Here’s the thing about workers’ compensation coverage: from the employers’ perspective, it’s an expense that impacts the company’s bottom line and total profits just as much, if not more, than it is a way to help employees who have been on the job.
Those workers’ compensation insurance policies can be expensive. Very expensive.
In fact, news reports last week had Illinois manufacturers pointing to the high cost of workers’ compensation coverage as a reason why their industries are hurting. According to the Illinois Manufacturers’ Association, the fact that Illinois has very high workers’ compensation rates means that companies in Illinois cannot compete with companies that don’t have this expense in their balance sheet. The Illinois companies cannot cut their prices, so they argue business goes elsewhere — like Indiana, where workers’ compensation is much cheaper than Illinois.
Companies Don’t Like Workers’ Compensation: It Hurts Their Profits
The cost of workers’ compensation is a big deal right now. Which is why all across the country, big corporations are trying to find ways to cut back on their workers’ compensation costs. And they are succeeding. Never mind how it’s impacting their workers and the workers’ families.
For more, read our earlier post and the current effort by members of Congress to get the Department of Justice to help here and increase federal oversight of workers’ compensation programs across the country.
It’s not just corporations trying to find ways to skirt around having to have coverage, like the opt-out strategies trending nationwide. Even if they acknowledge their workers’ compensation policy, they may still have lots of tricks up their sleeve to try and limit their exposure or liability.
One way to keep costs down: argue that the worker isn’t covered by the plan because they aren’t an “employee” as defined under the labor and employment laws. Instead, the injured person was an “independent contractor” and not covered by the workers’ compensation plan. (Companies don’t have to provide accident coverage for independent contractors hurt while working on a job for them. They only have to cover their employees.)
Another tactic: try and cut those costs regardless of the best interests of the injured person. Strategies here include things like:
- asking the treating physician to give the injured worker cheaper generic drugs or to prescribe an over-the-counter pain pill instead of a more powerful prescription pain medication (which will cost more to provide, though it may give the patient better relief); and
- requesting that therapy visits be scheduled after work hours, so the worker doesn’t have to miss work and the company then have to pay lost wages (forget that you are asking a recovering person to work a full shift and only then do therapy even though they’re hurt).
Fighting for Justice When Injured On the Job in a Work Accident
Work injuries are covered by state workers’ compensation laws in Indiana and Illinois. Both states have workers’ compensation programs established to help workers hurt or killed on the job. These programs not only cover medical expenses, they also provide the worker and her family with payments to cover lost wages because the person cannot work due to their injuries. Together, covering wages and providing accident coverage, are called “workers’ compensation benefits.”
Which sounds great until the worker actually starts needing help with the workers’ compensation plan.
1. The Claims Process May Mean Fighting With an Appeal
Filing a workers’ compensation claim to get the proper amount of damages and coverage can be a difficult fight. While both Illinois and Indiana provide coverage for things like lost wages and medical bills, each state has a bureaucratic system.
- In Indiana, things are overseen by the Workers’ Compensation Board of Indiana.
- In Illinois, it’s the Illinois Workers’ Compensation Commission.
Granted, millions of dollars are paid out each year in state workers’ compensation coverage. Indiana, for example, paid over $6.4 Million in workers’ compensation benefits in 2014.
Still, claims can easily be denied, and are. There is an appeals process which is there to help with denied claims, but it’s can be a maze of difficulty to get through and find justice. For injured workers trying to handle the paperwork themselves, it can mean months or even years of frustration.
2. Strict Requirements To Meet Under the Plans
Under each state’s law, there are rules and regulations that apply both to the employer and the employee. It’s possible for the employee to doom his own claim by failing to follow these rules and regulations. For instance, in Indiana, even if everyone saw the accident and knows you are hurt, it doesn’t matter insofar as workers’ compensation claims. There is a duty placed upon the employee to provide a written notice (yes, there’s a form) to the employer that they have been hurt on the job.
That’s not all. This notice has to be detailed. It has to be given to the company within 30 days, too. That’s the deadline.
3. Liability of Third Parties for the Injuries
All of this does not begin to cover the possibility that the cause of the accident is not the employer’s negligence but instead the fault of a third party. There are accidents on work sites, particularly ones with specific industrial equipment, machines, and tools (think construction, for instance) where a defective product may have caused the harm. Or perhaps a subcontractor who is independent of the injured worker’s employer is legally the cause of the accident.
There may be facts at the accident site or among the company documents that helps to support a personal injury or products liability claim against a company that is totally independent of the employer. These claims will proceed under standard personal injury law and not involve the state workers’ compensation plans.