As we’ve mentioned before, the stereotype of the scheming worker is not a myth. Insurance investigators frequently bust idjits and ne’er-do-wells who fake injuries and file false claims–only to be caught in videos performing activities too vigorous for their supposed injuries–curiously, some get caught when they themselves post the damning material online.

Nevertheless, judging from news stories, anyway, it seems the reverse is more often true. That is, it seems some employers just can’t stop themselves from trying to game the system by misreporting employee head-counts, denying or discouraging treatment or delaying the process any number of ways. We’ve covered some such actions here and here.

Well, here’s some more.

After all the horrible news about catastrophes in various mines through the years, wouldn’t you think a mine operator would be one of the last to get charged with safety or workers comp violations?

Obviously, the most recent case to grab headlines is the explosion in West Virginia, reported on April 6 in The New York Times and commented on the same day in an NYT editorial. No telling what sorts of legal actions and lawsuits may arise from such a well publicized tragedy.

Hiding mine employees in ‘trucking company’

But what about the smaller, “less volatile” cases?  For instance, According to an April 5 post at ClaimsJournal.com, Pamela Allen, “listed as the sole officer of Sly Branch Energy, an underground coal-mining operation” in Kentucky “has been indicted on charges stemming from an alleged scheme to avoid paying workers compensation insurance.

“A federal grand jury in Lexington has charged Pamela Allen with five counts of mail fraud.”

The allegations center around a fake trucking company, apparently created on paper in order to show mine employees as trucking company employees instead.

“The indictment charges that by hiding employees this way she was able to pay less than she should have for workers compensation insurance.”

Former Smurfit-Stone managers plead guilty

In California, two brainiac, ex-managers for Smurfit-Stone have pleaded guilty to charges involving a slapdash plot to dodge the workers’ comp system by allegedly, for instance, steering  injured workers to a physician’s assistant instead of using the proper medical channels; attempting to fudge leave time; and denying time off to recuperate.

If  it’s the same large company that uses the Smurfit-Stone name throughout North America and a couple of overseas locations, the problem may trace to the company’s pursuit for an exemplary safety record.

News accounts say the employees were managers at Smurfit-Stone’s Salinas, CA, factory, and the Smurfit-Stone Web site indicates that it does have a facility there.

The Insurance & Financial Advisor Web news site posted April 5 that subsequent to an investigation begun in 2006, “[t]wo former managers of a California-based container company pleaded guilty to conspiring to deny injured employees workers’ compensation benefits.

“David Lawrence Polk, 53,  . . .[and] Douglas Minoru Tateoka, 61, both former managers of the Smurfit-Stone Container Corp. plant in Salinas, Calif., recently entered the pleas, according to the California Department of Insurance.”

Between the IFA’s account and a late-March report in the The Herald of  Monterey County,  the picture that emerges is a twisted take on Dumb and Dumber, but instead of unintentionally intercepting a load of ransom money, the principals were intentionally misrouting injured workers away from bona fide medical treatment–and from the injury-reporting system.

Workers steered to physicians assistant

The local DA’s office was contacted in October 2006 by a pair of Smurfit-Stone employees, says The Herald, complaining that workers were discouraged from filing workers’ compensation claims at the Salinas plant.

“The original complaints . . . [reported] that workers were taken to the company doctor, who actually was a physician’s assistant.”

The IFA report says that Polk and Tateoka even managed to insert themselves into the examination area where they tried “to influence the diagnosis and treatment of injuries.

“Polk and Tateoka allegedly concealed workers’ injuries, tried to prevent leave time from being medically prescribed and denied injured workers time off to recover, officials said.”

Effort to reduce reporting injuries

Furthermore, in an apparent effort to keep from reporting time lost due to injuries, the affected employees were reassigned to answering phones, shown training videos, and in some cases relegated to “even remaining in their vehicles in the parking lot . . . .”

In 2007, officials from the DA’s office and state insurance regulators arrived with a search warrant and found that workers were being handled outside the system–so much so, according to The Herald, that “[o]ne employee was given a prescription written in the manager’s name, with the understanding the medication could be given to other employees at the manager’s discretion without medical consultation.”

Perhaps the  larger issue is whether Polk and Tateoka are competent managers who were pressured by a too-stringent company policy, or were they simply a pair of goofballs who overzealously interpreted a strong-but-good-faith effort by the company?

The prosecutor is on the record for the company’s sharing blame, according to The Herald: “Part of the motivation, said the DA, was an incentive program that paid bonuses to managers and other employees if the number of reported injuries was minimized.”

Certainly, we’ve such issues before, which we mentioned in our “Report Cards” post in September 2009, describing the concerns of Colorado legislators over reports of bonuses for state agency workers who denied workers comp claims.

And there’s little doubt that Smurfit-Stone with this homepage takes pride in its claims to safety. On the Web site’s “About our company” page, this is third paragraph: “When it comes to our people, safety is at the core of our operating culture. We are proud to have been recognized as the industry’s safety leader every year since 2001.”

Then, there’s a separate “Corporate Safety” page, with six paragraphs about goals, meeting objectives and so forth, including this: “We are proud to have led the industry in safety since 2001, and our performance continues to improve year after year. Our 2008 corporate safety goal was met by achieving a recordable case rate (RCR) of 0.94, making 2008 Smurfit-Stone’s safest year yet.”

Below a link to Pandemic Preparedness (with a specific bullet point admonishing workers to “stay at home” rather than coming to work sick) are three paragraphs that emphasize the RCR highlights of different divisions.

Unanswered e-mails

But what role the case that resulted in these guilty pleas played in the company’s emphasis on safety–if any–is unclear. Two separate e-mails requesting clarification from media relations personnel remained unanswered at post time.

According to The Herald and IFA, Polk and Tateoka are set to be sentenced May 20.

He may not be a terminator in real life, but that Gov. Shwarzenegger is a rip-snorter for putting state workers on furlough–so much so that now there’s seven separate lawsuits challenging the legality of the tactic, which the San Francisco Chronicle reports has affected nearly a quarter-million state employees.

Wow, if the Chronicle is correct (apparently they’re rounding up numbers, to 238,000), then all state employees are affected: according to the California State Controller’s Web site, the State Employee Demographics page shows a total of 237,731 employees, including part-time, intermittent and indeterminate workers.

Schwarzenegger says the furloughs are a cost-cutting measure for state coffers that have been ravaged by the Great Recession. Unemployment reached a record level in January, and California is one of five states sharing $1.5 billion in aid, for the areas hardest hit by foreclosures.

Whatever the total count turns out to be, the furloughs certainly involve several thousand employees of a state workers comp fund, a quasi-public agency that has one set of rules for line workers and another for execs.

Furloughs of 7,400 already ruled on, last year

We first mentioned the furloughs back in September, when a superior court ruled “that Gov. Arnold Schwarzenegger illegally furloughed 7,400 employees of the State Compensation Insurance Fund this year. . . .”

The governor’s actions have been upheld in some courts, but according to a March 20 San Francisco Chronicle piece, “An Alameda County judge ruled in December that Schwarzenegger illegally furloughed more than 50,000 employees in 68 agencies, [although] other judges have upheld the governor’s actions.”

But on Friday, Schwarzenegger took another hit when a three-judge appellate panel ruled that he “had no right to furlough about 475 lawyers who work for the State Compensation Insurance Fund.

“The Court of Appeal said the attorneys are protected by a provision of state insurance law that makes fund employees ‘exempt from any hiring freezes and staff cutbacks otherwise required by law,’ according to the Silicon Valley Mercury News.

The Chronicle had this: “The ruling by the First District Court of Appeal in San Francisco applies to about 500 attorneys and hearing officers who work for the State Compensation Insurance Fund. It is likely to affect a separate case, pending before another division of the court, that involves more than 7,000 clerical workers, support staff and other employees of the insurance fund.

“Other laws apply to most of the 238,000 state employees the governor furloughed for two days a month from February through June 2009, and for three days a month since then.”

Governor asks Supreme Court to intercede

A very interesting aspect of the seven suits is that Schwarzenegger has requested intervention from the state supreme court, which the Sacramento Bee earlier this month described as move that stunned labor unions: “Gov. Arnold Schwarzenegger’s request Tuesday for the California Supreme Court to take over seven key furlough lawsuits caught state employee unions off guard.

“Schwarzenegger wants to legally leapfrog two appellate courts now considering those cases and go straight to the state’s highest legal authority, sort of like skipping the playoffs and going straight to the Super Bowl.”

And, of course, the sheer size of the numbers grabs your attention–this from the Chronicle’s account: “At stake is more than $1 billion in back pay, plus interest, that the state would owe the workers if they won their cases.”

But here’s what really interesting, again (with our emphasis added) from the Chronicle:

“The governor’s Supreme Court request did not include suits by employees of the insurance fund, which is authorized by state law to make its own staffing decisions. Schwarzenegger’s press secretary, Aaron McLear, was noncommittal about an appeal of Friday’s ruling, saying only that the administration was reviewing its options.

“Patrick Whelan, lawyer for the union representing the insurance fund attorneys, said the ruling doesn’t apply directly to most furloughed state employees but is still encouraging.

” ‘It shows the governor’s authority is not as broad as he believes,’  he said.

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Whether you’re an injured employee or an aggrieved employer, if you’re facing legal problems regarding workplace injuries, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Denial of benefits

Choosing an attorney

AIG, the giant insurer and a major player at the core of the Great Recession, has been allowed by a federal judge to begin issuing subpoenas to 400 of its competitors in the workers compensation insurance business, according to a March 16 piece at businessinsurance.com.

The ruling, which allows AIG to pursue “nonparty discovery,” is part of a larger dispute between AIG and several competitors–but extends to “discovery of practices by insurers not named in the lawsuit, AIG said Monday in a statement.”

Industry leaders involved

The fracas involves some heavyweights in the industry, including some who joined forces in the original RICO suit against AIG: “The ongoing litigation grew out of a May 2007 lawsuit against AIG originally filed by the National Workers Compensation Reinsurance Pool made up of AIG competitors and operated by Boca Raton, Fla.-based NCCI Holdings Inc. That suit alleged violations of the Racketeer Influenced and Corrupt Organizations Act by AIG, among other assertions.”

It also involves some colorful language, for what might seem an otherwise dry topic.

Let’s pick up the story in 2005 when, according to an August 26, 2009 post at an insurance law blog, “a New York state investigation revealed that AIG had, over several decades, provided false reports of its workers’ compensation premiums to NCCI and state tax authorities to evade its residual-market obligations.” Id. Thereafter, in 2006, AIG entered into settlement agreements, including a $1.6 billion settlement with New York and federal authorities. The Participating Companies contested that the settlement agreements offered full and fair restitution. Id. at 5.

“On May 24, 2007, NCCI filed suit against AIG, alleging underreporting of premium data. AIG interposed numerous defenses and asserted counterclaims for an equitable accounting and an action on an open, current, and mutual account, both of which survived NCCI’s motion to dismiss. AIG also filed a 12-count third-party complaint against 24 named companies and numerous unnamed companies. Id. at 3.”

Court dismisses NCCI suit

But in August 2009, a federal district court dismissed the suit against AIG, “holding that the NCCI failed to establish standing to assert claims on behalf of the Pool.”

That’s when AIG came out swinging, inserting itself as plaintiff, and as described at workerscompsc.com, in September 2009 amended that complaint “in its Chicago racketeering conspiracy fight alleging fellow members of the National Workers’ Compensation Reinsurance Pool conspired to suppress a state and federal probe of the systematic underreporting of workers’ compensation premiums.”

AIG’s amendment, according to Michael Whiteley, “names as defendants the pool, NCCI and 19 insurance companies. It focuses on the actions of Liberty Mutual Group, Travelers, The Hartford, Ace INA Holdings and Sentry Insurance Co. as carriers AIG says have dominated the governing board of NWCRP.

“The amended complaint, which was filed under the Racketeer Influenced and Corrupt Organizations Act (RICO), alleges that NCCI flagged significant problems with the misreporting of premiums as early as 1986 and then conspired with pool members to conceal the problem while then-New York State Attorney General Eliot Spitzer was investigating the practice at AIG.”

AIG says it was targeted as scapegoat

Furthermore, AIG alleges the whole thing was a longstanding sham-up, designed to hurt AIG.

Again from the Whiteley piece: “And AIG repeated assertions that its competitors – led by Liberty Mutual, which last year overtook AIG as the leading comp insurer in America – conspired to make AIG the scapegoat in the Spitzer probe to prevent investigators from broadening their target.

“AIG said a Liberty Mutual representative on the pool’s governing board said at a board meeting in 2005 that the Spitzer probe gave the board ‘an opportunity to get the bastards at AIG.’ “

The residual market

What’s at stake is who-owes-what to cover costs in the so-called “residual market,” the pool for employers who can’t workers’ comp coverage in the primary market. As the insurance law blog explains:

“The action concerned the workers’ compensation insurance market. Employers obtain workers’ compensation insurance coverage from insurers in what is known as the “voluntary market.” Insurers that provide coverage to the voluntary market are required by state law to provide coverage to the “residual market,” which is the market for employers who cannot obtain coverage on the voluntary market. Those employers obtain workers’ compensation insurance coverage through an individual state’s assigned risk plan. Under that plan, the amount of insurance an insurer is required to provide for the residual market is directly proportional to the amount of premiums it collects for the policy it writes for the voluntary market. Mem Op. 3″

“Therefore, ‘any company that underreports its premiums to NCCI decreases its reinsurance participation rate and the overall total used to calculate all the rates.’ Id.”

‘Common practice in the insudtry’

Looking through the various accounts of the lawsuits and countersuits, it’s hard to find any instances in which AIG denies under-reporting these premiums. After all, it did settle for at least $1.6 billion in 2006. So far, it seems like AIG is merely saying, well, everybody did it.

From the businessinsurance.com conclusion, re AIG’s most recent action: “Now AIG is seeking proof through its subpoenas that premium underreporting practices it is alleged to have engaged in were common practice in the industry.”

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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.

Eddie Lampert, the billionaire hedge-fund operator who masterminded the Kmart/Sears deal and wound up as chairman of Sears Holding Corp., is making headlines recently over remarks in his annual letter to shareholders. For example, Michael Corkery gigs Lampert in the Wall Street Journal (“Sears’s Lampert Feeling Testy”); an AP writer takes a dig from BusinessWeek.com; and Rich Dupre, at MotleyFool concludes that “it seems a little early for Lampert to be churlish and thumb his nose at the critics by saying ‘I told ya so!’ ”

These opinions are reaction’s to Lampert’s assertions about “self serving . . . [b]usiness leaders, regulators, public officials, and journalists” who “have become an echo chamber of self-support and self-congratulation, whether on TV, in print or at numerous conferences.” He also had comments for critics of his investment and store-upgrade choices, as well as the role of rating agencies and “the seizure of Fannie Mae and Freddie Mac . . . .”

But what employees might notice–past. current or potential–is his take on regulation. Some highlights:

• “I fear that Americans have been provided a false choice between a little more and a lot more regulation and taxes.”
• “On the other hand, there are many who believe that less regulation, less government interference, less arbitrary regulation when it does exist, and lower government spending will generate more growth and more jobs.”
• “However, in most industries and societies where there is more regulation, there is typically lower growth, lower employment, and less innovation.”
• “Self-regulation is a better idea and it is a better choice, whether for an individual or a corporation.”

Maybe he’s talking about tariffs or trade restrictions or minimum wage–or all the above. Regardless, let’s hope he’s not talking about job safety and treatment of injured workers.

Worker injured, reassigned–then fired

A couple of recent cases show that at least a few hundred Sears workers have benefited from workers comp regulations.

The first one, dating to August 2005, seems to be a win for Sears–at first blush. In this case, reported Feb. 9 at Leagle.com, a Virginia court of appeals agreed with Sears and its insurers, in the sense that it remanded the case back to the workers comp commission. The appeals court found the commission erred when it denied “Sears’s request for a hearing on its claim that William L. Cruse (claimant) filed his claim for benefits after the statute of limitations had run.”

Things may not be as bright for Sears as that ruling might indicate, though. Here’s how it started, according to the Leagle summary: “On August 10, 2005, claimant was injured while working for Sears. Sears filed an accident report approximately one month later. Claimant filed a claim for benefits with the commission on August 16, 2007.”

In other words, Cruse filed the claim six days past the ostensible two-year limit.

But “[w]hen the commission held its hearing on the claim, no representative of Sears was in attendance. Claimant appeared and testified about the events that led to his workplace accident. He also explained that Sears’s operations manager told him after the accident to go to the doctor and that the manager said, ‘Sears will take care of it, we’ll pay for it.’ The doctor prescribed physical therapy, which Sears’s insurance carrier refused to cover.

Claimant testified that when he informed his manager that the carrier refused to pay for the physical therapy, the manager said that claimant should go to physical therapy and ‘we’ll pay for it.’ ”

Apparently, though, Sears never paid any of the medical bills, but the company did lighten Cruse’s work duties and “and paid him regular wages for a short time after the accident”–when they fired him.

Commission rules injury compensable

Following the hearing, the commission ruled in January 2008 that the injury was compensable and awarded Cruse medical expenses. The statute of limitations was not mentioned in the ruling, and Sears remained quiet, for a while. Then, nearly three years since the injury, on “August 8, 2008, Sears filed a motion to vacate the award, contending that claimant did not file his claim for benefits before the statute of limitations had run and, therefore, that the commission did not have jurisdiction to enter the award.”

The commission not only denied a hearing but also the motion to vacate, saying the original ruling had been final and “that the statute of limitations was not a subject matter jurisdiction issue.”

Sears appeals

So Sears turned to the appeals court. In its analysis, the court considered several cases, appelate decisions and the statutes themselves, in consideration of Sears’s assertion that the employee was out of luck simply for waiting more than two years to file. The court didn’t agree, however, quoting statute showing that the two-year time period can be “tolled,” or extended, under certain, specific circumstances. Then the court cited a state Supreme Court ruling that found ” ‘[u]nder these circumstances,’ it was appropriate to ‘affirm the rulings of the [c]ommission,’ but also to ‘remand the case for a hearing’ on the question of the statute of limitations and the possibility that it was tolled. Id. at 411, 83 S.E.2d at 733.

“We find that Winston most nearly addresses the issues raised by Sears. The commission here did not address the issue of the statute of limitations, perhaps in part because Sears failed to appear at the hearing. Claimant did not explicitly raise any issues regarding tolling during the hearing before the commission, although some evidence in the record suggests that the statute of limitations in this case might be properly tolled for a period of time.

Appeals court finds ‘tolling’ provisions may apply

Thus, we conclude that this case, as in Winston, should be remanded for an evidentiary hearing on the statute of limitations and any tolling or estoppel provisions that may apply.”

So, in other words, Sears “won” in the sense that the Cruse case now returns to the workers comp commission. But it also sounds like the court recognizes that by not appearing at the original hearing, Sears may have left the door open for the commission to ignore the two-year filing requirement. Plus, according to a footnote, Sears may have a problem with having changed Cruse’s duties and paying him a regular wage for a time before canning him. Certainly, the court did not grant Sears’s motion to vacate the award, so this story’s not over.

EEOC settlement from earlier case

The story is over, however, for 235 former Sears employees, who will receive anywhere from $2,500 to $125,000 as a result of the largest ever settlement involving the Americans with Disabilities Act (ADA). As ohs.online explains, “On Feb. 5, the U.S. Equal Employment Opportunity Commission announced court approval of the distribution of a $6.2 million compensation fund in the landmark Americans With Disabilities Act (ADA) litigation between EEOC and Sears, Roebuck & Co. The distribution is being carried out pursuant to the terms of a consent decree approved by Federal District Judge Wayne Anderson on Sept. 29, 2009.”

This case dates to 2004, when, says law.com, ” The EEOC sued Hoffman Estates, Ill.-based Sears in 2004 following a complaint from John Bava, an injured appliance service technician who said Sears fired him after he took a leave for knee, wrist and back injuries suffered on the job. Bava is the only plaintiff to get the top $122,500 payout, based on his initiation and the facts of his particular case, said John Hendrickson, who leads the Chicago regional EEOC office that pursued the matter.”

Now, this is a settlement, so Sears did not plead guilty to anything, as explained at chicagobusiness.com, “Sears did not admit guilt as part of the settlement, which brought and end to a November 2004 lawsuit filed by the EEOC on behalf of a former Sears employee. That employee claimed he was fired from his Sears job at the end of a one-year workers compensation leave.”

Settlement benefits employees still on the job

Moreover, the benefits of the settlement extend beyond the damaged former employees. Back at ohsonline: EEOC “Chicago Regional Attorney John Hendrickson said, ‘The Sears case has been a long haul, but now it’s over–this is it. The court has enjoined future discrimination by Sears and approved the amount of money each class member will receive for the particular discrimination he or she suffered. Their day for compensation is here, and as far as the EEOC is concerned, that makes it a good day for everyone involved.’

“EEOC Trial Attorney Aaron DeCamp noted that, in addition to the disbursement of settlement funds, EEOC is seeing positive effects from the consent decree. ‘As a result of the decree, we believe Sears has an improved worker’s compensation leave process, and it has posted notices regarding the decree. We know that employees have been seeing the notices because we’ve been receiving inquiries as a result. So we think it’s pretty clear that our lawsuit genuinely benefited the employees of Sears and strengthened the company’s human resources processes.’ ”

So, despite Lampert’s protests to shareholder about free markets and government regulations, it doesn’t take a legal scholar to understand what might have happened to these hundreds of workers without regulations and legal recourse.

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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.

A month after a private company’s issuance of “report cards” on individual states’ performance regarding working workers compensation, some states are reporting rate decreases, some are reporting increases, and others seem to be, well, in a mess. Officials in New York, according to “EHS Today,” are reminding 9/11 workers from around the country that only “12 months remain until the final registration deadline of Sept. 11, 2010″ for  “workers and volunteers who participated in rescue, cleanup or recovery operations following the attack on the World Trade Center to register with New York State’s Workers’ Compensation Board to preserve the right to file for 9/11-related workers’ compensation.”

Says EHS Today in a Sept. 16 post, “Those who have yet not registered must do so in order to file for medical and wage replacement benefits if they are currently sick or if they are concerned they might get sick in the future.”

On July 22, the Work Loss Data Institute (despite the name, a private company that says it has offices in Texas and California) announced its self-proclaimed “much-anticipated” 2009 edition of its “State Report Cards for Workers’ Comp,” which it says uses “the most current data available” in order to “help employers, insurers, TPA’s, state governments and consultants answer the questions, ‘Who is doing well and why?’ “

According to the company, which also sells a trademarked line of products under the “Official Disability Guidelines” umbrella, the 2009 report cards show that “Iowa performed the best of all the states for 2006 and Minnesota came in a close second. Both states received a grade of ‘A+’ based on an average of their 2006 scores in the five categories above. Illinois came in last, with Wyoming, Rhode Island and New York very close to the bottom. In total, nine of the 43 states received a grade of ‘F’ in 2006. A summary of each grade for all states is shown on a  U.S. Map Showing Grades by State.

According to that graphic, six states are in the best, top tier, (“Tier I,” from, roughly west to east): Utah, Kansas, Minnesotta, Iowa, Alabama and Virgina. Again roughly west to Eest, the “Tier II” states are Nevada, Arizona, Indiana and Georgia.

In the mid-ranks, “Tier III” states include Montanna, New Mexico, Missouri, Arkansas, Michigan, Delaware, Vermont and Maine; the “Tier IV” states are Alaska, Oregon, Washington, Nebraska, Wisconsin, Tennessee, Kentucky, Florida, North Carolina, South Carolina, Delaware and Connecticut.

In the lower two brackets, the “Tier V” states are Hawaii, California, West Virgina and Maine; apparently the Hall of Shame states, comprising Tier VI, are Wyoming, Texas, Oklahoma, Louisiana, Illinois, New York, New Jersey and Rhode Island.

Oddly enough, two neighboring “Tier IV” states, Oregon and Washington, are on divergent paths as far as workers comp rates are concerned.

From the Portland Business Journal, this Sept. 11 post says “Workers’ comp rates drop for fourth straight year.” But next door in Washington, also according to PBJ, “premiums will increase by an average of 7.6 percent, or about 4 cents per hour worked, the state Department of Labor and Industries announced” Sept. 21.

In Oregon, the “Department of Consumer and Business Services announced that the workers’ compensation ‘pure’ premium rate will decrease by a 1.3 percent average in 2010, saving employers $18.1 million. Workers’ compensation rates have decreased each year since 2006 and have not increased since 1990, according to department officials.

“Oregon’s costs remain low because the state continues to experience fewer workplace injuries and illnesses, said Cory Streisinger, director of the Department of Consumer and Business Services. The state’s workplace injury and illness rates in Oregon have declined nearly 19 percent since 2004.”

The rate story in Washington is a bad news/good news scenario. Yes, rates are expected to climb  nearly 8 per cent, but earlier projections had forecast a rise of 15 to 20 per cent. Several business groups decried the premiums hike, but the state’s director of the Department of Labor and Industries Judy Schurke explained that the “increase is needed for several reasons: Workers’ comp funds now have weaker investment returns, there are fewer premiums because people aren’t working as many hours, and there are fewer jobs for injured workers to return to. In addition, health-care costs have increased by 8.5 percent and wages increased by 3.4 percent.”

Another state with good news is Kentucky, as reported Sept. 21 in Business First–savings there will begin before 2010: “Kentucky’s largest workers’ compensation insurance provider is lowering its rates for businesses across the state.

“The reduction by Kentucky Employers’ Mutual Insurance amounts to an overall average of 6 percent, it said Monday in a news release.

Businesses eligible for preferred rates might see decreases of as much as 30 percent.

The new rates go into effect Oct. 1 and apply to both new and renewal policies.”

Apparently officials in Wisconsin and Colorado might be happy if all they had to deal with were rate hikes. According to a Sept. 21 account in the Green Bay Press-Gazette, a conference on workers compensation scheduled for today was quite apprpopriately organized around a railroad theme: ” ‘In Wisconsin, the workers compensation process is a bit of a train wreck,’ said Sandy Wight, marketing executive with the Orthopedic & Sports Institute of the Fox Valley in Appleton.”

According to a Sept 18 cbs4denver.com post, the recent Pinnacol hearings have left legislators in Colorado with little choice to revamp the current system. “Colorado lawmakers say they can’t ignore problems that came up during hearings on the state’s biggest workers compensation insurer, Pinnacol Assurance.”

One item in particular is a sore spot: seems Pinnacol employees have in the past earned bonuses for denying claims. Here’s a highlight of reform proposals, from a Sept. 18 piece on denverpost.com:

• “Bar financial incentives for denying or delaying claims or medical treatment and require that conflicts of interest be disclosed.
• “Require greater oversight by Pinnacol’s board, including “improved complaint provisions . . . and annual reporting.”
• “Institute a mechanism for lowering policyholders’ rates.
• “Create a “Worker’s Bill of Rights” to better inform injured employees of their rights.
• “Require a “probable reason” to suspect fraud before conducting surveillance on injured workers.

A detailed account of the Colorado situation is here.

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.

Workplace safety in Texas is something that you should have a great interest in if you live and work in this state. This is the place where you probably spend at least 8 hours a day and 40 hours a week or more. This alone makes your safety in the workplace in Texas to be of great importance.

The place where you work is probably not the same as where your father worked a generation ago. The primary focus used to be on manufacturer’s production lines or moving materials within a shipping, receiving or storage area. Repetitive action or motion was what businesses depended on to produce a product.

The workplace of today has expanded far beyond the assembly line. The workplace of today also involves mobility. It now involves the highways and byways that crisscross the United States.

This is certainly true in Texas. In Texas, your workplace can be in a building or an office, but it can also be on the streets and highways of this great state.

What constitutes a workplace in Texas? How is it defined? A workplace is by definition, “a place where commerce is conducted.” This means that any place where work is conducted can be your workplace. Your workplace can be an office, building or motor vehicle.

What, then, is meant by workplace safety in Texas? Workplace safety refers to the working environment at the place where you work. Workplace safety encompasses all of the factors that impact your health, safety and well being while you work.

Workplace safety in Texas can involve a lot of things. It can include workplace violence, unsafe working conditions or processes, drug and alcohol abuse and environmental hazards.

Workplace safety is governed at the national level by the Occupational Safety and Health Administration (OSHA). The cornerstone of OSHA’s policies and regulations are seen in its three stated goals.

• Improve the safety and health for all workers, as evidenced by fewer hazards, reduced exposures, and fewer injuries, illnesses and fatalities

• Change workplace culture to increase employer and worker awareness of, commitment to and involvement in safety and health

• Secure public confidence through excellence in the development and delivery of OSHA’s programs and services.

The federal guidelines of OSHA are complemented by state regulations in Texas. In Texas, the Workers’ Health and Safety Division of the Texas Workers’ Compensation Commission provides assistance with workplace safety and health issues to employers, employees, and workers’ compensation insurance carriers and policyholders.

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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.

The issue of workers compensation in Texas is important to you if you live and work in Texas, and you have been injured on your job or become ill due to the type of work that you do. In fact, you may be having problems and difficulties in getting compensated for that injury or illness at the present time.

It is well to keep in mind what workers compensation is. Workers compensation is a form of business insurance. It provides benefits in the form of medical coverage, income and rehabilitation to employees or their family who suffer injury, illness or death as a result of, or in the course of, their job.

This does not depend on whether the employee was at fault. If you were to lose your life at your place of employment these financial benefits may be given to your survivors or dependents. These benefits are yours or your dependents or survivors as a matter of “right.” Your employer cannot resort to any legal defense. In return for this, neither you and/or your dependents nor survivors can sue your employer for your injuries or death.

Workers compensation laws were established to reduce the need for litigation and to mitigate the requirement that injured workers had to prove that their injuries were the “fault” of their employer. Workers compensation laws have been around since Maryland enacted the first state law in 1902. The first federal law came 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.” Texas uses the term, “worker’s compensation” or “workman’s comp.”

When it comes to your safety and health at your workplace, although laws differ from state to state, they all must be in accordance with the Occupational Safety and Health Administration (OSHA). OSHA, at the national level, has the responsibility of making sure that your workplace is healthy and safe.

There is no national agency, however, that requires all employers to provide workers compensation benefits. The laws regarding workers compensation vary from state to state.

Workers compensation in Texas falls under the general heading of the Texas Department of Labor. More specifically, they are under the Division of Workers’ Compensation of the Texas Department of Insurance.

The Texas Workers’ Compensation Act of 2007 states that the Texas Department of Insurance, “is the state agency designated to oversee the workers’ compensation system of this state.” This act goes on to say that, “the division of workers’ compensation is established as a division within the Texas Department of Insurance to administer and operate the workers’ compensation system of this state as provided by this title.” In other words, the division of workers compensation is to administer the compensation system of Texas in accordance with the provisions of the Texas Workers’ Act of 2007.

In regard to these provisions, it is important for you to know and remember that workers’ compensation in Texas is elective. It is not mandatory or compulsory. This means that your employer can choose between providing workers’ compensation coverage or being subject to civil suit in the event of your injury on the job. The exceptions to this are governmental entities and construction contracts for governmental entities. In these cases, workers’ compensation insurance is required.

Workers compensation laws in Texas are based upon the theory that the burden of on-the-job injuries should be shifted from the worker to the employing business, and ultimately to the consuming public, as a cost of doing business. These laws protect and benefit you as an employee by providing simple, speedy, effective, and inexpensive relief, without regard to the fault of the employee, employer or third parties.

Texas employers who decide to provide workers compensation coverage for their employees have some important legal protections. One of the most important protections is immunity from most lawsuits by injured workers. If an employer has workers compensation, a lawsuit may go to court only after The Texas Department of Insurance’s (TDI) administrative dispute process has been exhausted.

In addition, TDI’s recommendations must be presented to the court. The evidence presented is limited to the issues in dispute, and resolved issues cannot be reintroduced. The employer’s insurance company pays attorneys’ fees and other defense costs.

In order to have these legal protections, employers have to provide workers compensation coverage to their employees in one of the following ways:

• Purchase a workers compensation insurance policy from an insurance company licensed by TDI to write this type of coverage in Texas
• Be certified by TDI to self-insure their workers’ compensation claims
• Join a self-insurance group that has received a certificate of approval from TDI
• Be a political subdivision, which may self-insure, buy coverage from insurance companies or enter into inter-local agreements with other political subdivisions providing for self-insurance.

Employers without workers’ compensation can be forced to pay punitive damages if they lose lawsuits arising from workplace accidents. They also lose certain common-law defenses. They are not allowed to defend themselves in court by arguing that:

• The injured worker’s negligence caused the injury
• The negligence of fellow employees caused the injury
• The injured worker knew of the danger and voluntarily accepted it.

There are several benefits that you are entitled to if your employer has workers compensation in Texas, and you are injured on the job. You are entitled to medical benefits with no time or monetary limits. You may also make the initial choice of the doctor that you want to use from a list of physicians prepared by the Workers’ Compensation Commission.

You are also entitled to disability benefits. Your surviving spouse or spouse and children can also be paid disability benefits in the event of your death on the job.

As mentioned at the beginning, you may be trying to get the compensation and benefits that you believe you are entitled to because of an injury at your job. You are having problems and difficulties with your employer.

You may need the services of a legal professional. You need an attorney who knows and specializes in employment law. You need an employment attorney.