SCOTT SIMON, HOST:
This is WEEKEND EDITION from NPR News. I'm Scott Simon. Thirty-three states across America have made it more difficult for injured workers to get workers' compensation benefits. State lawmakers have been making it tougher to qualify, cutting payments and making medical car harder to get - medical care harder to get. As part of a series that NPR and ProPublica began last month, Howard Berkes reports on an injured worker in North Dakota whose experience illustrates the trade-offs of limiting benefits.
HOWARD BERKES, BYLINE: Dennis Whedbee went home to Pennsylvania after an oil rig blowout in North Dakota tore off his lower arm.
DENNIS WHEDBEE: Oh, interception.
UNIDENTIFIED BOY: Oh (laughter).
BERKES: Using the arm he has left, the 53-year-old Whedbee tosses a football to three of his grandsons. The stump hanging from his left shoulder reaches just below the elbow. It has a tattoo with the date September 23, 2012, the word lost and a hand spurting blood.
WHEDBEE: I lost a hand at work, and this workmen's comp gave me what I deserve - what's going to help make my job - where I can go to work, make it easier for me during the day, you know? I deserve a hand.
BERKES: A working and realistic hand as part of an electronic prosthesis. Instead, Whedbee was offered a split hook at the end of a mechanical arm. That's despite the fact his orthopedic surgeon said he was a perfect candidate for the high-tech prosthetic. In North Dakota, workers' compensation insurance and benefits are provided exclusively by a state agency headed by Bryan Klipfel, who says electronic arm wasn't a good choice.
BRYAN KLIPFEL: They're very complicated. You know, if you're in - work in a dusty environment or something, they're not going to work quite as well as the other ones. And I think probably one of the other main reasons was because of his shoulder injury that he had.
BERKES: An out-of-state medical examiner reviewed the case for the workers' comp agency and said Whedbee's injured shoulder couldn't bear the additional few ounces of weight of the high-tech arm. But Whedbee says the mechanical arm and hook require movement of that shoulder, so they're not any better. He says he doesn't have to work in a dusty environment, and he says the hook won't do what the hand can do, from tying his shoes to cooking to playing with grandkids without scaring them.
WHEDBEE: I'm never going to be normal again; maybe be, like, 90 percent normal, you know? And not walk around like a - like a freak. They're going the cheap way out, what they're doing.
BERKES: In North Dakota and a few other states, the treatment decisions made by physicians for injured workers used to count most, but it doesn't work that way anymore, given a decade of changes in workers' comp laws. In North Dakota, the decisions of medical examiners working for insurers now count as much or more. That's an attempt to control costs, and the high-tech arm costs about $70,000. The hook is $50,000 less and could last decades longer. Still, the Whedbee decision wasn't based on money, insists agency director Bryan Klipfel.
KLIPFEL: We can't, you know, just pay for everything and not have any limits. But for this particular case, the cost wasn't really that much of a factor.
BERKES: But the agency said in a court document it needed to consider costs. Whedbee would've done better in states with some of the nation's lowest workers' comp benefits because even they give injured workers both prosthetics - the expensive high-tech arm and the cheaper hook. Alabama has the nation's lowest payments for workplace amputations as ProPublica and NPR reported. Jeremy Lewis lost an arm in a chicken feed plant there then lost his house and cars due to low benefits. But he received both the mechanical hook and the electric hand.
JEREMY LEWIS: It'll open and close, and the hand will go clockwise or counterclockwise all the way around. It's like another arm. Until I take my jacket or long sleeve shirt off, you'd never know it.
BERKES: And if he's in dusty or wet conditions, he can slip that arm off and put the hook on. Across the border in Georgia, injured worker Josh Potter also has both prosthetics. He shows off his electronic arm.
JOSH POTTER: Kids are the best part of being out in public with it. There was a little boy at the aquarium. He walks up and his mom asked if I minded if they came over and checked it out.
BERKES: It was cool, not scary, Potter says. Back in North Dakota, it seems the state workers' comp agency could afford the more expensive high-tech prosthetic for oil rig worker Dennis Whedbee because the agency is good at controlling costs and investing employer premiums. It sent back to employers $900 billion in the last decade, Director Bryan Klipfel.
KLIPFEL: We have extra dollars. It's the ones who pay the premiums, it's their dollars. So we gave it back because we've had good sound investments and we did good with the money that we had.
BERKES: So get this - in 2013 alone, North Dakota employers got back $150 million. That could have paid for electronic prostheses for all 1,800 workers across the country who lost arms or hands on the job in the previous 12 years - Dennis Whedbee.
WHEDBEE: They're not putting wooden stumps on people no more like they did 100-200 years ago, the pirate days, you know? They've improved that. We've come a long ways, you know? The thing is simple. It's black and white, you know? And I lost a hand. I didn't lose a hook.
BERKES: Director Bryan Klipfel says most workers' comp cases are resolved without dispute. But challenge cases tend to involve more serious injuries and more expensive treatment according to workers' advocates. And in North Dakota, when those cases are sent to the state's medical reviewers, they overrule workers' doctors 75 percent of the time. Howard Berkes, NPR News.
SIMON: We've posted the entire ProPublica-NPR series on workers' compensation on our website at npr.org.
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