Is the System Injured? despite Reforms 7 Years Ago, Lawsuits Involving Workers Compensation Claims Not Declining Significantly
Skidmore, Sarah, The Florida Times Union
Climbing around the innards of a ship and welding metal is hardly a trade for the meek. But after an on-the-job accident, Dave Samuels, a strong, healthy-looking shipyard welder, said he is timid. He performs everyday tasks, such as climbing up and down ladders and carrying his tools, with more-conscious motions now to avoid added strain or further injury.
Samuels injured himself while working several months ago when he fell into a ship hole and caught himself by his arms. The fall bruised his leg and limited the motion of his shoulders. He filed a request for workers compensation that his employer's insurer initially denied.
So then, like many people in Florida, Samuels chose to seek an attorney's assistance for his compensation. He was eventually granted the compensation for one shoulder and is heading to court soon to fight for the other.
Samuels is not alone. Initial numbers for 1999 show that 65,387 workers compensation injury cases in Florida went to litigation -- that number is expected to grow when final results become available.
The workers compensation system was designed to avoid litigation. Sweeping reforms to the system in the early '90s were intended to limit lawsuits and protect the interests of the employers and employees. But many people, frustrated and confused by the revamped system, are still turning to litigation seven years later. The number of cases is decreasing very slowly compared to the explosive growth of lawsuits prior to the reforms.
Many employees, employers and health care providers are, at some level, unhappy with the current system.
Some state agencies are working to tweak some details of the system, but no one has plans for major changes.
The system that was designed for an employee, the employer and its insurance provider has ballooned to include a compensation crew that can include claims adjusters, mediators, attorneys, primary physicians, specialists, managed care organizations and judges.
In most cases, injured employees receive a weekly benefit check of 66.67 percent of the average weekly wage they earned prior to their accident. However this amount cannot be more than the state maximum, $541 per week in Florida.
"It isn't uncommon for claimants to lose their house, their car -- it happens all the time," said Thomas Farrell, a Jacksonville attorney at Farrell & Gasparo and board member of the Florida Workers' Advocates. "I can't count the number of times my clients have said 'I am losing everything.' "
Employers are unhappy because they are paying high premiums. Florida's rates are among the highest in the nation, according to the Florida Division of Workers' Compensation.
Many health care providers will not handle workers compensation cases because the payment is so poor and the paperwork so cumbersome.
Shirley Straub, owner of Apex Physical Therapy, said because of her area of expertise in back and neck injuries she feels she needs to help people who are injured, but she doesn't do it for financial gains. Regardless of what a provider charges, she said, they will always be forced to make an adjustment to a lower rate.
Joseph Czerkawski, medical director of occupational medicine at Baptist Medical Center said he loses money on every re-check he conducts on a patient.
But Czerkawski said there is a "method to the madness." The reforms helped speed many patient visits to a doctor and reduce overall costs. The National Council on Compensation Insurance estimates a total cost reduction of 15.9 percent as a result of the reforms.
CREATION OF THE LAW
The government originally created workers compensation 65 years ago in Florida to provide reimbursement for any accidental injuries that occur while on the job, regardless of who is responsible. Without this law, if any employees injured themselves or was injured on the job, the only way they could receive compensation would be to bring legal action against the employer. …