Do Employers Lose Out in the Workers’ Compensation System?

employer workers compLast month our story “Employee v. Employer: Who Gets The Shortest End of the Work Comp Stick?” discussed a number of hardships employees face once they are designated as an “aging injured worker.”  Yet the difficulties employers experience in dealing with the workers’ comp system are significant as well.  To expand on the scenario we explored last week, the employer was not able to “downsize” the aging worker without consequences.  Before the worker’s injury, he was a productive and valuable employee with significant work experience, the ability to train new hires, and the competence to perform many different tasks in the company.  The worker had put in his time, and was quickly approaching retirement.  Yet due to the injury, the employer now owes that worker compensation for life, (unless he agrees to accept the insurance settlement).

Cost of Workers’ Compensation Claims

Many employers consider themselves to be the underdog in the kind of workers’ compensation battles we have profiled here. But our scenario is not the only kind of burden employers have faced in the last hundred years.  Rules and regulations dictating what qualifies for compensable have changed dramatically over time.  Standing up, falling randomly, or simply bending over a desk have are now compensable work injuries. Such claims may cost fifty thousand dollars or more by the time the case has been settled.

Chronic Pain in Today’s Workers’ Compensation Cases

One compounding problem is that chronic pain is the norm in today’s work injury. In years past, there were no definitions for chronic pain syndrome, fibromyalgia, repetitive stress injury and other such occupational injuries and workplace disorders.  Today, when doctors are unable to determine the source of a patient’s pain, they may simply apply one of these blanket diagnoses.  When the courts began to award compensation for these types of injuries, the floodgates opened.

In addition to chronic pain, there are more degenerative conditions that qualify as compensable if conditions are just so.  Degenerative spinal conditions as well as nerve disorders like stenosis can be lumped under workers’ comp claims even when the patient is nearly diabetic, or if they suffer from non-work related arthritis.

Workers’ Compensation has Become Increasingly Complex

All of this makes things quite difficult, but employers argue that the problem is further compounded by the workers comp system becoming a “money-making machine.”  Hypothetically, the workers’ compensation system is a way for injured workers to return to their jobs.  It operates as a benefit delivery system, compensating workers for lost wages and medical expenses when they are recovering from a work-related injury.  This seems to be fairly straightforward, but today it often takes an extensive bureaucracy to even get to this point, one involving doctors, lawyers, bill review companies along with their staff of nurses and lawyers, IME companies, pharmacy delivery services, medical network companies, etc.  Even Washington State requires everyone along this chain to complete reams and reams of paperwork, and if a form is not filled out correctly, the employer may be fined, sometimes at hundreds of dollars per day.

For all of these reasons, employers argue that is it the workers who are ultimately benefiting from the system, and that the days of helping genuinely injured workers are now long gone.  They feel that day to day wear and tear on the body, and the natural degenerative process should not be counted as work injuries caused by their employment.  Workers, on the other hand, have their own legitimate point of view on this debate, as we detailed in last week’s post.

 

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Emery Reddy