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In the News

A very big issue currently in work comp cases has to do with facebook. Insurance companies are now monitoring the facebook accounts and entries by injured workers, looking for information to deny benefits and claim fraud. They are also filing formal requests to produce facebook accounts and going to court for orders compelling injured workers and their lawyers to produce the information. If you are an injured worker with an active claim, my advice is to suspend your facebook activity at least until your case has been closed. As with surveillance, people frequently comment and think that they “have nothing to hide”. It is not what you may “have to hide”, but how the insurance companies and their lawyers can twist what you do and say. Please be careful.
April 9, 2013 The dam is cracking in Florida! After years of severe reduction of benefits to injured workers, the appeals court recently struck down the horrific 104 week limitation on entitlement to temporary total disability. This meant that severely injured workers who were unable to return to work more than 104 weeks after they were injured, received no compensation or wage loss, even while they continued to require significant medical care or additional surgeries. In a unanimous decision that severely criticized the systematic reduction in workers’ benefits by the Florida legislature in favor of the insurance industry, the court said, “the natural consequence of such a system of legal redress is potential economic ruination of the injured worker, with all the terrible consequences that this portends for the worker and his family”. The court went on to say that, “we hold there is simply no public necessity…that has been demonstrated to justify such a fundamentally unjust system of redress for injury”. This is a landmark decision in Florida for all injured workers and hopefully portends of better things to come in Florida as well as other states. This is a decision to celebrate! Congratulations to us all.

The Miami Herald recently reported that our work comp insurance market “remains strong”. The Herald got this information from the annual report of the Office of Insurance Regulation. The report states that a “key factor” has been the limitation on attorney fees. Now, the insurance industry is demanding a 3% premium increase, claiming that Dr fees and medication costs are driving up the costs of i…nsurance. Nothing could be further from the truth. Problem is, our insurance commissioner, Kevin McCarty and our legislature does not care about the truth; they only care about appeasing the insurance industry.
The truth is that it is not the reduction in claimant attorney fees paid, since it was proven that it never amounted to more then 2-6%, depending on whom you believe, that has affected the industry’s bottom line; it is the fact that the legislature took away so many benefits from injured workers and made it more difficult to obtain those meager benefits that were left. As a result of the severe limitation on attorney fees for claimant attorneys, injured workers have found it difficult to hire an attorney to fight for their benefits. Yet the insurance industry is fighting harder to deny even these remaining benefits, as evidenced by the fact that claimant fees have been reduced by 2/3, yet defense fees have DOUBLED!
Now, they are going after the doctors. This is ironic, since the only doctors an injured worker is allowed to treat with is a doctor authorized and controlled by the insurance company. I have been told in private by many physicians that they know my client needs a certain medical procedure, test, medication or device, but he will not prescribe it because he will lose too much business from the insurance company. I have witnessed many doctors change their opinions as a result of a secret meeting with insurance company nurses or attorneys. This is “business as usual” in the workers comp system. The insurance companies even own the managed care companies that regulate the doctors. They pay themselves to “review” medical bills, sometimes more than the bills themselves, and charge it off as medical expenses. And yet, the insurance industry and our insurance commissioner see the need to increase rates!
I fought this fight in 2003. It has become painfully obvious that our legislature and our insurance commissioner will refuse to do anything except that which the insurance industry wants, despite all of the reputable studies that have been done, despite the testimony of all of the independent experts who have testified, and despite the glaring fallacies and deficiencies of the information provided by the industry and our own Office of Insurance Regulation. Nothing will happen unless and until we, the people, the public, stand up and say, “we’re mad as hell, and we’re not going to take it anymore”! That will only happen when these studies and evidence get publicized by the media and the public listens and takes care of business with their vote.
I must include the media in this problem. The media is very quick to report these skewered findings without any investigation. No matter how many letters I have written to the appropriate newspapers and agencies regarding the “truth”, or at least the other side of the issue, nothing gets published. This is one thing that boggles my mind. This is an issue of great public importance. Higher rates affect injured workers as well as employers and the business community. Yet, the truth behind it remains unsaid. So I ask, “what needs to be done”?
Yes, the work comp insurance remains strong because they aren’t paying benefits, they aren’t paying claimant attorney fees, they own the managed care companies, they control the doctors, they no longer are required to pay back excess profits to the business community and they hide their profits in “underwriting expenses”, which consist of their perks and salaries. You think Rothstein had a scam?!

 I have been representing injured workers for over 30 years. I have witnessed the deterioration, restrictions and elimination of their rights and benefits, along with the capriciousness and inhumane treatment by work comp carriers on a regul…ar basis. I recently received this petition from a client, which I have signed, which is grassroots effort to help injured workers around the counrtry. This is an issue of great public importance. The following is part of the message I received:
“Even if you’ve never been injured on the job or by the job, all it takes is one problem, one day, and you too will enter the twilight zone of Worker’s Compensation injustices.

Every day, people go to work or at work and get injured.Sometimes, it’s a little injury.Sometimes, they have major injuries that stay with them for months, years or life.If you think we have problems with health care in this country, the Worker’s Comp “health care” system is worse. I was doing a job I loved for years as Editor of the SUN TIMES magazine for disabled students and issues.I did not go there to be made sick for years.”

She has been fighting the work comp system for her medical care since 2001!
Please sign the petition and pass it on. She needs 50 signatures.

A study recently released analyzing attorney fees paid by Florida workers’ comp carriers since 2003, when the Florida legislature severely reduced benefits to workers and limited the ability of their attorneys to receive a reasonable fee, shows that fees paid to claimant attorneys have been cut in half, and fees paid to insurance lawyers have doubled! Not only are injured workers and their attorneys receiving significantly less benefits, but the insurance companies are paynig their lawyers even more to contest them! And our Florida legislature thinks this is how it should be. They are not representing us, they are representing the insurance industry.

Whenever the public and our legislators hear the phrase, “workers’ compensation fraud”, they immediately think of injured workers. In fact, many times potential clients will tell me that they are not like the “other phony people” who claim to be injured. The inaccurate public perception of workers’ compensation fraud created by the media has become pervasive. However, in a recent article describing the top ten workers’ compensation fraud cases in the nation, three occurred in Florida. All ten involved employer fraud. None involved fraud by an injured worker. All of them involved attempts to under-report payroll, setting up phony companies and other schemes to avoid paying for workers’ compensation insurance. This was supported by an analysis of fraud in the Florida workers’ compensation system done in 2001 by Dr. Richard Coble, professor at the University of Florida, in which employer fraud in Florida was described as so widespread that “ you could drive a mack truck through it”.This type of fraud creates an unbalanced financial environment for honest employers who must absorb the cost of their premiums, and, in many instances, leave an injured worker without coverage for medical care and lost wages. Yet, the state legislatures continue to “crack down” on fraud committed by injured workers. Seems to me that they’re chasing the wrong chicken