Category Archives: Legislation

Broken Trust – Breaking The “Grand Bargain” Of Workers’ Compensation

More than 100 years ago, Workers’ Compensation was established as a “grand bargain” between workers and employers. The state legislature enacted laws where injured workers gave up their right to sue if they were hurt on the job as a result of their employers’ negligence in exchange for a no fault system of medical and wage loss benefits. 

Included in this bargain was the right of the injured worker to obtain financial compensation for a permanent injury to an extremity, such as arms, legs, hands, feet, fingers and toes. Unfortunately, this “grand bargain” – at least as it pertains to injured workers – has been under attack for the last 10 years in New York under the guise of rising costs to employers.

During the New York State budget negotiations, the Business Council created a false narrative that injured workers’ benefits for extremity injuries were archaic and didn’t account for modern medicine. They claimed that benefits paid were creating a crisis in New York and forcing businesses to flee the state. As a result of their lobbying, the New York State Legislature directed the Workers’ Compensation Board in April 2017 to create a task force consisting of labor, medical providers, and insurance groups to issue proposed revisions that account for advances in modern medicine that enhance healing and result in better outcomes. What we have subsequently found out is that the Workers’ Compensation Board, without direction or authority, has been secretly working for the last couple of years to not only revise the current guidelines, but to scrap them altogether. These provisions would essentially eliminate most schedule loss of use extremity benefits to injured workers. As an attempt to not fuel the fire, they released their proposed revisions at 11:00 p.m. on the Friday of Labor Day weekend.

The Workers’ Compensation Board has been heavily criticized for their Anti Injured Worker Proposals by a number of labor unions, NYCOSH, physician groups, Workers’ Compensation practitioners, and injured workers themselves. As a result of the outrage, the New York State Assembly’s Committee on Labor held hearings at which a number of people from the taskforce testified. When representatives from the Board were asked why there were secret meetings years before the Legislature directed them to review the issue, their weak response was that “they” couldn’t understand some of the large discrepancies between the findings of the treating doctors and the insurance doctors. However, that argument holds little weight because the scenario they cited was the exception rather than the norm. They also pointed out that they relied heavily on the New York State Orthopedic Group for input.  Yet, when the Chair of the task force, Dr. Jeffrey Lozman, an orthopedist, and Dr. John M. Olsewsky, President of the NYS Society of Orthopedic Surgeons, testified, it became clear that their recommendations were largely disregarded in a way that would negatively impact injured workers.

It is clear that the New York State Workers’ Compensation Board is pushing the Business Council’s agenda. What is unclear is why the Board seems to be taking sides when their mission statement is to “protect the rights of employees and employers by ensuring the proper delivery of benefits to those who are injured or ill, and by promoting compliance with the law.”

Injured workers don’t have the means to fight, and but there are still steps you can take to defeat these harmful proposals. There is a 45-day comment period set to expire on October 23, 2017. You can contact your state legislator and the New York State Workers’ Compensation Board to voice your opposition. For additional information please go to:  www.nyworkerscompensationalliance.org/protectinjuredworkers

Workers’ Compensation was set up to help you if you are ever injured on the job. These benefits are your right. They are your protection. Just because you might not need the benefits now, doesn’t mean you or a loved one won’t need them down the road. Only by working together can we fight to make sure that these benefits as we know them remain in place. While a single voice might not make a difference, a loud collective voice stands a better chance. Go to the link and voice your disapproval. Have your family and friends do the same.

 

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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New York State Workers’ Compensation Board Proposes Broad Anti-Worker Changes

There is a phrase in politics known as Friday News Dump or Take out the Trash Day. In other words, the act of releasing certain news items at the end of the work week in an attempt to avoid media scrutiny. In the case of the New York State Workers’ Compensation Board, the public servants that they are, the News Dump occurred at 11:00 pm on the Friday of Labor Day Weekend. As you may recall in April as part of the horse trade known as the New York State Budget, injured workers’ benefits were used as  bargaining chips. The Business Counsel had argued that schedule loss of use awards which are given to workers’ for permanent injuries to the extremities were suddenly unfair to the employer. The original guidelines they argue were outdated and did not take into consideration new advances in medicine. One of the Budget provisions directed the Board to “consult” with a group stacked with pro-business and insurance interests to re evaluate the current guidelines. Well at 11:00 before the holiday weekend they issued their proposed changes and like the impact of Hurricane Harvey and Irma, no one could have foreseen the complete and utter destruction these proposals would have on injured workers benefits. Rather than addressing how advances in modern medicine enhances healing or create better outcomes, the Board totally disregarded the legislation’s directive and instead simply rewrote the entirety of the guidelines to create a new evaluation process which would destroy previously awarded benefits for permanent injuries.

These changes are arbitrary and capricious and an abuse of discretion. The legislature had previously established a fixed period of compensation based upon a specific injury but the board has taken it upon themselves to reduce or eliminate many of the benefits previously awarded for an injury. Additionally the Board has proposed provisions which are punitive in nature against the injured worker, bordering on being downright insulting, which only provide more opportunities for insurance companies to deny benefits.

One of the amendments submitted allows the insurance carrier to go on a fishing expedition to obtain information that is privileged, irrelevant or against the injured workers’ interest and penalizes them for failing to comply. These “questionnaires” if not completed to the satisfaction of the insurance carrier can be negatively inferred against the injured worker. The carrier can deny benefits simply by stating that the injured worker was uncooperative. This new amendment seems to be in direct violation of HIPPA privacy laws. 

There are many who will be affected. Anyone who has been injured or knows someone who has been injured on the job should be appalled that their family and friends, when they are at their most vulnerable, would be attacked by the same State Agency that was established to protect them. Shocking as it is, these guidelines are being proposed by the Workers’ Compensation Board. The name itself implies it is for the benefit and protection of the Worker. Perhaps the name should be changed to the Business Council and Insurance Defense Agency as it appears their agenda has changed. Unions, particularly those that have workers who engage in any type of physical or hazardous activity should be outraged that their members will again be attacked financially when they are injured. The New York Daily News recently spoke to Mario Cilento, the President of the NY AFL-CIO, who commented that “the plan is an insult to all working men and women. Benefit cuts for injured workers are wholly unjustifiable.” 

Legislators, in particular should be infuriated knowing that a governmental agency has usurped their authority in an attempt to dismantle a system that has been statutorily in place for over 100 years.     

When will these attacks end if ever?  Who is the driving force behind these attacks? One of the unfortunate consequences of a typical day is that some people go to work healthy one day and leave as a casualty of a work place injury the next. Some of us will be permanently injured or even killed. Regulating away benefits will not prevent injuries but will only result in someone else paying for benefits -usually tax payers.  The slashing and burning must end.  All of us must take a stand to protect those of our society who did nothing wrong except be one of the unfortunate victims of a workplace injury. How ironic that this bomb was dropped upon the working men and women of New York State on a holiday weekend dedicated to honoring the working people of this country.  

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No Accident: How To Protect Yourself Against An Uninsured (Or Underinsured) Driver

As an attorney who has been practicing law for more than 27 years, I always try to keep myself updated on issues that affect not only my practice, but more importantly, my clients. In order to fully understand the numerous changes, I belong to a number of bar associations that offer continuing legal education programs, as well as the opportunity to lobby at both the state and federal level on issues that impact many New Yorkers.

During my last round of lobbying in Albany, one of the bills being proposed was the New York Driver and Family Protection Act. It deals with Supplementary Uninsured/Underinsured Motorists insurance (SUM Insurance) and it is likely that many of you have very little idea of what this is. I didn’t either until it was brought to my attention.

While every driver in New York State is required to have auto insurance, some opt for the minimum coverage required under the law, which is $25,000. Others purchase more than the minimum coverage so that in the event of an accident resulting in serious injuries, there will be a better chance that their policy will cover the medical expenses and injuries of the other driver. We do this to protect our personal assets in the event we are sued as result of an accident. What many do not realize is that if you are seriously injured by another driver who only has minimum coverage, you can only collect up to the $25,000 policy maximum, regardless of the extent of your injuries.  

SUM Insurance provides coverage to New Yorkers who are injured in an accident with a driver who is not insured or is underinsured. Unfortunately, many New Yorkers are unaware of their ability to purchase this additional insurance. Since I had not been advised of this insurance by my broker and had no idea it was available, I was one of those drivers who didn’t know it was an option. Once I found out about this, however, I immediately added it to my policy and was surprised to see how relatively inexpensive it was.

The bill would require insurers to provide information to consumers about this type of coverage at the time they are purchasing insurance, which would enable them to make a fully informed decision. Once consumers are aware of the coverage, they could decide to opt out of purchasing it but at least they would know that it’s even an option to begin with. Additionally, this bill would protect motorists by amending the Insurance Law to establish that drivers’ underinsurance (SUM Insurance) equal their liability coverage. If drivers opt to decline the additional SUM Insurance coverage, they may waive it only after they fully understand what type of coverage is available – and then they must do so in writing. 

This bill makes sense because if anyone is injured by a driver who only has the minimum coverage, the injured party will still need treatment. Oftentimes this will fall onto Medicaid and other programs that are essentially taxpayer funded. Once people are fully informed, it makes sense that those who take more than the minimum coverage would opt to take some amount of coverage for SUM Insurance.        

For those who are concerned about rising insurance rates due to this bill, you shouldn’t worry. SUM Insurance is low cost and according to insurance experts, will not raise insurance rates.

As of this writing, the SUM bill passed both the Senate and the Assembly in Albany, and now is waiting to be called up by Governor Andrew Cuomo for his review and hopefully his signature into law. It seems clear that this bill would help all New Yorkers make informed decisions on issues that impact them in their day-to-day lives. While we all hope we never have to use it, if anyone of us or a loved one is involved in a serious accident, it would be nice to know that we at least don’t have to worry about proper coverage.

 

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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Lobby Albany For Fair Treatment Of Injured Workers And Their Families

Last week I went to Albany to participate in Lobby Day on behalf of the New York State Trial Lawyers Association (NYSTLA). Our organization went to the capital to meet with members of the State Assembly and Senate to discuss a number of bills, outlining our support or opposition to proposed changes in various laws. 

There are two bills in particular that were borne out of heartbreak and therefore, impossible to understand why they have not been enacted into law. The first is the bill on Date of Discovery — commonly referred to as Lavern’s Law. You may be familiar with the background behind Lavern’s law as the Daily News published an article in 2015 about Lavern. She was a single mother who had visited a City hospital after feeling ill. The hospital sent her home even after an x-ray showed a suspicious mass in her lung. If she had been advised by the doctor about this, she would probably still be alive as the mass was a curable form of lung cancer. Tragically, she was not told about the results until it was too late and her condition was terminal. Lavern died in 2013, leaving behind a developmentally disabled daughter who was barred from bringing a lawsuit against the hospital and doctor because the time to bring a lawsuit had passed. The statute of limitations begins to run at the time of the malpractice, not when the malpractice was discovered. 

Sadly, this travesty has affected others who were never advised that their test results were abnormal.   We assume that once we have tests performed, doctors would notify us in a timely manner of any problems. But what if they don’t? There are a number of cases where CT scan results, mammograms, x-rays, and Pap smears all were misread or never reviewed, resulting in life-threatening consequences or death. For Lavern and others, this lifesaving information was never provided – and that failure proved fatal.  New York’s statute of limitations on malpractice is old and antiquated and needs to be updated.  We are one of only six states with a time limit that starts once an injury is caused and not when it is discovered. Lavern’s Law would provide a 2½-year statute of limitations from the time the person knew or should have known that a negligent act caused an injury. Governor Andrew Cuomo, understanding the impact, agreed to sign the bill into law if it passed the Senate and Assembly. 

The second bill proposed is known as the Grieving Families Law and would change the current New York Law on Wrongful Death, which only allows families to recover the lost income from a family member who died.  Many of my colleagues told stories of having to advise a grief-stricken family that their homemaker spouse, or child, or elderly parent’s life was worthless under the law, as the law only values the lives of high wage earners. This archaic law was enacted in 1847, and has never been amended.  While many other states have acknowledged that the loss of a loved one is monumental, and that the wrongdoers should be held accountable, New York is not one of them. This proposed law would allow families to be compensated for the profound emotional loss and grief caused by a wrongdoer. 

What these laws also will accomplish is to promote a safer society by holding wrongdoers accountable for their actions. It may be too late for Lavern and others in her situation, but by passing these laws, we may be able to prevent future tragedies and show that Lavern did not die in vain.     

 

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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New York’s Newest Budget Shortchanges Injured Workers

A couple of weeks ago Governor Cuomo signed the New York State Budget that contained some potentially detrimental provisions for injured workers. Big business interests are taking their victory laps as they continue with their campaign to dismantle the Workers’ Compensation system by further reducing benefits to injured workers.  See this for what it is- a relentless attack on the working men and women of this state.

If you believe that the majority of those on Workers’ Compensation are frauds, faking an injury, or taking advantage of taxpayers, then you are probably content with the changes in the law. That also probably means you were swayed by the alternative facts that the Business Council was promulgating, including the proposition that Workers’ Compensation benefits are to blame for the high cost of doing business in New York and that many injured workers are not deserving of the benefits they receive.   

My colleague Len Jernigan from North Carolina issues an annual report of the top 10 Workers’ Compensation fraud cases. In 2016, those top 10 fraud claims were against employers – not workers – and totaled more than $400 million! Much of the fraud involved misclassification of employees in order to circumvent payroll taxes and Workers’ Compensation insurance. In fact, very few workers would voluntarily subject themselves to a system that has become so bloated by bureaucracy and is more concerned about precluding medical treatment because a form is not filled out correctly or penalizing counsel for being too overzealous by submitting numerous requests for their client’s day in court. 

Injured workers do not have much political clout. They do not get rich off of Workers’ Compensation benefits. Their weekly benefits can be reduced if they are considered partially disabled without regard to their socio economic status, their educational level or whether or not they are still being treated for their injuries.   Many of them who were union workers now are no longer able to pay union dues; some cannot pay for medical insurance for themselves or their families as Workers’ Compensation insurance only covers the injured worker for the injuries sustained on the job.

Workers’ Memorial Day takes place annually on April 28.  It is a day to remember those who have suffered and died on the job. Each year there are symposiums, panel discussions, acknowledgements, and speeches paying tribute to the men and women who have lost their lives at work. Many of our politicians will issue statements or attend rallies to stand in solidarity with workers’ groups. We will hear how their deaths should not be in vain and how we must make our workplaces safer. We will be saddened to hear the list of names of those who went off to work never to return.

Many of the politicians giving these speeches are the same politicians who voted to reduce benefits to injured workers in order to appease big business interests. It is difficult to comprehend the hypocrisy involved, but we are told this is politics as usual. While it may be too late regarding the further limitation for lost wages, there is still an opportunity to let the Governor know that any further reduction for permanent injuries to limbs is just not acceptable. While honoring those who died on the job is laudable, properly compensating those who have suffered permanent injuries is equally important and ensures that we value both the dead and the living.

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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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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