I'm not sure it's going to be history that will be revered, or reviled, however.
The Tennessee House of Representatives on Thursday voted 68-24 along party lines to approve Senate Bill 200 Thursday morning and sent the bill back to the Senate, which approved an earlier version of the bill 28-2 on April 1. The Senate is expected to routinely approve an amendment added in the House that will require the state Division of Workers' Compensation to submit annual reports on the impact of the reforms beginning in 2015.
I think history will revere the part of SB 200 that creates a new Court of Workers' Compensation Claims.
Tennessee and Alabama currently use their state civil trial judges as the first venue for resolving workers' claims disputes.
The governor will be able to appoint a DWC administrator for two six-year terms. The administrator, in turn, would appoint workers' compensation judges. The governor would then appoint a three-judge appeals court.
The new court would handle disputes involving job-related injuries or illnesses occurring on or after July 1, 2014. Appeals of decisions from the DWC would go to the Tennessee Supreme Court, where the chief justice could send the cases to special panels of three judges. At least one member of each panel would have to be a justice of the Supreme Court.
I think this is a tremendous improvement to the dispute resolution system for Tennessee. Like the concept of workers' compensation itself, the new work comp court will be largely administrative in processes and should result in much more expeditious processing of litigated claims. Everyone wins with this proposal in my opinion.
SB 200 also will institute medical treatment guidelines after a consortium of doctors, insurers, employers and labor groups make their recommendation prior to Jan 1, 2016.
Again, a positive development in my opinion. Most states have guidelines now, and while guidelines have been criticized as "cookbook medicine" depriving individuals of choice, the fact is that for the vast majority of claims guidelines reduce delay in authorization and expedite payment to physicians because they eliminate disputes.
Other provisions that bring Tennessee into the 21st Century include creation of an electronic medical bill submission and payment process by July 1, 2014, and an ombudsman's office for injured workers who aren't represented by attorneys.
Not all claimants who would like some legal advise can get an attorney because their case may not be perceived to have sufficient value for attorney involvement - the ombudsman program should assist these claimants and such programs in other states have proven very effective in reducing disputes simply by providing workers' compensation claimants with better information.
Now for the revilement.
The new AOE/COE standard in Tennessee will make workers' compensation largely irrelevant and will transfer much of the social burden that should be covered by work comp to other state systems and the general health scheme.
The legislation limits compensation to injuries that arise "primarily out of and in course of employment" only if a worker can show by a preponderance of the evidence that employment contributed more than 50% to the cause of the injury.
In order to treat injured workers, doctors would have to attest to a "reasonable degree of medical certainty" that more than 50% of the need for medical treatment was caused by in injury.
These provisions should eliminate a large chunk of workers' compensation claims because there is no doctor, when utilization review appeals are going to be subject to a $250 fee, that is going to stick his financial neck out and provide treatment with these draconian standards.
The effect is to shift the burden of treatment for injuries that would otherwise be covered industrially to the general health system, which means, essentially, shifting the burden further upon all of the productive taxpaying citizens of the state.
In addition, while at first blush it would seem that SB 200 increased indemnity benefits, in fact what the bill does is reward failure in education and production by increasing permanent disability rating factors for lack of education and demonstrable unemployment where the claimant lives.
Injured workers on partial disability who've been unable to return to work or have a job earning less than their pre-injury wages could petition DWC to multiply the award by a factor of 1.35. The bill also would increase the award by 1.45 if the worker lacks a high school or general equivalency diploma, by 1.2 if the worker is older than 40 and by another 1.3 if the worker lives in a county where the unemployment rate is 2% higher than the statewide average.
Essentially, the bill says, "let's keep the poor even poorer" by making sure that those with less education are rewarded for not getting that degree and rewarding the unemployed to huddle together away from the nice, employed, productive (and wealthy) areas of the state.
Backwards thinking if I ever read it....
SB 200 is here.
I think this is a tremendous improvement to the dispute resolution system for Tennessee. Like the concept of workers' compensation itself, the new work comp court will be largely administrative in processes and should result in much more expeditious processing of litigated claims. Everyone wins with this proposal in my opinion.
SB 200 also will institute medical treatment guidelines after a consortium of doctors, insurers, employers and labor groups make their recommendation prior to Jan 1, 2016.
Again, a positive development in my opinion. Most states have guidelines now, and while guidelines have been criticized as "cookbook medicine" depriving individuals of choice, the fact is that for the vast majority of claims guidelines reduce delay in authorization and expedite payment to physicians because they eliminate disputes.
Other provisions that bring Tennessee into the 21st Century include creation of an electronic medical bill submission and payment process by July 1, 2014, and an ombudsman's office for injured workers who aren't represented by attorneys.
Not all claimants who would like some legal advise can get an attorney because their case may not be perceived to have sufficient value for attorney involvement - the ombudsman program should assist these claimants and such programs in other states have proven very effective in reducing disputes simply by providing workers' compensation claimants with better information.
Now for the revilement.
The new AOE/COE standard in Tennessee will make workers' compensation largely irrelevant and will transfer much of the social burden that should be covered by work comp to other state systems and the general health scheme.
The legislation limits compensation to injuries that arise "primarily out of and in course of employment" only if a worker can show by a preponderance of the evidence that employment contributed more than 50% to the cause of the injury.
In order to treat injured workers, doctors would have to attest to a "reasonable degree of medical certainty" that more than 50% of the need for medical treatment was caused by in injury.
These provisions should eliminate a large chunk of workers' compensation claims because there is no doctor, when utilization review appeals are going to be subject to a $250 fee, that is going to stick his financial neck out and provide treatment with these draconian standards.
The effect is to shift the burden of treatment for injuries that would otherwise be covered industrially to the general health system, which means, essentially, shifting the burden further upon all of the productive taxpaying citizens of the state.
In addition, while at first blush it would seem that SB 200 increased indemnity benefits, in fact what the bill does is reward failure in education and production by increasing permanent disability rating factors for lack of education and demonstrable unemployment where the claimant lives.
Injured workers on partial disability who've been unable to return to work or have a job earning less than their pre-injury wages could petition DWC to multiply the award by a factor of 1.35. The bill also would increase the award by 1.45 if the worker lacks a high school or general equivalency diploma, by 1.2 if the worker is older than 40 and by another 1.3 if the worker lives in a county where the unemployment rate is 2% higher than the statewide average.
Essentially, the bill says, "let's keep the poor even poorer" by making sure that those with less education are rewarded for not getting that degree and rewarding the unemployed to huddle together away from the nice, employed, productive (and wealthy) areas of the state.
Backwards thinking if I ever read it....
SB 200 is here.
Your insightful analysis is always intersting.
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