Does Workers’ Compensation “Cost Containment” Actually Increase Costs?4 minute read

All of us know something about workers’ compensation.  Some people learn about workers’ compensation after they are injured at work.  Other people learn about it when a friend or family member is injured.  Still others know about it because their job duties involve dealing with workers’ compensation claims in some ways.  Our experiences with workers’ compensation certainly affect our opinion about it and shape our beliefs about the purposes of workers’ compensation and whether it is a good system.

Why Do We Have Workers’ Compensation?

To evaluate how any system is performing, you need to understand the purpose behind it. We have not always had workers’ compensation systems.  In fact, they really started being enacted a little over a hundred years ago.

When they were created, workers’ compensation systems were set up to do two basic things.

  1. Pay benefits to injured workers who were injured on the job
  2. Provide immunity to employers from tort (personal injury) lawsuits

Each state has its own workers’ compensation system.  Although each of those systems provides different benefits, the basic idea is still the same as when these systems were first created.  An injured worker receives medical benefits and wage loss benefits needed to recover from the work injury. The employer still receives immunity from personal injury lawsuits where the injured worker could potentially recover for pain and suffering and other benefits.

Are there problems with workers’ compensation?

No system is perfect and each state’s system is different. I represent injured workers in Georgia workers’ compensation claims so I have many ideas about how Georgia’s system should be changed to be fairer to those injured workers. I am sure that those that represent employers and insurance companies have their own opinions about how the system should be changed.  Most years, some small changes are made to Georgia’s workers’ compensation laws to attempt to make the system better.

Michael Grabell with ProPublica has written a series of interesting articles about workers’ compensation systems across the U.S.  An article he published in December 2015 raises some interesting questions about a much larger and growing problem that has invaded Georgia’s workers’ compensation system and many others .  That problem is large “cost containment” corporations which have popped us as middlemen between insurance companies and injured workers.

Mr. Grabell’s article shows that there is a huge growth in companies seeking to make money off workers’ compensation systems.  These companies serving as middlemen are worth billions of dollars.  As most middlemen do, these corporations thrive by taking a percentage of the money that would be paid out by the insurance company to the injured worker or on behalf of the injured worker.  In other words, a significant part of the money that might be paid to the injured worker (or to a medical provider that has provided care on behalf of the injured worker) is instead paid to those “cost containment” middlemen.

As a result, the benefits paid to injured workers decrease and the money paid by insurance company companies increases because the middlemen are taking a significant portion of the benefits.  The result is a more expensive system that provides less to injured workers who need it the most.  So instead of a system that costs less, these “cost containment” companies probably cause the system to cost more.

Also, as Mr. Grabell’s article mentions, the result of “cost containment” is also a more complex system that is more difficult for injured workers to navigate.  I have represented injured workers for over fifteen years.  Our firm has represented them for over 40 years.  Almost every injured worker that I have helped wants two things:

  1. To recover from their injury; and
  2. To go back to work.

 

Unfortunately, the increasing invasion of cost containment companies into the workers’ compensation system will likely make it more difficult for injured workers to do those two things.  Their medical treatment will continue to be delayed and denied which will impede their recoveries and make it more difficult for them to get back to work.  Also, if the costs paid by insurance companies increase, their will definitely be a push by those companies to decrease the benefits to injured workers because the costs of the system have gotten too high.  Hopefully, lawmakers in Georgia and across the country will devote their time and effort to fixing this growing problem that threatens the future of injured workers.

What if I have other questions about workers compensation?

Georgia’s workers compensation system can be very confusing.  You have to worry about getting the treatment you need and paying your bills while also worrying about not missing any deadlines that could cause you to lose your right to receive workers compensation benefits.

If you have questions, I would recommend that you try to get answers.  To find out more about how to schedule a time to talk to me about your workers compensation questions, just read this short article.

Jason Perkins is an attorney who specializes in representing injured workers.  He regularly publishes videos and write blog articles about Georgia’s workers compensation system and issues that are important to injured workers and their families.

To be notified of Jason’s new workers compensation videos, subscribe to his Georgia Workers Compensation Video Series channel on YouTube by clicking the subscribe button below.

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