To the Editor:
It has been my honor and pleasure to serve the people of St. Lawrence County as a small part of the most progressive Worker’s Compensation system in the country.
Worker’s Compensation started out as a deal between unions and major employers. The pact allowed for treatment and disability payments, paid for by the employers. So long as employers complied with safe workplace standards, they could not be sued under most circumstances. Workers also promised not to sue for pain and suffering.
These rights were gradually eroded by employers and the insurance carriers during the past 10 to 15 years. Insurance companies attacked every claim. An injured worker almost had to hire an attorney to protect his or her interests before they even found a doctor. People were denied care on technicalities and were discouraged by tactics that ranged from petty harassment to complex stratagems.
Large carriers orchestrated a public relations attack on legitimate patients. The carriers act as if all claimants are vultures waiting to suck the system dry. Oh yes, I have seen the occasional exaggeration, and even an outright fabrication of an injury once or twice. But I have found that the vast majority of patients are honest and only want alleviation of their pain b y the method that helps them the most.
In the meantime, doctors like me gave hundreds of thousands of dollars worth of treatment with little or no hope for reimbursement. Most claims were contested. Sometimes when my patient had success in court, I would be paid, but I never knew and the case was seldom paid in full. I treated patients without any sort of cost of living rate increase since 1996.
The courts became overwhelmed since every claim was controverted. Cases were dragged out and thousands of pages of testimony were generated. Judges were overwhelmed by endless litigation and the legislature finally acted.
The Worker’s Compensation Reform Act was signed into law during Elliot Spitzer’s term. It is a sad commentary on the times, but these so-called ‘reforms’ won’t come close to fixing the fraud where it was truly taking place. Insurance fraud is what the company is doing to you, not the other way around.
The Board enacted new guidelines that bear no resemblance to reality. The sad truth is that many work accidents result in permanent disability. In the old system, patients were entitled to symptomatic care; if they felt better, they got treatment. The new guidelines say that there is no benefit to this type of treatment. Just tell that to my patient whose leg gets warm and the clamping pain in an unmentionable place eases for a day or two after treatment. Just tell that to my patient whose headaches recede to a dull roar for a week after treatment.
The board says that they did a survey that found no benefit for these patients. They won’t let us see the date or learn the size of their sample or know any of the parameters of their secret survey.
In the past, the burden of proof was on the employer of their carrier. They had to prove that a worker was not injured, not disabled and not entitled to compensation. The new guidelines shift the burden of proof squarely onto the shoulders of an already disadvantaged individual in favor of a faceless, irresponsible entity called the insurance carrier.
We are living in sad times. Our legislature and regulatory agencies are much more responsive to the demands of their corporate donors than to the people.
Robert Klein, DC