Posted by Del on March 19, 1999 at 11:38:30:
In Reply to: Re: Reply to T. Urtle posted by T. Urtle on March 19, 1999 at 09:06:51:
Although several workers we've talked to never received the Notice of Closure only one was successful in fighting it. Does it not seem strange to you that a certified letter is not required and why the ins. co.'s would not do this especially since they always send IME demands this way. I have to repeat that at this stage many workers are unable to find representation from an attorney due to the statutes that dictate workers' attorney fees.
YOU: Given these facts, what would you recommend if you were the administrator of the workers' compensation division?
I: I would suggest that that Dept. be reorganized and improved upon and then increase its involvement in claim closures. Although I disagree with your assessment of that Dept.'s record I will say that it's simple to dismantle Evaluations but the sign of a great administrator is to correct something that may not be working as well as it could and should.
Get injured workers involved in these changes.
SB 220 is not the answer since the insurance companies ARE NOT interested in acting honestly. They proved their true intentions when they strongly objected to a 2 year independent audit of claim closures which is why SB 220 is in limbo now.
YOU: Just to be clear, the evaluations unit is not allowed to advocate for workers and does not have the power to reverse closures performed by insurance carriers.
I: They have researched and advocated reversing specific claim closures that they performed and others that were later found to be wrong and have involved themselves in those done by ins. co.'s. although that may not be in their job desciption.
I would be surprised to find even one instance where an ins. co. voluntarily (without outside pressure) reversed itself in this situation.
The appellate unit is under-staffed and under-budgeted and takes months to reverse a closure. In the meantime the worker has no temp. compensation coming in and in most cases cannot continue medical treatment. I'm experiencing this right now. No new evidence after the process has started such as perjury by an ins. co. is admissible. Workers are not allowed to testify which we believe violates the Oregon Constitution's Bill of Rights (see IWA main page).
YOU: The wasted money on the evaluations unit would be better spent on increasing the number of auditors and increasing staff for the ombudsmans office.
I: If you read Mr. Mattis's earlier message you'd know that this savings WILL NOT be used for these purposes. Even though the Ombudsman's office presently has two extra workers they may be taken away and their office has been given much more responsibility recently which greatly offsets this increase if it stands. There was a more than doubling of inquiries since their last staff increase over 3 1/2 yrs. ago which should tell you that the carriers are not acting honestly especially since state records claim fewer injuries.
What these numbers really reveal is that injured workers in increasing numbers are not getting claims accepted due to the higher standard of proving that their injuries are work-related SB 369 1995).
P.S. T. Urtle, I have been very upfront about who I am. I use Del when my opinions are my own vs. that of IWA.
I think you've contributed greatly to this BB since opposing views are crucial to any open fforum.
Since a viewpoint on any subject such as WC can be slanted due to the writers' background or involvement why don't you come clean about who you are so we may better understand the rationale for your views.
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