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Q-Workers' Compensation System and Statistics

In late 2018, the State Board of Workers' Compensation published statistics for the entire year 2017, their last full year of numbers. 

What is most interesting to note is the amount of payments by employers and insurers and self-insurers for medical care.  This number was greater than the payment of weekly workers' compensation payments to the injured worker.  Here is the breakdown:

Payments to workers for lost time:     $651,233,036.00

Payments to all medical treatments:   $713,012,567.00

What does this tell us?  To me it says that I should have set out on a different career path – medicine!  All kidding aside, here are a few observations:

There are far more doctors, urgent care clinics, pain clinics, physical therapy clinics, hospitals, MRI facilities, and the like, than there are lawyers.  Clearly, there are lots of lawyers, but in the workers' compensation field, lawyers representing the injured worker and those who represent the insurance companies, the numbers are spread out evenly and there are about 450 in the State of Georgia at this time. 

Is this good?  Is this fair?  More importantly, does this number represent an evenly balanced workers' compensation system when both the employer and insurer are equally represented?   The data would say this is about the average in the United States. 

The number of injuries where the worker needs to stop working due to the severity of the injury was 31,979 in Georgia for the year 2017.  That means that there are approximately 88 injuries every day in the workplace in Georgia.

Georgia seems to be a rather dangerous place to work.  It is a right to work state, and the employer very clearly controls the workers' compensation system.

There is also a very interesting total and that is the number of medical only claims.  That means people who needed treatment but did not lose time from work.  There were 85,820 medical claims.  That means that there were approximately 235 at work injuries per day in Georgia.  If you add this 85,820 to the number where the employee was not able to continue working after the injury, the number is a staggering 117,799 or 322 people each day experiencing an injury of varying severity.  

The total medicals paid for those 85,820 who did not lose time from work was $96,790,241.  That is a heck of a lot of medical payments where the injured worker does not lose time from work.  Either this means that the clinic system is quickly patching people up and putting them back to work and they are not being reported as lost time injuries because the employer finds other temporary work for the employee or the injured worker does everything he or she can do to avoid losing time from work and having to file a workers' compensation claim and deal with the entire workers' compensation system which is litigation intensive, full of frustration and delay and deny throughout. 

The wisest thing to do to is avoid dealing with workers' compensation if at all possible.  Our outcomes are scattered at best, and at worst the litigation is plainly insufferable. 

On a rather morbid note, I recently found statistics for the year of 2017 that reported 5,147 deaths in the workplace in the entire United States (which is more than three times the amount of Georgia highway fatalities for the same time period.  In 2017, Georgia highway fatalities was 1,549.)  America's most dangerous occupations are as follows (per 100,000)

Fishers and related fishing workers                                                    99.8

Logging workers                                                                                 84.3

Aircraft pilots and flight engineers                                                     48.6

Roofers                                                                                               45.2

Refuse and recyclable materials collectors                                         35.0

Structural Iron and Steel workers                                                       33.4

Drivers/Sales workers and truckers                                                     26.8

Farmers/Ranchers and other agricultural managers                            24.0

First line supervisors of grounds keeping and landscaping services    21.0

Electrical powerline installers and repairs                                           18.7

Georgia has a moderate share of the most dangerous occupations.  So when your spouse gives you a kiss on the cheek in the morning (noon or night) and you grab your lunch pail to head to the job of your dreams, do be careful.  It's a dangerous world out there!

Q-Should I take the advice of the Nurse Case Manager assigned to my case by the insurance company?

A-I had a Nurse Case Manager e-mail me recently, stating she needed my permission to work directly with my injured client. This is the law. However, the NCM can speak to the doctor without my permission. I hate that Rule that allows this!

The NCM said: “The adjuster concedes that your client's injuries involved not only his right shoulder but his low back.” (This was going to be an issue but the insurance adjuster decided not to fight about it).

She continued: “I would like to recommend to you the following 3 orthopedic surgeons who are well qualified to treat back injuries and whom I have a lot of confidence in.”

“These 3 doctors are Lee Kelly, Hal Silcox, both with Peachtree Orthopedic Clinic and Dr. Robert Greenfield with Resurgens, she said.” The NCM must have thought I just started practicing workers' compensation law yesterday. These 3 doctors are NOTORIOUS insurance doctors. They are so far from fair and balanced it is not even funny. Recently, a judge called one of the 3 a “polarizing doctor.”

I told this NCM that if she sees her job through this lenses of these type of doctors, my client and I do not want nor need her help. I knew right then this NCM was bought and paid by the insurance folks. She had no objectivity whatsoever. How could I say this? Through 40 years of legal experience in this field.

Each of these doctors have been in business to help the insurance companies for about 30 years each. I avoid them “like the plaque” and I will tell anyone and everyone the same thing.

Lastly, my client has the right to sit in and participate in a conversation the Nurse Case Manager has with your treating doctor. But if the NCM schedules that appointment when are not in the office, how will you know it is taking place? This is why I hate this Rule!

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