How Obamacare Can Help Workers Compensation

Michigan workers compensation lawyer gives his take on how the Patient Protection and Affordable Care Act (PPACA) will help injured workers get better medical treatment and save taxpayers money.

It’s no secret that many Americans dislike Obamacare. They have real concerns about the role of government and whether this is a first step towards socialized medicine. For the sake of this blog post, forget the politics and just look at how workers compensation might be affected.

By way of background, workers compensation is a type of insurance that protects both employers and employees in the event of a workplace injury or illness. Employees are guaranteed some limited benefits, like medical treatment and wage loss, while employers get protection from civil lawsuits. Most states require that some form of workers compensation be purchased by nearly all employers.

The big lie about who is paying for work injuries

Many in the workers compensation community feel that premiums are artificially low and this will lead to a crisis as insurance companies exit the market. In fact, a recent study from UC Davis published in the Journal of Occupational and Environmental Medicine showed that nearly 80% of workplace injury costs were actually shifted to other payers.

So who are these generous people who are picking up the slack for workers compensation? The answer is all of us through higher taxes and health insurance premiums.

Injured employees don’t just go away when their workers compensation claims are denied. They seek medical treatment through employer-sponsored health insurance, Medicaid, and Medicare. They apply for cash assistance, food stamps, and Social Security disability benefits.

Some employees and their families end up footing the bills themselves. Doctors and hospitals get stuck when they don’t get paid and the patient files bankruptcy to avoid the debt. Many employees get no medical treatment at all.

How Obamacare can help fix the system

Studies have shown that the sooner an injured employee gets back to work, the better the outcome. The problem is that many injured employees cannot get proper medical treatment. This results in extended periods of disability and higher costs for employers.

So many of the cases we file could have been avoided if the injured employee was given prompt medical care and allowed to return to work with some temporary restrictions. Most of our clients simply want to recover and get back to gainful employment. Employers can actually save money and avoid litigation by treating their employees better.

The expansion of health care will give people more treatment options. It will allow the uninsured a chance to get medical treatment even if workers compensation has denied the claim. This will result in faster recovery times. It will also take the burden off emergency rooms and allow for a more efficient system.

Requiring reimbursement

It’s human nature to seek the path of least resistance. When a workers compensation claim is denied, most people simply give up and use other insurance. The uninsured will continue using the emergency room as their own industrial clinic.

Reimbursement from workers compensation becomes impossible unless a bad claims decision can be challenged in court. To make things worse, many people who are uninsured are unable to obtain medical proof that their injury is work-related.

The expansion of health care will allow individuals to obtain medical evidence showing that their condition is work-related. This will force workers compensation insurance to pay valid claims and will open the door for reimbursement.

The Centers for Medicare and Medicaid Services have already gone on the record stating that over $50 Billion in reimbursement has been obtained through the Medicare Secondary Payer Act. This amount will certainly increase under Obamacare. Private health insurance companies will also see a spike in reimbursement through more subrogation. Doctors and hospitals won’t wonder if they are going to get paid on work accident claims.

Alex Berman is the founder of Michigan Workers Comp Lawyers. He’s been representing injured and disabled workers exclusively for more than 35 years.  Alex has helped countless people obtain workers compensation benefits and never charges a fee to evaluate a case.

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