Oh, what a difference a state line makes. In Florida, a work-at-home workers’ compensation claims professional who tripped over her dog while reaching for a cup of coffee could not receive workers’ compensation benefits. If she moved just a few miles north, over the Georgia border, it would now be a different story. Last week the State Supreme Court there overturned 85 years of precedent by awarding benefits to another insurance claims professional who slipped and fell on her lunch break.
I know what you’re thinking. Claims professionals are no good on their own. They must be supervised constantly, or they end up falling down a lot. But that is not the point of the story.
Inconsistency in workers’ comp has been a hallmark of the industry since, well, there was a workers’ compensation industry. States adopted workers’ comp at a very inconsistent pace. The first did so in 1911. It was either New York or Massachusetts or Wisconsin, depending on who you ask. The last to join the party, Mississippi, adopted it in 1948. Benefits vary widely from state to state. Interpretations of “Course of Employment” (COE) and “Arising out of Employment” (AOE) also range from liberal to quite strict. Occupational illnesses are treated differently across the nation, as are mental only injuries. Reporting procedures and requirements are different in every state. Everyone has a different position on the Positional Risk Doctrine. Forms change on a daily basis. No one can seem to agree on Medical Guides to Impairment or what evidence should be used in Evidence Based Medicine. Even Electronic Data Interchange (EDI), the standardized method of reporting claims data to the states, has several different versions and flavors in use across the country.
No, if there is one consistent thing that the workers’ compensation industry has down pat, it is inconsistency across a multitude of issues. The recent Georgia Supreme Court decision definitely drives that point home.
Unless, of course, you are a First Responder. If you are in that golden category, you can pretty much do anything at any time and someone somewhere will cover it. But they are the exception to the rule. I suppose, when you think about it, it would just be another inconsistency from our industry.
As a guy whose company sells tools to navigate the myriad of complexities in comp, I suppose I shouldn’t complain.
And now we find ourselves in the Post-COVID world. That is not to say we are done with COVID, but rather that COVID has entered both the industry lexicon and what is now, in many states, an area of responsibility. Not surprisingly, the approach state by state is somewhat inconsistent. The unexpected saddling of COVID related expenses on the workers’ compensation industry is in fact one giant inconsistency; never before has the industry been forced to provide benefits for a commonly communicable disease. It likely represents a new era for the industry, ushering in the potential for a host of new and exciting inconsistencies for us to deal with.
There is a reason that some states require claims professionals to be licensed. No, it is not because they tend to fall down a lot. It is instead done to ensure proper training, and to make sure that all the inconsistent consistencies are applied in a relatively consistent manner. But in workers’ comp, no matter where you are or whether you have been licensed to do the work or not, you get an automatic license to toil in the great State of Confusion. There is always plenty to do, and much to keep us busy.
Which is a good thing, since clearly, we are no good on our own.