Many Experience Fallout of Workers’ Comp “Reforms”

In a recent article published by the NPR News Investigations titled “Injured Workers Suffer As ‘Reforms’ Limit Workers’ Compensation Benefits” the NPR details changes to workers’ compensation benefits in many states and details the issues faced by some workers in North Dakota, Oklahoma and California.   See:   http://www.npr.org/2015/03/04/390441655/injured-workers-suffer-as-reforms-limit-workers-compensation-benefits

In March 2015, ProPublica published an update to this article sharing stories of the real-life impact of these reforms titled “The Fallout of Workers’ Comp ‘Reforms’: 5 Tales of Harm”.   See: http://www.propublica.org/article/workers-compensation-injured-workers-share-stories-of-harm

In the March article, ProPublica noted that 22 states set arbitrary time limits on how long injured workers can receive temporary wage benefits. While most states are about 2 years, New Mexico allows for the longest with 13 ½ years. In Georgia, an injured workers’ income benefits are capped at 400 weeks if your doctor keeps you out of work or 350 weeks if you are restricted duty.

ProPublica also reported that 10 states, including Georgia, have increased their use of outside physicians to review treatment recommended by injured workers’ physicians. These “outside physicians” never see the injured workers and make their recommendations based solely on review of your paperwork.

Additionally, 10 states have been reported to show an increase in the use of “pre-existing conditions” to limit or deny claims. While Georgia has not followed this pattern, these states have either raised the qualifying standards when an injured worker aggravates a pre-existing condition or reduced the Employer/Insurer’s liability when other conditions, such as aging, could have been a contributing factor in the injury.

In a final study, ProPublica cited that 18 states allow the Employer and/or Insurer’s to choose the doctor for an injured worker, while 19 states restrict injured workers to a list of doctors approved by their Employer/Insurer. Georgia falls into the later category where the Employer is required to maintain a Panel of Physicians which must list at least six doctors or medical providers. It must include at least one orthopedic surgeon and no more than two doctors from “occupational clinics”.   In some cases, the Employer will have an MCO panel.

At the Law Offices of Laura Lanzisera, we know that figuring out what you are entitled to can be overwhelming. Contact our office and let us help you navigate the laws and get you the benefits you are due.