Florida Supreme Court rules for injured workers
As state legislatures continue to cut essential benefits and protections in the workers’ comp system, injured workers and their advocates have increasingly turned to the judiciary system—as with New Mexico farmworkers’ recent victory—to challenge unjust laws.
In two separate decisions this April, the Florida Supreme Court and First Court of Appeals ruled unconstitutional a workers’ comp statute that limits the amount injured workers can pay an attorney to represent them in a workers’ comp claim. By placing unreasonably low limits on attorney fees, the law has made it impossible for many injured workers to find legal representation to contest a denied claim. The Court’s decision stated that the law was unconstitutional because it violates injured workers’ “rights to free speech and to seek redress of grievances.” By allowing insurance companies to deny valid claims with impunity, the law also encouraged fraudulence and cost shifting.
“Without the likelihood of an adequate attorney’s fee award, there is little disincentive for a carrier to deny benefits,” wrote Justice Barbara Pariente in the Supreme Court’s majority decision, adding that “without the right to an attorney with a reasonable fee, the workers compensation law can no longer ‘assure the quick and efficient delivery of disability and medical benefits to an injured worker.’”
Unfortunately, the Florida Supreme Court recently declined to hear two other important workers’ comp cases that challenged the constitutionality of exclusive remedy on the grounds that the system’s eroded benefits no longer provide a reasonable alternative to suing an employer. The Court is still considering the case Westphal v. City of St. Petersburg, which addresses a workers’ comp statute that creates a gap in benefits for workers who are totally disabled by an occupational injury but have not reached maximum medical improvement by the time their temporary disability benefits expire. In the wake of these challenges, Florida leaders have said workers’ comp will be a priority in the 2017 legislative season.
Profiteers exploit injured California workers and defraud honest employers and the public out of $1 billion
A new study by the Center for Investigative Reporting shines a spotlight on the rampant fraud in California’s workers’ comp medical system. Medical professionals across the state have created and participated in kickback schemes that endanger injured workers, robbing the system of more than a billion dollars. Taking advantage of loose oversight in the workers’ comp system, scammers prey on injured workers by performing expensive, often unneeded, surgeries and prescribing unregulated medications, then bill insurance companies for these “treatments” through the lien system.
Originally designed to protect injured workers, the lien system is supposed to ensure timely medical care for workers whose claims have been denied or delayed. Medical providers can give immediate treatment, then file a claim to recover the cost from the insurance company. Yet profiteers have exploited the system’s regulatory holes and lack of transparency, placing injured workers at risk with unnecessary and even harmful treatment plans so they can reap bigger profits from their claims. A network of bribes encompasses workers’ comp attorneys, doctors, billing experts, and pharmaceutical sales reps, all of whom direct vulnerable injured workers towards fraudulent medical providers.
Prosecutors have brought cases against over 80 people for medical scams in the California workers’ comp system, but injured workers harmed by the fraud have so far had little recourse to justice. Moreover, widespread fraud has raised costs in a system that already places workers at odds with insurers and employers, fueling a “race to the bottom” in which state legislatures cut important workers’ comp benefits to appease big business. The medical fraud in California should serve as a wake-up call for legislators across the country to strengthen regulatory oversight, increase transparency, and ensure the workers’ comp system protects injured workers’ human rights.
Workers’ Memorial Day
Each year, Workers’ Memorial Day marks a moment of mourning for workers who have died on the job. It has also become a time to call attention to the causes of workplace fatality and fight for safer, healthier jobs. Worker deaths from traumatic incident rose to 4,821 in 2014, the last year for which data is available, and new research shows that annual deaths from occupational illness are much higher than previously estimated: 95,000 in one year. Tragically, most of these deaths are entirely preventable by compliance with basic health and safety regulations.
A report released by the National Coalition for Occupational Safety and Health (COSH) in April shows how irresponsible business decisions lead to increases in workplace deaths and emphasizes that contract workers are among those most at risk. The Center for Progressive Reform (CPR) has created a manual that further explains why employers are rarely held accountable for harming workers and guides workers’ rights advocates on the steps necessary to connect with prosecutors, law enforcement, and regulators about investigating workplace incidents as potential crimes. Co-author Ron Wright, a Criminal Law Professor and CPR Member Scholar, stresses that pursuing criminal charges “deters employer neglect by sending the message that ignoring workplace health and safety won’t be tolerated. Not only does prosecution lay blame where it belongs, it provides a powerful disincentive to reckless behavior.”