“It’s complicated” is one of the most repeated phrases heard in workers’ compensation. Whether it is in legislators, employers, judges, medical providers, administrators, or insurance companies, heads nod in agreement when someone says the basic problem is that “it’s complicated.” It does not matter if the issue is about the definition of a compensable injury, definitions of injuries, the right basis for compensation of permanent disability we use the phrase…
NOTE: This is a guest article written by Evelyn McGill, Executive Director for the Virginia Workers’ Compensation Commission (VWC). The VWC, established in 1918, is an independent judicial and administrative state agency that oversees the workers’ compensation system for employees, employers, and insurers. VWC interprets and applies the Virginia Workers’ Compensation Act and resolves claims through hearings and mediation. Evelyn studied as a Pre-Graduate Fellow at the University of Virginia…
NOTE: This is a guest article written by Jeffrey E. Hazlewood, M.D. Dr. Hazlewood practices Physical Medicine and Rehabilitation / Pain Management in Lebanon, TN, and is an Associate Staff Member at Vanderbilt Wilson County Hospital in Lebanon. After receiving his medical degree from the University of Tennessee, Memphis, he completed his residency at the University of Alabama, Birmingham, where he was chief resident. A Fellow of the American Academy…
NOTE: This is a guest article written by Paul H. Sighinolfi Esq., Senior Managing Director at Ametros. Paulwas previously the Executive Director and Chairman of the Maine Workers’ Compensation Board and a partner at Rudman & Winchell where he represented both plaintiffs and defendants. He is also one of the Deans, alongside Abbie Hudgens and Albert Betts, of the Regulatory / Legislative school for WorkCompCollege. Abbie Hudgens tapped into his…
NOTE: This is a guest article written by James “Jay” Hicks, an ombudsman attorney with the Tennessee Bureau of Workers’ Compensation. Abbie Hudgens requested he leverage his expertise on the complicated subject of self-represented injured workers to share insights on the process, trends, and best practices. Imagine that you got hurt on the job. You are unable to work because of the pain in your lower back. Now your benefits…
Some might say “second injury funds (SIFs)” are dinosaurs. However, structured effectively SIFs can enrich a state’s efforts to maximize their workforce. They have been a crucial element in states’ workers’ compensation for over a century. As early as 1916 states established programs to encourage employers to hire employees who had permanent disabilities by limiting the employer’s risk to costs related to subsequent injuries compensable under that state’s workers’ compensation…
The use of utilization review (UR) in workers’ comp has defenders and critics. Some consider UR (insurance companies and third-party administrators, et al) to be a basic tool to prevent unnecessary medical services and reduce costs. Others (physicians and plaintiff attorneys, et al) consider utilization review to be a cause of unnecessary delays in medical care that can result in poorer outcomes and frustration for physicians and injured workers. Finding…
Everyone agrees that workers' compensation is too complicated. But one aspect of it rises above others on the complicated scale – permanent partial disability benefits. The difficulty of finding the right balance for permanent partial disability benefits is at the heart of the differences among approaches, and it started with the grand bargain itself. The grand bargain means that benefits for workers' compensation claims aren't determined like claims based on…
Have you ever thought about whether you could live on your state's temporary total disability (TTD) benefits if you had a workers' compensation injury? It's a scary thought. The benefits in most states have formulas that begin with an injured worker's average weekly wage based on the prior 52 weeks' wages and multiply it by 66 2/3%. Then the resulting amount cannot exceed the maximum weekly wage for TTD benefits…
A 2021 Harvard Business School newsletter encouraged business leaders to take the long -term view rather than concentrating on quick returns. This is sound advice for several aspects of the medical component of workers' compensation, three of which are discussed below. First. Medical care is a major component of the total cost of workers' compensation. Policymakers have accepted that medical fee schedules help reduce medical costs in workers' compensation and…
