Flaws in Workers Compensation Programs

Apr 21, 2015 | Workers' Compensation

Since the time of the Industrial Revolution, American workers have – in theory – been partners in a basic agreement with their employers: In exchange for being assured payment of medical expenses and lost wages if they are injured on the job, they will not sue their employers. Indeed, this agreement lies at the heart of the workers’ compensation programs in Virginia and in states across the U.S.

The idea is that workers’ labor ultimately benefits the American public. So, it is only fair that workers receive support if they suffer a work-related injury or illness. Also, by requiring employers (and insurers) to pay these benefits, it can serve as incentive for employers to provide safe and healthy work environments.

Reports Find Flaws in Workers’ Compensation Programs

Unfortunately, this agreement has increasingly come under threat, according to two recent reports.

States have enacted reforms in recent years that undermine the rights of workers to a safe workplace and which burden them and taxpayers with the costs of work injuries and occupational diseases, according to a new report by the Occupational Safety and Health Administration (OSHA).

“Employers now provide only a small percentage (about 20 percent) of the overall financial cost of workplace injuries and illnesses through workers’ compensation,” OSHA reports. “This cost-shift has forced injured workers, their families and taxpayers to subsidize the vast majority of the lost income and medical care costs generated by these conditions.”

In Virginia, for example, employers pay just $1.17 in premiums per $100 of an injured worker’s lost wages (compared to $1.91 in 1988), according to a report by ProPublica and National Public Radio.

When all is said and done, workers and their families end up paying about 50 percent of the cost of a workplace injury – much of the rest is covered by tax-funded programs such as Medicaid or Social Security Disability Insurance, OSHA states.

The Human Cost of Declining Workers’ Compensation Benefits

As these reports highlight, declining workers’ compensation protection for workers carries tremendous human costs.

For instance, many state laws give employers and workers’ compensation insurers the authority to dictate the type of medical care a worker receives. They may refuse to pay for vital surgery or rehabilitative care.

As a result, workers may have to endure the debilitating effects of their injuries for years to come. Even when a worker returns to the job, the lack of proper care can lead to further injuries due to fatigue and/or the inability to work at full capacity.

These issues underscore why it is vital that workers receive quality legal assistance in order to obtain needed workers’ compensation benefits.

How Lawyers Can Protect Workers’ Rights

The more serious your workplace injuries are, or the more complicated your case is, the more you will need an experienced workers’ compensation attorney to help you seek the benefits you are due. You deserve this protection.

For example, to receive workers’ compensation medical benefits in Virginia, a worker must select a treating doctor from a panel of three doctors provided by the employer (or its workers’ compensation insurer). If no panel is provided, you can choose any doctor.

After the initial choice is made and treatment starts, the worker cannot change doctors without pre-approval by the employer or insurer. For instance, if you want to switch from a family doctor to an orthopedic specialist to treat your back injury, you would need to get this approval.

If an employer/insurer refuses to approve the change, an attorney can stand up for you by establishing a strong case for the change and, if needed, representing you in a hearing before the Virginia Workers’ Compensation Commission.

Even if your case for medical or wage-loss benefits is relatively straightforward, a lawyer can make sure that all of your paperwork is filed correctly and on time.

Additionally, an attorney can examine all options for a recovery. In some cases, a non-employer, non-co-worker may be held liable for an injured or ill worker’s losses such as a negligent driver who causes a crash or the manufacturer of a dangerous chemical or faulty piece of equipment.

A third-party liability claim, as these actions are commonly called, can provide compensation that goes well beyond what workers’ compensation provides.

You can be sure that employers and insurance companies hire skilled lawyers. If you have your own lawyer by your side, it will result in a more balanced process.

To learn more about the role a workers compensation lawyer can play in your workers’ compensation case, please feel free to contact Geoff McDonald & Associates, P.C., today. We can provide a free consultation about your case.

Geoff McDonald and Associates: 804-888-8888.


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