We are finalizing the initial notes from the Summit; the “national conversation” on workers' compensation held in Dallas last week, and we hope to publish them for public consumption as early as this afternoon. In the interim, I and other bloggers have been writing on specific points of the event, providing general overview information. One of the points I want to talk about today was a revelation (at least for me) that completely stunned me.
The topic being debated was inadequacy of benefits in some states, when an employer in the room cited a particular cap on TTD benefits that exists in one jurisdiction. They stated that, for a very small percentage of their employees who had not reached MMI, the time limit was too short, and that they would prefer to continue paying their injured workers' beyond that point. They could not do it, however, as they are subject to audits that would result in fines from the state for non-compliance.
Let me put that another way; the state will punish them for not strictly adhering to the standards established by the state – even when that action does MORE for the employee who is off the job due to a workplace injury.
Of all the stupid policies that could be established and must be followed, that one has to take the cake.
At first I simply did not believe it, but it was confirmed for me by someone in my company, who was also attending the Summit. She made a point that this provision may protect smaller employers wholly dependent on third party coverage for their workers' comp. The example she cited was that willful continuation of benefits beyond the legislated period by a TPA or insurer could affect the mod rate of that employer for several years after. Self-insured employers, such as the one who brought up this point, would not suffer that malady.
Still, it seems to me that common sense and logic could provide a solution to that problem. First and foremost, there should be no regulatory punishment for exceeding mandated care. State minimum periods should be just that – minimum periods. If an employer wishes to do right by one of their employees by extending those payments when needed, why on earth would we want to block it? And furthermore, why would we punish someone for going above and beyond? It makes no sense.
Workers' comp has been getting a black eye over several issues this past year. Some of those shots are deserved, and others are largely exaggerated or not portrayed accurately for the industry. I know that an employer who chooses to “do the right thing” will never end up on the pages of ProPublica or in an NPR report, and we should not throw up regulatory barriers to further discourage that behavior.
Stupid is as stupid does, and this type of recriminatory behavior does nothing to help our industry address the problems before it.
This issue, while a minor yet surprising point in our two day discussions, is largely symptomatic of a bigger issue in workers' comp; the complexity and burdens of over-regulation. That is a topic to be detailed further in future articles, but suffice it to say that legislatures are making the lives of regulators and industry professionals miserable with onerous legislation and reporting requirements.
And they are not helping injured workers one iota. If anything, they are making the injured workers less relevant to the process.
And that is even less intelligent than punishing people for doing the right thing.
The conversation will continue…..