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How Work Comp Insurance Companies Shift The Costs Of Injuries And Disabilities

In a past article, I discussed a study that revealed work related illnesses and injuries cost at least $250 billion a year. My prior post raises the question — Why does our system not focus on safety? A small investment in safety would pay huge returns.

Our current system fails to invest in safety. While workers are penalized for some unsafe conduct, the system does nothing to the few reckless employers who cause most of the injuries. The most reckless and dangerous employers suffer no penalties under Alabama workers’ compensation laws. They suffer no penalties causing them to lose lucrative government contracts. They suffer almost no penalties from OSHA which is overstressed, understaffed and rarely inspects unsafe worksites. Unless we focus on real safety by penalizing reckless employers, we will continue to see far too many work related injuries.

What is the cost of occupational accidents and injuries to reckless and unsafe employers? At worst, the injury may result in some type of premium increase for work comp coverage? A recent UC Davis study showed that the majority of workplace injury and illness costs are not even paid through workers’ compensation insurance. Instead, these costs are simply shifted to the government. Think taxpayers like us! When it comes right down to it, reckless and unsafe employers dispose of their workers by shifting the costs of accidents and disabilities to the taxpayer.

In my law practice, I see these unjust efforts to shift injury costs every day. While it may seem I am picking on insurance carriers, they are not the only ones to blame. A few doctors and lawyers are complicit. A small number of doctors and lawyers have adapted their practices to help shift costs. Wait. How do a few bad insurance adjusters, doctors and lawyers, shift costs to taxpayers? Here are some examples:

The Quick Denial

Some insurance adjusters follow a script for quickly denying almost all comp claims. They have a quick hit list of denial reasons. When they receive a claim, these adjusters quickly pick one of the generic denial reasons. Preexisting condition. Employee misconduct. Lack of notice. Their reasons are usually wrong. But, they are hoping the injured worker won’t seek good legal advice. For example, consider the “preexisting condition” denial. Maybe the injured worker did have some prior problems. What the insurance adjuster does not tell the worker is that our law provides benefits to workers who are less than perfectly healthy, who may have had some physical problems or who had some prior limitations. Occasionally, the adjuster will just claim the matter is under endless “investigation.” The goal is for the worker to go away. Someone else can pick up the tab for needed care later.

The Rushed Release

Doctors should treat illnesses and injuries. Most doctors care about their patients and do the very best possible to heal them. Everyone benefits when injured workers receive capable medical care and rehabilitation. Yet, in the work comp arena, an entire industry of biased, paper doctors exists. These clinics are small in number but their impact on injured workers is huge. Their sole business is to generate reports for insurance companies that dispute injuries, question disabilities, release workers prematurely, or deny treatment options. We have a few clinics who profit by herding a huge volume of injured employees through their doors to the finish line without proper care. These clinics usually report the patient has reached maximum improvement, is due to be released, and has little or no long-term problems.

Insurance carriers pay small medical costs to these work comp clinics to avoid the real costs of proper medical care. It’s cheaper for the insurance company to pay a few dollars for its company-doctor to generate a medical report. While it’s cheaper for the insurance company in the short-term, the long-term cost to communities is much larger. I recently worked on a case in Guntersville where the injured worker suffered two terrible work-related back injuries several years apart. After each injury, the company doctor saw the person a few times and then released the worker with a diagnosis of simple back strain. Each time, the worker went on his own to a surgeon who observed and operated on a huge ruptured lumbar disc. How could the company doctor ever miss such tremendous injuries and pain? He couldn’t miss these injuries without turning a blind eye to the obvious. Sadly, this company doctor has a long history of herding injured workers through the system on behalf of his insurance company clients. This time, the injured worker came to us after his second accident. We filed suit, fought the claim and won proper benefits for him.

The Settlement Mill

These are the attorneys who never darken the doors of the courthouse. Oh yeah, they talk tough in commercials. They know how to take a good picture for their ad. They tell you what you want to hear and ask for your call. Yet, they will not fight for their clients. They certainly will not go to trial. These settlement mill lawyers simply accept the insurance company offer without a real fight. Guess what? Insurance companies know which lawyers will fight for their clients and which lawyers will not. In Alabama, we have attorneys who advertise for car accident claims, workers’ compensation cases and other personal injury cases, that have never even tried a case. This is a real problem for injured people who need real help.

The Lost Medicals

In Alabama, work comp provides two very important benefits. One is medical treatment. Two is money benefits to you for disability. If you are hurt on the job, you are entitled to medical care. This is true whether or not you have a long-term disability. Your right to medical care for your injury is forever! And, you do NOT have to give up medical care in order to get any disability benefits owed you. Yet, a few large companies in Alabama will refuse to settle your disability benefits claim unless you simply give-up the right to all medical care. Through the years, Walmart has employed this strategy of settlement. They are hoping you don’t know any better, don’t have legal counsel, or are desperate for a settlement. Do not give up your medical rights. I’ve tried numerous cases against Walmart because of their unfair and unjust position on this issue. How many injured workers sign away their medical benefits? Who provides medical care for these injured workers?

If you have been genuinely hurt on the job, don’t let the insurance company herd you through the system. Get the care you need. Seek the benefits you are owed. If we want real reform that benefits our workers and their families, we need to make it more difficult for carriers to shift their costs of disability to the rest of us.

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From its office in Huntsville, the Blackwell Law Firm represents clients across Alabama. If you suffered a serious personal injury, let us know. We are happy to answer your legal questions. Consultations are always free and confidential.

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