Injured Workers Suffer As 'Reforms' Limit Workers' Compensation Benefits Over the past decade, states have slashed workers' compensation benefits, denying injured workers help when they need it most and shifting the costs of workplace accidents to taxpayers.
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Injured Workers Suffer As 'Reforms' Limit Workers' Compensation Benefits

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Injured Workers Suffer As 'Reforms' Limit Workers' Compensation Benefits

Injured Workers Suffer As 'Reforms' Limit Workers' Compensation Benefits

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DAVID GREENE, HOST:

Let's imagine you're on the job and you suffer a serious injury. Your expectation is that workers' compensation is going to serve as your safety net. It's supposed to cover your medical care and ensure that you don't face a financial downfall while you're out of work. Now, in exchange for that, employers are protected from lawsuits for workplace accidents. But now an investigation from ProPublica and NPR has found that benefits have changed drastically in dozens of states over the last decade. In some places, medical care is more difficult to get and payments are shrinking so much some workers are losing their homes. This reporting comes from NPR's Howard Berkes and ProPublica's Michael Grabell. They're both on the line with us. Gentlemen, good morning.

HOWARD BERKES, BYLINE: Good morning.

MICHAEL GRABELL: Good morning.

GREENE: Michael, let me start with you. I know reporting on the story has consumed much of the past year for you. Summarize some of the findings, if you can.

GRABELL: Well, the main finding is that we found that since 2003, more than 30 states have passed laws that either reduce benefits, created hurdles to getting medical care or simply made it harder for workers to qualify. And one of the thing that's really interesting is that there's no federal minimum standards, so where you get hurt really matters. Imagine if you lost your eye on the job. In Alabama, the most you can get is $27,000. Same thing happen to you in Pennsylvania, the most you can get is $261,000.

GREENE: A difference that big just based on geography, where you live?

BERKES: Right and that's just the beginning of it. We'll hear later this week from a worker in Alabama whose maximum lifetime benefit for the loss of his arm is $48,000, but just across the border in Georgia, a worker with a nearly identical imputation could get almost 700,000 more over the course of his lifetime.

GREENE: It does feel like we're getting sort of a different picture of workers' compensation hearing things like this.

GRABELL: You know, everyone thinks that workers' comp is so expensive, but, in fact, we looked at the numbers and we found that employers are actually paying the lowest cost for workers' compensation insurance since the 1970s. And insurers are doing fairly well too. In 2013, they had an 18 percent profit - their best year since the 1990s.

GREENE: OK. So workers struggling to get medical care and get these benefits if they're injured, but yet the insurance industry making more money and businesses paying less. What's happening here?

GRABELL: You know, one thing that's happening is that employers and insurers are actually getting more control over medical decisions such as whether an injured worker needs surgery or not. More and more disputes are being heard by outside medical examiners. These are doctors who sometimes see a patient for a brief exam or are merely reviewing medical records, and they have the ability to go against what the worker's own doctor says and simply say the injury is not work-related. California's a great example of this. Their independent medical reviewers have been denying the recommendations of the workers' doctors 91 percent of the time.

GREENE: And, Howard, not just California, but you and Michael have been in a lot of states watching this sort of control shift in a way towards businesses. I mean, is there a theme that you're seeing nationwide?

BERKES: Well, what we found when we went around the country is that these changes are being driven by, first, the rising cost of medical care in general, which we all know about. But some workers' comp systems tend to be bogged down by litigation that adds to the cost, it delays treatment for workers. There's the workers' comp insurance premiums. Michael mentioned the premiums are generally lower than they've been in the last 40 years, but the recessions of the last 15 years have states locked in very fierce competition for jobs. Here's what we heard in Oklahoma from Fred Morgan of the state chamber of commerce. He was comparing workers' comp costs with neighboring states.

FRED MORGAN: We were extraordinarily higher than Arkansas. This is a state that's right next door. You know, what's the answer to that? Well, obviously our benefits are not competitive in the marketplace, so we made some adjustments.

GREENE: OK. So states, you know, in tough financial times see an opportunity here to be more competitive. How exactly does that affect injured workers then?

BERKES: Well, it can quickly disrupt their lives. We met in Oklahoma John Coffell, a 30-year-old worker in a tire plant. He suffered a severe back injury last year. Under the newly reduced payments in Oklahoma, he went from about a $1,000 a week with overtime to less than $600 a week.

JOHN COFFELL: Right away it got to the point where, which utilities were we going to let go first? We let our gas go 'cause it was the middle of the summertime. After that was the water, and as soon as we lost water is whenever we sent our kids down to live with my mother. After that, it was electricity, and then we just had to let the house go.

GREENE: Well, Michael, I mean, if workers like John Coffell, who we just heard from, are not getting what they need from workers' comp, are there other options for people like him out there?

GRABELL: Yeah, to some extent taxpayers are having to pick up the cost. We spoke to a number of workers, like John, who say they've been forced to rely on food stamps or apply for Social Security disability when workers' comp fell short. Now, this isn't all due to recent cutbacks, but there have been a number of studies that say government programs are picking up about $30 billion in medical costs and lost wages for occupational injuries and illnesses that are not covered by workers' comp. And so there's a degree of cost-shifting going on where taxpayers are having to foot the bill for things that were supposed to be paid for by workers' comp insurance.

GREENE: All right, guys, I know I'll be hearing much more of your reporting in the coming days and months. That's Michael Grabell of ProPublica and also NPR's Howard Berkes. Thanks very much.

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