Who Is to Blame?

People who know about the system used in compensating workers agree that its full of problems and that these problems are always the fault of someone else. Fingers are pointed at lawyers and legislators, doctors and other health professionals and at insurance companies, while employers and employees are equally accused of fraud. The California Department of Insurance targets the bosses.

You will always see some form of employer fraud when workers' compensation insurance is involved. An employer can commit fraud by underreporting the payroll or by misclassifying employees. There is a different perception made by the state's top insurance regulator about this. According to the California insurance commissioner, people who are being paid large sums of money are abusing workers' computer insurance.

An attorney, who deals exclusively with workers? compensation issues, doesn't completely absolve any group, not even lawyers, from blame for the current crisis. The strongest defense he can give will be for the workers. Workers hardly have any cases of fraud. He refers to a number of sources including the California applicants' attorneys association Web site, which says that out of 4 million injuries reported between 1993 and 1998 only three people were arrested per 1,000 claims and only two per 1,000 were convicted.

According to him, it would give him a great relief if employers and employees come to the realization that they are in the same situation against insurance companies. Five years after the deregulation of the insurance industry in 1995, cost of insurance began to drop. Since the number of claims was low, insurance companies invested the premiums in the stock market and made huge profits.

Problems also came about because of 9/11. Billion dollar losses and many companies out of business were the results of these terrorist attacks. According to him, around 235 private companies are still offering workers' compensation insurance in California and that he approves legislation that would include them in the state Web site.

Rates are unaffected when there are no claims, but when there are claims, rates go up. Senate Bill 191 which aims to reward claim free employees is a legislation he supports.

Compitis is the word that comes to this physical therapist's mind as he describes the conditions of his patients. He believes that there is a notable difference in the recovery time of a work related injury when compared to the recovery time for a non related work injury.

A person who got injured because of a mishap at work would most likely take longer to recover than if he got injured because of an accident outside of work. This system of payment would help doctors recall who their patients with workers' compensation are.

Submission of the paperwork ensures that the check will be sent to the health professional promptly. According to him, this is very different from the many requirements and problems one may usually expect from an HMO.

Around 15% of patients served by one chiropractor make use of workers' compensation, while other chiropractors' patients estimate to be around 40% of their total number. He said chiropractors would bill for additional services, therapies, and treatments just to take advantage of the system. He is no stranger to how patients abuse the system. A fake injury can be discovered through certain tests.

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