The New York Times’ R.N. Kleinfield and Steven Greenhouse offer us a glimpse of the nightmare known as the workers’ compensation system.  In their article A World of Hurt: For Injured Workers, a Costly Legal Swamp,* they report from the Queens NY office of the NY State Workers’ Compensation Board and explain that injured workers:

“come to the board seeking authorization for medical treatment and replacement wages…what they find instead is…a $ 5.5 billion-a-year state-run bureaucracy that struggles to treat workers with due speed, protect employers from fraud or mute tensions in the workplace.”

The lengthy (5,000 word) feature article comes on the heels of a December 2008 task force report that identified serious problems with the NY State system, including an average of 200 days to resolve disputed injury claims.  Kleinfield and Greenhouse give us snapshots into the lives of workers who have suffered work-related injuries and forced into a system that is anything but fair, quick or no-fault.  One worker captures the sentiment of many others: 

“I don’t want to come here and feel like I’m begging.  Frankly, I’ll take just about anything, just so I don’t have to see this place every again.”

Even occupational health specialists say they would avoid the work comp system.

“‘This is a terrible thing to say,’ said Dr. Robin Herbert, co-director of the occupational and environmental division at Mount Sinai Medical Center, ‘but if I had a health problem at work, I’m not sure I’d file a workers’ comp claim.  It’s the Wild West of health insurance.’”

The bottom line of A World of Hurt: For Injured Workers, a Costly Legal Swamp* is that our current workers’ comp system doesn’t work well at all, especially not for injured and ill workers.    But the problems with workers’ comp are not something new, they are just getting worse as the years pass.   Nearly 40 years ago, Congress noted:

“The vast majority of American workers, and their families, are dependent on workmen’s compensation for their basic economic security in the event such workers suffer disabling injury or death in the course of their employment; and that the full protection of American workers from job-related injury or death requires an adequate, prompt and equitable system of workmen’s compensation…”

“…in recent years serious questions have been raised concerning the fairness and adequacy of present workmen’s compensation laws in the light of the growth of the economy, the changing nature of the labor force, increases in medical knowledge, changes in the hazards associated with various types of employment, new technology creating new risks to health and safety, and increases in the general level of wages and the cost of living.”  (Section 27, OSH Act)

As part of the OSH Act, Congress established the National Commission on State Workmen’s Compensation Laws, and the Commission issued a 132-page report and recommendations in July 1972.  The Commission’s work was guided by the following:

“There are five major objectives for a modern workmen’s compensation program.  Four of them basic, and an equally important one that supports the others. 

The four basic objectives are:

  • Broad coverage of employees and of work-related injuries and diseases
  • Substantial protection against interruption of income
  • Provision of sufficient medical care and rehabilitative services
  • Encouragement of safety (economic incentives in the program should reduce the number of work-related injuries and diseases)

The achievement of these four basic objectives is dependent on a fifth objective:

  • An effective system for delivery of the benefits and services”

Reading the comments posted in response to Kleinfield & Greenhouse’s A World of Hurt: For Injured Workers, a Costly Legal Swamp* there are plenty of examples of how the workers’ compensation system fails to meet these basic objectives.   Take the

  • carpenter who suffered a broken ankle building the federal courthouse at 500 Pearl Street, NYC, and said “it  took me over a year to get paid – and that’s in a case where the contractor and my lawyer agreed I had a legitimate case!  I didn’t get a cent until after I’d already healed and gone back to work!”; or 
  • the person writing about his partner who suffered a head traum at work which cause partial epilepsy and neuropathy.  He describes his partner’s experience as the 10 year “hell of Workers Comp”; or  
  •  the person who still suffers from a repetitive strain injury which keeps him/her “stuck in low wage job because it is all I can find that keeps my pain to barely tolerable levels. The compromise [work comp] award didn’t even come close to being a living wage.”

With Vice President Biden leading the Middle Class Task Force, and President Obama committed to reforms in our health care system, do we have an opportunity to remake the workers’ compensation system to actually meet the objectives laid out in 1972 by the National Commission?  

As Barbara from Virginia noted on the NYTimes site:

“The dysfunctional workers comp system in many states is yet ANOTHER reason to endorse universal health care, and stop devoting so many resources to assessing fault and apportioning liability. People should get health care because they need it, not because their injuries occurred in a particular setting or were some someone else’s fault.”

I’ll throw in my two cents on top of Barbara’s call for universal health care: Imagine a single-payer system, including coverage for work-related injuries and illnesses, teamed up with a system of electronic medical records.   We could potentially do a lot better job of linking injuries and illnesses to exposures at work, and follow-up with targeted prevention and enforcement efforts.

*(PDF here)

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