Posts Tagged ‘L&I’

Workers’ Compensation Boards Debate Disability Guidelines

Thursday, September 2nd, 2010

The default rate among self-insured group trusts has produced an alarming level of assessments on small businesses throughout the country. Workers’ compensation boards in states like New York are increasingly deliberating “safety programs” that would lower workers’ compensation costs.

Certain critics—notably the insurance industry itself—have long argued that the injury benefits awarded by state workers’ compensation boards are overinflated, and do not accurately reflect the true costs of a given injury.

While cases of fraud and “presumptions” are significant factors, many claim that the inability of workers’ compensation boards to objectively assess and quantify disability is a much greater problem. For years, many WCBs have not had a working definition of levels of disability or percentage-based schedules of loss. These boards have used arbitrary and every-changing criteria to calculate hundreds of millions of dollars’ worth of permanent damages benefits. On top of this there have been the massive cost of trials and testimonies to calculate what WCBs claimed had no definition in the first place.

At the present moment, workers’ compensation boards across the nation are once again involved in debates over the creation and use of more standardized, objective guidelines to evaluate disability. Yet for generations, the workers compensation system has carried on profitably by not having such standards. In short, disputes have been resolved by an arrangement in which worker’s compensation attorneys and insurers must engage in expensive and inefficient disputes until both sides are worn down and settle for a number around 50%, giving the misleading impression of a fair and reasonable outcome.

According to Seattle Workers’ Compensation Attorney Theodore Ronca, this state of affairs has come about through the unique history of workers comp boards.  In New York State, for example, the board has employed a medical advisor since its very first days. The initial advisors established guidelines that were widely accepted and implemented, until they eventually came to be considered obsolete in the 1950s.  After that point, the New York State workers’ compensation board had no working guidelines, and attempts to create new criteria came to a state of deadlock through stubborn opposition on all sides.

The New York Workers’ Compensation Board continued to operate (unofficially) with the older guidelines, and then later with no criteria at all for the next forty years. Responding to pressure in the 1990s, it produced new written guideline for workers’ compensation benefits, but failed to make these binding.  In practice, they were generally ignored when negotiating workers’ compensation claims.

This, of course, raises the question as to whether guidelines would automatically solve anything. As Ronca points out, “unless the guideline can be tested to determine if it can measure what it purports to measure it remains a blank yardstick masquerading as a set of calipers.”  Calculations of workers’ compensation disability, ultimately, result in the final settlements of injury claims, some that currently stand above $200,000 (and rising).  Whether these numbers are too high or too low is a question for which many workers’ compensation boards still have no satisfactory answer.

I-1082 Opens Workers’ Compensation to Private Insurers

Saturday, July 17th, 2010

In mid-July, an initiative qualified for the November ballot that could have far-reaching effects for Washington workers, employers and taxpayers.  I-1082, which would effectively privatize the current state-run workers’ compensation program, is backed by the insurance industry and a conservative trade group called the Building Industry Association of Washington (BIAW).  If the initiative passes, these two groups will reap enormous benefits.

I-1082 would allow private insurers to offer workers’ compensation coverage in competition with the current public system, giving yet another lucrative handout to the taxpayer-bailed-out insurance industry.  After receiving billions of taxpayer dollars over the past few years, firms like AIG (the world’s largest workers’ compensation insurer) are now attempting to undermine Washington’s non-profit public system — a system that “is statutorily required to keep costs down,” says Nicholas Corning, former President of the Washington State Association for Justice. If the private insurance industry is successful, I-1082 will leave Washington businesses “to deal with out-of-state corporations [who are] only concerned about siphoning profits into their Wall Street war chests.”  And state employers can expect a costly outcome from this transfer; as Corning points out, the existing state-run workers’ compensation program, L&I, operates with only 18% administrative costs; the private industry average, on the other hand, is 68%.

Opposition to I-1082

Small business owners and community leaders feel that privatization would prove highly unfavorable to businesses, employees and taxpayers, and have organized opposition groups to I-1082.  The campaign No on I-1082 maintains that the highest priority of our existing public system is to ensure that injured workers receive the medical care and job retraining they need.  For-profit insurers are not likely to share this priority.  According to the opposition group’s communications director, Adrianne Williams, “Handing our public, non-profit system over to the private insurance industry is mostly [designed] to generate profits for the industry and less about getting injured workers back to work.”  Other prominent groups opposing I-1082 include the Washington State Labor Council AFL-CIO, the Washington State Association for Justice, and Democratic Underground,

Many Washington businesses are also concerned about the higher insurance premiums they can expect if 1082 passes.  Alex Fryer, the spokesman of “No on I-1082,” argues that private insurance companies will end up “cherry-picking businesses that have low claims, forcing the remaining higher-risk businesses to pay higher premiums under the state plan.”  To underscore the consequences of moving away from a non-profit workers’ compensation plan, he cites figures on states that have adopted a private insurance option, some of which experienced a 200 percent premium increase.

In addition, I-1082 proposes to abolish the existing state mandate requiring employees to pay a portion of the state’s premium costs, shifting the entire financial burden to employers.  Analysts predict that this would cause small business owners’ annual costs to go up by 25 percent.

I-1082 would have an unfavorable outcome for workers as well, eliminating any transparency from the claims management process.  Under the present Washington State workers’ compensation system, L&I is required to come to a final decision regarding treatment of a worker’s injury or illness, and must notify all parties of that decision.  If L&I does not comply with these obligations, it can be compelled to do so by a writ of mandamus.  But I-1082 includes a provision stating that insurers do not have to notify anyone if a claim is rejected; in fact, the workers’ compensation insurer would never have to come to a decision on an injury claim at all.  This puts the insurance companies at a tremendous advantage, allowing them to protect their profit margins by denying or delaying claims indefinitely, without ever facing the threat of enforcement.  Not only would this potentially prevent workers from returning to their jobs; it would also make it extremely difficult for employers to verify whether an employee is able to work.

Critics of the initiative are also alarmed that I-1082 would leave the insurance industry unregulated and free of L&I oversight.  Private insurers would be allowed to set their own rates with no approval from the Washington State Insurance Commissioner. Equally troubling is the fact that I-1082 would abolish the Insurance Guaranty Act, leaving Washington businesses and employees vulnerable to insurer insolvency.  Currently, all lines of private insurance in the state are protected against fraud or bankruptcy by the Insurance Guaranty Act.  But with that regulation removed, an insurance company could collect workers’ compensation premiums and then fail to pay benefits due to insolvency.  Because of these reasons, Washington Insurance Commissioner Mike Kreidler and State Auditor Brian Sonntag both oppose I-1082.

Ultimately, I-1082 would establish an unregulated and largely independent playing field for private insurers to reap profits by squeezing Washington businesses and undermining worker safety.  Before voters cast their ballots in November, they should be aware that I-1082’s success would be a huge win for special interests, and a loss for the wellbeing of small businesses and injured workers.

Read more about I-1082:

Emery Reddy Files Class Action Lawsuit Against Safeway

Monday, May 24th, 2010

The attorneys at Emery Reddy recently filed a class action lawsuit against Safeway for failing to pay overtime wages and illegally preventing employees from taking meal and rest breaks.

Emery Reddy is committed to ensuring that workers receive the full compensation and benefits to which they are entitled under state and federal law.  To follow the developments of this and other overtime and wage violation cases, please check back regularly for updates.

Wage, hour, and benefit violations of this kind are unacceptably common in today’s workplace. Employers violate the law and their workers’ rights when they refuse to pay overtime wages, do not meet a state’s legally established minimum wages, fail to comply with the Equal Pay Act, coerce an employee to work off the clock, refuse to allow workers their mandatory breaks, or withhold commission payments, final wages or any other portion of a worker’s earned wages without that employee’s written consent.  For more information on wage disputes and workers’ rights, visit Emery Reddy’s Employment Law information center or the websites for the Washington State Department of Labor and Industries (L&I) and the US Department of Labor.

Workers’ Comp Claims Information Navigable Online

Sunday, November 22nd, 2009

This article by Timothy W. Emery, Esq., a partner with Emery Reddy, PLLC, Attorneys at Law.

Washington Labor and Industries is in the process of overhauling its website, www.lni.wa.gov. The revisions to the Washington L&I website are the result of user feedback collected over a significant period of time, as well as the efforts of L&I website designers. The new look improves the homepage, streamlines navigation and uses space more efficiently.

The new Washington L&I homepage, the content of which provides details on injured workers’ employment and workers’ compensation rights, provides better visuals and a more welcoming portal to the rest of the L&I site. Online services like the Claim and Account Center simplify the search for injured workers’ rights and remedies, workers’ compensation information, and specific claim information.

Streamlined navigation was a major focus of the L&I site revisions, and the result is a menu that includes headings for Safety, Claims and Insurance, Workplace Rights, and Trades and Licensing. These headings are continuously available. The new L&I site also restricts views to exactly what workers need, eliminating the confusing overload of unnecessary information. An injured worker pursuing a claim will find it easier to review his or her workers’ compensation and Washington L&I rights, understand workers’ comp injury data and statistics, verify workers’ comp coverage, and complete insurance forms. These changes promise to ease the burden on workers who depend on this web tool for information about injury claims.

The new L&I website also makes the most of its available space by consistently packaging information into succinct titles and removing duplication of information, such as contact information and Spanish translation for non-ESL workers.

Of the many revisions to the L&I site, one of the most effective is a new tool that permits a site user (commonly a worker with an L&I covered injury) to maintain a set of links packaged specifically for that worker. For example, a worker who suffered a back injury on the job could build links and bookmarks about necessary claim information, PPD awards related specifically to his or her injury, relevant contact information, and crucial information the worker would need if he or she found it necessary to appeal a claim with the Washington Board of Industrial Insurance Appeals. These links would remain consistently available regardless of the user’s navigation to other locations on the site. A review of the new site is available at http://www.lni.wa.gov/refresh.

Previously, an injured worker in need of advice might navigate the L&I website without access to important links that remained buried in inconspicuous locations. New content and links refer an injured worker directly to information about pursuing claims or appeals for his or her injury.

For more information, please visit Emery Reddy, PLLC online, or contact us via telephone at (206) 442-9106.

Emery Reddy represents plaintiffs in L&I, employment law and personal injury matters.  The firm and its attorneys are trusted advocates for Washington workers who experience job related injuries.