Tag Archives: Benefits

The Road Ahead: Adjusting To Life After An Injury

As an attorney who has represented injured workers for more than 27 years, I see first hand what an injury can do to workers and their families. A number of years ago I represented an injured electrician, who as a result of an overextension injury sustained on the job, ended up having multiple surgeries. Almost immediately, this once athletic, high wage earner with a beautiful family and comfortable lifestyle saw an abrupt end to the life he knew.

My client faced a debilitating injury. He was no longer able to travel, his personal relationships suffered, and his once strong physique withered away. His financial situation was dire and he was unable to afford his home. Beside the extreme physical impairment, he ended up being treated for major depression. Both the insurance carrier’s medical providers, as well as the claimant’s treating doctors in this particular case, agreed that the claimant was totally disabled or incapable of performing any meaningful work activity – a standard not easy to meet.

Many of those injured on the job may not be able to return to their prior employment. Yet, according to the law, that does not mean they are totally disabled from any employment. If they are able to perform any work activity at all then they may be considered partially disabled. The amount of weekly payments an injured person receives and the length of time an injured worker receives these benefits is dependent upon a number of factors including degree of disability and loss of earning capacity. A partial disability can be considered mild, moderate, or marked.  These degrees are further broken down into when an injury is deemed permanent to a percentage loss of earning capacity. In some cases the difference of one percent loss of earning capacity can mean the difference of a full year of additional benefits. As you can imagine, much of my practice is consumed with litigation regarding the degree of disability and the loss of earning capacity.

The road for those who are partially disabled is not an easy one. Despite the Workers’ Compensation Board’s determination that an injured person has an ability to perform some work activity, it does not always translate into being able to obtain employment. In the case of serious injuries resulting in extensive lost time, the employer may have had to fill the position or the employer may not be able to accommodate the physical limitations. This puts injured workers in a position of having to look for alternate employment that they may not be trained for. The Board recommends a number of resources available to those seeking assistance, including one-stop career centers, as well as participating in vocational rehabilitation programs and continuing education such as SUNY Educational Opportunity centers adult career and continuing education. For more information go to www.wcb.ny.gov/labor-market-attachment

Many workers who are unable to obtain employment because of their injuries apply for Social Security Disability benefits. The standard for Social Security disability is different than Workers’ Compensation and relies more on the age and ability of the injured person to be retrained and to obtain relevant future employment. Social Security Disability benefits are payable for any illness or injury and do not have to be work related. All medical conditions are considered by the federal judge when making a determination as to eligibility, including physical or emotional impairments.

While an injury on the job can be life altering, there are resources available. You may never be able to return to your pre-injury status, but knowing your options allows you the ability to have some control over your future.

 

Catherine M. Stanton is a senior partner in the law firm of Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP. She focuses on the area of Workers’ Compensation, having helped thousands of injured workers navigate a highly complex system and obtain all the benefits to which they were entitled. Ms. Stanton has been honored as a New York Super Lawyer, is the past president of the New York Workers’ Compensation Bar Association, the immediate past president of the Workers’ Injury Law and Advocacy Group, and is an officer in several organizations dedicated to injured workers and their families. She can be reached at 800.692.3717.

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Dirty Tricks Lead To Reduced Benefits In Cuomo’s New Budget

Governor Cuomo signed a new budget this week. While many extolled his progressive agenda that included free college tuition for the middle class, renewing the millionaire’s tax, and giving a tax break on dues for union members, he also quietly and without much fanfare in the news media, struck a huge blow to injured workers. 

Unfortunately for those members of our society who no longer are able to work as a result of an injury, or sustained a life altering injury while on the job, their benefits became part of a horse-trade in Albany much to their detriment. Governor Cuomo, anxious to get his big publicity items in the budget in case he seeks higher office, seems to have used Workers’ Compensation as a bargaining chip. 

The Business Council circulated fake facts blaming injured workers’ benefits for the high cost of doing business in the state, when in reality employer costs nationwide for Workers’ Compensation are at their lowest levels in 35 years.  Locally, Workers’ Compensation costs in New York have declined dramatically as well; compensation is only a small portion of employer costs and is extremely profitable for insurers. The Business Council seems to have a number of members with strong ties to the insurance industry, which makes their position even further suspect.

In 2007, the Council was successful in lobbying to obtain caps on indemnity benefits and has now continued its assault so that the prior limit on weekly benefits will be further reduced. When caps were first put into place, they did not go into effect until judges determined that injured workers had reached maximum medical improvement and that their conditions could be classified as permanent. This new provision automatically starts the cap after 2½ years, regardless of a person’s abilities or condition, or whether or not he will ever be able to work again or find work that meets medical restrictions. It is up to the injured worker to show that he has not reached maximum medical treatment that the carrier can refute.  

The Business Council has continued its attack by alleging that permanent loss-of-use awards were unfair to the employer. They argue that the prior guidelines were outdated and did not take into consideration new advances in medicine. Again, fake facts! The guidelines are based on range of motion and loss of function after all modalities are exhausted, including new advances in medicine available. As a result, the new law directs the Board to “consult” with a group stacked with pro business and insurance interests, but no representatives of injured workers to “review” the current guidelines with the ultimate goal of reducing benefits. The fact that workers who have permanent life-altering injuries to their arms, legs, hands, feet, fingers, and toes have absolutely no say is extremely distressing.

When does this eroding away of Workers’ Compensation benefits end? Two years ago, ProPublica published a series of articles entitled “The Demolition of Workers’ Comp”.  They documented the cutbacks made in many states with disastrous consequences. Their report noted that since 2003, 33 states passed Workers’ Compensation laws that reduce benefits or make it more difficult to obtain benefits. New York is part of that list, having enacted laws not once, but twice, since then.

Many believe that reducing benefits to injured workers will force them back to work. Studies have shown that this is another myth perpetuated by the falsehood that injured workers are frauds. What happens in reality is that many injured workers are unable to work and are forced into poverty or have to collect alternate benefits. Social Security Disability benefits, which are paid by the American taxpayers, are generally offset by Workers’ Compensation benefits. Without Workers’ Compensation payable by the insurance carrier, the burden on the taxpayer is larger. Rather than the Workers’ Compensation insurance carrier paying for medical treatment, it is put through Medicare. This is known as cost shifting and it affects all of us, as we are the ones who end up paying – and paying dearly.

 

Catherine M. Stanton is a senior partner in the law firm of Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP. She focuses on the area of Workers’ Compensation, having helped thousands of injured workers navigate a highly complex system and obtain all the benefits to which they were entitled. Ms. Stanton has been honored as a New York Super Lawyer, is the past president of the New York Workers’ Compensation Bar Association, the immediate past president of the Workers’ Injury Law and Advocacy Group, and is an officer in several organizations dedicated to injured workers and their families. She can be reached at 800.692.3717.

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Proposed Legislation Threatens To Eliminate 100 Years Of Progress

More than a century ago, 146 garment workers, mostly women, died when a raging fire trapped them behind doors that were locked by their employer to prevent perceived theft. They died of smoke inhalation or falls while trying to flee the fire, or were burned alive because they were unable to get out.  In order to save money and increase profits, their employer had previously refused to install sprinkler systems and provide working fire equipment. Despite clear fault on their part, the employers were cleared of any wrongdoing in what is known as the Triangle Shirtwaist Factory Fire in 1911.

Protracted lawsuits filed against them by the families of the dead were eventually settled for $75 per life lost. While this tragedy temporarily outraged the public and forced public officials to improve worker safety, which was the impetus for Workers’ Compensation legislation, years later workers are still getting injured, maimed, and killed and are not at all compensated adequately for their injuries.

I recently read a story in the New York Post about an incident that took place 10 years after the Triangle Shirtwaist Factory Fire about young women who were hired to paint watch dial numerals and hands with radium.  At the time, these young ladies were unaware of the dangers of radium, which is highly radioactive with exposure that can result in cancer and other illnesses, as well as death. The women would dip their paint brushes in the radium and then paint the watches. Since the brushes needed to have a fine point, they would put the tip of the paint brush in their mouths. They were never informed of the dangerous nature of their work. 

It appears that at least some, if not all, of the managers and owners of the factory knew of the dangers, but almost nothing was done to discourage the practice as it would have slowed down the work and thus reduced profits. Within a number of years, many of these women became quite ill and died torturous deaths. There was very little investigation by the Department of Labor, which was pro- business and worker safety was low on their list of priorities. Once the dying women learned that they had been poisoned by the radium, a law suit was filed. Despite the fact that the women’s skin was perpetually glowing, the company fought against the claim for years hoping they would die before they could testify, but eventually agreeing to a meager monetary settlement. 

Both tragic stories are similar in that worker safety was very much ignored in favor of profits. The hope for monetary compensation was pretty much a David and Goliath battle with big business and insurance companies pitted against the sick and injured. Neither was a fair fight.

Here we are, 100 years later and still fighting a battle against greed. Once again, big business in the form of the Business Council is using its vast resources to try to get Albany to again reduce the benefits given to injured workers in this state. Those people who now are unable to obtain adequate wage replacement or medical treatment, whose lives are uprooted, or have lost their homes and their hope for a healthy future are engaged in a battle that they are financially, physically, and emotionally unable to fight alone. 

You can help by contacting your State Senator and Assemblymember to vote against any bill that would reduce benefits to injured workers. Injured workers include those who have built your towns and cities, who have watched your children, who have served you at restaurants, and who have taken care of your sick. They are your family, your friends, and your neighbors – and they need you to help them battle Goliath. 

 

Catherine M. Stanton is a senior partner in the law firm of Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP. She focuses on the area of Workers’ Compensation, having helped thousands of injured workers navigate a highly complex system and obtain all the benefits to which they were entitled. Ms. Stanton has been honored as a New York Super Lawyer, is the past president of the New York Workers’ Compensation Bar Association, the immediate past president of the Workers’ Injury Law and Advocacy Group, and is an officer in several organizations dedicated to injured workers and their families. She can be reached at 800.692.3717.

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Removing The Safety Net: A National Trend Of Benefit Reductions For Injured Workers

Benefits for injured workers continue to be under attack throughout the country. In New York, there have been a number of changes in the last decade, all in the name of reform. These reforms were encouraging at first as they increased the weekly benefits for some higher wage-earning injured workers for the first time in decades. They also created medical treatment guidelines under the guise of allowing injured workers to obtain pre-approval on certain medical treatments and procedures. 

Unfortunately, the changes also resulted in reduction of benefits for many injured workers. Monetary benefits were capped, so injured workers deemed partially disabled could only receive a certain number of weeks of benefits regardless of their ability to return to their pre-injury jobs. The determination of the degree of disability has become a battle involving multiple, lengthy depositions of medical witnesses where the outcome is how long injured workers get wage replacement or whether they receive lifetime benefits. The criteria is not whether injured workers can return to their prior employment, but whether they are capable of performing any work at all, regardless of their past job experience or education. The battle is not limited to the amount of weeks of benefits injured workers can receive, however. The medical treatment guidelines, touted as getting injured workers prompt medical treatment, discounts the fact that if the requested treatment is not listed within the guidelines, it is denied and the burden is placed upon injured workers and their treating doctors to prove the requested treatment is necessary.

Other changes designed to cut administrative costs and court personnel include reducing the number of hearings held, thereby denying injured workers due process. There also has been a reduction in the number of presiding judges, and in many hearing locations the judges are not even at the site but are conducting hearings through video conferencing. At the end of October, the Board announced a new procedure authorizing the insurance carrier to request a hearing on whether injured workers should be weaned off of opioids that are used by many medical providers to treat chronic pain. While everyone would agree that the misuse of prescription pain medication is an epidemic in this country, many question whether the insurance industry really has the injured workers’ best interest at heart.    

As an attorney who has represented injured workers for more than 26 years, I have seen many workers successfully transition from injured worker back into the labor market. It is very encouraging to note that for many people the system has worked. They receive their treatment, which may involve physical therapy, surgery, pain management, prescription therapy, or whatever else their treating physician recommends. They are paid a portion of their prior income and after a period of convalescence, they are able to return to work. Some injured workers, however, are not so lucky. The decisions about what happens to those unable to work have been left to those who seem to care more about business and insurance industry profits. 

Just about one year ago, 14 people were killed and 22 more injured when ISIS-inspired terrorists went on a shooting rampage in San Bernardino, California. The nation and the world were horrified to hear about this tragedy and the story was in the news for many weeks. Now a year has gone by and many of the survivors have complained about treatment being denied and prescription medication being cut off.  While many injuries happen quietly without the headlines seen in the California attack, there are many similarities. It seems that when an initial injury occurs, there are many good protections and benefits in place. However, as time goes on and costs increase, injured workers are looked upon as enemies to defeat or to forget about. Unfortunately for injured workers and their families, they don’t have this luxury and they don’t have the means to fight.

Most people don’t think it will ever happen to them. That is what most of my clients have thought as well.

 

Catherine M. Stanton is a senior partner in the law firm of Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP. She focuses on the area of Workers’ Compensation, having helped thousands of injured workers navigate a highly complex system and obtain all the benefits to which they were entitled. Ms. Stanton has been honored as a New York Super Lawyer, is the past president of the New York Workers’ Compensation Bar Association, the immediate past president of the Workers’ Injury Law and Advocacy Group, and is an officer in several organizations dedicated to injured workers and their families. She can be reached at 800.692.3717. 

 

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A Dismantling of the Grand Bargain That Created Workers’ Compensation

This week marks the official start of the holiday season. It is a time for family and loved ones, and a time to reflect on the blessings that we have received in our lives. This week marks the countdown to a number of holidays including Christmas, Hanukah and Kwanzaa. Unfortunately for some people, however, the holiday season is fraught with anxiety, depression, illness and injury. Many people who sustain work-related injuries find that without their weekly salary, the holidays are a stark reminder of how their lives have changed dramatically. The inability to provide for even the basic necessities, let alone splurge on holiday presents, is a prescription for depression.

The Grand Bargain Premise of Workers’ Compensation laws in this country is that the employer, through their insurance carrier, is responsible to pay for injured workers’ medical treatment, lost wages, and permanent disability in exchange for injured workers giving up their rights to sue their employers for negligence. During the last couple of decades, Workers’ Compensation benefits have been under the continuous scrutiny of the Business Council, which has been alleging that the cost of benefits to injured workers is at the root of their increase in costs and reduction in profits.

However, a report from the National Academy of Social Insurance (NASI) indicates otherwise. Benefits as a percent of payroll declined in 46 states between 2010 and 2014, continuing a national trend in lower benefits relative to payroll that began in the 1990s. Costs to employers, on the other hand, continue to climb. Between 2010 and 2014, employer costs associated with Workers’ Compensation – such as insurance premiums, reimbursement payments, and administrative costs – grew at a rate nearly five times faster than benefits. Instead of using employers’ money to provide benefits for injured workers, insurance companies pay a host of businesses, including insurance medical examiners, nurse case managers, vocational rehabilitation companies and defense counsel, all of which profit from the system at the expense of workers and reap record profits for themselves. Meanwhile, the insurance industry and the Business Council falsely blame the claims of disabled workers so they can continue to increase profits by slashing benefits and shifting costs to taxpayer-funded programs instead of employer-paid insurance.

Benefits in New York have decreased under the current Workers’ Compensation system. The changes in the law in 2007 allowed higher wage earners to benefit in the short term as the amount of their weekly benefits has increased. However, these benefits are only available for a fixed period of time. If injured workers are able to return to work after a short period of lost time and a limited period of medical treatment, then some may say the system is a success. Unfortunately for many severely-injured high and low wage earners, the Grand Bargain wasn’t so grand. Medical providers’ hands are tied by Medical Treatment guidelines that limit the amount of treatment authorized based upon “best practices” or cookie cutter treatment, as opposed to what is recommended by the treating doctor. Now there is the prospect of limiting prescription medications as well, all in the name of cost reduction.

The reduction of medical treatment based on the treatment guidelines to injured workers should not imply they are fully recovered. Also, they don’t all return to work once they reach their indemnity cap. The cost of providing monetary benefits and medical treatment are shifted to the taxpayers to pick up the tab. Injured workers don’t expect that the very act of working will forever alter their lives in a negative way. Workers’ Compensation benefits are not a charitable donation, but an entitlement based upon a compromise between workers and their employers. Unfortunately, it is clear that these benefits have been gradually eroded. We should not allow any legislation that further erodes these benefits. While the holidays will continue to bring depression and despair for some injured workers, it should not be as a result of our treatment of them afterward.

 

Catherine M. Stanton is a senior partner in the law firm of Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP. She focuses on the area of Workers’ Compensation, having helped thousands of injured workers navigate a highly complex system and obtain all the benefits to which they were entitled. Ms. Stanton has been honored as a New York Super Lawyer, is the past president of the New York Workers’ Compensation Bar Association, the immediate past president of the Workers’ Injury Law and Advocacy Group, and is an officer in several organizations dedicated to injured workers and their families. She can be reached at 800.692.3717.

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Labor Report Urges Study Of A Federal Role In State Workers’ Comp Laws

Howard Berkes and Michael Grabell have been investigating the decline of workers compensation for Pro Publica and NPR.

Howard Berkes and Michael Grabell have been shining a light on the deterioration of state workers’ compensation benefits over the last decade. A new U.S. Department of Labor report bolsters their investigative journalism, noting that those hurt on the job are at “great risk of falling into poverty” because state workers’ compensation systems are failing to provide them with adequate benefits.

The Workers Injury Litigation Group (WILG) has been fighting against this decline for 20 years, and we will continue to advocate for fair benefits for injured workers. The following is a summary of Mr. Berkes and Grabell’s recent article:

A “race to the bottom” in state workers’ compensation laws has the Labor Department calling for “exploration” of federal oversight and federal minimum benefits.

“Working people are at great risk of falling into poverty,” the agency says in a new report on changes in state workers’ comp laws. Those changes have resulted in “the failure of state workers’ compensation systems to provide [injured workers] with adequate benefits.”

In the last decade, the report notes, states across the country have enacted new laws, policies and procedures “which have limited benefits, reduced the likelihood of successful application for workers’ compensation benefits, and/or discouraged injured workers from applying for benefits.”

The 44-page report was prompted by a letter last fall from 10 prominent Democratic lawmakers, who urged Labor Department action to protect injured workers in the wake of a ProPublica/NPR series on changes in workers’ comp laws in 33 states.

The ProPublica/NPR stories featured injured workers who lost their homes, were denied surgeries or were even denied prosthetic devices recommended by their doctors.

A “race to the bottom” in state workers’ compensation laws has the Labor Department calling for “exploration” of federal oversight and federal minimum benefits.

“Working people are at great risk of falling into poverty,” the agency says in a new report on changes in state workers’ comp laws. Those changes have resulted in “the failure of state workers’ compensation systems to provide [injured workers] with adequate benefits.”

In the last decade, the report notes, states across the country have enacted new laws, policies and procedures “which have limited benefits, reduced the likelihood of successful application for workers’ compensation benefits, and/or discouraged injured workers from applying for benefits.”

The 44-page report was prompted by a letter last fall from 10 prominent Democratic lawmakers, who urged Labor Department action to protect injured workers in the wake of a ProPublica/NPR series on changes in workers’ comp laws in 33 states.

The ProPublica/NPR stories featured injured workers who lost their homes, were denied surgeries or were even denied prosthetic devices recommended by their doctors.

“The current situation warrants a significant change in approach in order to address the inadequacies of the system,” the report says.

That’s where federal intervention comes in. The Labor Department calls for “exploration” of “the establishment of standards that would trigger increased federal oversight if workers’ compensation programs fail to meet those standards.”

The agency also suggests a fresh look at reestablishing a 1972 Nixon administration commission that recommended minimum benefits and urged Congress to act if states failed to comply.

“In this critical area of the social safety net, the federal government has basically abdicated any responsibility,” says Labor Secretary Thomas Perez.

Without minimum federal standards for workers’ comp benefits, Perez adds, the current system “is really putting workers who are hurt on the job on a pathway to poverty.”

Prior to the report’s release, employers, insurance companies and others involved in workers’ comp programs expressed alarm at the possibility of federal intervention.

“There has never been federal ‘oversight of state workers’ compensation programs’,” says a statement posted on the website of a group called Strategic Services on Unemployment and Workers’ Compensation, which says it represents the workers’ comp interests of the business community.

“Federal requirements imposed on a national basis would be inconsistent with the state workers’ compensation system, which has been in place for more than 100 years without federal oversight,” the group wrote.

Federal minimum benefits could ensure that injured workers across the country would not receive lesser benefits for often shorter periods of time simply because they lived in a state where lawmakers dramatically cut workers’ comp costs for employers.

“This is a system with no federal minimum standards and absolutely no federal oversight,” says Deborah Berkowitz, a senior fellow at the National Employment Law Project. “Clearly, more federal oversight is necessary to assure that that this system works for those most in need of assistance.”

No direct administrative or legislative action is proposed in the report, but Sen. Sherrod Brown, D-Ohio, says he’s “drafting legislation to address many of the troubling findings laid out in this report and will be working with my colleagues to advance it in the next Congress.” 

Brown echoes Perez, saying injuries on the job shouldn’t force workers into poverty.

“But without a basic standard for workers compensation programs, that’s exactly what’s happening in too many states across the country,” Brown adds. 

Another incentive for federal involvement, the report notes, is a shift of billions of dollars in workplace injury costs to taxpayers when state workers’ comp benefits fall short and workers are forced to turn to Medicare and Social Security for treatment and lost wages.

The report lays the groundwork for federal intervention by providing an extensive section detailing the government’s role in promoting national benefits standards in both Republican and Democratic administrations dating back to 1939.

But many in the workers’ comp world consider workplace injury policy and regulation a states’ right and any prospect of a controlling federal role will likely face stiff resistance.

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Governor Cuomo’s Proposal Benefits Big Businesses, Hurts Working People

As an attorney practicing in the field of Workers’ Compensation for more than 25 years, I have represented thousands of injured workers. My job as their advocate has been extremely rewarding.   Most of my clients are honest, hardworking people who got up one day, went to work, and suffered an unforeseen accident. Not every case was easy, but in the end, the injured worker would usually prevail in getting adequate wage replacement and prompt medical treatment because the system was reasonable and the fight was fair. 

Unfortunately, the last 10 years have not been kind to injured workers. I have seen a shift in attitude in some of my clients. Many feel the need to explain that they are truly hurt as if there was any doubt in my mind. I realized that this was happening as a result of the propaganda perpetrated against the injured – that somehow they were faking their accident, or didn’t really deserve the benefits they were receiving. It dawned on me that this attitude has been influenced by a large-budget marketing strategy aimed at making the general public believe that those who get hurt are perpetrating a fraud against the system or filing frivolous lawsuits in order to obtain benefits they don’t deserve.

Big business has made the injured worker the scapegoat for the failing economy and the cost of doing business not only in New York but across the country. In fact, Governor Cuomo even seems committed to the Pro-Business Agenda to reduce costs and increase profits. A couple of weeks ago I outlined the Governor’s budget proposals that were not a part of his public address, as well as the Business Council’s wish list that would ensure cost savings at the expense of the injured worker. Some of these proposals included a reduction in the amount of wage replacement injured workers receive, as well as a limit on their medical treatment and choice of treating doctor. It also would limit worker access to the Workers’ Compensation system by limiting – or even eliminating – hearings before a judge, or giving the Board the ability to handpick judges to listen to certain types of cases. These limitations are designed to “save money” at the expense of the injured worker. The Governor has said that one of his motivations for adding these “reforms” to the budget was based on increasing costs to employers. The Business Council has lobbied for changes saying that costs to employers have gone up, not down. However, this directly contradicts Governor Cuomo’s statement in 2014 announcing that the 2013 Business Relief Act had cut Workers’ Compensation employer costs by 30%.   

The line in the sand has been drawn. The average worker in this country works paycheck to paycheck and does not have the funds for a big budget marketing strategy to counter this position. However, as a result of the attacks on workers in this state, a number of groups have indicated their opposition to the Business Council’s proposals. The New York Workers Compensation Alliance points out that after the 2007 reforms, Workers’ Compensation has replaced less than 10% of the lost wages of permanently disabled workers, and the current proposals made by the Business Council would render Workers’ Compensation virtually meaningless as a source of wage replacement benefits.  

The New York Committee for Occupational Safety & Health (NYCOSH) slammed the Business Council for putting profits over safety. The NYS AFL-CIO is opposed to the changes noting that they would “alter the system to such an extent that many injured workers could never expect to maintain a decent standard of living”.  Let your voice be heard. Call your State Legislators. Let them know while no one goes to work expecting to be injured, it can happen to any of us at anytime and everyone deserves to be treated fairly.

 

Catherine M. Stanton is a senior partner in the law firm of Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP. She focuses on the area of Workers’ Compensation, having helped thousands of injured workers navigate a highly complex system and obtain all the benefits to which they were entitled. Ms. Stanton has been honored as a New York Super Lawyer, is a past president of the New York Workers’ Compensation Bar Association, past president of the Workers’ Injury Law and Advocacy Group, and is an officer in several organizations dedicated to injured workers and their families. She can be reached at 800.692.3717.

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“Reform” Warning – Governor Cuomo’s Proposed Budget Reduces Workers’ Compensation Benefits

Recently Governor Cuomo delivered his State of the State address for 2016. I heard the live telecast and noticed that many of the proposals in the budget are positive and beneficial to working class people, including allocating an additional $2.1 billion in school funding; rebuilding the infrastructure to improve roads and mass transportation; increasing the minimum wage to $15 per hour; and bolstering public safety. In reviewing the actual budget proposal itself, however, there appears to be amendments to the Workers’ Compensation system that will not benefit injured workers and their families.

In order to understand the so-called “reforms” on workers, you need the historical perspective. Prior to the enacting of state Workers’ Compensation statutes, simply put, workers were allowed to sue their employers for negligence. In the early 20th century, spurred on by social reformers and the tragedy of the Triangle Shirtwaist Factory Fire that killed almost 150 women and girls, laws were enacted to protect workers. Known as the “great compromise,” workers gave up the right to sue their employers in exchange for timely payment of medical and indemnity benefits. For much of that century, Workers’ Compensation laws were expansive and assisted injured workers in getting treatment so they could eventually return to work or receive ongoing benefits in the event they could not.

Today most states have seen changes where the concept of medical treatment and wage replacement for injured workers is being substantially eroded. This agenda to reduce benefits to the injured worker has been part of a nationwide effort starting more than 20 years ago by the Business Council (aka the Insurance Industry). Their agenda was put into effect almost nine years ago here in New York when workers gave up many benefits under the guise of “reform.” These included a reduction in the amount of wage replacement injured workers receive and a limitation on medical treatment in exchange for increasing the weekly benefits more in line with the state average.

Now the Business Council is back to further chip away at injured worker benefits. It has put together a wish list in hopes of further reducing medical benefits and monetary benefits to injured workers who should be able to rely on their treating doctors to determine the best course of treatment. However, one of their proposals is that treatment would be determined by a “panel” for the first 90 days of treatment. This panel, of course, would not include a doctor of the injured workers’ choice, but would be determined by the insurance company for the employer.

Additionally, the Council is proposing a cap on benefits based upon a fixed timeframe as opposed to when injured workers finish their treatment and/or surgical procedures. These measures are being proposed strictly based upon the cost savings realized by the insurance industry and have nothing to do with compensating injured workers or ensuring them of the best treatment available for their particular injury. What this will do, in essence, is shift the cost of medical treatment and wage replacement to other sources such as federal programs and state programs that are paid for by the tax payer instead of the employer’s insurance company. This will ensure continued growth in profits for the insurance industry at the expense of injured workers and their families.

Governor Cuomo’s budget proposal contains some of the Business Council’s “wish list,” but thankfully not everything – at least not yet. Please contact the Governor, your State Senator or Assembly Person and tell them that our rights and benefits should never be negotiated away. Workers are the backbone of this country. They have built this nation and rebuilt New York. We must ensure they are taken care of when they get hurt.

 

Catherine M. Stanton is a senior partner in the law firm of Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP. She focuses on the area of Workers’ Compensation, having helped thousands of injured workers navigate a highly complex system and obtain all the benefits to which they were entitled. Ms. Stanton has been honored as a New York Super Lawyer, is the past president of the New York Workers’ Compensation Bar Association, the immediate past president of the Workers’ Injury Law and Advocacy Group, and is an officer in several organizations dedicated to injured workers and their families. She can be reached at 800.692.3717.

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