Wednesday, April 1, 2009, 08:05 PM - Understanding the CA WC system"Meatball justice". A "MASH unit". A "subbasement of the legal world".
"Forget about personal. They don't think of you as a person. They think of you as a file with a dollar sign on it. They don't care if you can't put food on the table or put braces on your daughter. You're thinking of this logically. I stopped thinking that way a long time ago. This is comp."
Sounds like a day at the Los Angeles WCAB or one of many other California Workers' Compensation Appeals Board district offices?
Could be. But these quotes are from this week's New York Times 3-part series on the state of New York's workers' comp system (links to the articles are at the bottom of this blog post)
Written by N.R. Kleinfield and Steven Greenhouse, the series highlights a workers' comp system in great disarray.
Delays are said to be rampant. Fines against insurers for infractions are small, and many insurers ignore fines for years. Doctors shy away from treating comp cases. "Trials" where the worker barely gets a chance to speak. Hack doctors who tailor their opinions to please the hand that feeds them. Workers whose lives are upended by the economic and social fallout from their injuries. Claims of fraud which are hard to quantify.
Recognize any of these as themes in the California workers' comp system?
But as bad as aspects of the system are here in California, the series paints a picture of an even more decrepit New York system. At least here in California we have what is-for the most part- a very able and concientious applicant attorney bar that seeks to advance the interests of disabled workers.
Read the series and compare the systems for yourself.
For years New York has had a system that was among the most expensive for business and yet stingiest for workers. Some changes were enacted under Elliot Spitzer before his call-girl debacle. But New York has a long way to go.
Thanks to the Times for doing such an in-depth investigation. Unfortunately, with newsroom staffs shrinking and the survival of many newspapers in doubt, this is the kind of piece that we may be seeing less and less of.
As a blogger, I strive to be fair and accurate (readers are invited to kick my butt if I get it wrong), but the blogosphere will never be able to do the kind of sustained muckraking that is evident in these articles:
"For Injured Workers, A Costly Legal Swamp"
http://www.nytimes.com/2009/03/31/nyreg ... &scp=4
"Exams of Injured Workers Fuel Mutual Mistrust"
http://www.nytimes.com/2009/04/01/nyreg ... amp;st=cse
"System to resolve Workplace Injury Leaves Ill Will On All Sides"
http://www.nytimes.com/2009/04/02/nyreg ... p.html?hpw
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Tuesday, March 31, 2009, 07:31 AM - Political developmentsThe California Supreme Court will be hearing another workers' comp case.
On the Court's website is a note from its conference of 3/25/05 that the Petition for Review was granted in Hertz Corporation vs WCAB (Aguilar).
To se an earlier post I did on the Aguilar case, click here:
http://workerscompzone.com/index.php?en ... 223-213426
Stay tuned. I'll be commenting soon on the recent letter to the WCAB from John Duncan of the Department of Industrial Relations.
Wednesday, March 25, 2009, 10:15 PM"The Fight of the Century"?
We're not talking The Thrilla in Manila... Sugar Ray Robinson vs. Basilio..Marciano vs. Jersey Joe Walcott... Duran vs. Leonard...Foreman vs. Lyle... Hagler vs. Hearns... or Emile Griffith vs. Benny Paret.
Those were some bouts. Ah, the sweet science.
No, today we're talking comp. "The Fight of the Century", in comp, that is.
That's the hype for a seminar series sponsored by the defense law firm Bradford and Barthel on the recent WCAB en banc decisions in Almaraz and Guzman.
Bradford and Barthel represented Milpitas (a small city on the Santa Clara/Alameda County line) in the Guzman case. Almaraz arose out of Bakersfield. The cases could be headed toward different Courts of Appeals.
Bradford and Barthel has now filed a 100-plus page Petition for Writ of Review with the 6th District Court of Appeals. Courts of Appeals take workers' comp cases at their discretion, and most writ petitions in workers' comp are denied.
I'm aware that some in the comp community expect the courts to defer to the WCAB, particularly where the Almaraz/Guzman decisions were the result of unanimous decision by commissioners all appointed or reappointed by Gov. Schwarzenegger.
But the 6th District Court of Appeals has been somewhat unfriendly to worker interests. A recent 6th District decision, Hertz vs. WCAB (Aguilar) has been vociferously criticized by some comp commentators.
I'll be very surprised if the court does not elect to take the case.
Perhaps the "Fight of the Century" is not hype after all.
The Petition for Writ is long, and not for the faint of heart.
Click here to view the Guzman Petition
I'll be covering this in more depth in coming days.
Monday, March 23, 2009, 10:57 PM - Political developmentsAccording to the San Jose Merc, Lt. Gov. John Garamendi is said to have likened workers' comp issues to cockroaches, noting that they are impossible to kill.
Every half decade the system goes from broken to fixed to broken again.
The issue de jour? Fast rising workers' comp medical treatment costs.
The Merc's solution? Broadly based healthcare reform. Until health costs generally can be brought under control, treatment costs in the comp system will follow the general spiral.
Here's the Merc's take:
But in California, healthcare reform efforts have fizzled. In Washington, the rubber is about to meet the road. Trying to launch a major healthcare reform at this particular moment is like launching a vessel in the midst of a perfect storm. The recent Congressional Budget Office report, which questions underlying budgetary financial assumptions, threatens to ground Obama administration attempts to sculpt a healthcare reform by funding up front costs.
Here's the CBO's report:
http://www.cbo.gov/ftpdocs/100xx/doc100 ... Budget.pdf
It will take a lot more than thousands of canvassers from "Obama's
Army" to keep this plan on track. Look for Obama's budget to be undergo major surgery soon, with either more modest reform plans or some serious priority setting (which is more important, climate cap and trade policy or healthcare?)
Since I began this blog I've steadily supported efforts to create a plan which would include elements of universal coverage and limits on overhead and profits of health insurers. Or a single payer system.
But I have to agree with Democratic Budget Committee chair Sen. Kent Conrad. Speaking to George Stephanopoulos this past Sunday, Conrad noted this is not an issue that should be resolved through the "reconciliation process" (a parliamentary maneuver used to resolve some simpler budgetary issues in Congress). But there is great pressure from some to run with the issue, even if it means jamming a plan in the face of trillion dollar deficits.
Healthcare reform deserves debate (and compromise) of the old-fashioned variety.
The stakes are high. And there are implications for California workers' comp. If you're not watching, you should be.
Saturday, March 21, 2009, 12:31 PM - Political developmentsI recently attended a panel at the on the current California workers' comp insurance market at the DWC's annual conference in Oakland. As the panel wrapped up and took a few questions, I asked whether-given the turmoil at AIG's parent company-they had concerns about AIG's workers' comp subsidiaries as we go forward.
The response from the panelist who took the question? There is no great concern about the viability of AIG's units writing California workers' comp.
But is that the case?
Newsweek writer Michael Hirsh has published a piece, "The Next AIG Scandal?" (a link to the article is at the end of this blog post)
Hirsch cited allegations by an industry veteran that "AIG's supposedly solvent insurance business may be at least as troubled as its reckless financial-products unit".
Hirsch's source claims that the "as-yet-undiscovered problem" may be in reinsurance slight of hand and the way risks were carried on AIG's books, with "the vast majority of AIG's reinsurance contracts" being "negotiated internally among its affiliates".
These are serious allegations. Perhaps the allegations aren't true and are just sensationalist paranoia to kick the company more when it is down. But if they are true, and if there is a undiscovered iceberg lurking out there, this would be of great concern for the California insurance market. AIG is a major player in the California workers' comp market.
AIG has been a company that seemingly played by its own rules. But it's beyond the scope of my expertise and data access to fathom the truth of these particular allegations.
But one hopes that Commissioner Poizner's folks at the California Department of Insurance or AG Jerry Brown will look into these allegations and do whatever due diligence needs to be done.
Here's the link to the Hirsh piece:
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