The New York Times published an article this weekend titled Pain Pills Add Cost and Delays to Job Injuries. Interestingly, many of the quotes in the article were supplied by individuals associated with workers’ compensation insurance carriers.
Let’s be honest. Are pain medications over supplied to a few injured workers? Absolutely. The opposite is also true — Some severely injured workers have been wrongly denied needed pain medications. In my practice, I have seen both situations. Frankly, I see many more people who need medications or medical care but, instead, have suffered only denials and delays.
Insurance carriers are now raising the pain medication issue because they see an opportunity to further cut costs. This is NOT the real problem the workers’ compensation system faces. The real issue is the proper provision of health care, itself, to injured workers.
Insurance carriers routinely attempt to shift their responsibility for the medical care of injured workers to already over burdened taxpayer-funded sources. Remember – these insurance carriers are collecting premiums to meet this legal obligations. Yet, we are too often paying their costs. A recent UC Davis study highlights this huge amount of cost shifting concerning work-related accidents and illnesses.
In my practice, I routinely receive calls from injured workers where the insurance carrier has simply refused to provide basic care, such as physical therapy, an MRI request to diagnose the injury, or even a referral to a specialist for an evaluation. If those simple medical treatments are an issue, just think what carriers sometimes do when a doctor recommends costly surgery. In those cases, carriers will often shop for a second opinion that allows them to deny the request.
The larger picture (and real issue) relates to the responsibility for health care in workers’ compensation cases. Here are three quick observations I have on this issue in Alabama:
- Too often, injured workers have to fight just to get the basic medical treatment required by Alabama law. This situation exists because insurance carriers first get to choose the treating physician. Second, the carriers can deny or delay care prescribed by that physician and suffer no real penalties under our law. For every worker who gets an attorney and is eventually successful in getting treatment, how many simply give up?
- Too often, needless denials and delays by the insurance carriers result in a treatable injury worsening to the point it becomes disabling. How many injured workers could have recovered their health and returned to work by the prompt provision of medical care? Instead, the worker does not receive needed care, gets worse, and ends up requiring long-term pain medications.
- Too often, insurance carriers try to completely avoid any medical costs by simply sending the injured worker to a doctor who will release the person despite evidence of continued problems that could be treated. This situation happens in Alabama all too frequently. How many injured people are released by the comp doctor without needed care and simply end up getting pain medications from their personal physician?
by Jeff Blackwell