What is the Human Cost?

Saturday, September 24, 2005 | 0

Over the past several years we have watched the legislative process concerning workers compensation in Florida. Of course there is always mention of fraud and exorbitant attorney fees. Of course the fraud is always committed by someone other than the carrier. Of course the answer to the problem is capping claimant attorney fees and further restricting the rights of injured workers. And of course there are no restrictions placed on defense attorney fees while the carriers trample on the rights of those who can't afford to defend themselves.

The concerns are about keeping businesses in the state, about keeping insurance carriers in this state. And of course there are concerns about reasonable premiums and availability of comp coverage, especially for small businesses.

Where are the concerns about the humanity, justice, and well being of those injured and their families? Who is asking who will be willing to work in Florida in the future? Who is asking: what is the human cost of the workers compensation systems across America?

Every day millions of people innocently go to work and do the jobs they were hired to do. They will be most fortunate if they never have a serious work injury. They have control over their futures and the futures of their families. They have control over how many jobs they will work, where, and when. They have control over their financial destiny. They decide when they will retire or when they will not. They have years to plan their retirement funds. They have options for health insurance, life insurance, and disability insurance. They get to choose their own doctors and be an active participant in their health care.

Where are the options for those less fortunate? Where are the options for injured workers? What happened to the exchange made in the exclusive remedy for workers compensation victims? A change I might add that was never voted upon by the working people of America. A change that was forced on us by our elected officials. A change that was intended to do good things but as always politics has corrupted the noblest of intentions.

At first I really thought it was a lack of education on the part of our elected officials to allow something that's intent was meant to be so good to go so wrong. To some degree it is a lack of understanding on our lawmakers part. However it is the job of those elected to office to educate themselves on issues most important to the people they represent. That means all the people.

Not just those with money for campaign contributions.

How hard is it to really fix the workers compensation systems of America?

I think a better question is: who really wants to fix the workers compensation systems of America and at what human cost?

The fixes to the comp system are simple. Instead of fixing the comp crisis once and for all across America, our elected officials put Band-Aids on the problems like moving around deck chairs on a sinking ship. They know their solutions are wrong. They even have trouble convincing themselves that their solutions are the right thing. They know they are responding to the pressures of their party and special interest groups while selling out the average citizen. Most politicians really want to do the right thing I believe, but they are stuck in election campaigns that are expensive and often funded by special interest groups. Believe me for every dollar special interest gives, special interest collects.

They know that they have done nothing to stop the crisis. They know that comp will be back in the legislature each and every year. They know that premiums will continue to climb while benefits decrease and while the rights of those affected decline. They continually pass the buck hoping that they won't have to really address the issue during their term in office. Let the problem fall to the next guy. It is an unpopular subject to deal with after all.

So while all of this is going on what is the human cost? Who suffers in the meantime? Is it just the injured worker? Of course not. It all starts out with a person going to work just like any other day. Then something tragic happens and the person is unfortunate and sustains a serious injury as opposed to one that only needs little medical treatment.

Thus the nightmare begins. The injured employee is sent to a comp specialist who assures him/her that everything is okay. Believing that doctors know what they are talking about and not knowing the hold the insurance carriers have over the comp system the injured worker innocently believes the doctor. He/she returns to work or rests at home believing he/she has only sustained a minor injury.

But then weeks go on and the pain is still there. His/her family becomes frustrated because there is nothing they can do to help him/her. The carrier starts sending you on an IME merry-go-round. Still the injured worker believes he/she is in good hands and the health problems will be taken care of. Then comes the denials of the medical treatments ordered by the doctors the carriers chose for the injured worker.

Then comes the rumors from work. Your coworkers are no longer allowed to talk to you if they want to keep their jobs. Suddenly you start hearing that you are a fraud or you are a malingerer exaggerating your injury. Then you start noticing an unusual car parked outside and hearing from your neighbors that a private investigator is going around talking with your neighbors and insinuating that you are being investigated for comp fraud. Your children become scared because they don't know who is watching them and following them to school as well as following you and your family any where you may decide to go.

Then comes the letter telling you have been fired from your job on trumped up charges or that the company has downsized and unfortunately your position has been eliminated. This is where all injured workers begin to become aware of the hell of a life they have been thrown into as a result of their work injury.

As time goes by you are not getting the needed medical care so you go to the EAO office for assistance. In some cases they are helpful; however if the carrier refuses to work with them you have no other option than to file a petition for benefits. Most injured workers never even think of getting an attorney until they are caught between a rock and a hard place. "Who would have thought I would need an attorney to get benefits the laws say I am entitled to," they often say to me.

Then after exhausting all other avenues the injured worker decides to hire an attorney if he/she can find one to take the case. It normally takes an injured worker approximately one year before considering hiring an attorney. There just are no other options available to the injured worker because the state does not enforce the law.

The injured worker is already feeling insecure and lazy for not being able to work and provide for his/her family. He/she is bored to death because he/she has been working all of his/her life and even though the pain is intense and the medications cause him/her to sleep he/she still feels he/she ought to be out doing something.

After hiring an attorney he/she finds out that this injury is more serious than first thought. He/she is going to be out of work either temporarily or permanently. The ironic thing is the doctor said if he/she had received the prescribed treatment at an earlier date that he/she would already be back to work.

Unknown to the injured worker at this time, the battle has just begun. He/she is in for the fight of his/her life. The family is tired of him/her being sick all the time and the moodiness he/she displays out of frustration in the comp system. The children and sometimes the spouse don't understand why mommy or daddy are no fun anymore. They can't understand why there is never any extra money. Why they can't sit on mommy or daddy's lap anymore. Why can't they go to the doctor when they are sick and why does the electric, water and phones keep getting cut off? Why is there never any food in the house and what has changed so much that there is never enough to eat?

Mommy or daddy always seem so very worried and definitely short tempered. Sometimes he/she never even gets out of bed each day. Mommy and daddy fight all the time. Why can't the doctor just make it all better? The injured worker has become so depressed by his/her treatment in the comp system that he/she begins to lose his/her self esteem. He/she wonders which is worse, the workers compensation system or the initial injury. He/she actually wonders if the family wouldn't be better off without him/her.

Between the pain and depression he/she often thinks of suicide as the only way out of this awful mess. Thank God, there are support groups around to see him/her through the rough times and remind him/her how much his/her family needs him/her.

Then there is the acceptance thing. It is so hard to accept a permanent disability. The injured workers whole future is now shot leaving him/her to the mercy of the workers compensation system for the rest of his/her life and it has been a very adversarial system to live in so far. Could it always be this bad? How will he/she fill the hole left in his/her gut by the reality of his/her injury? I mean who wants to be nonproductive? Who wants to wake up each day and watch the world go by and leaving him/her behind? Somehow the void has to be filled but with what?

He/she can't consistently do anything because he/she has no idea which day will be a good day and which one will be bad. He/she has doctors appointments to go to and he/she tires so much easier than he/she used to. When the pain is bad the meds he/she is on makes him/her sleep all the time.

All of these things wear on the family. Divorces often follow. The spouse and the children are often either on Welfare, Medicaid, or Social Security. No other insurance is affordable and it is now considered a luxury as opposed to a necessity.

The kids are hungry, need new clothes, and need to go to the dentist. Who will be paying for all of that or is that just one of the hidden human costs? The injured worker is so stressed that he/she cannot provide the necessities for his/her family and he/she has no idea how to make things better. He/she draws closer to a nervous breakdown with the draw of each breath.

The older kids drop out of school to help provide for their family. The younger ones just plain don't understand why everything is so different. By now all the money that he/she has saved is gone and he/she is one step closer to homelessness. He/she has already sold everything of any value. Where do I go from here? A week later he/she is now living on the streets compliments of an on the job injury and the comp system. Still a mediation and court date has not been set. It can take years to get to a final hearing in the workers compensation system.

The family has not only fallen apart but has also fallen into poverty and homelessness. The comp carrier is still jerking him/her around with no relief to his/her harassment in sight. The injured worker still has never gotten the prescribed treatment by his/her doctor. The injury is much worse, if not life threatening, and will cost three times more for treatment than it would have had it been treated promptly. The saddest part of this whole thing is that there are laws in place to stop this kind of human suffering. Unfortunately they are rarely, if ever, enforced.

So again I ask at what is the human cost? How long will our elected officials allow this kind of suffering to go on? How long will society itself allow this to go on? There are ways to fix this problem but no one seems to be willing to do that because it is not what the special interest groups want.

When will the injured workers become the true priority of the comp system? The people it was designed for.

by Mary Bailey, president of the injured workers' advocacy group Voices, Inc. Mary can be reached by e-mail at Crs012001@cs.com

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