A few years ago, The Center for Justice & Democracy (CJ&D) published a post titled Snapshot of Justice: The Failure of Workers’ Compensation. The post begins by stating —
When a worker is hurt, workers’ compensation is the exclusive remedy against an employer.
This is an important opening statement. When workers’ compensation systems were first created, the concept was seen as a bargain benefiting both employers and employees. Employers gained protections from lawsuits (with potentially huge damages) in the event company or co-employee negligence caused the injury. Employees gained basic medical care (promoting rehabilitation and the return to work) and important disability benefits.
Yet, in the last few decades, this bargain has been forgotten. Slowly, workers have seen basic benefits erode. The CJ&D post made four significant points demonstrating how workers have slowly lost workers’ compensation benefits. Here are the post’s four points (in bold) with my comments following:
- Chipping away at already meager compensation. From the beginning, workers’ compensation systems did not fully compensate workers for injuries. These systems generally did not provide benefits for pain, suffering, or other tremendous losses due to injury. Yet, important benefits were provided — medical care, rehabilitation, a small percentage of wage losses for disability. The goal was to treat and return employees to work if possible. If not possible, a minimal level of benefits would be provided. However, in many states, recent laws have reduced these benefits. In Alabama, our appellate courts have also restricted the benefits available to disabled workers. Unfortunately, many attorneys accept workers’ compensation claims without truly understanding the benefits available to their clients. The lack of competent legal representation can further shortchange injured workers needing basic benefits.
- The fraud of worker fraud. The CJ&D post discusses the false campaign by insurance companies over the last twenty years to create issues of employee fraud. In reality, employee fraud is minimal. Overwhelmingly, most fraud is committed by employers as reports clearly show. In my practice, I routinely face insurance carriers which deny claims based on false reasons or file multiple frivolous defenses to avoid paying basic benefits.
- System costs. The system should efficiently provide medical and disability benefits. Yet, it does not. In Alabama, the employer (meaning its insurance carrier) picks the authorized doctor. Sometimes, insurance carriers pick doctors they know will not treat injuries. When the doctor does recommend treatment, the insurance carrier will often use administrative procedures to delay or deny care. This results in significant costs to workers. It also results in additional administrative costs to doctors. That’s just the beginning. When the claim is disputed, the worker must resort to a judicial system that creates more needless costs. Instead of efficiency, the system now has administrative and judicial procedures delaying needed benefits. This gives insurance companies a huge advantage at the expense of injured workers and their families. Because of administrative and judicial hurdles, it is important injured workers consult legal counsel with expertise in this area of law.
- Safety. This is a subject I’ve discussed many times. Safety is a one-way street in workers’ compensation. That’s wrong. If an employee intentionally breaks safety rules, he can be denied benefits. What if the employer neglects safety? An unsafe employer faces no additional workers’ compensation penalties or costs in Alabama. And, because the system is designed to pay workers only a percentage of losses, the employer never faces the true costs of an injury.
A system designed to benefit both employers and injured employees has lost balance. Increasingly, the system neglects injured workers. Increasingly, employers and insurance carriers shift the costs of injury and disability to families and government. That’s wrong. It harms workers, their families, and all of us.