The United States Department of Labor issued a scathing report on how states handle their workers compensation systems and the fact that injured workers are often led into poverty, because of an injury on the job. The report recommends additional Federal Government oversight to help injured workers overcome state deficiencies in state systems.
Four reasons I note here from the report are legitimate concerns I hear often.
- Increased denials due to decreased benefits
- Decrease in adequacy of benefits
- New procedures and evidentary guidelines that create barriers
- Quality of care
In my practice, #2 and #4 above are significant. First, Pennsylvania does provide the Federally suggested 2/3 compensation rate based on the injured workers’ average weekly wage. In fact, lower wages in Pennsylvania get 90% of their average weekly wage. However, when workers are living pay check to check, taking a 1/3 reduction in pay is financially devastating. It is increasing poverty rates. I see it on a daily basis. I have seen injured workers have to put their home in foreclosure, or move in with family, or borrow money from family and friends. It is truly sad. Their is just a big misnomer out there that people sit on workers compensation and soak the system. Believe me, that is an absolutely rarity. First, insurance companies have Attorneys. Those attorneys will take legal step to limit or eliminate benefits to an injured workers when the medical records no longer supports disability. Pennsylvania has a healthy litigation system that allows employers several avenues to terminate, suspend, or modify benefits for an injured worker. Many of my injured clients are struggling to try and get back to work because they can’t afford to stay on workers compensation.
Additionally, the state mandated 90 day panel provision has been an absolute disaster. I would argue as well, that provision has also caused an increase in medical costs to the workers compensation system in general.
Let me explain. Currently, in Pennsylvania, if you have an accepted injury, AND your employer complied with the panel provider requirements, you must treat with a panel doctor for the first 90 days. The employer provides the injured workers a list of doctors and they must treat on that list. (There are very specific issues involving the panel list and requirements. If you have questions, give Mooney & Associates a call at 717-200-HURT). Often times, examinations are not that in depth. Panel providers purposely try to keep costs down, failing to undertake diagnostics tests, such as X-Rays, MRI, EMG, or CT Scans. Furthermore, many times panel doctors send clients back to work under limited restrictions, well before they are physically ready to return to work.
The panel provider provision was implemented to help control costs. I see on a daily basis the opposite occurring. I see workers put back to work too soon and the end result being a more severe and expensive injury than the initial injury. I see the lack of diagnostic tests that lead to incorrect diagnosis, furthering more substantial costs down the road. I see mediocre treatment at best for 90 days that leads to a worsening condition, which of course could have been avoided with appropriate care. I see injured workers suffering in pain from their work injury and getting very little relief for the first 90 days. The panel provision in Pennsylvania has been an absolute failure. In my opinion, it has led to the exact opposite outcome than the intention of the provision when implemented.
If you have been injured at work, don’t make serious missteps in your case. Call Mooney & Associates RIGHT ALWAYS to protect and fight for the benefits you may be entitled to under the Pennsylvania Workers Compensation Act. For a FREE consultation, call us today at 717-200-HURT or 1-877-632-4656.