary disability- San Jose workers who suffer an injury at work are only paid temporary disability benefits if the worker does not return to work within three days. Temporary disability may include wage replacement up to 2/3 of the lost wage amount. There is a maximum amount of wage replacement allowed which is outlined in workers compensation law.
• Permanent Disability- San Jose workers who suffer a work injury may be eligible to receive permanent disability payments if a medical doctor determines their work injury is permanent. Workman’s comp for permanent disability is calculated based on the injured worker’s age, date of the injury, occupation and their diminished work capacity.
• Vocational Rehabilitation – Some San Jose workers who suffered an injury at work may no longer be capable of performing their past job tasks but can be retrained for new employment. These workers may be eligible for vocational rehabilitation which means work comp insurance will provide job training benefits up to a maximum limit.
• Death benefits – Dependents of San Jose workers who are fatally injured at work may be eligible to receive workers comp death benefits. Death benefits may include work injury compensation which is a percentage of the deceased workers lost wages as well as a certain amount of money to cover the deceased worker’s burial.

Do I Need a San Jose Worker’s Compensation Attorney?

San Jose workers who suffer an injury at work can file their workers comp insurance claim without the assistance of a work injury attorney, but work compensation laws can be complicated and do occasionally get denied. Workers who suffer a work injury should contact a work injury lawyer if their injury was caused by a faulty product or if the work injury has caused the worker to suffer workplace discrimination, workplace harassment or if the worker has been demoted or fired.

Hard times are causing states to rethink approaches for funding various workers’ comp funds, and in California, a superior court judge “has ruled that Gov. Arnold Schwarzenegger illegally furloughed 7,400 employees of the State Compensation Insurance Fund this year,” according to a post at the Insurance & Financial Advisor Web site.

“Superior Court Judge Charlotte Woolard affirmed a prior ruling against the state involving the employees for the “State Fund,” which sells workers’ compensation insurance to employers and uses the proceeds to operate, according to the San Francisco Chronicle. The State Fund relies on no funding from the state treasury.”

The IFA post said the ruling would provide “back pay plus interest for the days they missed work,” but a more recent Chronicle story reports the issue is undecided. Explaining that “[t]he ruling came in a case filed by the Service Employees International Union Local 1000, which represents 6,260 fund employees,” the article also says,  “It’s unclear whether employees will be able to collect back pay for the days they were furloughed. The state fund and the SEIU believe the order entitles them to it.

“But, said a spokesman for the governor’s office, ‘The judge did not rule on the issue of back pay. She was silent on the issue.’ ”

A legislative task in Oklahoma recently heard testimony from Nevada officials that changing from a state-operated to a privately operated system has improved rates for businesses in Nevade, according to a CNBC post dated Sept. 2.

“Nevada’s workers’ compensation insurance rates have dropped since that state privatized the agency providing such insurance, Nevada executives told an Oklahoma legislative task force Wednesday.

“The task force is considering privatizing Oklahoma’s workers’ compensation agency, CompSource Oklahoma.”

The change in Nevade came a decade ago, “when it transformed the agency from a monopoly to a mutual insurance agency owned by its policyholders, said Douglas Dirks, president and chief executive of Employers Holdings, Inc.

” ‘Rates have gone down fairly consistently since the market was opened,’ Dirks said.”

Reports from Colorado include descriptions of  a “parade of angry workers [who were] hurt on the job” and subsequently testified in a recent probe of the state-chartered, tax exempt, quasi-governmental agency Pinnacol by a special committee of legislators and citizens.

According to a “Politics West” spot in The Denver Post on Sept. 1, injured workers questioned not only a surplus of coverage denials but also surplus cash reserves, too much spying on claimants and an out-of-touch perks package for agency compensation packages.

“Mike Byrd, hurt in a work-related car accident in 2004, told a special panel created by the legislature about Pinnacol denying treatments and trying to send a company nurse with him to every one of his doctor’s appointments as a ’spy.’

“Like others, Byrd questioned how Pinnacol, a quasi-governmental agency that was struggling to remain solvent a decade ago, could grow so profitable that it has amassed a $700 million surplus.”

Also on Sept. 1,  the Durango Herald reported: “A former Durango firefighter testified Monday that the state’s workers’ compensation company spied on him and trashed his reputation in the community in an attempt to deny his claim for an injured back.”

Stahl said he was injured twice and Pinnacol paid for the first claim but refused the second. “He finally sold his house to pay for surgery out of his own pocket. Surgery has helped, but he had to retire from the fire department. He became a nurse and now is studying case management for injured workers.”

Both accounts report a few injured workers testified that their cases were handled well by Pinnacol, but the Herald piece ends thusly:

“Stahl said it was inexcusable for the state’s dominant workers’ compensation insurer to spend $143,930 for a luxury suite at Invesco Field, home of the Denver Broncos; a $133,000 trip to the Four Seasons Resort in Scottsdale, Ariz.; and a $2,515 dinner, which included two plates of $144 lobster and three bottles of $115 wine, while workers suffer.

“Pinnacol has defended the expenses as good for morale.”

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Have you been injured on the job?

Here’s what to do first.

Workers’ compensation in California is of interest to you if you live and work in California, and you or ill or have been injured as a result of your job. You may currently be having problems and difficulties with your employer in being compensated for that injury or illness.

You need to remember what workers’ compensation is. Workers’ compensation is a kind of business insurance. This business insurance provides benefits in the form of income, rehabilitation and medical coverage to employees and/or their family who suffer injury, illness or death in the course of, or as a result of, their job. This does not depend on whether you were at fault as an employee.

These benefits may be given to your surviving spouse and/or children if you die as a result of injury at your place of employment. These benefits are yours or your dependents or survivors as a matter of “right”. Your employer cannot resort to any legal defense. You and/or your dependents or survivors, in turn, cannot sue your employer for your injuries or death.

Workers’ compensation laws were established to mitigate the need for workers to prove that their injuries were the “fault” of their employer and to reduce the need for litigation. The first workers’ compensation laws were passed in Maryland in 1902. The first federal law was passed in 1906. By 1949, all of the states had passed some kind of workers’ compensation laws.

Originally, these laws were known as “workman’s compensation.” California uses the term, “worker’s compensation” or “workers’ comp.”

The Occupational Safety and Health Administration (OSHA) oversees workplace health and safety at the national level. State laws vary and complement the regulations of OSHA.

There is no national agency, however, that requires all employers to provide workers’ compensation benefits. The laws regarding workers’ compensation are determined by each state.

Workers’ compensation in California is governed by the Department of Industrial Relations. The Division of Workers’ Compensation has the specific responsibility of administering workers’ compensation in California.

California passed its first workers’ compensation law under the Compensation Act in 1911. Under this law participation was voluntary for employers. In 1913, the Workers’ Compensation Insurance and Safety Act was passed that required employers to participate. Since that time this Act has been revised and reformed many times.

Workers’ compensation in California is seen as a trade-off between employers and employees. Employees are entitled to receive prompt, effective medical treatment for on-the-job injuries or illnesses no matter who is at fault. In return for these benefits, employees are prevented from suing employers because of those injuries.

If you live and work in California it is important for you to know and remember that all employers are required by law to have workers’ compensation insurance, even if they have only one employee. Workers’ compensation is mandatory meaning all employers are required to participate. Your employer has to pay for workers’ compensation benefits if you are hurt or become ill because of your work.

Workers’ compensation in California provides six basic benefits. These workers’ compensation benefits are:

§  Medical care

§  Temporary disability benefits

§  Permanent disability benefits

§  Supplemental job displacement benefits or vocational rehabilitation

§  Death benefits.

The vast majority of workers’ compensation claims are resolved without any need for legal recourse. However, sometimes there can be a disagreement that arises between you and your employer. This disagreement can relate to issues such as was your injury or illness the result of your job, or how much in benefits you are entitled to receive because of the injury or illness.

When there is a dispute between you and your employer, the Division of Workers’ Compensation can help resolve it through its Information and Assistance Unit or by going before a judge at one of the division’s 24 local offices.

It is important to know the rights that you have when you are injured at your workplace in California. Under workers’ compensation laws in California you have the right to receive medical treatment. State law requires that your medical treatment has to be, “scientifically based, nationally recognized and peer-reviewed. Guidelines published by the American College of Occupational and Environmental Medicine (ACOEM) are correct in most cases.

You also have the right to disability payments. These may be temporary or permanent depending on the type and nature of your injury or illness that is work related. Permanent disability is any lasting disability that reduces your earning capacity after maximum medical improvement is attained.

You also have the right to return to work after you have recovered from your illness or injury. Returning to work as soon as possible after an illness or injury is important for both you and your employer. Workers who return to their jobs as soon as it is medically possible have the best outcomes. Recovery from injuries and illness is faster and wage loss is less.

You also have the right to the resolution of a disagreement over your claim. The steps for this resolution have already been mentioned above.

Workers’ compensation in California may be a serious matter for you. You or a friend or loved one may have been injured or become ill as a result of your work. To make matters worse, you or your friend or loved one is in an unresolved dispute with the employer over the injury or illness.

What can you do? What options do you have? Who can you turn to for help?

You or your friend or loved one may need the help of a legal professional. You may need the help of an attorney who knows and specializes in employment law in California. You may need the representation of a workers’ compensation attorney.