NPR Reports Insurers Gaining Control in the California Worker’s Compensation System

According to a recent report by NPR, the California Worker’s Compensation System is giving too much control regarding medical decisions to employers and insurers. The State Compensation Insurance Fund, a quasi-governmental agency, employs anonymous independent medical reviewers. The reviewers, who are not required to be licensed in the state, have the power to make decisions regarding treatments without ever examining the worker. Many believe that too much deference is given to the reviewers, who side with the insurance companies 90% of the time.

In the case of a worker who was injured in a work accident in 1997, reforms made to the California worker’s compensation system have denied her the continuation of effective treatment which included pain medications and a home aide. This worker might never be able to use her feet again, and suffers from what is known as chronic or complex regional pain syndrome. After the State Compensation Fund reviewed only the worker’s medical paperwork, and not her actual injuries, the reviewer determined that the medication and the home aide were not helping her recover and thus, denied her request.

Because the reviewers are anonymous, it is impossible to override their decisions or even depose them for trial purposes.

In another heartbreaking case, a worker who suffered from job related injuries which resulted in paralysis is unable to live at home because his request for modifications to his home for wheelchair access were denied. Even though his doctor prescribed $170,000 in home modifications, an independent medical reviewer employed by the California Insurance Guarantee Association rejected the prescribed modifications. However, after NBC4 News in Los Angeles featured the story, the CIGA approved the modifications and publicly announced that the claim was not handled properly.

Click here to read the full NPR story.

If you have suffered from a workplace injury, contact an experienced worker’s compensation attorney who will fight for your rights. The attorneys at McIntyre, Donohue, Accardi, Salmonson & Riordan, LLP have experience representing clients before Workers’ Compensation boards throughout New York City and Long Island, including Manhattan, the Bronx, Queens, Brooklyn, Staten Island, Nassau County, and Suffolk County. For a consultation, call (866)557-7500.

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Recent Report Exposes the Injured System of Worker’s Compensation Benefits

A recent report by ProPublica and National Public Radio exposed how states, including New York, have implemented cuts to worker’s compensation benefits which has resulted in shifting the costs of workplace accidents away from the employers and to the taxpayers. Employers are paying the lowest premium rates on workers’ compensation since the 1970’s. Both the risk of injury is increasing due to changing trends in the labor market, as well as the financial hardships suffered by employees who cannot work due to work related disabilities. Due to implementing cost saving strategies, insurance companies are seeing an 18% return in profits while workers are not getting the compensation they deserve. In many instances, the workers who suffer injury are forced into poverty as a result of being unable to return to their job, in addition to paying extraordinary medical expenses.

In New York, medical treatment guidelines were implemented in 2010 which lowered worker’s compensation costs for employers while limiting adequate treatment available to many workers. According to the ProPublica report, in 1988, the average rate for worker’s compensation insurance in New York was $2.98 per $100 of the worker’s wages. Last year, it was $2.85.

In a report published this month by OSHA entitled “Adding Inequality to Injury: The Costs of Failing to Protect Workers on the Job,” OSHA analyzed the economic burdens that work injuries place on families and the trickle-down effect low worker’s compensation pay out rates have on society. The injuries suffered by many workers affect their entire family structure. In many cases, a worker’s spouse will need to cut back on their own hours of employment in order to care for their disabled family member. In other cases, the non-disabled spouse may take on an extra job or extra hours to support their family. Such long days causes workers to run the risk of fatigue and illness which causes a 61% increase in both work related injuries and motor vehicle accidents. Additionally, because workers cannot sue their employers, they largely rely on paying out of pocket for their medical expenses.

It is also interesting to note the price tags attached to injuries regarding worker’s compensation benefits. For example, in New York, the maximum compensation for loss of an arm is $252,299. In many jobs that involve labor, a worker will be unable to return to his previous duty without a limb. In many cases, the worker will have to support a family in addition to paying medical expenses out of the amount provided. Nevertheless, New York’s worker’s compensation benefits are still higher for most body parts than the national average.

OSHA has asserted that the “acceptable number of work injuries, especially fatal work injuries is zero.” In order to accomplish this, employers must take preventative measures to eliminate dangerous conditions. The attorneys at McIntyre, Donohue, Accardi, Salmonson & Riordan, LLP have experience representing clients before Workers’ Compensation boards throughout New York City and Long Island, including Manhattan, the Bronx, Queens, Brooklyn, Staten Island, Nassau County, and Suffolk County. For a consultation, call (866)557-7500.

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Executive Seeks Fund Reallocation to Address Social Security Disability

The United States Social Security Disability Insurance program, which provides benefits to over 11 million Americans, could be cut by nearly 20 percent. According to reports from the Social Security Administration Board of Trustees released in July 2014, the Social Security trust fund, which finances the federal program, is projected to be depleted by the end of 2016.

To address potential shortfalls in the past, Congress has reallocated payroll taxes from Social Security’s Old Age and Survivors Insurance fund to the disability trust. Similarly, while recognizing the need for a congressionally crafted long-term solution, the White House has proposed reallocating payroll taxes from the social security retirement fund to the social security disability trust fund to prevent the looming depletion.

Specifically, the White House’s proposal would shift $330 billion from retirement accounts over the next five years. However, according to the White House, the proposed reallocation will not affect the overall health of the retirement and disability trust funds on a combined basis. It is important to note that it is still unclear whether such measures will be adopted.

If you or a loved one have any questions regarding your Workers’ Compensation, social security, or New York State disability benefits, contact our experienced attorneys at McIntyre, Donohue, Accardi, Salmonson & Riordan, LLP. For a consultation, call (866)557-7500.

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Bus Drivers Face High Risk of On-the-Job Injury

Public transportation drivers have an especially important role to play in society- they are entrusted with delivering thousands of people every day safely to their destinations. In fact, in 2013, Americans took 10.7 billion trips on public transportation and half (5.4 billion) of those trips were rides in a bus. Therefore, when a bus driver suffers from an injury or illness, there is a trickle down effect. A recent survey was published by the U.S. Bureau of Labor Statistics reflecting the kinds of hazards bus drivers face on a daily basis. Due to the nature of their employment, bus drivers spend a great deal of time on the road and as a result, 42% of work related injuries in 2013 were related to transportation incidents. However, these incidents were second to physical overexertion in 2012, which accounted for 34% of cases. In 2013, overexertion constituted 22%.

In addition to vehicle accidents and bodily reactions, bus drivers also are exposed to the elements of nature as a condition of their job, and thus, slips and falls accounted for 14% of injuries in 2013- a decrease from 20% in 2011. The remainder 35% of accidents faced by bus drivers in 2013 fell into the categories of contact with objects/equipment, violence by people or animals, and exposure to harmful substances.

Bus drivers can often face long hours, and both physically and mentally stressful conditions. To be entrusted with the safety of so many passengers each day is a very serious undertaking. If you are a bus driver, or a loved one is, who has been injured while on duty, contact an experienced attorney who can assist you with your Worker’s Compensation claim. The attorneys at McIntyre, Donohue, Accardi, Salmonson & Riordan, LLP have experience representing clients before Workers’ Compensation boards throughout New York City and Long Island, including Manhattan, the Bronx, Queens, Brooklyn, Staten Island, Nassau County, and Suffolk County. For a consultation, call (866)557-7500.

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