In Tom’s recent blog post, he talked about the attempts Republicans have made to cut back on workers’ comp benefits for injured workers. All in the name of making Ohio a better state for business, these politicians argue that the cost of our workers’ comp system costs employers too much money. The latest rallying cry for privatization has begun. And when you get right down to it, privatization of workers’ comp means fewer benefits.
Over the past ten years, benefits have been limited in a number of ways. But perhaps the most offensive cut back in the Ohio workers’ comp system has been in medical treatment. Though they couldn’t get privatization through in the 1980s, the 1990s saw the introduction of MCO’s-essentially private insurance companies that contract with employers to deny treatment requests made by doctors under workers’ comp claims. The state pays millions of dollar to these private insurance companies all in the name of reducing medical costs-that is actually their stated purpose!
MCO’s brought with them a lengthy appeal system and a set of physician and nurse reviewers who regularly find even routine treatment to be “medically unnecessary” or “unrelated to the allowed conditions of the claim.” We fight these denials for our clients, but it takes months of appeals and hearings to get a decision overturned. So, even when we know we can win, there is a delay in treatment that can leave injured workers with permanent damage to their bodies and months off work while they are waiting to get approval for something like therapy or surgery.
Additionally, employers have increasingly contracted with occupational health doctors, who provide initial medical care to injured workers after they are hurt on the job. These doctors serve two masters: the employer who pays them to keep claim costs low, and the injured worker who seeks their medical advice. You can imagine the result of that. Injured workers’ are sent back to work immediately, dissuaded from getting testing to really evaluate their medical conditions, and declared all better within weeks of injury-even when they haven’t had any treatment! And despite the law explicitly stating that injured workers have free choice of physician, employers repeatedly tell their injured employees that they must see the occupational health doctor.
The end result of these two end runs around the system is that people injured on the job have a hard time finding a doctor to treat them in the first place. We have numerous clients who cannot find a doctor to take a workers’ comp claim because it is so difficult for a doctor to get treatment approved and then to get paid for giving the treatment. And while that may reduce medical costs for the employer, it’s a terrible price to pay for a person injured on the job.
A privatized workers’ comp system would make this situation even worse than it is now for injured workers in Ohio. In Indiana, for example, their private workers’ comp system allows the employer to choose the doctor who treats an injured worker. How can a doctor provide you with the treatment that you need when he or she is acting on behalf of an employer whose goal is to keep down the cost of your claim? It is a clear conflict of interest. If you consider what the MCO’s and the occupational health doctors in Ohio do, you can see exactly where things are headed when the employer picks your doctor. This is why Republicans want to privatize Ohio. It may encourage companies to do business here, but only at the terrible expense of the state’s workers.