Category Archives: Workers’ Compensation

Back In The game Or Back To Work Too Soon?

Senator Dan Quick has introduced employee-friendly legislation

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

Last weekend’s Big 10 Conference football championship game between Ohio State and Wisconsin contained some off-the-field controversy when former Wisconsin Badger and current Cleveland Browns player, Joe Thomas, criticized the fact that Ohio State starting quarterback J.T. Barrett was playing in the game six days after arthroscopic knee surgery.

While Barrett lead the Buckeyes to victory with 211 passing yards and 60 rushing yards, Thomas argued that college players should have the option of a second opinion when it comes to major surgeries like players do in the NFL. Thomas argued that team doctors are overly influenced by coaches who want players to return to action as soon as possible and that college players are over eager to return to the field.

A similar issue will be debated in Nebraska’s legislature next month. Senator Dan Quick of Grand Island has a bill on the floor that would require an employer to pay for a second opinion if an employee disputes a finding from a doctor paid for by the employer. Quick’s bill was inspired by his experience of being sent back to work prematurely by a doctor chosen by his employer’s workers compensation insurer.

Quick is an electrician by trade and is one of the few blue-collar workers who serves in the Nebraska Legislature. Another blue-collar worker, Lee Carter, was recently elected to the legislature in Virginia. Like Quick, Carter had a bad experience after a work injury. Carter had his hours reduced after his accident and was unable to find a lawyer because of confusion over which state had jurisdiction over his work injury.

Blue collar workers running for office may be a trend as iron worker Randy Bryce is running for Congress against House Speaker Paul Ryan and Wisconsin Firefighter’s union president Mahlon Mitchell is running for Governor of Wisconsin. I am encouraged that people like Dan Quick and Lee Carter have taken their bad experiences after work injuries and have gone into politics to directly address the problems they  faced first hand and make sure other workers will have better experiences if they get hurt on the job.

What Do You Mean, I Can’t Sue My Employer?

OSHA find the owner of the Didion Milling Plant in connection with an explosion that killed 2 workers and injured several more.

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

I sat down this morning with a television reporter interviewing me about a horrific explosion in Wisconsin that killed 5 workers and injured many more.  The explosion on May 31, 2017 at the Didion Ethanol Plant in Cambria, Wisconsin occurred when corn dust exploded, destroying the entire plant.  OSHA hit the company with a $1.8 million fine, calling it a preventable explosion.

The reporter’s question to me was “Why can’t the employees sue their employer?”  The answer goes back over 100 years in Wisconsin to the “Grand Bargain” that was struck between management and labor.  Sometimes referred to as the “great tradeoff,” employees traded away their right to sue their employer, even for egregious safety violations, in return for wage loss and medical benefits to be paid regardless of fault.  The goal was to relieve the injured employee from the burden of paying for medical care and replace lost wages.  At the turn of the 20th Century, Wisconsin workplaces were often dangerous places, and employers had little incentive to make them safer.  Injured workers could rarely afford the kind of legal cost for recovery efforts in court and employers benefitted by use of contributory negligence, assumption of risk and co-employee negligence as bars to an employee’s recovery in court.

The administrative system that was established by worker’s compensation was created to provide a direct remedy to the employer and to limit (by Exclusive Remedy) litigation against the employer.  The system was supposed to insure a method of providing benefits to an injured employee during the period of disability and to ensure the employees were not reduced to poverty because of injuries.

Speed, dependability, and financial assistance were components of the new system, and by making employers responsible for injury, the law offered strong incentives to make workplaces safer.  Unfortunately, that has not occurred.  The latest statistics indicate that over 100 people die annually in Wisconsin and over 5,000 annually across the nation.

Revealing to a grieving widow that the remedy available is limited to four times the deceased worker’s annual income is precious little consolation for loss of a spouse’s life and lifetime income.

Medicaid Cuts Will Cause More Nursing Injuries

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

While efforts to repeal the Affordable Care Act and cut Medicaid appear to have stalled for now, any successful effort to cut Medicaid will adversely impact workplace safety for nurses and nurse’s aides.

Studies by the National Institutes of Health show that reductions in Medicaid funding leads to less staffing at long term care facilities and that lower staffing leads to more injuries for nursing employees. Since most nurses and nurse’s aides are covered under state-based workers compensation laws the additional costs of work injuries from Medicaid cuts may not be fully accounted for on a federal level.

At least in Nebraska nursing employees have some ways to protect themselves when advocating for safer working conditions even if they do not belong to a union.

Nebraska has a whistleblower law that applies specifically to health care workers, including nurses. The benefit of this act is that it allows employees to recover for damages similar to what they could collect under the Nebraska Fair Employment Practices Act, including front pay and possibly attorney fees, without having to exhaust administrative remedies. Additionally, health care workers would have four years to bring a suit under the health care whistleblowers law, rather than the much shorter and complicated statute of limitations under the Nebraska Fair Employment Practices Act.

Nebraska has a broad general whistleblower law that allows employees to oppose unlawful conduct by their employers. Nebraska law requires that nursing homes to be adequately staffed. Federal law also requires that employers provide a workplace to be free of recognizable hazard. Inadequate staffing would certainly be deemed be a recognizable hazard in a nursing home. The only drawback to Nebraska’s whistleblower law is the short and potentially uncertain statute of limitations.

Nebraska law would also allow nurses reporting inadequate staffing to be protected from retaliation under a public policy claim that also has a four year statute of limitations.

As Construction Jobs Increase, So Do Work Deaths

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

More work-related falls and fatalities have gone hand-in-hand with the rebounding construction jobs in the economy. The data in a recent journal showed a positive correlation with fall injuries and population density and construction activity. The full article, from a data report by the Center for Construction Research and Training, can be found here (PDF link).

While the article indicates the amount of construction industry jobs still have not reached pre-recession levels, the industry as a whole is rebounding. With that increase in construction activity is a coinciding increase in falls—and even deaths. As the article points out, “fall deaths in construction are more prevalent than in other major industries.”

Interestingly, according to the data, roofers, older workers, Hispanic workers, foreign-born workers, and self-employed workers had a higher risk of fatal falls than the average among all construction workers. 

Further safety efforts (and reinforcement) are necessary in the construction industry.  The base level nature of the job, however, means that some work injuries will occur. Workers’ compensation law helps protect those workers are their families.

A More Dangerous And Demanding Future For Retail Employees?

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

Walmart announced last week that it started a pilot program where store employees will deliver packages from stores on their way home from work. If this practice is adopted company wide and adopted by the retail industry as a whole, it will change the nature of retail employment.

As written about on this blog before, delivery and warehousing jobs tend to have more physical injures than traditional retail clerk jobs. If employee delivery becomes a regular part of retail employment, then retail jobs should become more hazardous. One positive part about Walmart using employees to make deliveries would be the fact that those employees should be covered by workers’ compensation if they are injured while delivering packages. Fed Ex has faced legal challenges for misclassifying their delivery drivers as independent contractors. Uber, who has also faced challenges on how they classify their drivers, also has a package delivery service.

Delivery jobs tend to be more physically demanding than retail clerk jobs and can also subject employees to DOT requirements. If package delivery becomes an expected part of retail employment, retail jobs will have more physical and occupational requirements. This could mean in the future that retail jobs may not be a fallback option for workers from other physically demanding occupations who become unable to do their old jobs because of injuries or health problems.

The rise of online shopping has greatly reduced the number of stores of traditional retailers. This decline in so-called “big box” stores lead to a parallel reduction in retail employment. Jamelle Bouie pointed out in Slate that this collapse in retail employment has harmed women, people of color and urbanites who tend to work in retail. Bouie points out, I think correctly, that retail employees tend to be disrespected in part because of gender and race. Bouie also states the decline in retail employment has received much less attention than declines in employment in other sectors like manufacturing and mining that tend to employ more white males.

In contrast to traditional retail workers, delivery drivers tend to be paid better. UPS delivery drivers seem to enjoy a certain level of prestige, respect and even a mystique within the workforce. (11) Maybe some of that respect will rub-off on retail workers if they become delivery employees.  On the flip slide, competition from largely non-unionized and lower-paid retail workers may cut into pay and benefits that delivery drivers and their unions have fought for over the years.

Seeking Balance and Value – Workers’ Comp Expenses and Benefits

Today’s post comes from guest author Kit Case, from Causey Wright.

Employer Rate Expenses and Injured Worker Compensation, by State

The Oregon Department of Consumer and Business Services issues their Workers’ Compensation Premium Rate Ranking Summary annually. In it, the Department quantifies the cost of workers’ compensation premiums in each state and ranks the states numerically based on the cost to employers for providing workers’ compensation benefits to the workforce.

The Oregon study is focused on the dollar-cost of coverage from the viewpoint of employers.  But, the employer is only one of the parties involved in the workers’ compensation world.  There are also medical professionals, vocational counselors, and the injured workers.  I was interested in how the ranked states would stack up from the injured worker’s perspective, so I looked up the maximum weekly benefit rates for each state, based on information maintained by the Social Security Administration – and made a comparison of my own. 

Understand that workers’ compensation claims have many facets that go beyond weekly benefit rates, and that every state has their own system with it’s own set of benefits and criteria for receiving those benefits.  This includes variations across the states that affect allowance of claims, compensability of claims, allowance of medical treatment and procedures, provision of vocational retraining benefits, conclusions about ability to return to work or placement on total disability pensions, caps on weeks of compensation paid and a variety of compensation structures for final settlements or awards for permanent partial disability.

My comparison is only of two data points: the ranking of cost per the Oregon study and each state’s maximum compensation rate paid to injured workers. It does not factor in the cost of living or average salaries in each state. It does not begin to touch on the issue of the quality of medical care available to workers in each state nor on claim outcomes, restoration of physical function or loss of wage-earning capacity for injured workers. It is a simplistic look at a complicated dataset.

To see an interactive map charting the results, click here.

To see my tally of the maximum compensation rates against the rankings of employer expense, click here.

In the most-recent Oregon summary, issued in October 2016, Washington State ranks 15th out of the 50 states and the District of Columbia, with a cost rate of 107% of the median.  The highest-cost state was California, at 176% of the median cost. The lowest was North Dakota, ranked at 51st with 48% of the median expense rate. But, the highest-cost states do not have the highest level of benefits paid to injured workers.

In my non-scientific analysis, Washington State ranked 5th out of the 50 states and the District of Columbia in terms of maximum weekly compensation rates, at $1,313.06 per week or $5,689.93 as a monthly amount. The state with the highest maximum weekly rate was Iowa at $1,688.00 per week or $7,314.67 monthly. At the bottom of the list was Mississippi with a weekly rate of $468.63 or $2030.73 per month.

The most expensive state, California per the Oregon study, came in at #14 in monetary benefits to workers at a maximum of $1,128.43 per week or $4,889.86 per month. The least expensive state, North Dakota, came in at #10 based on maximum weekly compensation of $1,214.00 or $5,260.67 per month.

It is important for each state’s workers’ compensation system to be run efficiently, fairly, and provide the most “bang for the buck” to improve claim outcomes. For injured workers, on a personal scale, this means quick decisions on medical treatment authorizations to allow a speedy and full recovery after an injury. It also means providing meaningful vocational services when a full recovery is not possible to limit the decrease in earning capacity. On a bigger scale, injured workers need to know that quality medical care is available to them. This requires that doctors receive the payment and support they need to efficiently be able to treat injured workers without drowning in red tape and delays.

A well-run system can result in better outcomes for injured workers and lower costs to employers, all the while avoiding doctor flight. It would appear from the numbers that some states are doing better than others at achieving this goal with several that have lower employer costs and higher maximum weekly benefits to injured workers. This is a goal we can all work towards.

Photo credit: jimmiehomeschoolmom via Foter.com / CC BY

 

Cries of High Costs and Fraud – Watch for Reforms

Today’s post comes from guest author Kit Case, from Causey Wright.

There is always discussion, in every state, about the expense of workers’ compensation insurance to employers. It is common to hear stories of corruption and fraud when employer costs run high. This discussion can lead to cries of fraud, usually with fingers pointed towards claimants and often tied into efforts to reduce benefits to injured workers. As a recent example, take a look at the article published on July 23rd in the Fresno Bee, written by Dan Walters of CALmatters, titled “California workers’ compensation system plagued by high costs and fraud.” In the article, Mr. Walters points to Southern California as an area particularly afflicted by fraud, inserting the hot-button phrase “immigrant workers,” as follows:

“Why Southern California? Its large numbers of immigrant workers are easily persuaded by recruitment agents, called “cappers,” to file claims that allow unscrupulous lawyers and medical providers to milk inflated payments for nonexistent injuries.”

Mr. Walter’s statement is misleading and inflammatory. The link provided by Mr. Walters to support his claim of fraud leads to a news piece – not a study – released by the Center for Investigative Reporting on their “Reveal” radio and web platform.  

The story on Reveal, titled “Profiteering masquerades as medical care for injured California workers,” published in March of 2016, focuses on fraud within the medical component of the workers’ compensation system.  It makes no mention of “immigrant workers” although there is discussion of Spanish-language service providers within the article. The conclusion of the Reveal piece describes injured workers as the real victims of the scams they investigated.

From our experience representing injured workers in Washington State, we see very little in the way of fraudulent acts, by medical providers, injured workers, insurance carriers or employers. In our cases, the fraud we encounter most, on both small and large scales, is committed by employers. We see misclassification of workers to reduce premium rates paid or the failure to provide coverage of a worker by stating they are independent contractors.  We see inaccurate data about earnings and overtime provided by employers in an effort to reduce compensation paid to injured workers and even outright lies about the circumstances of an injury to try to keep a claim rejected.

We do, however, see inefficiencies, on a daily basis, usually under the guise of cost management. Claims managers spend an incredible amount of time and energy micromanaging claims, segregating medical conditions from claim coverage, delaying or denying medical treatment authorizations, sometimes leading to litigation with months, or even years, involved and no relief from legal fees or costs for the claimant, even if successful at trial. In most cases, private insurance policies will not authorize treatment or surgery when a workers’ compensation claim is involved until the litigation has been concluded and the responsibility for coverage is clearly under their policy.

Fraud is a problem whenever it occurs, whomever is committing the fraudulent acts. To hear the cry of “fraud!” – especially when peppered with phrases like “immigrant workers” –  is a good warning bell. These cries often indicate another round of injured worker benefit cuts will soon be on the table. Watch for more news stories, videos of an injured worker riding a jet ski, and you’ll know there’s soon to be “reforms” proposed.

“The “grand compromise” is just as valid today as it was in 1914, but it could collapse if costs – and the fraud and other unseemly aspects of work comp that drive them – are not tamed. The next overhaul should be systemic, not just another backroom deal.” – Dan Walters

An efficiently run system run with fairness and respect and a focus on a speedy, full recovery after an injury and limiting lost wage earning capacity for workers permanently injured on the job should be the goal of all of the players within a workers’ compensation system. Cost savings and improved outcomes can both be achieved. These goals are best met through broad-based efforts to work together on the full spectrum of issues rather than singling out one or more of the segments – doctors, lawyers, claimants, carriers or government agencies – as the primary culprit. There’s room for improvement in all of these segments.

Photo credit: Kit Case

Will The Supreme Court’s Attack On State Courts Affect Workers’ Compensation?

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

One of the biggest and least understood developments of the current session of the Supreme Court session is how the Supreme Court has undercut the power of state courts to decide cases. This development may also impact the traditionally state law centered world of workers’ compensation.

In Bristol Meyer-Squibb v. Superior Court the Supreme Court held that non-California residents could not join a class action against Bristol Meyer-Squibb in California state court. In Tyrell v. BNSF the Supreme Court held that North Dakota residents could not sue the BNSF in Montana state court in an FELA case.

Despite Bristol-Meyer and the BNSF having a substantial number of employees and doing a substantial amount of business in California and Montana respectively, the Supreme Court held that it would violate due process to subject defendants to litigation in those states. State court litigation should be limited to states where a defendant is incorporated, where they are headquartered or where the events in the case took place..

Bristol-Meyer and Tyrell both rely on the Daimler v. Bauman case that was decided in 2014. In her dissent in Daimler, Justice Sonia Sotomayor wrote that the effect of Daimler was “to shift the risk of loss from multinational corporations to the individuals harmed by their actions.” Essentially Sotomayor believes that the rule that a corporation can be sued in any state court where they have substantial contacts has been repealed. Sotomayor was the lone dissenter in both the Tyrell and Bristol Meyers case.

The constitutional basis for limiting state court jurisdiction is the due process clause of the 14th Amendment. The use of the due process clause to weaken the ability of states to regulate corporate conduct has echoes of the so-called Lochner era where state laws that impeded on contracts were overturned unless they were based on general police powers.

So-called forum shopping gets a bad rap from tort reformers. Terms like “judicial hellhole” have coined by pro-corporate legal advocacy groups. But the ability to pick a forum to  bring a legal case is inherent in a federal system like we have in the United States. Lawyers have a duty to bring cases in a forum where they think it is most favorable to their client. Corporate and management interests also engage in forum shopping. In November business interests persuaded a business-friendly federal judge in Texas to block enforcement of the so-called blacklist rule that would have prevented employers who violated workplace safety and fairness laws from receiving federal contracts.

Workers’ compensation laws were enacted during the Lochner era and were held to be constitutional because they were enacted under state police powers under the 10th Amendment. But the mere fact that workers’ compensation laws were enacted under 10th Amendment authority of the states does not mean corporate friendly federal courts can not find a way to strip states of jurisdiction over certain workers’ compensation claims. This is particularly true for workers who may be able to claim workers’ compensation benefits in multiple states.

In Magnolia Petroleum v. Hunt, the Supreme Court ruled that an employee who was injured in Texas but lived in Louisiana could not claim workers’ compensation in his home state of Louisiana because he had already accepted benefits in Texas. The court held that the Hunt could not collect benefits in Texas because of the full faith and credit clause of the U.S. Constitution.

Justice Hugo Black’s dissent in the case that pointed out that the only reason that Hunt received workers compensation benefits in Texas was signing a form in the hospital after the accident. Black also forcibly denounced the idea that Hunt was double- collecting benefits in Texas and Louisiana for two reasons. First, Louisiana offset the benefits that Hunt received in Texas. Secondly, Black stated “the aggregate of the awards from both states, if added together, would be far less than the total loss suffered by respondent. The Texas allowance scarcely amounts to a “recovery” in the sense of giving full compensation for loss, and has been described by a Texas court to be “more in the nature of a pension than a liability for breach of contract, or damages intact.”

Black’s description of the benefits available to injured workers who could claim benefits in two states is as true as it is now as it was 73 years ago when Magnolia came out.

In Magnolia, Black also drew parallels between how the due process and full faith and credit clauses could be used to protect corporate interests.

“For more than half a century the power of the states to regulate their domestic economic affairs has been narrowly restricted by judicial interpretation of the federal Constitution. The chief weapon in the arsenal of restriction, only recently falling into disrepute because of overuse, is the due process clause. The full faith and credit clause, used today to serve the same purposes, is no better suited to control the freedom of the states.”

Three years later Magnolia was distinguished by the McCartin decision. In McCartin the Supreme Court allowed an employee to collect benefits in Wisconsin who had first collected benefits in Illinois to collect benefits in both states because unlike Texas, Illinois had no laws stating accepting workers’ compensation benefits in Illinois ruled out a claimant from receiving benefits in another state.

In 1980, the Supreme Court applied McCartin in Thomas v. Washington Gas and Light to rule that an injured employee could collect benefits in Washington D.C. and Virginia.

But the decision in Thomas was far from the enthusiastic endorsement of multi-jurisdiction workers’ compensation claims voiced by Justice Black in his dissent in Magnolia. Three concurring Justices criticized McCartin but upheld the award of benefits to Thomas based on the legal doctrine of stare decisis. Two justices, including William Rehnquist, dissented ruling that Magnolia should still govern multi-jurisdictional claims. Current Chief Justice John Roberts clerked for Rehnquist and holds a great deal of respect and affection for his former boss.

Considering how eager the majority of the Supreme Court is to limit the jurisdiction of state courts, I would be very concerned if the constitutional of multi-jurisdictional workers compensation claims were reviewed by the Roberts’ court.