House lawmakers got an earful this week on proposed workers' compensation measures. Business groups and health care advocates complain the draft legislation doesn’t do enough to address attorney fees, premium costs, physician fees and patient choice.
Workers' compensation is the health system for workers who get hurt on the job. Employees get medical care and lost wages from their employers for promising not to sue. But workers do sue when insurers deny their claims. State laws allows judges in compensation claims to insurers pay all the attorney fees.
“Right now essentially you have the insurance industry setting its own rates as they did just a few months ago and then coming to the legislature saying we have a crisis,” said Rich Templin of AFL-CIO.
He blames the insurance industry for the spike in workers' comp rates. The state approved a nearly 15 percent increase last year when the Florida Supreme Court struck down limits on attorney fees and disability payments. Legislators want to lower the rates, but a fix may prove elusive this session.
The draft legislation caps attorney’s fees at $250 an hour. It also ties outpatient care to the Medicare fee schedule. But retired orthopedic surgeon Fraser Cobbe said that could force doctors to stop seeing workers' compensation patients. He said those are very different than Medicare patients because of the larger amount of bureaucracy involved.
“We need to treat these patients," he said. "I enjoy treating them. The clinic where I was before and retired treats a large number of worker’s compensation patients. But, if you cut back on fee schedules, you going to cut down on access. There’s no question about that.”
Businesses and insurance carriers blame attorney’s fees for driving up the cost of workers' compensation. Florida employers are facing a $1.5 billion rate increase because of the 2016 supreme court decisions. Samantha Padgett with the Florida Retail Federation said last year’s 14.5 percent increase is hard for companies to pay. She says injured workers should pay their own attorney fees.
“Thirty-two states, which includes the District of Columbia have purely claimant-paid fees in the worker’s compensation system,” she said.
But Richard Chait with the Florida Justice Association disputes that claim. He said employers and insurers are wrongfully denying claims they should pay.
“They have a business model where they’re building in an intention to deny benefits," he said. "Provide the benefit and you’ll never have to pay the attorney’s fee.”
Cumulatively rates fell 60 percent after lawmakers made employer-friendly changes in 2003. But Templin said those "reforms" helped the insurance industry at the expense of both employers and workers.
“The insurance folks were kind of just the middle men, if you will, not really a part of that original agreement and what has happened is this system and this agreement has been taking over by an industry that seems to continue to put profits over people,” he said.
While calling out the legislation’s shortcomings, business groups did praise a proposal excluding personal information on injured workers from public records. That could make it harder for lawyers to recruit clients.