I imagine it is pretty difficult for most people to picture themselves injured at work, whether it is falling off a step-ladder while reaching for some files, slipping on a wet floor, or having a nasty encounter with some type of failed or mis-used equipment, because the state workers compensation system is totally corrupt, mis-managed and dulsetory. Even though most folks don't risk their lives in poor, regional Texas factories, mills, packing plants, poultry processors, and other high occupational hazard industries like fishing, forestry, and petro chemicals, the dangers in a seemingly "safe" white collar environments can include sick buildings, repitious trauma, assaults, and work transportation-related mishaps.
Nevertheless, if our friend to the right got hit by that lightning, his widow and family would receive about 180-grand death benefit under most state standard policies, and nothing more. If he were a contractor, he might not receive anything at all. Even so, less than 50% of Texas employers even carry coverage.
If our buddy lived, he would have a $385 on his maximum benefit, if 70% of his average wages exceeded that amount. If the insurance carrier balked at the claim, (which they do by reflex) he shouldn't expect much help from the state commision responsible for protecting him. The commisioners get gifts, junkets and largess from the few insurance carriers that rule the state. Our ironworker better have a computer (and a state legislator) in his house because that is basically the only place he could get information. It is, sadly, a virtual blind alley.
He could try to hire a lawyer, but he/she must be paid in advance from his meager benefits. This is a system the vast majority don't like, so they don't participate in it. Similarly, doctors don't like it either because they can't get paid, or as often as not, the insurance carrier stiffs them because they know as likely as not, nobody will force them to pay the bills accumulated by the injured worker. Try to find a real doctor in Texas who will accept patients under the current system. What has filled the mpty vacuum is an army of chiropractors, that in effect, systematiclly reduces every injury into a temporary on of very limited scope. I have heard Texas trial lawers say, but never proclaim the following sentiments expressed by the Florida Bar, who face the same problems:
Palm Beach Post Columnist
Monday, April 16, 2007
Last time the Legislature "reformed" workers compensation, it should have satisfied the lobbyists who wanted to keep injured workers in Florida from getting anywhere with their complaints if their claims are denied.
The plan was to starve out the lawyers who represent injured workers by limiting their fees. Division of Workers Compensation statistics show that the plan is working. In 2003, the last year under the old law, there were 22,153 settlements, usually involving a lawyer, with the average payment $21,196. The numbers have declined every year since then.
Like the public health, mental health, worker safety, civil rights, education systems, the workers compensation/insurance system has failed through public apathy. That's the only thing I can think of. I mean, nobody likes the racket we are faced with.
Government advocates for public policy (wonks):
Texas has one of the worst workers' compensation insurance programs in the nation, whether one looks at it from the perspective of the injured worker or the cash-strapped employer. Despite decades of effort, the Texas Workers' Compensation System is ineffective and inefficient.
The existing non-network medical fee guidelines, possibly reasonable in some geographic markets for other health care delivery systems, have proven to be inadequate. They have caused great harm to access to care to our best physician specialists for injured Texas workers. The fee guideline needs immediate adjustment to at least reflect commercial fees plus an increase for the administrative hassles and burdens uniquely present in our current workers' compensation system. Inattention to this matter likely will foster continued attrition of the high quality physician specialists our state will need to restore the injured workforce of Texas in the future.
The only thing I can think of the make this institutional rot in Texas get a little better are Democratic canditdates who articulate muscular, common-sense public policy changes that radically reform and simplify agencies who are re-dedicated to their charge of representing voters and not special interests.