Tag Archives: New York

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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We Protect Workers’ Rights: Partner Mike Gruber Is Installed at WILG President & Helping Injured First Responders

I just returned from the Workers’ Injury Law and Advocacy Group’s (WILG) Annual Convention. I am extremely proud to announce that one of my law firm’s partners, Mike Gruber, was installed as the president of this esteemed group of men and women whose common bond is representing the interests of injured workers and their families. Mike is the fourth partner from my firm to hold this office, which includes former partner Lew Heller, Senior Partner Edgar Romano, and me. My firm is proud to continue the tradition of national leadership in an organization that fights to protect injured workers.

This year we were updated on a number of interesting topics including one near and dear to my heart – benefits for first responders. My friend and colleague JR Boyd, a past president of WILG and a leader in his home state of Missouri, lectured about the dangers inherent in firematic duties.  As the daughter and sister of retired firefighters and sister of a current FDNY Lieutenant, I am always trying to keep updated on the latest issues affecting those I love. I have grown up knowing that at any moment tragedy may strike. 

Ironically, on the day of the lecture news broke of the death of New York City Firefighter Chief Michael Fahy. He was on the scene of a reported gas leak and while in the midst of an investigation, an explosion occurred and part of the structure fell on him. Chief Fahy graduated from law school but decided to pursue his dream as a firefighter. He was following in the footsteps of his father Thomas Fahy, himself a retired FDNY Chief.

Chief Fahy is but one of the many men and women who have sacrificed their lives for their City, their state, or their country. Tragedy can strike without warning in the form of a building collapse, an explosion, a flashover, or when a floor or roof is compromised. First Responders may end up burned, electrocuted, or receive blunt force trauma. These are just a few of the ways firefighting can turn deadly. Unfortunately, our firefighters do not just face immediate dangers on the job, but also must contend with lung issues, cancer, and heart conditions. Three hundred forty-three firefighters lost their lives during the attacks of 9/11, but so many more have died from the after effects of being exposed to toxins in the air.

While there are still nine volunteer fire companies in New York City that respond to calls in their neighborhoods and are covered under the New York State Workers’ Compensation System, the vast majority of residents are protected by a paid force of brave men and women who are employed by the City. The Fire Department of New York is the largest municipal fire department in the United States, employing more than 10,000 uniformed firefighters.

When firefighters get injured, they are paid a salary until they are able to return to work. Some firefighters who get injured on the job as a result of the wrong doing of another may be able to file suit against the negligent party. Some firefighters may receive a three-quarter disability pension if they suffer an injury and are unable to work but benefits may differ depending upon the type of injury sustained and years of service. As a result of the heart, stroke and lung bills, there is a presumption that disabling heart, stroke, and lung conditions are the result of employment as a firefighter. I have seen the damage the job has done to the people I care about and the untimely deaths of many whose health has been severely compromised as a result of the rigors of the job. While benefits do exist, one can never truly repay these brave men and women who put their lives on the line every day to protect us.

 

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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“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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Call “Reform” What It Is: Death By A Thousand Cuts For Workers’ Rights

This week I attended the 20th anniversary of the Workers’ Injury Law and Advocacy Group (WILG) in Chicago. I am a proud past president of this group – the only national Workers’ Compensation bar association dedicated to representing injured workers.  

As an attorney who has represented injured workers for more than 25 years, I have seen their rights and benefits shrink under the guise of “reform”. After the tragic Triangle Shirtwaist Factory fire in 1911, which killed almost 150 women and girls, workplace safety and Workers’ Compensation laws were enacted. For the next half century or so, many protections and safeguards were implemented. However, many of these reforms were not sufficient, and in 1972, the National Commission on State Workmen’s Compensation Laws, appointed by then-President Nixon, issued a report noting that state Workers’ Compensation laws were neither adequate nor equitable. This led to a decade when most states significantly improved their laws. 

Unfortunately, there has once more been a steady decline in benefits to injured workers, again under the guise of reform. One major argument is that many workers are faking their injuries or they just want to take time off from work. There was even a recent ad campaign in which a young girl was crying because her father was going to jail for faking an injury. Workers’ Compensation fraud does exist, but the high cost of insurance fraud is not as a result of workers committing fraud.

A colleague of mine compiled a list of the top 10 Workers’ Compensation fraud cases in 2014 in which he noted that the top 10 claims of fraud cost taxpayers well more than $75 million dollars with $450,000 of the total amount resulting from a worker committing insurance fraud. That leaves $74.8 million as a result of non-employee fraud, including overbilling and misclassification of workers. We are told that insurance costs are too high; yet, according to the National Council on Compensation Insurance (NCCI) in 2014, estimates show that private Workers’ Compensation carriers will have pulled in $39.3 billion in written premiums, the highest since they began keeping data in 1990. More premiums result in higher net profits. Despite this, many states have implemented changes in their Workers’ Compensation systems aimed at reducing costs to the employer. The end results, however, is that fewer benefits are given to the injured worker and more profits go to the insurance companies.

In New York, one of the reform measures increased the amount of money per week to injured workers but limited the amount of weeks they can receive these benefits with the idea that they will return to work once their benefits run out. Additionally, limitations have been placed on the amount and types of treatment that injured workers may receive. Again, this is with the notion that once treatment ends, injured workers miraculously are healed and will not need additional treatment. In reality, those injured who can’t return to work receive benefits from other sources from state and federal governments at the taxpayer’s expense.  This is what is known as cost shifting, as those really responsible to pay for benefits – the insurance companies who collect the premiums from the employers – have no further liability. The reformers of 100 years ago would be appalled at what is happening to injured workers and their families today. It is time that those who are generating profits at the expense of injured workers do what is fair and just – provide prompt medical care and wage replacement to injured workers for as long as they are unable to work.

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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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