Slow Recovery Affects Workers’ Compensation Benefits and Costs

Today’s post comes from guest author Kit Case from Causey Law Firm.

A Press Release by the National Academy of Social Insurance


WASHINGTON, DC – Workers’ compensation benefits declined to $57.5 billion in 2010 according to a report released today by the National Academy of Social Insurance (NASI). The drop in workers’ compensation benefits was largely due to a 2.1 percent drop in medical benefits for injured workers. Employers’ costs for workers’ compensation also fell by 2.7 percent in 2010. As a share of covered wages, employers’ costs in 2010 were the lowest in the last three decades.


“As a share of covered wages, employers’ costs in 2010 were the lowest in the last three decades.”


“Employers’ costs as a percent of payroll declined in 43 jurisdictions,” said John F. Burton, Jr., chair of the study panel that oversees the report. “This decline is probably due to the slow pace of the recovery, with many jurisdictions still experiencing relatively high unemployment rates.”


Workers’ Compensation Benefits, Coverage, and Costs, 2010



Change   Since 2009 (%)

Covered workers (in thousands)



Covered wages (in billions)



Benefits paid (in billions)



Medical benefits



Cash benefits



Employer costs (in billions)



Per $100 of Covered Wages


Change   Since 2009 ($)

Benefits paid



Medical benefits



Cash benefits



Employers’ costs



Source: National Academy of Social Insurance, 2012.


The new report, Workers’ Compensation: Benefits, Coverage and Costs, 2010, is the fifteenth in the series that provides the only comprehensive data on workers’ compensation benefits for the nation, the states, the District of Columbia, and federal programs. 


“This report represents the first time the Academy has released employers’ costs by state.”


This report represents the first time the Academy has released employers’ costs by state. For a table showing employers’ costs for all fifty states and the District of Columbia, refer to Table 12 (page 34).

Most states reported a decrease in the number of workers covered but an increase in covered wages between 2009 and 2010. During the same period, the total amount of benefits paid to injured workers declined in 26 jurisdictions and increased in 25. As a share of payroll, benefits paid to injured workers fell by three cents to $0.99 per $100 of payroll in the nation.

The share of medical benefits for workers’ compensation has increased substantially over the last 40 years. During the 1970s medical benefits nationally accounted for 30 percent of total benefits, whereas in 2010 the share of benefits paid for medical care was almost 50 percent. Experts attribute this trend to the rising cost of health care.


“I’m In It for the Money!”

Today’s post comes from guest author Roger Moore from Rehm, Bennett & Moore.

Surprisingly, many employers and insurance companies actually believe workers hurt themselves on purpose or at the very least put themselves in positions where they think an injury is likely. We hear this a lot as a basis for not settling claims for existing employees. Employers are worried that it will encourage other employees to get injured as well. What does that say about the particular employer who believes this? Either they are downplaying lots of injuries or they truly believe employees are willfully getting hurt. 

The reality is that most of our clients come to us because their injury-related medical bills are not being paid or they’re not being paid for time off from work due to their injury.

In this age of limited, and in some cases very limited, workers’ compensation benefits, you would have to be an imbecile to actually believe people are willingly causing permanent injuries to themselves to cash in on the “windfall” that is workers’ compensation. Who would honestly trade even thousands of dollars for a lifetime of uncompensated pain and suffering? The reality is that most of our clients come to us because their injury-related medical bills are not being paid or they’re not being paid for time off from work due to their injury. The vast majority of them don’t even ask how much they could get for their injuries in their initial meeting with us, as I’m sure is the case with most workers’ compensation law firms. 

This is one of a long line of personal-injury myths perpetrated by the insurance industry to make filing a workers’ compensation claim a stigma. It’s similar to the one about “if you file a claim our premiums will go up and they’ll have to shut down the plant.” Shouldn’t the question really be: are we requiring too much physically of our employees, and if so, what can we do to make things safer? Instead, Continue reading »


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The Costs and Complications of The Other Disease on Workers’ Compensation Claims

Source: NCCI

Today’s post comes from guest author Jon Gelman from Jon Gelman, LLC – Attorney at Law.

Employers and their insurance companies are responsible for the treatment of all medical conditions that arise from an industrial accident or exposure. A recent study published by The National Council on Compensation Insurance (NCCI) concludes that costs are soaring as medical conditions become more complicated by other conditions known as comorbidity diagnoses. These conditions are frequently: obesity, hypertension, drug abuse, chronic pulmonary conditions, and diabetes.

While the average medical cost for a workers’ compensation claim is approximately $6,000, the medical cost of an individual claim can be a few hundred dollars or millions of dollars. In 2010, an NCCI study found that claims with an obesity comorbidity diagnosis incurred significantly higher medical costs than comparable claims without such a comorbidity diagnosis. Relative to that study, this study expands the number of comorbidities examined and provides additional information on both the types of claimants receiving comorbidity diagnoses and the types of providers submitting comorbidity diagnoses.”


  • The share of workers’ compensation claims with a comorbidity diagnosis nearly tripled from Accident Year 2000 to Accident Year 2009, growing from a share of 2.4% to 6.6%. Claims with a comorbidity diagnosis have about twice the medical costs of otherwise comparable claims.
  • Comorbidity diagnoses for hypertension are the most prevalent of those investigated.
  • The initial comorbidity diagnosis tends to occur early in the life of a claim.
  • Hospital and physician visits account for a majority of visits resulting in a recorded comorbidity diagnosis.
  • Only a small portion of visits result in the recording of a comorbidity diagnosis.

View complete report: Comorbidities in Workers Compensation




Can Cell Phones Cause Cancer (On The Job)?

An Italian court ruled that excessive mobile phone use can cause cancer.

Today’s post comes from guest author Tom Domer from The Domer Law Firm.

An Italian court ruled that excessive mobile phone use can cause cancer. Italy’s Supreme Court upheld a ruling linking a business executive’s brain tumor and excessive mobile phone use. While much of the scientific opinion generally suggests there is not enough evidence to declare such a link, those studies were co-financed by the same companies that produce mobile telephones. The evidence in the Italian case was based on studies conducted between 2005 and 2009 by a group led by Dr. Lennart Hardell, cancer specialist at the University Hospital in Orebro in Sweden. The Italian court, relying on this research, noted this was independent research unlike other research financed by mobile telephone companies. The business executive Innocenzo Marcolini developed a tumor in the left side of his head after using his mobile telephone for 5 to 6 hours a day for a dozen years. He usually held the phone in his left hand while taking notes with his right hand.  He developed a “neurinoma” which affected his cranial nerve, and sought worker’s compensation from the Italian Worker’s Compensation Authority. The initial application was rejected because of a lack of proof but a court in Brescia later ruled there was a causal link between the use of mobile and cordless telephones and tumors.

Wisconsin provides benefits for an employee’s death or disability due to a cancerous condition if causally related to work exposure to carcinogens. There are numerous potential cancer causing agents in the workplace, but none so far have been linked to cell phone use. The causation standard is straightforward in Wisconsin. If the patient suffers from a condition caused by an “appreciable period of workplace exposure” the physicians are asked whether that exposure was either the sole cause of the condition or at least a material, contributory, causative factor in the condition’s onset or progression. This Italian court case suggests a further inquiry into the subject may be appropriate.


Ten Tips for Massachusetts Correctional Officers

Today’s post comes from guest author Ryan Benharris from Deborah G. Kohl Law Offices. We believe that Ryan’s valuable advice for Massachusetts correctional officers also applies to us in Iowa.

     Law Offices of Deborah G. Kohl, PC proudly represents Massachusetts’ hardworking Correctional Officers.

     Workplace injuries are common in every profession. In Massachusetts, Correctional Officers are more likely to sustain an injury on the job than any other worker in the state. Here are ten helpful tips to making sure that your rights are protected if you are injured on the job:

1.)    Report your injury to a supervisor immediately - The most common defense to a work related injury is that, “It never happened.” This defense can almost completely be avoided if you tell someone right away. This is obvious in situations of an inmate assault or a slip-and-fall where you sustain a traumatic injury. It is also equally as important in a case where you feel pain but you continue working. You should report this as soon as possible. There is a four (4) year statute of limitations on when you can bring a workers’ compensation case in Massachusetts. The last thing you want is for someone to tell you that you brought your claim too late.

2.)    Fill out all of the appropriate documentation – Make sure you fill out an appropriate IA Packet and get it to the proper office. If you fail to do this you will not get paid.

3.)    DO NOT PUT OFF SEEKING MEDICAL TREATMENT! – Your health is the most important thing there is. Do not risk your health for the sake of your job. Seek medical treatment immediately. You have the right to see any doctor you choose. Follow your doctor’s recommendation as it is written. You do not have to return to work if your doctor says it is unsafe to do so; regardless of any letters you receive from your employer telling you that you must return. If your condition does improve, there is likely temporary modified work available for you. If you have questions about whether you qualify for this, ask someone!

4.)    Be Open and Honest With Your Doctor - Give the doctor all of the information he or she needs to write the proper medical documentation that will make sure that you get all of your benefits. Tell the doctor HOW you hurt yourself. Tell the doctor WHERE you hurt yourself. Tell the doctor if you had any prior injuries to the same body part and if this injury has made those prior injuries worse. Do not hide anything from the doctor. That can only hurt your case.

5.)    Know what they owe you - If you are unable to work, workers’ compensation must pay you 60% of your average weekly wage, tax free. They also must pay for any and all medical expenses to you. This includes any out of pocket co-pays for prescriptions and doctors’ visits. They also must pay you mileage for your trips to and from the doctor’s office. Also, if you have a part-time job that you are also unable to do, workers’ compensation must pay you for those lost wages as well (as long as you work for an employer who also has workers’ compensation insurance).  If you are getting less than this, you are not getting what you are owed.

6.)    Being paid your earned sick and vacation time is not the same thing as being paid workers’ comp – You are not supposed to lose any of your earned sick and vacation time as a result of your workplace injury. If you they are paying you from your earned time and not specifically from workers’ comp, something is wrong. The sick that is taken from you can be reimbursed if workers’ compensation is found responsible to pay you.

7.)    Do not mistake “immediate payment” for “admission of guilt.”– Massachusetts has a “Six Month Payment Without Prejudice Period.” This allows for Workers’ Compensation to pay you for six months without actually accepting any liability on your injury. One of the benefits the insurer gets of this law is that they can stop paying you for any reason they deem fit at any time. They only need to give you seven (7) days written notice. Once they terminate your benefits, you need to file a claim with the Department of Industrial Accidents to get them back (calling your claims adjuster and insisting that “this must be a mistake,” is useless. It will not help you). This is a lengthy, difficult process that you would strongly benefit from representation by an attorney during. Your Employer will certainly be represented by an attorney at this time. Don’t allow yourself to have the cards stacked against you even before you begin. You don’t want to be fighting against another lawyer without a lawyer. Insurance companies will use anything they can against you to try to refrain from paying your benefits. If they do terminate your payments, you may use your accrued sick and vacation time to continue getting paid until you can get back on workers’ compensation. Sick time is reimbursable. Vacation time is not.

8.)    If you are out on workers’ compensation, they are following you! – Expect to see a private investigator with a camera stationed outside your home. This is not paranoia. It is the truth. It is common practice for workers’ compensation to hire someone to take pictures and video of you. They hope to catch you mowing your lawn, taking out your trash, jogging, lifting bags of groceries, working a side-job. Expect to be followed by a private investigator. Behave accordingly.

9.)    Keep a good line of communication open between yourself and your Union – Your Union is there to help you. They are hardworking, diligent and are on your side. They know your Collective Bargaining Agreement better than anyone. If you have any questions about whether you are receiving all of your benefits possible, contact them immediately.

10.)  Hire an attorney early – It does not cost you one penny to retain an attorney to represent you in your workers’ compensation case. The sooner you get to an attorney, the sooner they will be able to tell you if you are receiving everything you are supposed to get. Remember that the Workers Compensation Division is an insurance agency. It will do everything in its legal power to ensure that it only has to pay you when the law absolutely calls for it. Your case will be closely monitored by their attorneys almost immediately after you report your injury. It makes sense to have an attorney working for you equally as quickly.