What Price an Arm or a Leg?

Taken from here 

In 19th century capitalism, if a worker got hurt, he lost his job, had to rely on charity from friends, neighbors, family, the church, while the owner of the business went right on making a profit. It is now becoming the same today. We're all commodities and once we're injured, we're damaged goods and have no value.

Over the past decade, US states have slashed workers’ compensation benefits, denying injured workers help when they need it most. State after state has been dismantling America’s workers’ compensation system with disastrous consequences for many of the hundreds of thousands of people who suffer serious injuries at work each year. The cutbacks have been so drastic in some places that they virtually guarantee injured workers will plummet into poverty. Workers often battle insurance companies for years to get the surgeries, prescriptions and basic help their doctors recommend. The cuts have gone so deep in some states that judges who hear workers’ comp cases, top defense attorneys for companies and even the father of the modern workers’ compensation scheme say they are inhumane. Recently, some judges have questioned whether states have cut too deeply in the name of saving employers money.

In August 2014, a Florida circuit court judge ruled that the state’s workers’ comp law was unconstitutional, saying benefits had been “decimated” and the law “fails miserably” as to safety, health, welfare and morals. If the ruling is upheld, workers in Florida would be able to sue their employers, and the legislature would have to rewrite the law.

 “The only interest that’s being protected here is industry,” said Judge John C. Gutierrez, a Californianworkers’ comp jurist for 22 years, “I feel that their financial influence has had an impact on how this legislation came out.” Workers, he said, “are losing their voice.”

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 The changes, often passed under the banner of “reform,” have been pushed by big businesses and insurance companies on the false premise that costs are out of control. In fact, employers are paying the lowest rates for workers’ comp insurance since the 1970s. In 2014, employers in North Dakota paid the least, averaging $0.88 for every $100 they paid workers in wages. In 1988, North Dakota averaged $2.39. California employers pay the most: $3.48, which is still far cheaper than the rates they paid in 1988.And in 2013, insurers had their most profitable year in over a decade, bringing in a hefty 18 percent return. Sen. Bob Casey, D-Pa., one of the leading worker advocates in Congress, said the changes undermine the basic protections for injured workers. “They call them reforms,” Casey added. “That’s a real insult to workers.”

In the early 1970s when Congress established a commission to study state laws as part of the Occupational Safety and Health Act led by John Burton, a Republican economist and law professor, the commission unanimously concluded that state laws were “inadequate and inequitable.” The recent changes are “unprecedented in the history of workers’ comp,” Burton said in a recent interview. “I think we’re in a pretty vicious period right now of racing to the bottom.”

Legislators who pushed through cuts in their states, however, insist they are necessary to keep and attract business. “That was always the number one issue,” said state Sen. Brian Bingman, the Republican president pro tem of the Oklahoma Senate. “Your workers’ comp rates are way too high.”

Oklahoma cut benefits three times between 2005 and 2011, resulting in a 10 percent drop in employers’ insurance rates. But other states experienced even steeper drops in costs, leaving Oklahoma comparatively expensive, he said, especially against neighbors like Texas and Arkansas. So the state chamber of commerce cut the maximum wage-replacement benefits for injured workers from $801 a week to $561 a week. The new rate was the third lowest in the country. The chamber’s lobbyist, Jonathan Buxton, rationalized the cuts as tough love for Oklahoma workers. “Getting them healed and back to work is the goal of our system, and it’s better incentivized now,” he said.

ProPublica analyzed the data and found:

 Since 2003, legislators in 33 states have passed workers’ comp laws that reduce benefits or make it more difficult for those with certain injuries and diseases to qualify for them. Florida has cut benefits to its most severely disabled workers by 65 percent since 1994.

Alabama is among the worst states in terms of compensation when an Alabama legislature capped the amount of lost wages that an injured worker could receive at $220 a week in 1985, and never tied the amount to inflation. The 1985 cap persists, meaning that an injured worker in Alabama can receive only up to $11,440 in workers’ compensation per year, below the poverty line for a single person and not even half the poverty line for a family of four. And benefits don't last long: Those who lose an arm, for example, are only paid for four years.

Where a worker gets hurt matters. Because each state has developed its own system, an amputated arm can literally be worth two or three times as much on one side of a state line than the other. The maximum compensation for the loss of an eye is $27,280 in Alabama, but $261,525 in Pennsylvania.

Many states have not only shrunk the payments to injured workers, they’ve also cut them off after an arbitrary time limit — even if workers haven’t recovered. After John Coffell hurt his back at an Oklahoma tire plant last year, his wages dropped so dramatically that he and his family were evicted from their home.

Employers and insurers increasingly control medical decisions, such as whether an injured worker needs surgery. In 37 states, workers can’t pick their own doctor or are restricted to a list provided by their employers.

In California, insurers can now reopen old cases and deny medical care based on the opinions of doctors who never see the patient and don’t even have to be licensed in the state. Without examining Ramirez or even sending someone to assess his daily struggles — his former employer’s insurance company terminated the home health aide he relied on.Joel Ramirez, who was paralyzed in a warehouse accident, had his home health aide taken away, leaving him to sit in his own feces for up to eight hours. Ramirez had worked for 17 years at Kuehne and Nagel, the second largest freight forwarder in the world. One day in July 2009, his boss asked him to move a crate. A nearly 900-pound crate loaded with boxes full of satellite dish mounting poles came crashing down on him. The crate, which OSHA said had been unsafely stacked, folded Ramirez’s body in half, crushing his spinal column and pinning his head between his feet. A judge ruled him permanently and totally disabled and awarded him coverage for future medical care. The system appeared to be working. But a month later, the governor signed the new law, making old cases like Ramirez’s subject to the new review process. In Ramirez’s case, Travelers Insurance relied on the opinion of a doctor with no background treating spinal cord injuries who later withdrew his opinion and said he didn’t know he was denying 24-hour home health care.

Under the new process, disputes are decided by independent medical reviewers chosen by a state contractor. These doctors, many of whom are licensed out of state, rely solely on medical records and remain anonymous. Their decisions can’t be overturned except in limited cases. Lawmakers also added a surprising twist: The medical dispute process wouldn’t just apply to new cases, but retroactively. Suddenly every treatment request in the system — whether it be for surgery or a simple prescription refill — could now be subject to reviews by insurance company doctors and compared against more rigid medical treatment guidelines that might not have been in place when care was approved. When the law took effect for old cases in July 2013, it quickly proved as problematic as the one it replaced — and insurance premiums went up. A process that was supposed to take less than six weeks has often stretched to six months. And reviewers routinely rule against injured workers’ doctors, denying treatment in 91 percent of disputes, according to preliminary data to be released this month by the California Workers’ Compensation Institute

In North Dakota, Dennis Whedbee, a 50-year-old derrickhand, was helping another worker remove a pipe fitting on top of the well when it suddenly blew.Oil and sludge pressurized at more than 700 pounds per square inch tore into Whedbee’s body, ripping his left arm off just below the elbow. His doctor said he’d be an ideal candidate for a modern prosthesis with a movable hand. But North Dakota’s workers’ comp insurer sent him to another doctor — not in North Dakota or his home state of Pennsylvania — but in Minnesota. After seeing him once, that doctor recommended a cheaper prosthesis with a metal hook. Unbeknownst to Whedbee, since the early 1990s, North Dakota has steadily made it harder for workers to get benefits for their injuries. A company recently hired by the state auditor to review the system found that when disputes occur, North Dakota’s Workforce Safety & Insurance agency (WSI) — the government entity that is the state’s sole workers’ comp insurer relied entirely on out-of-state physicians mostly working for private companies that perform medical reviews for insurers. These doctors reversed the recommendations of workers’ physicians 75 percent of the time, the September report by Sedgwick Claims Management Services found. WSI’s own medical director, Dr. Luis Vilella, questioned the impartiality of medical decisions in a letter to WSI’s top administrator last year, saying the agency’s lawyers overrode valid medical opinions and diagnoses to beat back the appeals of injured workers. Vilella resigned in August 2014.

“I lost a hand,” Whedbee pleaded with the insurer to no avail. “I didn’t lose a hook… I deserve as normal a life as I had before the accident”

In March 2014, Whedbee’s attorney, Stephen Little, told the North Dakota Supreme Court that WSI was looking for the cheapest solution. Whedbee was more than a “wage slave,” he wrote in his brief. He was also “a Little League coach, hunter, fisherman, bicyclist, outdoorsman, taxidermist and cook.”

John Coffell, 30, a tread booker at a Goodyear Tire & Rubber plant in Lawton, Oklahoma, felt a pinch and burning sensation in his lower back. “As time went on throughout the night, it got worse and worse and worse,” he said. “It hurt when I walked. It hurt when I stood up. It hurt when I sat down.” When the pain didn’t go away, he was prescribed physical therapy and placed on temporary disability. If Coffell had been hurt a few months earlier, workers’ comp would have provided close to his take-home pay. But under the new law that took effect in early 2014, his disability check was capped at $561 a week — just above the poverty line for a family of five. With less money coming in, things slid downhill quickly. The utilities went first, followed by Coffell’s truck, which was repossessed. Then the family received a letter from their landlord evicting them from their rental home then the family had to split up.

ProPublica’s review of workers’ comp changes nationwide found that many were steered by big business, aided by the recent Republican takeovers of state legislatures. In the previous cited case of Oklahoma cuts it was spearheaded by a group led by retailer Hobby Lobby and Unit Corp. The reforms were mostly driven by the recessions of 2001 and 2007-2009, which pitted states in a seemingly endless competition to lure business with lower costs. Even in states dominated by Democrats, worker advocates have been forced to make major concessions to achieve slight increases in benefits — sometimes just to keep up with inflation. Florida, New York and Tennessee have chopped compensation for workers with permanent partial disabilities — such as debilitating back injuries — by at least 20 percent. In California, West Virginia, North Dakota and Oklahoma, lawmakers have placed time limits on wages for temporarily disabled workers, limiting such benefits to two years even for those who can’t go back to work or need more medical care. Few of the cuts were driven by concerns about fraud, which is estimated to account for only a small percentage of the $60 billion spent on workers’ comp each year. And studies show most of the money lost to fraud results not from workers making false claims but from employers misclassifying workers and under-reporting payroll to get cheaper insurance rates.

On top of reducing benefits or capping the time injured workers can receive them, states have found another way to cut workers’ comp costs: shifting control over medical decisions from workers and their doctors to employers and their insurers. Thanks to a 2011 reform in Montana, for example, once insurers accept claims, they can choose workers’ doctors and change them at any time. In 2013, Georgia ended the promise of lifetime medical care for workers’ injuries, capping it at eight years for all but the worst cases. As a result, workers who have had hips or knees replaced because of workplace accidents may be out of luck when the devices wear out. Other states, like Illinois and Delaware, have enacted more subtle changes, such as placing strict caps on payments to doctors and hospitals through medical fee schedules. The measures help control costs, but, critics say, they also cause some doctors to stop taking workers’ comp patients.

It's astounding that so many average Americans leap to the defense of the "job creators" when they are only one injury away from ending up like any of the people in the above article. American workers are being slowly robbed of their rights, health and compensation. No union protection, no workmen's compensation, minimum wage jobs, deteriorating working conditions, and demands for greater output will soon have American workers on a par with Chinese worker in forced labor factories. We are witnessing the growing corporate oligarchy deconstruct American democracy and return the world's industrial nations into feudal states run by financial elites only interested in profits. The wealthy have the best health care in the world and the rest of us are left with the scraps. We live in an era where profit trumps all. Workers comp is considered an expense to be slashed at any cost – less expenses equals more profit. The Oligarchy that really runs the United States have their pawns elected to do their bidding in Washington and state legislatures. Cheap labor enriches the wealthy.