New York’s Workers’ Compensation Reform

Here Are The Six Ways The Proposed Reform Will Affect You

1. The Aggreagte Fund will be removed making it more difficult for disabled workers to get the compensation they need.
2. Injured workers will be forced to choose a doctor from a list rather than going to their trusted personal physican.
3. The Workers’ Compensation Board will be able to assign cases to any judge, at any time.
4. The new lost earnings calculation will reduce the amount injured workers will receive.
5. Changes to the appeal process would mean any single Workers’ Compensation Board member with a law degree could determine the outcome of an appeal, instead of a panel of Commissioners.
6. The Workers’ Compensation Board would be able to remove any doctors from the system that will not sign a authorization agreement.

Introduction to the New York Workers Comp Reform

While it may seem like workers’ compensation is an idea that was invented along with the Industrial Revolution, the fact is that the idea of compensating an employee for their loss has been around for thousands of years. Ancient Greeks and Romans had laws which gave guidelines as to the type of monetary compensation that should be provided for specific injuries.

Modern day workers’ compensation insurance began under Chancellor Otto von Bismarck in Prussia, who began to fight for what he called Workers’ Accident Insurance in 1884. The United States began to pass laws protecting workers in 1906.

Why Workers’ Compensation Is Important

Every employer in New York is required to have workers’ compensation insurance. Workers’ compensation is supposed to benefit both the employer and the employee. Coverage should provide injured workers with:

• payment for medical care if they are injured on the job
• compensation for lost wages if they can’t return to work due to their injury
• compensation for families whose loved ones were killed while working
• partial or total disability payments if the injury is so serious that it keeps the employee from returning to work

In addition, if someone accepts workers’ compensation benefits, they can’t pursue legal action against their employer. This doesn’t prevent them from filing against a third party, however, the employer is safe.

The system isn’t perfect though and many injured workers’ spend months or years fighting to get what they need.

Problems With Workers’ Compensation

There are some very serious issues with workers’ compensation. Sadly, insurance companies, who are supposed to help in a time of need, are often more concerned with keeping money for the company than paying for employees care.

First, while medical expenses are supposed to be covered if the treatment relates to the employee’s injury, insurance companies frequently try to avoid paying for medical expenses by saying that certain surgeries and treatments require pre-authorization before they are performed. When it comes to lost wages, only a fraction of the wages the employee would have made will be paid out – typically not enough to pay the bills and survive on while they heal.

Additionally, workers’ compensation doesn’t pay for the physical and emotional pain and suffering that the injured experiences.

Since workers compensation was first introduced to the U.S.  many reforms have been made in an attempt to perfect the system, some of which favor the employee, but many of which, like recent proposals, put employees at a disadvantage and favor the employer. Since the early 2000’s, more than 30 states have created reforms which have reduced the benefit that injured workers can recover, restricted the amount of time an employee can collect for, and have set limitations on which doctors a worker is allowed to seek treatment from.

Today, another reform has been proposed in New York by Governor Cuomo, and business owners are embracing it for the savings they will receive. Unfortunately, this is another reform that will be an obstacle for injured workers and could potentially leave many financially stranded.

Current Proposed Reform In NY

The proposed reform would change numerous things including the removal of a deposit that is currently required by insurance companies and would extend the use of managed care doctors for another 120 days. It would also mean that a two-year cap would be placed on the “improvement period” granted to seriously injured and permanently partially disabled workers.

Currently, when a worker is prevented from doing their job because of an injury, they are given an improvement period in which they have time to reach their maximum level of improvement. Once they have healed to this maximum level, a ten-year time period for limiting compensation begins. But the improvement period can take years, especially for those who have suffered a brain or spinal injury. A two-year cap would mean another reduction in benefits to injured workers.

Six Ways The Reform Will Affect All Injured Employees

After a review of the entire reform, it is clear that workers will have their benefits limited due to:

The Removal of the Aggregate Fund

The proposed reform would completely eliminate the Aggregate Fund, which is a fund that was created in 1935 to assure those who are partially or permanently disabled or who lost a family member due to a fatal work accident, would receive payment. There was already one reduction for disabled workers in 2007, an additional one would wreak havoc on people’s lives.

Limitations Regarding The Choice Of Doctor

Employees who have been hurt should have the ability to choose who they will be treated by. This reform would mean that an injured worker would have to choose a doctor from a list provided by their employer, not seek care with their own personal provider. It would also allow the Workers’ Compensation Board to regulate any doctors that employers may present as options.

Changes To How Cases Are Assigned

The Workers’ Compensation Board would be allowed to assign any case, to any judge, at any time. This means that, in some cases, a decision may be reached by a judge who did not hear the arguments presented by the worker and their legal representation. This essentially means that they wouldn’t be able to have a fair hearing.

Changes To How Lost Earnings Benefits Are Calculated

The new way of calculating lost earnings benefits would reduce the amount that employees in all fields would be able to obtain, but would be particularly damaging to anyone who works two jobs in order to pay the bills.

Changes To The Appeal Process

Anyone who has had their workers’ compensation benefits denied has the right to pursue an appeal. This reform would reduce the number of Commissioners on the review panel and would let any single Commissioner or attorney who works for the Workers’ Compensation Board to make a decision regarding an appeal. Currently, appeals are presented to a panel of three Commissioners, to ensure that a fair review is given.

Power Given To The Workers’ Compensation Board Over Doctors

The Workers’ Compensation Board would be allowed to make doctors sign an authorization agreement and the Board would also be given the power to eliminate doctors from their system if those doctors don’t follow the agreement. Medical societies would no longer have the power to qualify who is capable of treating injured workers.

What Can Be Done To Stop This Reform?

A petition, which will be delivered to the New York State House and the New York State Senate, has been created. You can sign the petition here.