Workers’ compensation works best when it serves its core function: a dedicated, non-litigation pathway to medical care and benefits for work-caused injuries.
Maintaining workers’ comp for work-caused injuries is the only way to maintain predictability and stability in costs and performance.
Efforts to distort this core function and use workers’ compensation for other purposes or pay for non-work issues threaten to derail the system and send it back into crisis.
These abuses happen “in the trenches” of the system, in between reforms and while lawmakers aren’t watching, as special interests try to increase their profits out of the system. These efforts also happen through proposed legislation that purposefully distorts the basic premise of workers’ comp.
EFFORTS TO DISTORT THE PURPOSE OF WORKERS’ COMP
- Benefits for Non-Work Disability: Over the last two decades, there have been numerous legislative proposals and countless lawsuits attempting to eliminate or reduce “apportionment.” This term refers to the requirement in state law that employers pay benefits for the percentage of disability caused by the workplace injury, but not for disability that is caused by other, non-work factors. These attempts have sought to increase what employers pay for non-work disability.
- Effects of Aging: The attacks on apportionment and the growth in “cumulative trauma” claims has been attributed to attempts to force the workers’ compensation system to pay for medical conditions that are associated with the normal effects of aging.
- “Free Health Care:” Some workers are recruited into filing workers’ comp claims based on the promise of “free health care and cash” by illegal recruitment activities known as “capping.” These cappers funnel workers to medical providers and others who bill for inappropriate services or services never provided to the workers.
- Exploding Claims for “Subsequent Injuries:” There is concern that the explosion in claims to the “Subsequent Injuries Benefits Trust Fund” are not for prior work-related injuries, but for non-work injuries and ailments.
- Retirement Benefits: In some instances, late-career claims have been filed inappropriately to enhance retirement benefits by adding a disability component.
- Unemployment Payouts: The growth in “cumulative trauma” claims includes a significant proportion that are filed “post termination” or “post employment,” indicating that these claims are being filed to recoup lost earnings or retaliate against prior employers, rather than for an actual work-caused injury.
- Presumptions to Override Work-Causation Rules: Even though the vast majority of claims are accepted under current causation rules, each year the Legislature considers new or expanded workers’ compensation “presumptions” to change the work causation standard. The risk in enacting presumptions is that by shifting the burden of proof onto employers, more claims for non-work injuries and diseases will be placed inappropriately into the workers’ compensation system.
