Tag Archives: return to work

Say Goodbye to Comp

Fellow blogger, Joe Paduda, today wrote a very prescient article about the impact the jobless economy will have on workers’ comp in the coming decades.

While the idea of driverless trucks may be something in the works, there are many factors working against it from becoming reality in the near term, and perhaps for many years to come. Laws and insurance requirements and what to do if the truck breaks down on a stretch of highway not easily accessible by repair trucks or miles from the nearest truck stop, will have to considered before driverless trucks put drivers out of work.

Yet, as Joe points out, manufacturing is already seeing a loss of jobs due to automation and higher productivity, which will lead to lower consumer costs, but will exact an even higher cost on the nation’s stability and will force politicians to come to grips with what to do with a permanently unemployed population, especially those in the service sector, who are being replaced, and will be replaced by automated cashiers, as well as those occupations tied to the workers’ comp industry.

If, as I reported yesterday, that 50% of all jobs will be gone by 2025, what do you do with those individuals who lose their jobs to machines and software?

It is a question that few have asked, and one that fewer have provided answers for. Also, what happens, as I also asked yesterday, if the 50% goes to 75% or higher?

The UBI is one idea floating around, but short of that, what else can we do to put permanently unemployed back into the workforce once technology makes them, in the words of that “Twilight Zone” episode, “Obsolete!”

It makes no sense, Joe states, to reform a system that won’t be around much longer. So, say goodbye to workers’ comp, say goodbye to claims adjusters, occupational therapists and physicians and nurses in same, pharmacy benefit managers, rehabilitation personnel, return to work specialists, case managers, utilization reviewers and bill reviewers, as well as underwriters and lawyers.

Florida Workers’ Comp Outcomes Similar to 14 Other States

Introduction

Earlier this week, the Workers’ Compensation Research Institute (WCRI), released a study that compared the outcomes for injured workers across 15 states. It can be purchased here.

Each state has a separate, multi-page report, so I requested a copy of the report for Florida, as that is where I currently reside (offers of employment elsewhere are greatly appreciated).

As this report has over 100 pages, it is reasonable to assume that 15 such reports would have a combined 1500 pages or more. So, I took the easy way and just looked at one state.

In the introduction to the report, there are two key dimensions of the performance of any workers’ comp system in the US:

  1. Post-injury outcomes achieved by injured workers and;
  2. Costs paid by employers.

The study measured the following worker outcomes:

  • Recovery of physical health and functioning
  • Return to work
  • Earnings recovery
  • Access to medical care
  • Satisfaction with medical care

The study was also conducted in three phases:

  • Phase 1: Eight states (IN, MA, MI, MN, NC, PA, VA, WI)
  • Phase 2: Four states: (IA, AR, CT, TN)
  • Phase 3: Three states: (FL, GA, KY)

The WCRI will collect data from other states and revisit states from earlier phases that implemented reforms to measure the impact of those reforms on outcomes in subsequent phases.

Key Findings for Florida

The WCRI found that workers in Florida reported outcomes that were similar to the median study on some of the key measures, but they reported somewhat higher rates of problems accessing desired services, accessing desired providers, and higher dissatisfaction with overall medical care.

For Recovery of physical health and functioning, they found that for Florida, it was similar to the other 14 states.

For Return to work, injured workers in Florida reported rates of return to work in the middle range of the study. 14% of Florida workers with more than seven days of lost time reported never having a return to work that lasted at least one month due to the injury as of three years’ post-injury; 17% reported no return to work within one year of injury. The median worker in Florida had a return to work about 12 weeks after injury.

For Earnings Recovery, 11% of Florida injured workers reported earning “a lot less” at the time of return to work; the median was 8%.

For Access to care, 21% of Florida injured workers reported they had “big problems” getting the services they or their provider wanted; 20% reported “big problems” getting the primary provider they wanted. Florida was among the states, the study reported, with higher rates of problems of access to care and providers, and higher or somewhat higher than in nine or eight other states.

For Satisfaction with care, the study found nearly three in four Florida workers were “somewhat” or “very” satisfied with their overall care (71%); however, 20% said they were “very dissatisfied”. This was higher than the median of the states, and higher than in 10 states.

Table 1 is a comparison of the medical costs and outcomes between Florida and the other 14 states in the WCRI study. What is interesting to note is that when compared to the other 14 states, Florida had similar outcomes in many of the measures, as the study suggested.

Table 1

Source: WCRI

The study found that medical costs in Florida, recovery of health and functioning, rates of return to work, duration of time before return to work were typical, while problems with getting desired services, and providers were somewhat higher or higher. Satisfaction was lower, but dissatisfaction was higher.

What I found interesting, and perhaps a little disturbing, but not unexpected, was that with the exception of the percentage of satisfaction, all the figures were below 50%, and while the score mechanism for recovery of health and functioning is not further discussed in the Summary, but is mentioned in the notes, those also seem to be very low.

I am not surprised that Florida has a higher percentage of dissatisfaction with medical care, this despite the fact that everywhere you look in Florida cities and towns, there are hundreds of medical offices, clinics, and many hospitals; some large, some small.

What to make of this?

While it is too early to tell how these 15 states compare with the other 35 states, what we can gather from this data is that the workers’ comp systems in these states are falling far short of where they should be in almost all of the measures.

Satisfaction percentages, notwithstanding, there are real issues with the way injured workers are treated in these 15 states.

That Florida is similar to 14 other states in five outcome measures, and not even above 50%, tells me that the industry needs to stop kidding itself that everything is honky-dory. It’s not.

How worse do you think it would be if the only current alternative being suggested is the opt-out option? If workers are not getting back to work or getting better care or better health and functioning under the current state systems, how do you think it would be if states like FL, GA, KY, NC, TN and VA go to opt-out as ARAWC is trying to do?

And without going into the details of each states report, it is hard to know just how much of these outcomes are related to common workers’ comp surgeries that could be provided for by outside medical facilities in other nations in the Western hemisphere?

Denying injured workers, the access to the services and providers they want or need is not a sign that everything is okay, having long-delayed return to work three years after injury is not okay, and earning less after an injury is also not okay.

WHEN ARE YOU GOING TO WAKE UP OUT OF YOUR DREAMSTATES AND REALIZE THERE ARE MAJOR PROBLEMS HERE THAT ARE NOT BEING SOLVED?

WHEN ARE YOU GOING TO STOP LISTENING TO PEOPLE WHO DO NOT WANT TO IMPROVE THE SYSTEM BECAUSE IT ONLY SERVES TO MAKE THEM WEALTHIER OR SOMEONE ELSE WEALTHIER?

WHEN ARE YOU GOING TO REALIZE THAT AMERICAN PHYSICIANS ARE NOT THE ONLY ONES WHO CAN PRACTICE MEDICINE, AND MAY EVEN BE BETTER THAN THOSE HERE WHO ARE ONLY IN IT FOR THE MONEY?

No matter how many studies or reports the WCRI or NCCI, or anyone else issues, until you disavow yourselves of the notion that workers’ compensation is failing and that there are ways to fix it, it will just get worse, until one day it is no longer here for anyone.


I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp.

I am also looking for a partner who shares my vision of global health care for injured workers.

I am also willing to work with any health care provider, medical tourism facilitator or facility to help you take advantage of a market segment treating workers injured on the job. Workers’ compensation is going through dramatic changes, and may one day be folded into general health care. Injured workers needing surgery for compensable injuries will need to seek alternatives that provide quality medical care at lower cost to their employers. Caribbean and Latin America region preferred.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com.

Will accept invitations to speak or attend conferences.

Connect with me on LinkedIn, check out my website, FutureComp Consulting, and follow my blog at: richardkrasner.wordpress.com.

Transforming Workers’ Comp Blog is now viewed all over the world in over 250 countries and political entities. I have published nearly 300 articles, many of them re-published in newsletters and other blogs.

Share this article, or leave a comment below.

A Little Disruption is a Good Thing

Staying on the topic of single payer, this time discussing its impact on workers’ comp, David De Paolo wrote an article today that describes Colorado’s Amendment 69 as a disruption of the status quo, and he points out that the tech industry has disrupted business models and industries for several decades and that the work comp industry needs to be disrupted as well.

He goes on to say that ColoradoCare (Amendment 69) is a debate and idea that is long overdue. The arguments against the idea, De Paolo writes, of a single payer system strikes him as simply entrenched interests seeking to protect their turf and business models.

Earlier this week, Workers’ Comp Insider published an article, “It’s A Colorado Rocky Mountain Low” that opposed the approval by Colorado voters this November of the amendment, using the reasons David cites in his piece, and some of the usual misleading distortions that only confuse voters on substantive issues such as this.

Readers will recall my previous two posts, the first, “Colorado Gets Real on Workers’ Comp and Health Care” which introduced the Amendment and the push to bring the two silos of workers’ comp and health care together, and the second, “Colorado “Single Payer” in Health Care Industry’s Sights” which described the health care industry’s attempts to derail the amendment’s approval.

The issue of combining the two silos was brought up by yours truly in an earlier post, “Betting the Farm“, and as I wrote then, not an original idea of mine. Yet, by reading David’s post, and the one by LynchRyan, you get the feeling that the only reason not to combined the two is greed and protection of vested interests.

Yet, in the business world, mergers happen all the time. And while it is true that some are not approved by the Justice Department or other government agencies, most mergers do take place.

The argument about issues like return to work being the purview of insurance companies under work comp is specious at best, because if we consider two patients, both of whom injure the same body part and require the same surgery to repair that injury, one must be put in a return to work program because he is covered for his injury under work comp; the other does not because his injury is not work-related, but did cause him to miss time from work. Does that make sense? Doesn’t the second patient also need to get back to work?

It is not logical to divide injured individuals by who picks up the check. It is more logical to treat all injuries the same, and to treat all medical issues the same, no matter if they are work-related or not. Getting cancer from occupational exposure to carcinogenic chemicals is no different than getting cancer from smoking, or being genetically predisposed as in breast cancer, or other types of cancer. They both are going to be seen by an oncologist, maybe even the same one if they live in the same area.

So keeping workers’ comp and health care separate and unequal, like education and social accommodations once did to African-Americans, is not only stupid, it is wrong. ColoradoCare is one way this can be accomplished, and as David points out, “Nobody really knows how all of this will play out.”

Maybe it is time we find out.


I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp.

I am also looking for a partner who shares my vision of global health care for injured workers.

I am also willing to work with any health care provider, medical tourism facilitator or facility to help you take advantage of a market segment treating workers injured on the job. Workers’ compensation is going through dramatic changes, and may one day be folded into general health care. Injured workers needing surgery for compensable injuries will need to seek alternatives that provide quality medical care at lower cost to their employers. Caribbean and Latin America region preferred.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com.

Will accept invitations to speak or attend conferences.

Connect with me on LinkedIn, check out my website, FutureComp Consulting, and follow my blog at: richardkrasner.wordpress.com.

Transforming Workers’ Comp Blog is now viewed all over the world in over 250 countries and political entities. I have published nearly 300 articles, many of them re-published in newsletters and other blogs.

Share this article, or leave a comment below.