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| Office of the Chancellor / Public Affairs |
Monday, February 16, 2004
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Sacramento Bee 2-15-04 Daniel Weintraub: How to get state workers comp that really works |
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| Californians who are injured at work spend more time off the job than do people in almost every other state. Is the Golden State inherently a more dangerous place to work? It doesn't seem to be. Do workers here suffer more crippling injuries? No. Is the health care in California substandard? That's never been alleged. But here's a clue that might lead somewhere: Californians who are hurt on the job are also more likely than workers elsewhere to hire a lawyer to help them navigate the system for compensating injured workers. They hire lawyers because our system is more contentious than other states, more open to differing interpretations and thus dispute. In other words, it has built-in incentives to fight. Eliminating much of that conflict is one goal of the changes Gov. Arnold Schwarzenegger and his legislative allies are pushing as they seek to overhaul a system that employers say is out of control. Fast-rising insurance premiums are not only eating into profits, they are hindering new hiring and soaking up revenues that could otherwise go toward higher wages. A comprehensive national study of workers compensation rates based on premiums charged in January, 2002 found that California was by far the most expensive in the nation. At the time, California employers paid an average of $5.23 in workers compensation premiums for every $100 of payroll. The next highest state, Florida, was at $4.50, or 16 percent less. Only seven states had rates of $3 or higher. Since then, California's rates have climbed at least 20 percent. California, not coincidentally, also has the most litigious system. A recent study by the RAND Institute found that in most states, about 10 percent of lost-time claims lasting eight or more days involved attorneys. In Oregon, the ratio was about 15 percent. In California, 30 percent. That litigation is harmful for many reasons. Obviously the lawyers have to be paid. But dueling lawyers also mean dueling doctors, and the competing medical opinions also drive up costs. The bad blood that results makes it less likely that an injured worker will return to the same employer, which means he or she is more likely to be off the job for a longer period of time. What is different about California's system that leads to more conflict? One major factor is our method for compensating permanent disability - an injury that is not going to go away, and one for which the employee is compensated even if he or she returns to the same job with the same pay. Some of these injuries are clear cut and compensated in part according to a schedule set in advance. A severed finger, for example, is worth a certain amount, depending on whether the worker is a typist or a truck driver. These injuries tend not to be disputed: A doctor can certify that a finger was amputated and be done with it. But California, unlike most other states, also allows compensation for permanent disabilities that cannot be so objectively measured and quantified. A sore lower back. Aching wrists. Mental stress. In many cases, doctors simply have to take the injured worker's word about the extent of his or her pain and the effect on the worker's ability to return to the job. These objective and subjective ratings are added together to determine the extent of the disability. That number is compared to a separate estimate of the employee's reduced capacity to perform functions such as lifting, bending or sitting for a long time. Each method leads to the calculation of a potential benefit. The worker then gets the higher of the two amounts. California also allows, in disputed cases, the worker and the employer to each obtain a doctor's opinion. The RAND study compared the ratings typically delivered by each. Not surprisingly, doctors hired by the injured worker tended to assess the injury as more serious; doctors hired by the employer tended to rate it less so. The average spread was 34 percent. Among the possible fixes: Eliminate permanent disability payments for injuries that cannot be objectively measured (that's Schwarzenegger's proposal). Or base such payments only on the documented diminished ability to work. Or drop the dueling doctors and go straight to a neutral third party. The goal should be to reduce the incentives for conflict, get the injured worker back on the job as quickly as possible and maximize compensation for employees whose serious injuries prevent them from returning to work at all. It's a complicated issue, with winners and losers from every change.
But the governor and legislators ought to be able to find a solution if
they focus on the employers who pay the bills and the injured workers
who need the help and stop obsessing on the demands of the doctors, lawyers
and insurers in the middle. |
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