Monday, September 26, 2011

9/11 Claims Report Demonstrates Limited Relevancy of Work Comp

The most recent report by the New York State Workers Compensation Board (SWCB) concerning the ratio of 9/11 claims being controverted versus the rate of "normal" claims should not be surprising to anyone that reads this blog.

SWCB said 5,109 of the 12,296 workers' compensation claims filed by people who worked at or near Ground Zero and those involved in the rescue and cleanup – or about 41% -- were controverted by insurers or employers.

By comparison, 161,744 of the 986,849 claims not related to the World Trade Center attack – or 16% -- analyzed by the board between 2001 and 2007 were controverted by employers and insurers.

Robert Grey, a claimants' attorney and chairman of the New York Workers' Compensation Alliance, told WorkCompCentral that the disputes filed by private carriers most often involve disagreements among multiple insurers over which carrier is responsible for paying but that the New York City Law Department is routinely disputing 9/11 claims filed with SWCB.

SWCB reported that private employers controverted 61.5% of the 9/11 claims filed with SWCB. New York City agencies disputed a little more than half -- 50.2% -- of the claims.

The City denies any systemic distinction involving claims arising out of 9/11.

Robert Grey, a claimants' attorney and chairman of the New York Workers' Compensation Alliance, said carriers and the city found that by dragging out claims with disputes workers often give up before the claim is resolved.

In response to complaints from District Council 37 of the American Federation of State, County and Municipal Employees (AFSCME), the 19-member Worker Protection Task Force was created by the New York Legislature in 2005, assigned its Workers' Compensation Committee to review allegations that claims by rescue and clean-up workers were more frequently litigated.

The committee reported in May 2009 that it had found "strong evidence" that the union's contentions were valid. The committee said rescue, recovery and clean-up (RRCU) claims were being controverted at more than three times the typical rate.

Workers' compensation is a cash flow industry. In an economy as difficult as the one we have been in since 2008, it is no wonder that 9/11 claims - which are very expensive to compensate with claims of pulmonary disease, cancer and mental health injuries predominant - are going to face greater scrutiny, and greater delay.

Lee Clarke, occupational safety director for AFSCME's District Council 37, said, "It's taking 18 months to three years to get these claims resolved. It's making it difficult to get medical care for the first responders."

Three years to resolve a dispute. That's sounding more like the time frame of a civil law suit.

And when a civil law suit is resolved, that's the end of the case at least (pending appeals, which apply likewise to workers' compensation cases). A workers' compensation case is not over unless there's some final cash out settlement, which means that three years is only the beginning of a controverted claim going through the litigation process.

Is this evidence of the limited relevancy of workers' compensation to today's society as it is currently constructed and applied? I think so.

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