Reverse Roles And Take It In

I hear two opposing arguments about workers' compensation all of the time.

One camp says that workers' compensation is broken, doesn't do what it's supposed to do, costs too much and delivers too little.

The other side says stop the whining, buck up and use the system; that it is what it is and won't get any better and works just fine if you're willing to put in the effort.

Both sides of the debate have some merit, and both are likewise erroneous - it all depends upon how one fits into the system, and what one's expectation is from the system.

The argument that an employer should just pay claims and not worry about the cost because it gets passed along to the ultimate consumer ignores that fact that there are plenty of competing business owners who are going to cheat or otherwise fudge their workers' compensation obligations for a competitive advantage.

In that sense, the cost of any claim isn't passed along to the consumer because the business that tries to do so is driven out of business by the others seeking the unfair advantage.

And for the majority of claims workers' compensation does work just fine - so long as there isn't any lengthy period of disability or medical treatment and expense that fall outside guidelines.

We pass laws and implement regulations because we need to deal with the outliers. In doing so we sweep the vast majority of the workers' compensation experience into these laws and regulations even though they really shouldn't be so constricted.

When I first started practicing workers' compensation defense law our firm required all of the attorneys to take applicant/injured worker cases where there was no conflict of interest. The purpose was to make sure the attorneys had experience dealing with the "other side."

Part of this was to ensure that the attorneys had compassion for what was going on with the injured worker. Part of this was to provide the education that can only be obtained by going through what one must go through in the system. And of course this would translate into a competitive advantage because experience allows us to have a deeper understanding of how everything fits together.

The real advantage as I look back on that experience some 25 years later is that it helps with the understanding that not every claim is bad or fraudulent, and not every claim is meritorious.

Some claims are just paid. Some claims are fought hard. Sometimes we pick the wrong battles, and other times it was obvious that the right battle was fought.

But most claims are just what they are - an injury that requires some medical attention and a couple of bucks to get through the tough time. They fit within the system and the system works just fine.

When we think of the gross volume of claims that go through workers' compensation it is a wonder things work at all, let alone as well as they do.

We make changes and adjustments to the system, and to our handling procedures, to accommodate those that aren't within the four corners of the system as we know it, and there are the claims that don't fit within those parameters either.

So not everything works as intended, and not everything is as bad as it seems. There's always room for improvement, but we don't need to improve everything all of the time.