Benefits for injured workers are under attack in many- if not all- states around this country. As a member of the Worker's Injury and Law and Advocacy Group (WILG), I attended a national conference recently regarding the status of worker's compensation systems and benefits around the country. Sordid tales exist. Despite the political positive talking point about the benefits from worker's efforts and labor around the country, the reality is continual political and legislative efforts to undermine worker's compensation benefits.
Specifically, in the past 20 years, average total benefits to injured workers have declined by 40%. Running concurrent with the decline in benefits for injured workers over the past two decades are insurance company profits. Worker's compensation still remains a hugely profitable industry - generally the second most profitable line of insurance in the country (second only to auto insurance)! Worker's compensation insurance companies continually reap profits, while simultaneously, workers' benefits are being reduced around the country. There are a host of legislative and statutory mechanisms employed to reduce benefits. These include capping the amount of weeks of medical treatment, medical fee schedules, limitations on attorney's fees, "opt-out" provisions, limitations on claims for occupational diseases and mental health claims, limitations on the definition of "in the course and scope of employment", and limitations on who is or is not an employee...among many other tactics.
In certain states, like Montana and Georgia, there are now caps on the amount of weeks of medical treatment. After a certain amount of weeks of medical treatment (example of 400 weeks), there can be a hard cap on medical treatment liability for the worker's compensation insurance company. Even if a worker's medical treatment continues beyond that date, worker's compensation would have no further liability - which means the health insurance or public taxpayer (through Medicare or Medicaid) ends up holding the bag. This is a direct example of cost shifting to increase the profits of the worker's compensation insurance industry.
So far, Wisconsin has been relatively immune from these ill effects around the country. Listening to my colleagues around the country, the Wisconsin worker's compensation system is still in an envious position. It is a beneficial system for workers, employers, and the insurance industry. Despite our current stable status, injured workers and their representatives in Wisconsin should remain vigilant of the tales of woe around the country.
As a cautionary tale to any legislators considering changes, a recent court decision in Florida declared the worker's compensation system in that state unconstitutional because of its failure to adequately provide benefits to injured workers. Essentially, the "deal" between employers and employees, whereby employees gave up the right to a jury trial in exchange for guaranteed, lesser benefits regardless of fault, had tilted too far to one end, thereby violating due process under the constitution. If politicians go too far in limiting benefits, the worker's compensation system could be deemed unconstitutional - thus throwing injury claims back to the uncertainty of a jury trial.
We have a stable system in Wisconsin-one that generally benefits both workers, employers, and the insurance industry. Any changes to the "great bargain" of worker's compensation could have ill effects for all.