Insurance Policy, Not Retirement Policy Mary Bailey Feb. 1, 2003

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As I was speaking yesterday with Senator Posey's aide, who deals with workers compensation issues, I once again heard the words "workers compensation was not meant to be a retirement fund." In essence he was saying that PTD injured workers are double dipping. If they are PTD (permanent total disability), they should be shifted over to Social Security Disability and not be allowed to be paid indemnity benefits through workers compensation. (Of course I intend to find out if that is Senator Posey's position or if it is just his aide's position. Especially since he is the Chair of the Senate Banking and Insurance Committee.)

Injured workers do not have that option. They no longer have the option of improving their financial status or working a second job if they need or choose to do so.

Some Statistics

• It is a fact that 80% of the cases go right through the comp system with no problem. Those are the minor injuries.
• I have seen two PTD rates cited for Florida, 10% and 5%. Both statistics were projections and not actual real numbers.
• Half of those I have met that are on PTD had a prognosis that most likely would have allowed them to go back to work had they received the timely medical treatment guaranteed them by law. Only those who are on PTD get permanent funds.
• I would really like to be able to find a statistic on how many PTD cases are settled out but so far I have been unable to. I am sure it is not kept by anyone because that would be a statistic that insurers could be held accountable with. Those kind of statistics for the most part are not kept.
• And where is the statistic saying how much the carrier saved by settling out that case if the injured worker lived to the normal life expectancy?
• And how about a statistic that shows how much the injured workers that are PTD lose when they agree to these settlements?

• When injured workers become PTD, they are no longer able to work or have any control over their income.
• They can no longer contribute to their Social Security Fund.
• Those injured workers and their families who were insured through their employers lose their medical benefits and have to pay exorbitant premiums if they can afford it. I know that the premiums that come out of the injured workers salary are figured into the average weekly wage in most cases, but that does not include the amount of the discount an employer gets based on the number of employees.
• A policy outside of work is usually much higher. Most injured workers that are PTD can't even get themselves insured in most cases unless they are under one of the state or federal programs.
• Often insurers will not cover them because they are PTD.
• When you stop contributing to your Social Security Fund the amount you would have received at retirement is lowered. You start losing money for every day you are out of work. The amount you would have received at retirement is much less than it would be if you had been able to work and build up that fund the way you wanted to before retirement.
• Most injured workers that are PTD can no longer afford to contribute to their 401K.
• In most cases the injured workers have to take their money out of their 401K to live on while they are having to go through the denials and delays the insurers are allowed to starve you out with.

Are some of our lawmakers saying that injured workers should have to live at just above or below the poverty level just because they had an accident at work? That just because of our accident we are no longer eligible to live expecting enough money to support our medical needs and our families? Is that what they are really saying? Most of us already live way below our living standard that we had at the time of our injury.

A good majority of injured workers' indemnity benefits are capped out far below their earning ability. Those who earned higher wages lose big time because of these caps.

I know. I was injured in 1987 and even with the small cost of living increase I get each year I have still not gotten to 80% of the earnings I made in 1987 between SSD and comp indemnity payments. Inflation didn't stop between 1987 and 2003.

Insurers are starving people out and shifting their costs to other agencies such as Medicare, Medicaid, Social Security, and any other place they can. They are allowed to get away with this too. They are big winners because of their operating practices. They don't come close to paying what they would have had to pay had you not had your right to sue taken away by the exclusive remedy. They are costing our employers big bucks as well with their deny and delay tactics and frivolous litigation they cause. The frivolous litigation is not on the claimants part in most cases these days. It is on the part of the carrier for denying legitimate claims.

I would love to see a study on how many people that were on one source of insurance or another have settled their cases and are now on one of these state or federal programs as a result of whatever caused them to use the insurance to begin with. That study would tell the true story about what insurance carriers are allowed to get away with.

I am tired of hearing how bad the insurers have it. The only costs rising are premiums, insurance executive's perks and salaries, contributions to political campaigns, and corporate lobbyists salaries and operating expenses. If insurers manage their money poorly or are just plain greedy they should be held accountable instead of penalizing everyone that has insurance.

Responses

The next time someone says to you that "workers compensation was not supposed to be a retirement fund" ask the person

• if he would like to be limited to the same income as you with the same lack of opportunities and health deterioration you live with each day.
• Also ask him how much is going out in state and federal dollars to state and federal elected officials in retirement funds. Especially to those who are not career politicians, those serving one term, for example. They are healthy and able to work. We are not.

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What If?

I think that state and federal officials who decide eligibility for programs should have to live for one year under the standards and unreasonable limitations they have created. They should have no savings, no credit cards, no insurance coverage and be disabled and poverty stricken for that whole year.

In the real world we all know this will never happen, but if it ever happened, I do believe we would see some big changes in the attitudes of our elected officials.

Mary

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