Posted by Del on March 12, 1999 at 23:06:09:
In Reply to: Re: What is great about 220? posted by Tom Mattis on March 12, 1999 at 12:39:32:
Your reputation is that of a very intelligent and caring person. The following perspective comes from someone who has been through the "Oregon Workers' Comp Experience." Since I am unaware of you ever having a moderate to severe injury that placed you in Oregon's system it is easy to understand your lack of "street-wise" knowledge of the reality of the system for injured workers. Your assumptions are that the insurance carriers follow the law and act responsibly and morally in their treatment of the injured. They seldom do.
YOU SAID: I will explain why we introduced it. Whether or not it is good or "great" public policy is for the Legislature to decide.
I SAY: The Legislature automatically assumes that what WCD introduces has been thoroughly investigated to determine whether it's good or "great" public policy. When WCD has not canvassed those directly involved (injured workers), ignored those in government who know the gruesome realities, or only relies on the opinions and information provided to it by a special interest (insurance co's and businesses) it taints the entire process. WCD is giving its seal of approval without knowing the true consequences.
YOU SAID: We looked at what had changed over the last 10 years, and tried to determine what duties we had that were either obsolete, out-moded or did not have to be done by government.
I SAY: Using this same thinking should Oregon get out the health care business (Oregon Health Plan). What has changed in the last ten years to change WCD's opinion? Is it not WCD's responsibility to look after the best interest of all Oregonians?
YOU SAID: Claim closure is not a duty which must be done by government and, in fact, rarely is.
I SAY: You fail to mention that one of the responsibilities of the Evaluations Unit which will no longer exist if SB 220 does pass was to look into unreasonable and unjust closures. When fraud is found as in insurance company perjury they could reverse closures in a timely fashion versus the alternatives which take several months or even years.
YOU SAID: You are correct, that we only close about 25% of claims now. Clearly, insurers are more than capable of doing the job.
I SAY: You're absolutely correct and they do so whether itís appropriate or justified. All their decisions are based on economic considerations. They are extremely efficient when involving saving themselves money.
YOU SAID: It is interesting to note that when the law was changed to give insurers the choice to close claims, no one opposed giving them that authority. To raise the argument now that SB 220 harms workers rings rather hollow.
I SAY: Is it your contention that because injured workers weren't organized in large numbers then and others who also oppose SB 220 such as unions and workers' "defense" lawyers did not have the resources to oppose it then that this automatically determines that SB 220 is good for Oregon workers and we are not righteous in wanting to stop what we know will cause great harm.
YOU SAID: Moreover, unlike 10 years, WCD has a mandatory reconsideration process which gives a worker who is dissatisfied with the claim clsoure or disability award to have impartial disability experts in WCD review whether the insurer closed the claim properly. It is interesting that workers do not appeal insurer closures at any greater rate than they appeal WCD's closures.
I SAY: This process takes months. A worker can't contest a closure if the ins. carrier never tells them of it until after the time limit imposed for filing a reconsideration, etc. Why aren't ins. carriers mandated by rule or law to send closures by certified mail?
Could you send us this data of claim closure and appeals comparisons? We were under the impression no such data existed. Are the ins. companies required to send WCD their internal documents on this subject?
YOU SAID: The Management-Labor Advisory Committee and auditors for the Secretary of State have endorsed SB 220, as has the Governor by virtue of inlcuing it in his 1999 Legislative Agenda.
I SAY: Maybe you should check the labor side of MLAC for what they think now. Does the S.O.S. and the Governors endorsement automatically mean that this is good for Oregonians? Have these people ever been wrong on something? How does the S. O. S. Office relate to whether SB 220 is good for Oregon? Legality doesn't always equal right (vs. wrong). They have been just as misinformed as WCD Management since until recently their decisions have been based on misleading and untrue data and input by only high priced ins co. lobbyist. They're in just as much of the dark as yourself to the realities injured workers face because of immoral and outright sadistic behavior by workers comp insurance companies.
YOU SAID: If we felt that this bill was truly going to harm workers (or employers)we would not have introduced it.
I SAY: A rule of thumb should be this when it relates to workers compensation statutes or law.
1) What is good for employers/ins co.'s is always bad for workers.
2) Anything pro-worker in the long term is very good for Oregon and its economy.
We know you're sincere with your statement above but injured workers are unanimous (along with many others) that SB 220 will cause injured workers further harm to their health. Please, take the time to hear from those who your decisions most directly affect.
Although I'm the IWA Webmaster these opinions are solely my own as a citizen of the world.
I appreciate the time Tom Mattis, Deputy Administrator for WCD has taken to write in this BB and we hope he'll continue to contribute his thoughts and insights.
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