Delays and denials in California’s workers’ comp system
In California, a series of investigative reports have drawn attention to widespread delays and denials in the workers’ comp system that cause lasting harm to injured workers. California bases its workers’ comp decisions on “utilization reviews,” which are partial computerized medical reviews done by insurance company doctors who never actually see the patients. The reviews pad the profit margins of insurance companies by denying care and income supports to workers. In one survey, 67% of treating doctors reported difficulty getting authorization from workers’ comp insurance companies to go ahead with needed treatments. There is also a lack of transparency in the system; the only available report on how many workers’ comp applications are approved or denied comes from California Workers’ Compensation Institute (CWCI), a private industry organization with data voluntarily submitted by its members. Two bills are on the table in California State Legislature that would help injured workers receive timely, adequate care. SB1160 would increase the timeliness of utilization reviews, while SB563 would prevent insurance companies from offering financial incentives to evaluating doctors based on the number of denials and delays they issue.
Illinois Governor continues assault on workers’ comp
In Illinois, Governor Bruce Rauner wants to cut or eliminate benefits for many injured workers. Rauner wants to exclude all injuries that are not caused “more than 50%” by an incident at the worker’s current employer. This means that if an injured worker’s condition has complex causes that involve or may involve multiple contributing factors, her workers’ comp claim may be denied. Dave Menchetti, a workers’ comp attorney in Chicago, says the measure “would severely prejudice older workers and workers in heavy industries because those are the kind of workers who have pre-existing conditions.” He also points out that doctors are not trained to quantify the causes of an injury, making such a formula arbitrary and open to unjust influence from employers and insurance companies. A report by In These Times highlights the competition over employers with neighboring Indiana, making the two states a classic example of the workers’ comp “race to the bottom.” To back up his push to cut comp benefits, Gov. Rauner has been touting the threat that employers will chase cheaper costs and head to Indiana, evoking the “spectre of the vanishing employer” that was debunked by the 1972 National Commission Report of the National Commission on State Workmen’s Compensation Laws but is still often trotted out by politicians and business lobbies to this day.
Uber drivers finally recognized as employees in California
Rejecting a $100 million settlement proposed by Uber’s lawyers, U.S. District Court Judge Edward Chen said that the company’s drivers should be classified as employees, entitling them to the right to organize, workers’ comp, and other important workplace protections tied to employee status. Chen noted that although Uber does not control hours, they do control hiring and firing as well as other aspects of the job. He also pointed out that the settlement grossly undercut the claims from the drivers filing the class-action lawsuit, which totaled $854.4 million.
California women call out gender discrimination in workers’ comp
A group of female workers and the Service Employees International Union (SEIU) California State Council have filed a class action lawsuit calling out gender-based discrimination in the California workers’ comp system. Their claim cites systemic biases that reduce women’s workers’ comp benefits by attributing work-related injuries and illness, particularly carpal tunnel and breast cancer, to pregnancy, breastfeeding, menopause, or other gender-related “risk factors”. Psychiatric conditions such as depression are also reduced, by as much as 80%, due to vague assumptions about reproductive factors. The state’s workers’ comp system “deprives women workers of fair compensation on the basis of stereotypes about gender and women’s reproductive biology,” says the complaint, adding that “by permitting and condoning the distribution of workers’ compensation benefits on the basis of sex, the State of California sends a clear message that women’s work is worth less.” For more about gender discrimination in the comp system, see our previous story.
New reporting rule from OSHA turns up revealing data from meatpacking industry
In July, the Occupational Safety and Health Administration (OSHA) imposed a fine of $78,000 on poultry supplier Pilgrim’s Pride for denying access to medical care to injured workers at their Florida, often leading to prolonged and exacerbated injuries. The poultry industry is known for the particularly horrible health threats their employees face. Inadequate safety equipment and training regularly lead to chemical burns, zoonotic diseases, and crushed limbs, while Oxfam reports that poultry industry workers have ten times the rate of repetitive strain and seven times the rate of carpal tunnel than the rest of the workforce. Workers are fearful of reporting injuries and safety hazards, even to inspectors, because of threats of retaliation from their supervisors. While it is important that OSHA is holding the poultry industry accountable, the fine for this violation remains too low, giving little more than a slap on the wrist to Pilgrim’s Pride. “Until the financial consequences of mistreating workers becomes greater, we’re going to keep seeing these kinds of conditions being endemic to the industry,” says Naomi Tsu, Deputy Legal Director for the Southern Poverty Law Center (SPLC). Debbie Berkowitz, a senior fellow at the National Employment Law Project, adds that “This is about dignity and justice for the workers. It’ll take quite systemic change for these things to be in line for full rights and dignity for workers.”
Reports show workers' comp benefits diminishing
The Department of Labor has released an important report detailing the history of workers’ comp and assessing how the current situation affects injured and ill workers. Emphasizing that only a small proportion of the costs of occupational injury and illness are covered by employers, the report highlights several state legislative trends that have led to decreased benefits for workers. These include more exclusionary standards, decreased cash benefits, programs that discourage reporting of injuries, and restrictive rules for procedure and evidence. The report calls for a “significant change in approach in order to address the inadequacies of the system” and recommends further exploration of instituting federal minimum standards and re-establishing a national commission.
The National Association of Social Insurance has also released its annual workers’ comp report on trends in costs and benefits. Among its findings are that workers’ compensation benefits decreased for the second year in a row in 2014, in line with a general trend since the early nineties (see figure above).