May 2011

First Responders and Firefighters Worry About Implications of North Carolina Workers’ Compensation Defunding

May 31, 2011, by Michael A. DeMayo

As lawmakers mull over how and whether to reform the North Carolina workers’ compensation system, first responders, firefighters, and other volunteers are fretting about what might happen to the Volunteer Safety Workers’ Compensation Fund. This is a fund paid in part by the state and by premiums from 1,300 members, such as firefighters and first responders, to offset North Carolina workers’ compensation coverage costs. It was established in the 1990s, and its current custodians estimate that the fund needs $2 million from North Carolina to survive.

Problem is, the current House budget has allotted just half of that – $1 million – for the fund, and the state may not even make that allocation permanent. In other words, the fund might get $1 million this year, but $0 million the next year. When the fund was established, the original plan was that North Carolina would provide $4.5 million over a period of seven years, until the fund could become self-sustaining. But that amount has been chipped away for various political and financial reasons.

The Executive Director of the North Carolina State Firemen’s Association, Paul Miller, recently voiced concerns about what might happen if the fund fails to be viable. Essentially, the assigned risk pool would have to inflate rates, and this would ultimately lead to the loss of savings that Miller argues are “used to buy equipment, uniforms, and pay for trainings so that North Carolinians can rest assured that they have the very best fire and safety services available.” State Insurance Commissioner, Wayne Goodwin, weighed in on the side of the volunteer workers: “I implore our legislators to fund the Volunteer Safety Workers’ Compensation Fund in a way that allows it to continue to meet its obligation to its members.”

Until the House resolves the debate over potential changes to the law, even a stellar North Carolina workers’ compensation law firm might have a difficult time suggesting an appropriate strategy for firefighters, volunteers, and sick and injured workers. The fact is that, as long as the state’s workers’ comp system remains in a state of limbo, it will be difficult for people, institutions, and funds like this to get a grip on what’s the most appropriate strategy.

More Web Resources:

Volunteer Safety Workers’ Compensation Fund

North Carolina State Firemen’s Association

Ohio Fraud Case Puts North Carolina Workers’ Compensation Scam Artists on Notice

May 27, 2011, by Michael A. DeMayo

Whether you’ve recently been injured, and you need to collect North Carolina workers’ compensation benefits – or you’re a healthy individual who’s concerned with the North Carolina’s fiscal state, you want to stamp out workers’ comp fraud. When someone – or some company or institution – steals money from the North Carolina workers’ compensation system, you suffer, and the state in general suffers.

Often, the indirect effects are the most insidious.

Breaking news out of Ohio illustrates the seriousness of this crime. According to – an action news team based out of Ohio – On April 29th, a man named Luiz Paneto pled guilty to a fourth degree felony for defrauding the Ohio workers’ comp system. Paneto was ordered to pay over $24,000 in restitution and nearly $20,000 in investigative costs.

In 2001, Paneto got hurt at work while performing a general contracting service. Shortly thereafter, he began to collect living maintenance and temporary total disability benefits. In 2007, he was granted permanent total disability.

In 2009, however, the Ohio Bureau of Workers Compensation’s Special Investigations Department received a tip off that Paneto had been doing home remodeling and labor – the same heavy work that he had being doing prior to his 2001 injury.

Per “[the special investigations department] conducted surveillance and Paneto was seen walking, lifting heavy construction materials, driving his truck, and performing work as a home remodeler… in April 2010 [he] admitted to working in violation of his receipt of BWC benefits.”

Now look: $43,000 is not a tremendous amount of money, especially when you consider the millions of dollars that flow through the North Carolina workers’ compensation system every year.

But every case of fraud essentially pokes holes in people’s trust in the system. Stopping fraud is more than about simply preventing funds from being siphoned off. When fraud happens, suspicion ratchets up, and the system degrades.

If you or someone you care about has been dealing with a benefits issue – or an uncooperative insurer or employer – leverage the resources of a North Carolina workers’ compensation firm today to get results.

More Web Resources:

Luiz Paneto fraud

North Carolina Workers’ Compensation Reform Debate Boils Over

May 24, 2011, by Michael A. DeMayo

Tensions mounted this week as the debate over potential North Carolina workers’ compensation reforms stoked passions on both sides.

An April 21st article in the Huffington Post quoted the President of North Carolina’s AFL-CIO, James Andrew, about the proposed reforms: “We believe there is a number of provisions being proposed that would hurt workers… [changes to make it more difficult for hurt workers to change physicians and the redefinition of what might constitute suitable employment] would require workers to take Wal-Mart type jobs in an effort to quickly return to work.”

The Post also quotes Ray Evans, the North Carolina Rate Bureau’s current Director, who did his best to cool the tensions between labor groups and business groups over the proposed North Carolina workers’ compensation reforms. Evans said “in this legislative environment, it’s difficult to separate the anecdotal evidence from what we consider more factual evidence… we hear all the time about people on disability out playing golf or basketball. We don’t know if that’s urban legend.”

As this blog reported last year, the Workers Compensation Research Institute (WCRI) found that our state’s workers’ comp costs were one of the highest in a group of 15 different states analyzed. Advocates of the Republican sponsored reforms point to this and other related indicators as signs that something must be done – now – to help to us regain fiscal control.

Meanwhile, as the debate rages in the state capital, hurt and injured workers – and their families – are anxiously awaiting the passage (or not) of the bill.

How will passage affect them, personally?

If you or someone you care about has been hurt, will you no longer be able to change doctors as easily, if you want to? Will you be forced to go back to work earlier than you thought? Will your workers’ comp benefits be cut off sooner than you had expected them to be?

These and other uncertainties may be plaguing you. Fortunately, you don’t have to go through this battle alone. A North Carolina workers’ compensation law firm can review your situation and help you understand how/if the changes to the law might impact you.

Part of what is so distressing about proposed reforms is that employers and employees alike are stuck in this state of transition. When you are in limbo, it is difficult to plan. Hopefully, this limbo won’t last too much longer, and we will get some resolution either way about the law, so hurt and injured workers and their families can take practical, proactive steps to protect their rights and their benefits.

More Web Resources:

Workers Compensation Research Institute (WCRI)

President of North Carolina’s AFL-CIO, James Andrew

What Do North Carolina Workers’ Compensation Pros Think About Ohio’s Plan to Lower State's Workers’ Comp Rates?

May 20, 2011, by Michael A. DeMayo

Ohio Governor John Kasich is seeking to lower that state’s workers’ comp rates – if the Governor succeeds, what will that mean for Ohio, and what will it mean in general for the programs of other states, like North Carolina workers’ compensation?

First, the basics, courtesy an April 29 story from the AP: “Ohio’s Governor wants to lower premiums employers pay for workers’ compensation by 4% for a total cut of about $65 million a year.”

Governor Kasich submitted his proposal last Thursday to the Ohio Bureau of Workers Compensation – his goal is to encourage businesses to work in Ohio and “make the state more competitive.” If the BWC adopts his plan this month, employers would not see changes in their premiums until February 2012. Steve Beuhrer, the CEO of the BWC’s Board of Directors had the following comments regarding the proposal (courtesy “our goal is to increase premium stability and lower costs for all Ohio employers… rates are a critical part of job growth decisions made by Ohio employers, but will also continue to focus on other aspects, such as containing medical costs and helping injured workers return to leading healthy productive lives sooner.”

Beuhrer’s comments here are germane to discussions about how to renovate and streamline the North Carolina workers’ compensation system. It’s NOT just about slashing rates and limiting benefits. Our solutions must also focus on “continuing medical costs” – and perhaps even more importantly “helping injured workers return to leading healthy productive life sooner.” After all, this is the raison d’etre of workers’ comp – it’s to help return us to productivity ASAP.

Unfortunately, the political discussion about workers’ comp reform often revolves around costs: whether to spend or not; on what; and for how long. This inevitably leads to political calculations.

But what if the most relevant parts of the equation are those two factors that Beuhrer named – containing costs and helping people recover?

Perhaps we are giving short shrift to these questions. Maybe we’re not thinking “out of the box” enough. For instance, cost control measures tend to focus on measurable, direct contributing factors. We aim to reduce the severity and number of workplace injuries, for instance. But we don’t take time to look at long-term exacerbating factors. For instance, are workers getting enough rest? Are workers too distracted by things like the internet and social media to concentrate effectively on their tasks? These indirect factors – such as how much sleep we get, how distracted we are, how much sugar we eat, et cetera – must be addressed if we want to lower injury rates and reduce hospital bills.

Backing away from the philosophical discussion… you may have more practical concerns about how to collect benefits and how to deal with insurance companies and employers. A North Carolina workers’ compensation law firm can answer your questions and put you on a good track.

More Web Resources:

Ohio Governor John Kasich

Steve Beuhrer, the CEO of the BWC’s Board of Directors

North Carolina Workers’ Compensation Law Debated by Legislative Committee: Passion and Emotions Run High

May 12, 2011, by Michael A. DeMayo

On Thursday, May 12, a House committee worked feverishly on North Carolina workers’ compensation legislation designed to relax employer responsibility for workers’ comp claims.

The AP has reported that the current sticking points “include whether employers, their attorneys and their insurers should have greater access to the medical records and doctors of an injured worker. Another issue is whether to cap temporary payments for a totally disabled worker at nearly 10 years.”

Powerful figures in the North Carolina workers’ compensation system are currently “at the table” per the AP, including insurance companies, legal representatives, NC workers’ comp lawyers and the Chamber of Commerce. Workers filled the hearing room in a bid to influence the proceedings. As of 6:41pm on May 12th, no compromise had been yet worked out, but observers remained hopeful that something could be accomplished.

It’s easy during moments like these – when everything seems to be on the line – to get defensive and to start about thinking in catastrophic terms. If you are a hurt or injured worker, for instance, you might worry that reforms will result in unexpected and decidedly unwelcome changes in your recuperation plan and your family’s financial strategy. And, depending on your situation and the outcome of the debate, you very well might have to adjust your expectations.

But it’s a good idea to remember the difference between what productivity guru Steven Covey once designated your “circle of control” and your “circle of influence.” Unless you are currently in the assembly room right now, chances are the bill is way out of your hands. Your best strategy for success, therefore, is to react appropriately to whatever laws get passed (or don’t get passed).

Part of dealing with the fallout effectively is getting good help. A North Carolina workers’ compensation law firm can help you understand how the new laws might influence your benefits and take the smartest, most efficient steps towards minimizing any negative fallout.

More Web Resources:

House committee works feverishly on NC workers’ comp

Catastrophic thinking

Debate Over North Carolina Workers’ Compensation Law Heats Up (Part 1)

May 12, 2011, by Michael A. DeMayo

In this two part blog post on the possible reform of the North Carolina workers’ compensation system, we’re going to boil down legislation proposed recently by business groups.

According to an Associated Press article from April 22nd, business groups are practically giddy about the potential to alter North Carolina workers’ compensation laws to reduce employer costs and set limits and constraints.

The AP quotes Bruce Clark, the President of a business group called Capital Associated Industries: “a multi-million dollar event with no legal means to ever end or settle the open-ended, lifelong claim… this is not what good and fair workers’ compensations do around the country and it should not happen here.”

The newly Republican controlled state General Assembly aims to prioritize workers’ comp reform, and the proposed bill will do the following:

• Limit temporary total disability payments to approximately 9.5 years (currently, these payments can last a lifetime)
• Extend benefits for families of workers who die on the job from 400 weeks to 500 weeks.
• Burial benefits will also be ratcheted up by an additional $10,000.
• A provision will be inserted that “would allow employers, their attorneys and their insurers access to the medical records and physician of an injured worker seeking compensation.”
• Workers will be restricted in how they choose the physicians who treat them.

Advocates of hurt workers admit that some people do try to “game” the system by staying on workers’ comp too long or even faking symptoms. But they also point out that insurance companies and employers work relentlessly to challenge claims. The AP article quoted an advocate: “every insurance company works overtime to limit payouts, sometimes by putting injured workers on a carousel of different doctors until one provides an employer friendly diagnosis.”

The AP article then discusses the sad case of a 42-year old Randolph County man, Levy Grantham, a tree trimmer who seriously hurt his back, arm and shoulder on the job. Grantham’s “employer’s insurer… sent [him] to five doctors after the initial diagnosis in a pattern of persistent refusal to provide timely treatment.”

So the debate rages on, and both business advocates and advocates of hurt workers are more than well aware of the stakes. In a subsequent blog post, we will discuss possible outcomes to this fractious debate and analyze the deeper implications.

If someone you care about needs immediate help with a claim or a benefits issue, connect with a North Carolina workers’ compensation law firm to go over your resources.

More Web Resources:

NC panel hears effort to change workers’ comp law

NC panel hears effort to change workers’ comp law

Debate Over Reform to North Carolina Workers’ Compensation System Rages On (Part 2)

May 10, 2011, by Michael A. DeMayo

Several days ago, this blog reported on proposed changes to the North Carolina workers’ compensation laws. Politicians, business advocacy groups, and workers rights groups have contentiously debated the merits of the reform proposals. Some of the changes would redound to “good effect” for workers (e.g. the ratcheting up of death benefits); while some of the changes would take away rights that injured workers currently have (e.g. allowing employers and insurers access to workers’ medical records, limiting the time workers can collect temporary total disability, et cetera).

Anyone who even casually reads the news about North Carolina workers’ compensation will be struck by the passions exuded in this debate.

Indeed, many advocates of the reforms see them as nothing short of foundational – in other words, if the state doesn’t pass them, NC will go to heck in a hand basket.

Conversely, opponents of the law worry that, if it gets passed, hurt workers are going to be essentially abandoned by the state.

Obviously, both of these positions are extreme. In reality, the reforms may not do much of anything – that is, they may not solve our states’ fiscal crisis or even workers’ comp crisis – nor might they particularly derange the care and treatment that workers receive. This isn’t to say that the passing of reforms won’t change the playing field – in some ways, significantly. But it is to say that we should “let the air out of the balloon” and stop awfulizing and catastrophizing about it [or overly celebrating it].

As this blog tirelessly advocates… we must examine root causes of our problems if we want to contain costs, help workers, and get to “win win” outcomes.

Here is a rough (an obviously not totally consistent) analogy. Imagine a family fighting over money. A 16-year old daughter uses her credit card to buy clothes, purses, et cetera, while the family struggles to stay in the black. The father and daughter might get into serious screaming matches over the daughter’s purchases at the mall. Might there be ways that the daughter could cut down on her spending? Would that help with the family situation? Probably and probably. But does the debate about the daughter’s spending really address the root causes of the family’s crisis? Almost certainly not.

The analogy here is that our focus on controlling workers’ comp costs may be legitimate; but it’s definitely not the only thing we need to be focusing on. Instead, we need to look at the broader picture – the structural, fundamental problems with our state’s (and perhaps even our country’s) medical problems and institutions. These problems may not be easily tractable. For instance, the baby boomer generation is getting older – this is going to create a demographically “top heavy” situation, in which the sheer number of older Americans requiring medical help will go up, and the number of active workers engaged in productive work will decline.

This top heaviness is no one’s “fault” — but it’s a real structural problem.

Continuing our analogy – it’s as if the family home got flooded, and the basement got rotted out and mold developed in the house. It’s a structural problem that drains the family’s finances. It’s no one’s fault — it just is what it is. Efforts should go to sorting out that problem instead of simply addressing the more emotional (“political”) problems. Let’s spend less time trying to control “spending at the mall” (although that is important) and more time “fixing the foundation of the house.”

Need help with a claim? A North Carolina workers’ compensation law firm can help you get the benefits and fair treatment you need and deserve.

More Web Resources:

NC panel hears effort to change workers’ comp law

New Bill Could Change Workers’ Compensation Laws in NC

Your Office Vending Machine: The Source of Your North Carolina Workers’ Compensation Woes?

May 3, 2011, by Michael A. DeMayo

Experts who study North Carolina workers’ compensation issues are constantly trying to puzzle out why accidents, injuries, and illnesses happen at work and how these catastrophes can be prevented. The thinking is, if policy analysts can suss out the root causes, we can collectively reduce injury rates and sickness rates everywhere from the Research Triangle to the far West of NC.

So what ARE the major root causes of workplace related injuries and illnesses, and can they be effectively treated with smart policy?

Typically, we focus on improving safety of equipment and machinery; limiting number of hours worked (too many hours leads to fatigue and worker error); boosting worker education (poor training leads to safety catastrophes); and limiting repetitive work (repetitive labor leads to soft tissue injuries, like carpal tunnel syndrome).

But sometimes it helps to think out “outside the box” and look at other potential root causes of worker pain. According to a very provocative article in the April 19 issue of the New York Times magazine, the sugary snacks and beverages in your local office vending machine may be causing far more problems than you, your employers, and most North Carolina workers’ compensation experts realize. Taking his cue from pediatric obesity specialist Robert Lustig, science writer Gary Taubes argues that refined sugars – particularly sugars taken in liquid form (such as the Cokes and Pepsis in your local vending machine – as well as the fruit juices) may be making many, many people not only overweight but also sick.

What Lustig says is that, when you eat sugars – particularly when you drink them – your liver gets essentially biochemically “punched” and injured. Fatty deposits form in the liver, and this process may stimulate a condition known as insulin resistance, which appears to be the common denominator in many diseases of civilization, including obesity, diabetes and heart disease as well as many types of cancer.

If this supposition is correct, that means that one (albeit indirect) way to seriously reform our entitlement system is to get people to stop eating so many sugary snacks – particularly sugary beverages. Even a slight decrease in our sugar consumption might lead to a collective boost in our national health and lend some genuine relief to over stressed and under supplied healthcare providers.

On a more personal note, if you or a family member or someone at work is struggling with benefits issues, a North Carolina workers’ compensation law firm can provide the essential services you want and deserve.

More Web Resources:

Is Sugar Toxic?

Lustig’s YouTube video

The Paradox of North Carolina Workers' Compensation: Can Calling Yourself Ill or Hurt Make You More Likely To Stay That Way?

May 1, 2011, by Michael A. DeMayo

The whole point of North Carolina workers’ compensation and other similar entitlement systems is to provide resources for hurt/injured workers, so that they can reboot their lives, treat medical conditions and reenter the work force.

For most people, these entitlements are stop gap measures.

Unfortunately, hurt and injured workers may come to depend on their benefits not only for essentials such as grocery and rent money but also for psychological reasons. And this dependence can be hugely problematic – not only for the employers, insurance companies, and taxpayers who foot the bill, but also for the hurt and injured workers themselves.

So, how can we deal better with these psychological hang ups?

First of all, it’s easy to grow dependent on any source of income – whether you’re earning six figures as an investment banker or you’re scraping by on the (unfortunately) low salary of a public school teacher. You start to think of your incoming sources of money as “your own” and you adjust your life style accordingly. This happens to everybody, irrespective of “will power,” class, or history. Trying to think about life without this income stream is frustrating and scary.

But a deeper and perhaps more problematic issue is that, when you are hurt and sick, you may start to think of yourself as “a hurt/sick person.” In other words, you may actually revise your internal self concept to think that you will never get to go back to work. This kind of thinking can, unfortunately, take on a reality of its own. If you think this way, there’s a very real possibility that you will accidentally manifest this reality.

Don’t get mixed up here, however: The idea that negative (or positive, for that matter) thinking can influence your real world destiny in no way suggests that the pain you feel is “all in your head” or anything like that. Indeed, one of the terrible (and ultimately illogical) criticisms leveled against people on workers comp is that they “want” to be “on the dole.” If you actually talk to people who use these benefits programs, it’s clear that nothing could be farther from the truth. People want to be motivated, independent. They want to work. They really do. There has nothing to do with will power or psychological constitution. Indeed, it takes tremendous courage and strength to recover from an illness and try to rebound and get your old life back.

The takeaway is simple: fixing the way you think can potentially have profound, positive effects.

But you likely need good help as you progress with your recovery. A North Carolina workers’ compensation law firm, for instance, can help you fight back against insurance companies, employers, and others who needlessly and unfairly block you from getting the benefits you need to get back on your feet.

More Web Resources:

You Are What You Focus On

Calling Yourself “Sick” Makes You Sick? – Power of Language