We have talked disability policy as it affects birth disability----chronic disease disability----bad medicine disability-----mental health/addiction disability and today the US has the greatest number of citizens in history categorized as disabled. Nothing allows the 1% to MOVE FORWARD as is the 1% global corporate rule political slogan----than creating great poverty and disability in its populations.
I'll end with disability policy today with workplace disability. The US during NEW DEAL and FDR created Federal workplace laws to move away from the large number of US citizens being disabled during the 1800s Industrial Revolution. We see pictures of child labor and industrial laborers harmed by toxic chemical exposure and accidents causing physical disability. Well, Clinton/Bush/Obama while dismantling all those Federal workplace structures in the US created the conditions in International Economic Zones for these workplace disabilities to SOAR. The number of just Chinese citizens left with toxic exposure/accident disability is astounding. We know this will be coming back to the US under US International Economic Zone and Trans Pacific Trade Pact policies in cities like Baltimore.
Someone like me who studies public policy including international public policy have always read the policy coming from global policy groups including the 1% DAVOS Switzerland crew ----THE CLINTON/BUSH MOVING FORWARD GLOBAL CORPORATE TRIBUNAL group. They have for decades been pushing to be rid of WORKMAN COMPENSATION INSURANCE. Clinton/Bush/Obama has set the stage for this by making it harder for injured employees to access doctors---changing timelines for filing and treatment---and now just openly firing workers who are injured instead of allowing them the pathway to workman's compensation. This is happening now and this is unofficially ending that program. Immigrant labor has for decades faced this automatic dismissal----these few decades have seen low-income workers having the same. Baltimore has a long history of this for both groups of workers. Think what bringing global corporate factories on campuses like UnderArmour will do to super-size these conditions and it will. What we see below since Clinton/Bush is the breakup of the Trust and movement into separate Departments all of which are now defunding or disconnecting from this medical process. Look at the Bush Administration creating this breakdown by creating different departments and think how it is the Republicans shouting there are two many agencies handling services----THEY CREATED THIS BREAKDOWN. Then Obama came in with appointments to Health and Human Services, Education, and Labor who are now dismantling the structures in each of these departments that allowed for what was an easy, efficient, quality process for workers injured on the job. IT WORKED PERFECTLY UNTIL THE SUBPRIMING OF THE PROGRAM.
GET RID OF WORKMAN'S COMPENSATION IN DEVELOPED NATIONS SAID THE DAVOS 1%----AND THE WALL STREET GLOBAL CORPORATE POLS SAID---OK.
Workers' Compensation, A Brief Historyby Lloyd Harger, Division of Workers' Compensation
'The Future…We are just a few years into 21st Century and have already seen sweeping changes with the abolishment of the Department of Labor and Employment Security, the Division of Safety and the Special Disability Trust Fund. The Agency for Health Care Administration was elevated to full Department status in 2001 and received the Medical Services portion of the Division of Workers’ Compensation in February 2001with permanent transfer effective July 1, 2002. The Reemployment section transferred to Department of Education, Division of Vocational Rehabilitation with the remainder of the Division moving to Department of Insurance also effective July 1, 2002. Department of Insurance and Department of Banking and Finance merged into the new Department of Financial Services effective January 1, 2003'.
We see an article from 2005----soon after all those revisions were made where workers were not able to access the process as they had. This is creating more and more disability as people injured do not get the rehabilitation they need.
Mind you----Republican pols are behind this and you can be sure Republican voters are amongst those injured and wanting these benefits as much as anyone else. Clinton/Obama Neo-liberal/ Bush/Hopkins neo-cons are far-right politicians.
Workers’comp injured hold protest / They say system’s recent overhaul denies them care they need
Tom Abate, Chronicle Staff Writer
Published 4:00 am, Thursday, January 20, 2005
WORKERS20_029.jpg_ Steve Duncan, who jumped off a catwalk 57 feet above the ground to survive the Tosco refinery fire in February 1999, makes a point wed morning. A group of injured workers protested the ... more
Workers hurt on the job rallied in Oakland on Wednesday to argue that recent overhauls to the workers' compensation system have gone too far, making it harder for people hurt on the job to get benefits.
"Until now, voters injured at work have had no political voice," said Steve Duncan, a founder of the newly formed political action group VotersInjuredatWork.org.
The group was formed to protest changes in the workers' compensation system put in place in the last few years that have curtailed employers' fast- rising costs. The workers group says the savings are being achieved in part by depriving those hurt on the job of benefits they deserve.
Duncan, 53, survived a 1999 oil refinery accident near Martinez by jumping off a 57-foot catwalk and landing in flames. He said that while most of his claims were handled under the old rules, the changes are making it harder for him and other injured workers to get treatment.
"They delay everything. You have to prove this and prove that," said Duncan, who has a history of political action over workers' compensation. He was one of several activists who persuaded former Gov. Gray Davis to sign legislation increasing benefits in 2002.
Sen. Charles Poochigian, R-Fresno, who wrote the most recent in a series of bills designed to curb the rising cost of workers' compensation costs, noted that the new group is backed by the California Applicants' Attorneys Association, composed of lawyers who represent injured workers. He said the attorneys instigated the protest out of fear that the changes would cut their income.
"Nothing that was done was intended, nor has the effect of harming truly injured workers," Poochigian said.
Oakland resident Peggy Sugarman, who is the executive director of the workers group, which is based in Sacramento, said the attorneys association had provided less than $100,000 to start Voters Injured at Work. She said the group plans to recruit enough $25-a-year members to become self-sustaining.
"We hope to have 10,000 members by next January," said Sugarman, a former deputy director of the state Division of Workers' Compensation.
About 100 people attended Wednesday's rally in Oakland outside the state office building where the Workers' Compensation Appeals Board settles benefit disputes between injured workers and their bosses or insurers. Sugarman said rallies were scheduled at more than a dozen similar locations statewide.
Frances Quintana, 44, of Union City attended the Oakland rally at the suggestion of her lawyer to protest recent changes that have ended her access to acupuncture. Quintana said the treatments helped relieve the pain of carpal tunnel injuries sustained during 23 years as a court clerk.
"I am not faking," said Quintana, in response to a question about the oft-repeated charge that workers' comp rolls are swelled with abusers. "I've worked very hard," she said. "That's the only job I've ever had since I was 20 years old."
Three bills -- two passed before and one after the 2003 gubernatorial recall election -- have sought to curb the costs of providing medical treatments and disability payments to injured workers. The legislation was passed after employers were stung by a series of double-digit increases in workers' compensation insurance premiums that began in 2000.
In legislative hearings, critics argued that injured workers in California used more medical services and spent more time out of work than employees in other states, suggesting a lax system in need of reform.
Organized labor argued that the premium crisis was partly precipitated by the deregulation of insurance rates beginning in 1993.
Rates dropped for several years, but competition became so cutthroat that, by 2000, more than 20 insurance firms were either leaving the California market or on their way to bankruptcy.
Against this backdrop, the Democratic-controlled Legislature -- first under Democrat Davis and then Republican Gov. Arnold Schwarzenegger -- overhauled the system twice.
Lawmakers created guidelines for medical treatments, set standards for disability pay for certain injuries and let employers form preapproved pools of doctors to treat the injured instead of letting workers choose doctors for themselves.
The Workers' Compensation Insurance Rating Bureau, a San Francisco group that is the system's official fact-gatherer, released data last week showing that cost containment is working.
The average cost per indemnity claim, after rising steadily from about $19,000 in 1992, began to level off at roughly $50,000 in 2002. Insurance premiums have retreated about 16 percent from their July 2003 peak, it said.
But injured workers say the premiums are still too high.
In 1999, insurers incurred $1.82 in costs and liabilities for every dollar they collected in premiums, the Bureau said. In 2003, the comparable figure was 85 cents per dollar.
"We are calling for insurers to roll back their prices at least 30 percent," Duncan said at the injured workers' rally in Oakland on Wednesday.
Nicole Mahrt, Sacramento spokeswoman for the American Insurance Association, said that without the recent changes, premiums would have continued to escalate, meaning that the 16 percent cuts understate the savings.
Economist David Neumark, who will summarize the reforms at a Public Policy Institute of California forum in San Francisco today, framed the latest turn in the debate this way:
"Are we creating a system that reins in costs and is humane to workers or that is going to aggressively cut costs but not meet their needs? It's too early to say."
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The Workman's Compensation Disability Trust was broken and send to different agencies like labor and vocation----education -----insurance agencies this then saw that concentrated funding just for workman's compensation now directed to what are not functions for this service. We see Federal Labor and Education Departments using funding to create the vocational job training structures for example and here we see Obama and Clinton neo-liberals directing what were funds to this Special Disabilities Trust for Workman's Compensation to boost SOCIAL SECURITY DISABILITY-----a trust emptied by subpriming unemployed citizens into a disability status. So, media presented this as progressive-----WALL STREET GLOBAL CORPORATE POLS PROTECTING SOCIAL SECURITY DISABILITY----when this temporary solution to what will be the end of SS Disability is now receiving what was WORKMAN'S COMPENSATION.
It is a ponzi scheme in moving Federal funds that once served programs across the board to supporting a subprimed Social Security Trust and SS Disability Trust. Remember, these Trusts will disappear with the $20 trillion in US Treasury bond debt so this is simply moving and defunding agency by agency.
Yes, it reallocates Social Security Trust funds----but it moves as well funds from other agencies.
So Obama is now a hero for fighting for SS Disability all while knowing Obama has imploded the US Treasury with Wall Street bond leverage with the goal of ending Social Security AND SS Disability Trusts.
President's Budget Proposes Disability Trust Fund Fix, Other Assistance for People with Disabilities
President Obama's recently-released Fiscal Year 2016 Budget proposes a reallocation of payroll taxes to fix the anticipated shortfall in the Social Security Disability Insurance (SSDI) trust fund, along with increased employment assistance for people with disabilities and additional funding for the hiring of administrative law judges to handle disability benefit appeals.
The SSDI trust fund holds excess payroll taxes collected in years when the government was taking in more money than it was spending on SSDI benefits. However, in recent years, the government has collected fewer payroll taxes than it has paid out in SSDI benefits, forcing it to spend the trust fund reserve in order to fully fund the SSDI program. If changes are not made, the trust fund will run out in 2016 and SSDI benefits will be cut by approximately 20 percent in order to balance the program's budget. (For more information on the mechanics of this problem, click here.)
The Social Security Administration has proposed solving this problem by reallocating a small percentage of payroll tax revenue away from the Social Security Old Age and Retirement trust fund and into the SSDI trust fund. However, the House of Representatives, in one of its first orders of business in 2015, passed a rule change that would prohibit it from reallocating money between the two trust funds, something that has been done frequently in the past, unless the reallocation does not affect the actuarial stability of either fund.
In his proposed Fiscal Year 2016 Budget, President Obama advocated the SSA's position, calling for the temporary reallocation of funds in order to buy time for Congress to develop a permanent solution to the SSDI funding problem.
In addition to the trust fund reallocation, President Obama's budget also contains several other items of note for people with disabilities. The budget requests $400 million to set up new programs such as supportive employment services and incentive programs for employers who hire people with disabilities, and it also requests additional funding to hire administrative law judges to handle the massive backlog of disability appeals.
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As Wall Street global pols move Workman's Comp Trust funds to simply be used for global investment leveraging the small businesses tied most closely to paying these workman's compensation contributions are shouting loudly about the hardship of growing contributions. Remember, these contributions were raised at the same time US corporations were heading overseas so the bulk of payroll contributions have been hitting smaller businesses.
Maryland is great for this. They hit businesses hard for these payroll taxes while being one of the lowest benefit payer's to actual injured citizens. Maryland is well under half of what other states pay workers when hurt---but they love collecting that worker's comp from Maryland businesses. So, where has all that worker's comp trust been going in Maryland? To Wall Street investment leverage because it surely is not making it to citizens in Baltimore on a great scale.
This article is long but please glance through. We have known this problem existed these few decades of Clinton/Bush/Obama but now it is far worse because they intend to end this program for worker's injured on the job completely very soon.
The Fallout of Workers’ Comp ‘Reforms’:
5 Tales of Harm
Injured workers share their stories, revealing the real-life impact of rollbacks that have been spreading across the country.by Michael Grabell, ProPublica photographs by Glenna Gordon for ProPublica March 25, 2015
An investigation by ProPublica and NPR earlier this month detailed how states across the nation have been dismantling their workers’ compensation systems, with disastrous consequences for many of the hundreds of thousands of people who suffer serious injuries at work each year.
In some states, the cuts have been so drastic that injured workers have plummeted into poverty, losing their cars and even their homes. In others, workers spend years battling insurance companies for the surgeries, prescriptions and basic help their doctors recommend.
The five case studies below are emblematic of the bewildering labyrinths injured workers have to navigate as a result of these cutbacks. As attorneys for injured workers are fond of noting, it’s no coincidence that Franz Kafka — known for his tales of suffering at the hands of faceless bureaucracies — was once a clerk in the workers’ comp bureau of Bohemia.
22 States Now Set Arbitrary Time Limits on Injured Workers’ Temporary Wage Benefits
Green states cap temporary wage-replacement benefits after a period of time ranging from two years in California, Florida, North Dakota, Oklahoma, West Virginia and Texas to about 13 ½ years in New Mexico. Some states have had such caps on the books for decades, but several have recently lowered their limits to two years. Explore the full interactive. (Source: Workers Compensation Research Insitute)
Gary Fury was working at a Simonton Windows factory in West Virginia in July 2012 when a large two-window unit slipped to the floor. Fury bent to help a coworker slide it back onto a cart.
“When I went to pick it up,” he recalled, “I felt something pop.”
Fury, then 49, had torn his rotator cuff and ruptured his bicep. After trying less invasive treatments, his doctor recommended surgery and warned of poor results if it was delayed.
Instead of approving it, Sedgwick Claims Management Services, an insurance claims administrator hired by Fury’s employer, sent him to its own doctor for a second opinion six weeks later, according to workers’ comp court records. That doctor also said surgery should be authorized immediately and warned that delays could lead to permanent impairment.
The Demolition of Workers’ Comp
Over the past decade, states have slashed workers’ compensation benefits, denying injured workers help when they need it most and shifting the costs of workplace accidents to taxpayers.
But in West Virginia, time is on the insurer’s side. In 2003, the state passed a law capping wage benefits for temporary injuries like Fury’s to two years -- even if the worker hasn’t recovered yet. Several other states, including California, Oklahoma and North Dakota, have recently capped payments at two years. Today, 22 states set arbitrary time limits on temporary wage benefits, according to data collected by the Workers Compensation Research Institute.
Despite the recommendations of two doctors, Sedgwick waited another five weeks before approving surgery — a delay that a workers’ comp judge said was “especially unwarranted” after Sedgwick’s own physician said he needed it “ASAP.” By the time Fury finally got surgery, it was January 2013.
“They just don’t know how much pain I sat for six months in waiting to get surgery,” he said.
As the doctors had warned, Fury still had pain and limited range of motion after the surgery and was unable to return to regular work. Now, his doctor has recommended additional treatment and possibly another surgery.
But since Fury’s two years of wage benefits have run out, if he gets the surgery, his employer doesn’t have to pay him while he recovers -- even though a state workers’ comp judge said Sedgwick is “at least in part responsible” for his medical problems.
After his injury, Fury initially survived on two-thirds of his wages, which are provided by workers’ comp, tax-free. But when the payments stopped, Fury has at times had to rely on food stamps and Medicaid.
“It got down to the point where I had to go get help, like from what they call welfare,” Fury said. “That was so embarrassing for me. You know, you’re used to working all your life. I raised two kids and never had to be on there. Sometimes, it really degraded me to go to a grocery store and you had to pull out your card instead of pulling out your cash -- all because you’re an injured worker.”
Sedgwick and Simonton declined to comment about what happened to Fury.
After hearing the details of the case, Chris Stadelman, communications director for Gov. Earl Ray Tomblin — who was state senate president when the workers’ comp reform passed — said the governor’s office was “comfortable with the changes that were made” and has not heard complaints from injured workers.
Fury is now applying for Social Security Disability Insurance and watching his life savings slowly drain away.
Meanwhile, Tomblin recently announced a boon to West Virginia employers: Workers’ comp insurance rates would be cut for the 10th year in a row.
10 States Since 2003 Have Expanded Their Use of Outside Medical Reviewers to Assess Injured Workers’ Doctors’ Recommendations
Green states have increased their use of — or the weight given to — outside doctors who review treatment recommended by workers' physicians. In some states, these reviewers have the power to rule an injury isn't work-related or to deny treatment after only a brief exam or paperwork review.
Nicolas Mercado, a 54-year-old quadriplegic, sits in a long-term care facility waiting to return to his home in San Bernardino, California, to return to the smells of home-cooked Mexican food and the giggles of his granddaughter. Home to the same street corner where he and his wife met as teenagers.
Mercado has not lived there since December 2011, when the tanker truck he was driving to collect kitchen grease flipped over on an exit ramp, leaving him paralyzed from the neck down.
Mercado misses the taste of his wife’s home-cooked Mexican food so he asks the nurses at his long-term care facility to cut up chilis to spice up his meals.
In March 2013, his doctors said that his medical condition had stabilized and he could go home as soon as modifications were made to accommodate his wheelchair. Under state law, home modifications are covered by workers’ comp.
The California Insurance Guarantee Association (CIGA) — which took over the claim when the original insurer went bankrupt — sought a second opinion from another doctor, who approved some modifications and rejected others. Then CIGA ignored many of its own doctor’s recommendations and insisted a new state-mandated medical review process allowed it to delay the fixes.
A 2012 law in California put medical disputes between the workers’ doctors and insurers into the hands of “independent medical reviewers” who remain anonymous and make decisions based solely on medical records. California is one of 10 states since 2003 to expand its use of such outside doctors, who have the power to say an injury isn’t work-related or deny recommended medical care after only a brief exam or paperwork review.
In Mercado’s case, CIGA approved a wheelchair lift, but it didn’t fix the doorway it leads to, which has a step and is too narrow for Mercado’s chair.
One of several rosaries and other religious items Mercado keeps in his room at his assisted living facility. His doctor say he is ready to go home as soon as some modifications are made to accommodate his wheelchair.
CIGA argued that the “prudent and responsible” course was to wait until the new medical review process was complete before doing any further modifications.
Judge Paul DeWeese, a workers’ comp judge in Anaheim, rebuked CIGA, saying it was insisting on “form over substance” and that the medical review process was never intended for cases like Mercado’s.
“That assertion is outrageous,” DeWeese wrote in his May 2014 opinion. “The ‘prudent and responsible course,’ not to mention the legally required course and the only moral and humane one, is to assist Mr. Mercado in returning home forthwith.”
For Mercado’s wife, Linda, it’s been especially wrenching to leave her husband at the long-term care facility month after month, when he could be home.
“When I leave him over there and I see him through the window, and I wave bye and I throw him a kiss and he throws me a blessing, and I give him a blessing, it just tears my heart,” she said. “I don’t like to let him see me crying, but once I leave that parking lot, everything comes out.”
Mercado lost the ability to move his left hand, but still has some movement in his right and must sleep in this wrist brace to protect the nerves.
The independent medical reviewer, who is supposed to have the final word under the new law, denied the additional home modifications. In October, the state Workers’ Compensation Appeals Board ruled in Mercado’s favor and ordered CIGA to finish the job. But the insurance company appealed once again.
After a local TV station aired a story about Mercado’s case in January, CIGA agreed to make the home modifications.
“I took a look at what had happened in terms of the case and determined we could have probably gone down a different path,” Wayne Wilson, CIGA’s executive director, said in an interview.
10 States Since 2003 Have Increased Use of Pre-Existing Conditions to Limit or Deny Care After Workplace Injuries
Green states have either raised the qualification standards for workers' comp when a work injury aggravates a pre-existing condition or have reduced the liability of employers and insurers for the full effects of the injuries when other conditions, such as aging, may have contributed.
Brenda Albright spent 16 years as a forklift driver hauling rolls of paper to make cardboard boxes for Smurfit-Stone Container in Fargo, North Dakota.
One day in June 2010, she squatted down to remove a tag from one of the rolls. As she stood back up, she suddenly felt what she describes in workers’ comp records as an “extremely ungodly pain.”
Her husband, who was Smurfit-Stone’s plant superintendent, rushed her to the emergency room, and she was diagnosed with a herniated disc.
Two doctors for North Dakota’s Workforce Safety & Insurance agency (WSI), including its medical director, reviewed Albright’s records and agreed that despite prior back problems, her herniated disc was due to the incident at work and not a pre-existing condition, according to court records. The agency, which insures North Dakota businesses, accepted the claim.
Or so it seemed.
Then Albright came face to face with a growing trend in workers’ comp — the aggressive effort to pin workplace injuries on pre-existing conditions. In recent years, North Dakota and several other states have increasingly allowed insurers to deny claims by saying that work injuries only aggravated existing conditions caused by aging, prior injuries or the structure of workers’ bodies.
Since 2003, insurers in 10 states have moved in this direction. In one case in Kansas, an insurer refused to cover carpal tunnel surgery for a hand packer at a warehouse, asserting that her thin body frame made her susceptible to repetitive stress injuries. Florida lawmakers have added a twist: Insurers there can cite pre-existing conditions to require workers to pay up to 49 percent of their medical costs even when work was the primary cause of their injuries.
In 2008, employees at North Dakota’s WSI told auditors that their bosses were directing them to look for reasons to deny claims. They reported a recent “shift in management focus to a more aggressive and in-depth search for prior injuries or pre-existing/degenerative conditions, which could possibly reduce WSI liability for the injury.”
According to her claims adjuster’s notes, Albright’s employer, Smurfit-Stone, was “not happy” with WSI’s decision to accept her claim. The agency agreed to reconsider — a decision a judge later described as “bowing to pressure from the employer” — and hired an independent medical reviewer to look over Albright’s records.
Without examining Albright, that doctor said her back problems were the result of a degenerative condition unrelated to work. Using the new opinion, the agency denied the claim.
Albright’s own doctor was dumbfounded, according to a letter he wrote WSI. While Albright had problems in her neck and lower back, an MRI from a few years before showed she didn’t have any problems in her lower middle back, where the herniated disc was, he wrote. Any pre-existing condition, he said, was most likely caused by the repetitive twisting and jarring she experienced driving the forklift.
“Clearly, the single event at work led to her herniated disc,” he wrote in his letter. Millions of Americans had her back problem, he noted, but it didn’t mean they were all doomed to have herniated discs in the future.
A judge in Albright’s case called the agency’s medical reviewer a “professional witness” who had “only read about” the tissues and intervertebral discs that Albright’s neurosurgeon “once held in his hands.”
The judge ruled in her favor, but the North Dakota Supreme Court overturned that decision, noting that the legislature has restricted the courts’ oversight of the workers’ comp agency to cases where no “reasoning mind” could have come to the same conclusion.
In an interview, WSI director Bryan Klipfel stood by the decision, saying work didn’t cause Albright’s injury.
“I’ve got bad back issues also,” he said. “But if I’m at work and I bend over to pick up a paper clip or something and my back goes out, it’s maybe caused at the job, but my job didn’t cause the injury.”
RockTenn, which owns Smurfit-Stone, said the case was handled appropriately.
Albright, 57, remains out of work and on programs funded by taxpayers. The Social Security Administration awarded her disability benefits immediately, listing the onset date as the day she felt the “ungodly pain” at work.
37 States Now Restrict Injured Workers’ Ability to Choose Their Doctors
Green states allow employers and insurers to choose workers’ doctors, at least initially. Blue states restrict workers to doctors approved by their employer, state or insurer or to those in their employers’ managed-care plans. Explore the full interactive. (Source: Workers Compensation Research Insitute)
Christopher Carter’s left foot was mangled when it got sucked into a conveyor belt at a gravel pit in Great Falls, Montana, in July 2012.
The 43-year-old mining equipment mechanic went to a podiatrist who recommended a simple, inexpensive remedy: a cortisone injection to reduce inflammation and alleviate the pain, according to medical records.
His workers’ comp claim could have ended there. But Carter soon learned that something as basic as choosing your own doctor is no longer guaranteed in workers’ comp. A 2011 Montana law gave employers and insurance companies the right to pick workers’ doctors after accepting their claims and to transfer their care to another doctor at any time.
Eighteen states now allow employers to select the physician who treats their injured workers at least initially, according to the Workers Compensation Research Institute. And another 19 states require many workers to choose from a list of doctors — sometimes as few as four — approved by their state, insurer or employer.
After Carter saw the podiatrist, his employer’s insurer, the Montana Contractor Compensation Fund, sent him to an independent medical examiner, who also recommended a cortisone shot.
Instead of approving the treatment, the insurer changed his treating physician. Same result: The new doctor also recommended the shot, referring Carter back to the podiatrist he’d seen to begin with.
Carter’s insurer wouldn’t authorize him to see the podiatrist who initially cared for him or even another recommended by the new treating doctor. Instead, the insurer inexplicably sent Carter for another exam, this time bringing in an orthopedic surgeon from Missoula, 170 miles away. She recommended a similar injection.
Two years after his injury, Carter still hadn’t received approval for an injection, although four doctors had recommended it. His insurer just kept sending him to more doctors.
Mel Pozder, senior claims examiner for the contractors’ fund, declined to comment, citing health privacy laws.
Out of frustration, Carter settled his case with the Montana Contractor Compensation Fund last spring for $46,250 to cover his unpaid medical bills and future wage loss. He has struggled to find work to support his three children, ages 11 to 15, and now works at a relative’s auto body shop.
“I think that my foot and ankle could have been healed by now, or greatly improved, if Montana law allowed me to choose my treating physician,” he wrote to a state legislative committee studying workers’ comp last year.
“I’m 43,” he said in an interview, “and I walk like I’m 80.”
California Now Uses New, Stricter Guidelines to Reassess Old Cases and Deny CareIn 1997, Frances Stevens was the editor and publisher of Curve, one of the best-selling lesbian magazines in the country. She was in incredible shape and training for the Golden Gloves boxing tournament.
Before she was injured at work, Frances Stevens was an avid boxer as well as the editor and publisher of one of the best-selling gay and lesbian magazines in the country.
One day in October, she and her staff were carrying boxes of the magazine’s latest issue to a storage closet. Stevens, 30, tripped over an area rug and broke a bone in her foot. She was put in a cast and had surgery.
The bone healed, but the fall damaged her nerves, leaving her with excruciating, unexpected pain, often affecting both feet.
More than 17 years later, Stevens can’t walk and gets around in a motorized wheelchair. At night, the simple brush of a bed sheet over her feet will send her screaming in pain. She can’t take a shower without submerging her feet in a bucket of water so that the stream won’t touch them directly.
“It’s like that nerve pain that just zings through your whole body like an ice pick,” she said.
California’s workers’ comp system once paid for a home health aide to help Stevens during the day. But in 2013, a new law took effect, subjecting old cases like Stevens’ to a greater emphasis on narrow guidelines that, among other things, severely limited home health care for people injured at work. When Stevens needed to replace her aide, her insurer, the State Compensation Insurance Fund, used that request to decide that an aide was not medically necessary.
Under the new law, Stevens’ only recourse was to appeal to an independent medical reviewer chosen by a company hired by the state. But that doctor never needed to see her, didn’t have to be licensed in California, would remain anonymous and could only be challenged under limited circumstances.
A letter to Frances Stevens from her insurance company, denying four of four requests for medications. When court dates in her legal fight for care approach, she often receives this much paperwork in the mail in just one week.
She was supposed to get an answer in 30 days, but instead the process took nearly seven months. The medical reviewer upheld the insurance company’s decision to deny the aide.
Now, Stevens is challenging the constitutionality of that process. In a petition recently accepted by the 1st District Court of Appeal in San Francisco, she argues that allowing medical decisions to be made by anonymous doctors who don’t examine the patients and can’t be questioned violates the rights of injured workers.
California workers’ comp issued a warning to insurance companies last week that the new law shouldn’t be used to revisit existing agreements for home health care.
The State Compensation Insurance Fund said the request for the aide was denied based on medical evidence. In documents filed with the appeals court, it argued that workers have adequate avenues for appeal and that the legislature acted appropriately to try to create a “faster and cheaper” process that would “promote better health.”
The pills Frances Stevens takes daily to manage the pain and other side effects resulting from her on-the-job accident, and a whistle she carries with her when she leaves the house so she can call for help if she falls or has any other emergencies.
“The legislature’s motivation was to help both employers and injured workers,” it wrote.
Having been both an employer and injured worker has given Stevens a unique perspective on a system she only thought about when she paid her insurance premiums.
“I had just turned 30. I was an athlete. I had a job that I loved, a life that I loved. I couldn’t ever imagine this happening to me, and in a second, my life changed,” Stevens said. “If people don’t stand up and start noticing how broken the system is, by the time you figure it out, it’s going to be too late.”
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You know your state is not enforcing or providing oversight and accountability in any area if the major legal industry is trial lawyers. If citizens need trial lawyers to get workman's comp-----then the system is not working. This works well for the lawyers pocketing much of what would have gone to health care ----what Wall Street leverage doesn't get trial lawyers are getting. What the American people are not getting IS ACCESS TO HEALTH CARE----ERGO THE GROWING POPULATION OF DISABLED IN THE US.
You can see in every case the collusion of lawyers and bankers to suck all our Federal, state, and local revenue---and this is yet another case. Who are primarily politicians in Maryland? Lawyers and development/financial people. This was what Baltimore City Council and Mayoral race was about----making this dynamic stronger.
All of this is not clever or smart----it is illegal because our elected officials are NOT allowed to conspire against citizens and taxpayers to undermine them. These programs have a mission and that mission is not being met.
Baltimore Workers’ Compensation Lawyers
Types of Wage Loss Benefits-
Under Maryland Workers’ Compensation law, employees suffering from a work-related injury or illness are entitled to receive compensation for wages lost as a result of the injury. The total amount you may receive depends largely on the nature and extent of your injury, and your average weekly wage prior to the date of disability. There is great likelihood that any of these factors will be argued by your employer or insurance company in an attempt to reduce the amount to which you are entitled. For this reason, it is highly recommended that you seek the assistance of a reputable and qualified Baltimore Workers’ Compensation lawyer to assist you with your claim and make sure you receive the full amount of compensation you deserve.
Temporary Total Disability
If you are being treated for a job-related illness or injury that prevents you from returning to work, you are entitled to temporary total disability benefits of two-thirds of your average weekly wage. Payments are based on your average gross earnings during the 14 weeks immediately preceding your injury. All payments are tax free and subject to a maximum rate as determined by the average weekly wage for all Maryland employees for the year you were injured. It is critical that your average weekly wage is calculated accurately and includes not only your regular wages, but bonuses, vacation pay, overtime, and expense allowances. A Workers’ Compensation lawyer in Baltimore can help to make sure your benefits are calculated correctly.
Compensation is allowed from the first date of disability, provided the period of disability lasts longer than 14 days. If the period of disability is 14 days or less, then wage benefits are covered beginning the fourth day of disability. These payments end when you return to work, or when a doctor determines that you have achieved maximum medical improvement, meaning that the work injury has healed to the point wherein no further improvement is expected.
Temporary Partial Disability
In some situations, workplace injuries are not so severe as to completely prohibit your ability to work. If this is the case, you may be able to return to a lighter duty position or work fewer hours at the same job. During this time, you are entitled to receive benefits totaling 50% of the difference between your average weekly wage before the injury and what it is while on restricted duty, subject to a maximum payment of 50% of the statewide average weekly wage.
Permanent Partial Disability
If your injury at work has caused you to suffer any permanent physical problems, and your doctor has determined that your condition will not improve further with time, you may still be eligible to receive additional Workers’ Compensation in the form of permanent partial disability benefits.
The process by which the Workers’ Compensation Commission determines the full amount of benefits is extremely complex. Several factors are considered, including the nature and extent of the injury, as well as the effect the injury will have on your ability to earn wages in the future. You will have to provide evidence of permanent injury including any pain, weakness, atrophy, or loss of use or endurance in the affected area. It is important not to rely solely on the opinion of the physician hired by the insurance company, as they frequently will fail to fully consider the full impact of these factors. Your age, level of education, and prior work experience are also used in determining awards. Other factors include which body part was injured; the percentage of the disability; your average weekly wage and the average statewide weekly wage; and other factors such as the presence of a pre-existing medical condition.
The Maryland Workers’ Compensation Commission has established a maximum number of compensable weeks for each specific body part. Maximum compensable weeks range from ten weeks for a small toe, to 500 weeks for a serious head or back injury. Compensation is further broken down into three tiers based on the number of compensable weeks:
First tier (less than 75 weeks): You are entitled to one-third of your average weekly wage, not to exceed one-third of the statewide average weekly wage.
Second tier (75 – 249 weeks): You may receive two-thirds of your average weekly wage, not to exceed 50% of the statewide average weekly wage.
Third tier (250 weeks or more): You may receive two-thirds of your average weekly wage, not to exceed 75% of the statewide average weekly wage.
Permanent Total Disability
If your injury is so severe that you cannot return to work at all, you may be eligible for permanent total disability benefits for life. These payments are subject to an annual cost of living adjustment of up to five percent as determined by the Department of Labor. Under these circumstances, you may also qualify for Social Security Disability benefits. An experienced Baltimore Workers’ Compensation lawyer can help you sort out your options and make sure you are getting the full amount of benefits possible.
Baltimore Workers’ Compensation Lawyers at LeViness, Tolzman & Hamilton Obtain Maximum Compensation for Injured Workers
When you are recovering from an accidental work injury or occupational disease, dealing with the complexities of filing a Workers’ Compensation claim can seem overwhelming. At LeViness, Tolzman & Hamilton, our dedicated Baltimore work injury law firm has helped countless individuals get the maximum compensation allowed by law. Our goal is to minimize your stress so that you can focus on what matters most – your recovery.
Our offices are conveniently located in Baltimore, Columbia, Glen Burnie and Towson, Maryland and we represent clients throughout Baltimore City and Baltimore County and the state of Maryland. To schedule your free consultation with one of our highly qualified Baltimore Workers’ Compensation lawyers, call 844-556-4LAW (4529) today or contact us online. A member of our team is available to answer your questions 24 hours a day.
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As US corporations moved overseas in large numbers during Clinton/Reagan----the only groups of businesses paying into this system is now regional and small businesses. Most people now long-term unemployed by US corporations moving overseas are now those hitting the SS Disability for support so the entire workman's disability system is dysfunctional---it was never meant to be this big of a burden on our mid-size and small businesses. While we can be sure global corporations in the US are not paying all these payroll taxes----our regional and small businesses receiving more IRS and State scrutiny over tax payments have been paying them.
What will happen as global corporations are allowed to operate in US International Economic Zones free from all these labor laws----pushing regional and small businesses out of business----all this worker's compensation health disability structure is slated to disappear.
ALL MARYLAND ASSEMBLY AND BALTIMORE CITY HALL POLS HAVE THESE FEW DECADES PUSHED THESE POLICIES AND WILL END ACCESS TO DISABILITY COVERAGE WHETHER SS DISABILITY OR WORKER'S COMP. WE HAVE ONE OF THE MOST PROFIT-DRIVEN PRIVATE HEALTH SYSTEMS IN THE NATION AS WELL.
'Workers Compensation Insurance
Worker’s compensation insurance covers claims by employees against a company for job related injuries or illness. With the exception of Texas, every state will require that you buy worker’s compensation insurance. In most states, worker’s compensation insurance is sold and underwritten by private companies, although some states require you to buy it from specific state-managed carriers'.
All while people are not accessing the health care----leading from recovery to disability.
FICA Taxes, Unemployment Insurance, & Workers Comp For Owners
By Jeremy Marsan on March 7, 2016 |
When you start hiring employees, you will have expenses over and above the salary that you pay them. Social security and medicare make up the taxes known as Federal Insurance Contributions Act (or FICA). FICA taxes, along with unemployment insurance taxes (known as FUTA and SUTA), add up to around 10% of their wages or higher. Additionally, most states will require that you buy workers compensation insurance.
In this guide, we’ll cover all these hidden expenses of hiring employees, including the current 2016 tax rates.
If you’re looking for an easier way to manage employment taxes, we recommend Gusto payroll software (formerly ZenPayroll). In addition to running payroll with direct deposit, Gusto calculates, files and e-pays payroll taxes (as well as workers comp insurance) on your behalf.
Wondering how to add an employee to payroll? Click Here to get our FREE Payroll guide and find out how.
2016 Employer Tax Rates
Cost In Dollars or Percentage (%) of WagesMaximum Dollar ($) Amount Taxed Per EmployeeTotal Cost For A Worker Earning 30,000 per Year
Social Security Tax
Medicare Tax
(FICA taxes)6.2%
1.45%$118,500 (in 2016)
Unlimited$1,860
$435
State Unemployment Insurance (New Employers*)CA 3.4%
NY 4.1%
TX 2.7%$7,000
$10,700
$9,000$238
$438.70
$243
Federal Unemployment Insurance
Most States 0.6%
CA, OH 2.1%
CT, 2.7%$7,000
$7,000
$7,000$42
$147
$189
Worker Compensation Insurance
Average $1.50 for every $100 of payroll, but varies widelyn/a$450
PostersFree / $63 Per Yearn/an/a
Total: Approx. $3,000 – $3,500 for an employee earning $30,000 per year, depending on your state and SUI tax rate.
*Note: State Unemployment Insurance (SUI) Rates vary from business to business. You should have a rate assigned to you each year by your state’s Department of Labor. If you’re unsure of your rate, try logging into your state tax website to check.
Also, bear in mind that healthcare will be an additional cost to businesses with over 50 employees. If you have fewer than 50 full time equivalent employees, you are not required to provide health insurance to employees. To learn more about health insurance and Obamacare requirements, check out our full guide here.
Why are posters an expense related hiring employees?
In many lunchrooms or employee only areas, you will see posters detailing employee rights like the minimum wage. Both the federal and state governments require that certain information be posted in a location visible to all employees. The employment posters required by the Federal Government are available here and can be ordered for free.
Unfortunately, states aren’t always as organized as the federal government and may only provide a list of requirements. For around $63 per year, The Labor Law Center will provide you a poster to comply with the requirements for both state and federal labor laws. Additionally, if the requirements change, they will automatically send you a new poster.
FICA Taxes (Social Security & Medicare)The bulk of employer taxes are Social Security and Medicare. Together, these two taxes make up FICA, which stands for the Federal Insurance Contributions Act:
Unemployment Insurance (SUTA & FUTA)Employers are required to pay unemployment insurance taxes to both their state and federal governments. These are known as SUTA and FUTA, respectively.
State unemployment tax rates (also known as SUTA or SUI) are set individually for each business. Your rate should be mailed or delivered electronically to you each year.
Federal unemployment tax (FUTA), on the other hand, is a flat 6.0%. In reality, however, the rate is typically much smaller:
Workers Compensation Insurance
Worker’s compensation insurance covers claims by employees against a company for job related injuries or illness. With the exception of Texas, every state will require that you buy worker’s compensation insurance. In most states, worker’s compensation insurance is sold and underwritten by private companies, although some states require you to buy it from specific state-managed carriers.
Check out our full guide to worker’s comp insurance for state-specific requirements, pricing estimates and more.
Another benefit to using Gusto payroll software (formerly ZenPayroll) is that you can purchase a worker’s comp policy directly through the program.
As with payroll taxes, Gusto will make deductions and send payments automatically on your behalf. Besides your premiums, there’s no additional cost to workers comp insurance when you purchase through Gusto.
The Bottom Line
In summary, these are the payroll taxes and hidden costs you need to look out for:
Sound complicated? This is why we highly recommend business check out Gusto payroll software (formerly ZenPayroll). In addition to administering payroll with direct deposit, they’ll handle all tax paperwork and payments, including workers comp. This is not only a huge time saver for small businesses, but a load-off when it comes to protecting yourself from tax penalties.
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This shows just what was said above-----now this AG may sound progressive in saying NO to insurance corporation rate hikes but she is not. This trade union knows if a rate hike does not happen----the funds will not be there to meet insurance obligations. As the AG says----these hikes only go towards insurance corporation profits but who voted to allow insurance corporations to INVEST THESE PROFITS especially in the most global leveraged investment packages? That's right ---Coakley and the MA Wall Street global corporate neo-liberals. Who supports Clinton/Obama every election every election these few decades? National Labor Union leaders. We have watched this cycle of labor shouting to stop killing what are labor union-backed benefits like WORKER'S COMP while being partnered with Clinton----
So, state's were given the power in the Affordable Care Act to deny insurance rate increases and everyone knows with only regional and small businesses paying these rates THERE IS NOT ENOUGH REVENUE IN THE TRUST.
Is Coakley doing this to protect small businesses? OF COURSE NOT. States are now giving reason for major health insurance corporations to not tie to state health systems. We see small insurance businesses being created to fill that niche which would be fine---but the costs of health care are climbing so fast these small insurance businesses cannot fund the health coverage required for full recovery. Workers are seeing very truncated attempts at treatment with positive outcomes falling.
MA has the Romney Care that was supposed to lead to health care for all-----neo-liberal states like Maryland and MA send all state trust funds including health care into the Wall Street market---as with pensions---and indeed, the losses each economic collapse to pensions comes to these health trust investments. Assigned risk pool!
Maryland is one of the worst of states for placing taxpayer and state and city funds in Wall Street leverage deals that end with great losses to those public funds. So, remember the 1% DAVOS global corporate tribunal bunch telling developing nations to get rid of worker's comp? Well, this is the Bush/Obama Wall Street global pols doing just that.
From commenters who may know the goals:
1)MA may have the very highest share of its market in the assigned risk pool of any state. It is the highest of 25 or so states listed by NCCI. Rate suppression is the most likely explanation.
2) They won’t be happy until private insurers completely walk from the state and every risk is in the state pool (thereby under the control of the Democratically controlled legislature, thereby giving them more to raid when they overspend and cannot find revenue).
'MAIA: Worker’ Comp Market Deteriorating
Also speaking at the hearing was Frank Mancini, president and chief executive officer of the Massachusetts Association of Insurance Agents (MAIA), a statewide trade association representing 1,400 member agencies and their 10,000 employees. In his testimony, Mancini warned regulators that Massachusetts’ workers’ comp market is deteriorating'.
Mass. AG Office Says 7.7% Workers’ Comp Rate Hike Unnecessary
By Young Ha | February 11, 2014
At a recent public hearing, Massachusetts Attorney General Martha Coakley’s office expressed its opposition to the workers’ compensation average rate increase proposal and argued that the rate should be lowered instead.
The Attorney General’s office expressed its view at the Massachusetts Division of Insurance hearing on Jan. 30. The hearing provided interested parties an opportunity to provide testimony regarding a proposal by the Workers’ Compensation Rating and Inspection Bureau of Massachusetts (WCRIB) to raise the state’s average worker’s comp rate by 7.7 percent.
The hearings are expected to continue later this month or in March, with WCRIB presenting its case for a 7.7 percent rate increase. Afterwards, the State Rating Bureau and the Attorney General’s office will release their recommendations and make their cases.
If WCRIB’s proposal is approved, it would be the state’s first workers’ comp average rate increase in more than 10 years. WCRIB’s last filing in 2012, which requested an 18.8 percent average rate hike, was rejected by regulators.
“It is the Attorney General’s view that the insurers’ requested 7.7 percent workers’ compensation rate increase is excessive and should be disapproved,” said Monica Brookman, deputy chief of the Insurance and Financial Services Division at the Office of the Attorney General, who appeared at the Jan. 30 hearing on behalf of Attorney General Coakley.
“In fact, if any rate change is needed, it is a reduction, not an increase, in rates,” Brookman argued.
Workers’ comp insurance is a cost of doing business in Massachusetts, and it directly affects companies’ ability to stay in business, to create jobs, and to pay competitive wages. It also increases the prices consumers pay for goods and services in Massachusetts, she said.
Brookman estimated that if approved, a 7.7 percent average rate hike would increase the cost of doing business in Massachusetts by about $75 million.
Potential Impact on Small Businesses
Further, the burden of higher costs would fall disproportionately on small businesses, she argued. “Because large businesses often receive preferential rate treatment, this increase will fall disproportionately on small businesses,” she told the regulators. “In the current economy, many small businesses are struggling, and unemployment is high. This is not the time to unfairly increase the cost of doing business in Massachusetts.”
Brookman also argued that the proposed increase is particularly inappropriate because it is based not on any projected increase in claims payments which are the underlying purpose of workers’ comp insurance, but solely on the insurers’ desire to increase their level of profit in Massachusetts.
“Using the last profit provision approved by the commissioner instead of the inflated profit provision in the insurers’ filing, the indicated rate increase drops from 7.7 percent to a substantial rate reduction,” she said.
“A similar attempt by the insurers to grab more profit at the expense of other businesses in Massachusetts was rejected by the commissioner in a 2012 decision that provided explicit guidance on a reasonable profit,” Brookman said at the hearing. “Following the 2012 decision on profit and making no other changes in the filing, the insurers’ proposed rate increase turns into a substantial rate reduction.”
She said the profit earned by workers’ comp insurers in Massachusetts during the last 10 years has been higher than those earned by workers’ comp insurers countrywide. One indicator of the healthy profitability of workers’ comp insurance in Massachusetts is the behavior of voluntary rate deviations, which have risen steadily over the last few years, she said.
“Nor is the problem workers’ comp losses. Even in the insurers’ filing, the net loss trend is negative,” Brookman added. “There is no need for a rate increase.”
“In this proceeding, we will ask the commissioner to reject the insurers’ proposed 7.7 percent increase and ensure that Massachusetts employers do not pay excessive rates,” she told the regulators.
MAIA: Worker’ Comp Market Deteriorating
Also speaking at the hearing was Frank Mancini, president and chief executive officer of the Massachusetts Association of Insurance Agents (MAIA), a statewide trade association representing 1,400 member agencies and their 10,000 employees. In his testimony, Mancini warned regulators that Massachusetts’ workers’ comp market is deteriorating.
Independent insurance agents write and service over two-thirds of the workers’ comp direct written premium in Massachusetts, MAIA’s Mancini noted. Because of the large market share of workers’ comp business handled by independent insurance agents, MAIA members have a firsthand knowledge of the state of the workers’ comp market in Massachusetts, he said, “and our members tell us that the market is unhealthy and is deteriorating.”
MAIA members deem the market as unhealthy because they are seeing fewer and fewer choices available to their clients, Mancini noted. “Our members tell us that many companies are tightening their underwriting, non-renewing more business than usual, and reducing or eliminating deviations enjoyed by safety-conscious insureds,” he said.
“Deviations provide incentives to insureds to do all they can to reduce losses and, in turn, their workers’ compensation premiums,” Mancini said. “With disappearing deviations goes the incentive for the client to put forth the effort to reduce losses.”
Another sign of an unhealthy marketplace is the increased number of risks being placed in the workers’ compensation assigned risk pool, he commented. Recent data released by the Workers’ Compensation Rating and Inspection Bureau indicates that one out of every four employers in Massachusetts is in the pool.
“Our members have advised us that business is forced to the pool at levels they haven’t observed in a decade,” Mancini said at the hearing. “And these are not just risks that find themselves in the pool because of the nature of their business, but rather risks that would normally find a home in the voluntary market.”
Mancini said the numbers bear out what MAIA members are observing in the marketplace. Recent WCRIB data indicates that as of Oct. 2013, 16.9 percent of the workers’ comp written premium in the state was in the assigned risk pool. This amount represents a 65 percent increase in written premium in the pool over a 30-month period beginning in April 2011, when the written premium in the pool was at 10.2 percent, he noted.
And while assigned risk pool premiums match those in the voluntary market, for the 50,000 Massachusetts employers who find themselves in the pool, there are many drawbacks that come with the assignment, he observed.
Employers in the pool have no choice of company, and pool policies are only for Massachusetts exposures, which presents a problem for insureds with out-of-state operations. Further, there are no dividends or deviations available, and there are only limited payment plans available, particularly for smaller risks with under $10,000 in premium.
Another issue with the assigned risk pool is the inability to obtain certificates of insurance immediately, which creates an uncompetitive situation for some insureds, particularly contractors, Mancini said.
“So as more and more employers are forced into the assigned risk pool, often for no fault of their own, these insureds now find themselves with little, if any, flexibility in their workers’ compensation programs,” Mancini said.
MAIA is not in a position to actuarially comment on the rate filing made by the WCRIB, he told regulators. “However, we are in the best position to advise you that independent insurance agents — who deal in the workers’ compensation marketplace every day with insurers and employers — are concerned that without rate relief the workers’ compensation market will continue to shrink, resulting in fewer choices in companies, reduced dividends and deviations, more business in the pool, and all the drawbacks that go with that assignment,” Mancini said.
Commission Rates Study
MAIA’s Mancini also spoke at the hearing about commission rates for agents. In its filing, WCRIB also included a study that found commission rates for independent agents in Massachusetts for writing and servicing workers’ comp insurance are reasonable and that producer markets for workers’ comp remain competitive. The study was conducted by Sharon Tennyson, a professor in the Department of Policy Analysis and Management at Cornell University.
“We reviewed the study performed by Prof. Sharon Tennyson and view her findings as persuasive. We can attest that the summary and conclusion of her study is accurate, particularly regarding competition among agencies to write workers’ compensation insurance,” Mancini said.
Workers’ compensation is one of the most demanding lines of insurance to service, Mancini commented. And independent insurance agencies add great value to the process, working with the employer/insured and the company to assure that a risk has met all the necessary requirements to write the policy, he said.
These efforts take an added importance for employer/insureds who now find themselves in the assigned risk pool, which involves more rigid placement requirements, he added.
Independent insurance agencies well earn the commissions paid to them for writing and servicing workers’ compensation insurance, Mancini said.
“The great majority of Massachusetts employers utilize the services of independent insurance agencies to assist them with their workers’ compensation insurance,” he said. “Maintaining adequate and reasonable commission levels for workers’ compensation insurance will assure that the value provided by independent insurance agencies will be preserved and employers will have access to the expertise offered by agencies in the workers’ compensation marketplace.”
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If you are a labor union member you understand OSHA and workplace safety laws are what was key to workplace injuries falling while Worker's Comp was strong if injury did occur. Clinton/Bush/Obama defunded and dismantled OSHA and the attack on union apprenticeships known to be the best in the world through growing career college as job training apprenticeships are a much lower quality and standard. I hear union members shouting all the time-----workers are being allowed on work sites having no safety training and/or having training not tied to OSHA's strong protections.
This is why workplace accidents have grown in the US these few decades and it is these accidents that soar in International Economic Zones with global corporate factories breaking all safety standards especially ones including long work in strenuous jobs.
THIS IS WHY CLINTON/BUSH/OBAMA CREATED THE HIGHEST LEVEL OF CITIZEN DISABILITY IN AMERICAN HISTORY. THEY THINK THIS IS EXCEPTIONAL-----WE KNOW IT IS SOCIOPATHY.
1/10/2012 1:01 pm
Top 5 workplace injury causes make up 72% of direct workers comp costs: Analysis
By Roberto Ceniceros
Benefits Management Disability Workers Comp Coverage Mid-Market Executive Workers Comp
Health Care Reform
The five leading causes of workplace injuries drive nearly 72% of the nation's direct workers compensation costs, according to research released Tuesday by Liberty Mutual Group Inc.
Overexertion—or injuries caused by lifting, pushing, pulling, holding and carrying—costs businesses $12.75 billon in direct annual expenses and accounts for more than 25% of the national burden, according to Liberty Mutual's Workplace Safety Index.
The index, compiled by the Liberty Mutual Research Institute for Safety, relies on data that researchers collected on injuries causing at least six missed days of work.
Injury types are ranked by total workers comp costs with the latest findings culled from 2009 data compiled from Liberty Mutual claims, the Bureau of Labor Statistics and the National Academy of Social Insurance.
“Fall on same level” ranks as the No. 2 cause of disabling injury that drives direct costs of $7.94 billion, or 15.8% of the total injury burden.
The other three leading causes of workplace injuries include:
• Fall to lower level, which caused $5.35 billion in costs.
• Bodily reaction—defined as injuries from bending, climbing, reaching, standing, sitting, and slipping or tripping without falling, which drove $5.28 billion in expenses.
• Struck by object, which accounted for $4.64 billion in costs.
Injuries that round out the top 10 causes are highway incidents, “caught in/compressed by” mishaps, struck against object, repetitive motion and assaults. Each category accounted for less than 5% of the direct cost of disabling injuries in 2009.
Overall, the top 10 cause categories accounted for 89.3% of the entire cost burden of disabling work-related injuries in 2009.
Liberty Mutual also found that after adjusting for inflation, the overall direct costs of disabling workplace injuries decreased 4.6% in 2009 compared with 1998.
I'll end with disability policy today with workplace disability. The US during NEW DEAL and FDR created Federal workplace laws to move away from the large number of US citizens being disabled during the 1800s Industrial Revolution. We see pictures of child labor and industrial laborers harmed by toxic chemical exposure and accidents causing physical disability. Well, Clinton/Bush/Obama while dismantling all those Federal workplace structures in the US created the conditions in International Economic Zones for these workplace disabilities to SOAR. The number of just Chinese citizens left with toxic exposure/accident disability is astounding. We know this will be coming back to the US under US International Economic Zone and Trans Pacific Trade Pact policies in cities like Baltimore.
Someone like me who studies public policy including international public policy have always read the policy coming from global policy groups including the 1% DAVOS Switzerland crew ----THE CLINTON/BUSH MOVING FORWARD GLOBAL CORPORATE TRIBUNAL group. They have for decades been pushing to be rid of WORKMAN COMPENSATION INSURANCE. Clinton/Bush/Obama has set the stage for this by making it harder for injured employees to access doctors---changing timelines for filing and treatment---and now just openly firing workers who are injured instead of allowing them the pathway to workman's compensation. This is happening now and this is unofficially ending that program. Immigrant labor has for decades faced this automatic dismissal----these few decades have seen low-income workers having the same. Baltimore has a long history of this for both groups of workers. Think what bringing global corporate factories on campuses like UnderArmour will do to super-size these conditions and it will. What we see below since Clinton/Bush is the breakup of the Trust and movement into separate Departments all of which are now defunding or disconnecting from this medical process. Look at the Bush Administration creating this breakdown by creating different departments and think how it is the Republicans shouting there are two many agencies handling services----THEY CREATED THIS BREAKDOWN. Then Obama came in with appointments to Health and Human Services, Education, and Labor who are now dismantling the structures in each of these departments that allowed for what was an easy, efficient, quality process for workers injured on the job. IT WORKED PERFECTLY UNTIL THE SUBPRIMING OF THE PROGRAM.
GET RID OF WORKMAN'S COMPENSATION IN DEVELOPED NATIONS SAID THE DAVOS 1%----AND THE WALL STREET GLOBAL CORPORATE POLS SAID---OK.
Workers' Compensation, A Brief Historyby Lloyd Harger, Division of Workers' Compensation
'The Future…We are just a few years into 21st Century and have already seen sweeping changes with the abolishment of the Department of Labor and Employment Security, the Division of Safety and the Special Disability Trust Fund. The Agency for Health Care Administration was elevated to full Department status in 2001 and received the Medical Services portion of the Division of Workers’ Compensation in February 2001with permanent transfer effective July 1, 2002. The Reemployment section transferred to Department of Education, Division of Vocational Rehabilitation with the remainder of the Division moving to Department of Insurance also effective July 1, 2002. Department of Insurance and Department of Banking and Finance merged into the new Department of Financial Services effective January 1, 2003'.
We see an article from 2005----soon after all those revisions were made where workers were not able to access the process as they had. This is creating more and more disability as people injured do not get the rehabilitation they need.
Mind you----Republican pols are behind this and you can be sure Republican voters are amongst those injured and wanting these benefits as much as anyone else. Clinton/Obama Neo-liberal/ Bush/Hopkins neo-cons are far-right politicians.
Workers’comp injured hold protest / They say system’s recent overhaul denies them care they need
Tom Abate, Chronicle Staff Writer
Published 4:00 am, Thursday, January 20, 2005
WORKERS20_029.jpg_ Steve Duncan, who jumped off a catwalk 57 feet above the ground to survive the Tosco refinery fire in February 1999, makes a point wed morning. A group of injured workers protested the ... more
Workers hurt on the job rallied in Oakland on Wednesday to argue that recent overhauls to the workers' compensation system have gone too far, making it harder for people hurt on the job to get benefits.
"Until now, voters injured at work have had no political voice," said Steve Duncan, a founder of the newly formed political action group VotersInjuredatWork.org.
The group was formed to protest changes in the workers' compensation system put in place in the last few years that have curtailed employers' fast- rising costs. The workers group says the savings are being achieved in part by depriving those hurt on the job of benefits they deserve.
Duncan, 53, survived a 1999 oil refinery accident near Martinez by jumping off a 57-foot catwalk and landing in flames. He said that while most of his claims were handled under the old rules, the changes are making it harder for him and other injured workers to get treatment.
"They delay everything. You have to prove this and prove that," said Duncan, who has a history of political action over workers' compensation. He was one of several activists who persuaded former Gov. Gray Davis to sign legislation increasing benefits in 2002.
Sen. Charles Poochigian, R-Fresno, who wrote the most recent in a series of bills designed to curb the rising cost of workers' compensation costs, noted that the new group is backed by the California Applicants' Attorneys Association, composed of lawyers who represent injured workers. He said the attorneys instigated the protest out of fear that the changes would cut their income.
"Nothing that was done was intended, nor has the effect of harming truly injured workers," Poochigian said.
Oakland resident Peggy Sugarman, who is the executive director of the workers group, which is based in Sacramento, said the attorneys association had provided less than $100,000 to start Voters Injured at Work. She said the group plans to recruit enough $25-a-year members to become self-sustaining.
"We hope to have 10,000 members by next January," said Sugarman, a former deputy director of the state Division of Workers' Compensation.
About 100 people attended Wednesday's rally in Oakland outside the state office building where the Workers' Compensation Appeals Board settles benefit disputes between injured workers and their bosses or insurers. Sugarman said rallies were scheduled at more than a dozen similar locations statewide.
Frances Quintana, 44, of Union City attended the Oakland rally at the suggestion of her lawyer to protest recent changes that have ended her access to acupuncture. Quintana said the treatments helped relieve the pain of carpal tunnel injuries sustained during 23 years as a court clerk.
"I am not faking," said Quintana, in response to a question about the oft-repeated charge that workers' comp rolls are swelled with abusers. "I've worked very hard," she said. "That's the only job I've ever had since I was 20 years old."
Three bills -- two passed before and one after the 2003 gubernatorial recall election -- have sought to curb the costs of providing medical treatments and disability payments to injured workers. The legislation was passed after employers were stung by a series of double-digit increases in workers' compensation insurance premiums that began in 2000.
In legislative hearings, critics argued that injured workers in California used more medical services and spent more time out of work than employees in other states, suggesting a lax system in need of reform.
Organized labor argued that the premium crisis was partly precipitated by the deregulation of insurance rates beginning in 1993.
Rates dropped for several years, but competition became so cutthroat that, by 2000, more than 20 insurance firms were either leaving the California market or on their way to bankruptcy.
Against this backdrop, the Democratic-controlled Legislature -- first under Democrat Davis and then Republican Gov. Arnold Schwarzenegger -- overhauled the system twice.
Lawmakers created guidelines for medical treatments, set standards for disability pay for certain injuries and let employers form preapproved pools of doctors to treat the injured instead of letting workers choose doctors for themselves.
The Workers' Compensation Insurance Rating Bureau, a San Francisco group that is the system's official fact-gatherer, released data last week showing that cost containment is working.
The average cost per indemnity claim, after rising steadily from about $19,000 in 1992, began to level off at roughly $50,000 in 2002. Insurance premiums have retreated about 16 percent from their July 2003 peak, it said.
But injured workers say the premiums are still too high.
In 1999, insurers incurred $1.82 in costs and liabilities for every dollar they collected in premiums, the Bureau said. In 2003, the comparable figure was 85 cents per dollar.
"We are calling for insurers to roll back their prices at least 30 percent," Duncan said at the injured workers' rally in Oakland on Wednesday.
Nicole Mahrt, Sacramento spokeswoman for the American Insurance Association, said that without the recent changes, premiums would have continued to escalate, meaning that the 16 percent cuts understate the savings.
Economist David Neumark, who will summarize the reforms at a Public Policy Institute of California forum in San Francisco today, framed the latest turn in the debate this way:
"Are we creating a system that reins in costs and is humane to workers or that is going to aggressively cut costs but not meet their needs? It's too early to say."
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The Workman's Compensation Disability Trust was broken and send to different agencies like labor and vocation----education -----insurance agencies this then saw that concentrated funding just for workman's compensation now directed to what are not functions for this service. We see Federal Labor and Education Departments using funding to create the vocational job training structures for example and here we see Obama and Clinton neo-liberals directing what were funds to this Special Disabilities Trust for Workman's Compensation to boost SOCIAL SECURITY DISABILITY-----a trust emptied by subpriming unemployed citizens into a disability status. So, media presented this as progressive-----WALL STREET GLOBAL CORPORATE POLS PROTECTING SOCIAL SECURITY DISABILITY----when this temporary solution to what will be the end of SS Disability is now receiving what was WORKMAN'S COMPENSATION.
It is a ponzi scheme in moving Federal funds that once served programs across the board to supporting a subprimed Social Security Trust and SS Disability Trust. Remember, these Trusts will disappear with the $20 trillion in US Treasury bond debt so this is simply moving and defunding agency by agency.
Yes, it reallocates Social Security Trust funds----but it moves as well funds from other agencies.
So Obama is now a hero for fighting for SS Disability all while knowing Obama has imploded the US Treasury with Wall Street bond leverage with the goal of ending Social Security AND SS Disability Trusts.
President's Budget Proposes Disability Trust Fund Fix, Other Assistance for People with Disabilities
President Obama's recently-released Fiscal Year 2016 Budget proposes a reallocation of payroll taxes to fix the anticipated shortfall in the Social Security Disability Insurance (SSDI) trust fund, along with increased employment assistance for people with disabilities and additional funding for the hiring of administrative law judges to handle disability benefit appeals.
The SSDI trust fund holds excess payroll taxes collected in years when the government was taking in more money than it was spending on SSDI benefits. However, in recent years, the government has collected fewer payroll taxes than it has paid out in SSDI benefits, forcing it to spend the trust fund reserve in order to fully fund the SSDI program. If changes are not made, the trust fund will run out in 2016 and SSDI benefits will be cut by approximately 20 percent in order to balance the program's budget. (For more information on the mechanics of this problem, click here.)
The Social Security Administration has proposed solving this problem by reallocating a small percentage of payroll tax revenue away from the Social Security Old Age and Retirement trust fund and into the SSDI trust fund. However, the House of Representatives, in one of its first orders of business in 2015, passed a rule change that would prohibit it from reallocating money between the two trust funds, something that has been done frequently in the past, unless the reallocation does not affect the actuarial stability of either fund.
In his proposed Fiscal Year 2016 Budget, President Obama advocated the SSA's position, calling for the temporary reallocation of funds in order to buy time for Congress to develop a permanent solution to the SSDI funding problem.
In addition to the trust fund reallocation, President Obama's budget also contains several other items of note for people with disabilities. The budget requests $400 million to set up new programs such as supportive employment services and incentive programs for employers who hire people with disabilities, and it also requests additional funding to hire administrative law judges to handle the massive backlog of disability appeals.
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As Wall Street global pols move Workman's Comp Trust funds to simply be used for global investment leveraging the small businesses tied most closely to paying these workman's compensation contributions are shouting loudly about the hardship of growing contributions. Remember, these contributions were raised at the same time US corporations were heading overseas so the bulk of payroll contributions have been hitting smaller businesses.
Maryland is great for this. They hit businesses hard for these payroll taxes while being one of the lowest benefit payer's to actual injured citizens. Maryland is well under half of what other states pay workers when hurt---but they love collecting that worker's comp from Maryland businesses. So, where has all that worker's comp trust been going in Maryland? To Wall Street investment leverage because it surely is not making it to citizens in Baltimore on a great scale.
This article is long but please glance through. We have known this problem existed these few decades of Clinton/Bush/Obama but now it is far worse because they intend to end this program for worker's injured on the job completely very soon.
The Fallout of Workers’ Comp ‘Reforms’:
5 Tales of Harm
Injured workers share their stories, revealing the real-life impact of rollbacks that have been spreading across the country.by Michael Grabell, ProPublica photographs by Glenna Gordon for ProPublica March 25, 2015
An investigation by ProPublica and NPR earlier this month detailed how states across the nation have been dismantling their workers’ compensation systems, with disastrous consequences for many of the hundreds of thousands of people who suffer serious injuries at work each year.
In some states, the cuts have been so drastic that injured workers have plummeted into poverty, losing their cars and even their homes. In others, workers spend years battling insurance companies for the surgeries, prescriptions and basic help their doctors recommend.
The five case studies below are emblematic of the bewildering labyrinths injured workers have to navigate as a result of these cutbacks. As attorneys for injured workers are fond of noting, it’s no coincidence that Franz Kafka — known for his tales of suffering at the hands of faceless bureaucracies — was once a clerk in the workers’ comp bureau of Bohemia.
22 States Now Set Arbitrary Time Limits on Injured Workers’ Temporary Wage Benefits
Green states cap temporary wage-replacement benefits after a period of time ranging from two years in California, Florida, North Dakota, Oklahoma, West Virginia and Texas to about 13 ½ years in New Mexico. Some states have had such caps on the books for decades, but several have recently lowered their limits to two years. Explore the full interactive. (Source: Workers Compensation Research Insitute)
Gary Fury was working at a Simonton Windows factory in West Virginia in July 2012 when a large two-window unit slipped to the floor. Fury bent to help a coworker slide it back onto a cart.
“When I went to pick it up,” he recalled, “I felt something pop.”
Fury, then 49, had torn his rotator cuff and ruptured his bicep. After trying less invasive treatments, his doctor recommended surgery and warned of poor results if it was delayed.
Instead of approving it, Sedgwick Claims Management Services, an insurance claims administrator hired by Fury’s employer, sent him to its own doctor for a second opinion six weeks later, according to workers’ comp court records. That doctor also said surgery should be authorized immediately and warned that delays could lead to permanent impairment.
The Demolition of Workers’ Comp
Over the past decade, states have slashed workers’ compensation benefits, denying injured workers help when they need it most and shifting the costs of workplace accidents to taxpayers.
But in West Virginia, time is on the insurer’s side. In 2003, the state passed a law capping wage benefits for temporary injuries like Fury’s to two years -- even if the worker hasn’t recovered yet. Several other states, including California, Oklahoma and North Dakota, have recently capped payments at two years. Today, 22 states set arbitrary time limits on temporary wage benefits, according to data collected by the Workers Compensation Research Institute.
Despite the recommendations of two doctors, Sedgwick waited another five weeks before approving surgery — a delay that a workers’ comp judge said was “especially unwarranted” after Sedgwick’s own physician said he needed it “ASAP.” By the time Fury finally got surgery, it was January 2013.
“They just don’t know how much pain I sat for six months in waiting to get surgery,” he said.
As the doctors had warned, Fury still had pain and limited range of motion after the surgery and was unable to return to regular work. Now, his doctor has recommended additional treatment and possibly another surgery.
But since Fury’s two years of wage benefits have run out, if he gets the surgery, his employer doesn’t have to pay him while he recovers -- even though a state workers’ comp judge said Sedgwick is “at least in part responsible” for his medical problems.
After his injury, Fury initially survived on two-thirds of his wages, which are provided by workers’ comp, tax-free. But when the payments stopped, Fury has at times had to rely on food stamps and Medicaid.
“It got down to the point where I had to go get help, like from what they call welfare,” Fury said. “That was so embarrassing for me. You know, you’re used to working all your life. I raised two kids and never had to be on there. Sometimes, it really degraded me to go to a grocery store and you had to pull out your card instead of pulling out your cash -- all because you’re an injured worker.”
Sedgwick and Simonton declined to comment about what happened to Fury.
After hearing the details of the case, Chris Stadelman, communications director for Gov. Earl Ray Tomblin — who was state senate president when the workers’ comp reform passed — said the governor’s office was “comfortable with the changes that were made” and has not heard complaints from injured workers.
Fury is now applying for Social Security Disability Insurance and watching his life savings slowly drain away.
Meanwhile, Tomblin recently announced a boon to West Virginia employers: Workers’ comp insurance rates would be cut for the 10th year in a row.
10 States Since 2003 Have Expanded Their Use of Outside Medical Reviewers to Assess Injured Workers’ Doctors’ Recommendations
Green states have increased their use of — or the weight given to — outside doctors who review treatment recommended by workers' physicians. In some states, these reviewers have the power to rule an injury isn't work-related or to deny treatment after only a brief exam or paperwork review.
Nicolas Mercado, a 54-year-old quadriplegic, sits in a long-term care facility waiting to return to his home in San Bernardino, California, to return to the smells of home-cooked Mexican food and the giggles of his granddaughter. Home to the same street corner where he and his wife met as teenagers.
Mercado has not lived there since December 2011, when the tanker truck he was driving to collect kitchen grease flipped over on an exit ramp, leaving him paralyzed from the neck down.
Mercado misses the taste of his wife’s home-cooked Mexican food so he asks the nurses at his long-term care facility to cut up chilis to spice up his meals.
In March 2013, his doctors said that his medical condition had stabilized and he could go home as soon as modifications were made to accommodate his wheelchair. Under state law, home modifications are covered by workers’ comp.
The California Insurance Guarantee Association (CIGA) — which took over the claim when the original insurer went bankrupt — sought a second opinion from another doctor, who approved some modifications and rejected others. Then CIGA ignored many of its own doctor’s recommendations and insisted a new state-mandated medical review process allowed it to delay the fixes.
A 2012 law in California put medical disputes between the workers’ doctors and insurers into the hands of “independent medical reviewers” who remain anonymous and make decisions based solely on medical records. California is one of 10 states since 2003 to expand its use of such outside doctors, who have the power to say an injury isn’t work-related or deny recommended medical care after only a brief exam or paperwork review.
In Mercado’s case, CIGA approved a wheelchair lift, but it didn’t fix the doorway it leads to, which has a step and is too narrow for Mercado’s chair.
One of several rosaries and other religious items Mercado keeps in his room at his assisted living facility. His doctor say he is ready to go home as soon as some modifications are made to accommodate his wheelchair.
CIGA argued that the “prudent and responsible” course was to wait until the new medical review process was complete before doing any further modifications.
Judge Paul DeWeese, a workers’ comp judge in Anaheim, rebuked CIGA, saying it was insisting on “form over substance” and that the medical review process was never intended for cases like Mercado’s.
“That assertion is outrageous,” DeWeese wrote in his May 2014 opinion. “The ‘prudent and responsible course,’ not to mention the legally required course and the only moral and humane one, is to assist Mr. Mercado in returning home forthwith.”
For Mercado’s wife, Linda, it’s been especially wrenching to leave her husband at the long-term care facility month after month, when he could be home.
“When I leave him over there and I see him through the window, and I wave bye and I throw him a kiss and he throws me a blessing, and I give him a blessing, it just tears my heart,” she said. “I don’t like to let him see me crying, but once I leave that parking lot, everything comes out.”
Mercado lost the ability to move his left hand, but still has some movement in his right and must sleep in this wrist brace to protect the nerves.
The independent medical reviewer, who is supposed to have the final word under the new law, denied the additional home modifications. In October, the state Workers’ Compensation Appeals Board ruled in Mercado’s favor and ordered CIGA to finish the job. But the insurance company appealed once again.
After a local TV station aired a story about Mercado’s case in January, CIGA agreed to make the home modifications.
“I took a look at what had happened in terms of the case and determined we could have probably gone down a different path,” Wayne Wilson, CIGA’s executive director, said in an interview.
10 States Since 2003 Have Increased Use of Pre-Existing Conditions to Limit or Deny Care After Workplace Injuries
Green states have either raised the qualification standards for workers' comp when a work injury aggravates a pre-existing condition or have reduced the liability of employers and insurers for the full effects of the injuries when other conditions, such as aging, may have contributed.
Brenda Albright spent 16 years as a forklift driver hauling rolls of paper to make cardboard boxes for Smurfit-Stone Container in Fargo, North Dakota.
One day in June 2010, she squatted down to remove a tag from one of the rolls. As she stood back up, she suddenly felt what she describes in workers’ comp records as an “extremely ungodly pain.”
Her husband, who was Smurfit-Stone’s plant superintendent, rushed her to the emergency room, and she was diagnosed with a herniated disc.
Two doctors for North Dakota’s Workforce Safety & Insurance agency (WSI), including its medical director, reviewed Albright’s records and agreed that despite prior back problems, her herniated disc was due to the incident at work and not a pre-existing condition, according to court records. The agency, which insures North Dakota businesses, accepted the claim.
Or so it seemed.
Then Albright came face to face with a growing trend in workers’ comp — the aggressive effort to pin workplace injuries on pre-existing conditions. In recent years, North Dakota and several other states have increasingly allowed insurers to deny claims by saying that work injuries only aggravated existing conditions caused by aging, prior injuries or the structure of workers’ bodies.
Since 2003, insurers in 10 states have moved in this direction. In one case in Kansas, an insurer refused to cover carpal tunnel surgery for a hand packer at a warehouse, asserting that her thin body frame made her susceptible to repetitive stress injuries. Florida lawmakers have added a twist: Insurers there can cite pre-existing conditions to require workers to pay up to 49 percent of their medical costs even when work was the primary cause of their injuries.
In 2008, employees at North Dakota’s WSI told auditors that their bosses were directing them to look for reasons to deny claims. They reported a recent “shift in management focus to a more aggressive and in-depth search for prior injuries or pre-existing/degenerative conditions, which could possibly reduce WSI liability for the injury.”
According to her claims adjuster’s notes, Albright’s employer, Smurfit-Stone, was “not happy” with WSI’s decision to accept her claim. The agency agreed to reconsider — a decision a judge later described as “bowing to pressure from the employer” — and hired an independent medical reviewer to look over Albright’s records.
Without examining Albright, that doctor said her back problems were the result of a degenerative condition unrelated to work. Using the new opinion, the agency denied the claim.
Albright’s own doctor was dumbfounded, according to a letter he wrote WSI. While Albright had problems in her neck and lower back, an MRI from a few years before showed she didn’t have any problems in her lower middle back, where the herniated disc was, he wrote. Any pre-existing condition, he said, was most likely caused by the repetitive twisting and jarring she experienced driving the forklift.
“Clearly, the single event at work led to her herniated disc,” he wrote in his letter. Millions of Americans had her back problem, he noted, but it didn’t mean they were all doomed to have herniated discs in the future.
A judge in Albright’s case called the agency’s medical reviewer a “professional witness” who had “only read about” the tissues and intervertebral discs that Albright’s neurosurgeon “once held in his hands.”
The judge ruled in her favor, but the North Dakota Supreme Court overturned that decision, noting that the legislature has restricted the courts’ oversight of the workers’ comp agency to cases where no “reasoning mind” could have come to the same conclusion.
In an interview, WSI director Bryan Klipfel stood by the decision, saying work didn’t cause Albright’s injury.
“I’ve got bad back issues also,” he said. “But if I’m at work and I bend over to pick up a paper clip or something and my back goes out, it’s maybe caused at the job, but my job didn’t cause the injury.”
RockTenn, which owns Smurfit-Stone, said the case was handled appropriately.
Albright, 57, remains out of work and on programs funded by taxpayers. The Social Security Administration awarded her disability benefits immediately, listing the onset date as the day she felt the “ungodly pain” at work.
37 States Now Restrict Injured Workers’ Ability to Choose Their Doctors
Green states allow employers and insurers to choose workers’ doctors, at least initially. Blue states restrict workers to doctors approved by their employer, state or insurer or to those in their employers’ managed-care plans. Explore the full interactive. (Source: Workers Compensation Research Insitute)
Christopher Carter’s left foot was mangled when it got sucked into a conveyor belt at a gravel pit in Great Falls, Montana, in July 2012.
The 43-year-old mining equipment mechanic went to a podiatrist who recommended a simple, inexpensive remedy: a cortisone injection to reduce inflammation and alleviate the pain, according to medical records.
His workers’ comp claim could have ended there. But Carter soon learned that something as basic as choosing your own doctor is no longer guaranteed in workers’ comp. A 2011 Montana law gave employers and insurance companies the right to pick workers’ doctors after accepting their claims and to transfer their care to another doctor at any time.
Eighteen states now allow employers to select the physician who treats their injured workers at least initially, according to the Workers Compensation Research Institute. And another 19 states require many workers to choose from a list of doctors — sometimes as few as four — approved by their state, insurer or employer.
After Carter saw the podiatrist, his employer’s insurer, the Montana Contractor Compensation Fund, sent him to an independent medical examiner, who also recommended a cortisone shot.
Instead of approving the treatment, the insurer changed his treating physician. Same result: The new doctor also recommended the shot, referring Carter back to the podiatrist he’d seen to begin with.
Carter’s insurer wouldn’t authorize him to see the podiatrist who initially cared for him or even another recommended by the new treating doctor. Instead, the insurer inexplicably sent Carter for another exam, this time bringing in an orthopedic surgeon from Missoula, 170 miles away. She recommended a similar injection.
Two years after his injury, Carter still hadn’t received approval for an injection, although four doctors had recommended it. His insurer just kept sending him to more doctors.
Mel Pozder, senior claims examiner for the contractors’ fund, declined to comment, citing health privacy laws.
Out of frustration, Carter settled his case with the Montana Contractor Compensation Fund last spring for $46,250 to cover his unpaid medical bills and future wage loss. He has struggled to find work to support his three children, ages 11 to 15, and now works at a relative’s auto body shop.
“I think that my foot and ankle could have been healed by now, or greatly improved, if Montana law allowed me to choose my treating physician,” he wrote to a state legislative committee studying workers’ comp last year.
“I’m 43,” he said in an interview, “and I walk like I’m 80.”
California Now Uses New, Stricter Guidelines to Reassess Old Cases and Deny CareIn 1997, Frances Stevens was the editor and publisher of Curve, one of the best-selling lesbian magazines in the country. She was in incredible shape and training for the Golden Gloves boxing tournament.
Before she was injured at work, Frances Stevens was an avid boxer as well as the editor and publisher of one of the best-selling gay and lesbian magazines in the country.
One day in October, she and her staff were carrying boxes of the magazine’s latest issue to a storage closet. Stevens, 30, tripped over an area rug and broke a bone in her foot. She was put in a cast and had surgery.
The bone healed, but the fall damaged her nerves, leaving her with excruciating, unexpected pain, often affecting both feet.
More than 17 years later, Stevens can’t walk and gets around in a motorized wheelchair. At night, the simple brush of a bed sheet over her feet will send her screaming in pain. She can’t take a shower without submerging her feet in a bucket of water so that the stream won’t touch them directly.
“It’s like that nerve pain that just zings through your whole body like an ice pick,” she said.
California’s workers’ comp system once paid for a home health aide to help Stevens during the day. But in 2013, a new law took effect, subjecting old cases like Stevens’ to a greater emphasis on narrow guidelines that, among other things, severely limited home health care for people injured at work. When Stevens needed to replace her aide, her insurer, the State Compensation Insurance Fund, used that request to decide that an aide was not medically necessary.
Under the new law, Stevens’ only recourse was to appeal to an independent medical reviewer chosen by a company hired by the state. But that doctor never needed to see her, didn’t have to be licensed in California, would remain anonymous and could only be challenged under limited circumstances.
A letter to Frances Stevens from her insurance company, denying four of four requests for medications. When court dates in her legal fight for care approach, she often receives this much paperwork in the mail in just one week.
She was supposed to get an answer in 30 days, but instead the process took nearly seven months. The medical reviewer upheld the insurance company’s decision to deny the aide.
Now, Stevens is challenging the constitutionality of that process. In a petition recently accepted by the 1st District Court of Appeal in San Francisco, she argues that allowing medical decisions to be made by anonymous doctors who don’t examine the patients and can’t be questioned violates the rights of injured workers.
California workers’ comp issued a warning to insurance companies last week that the new law shouldn’t be used to revisit existing agreements for home health care.
The State Compensation Insurance Fund said the request for the aide was denied based on medical evidence. In documents filed with the appeals court, it argued that workers have adequate avenues for appeal and that the legislature acted appropriately to try to create a “faster and cheaper” process that would “promote better health.”
The pills Frances Stevens takes daily to manage the pain and other side effects resulting from her on-the-job accident, and a whistle she carries with her when she leaves the house so she can call for help if she falls or has any other emergencies.
“The legislature’s motivation was to help both employers and injured workers,” it wrote.
Having been both an employer and injured worker has given Stevens a unique perspective on a system she only thought about when she paid her insurance premiums.
“I had just turned 30. I was an athlete. I had a job that I loved, a life that I loved. I couldn’t ever imagine this happening to me, and in a second, my life changed,” Stevens said. “If people don’t stand up and start noticing how broken the system is, by the time you figure it out, it’s going to be too late.”
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You know your state is not enforcing or providing oversight and accountability in any area if the major legal industry is trial lawyers. If citizens need trial lawyers to get workman's comp-----then the system is not working. This works well for the lawyers pocketing much of what would have gone to health care ----what Wall Street leverage doesn't get trial lawyers are getting. What the American people are not getting IS ACCESS TO HEALTH CARE----ERGO THE GROWING POPULATION OF DISABLED IN THE US.
You can see in every case the collusion of lawyers and bankers to suck all our Federal, state, and local revenue---and this is yet another case. Who are primarily politicians in Maryland? Lawyers and development/financial people. This was what Baltimore City Council and Mayoral race was about----making this dynamic stronger.
All of this is not clever or smart----it is illegal because our elected officials are NOT allowed to conspire against citizens and taxpayers to undermine them. These programs have a mission and that mission is not being met.
Baltimore Workers’ Compensation Lawyers
Types of Wage Loss Benefits-
Under Maryland Workers’ Compensation law, employees suffering from a work-related injury or illness are entitled to receive compensation for wages lost as a result of the injury. The total amount you may receive depends largely on the nature and extent of your injury, and your average weekly wage prior to the date of disability. There is great likelihood that any of these factors will be argued by your employer or insurance company in an attempt to reduce the amount to which you are entitled. For this reason, it is highly recommended that you seek the assistance of a reputable and qualified Baltimore Workers’ Compensation lawyer to assist you with your claim and make sure you receive the full amount of compensation you deserve.
Temporary Total Disability
If you are being treated for a job-related illness or injury that prevents you from returning to work, you are entitled to temporary total disability benefits of two-thirds of your average weekly wage. Payments are based on your average gross earnings during the 14 weeks immediately preceding your injury. All payments are tax free and subject to a maximum rate as determined by the average weekly wage for all Maryland employees for the year you were injured. It is critical that your average weekly wage is calculated accurately and includes not only your regular wages, but bonuses, vacation pay, overtime, and expense allowances. A Workers’ Compensation lawyer in Baltimore can help to make sure your benefits are calculated correctly.
Compensation is allowed from the first date of disability, provided the period of disability lasts longer than 14 days. If the period of disability is 14 days or less, then wage benefits are covered beginning the fourth day of disability. These payments end when you return to work, or when a doctor determines that you have achieved maximum medical improvement, meaning that the work injury has healed to the point wherein no further improvement is expected.
Temporary Partial Disability
In some situations, workplace injuries are not so severe as to completely prohibit your ability to work. If this is the case, you may be able to return to a lighter duty position or work fewer hours at the same job. During this time, you are entitled to receive benefits totaling 50% of the difference between your average weekly wage before the injury and what it is while on restricted duty, subject to a maximum payment of 50% of the statewide average weekly wage.
Permanent Partial Disability
If your injury at work has caused you to suffer any permanent physical problems, and your doctor has determined that your condition will not improve further with time, you may still be eligible to receive additional Workers’ Compensation in the form of permanent partial disability benefits.
The process by which the Workers’ Compensation Commission determines the full amount of benefits is extremely complex. Several factors are considered, including the nature and extent of the injury, as well as the effect the injury will have on your ability to earn wages in the future. You will have to provide evidence of permanent injury including any pain, weakness, atrophy, or loss of use or endurance in the affected area. It is important not to rely solely on the opinion of the physician hired by the insurance company, as they frequently will fail to fully consider the full impact of these factors. Your age, level of education, and prior work experience are also used in determining awards. Other factors include which body part was injured; the percentage of the disability; your average weekly wage and the average statewide weekly wage; and other factors such as the presence of a pre-existing medical condition.
The Maryland Workers’ Compensation Commission has established a maximum number of compensable weeks for each specific body part. Maximum compensable weeks range from ten weeks for a small toe, to 500 weeks for a serious head or back injury. Compensation is further broken down into three tiers based on the number of compensable weeks:
First tier (less than 75 weeks): You are entitled to one-third of your average weekly wage, not to exceed one-third of the statewide average weekly wage.
Second tier (75 – 249 weeks): You may receive two-thirds of your average weekly wage, not to exceed 50% of the statewide average weekly wage.
Third tier (250 weeks or more): You may receive two-thirds of your average weekly wage, not to exceed 75% of the statewide average weekly wage.
Permanent Total Disability
If your injury is so severe that you cannot return to work at all, you may be eligible for permanent total disability benefits for life. These payments are subject to an annual cost of living adjustment of up to five percent as determined by the Department of Labor. Under these circumstances, you may also qualify for Social Security Disability benefits. An experienced Baltimore Workers’ Compensation lawyer can help you sort out your options and make sure you are getting the full amount of benefits possible.
Baltimore Workers’ Compensation Lawyers at LeViness, Tolzman & Hamilton Obtain Maximum Compensation for Injured Workers
When you are recovering from an accidental work injury or occupational disease, dealing with the complexities of filing a Workers’ Compensation claim can seem overwhelming. At LeViness, Tolzman & Hamilton, our dedicated Baltimore work injury law firm has helped countless individuals get the maximum compensation allowed by law. Our goal is to minimize your stress so that you can focus on what matters most – your recovery.
Our offices are conveniently located in Baltimore, Columbia, Glen Burnie and Towson, Maryland and we represent clients throughout Baltimore City and Baltimore County and the state of Maryland. To schedule your free consultation with one of our highly qualified Baltimore Workers’ Compensation lawyers, call 844-556-4LAW (4529) today or contact us online. A member of our team is available to answer your questions 24 hours a day.
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As US corporations moved overseas in large numbers during Clinton/Reagan----the only groups of businesses paying into this system is now regional and small businesses. Most people now long-term unemployed by US corporations moving overseas are now those hitting the SS Disability for support so the entire workman's disability system is dysfunctional---it was never meant to be this big of a burden on our mid-size and small businesses. While we can be sure global corporations in the US are not paying all these payroll taxes----our regional and small businesses receiving more IRS and State scrutiny over tax payments have been paying them.
What will happen as global corporations are allowed to operate in US International Economic Zones free from all these labor laws----pushing regional and small businesses out of business----all this worker's compensation health disability structure is slated to disappear.
ALL MARYLAND ASSEMBLY AND BALTIMORE CITY HALL POLS HAVE THESE FEW DECADES PUSHED THESE POLICIES AND WILL END ACCESS TO DISABILITY COVERAGE WHETHER SS DISABILITY OR WORKER'S COMP. WE HAVE ONE OF THE MOST PROFIT-DRIVEN PRIVATE HEALTH SYSTEMS IN THE NATION AS WELL.
'Workers Compensation Insurance
Worker’s compensation insurance covers claims by employees against a company for job related injuries or illness. With the exception of Texas, every state will require that you buy worker’s compensation insurance. In most states, worker’s compensation insurance is sold and underwritten by private companies, although some states require you to buy it from specific state-managed carriers'.
All while people are not accessing the health care----leading from recovery to disability.
FICA Taxes, Unemployment Insurance, & Workers Comp For Owners
By Jeremy Marsan on March 7, 2016 |
When you start hiring employees, you will have expenses over and above the salary that you pay them. Social security and medicare make up the taxes known as Federal Insurance Contributions Act (or FICA). FICA taxes, along with unemployment insurance taxes (known as FUTA and SUTA), add up to around 10% of their wages or higher. Additionally, most states will require that you buy workers compensation insurance.
In this guide, we’ll cover all these hidden expenses of hiring employees, including the current 2016 tax rates.
If you’re looking for an easier way to manage employment taxes, we recommend Gusto payroll software (formerly ZenPayroll). In addition to running payroll with direct deposit, Gusto calculates, files and e-pays payroll taxes (as well as workers comp insurance) on your behalf.
Wondering how to add an employee to payroll? Click Here to get our FREE Payroll guide and find out how.
2016 Employer Tax Rates
Cost In Dollars or Percentage (%) of WagesMaximum Dollar ($) Amount Taxed Per EmployeeTotal Cost For A Worker Earning 30,000 per Year
Social Security Tax
Medicare Tax
(FICA taxes)6.2%
1.45%$118,500 (in 2016)
Unlimited$1,860
$435
State Unemployment Insurance (New Employers*)CA 3.4%
NY 4.1%
TX 2.7%$7,000
$10,700
$9,000$238
$438.70
$243
Federal Unemployment Insurance
Most States 0.6%
CA, OH 2.1%
CT, 2.7%$7,000
$7,000
$7,000$42
$147
$189
Worker Compensation Insurance
Average $1.50 for every $100 of payroll, but varies widelyn/a$450
PostersFree / $63 Per Yearn/an/a
Total: Approx. $3,000 – $3,500 for an employee earning $30,000 per year, depending on your state and SUI tax rate.
*Note: State Unemployment Insurance (SUI) Rates vary from business to business. You should have a rate assigned to you each year by your state’s Department of Labor. If you’re unsure of your rate, try logging into your state tax website to check.
Also, bear in mind that healthcare will be an additional cost to businesses with over 50 employees. If you have fewer than 50 full time equivalent employees, you are not required to provide health insurance to employees. To learn more about health insurance and Obamacare requirements, check out our full guide here.
Why are posters an expense related hiring employees?
In many lunchrooms or employee only areas, you will see posters detailing employee rights like the minimum wage. Both the federal and state governments require that certain information be posted in a location visible to all employees. The employment posters required by the Federal Government are available here and can be ordered for free.
Unfortunately, states aren’t always as organized as the federal government and may only provide a list of requirements. For around $63 per year, The Labor Law Center will provide you a poster to comply with the requirements for both state and federal labor laws. Additionally, if the requirements change, they will automatically send you a new poster.
FICA Taxes (Social Security & Medicare)The bulk of employer taxes are Social Security and Medicare. Together, these two taxes make up FICA, which stands for the Federal Insurance Contributions Act:
- Employers must contribute 6.2% of salary / wages for social security on the first $118,500 paid to an employee (for 2016)
- Employers must contribute 1.45% of salary / wages for medicare without limit to the employee’s salary / wages (for 2016)
Unemployment Insurance (SUTA & FUTA)Employers are required to pay unemployment insurance taxes to both their state and federal governments. These are known as SUTA and FUTA, respectively.
State unemployment tax rates (also known as SUTA or SUI) are set individually for each business. Your rate should be mailed or delivered electronically to you each year.
Federal unemployment tax (FUTA), on the other hand, is a flat 6.0%. In reality, however, the rate is typically much smaller:
- If your company is up to date on your state unemployment taxes, your company receives a credit, reducing the rate to only 0.6%. (If your state owes the federal government money, you will receive less of a credit. Companies with employees in California and Ohio, for example, will pay a 2.1% rate in 2016. Those in Connecticut will pay 2.7%. See more info here.)
- The tax applies only to the first $7,000 of income per employee. Assuming that your company is paying 0.6% and every employee makes at least $7,000 per year this tax only comes to $42 per year per employee.
Workers Compensation Insurance
Worker’s compensation insurance covers claims by employees against a company for job related injuries or illness. With the exception of Texas, every state will require that you buy worker’s compensation insurance. In most states, worker’s compensation insurance is sold and underwritten by private companies, although some states require you to buy it from specific state-managed carriers.
Check out our full guide to worker’s comp insurance for state-specific requirements, pricing estimates and more.
Another benefit to using Gusto payroll software (formerly ZenPayroll) is that you can purchase a worker’s comp policy directly through the program.
As with payroll taxes, Gusto will make deductions and send payments automatically on your behalf. Besides your premiums, there’s no additional cost to workers comp insurance when you purchase through Gusto.
The Bottom Line
In summary, these are the payroll taxes and hidden costs you need to look out for:
- Social Security
- Medicare
- State Unemployment Insurance (SUTA)
- Federal Unemployment Insurance (FUTA)
- Workers Comp Insurance
Sound complicated? This is why we highly recommend business check out Gusto payroll software (formerly ZenPayroll). In addition to administering payroll with direct deposit, they’ll handle all tax paperwork and payments, including workers comp. This is not only a huge time saver for small businesses, but a load-off when it comes to protecting yourself from tax penalties.
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This shows just what was said above-----now this AG may sound progressive in saying NO to insurance corporation rate hikes but she is not. This trade union knows if a rate hike does not happen----the funds will not be there to meet insurance obligations. As the AG says----these hikes only go towards insurance corporation profits but who voted to allow insurance corporations to INVEST THESE PROFITS especially in the most global leveraged investment packages? That's right ---Coakley and the MA Wall Street global corporate neo-liberals. Who supports Clinton/Obama every election every election these few decades? National Labor Union leaders. We have watched this cycle of labor shouting to stop killing what are labor union-backed benefits like WORKER'S COMP while being partnered with Clinton----
So, state's were given the power in the Affordable Care Act to deny insurance rate increases and everyone knows with only regional and small businesses paying these rates THERE IS NOT ENOUGH REVENUE IN THE TRUST.
Is Coakley doing this to protect small businesses? OF COURSE NOT. States are now giving reason for major health insurance corporations to not tie to state health systems. We see small insurance businesses being created to fill that niche which would be fine---but the costs of health care are climbing so fast these small insurance businesses cannot fund the health coverage required for full recovery. Workers are seeing very truncated attempts at treatment with positive outcomes falling.
MA has the Romney Care that was supposed to lead to health care for all-----neo-liberal states like Maryland and MA send all state trust funds including health care into the Wall Street market---as with pensions---and indeed, the losses each economic collapse to pensions comes to these health trust investments. Assigned risk pool!
Maryland is one of the worst of states for placing taxpayer and state and city funds in Wall Street leverage deals that end with great losses to those public funds. So, remember the 1% DAVOS global corporate tribunal bunch telling developing nations to get rid of worker's comp? Well, this is the Bush/Obama Wall Street global pols doing just that.
From commenters who may know the goals:
1)MA may have the very highest share of its market in the assigned risk pool of any state. It is the highest of 25 or so states listed by NCCI. Rate suppression is the most likely explanation.
2) They won’t be happy until private insurers completely walk from the state and every risk is in the state pool (thereby under the control of the Democratically controlled legislature, thereby giving them more to raid when they overspend and cannot find revenue).
'MAIA: Worker’ Comp Market Deteriorating
Also speaking at the hearing was Frank Mancini, president and chief executive officer of the Massachusetts Association of Insurance Agents (MAIA), a statewide trade association representing 1,400 member agencies and their 10,000 employees. In his testimony, Mancini warned regulators that Massachusetts’ workers’ comp market is deteriorating'.
Mass. AG Office Says 7.7% Workers’ Comp Rate Hike Unnecessary
By Young Ha | February 11, 2014
At a recent public hearing, Massachusetts Attorney General Martha Coakley’s office expressed its opposition to the workers’ compensation average rate increase proposal and argued that the rate should be lowered instead.
The Attorney General’s office expressed its view at the Massachusetts Division of Insurance hearing on Jan. 30. The hearing provided interested parties an opportunity to provide testimony regarding a proposal by the Workers’ Compensation Rating and Inspection Bureau of Massachusetts (WCRIB) to raise the state’s average worker’s comp rate by 7.7 percent.
The hearings are expected to continue later this month or in March, with WCRIB presenting its case for a 7.7 percent rate increase. Afterwards, the State Rating Bureau and the Attorney General’s office will release their recommendations and make their cases.
If WCRIB’s proposal is approved, it would be the state’s first workers’ comp average rate increase in more than 10 years. WCRIB’s last filing in 2012, which requested an 18.8 percent average rate hike, was rejected by regulators.
“It is the Attorney General’s view that the insurers’ requested 7.7 percent workers’ compensation rate increase is excessive and should be disapproved,” said Monica Brookman, deputy chief of the Insurance and Financial Services Division at the Office of the Attorney General, who appeared at the Jan. 30 hearing on behalf of Attorney General Coakley.
“In fact, if any rate change is needed, it is a reduction, not an increase, in rates,” Brookman argued.
Workers’ comp insurance is a cost of doing business in Massachusetts, and it directly affects companies’ ability to stay in business, to create jobs, and to pay competitive wages. It also increases the prices consumers pay for goods and services in Massachusetts, she said.
Brookman estimated that if approved, a 7.7 percent average rate hike would increase the cost of doing business in Massachusetts by about $75 million.
Potential Impact on Small Businesses
Further, the burden of higher costs would fall disproportionately on small businesses, she argued. “Because large businesses often receive preferential rate treatment, this increase will fall disproportionately on small businesses,” she told the regulators. “In the current economy, many small businesses are struggling, and unemployment is high. This is not the time to unfairly increase the cost of doing business in Massachusetts.”
Brookman also argued that the proposed increase is particularly inappropriate because it is based not on any projected increase in claims payments which are the underlying purpose of workers’ comp insurance, but solely on the insurers’ desire to increase their level of profit in Massachusetts.
“Using the last profit provision approved by the commissioner instead of the inflated profit provision in the insurers’ filing, the indicated rate increase drops from 7.7 percent to a substantial rate reduction,” she said.
“A similar attempt by the insurers to grab more profit at the expense of other businesses in Massachusetts was rejected by the commissioner in a 2012 decision that provided explicit guidance on a reasonable profit,” Brookman said at the hearing. “Following the 2012 decision on profit and making no other changes in the filing, the insurers’ proposed rate increase turns into a substantial rate reduction.”
She said the profit earned by workers’ comp insurers in Massachusetts during the last 10 years has been higher than those earned by workers’ comp insurers countrywide. One indicator of the healthy profitability of workers’ comp insurance in Massachusetts is the behavior of voluntary rate deviations, which have risen steadily over the last few years, she said.
“Nor is the problem workers’ comp losses. Even in the insurers’ filing, the net loss trend is negative,” Brookman added. “There is no need for a rate increase.”
“In this proceeding, we will ask the commissioner to reject the insurers’ proposed 7.7 percent increase and ensure that Massachusetts employers do not pay excessive rates,” she told the regulators.
MAIA: Worker’ Comp Market Deteriorating
Also speaking at the hearing was Frank Mancini, president and chief executive officer of the Massachusetts Association of Insurance Agents (MAIA), a statewide trade association representing 1,400 member agencies and their 10,000 employees. In his testimony, Mancini warned regulators that Massachusetts’ workers’ comp market is deteriorating.
Independent insurance agents write and service over two-thirds of the workers’ comp direct written premium in Massachusetts, MAIA’s Mancini noted. Because of the large market share of workers’ comp business handled by independent insurance agents, MAIA members have a firsthand knowledge of the state of the workers’ comp market in Massachusetts, he said, “and our members tell us that the market is unhealthy and is deteriorating.”
MAIA members deem the market as unhealthy because they are seeing fewer and fewer choices available to their clients, Mancini noted. “Our members tell us that many companies are tightening their underwriting, non-renewing more business than usual, and reducing or eliminating deviations enjoyed by safety-conscious insureds,” he said.
“Deviations provide incentives to insureds to do all they can to reduce losses and, in turn, their workers’ compensation premiums,” Mancini said. “With disappearing deviations goes the incentive for the client to put forth the effort to reduce losses.”
Another sign of an unhealthy marketplace is the increased number of risks being placed in the workers’ compensation assigned risk pool, he commented. Recent data released by the Workers’ Compensation Rating and Inspection Bureau indicates that one out of every four employers in Massachusetts is in the pool.
“Our members have advised us that business is forced to the pool at levels they haven’t observed in a decade,” Mancini said at the hearing. “And these are not just risks that find themselves in the pool because of the nature of their business, but rather risks that would normally find a home in the voluntary market.”
Mancini said the numbers bear out what MAIA members are observing in the marketplace. Recent WCRIB data indicates that as of Oct. 2013, 16.9 percent of the workers’ comp written premium in the state was in the assigned risk pool. This amount represents a 65 percent increase in written premium in the pool over a 30-month period beginning in April 2011, when the written premium in the pool was at 10.2 percent, he noted.
And while assigned risk pool premiums match those in the voluntary market, for the 50,000 Massachusetts employers who find themselves in the pool, there are many drawbacks that come with the assignment, he observed.
Employers in the pool have no choice of company, and pool policies are only for Massachusetts exposures, which presents a problem for insureds with out-of-state operations. Further, there are no dividends or deviations available, and there are only limited payment plans available, particularly for smaller risks with under $10,000 in premium.
Another issue with the assigned risk pool is the inability to obtain certificates of insurance immediately, which creates an uncompetitive situation for some insureds, particularly contractors, Mancini said.
“So as more and more employers are forced into the assigned risk pool, often for no fault of their own, these insureds now find themselves with little, if any, flexibility in their workers’ compensation programs,” Mancini said.
MAIA is not in a position to actuarially comment on the rate filing made by the WCRIB, he told regulators. “However, we are in the best position to advise you that independent insurance agents — who deal in the workers’ compensation marketplace every day with insurers and employers — are concerned that without rate relief the workers’ compensation market will continue to shrink, resulting in fewer choices in companies, reduced dividends and deviations, more business in the pool, and all the drawbacks that go with that assignment,” Mancini said.
Commission Rates Study
MAIA’s Mancini also spoke at the hearing about commission rates for agents. In its filing, WCRIB also included a study that found commission rates for independent agents in Massachusetts for writing and servicing workers’ comp insurance are reasonable and that producer markets for workers’ comp remain competitive. The study was conducted by Sharon Tennyson, a professor in the Department of Policy Analysis and Management at Cornell University.
“We reviewed the study performed by Prof. Sharon Tennyson and view her findings as persuasive. We can attest that the summary and conclusion of her study is accurate, particularly regarding competition among agencies to write workers’ compensation insurance,” Mancini said.
Workers’ compensation is one of the most demanding lines of insurance to service, Mancini commented. And independent insurance agencies add great value to the process, working with the employer/insured and the company to assure that a risk has met all the necessary requirements to write the policy, he said.
These efforts take an added importance for employer/insureds who now find themselves in the assigned risk pool, which involves more rigid placement requirements, he added.
Independent insurance agencies well earn the commissions paid to them for writing and servicing workers’ compensation insurance, Mancini said.
“The great majority of Massachusetts employers utilize the services of independent insurance agencies to assist them with their workers’ compensation insurance,” he said. “Maintaining adequate and reasonable commission levels for workers’ compensation insurance will assure that the value provided by independent insurance agencies will be preserved and employers will have access to the expertise offered by agencies in the workers’ compensation marketplace.”
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If you are a labor union member you understand OSHA and workplace safety laws are what was key to workplace injuries falling while Worker's Comp was strong if injury did occur. Clinton/Bush/Obama defunded and dismantled OSHA and the attack on union apprenticeships known to be the best in the world through growing career college as job training apprenticeships are a much lower quality and standard. I hear union members shouting all the time-----workers are being allowed on work sites having no safety training and/or having training not tied to OSHA's strong protections.
This is why workplace accidents have grown in the US these few decades and it is these accidents that soar in International Economic Zones with global corporate factories breaking all safety standards especially ones including long work in strenuous jobs.
THIS IS WHY CLINTON/BUSH/OBAMA CREATED THE HIGHEST LEVEL OF CITIZEN DISABILITY IN AMERICAN HISTORY. THEY THINK THIS IS EXCEPTIONAL-----WE KNOW IT IS SOCIOPATHY.
1/10/2012 1:01 pm
Top 5 workplace injury causes make up 72% of direct workers comp costs: Analysis
By Roberto Ceniceros
Benefits Management Disability Workers Comp Coverage Mid-Market Executive Workers Comp
Health Care Reform
The five leading causes of workplace injuries drive nearly 72% of the nation's direct workers compensation costs, according to research released Tuesday by Liberty Mutual Group Inc.
Overexertion—or injuries caused by lifting, pushing, pulling, holding and carrying—costs businesses $12.75 billon in direct annual expenses and accounts for more than 25% of the national burden, according to Liberty Mutual's Workplace Safety Index.
The index, compiled by the Liberty Mutual Research Institute for Safety, relies on data that researchers collected on injuries causing at least six missed days of work.
Injury types are ranked by total workers comp costs with the latest findings culled from 2009 data compiled from Liberty Mutual claims, the Bureau of Labor Statistics and the National Academy of Social Insurance.
“Fall on same level” ranks as the No. 2 cause of disabling injury that drives direct costs of $7.94 billion, or 15.8% of the total injury burden.
The other three leading causes of workplace injuries include:
• Fall to lower level, which caused $5.35 billion in costs.
• Bodily reaction—defined as injuries from bending, climbing, reaching, standing, sitting, and slipping or tripping without falling, which drove $5.28 billion in expenses.
• Struck by object, which accounted for $4.64 billion in costs.
Injuries that round out the top 10 causes are highway incidents, “caught in/compressed by” mishaps, struck against object, repetitive motion and assaults. Each category accounted for less than 5% of the direct cost of disabling injuries in 2009.
Overall, the top 10 cause categories accounted for 89.3% of the entire cost burden of disabling work-related injuries in 2009.
Liberty Mutual also found that after adjusting for inflation, the overall direct costs of disabling workplace injuries decreased 4.6% in 2009 compared with 1998.
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