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 BND.com, “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.”

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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

Georgia workers’ compensation or workman’s compensation is provided to Georgia employees who are injured while performing their job or who have contracted an occupational illness. Georgia workers’ compensation program is managed and administered by Georgia’s State Board of Workers’ Compensation (SBWC).

The goal of the SBWC is “to provide superior access to the Georgia Workers’ Compensation program for injured workers and employers in a manner that is sensitive, responsive, and effective and to insure efficient processing and swift, fair resolution of claims, while encouraging workplace safety and return to work”.

Workers’ compensation or workers comp is a mandatory insurance policy that certain employers in the state of Georgia are required to purchase to protect their employees who are injured in a Georgia work injury. Mandatory workers’ compensation has eliminated the rights of most injured employees to file a personal injury claim and sue their employer. The trade-off for the worker, who may have forfeited a larger payout, is immediate medical benefits and potential wage loss compensation without the need for a costly legal battle.

Work Injuries covered by Georgia Workers’ Compensation

Work injuries are generally covered if they occur while an employee is performing a job duty. Work injuries which were the result of an employee’s horseplay, intoxication, failure to follow company policies or which were intentionally self-inflicted may not be covered.

Common work injuries which should be covered under Georgia’s Work compensation laws include:

• Neck injuries                             Back injuries
• Carpal Tunnel                            Concussions
• Heart attacks on the job             Strokes on the job
• Amputations                             Injuries from inhaling toxic chemicals
• Closed head injuries                  Paralysis
• Burns                                        Spinal cord injuries
• Abrasions                                 Electrocution
• Puncture wounds                       Post Traumatic Stress Disorder (PTSD)

Georgia Workers Compensation Benefits

• Medical Benefits

Medical benefits including rehabilitation and other treatments considered reasonable and necessary are covered under Georgia workman’s compensation laws. This can include hospital stays, prescribed medication, doctor’s visits, medical services and laboratory tests. In some cases the non-emergency care services may require approval from a panel of approved physicians. Georgia workers’ comp laws also allow the employee to choose their physician, but the choice must be from a list determined by the employer.

• Temporary Total Disability Benefits (TTD)

Temporary total disability benefits are paid to workers who have been injured on the job and are unable to return to work due to their work injuries. Employees receiving TTD will receive 2/3 of their average weekly wage up to a predetermined maximum. TTD benefits are paid for a maximum of 400 weeks from the date of the work accident. Under some conditions, such as a catastrophic accident, TTD benefits may be extended. There is a 7 day waiting period prior to receiving TTD benefits. Workers who are injured for 21 or more consecutive days may receive payment from the first day of the work injury.

• Temporary Partial Disability Benefits (TPD)

Temporary partial disability benefits are paid to injured workers who are able to return to work but who, due to their work injury, are unable to make a similar wage. TPD benefits are paid at 2/3 the difference between the injured worker’s average weekly wage prior to and after the work injury. TPD benefits can be paid for 350 weeks or up to a maximum established under Georgia workers’ compensation law.

• Permanent Partial Disability (PPD)

Permanent partial disability benefits are paid weekly to injured workers who have been permanently disabled and may be unable to work their previous job, but may be able to do alternate work. Prior to determining the compensation amount, a medical examination is conducted by an independent medical examiner. The disability examiner rates the level of impairment. Disability payments are calculated by using the American Medical Associations ratings guidelines.

PPD payments are made by multiplying 2/3 of the injured worker’s average weekly salary by the PPD percentage and a specified number of weeks. The number of weeks is determined according to a pre-determined schedule. The calculation for PPD benefits is not made until the treating physician has determined the worker has reached their maxim medical improvement.

• Death Benefits

Death benefits are paid to the surviving spouse or dependents of Georgia workers who have died from a work injury or illness. Death benefits are 2/3 of the deceased employee’s average weekly wage at the time of the work injury. Death benefits are paid to the surviving spouse who has does not have children up to $150,000 maximum. Surviving children may be eligible to receive death benefits until they are 18 years old or longer if they are a full-time student.

• Vocational Rehabilitation Benefits

Vocational rehabilitation benefits may be offered to qualifying injured workers who are unable to return to work due to their physical health condition after a work injury. Georgia vocational rehabilitation may include: job placement, custom job training, job matching, counseling, technological accommodations and resource assistance.

Hiring a Georgia Workers’ Compensation Lawyer

Not all workers will need to hire a Georgia workman’s compensation lawyer, but if the injuries suffered are severe or permanent or the worker and employer have an adversarial relationship, it may be a good idea to seek legal counsel. Many workers’ compensation cases are litigated in Georgia simply because the insurance company wants to pay a low settlement amount and close the case as quickly as possible.

If you feel you have received poor medical treatment, if your Georgia workers’ compensation case has been denied or if you have been severely injured, contact a Georgia workman’s comp attorney.

Is workers’ compensation in Illinois a subject that interests you? If you live and work in Illinois, and if you have been injured on your job or become ill due to the nature of your job, workers’ compensation in Illinois probably holds great interest for you. You or a friend or loved one may be in a dispute with their employer regarding workers’ compensation benefits, right now.

If this is the case, remember what workers’ compensation is. Workers’ compensation is a kind of business insurance that is provided by your employer that gives you and/or your family benefits in the form of income, medical coverage and rehabilitation in the event that you suffer injury, illness or death as a result of, or in the course of, your job. This is true no matter who is at fault for your injury or illness.

If you were to lose your life on your job, these financial benefits can be given to your surviving spouse and/or children or dependents. These benefits come as a matter of “right” to you or your dependents or survivors. Your employer is not allowed to resort to any legal defense. In return for this, you cannot sue your employer, nor can your spouse and/or children or dependents.

Workers’ compensation laws came about so you would not have to prove that your injuries or illness was the “fault” of your employer. They were also established to reduce the need for litigation. Workers’ compensation laws were first passed in Maryland in 1902. The first federal workers’ compensation law came in 1906. By 1949, every state had passed some form of workers’ compensation law.

The Occupational Safety and Health Administration (OSHA) ensures your safety and health on the job at the national level. State laws that vary from state to state complement the national regulations of OSHA.

This is not true regarding workers’ compensation. Each state has its own workers’ compensation laws because there in no national agency to administer workers’ compensation.

The Illinois Department of Labor administers the laws regarding employment and labor in the state. The Illinois Workers’ Compensation Commission operates the state court system for workers’ compensation cases.

Illinois regards workers’ compensation as a no-fault system of benefits paid by employers to workers who experience job-related injuries or diseases. Workers’ compensation in Illinois is mandatory. Employers are required to provide workers’ compensation insurance. No waivers are permitted, but in some instances employers with two or less employees do not have to provide workers’ compensation coverage.

The first workers compensation act in Illinois was passed in 1912. Since that initial act was passed, workers’ compensation laws have been reformed and amended several times. The Illinois Workers’ Compensation Act was lasted amended in on August 21, 2007. Illinois also refers to workers’ compensation as ‘work comp’ and ‘on-the-job injuries’.

Again, it is important for you to keep in mind that workers’ compensation, with a few exceptions, is required of your employer. Your employer has the option to purchase workers’ compensation coverage from a licensed insurance company, be self-insured or be a part of group self-insurers who have pooled their liabilities.

There are good workers’ compensation benefits in Illinois. These benefits include:

• Choice of physician – You are allowed to choose the first two doctors that you want to treat you. If you choose a third physician without your employer’s approval, your employer is not required to pay for those services.
• Medical benefits – Your employer is required to pay for all medical care that is reasonably necessary to cure or relieve you from the effects of your injury.
• Temporary total disability (TTD) benefits – These are benefits that are paid during the period in which you are either temporarily unable to return to work or you have been released by your doctor to do light-duty work but your employer is unable to accommodate you. The payment amount is based on a percentage of your average weekly wage. This is paid until you have returned to work or finished healing. There are caps on these temporary total disability benefits.
• Temporary partial disability (TPD) benefits – These are benefits that are paid during the period in which you are healing and are working light duty, on a part-time or full-time basis and earning less than during your pre-injury job. Again, the amount is based on a percentage.
• Vocational rehabilitation/maintenance benefits – These benefits include treatment, instruction and training necessary for your physical, mental and vocational rehabilitation when you cannot return to you pre-injury job.
• Permanent Partial Disability (PPD) benefits – These are benefits that are paid if you experience some permanent physical loss. The amount is based on a percentage with caps.
• Permanent Total Disability (PTD) benefits – These are benefits paid to you if you experience the loss of certain body parts, or you are permanently unable to do any kind of work for which there is a reasonably stable employment market. Amounts are again based on percentage with caps.
• Death/Survivors’ benefits – These benefits are payable in the event of your death on the job to your surviving spouse and/or children or dependents. The amount is based on a percentage of your wages. There is also a burial benefit.
• Limited attorney fees – Attorney fees are usually 20% of your settlement.

If you have a dispute with your employer over workers’ compensation benefits because of an injury or illness, your first step is to have your case tried by an arbitrator. The decision of the arbitrator can be reviewed by a panel of three commissioners from the Illinois Workers’ Compensation Commission. Additional appeals can allow a workers’ compensation claim to go all the way to the Illinois Supreme Court. However, the vast majority of claims are not appealed after being reviewed by the commissioners.

Once again, you or a friend or loved one may be currently in a dispute regarding workers’ compensation benefits. You will probably need the help of a legal professional to settle this dispute because of the legal process involved.

The Illinois workers’ compensation attorney that you choose could make all the difference in the world.