Investigators: State workers' comp system adds insult to injury

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by LINDA BYRON / KING 5 News

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KING5.com

Posted on July 6, 2010 at 10:58 PM

Jeremey and Suzette Jackson own Northwest Granite & Flooring on Whidbey Island. They say that the current economy is hurting their bottom line, but what's really killing them is escalating workers’ compensation rates.
 
"We're a small business, we can't really afford for the rates to go higher," said Suzette.

But the Jacksons don't have a choice. Under state law, they have to pay into an Industrial Insurance Fund that covers medical costs and lost wages for workers hurt on the job.

Jeremey demonstrated the work their lead fabricator was doing on a big tub surround when he hurt his back.

“Basically a polishing movement back and forth,” he said.

"This is the original prescription that the doctor gave him, saying that he should be off work for one week," said Suzette.  She showed us the prescription that was written nearly four years ago in August 2006. The claim is still pending.

Having an open claim drag on for years is a big deal. It means the Jacksons pay substantially higher rates for all of their employees.

"It's cost us thousands and thousands of dollars," said Suzette.

The Jacksons' rate went up nearly 30 percent in just the past year because they have an open claim in what's already considered a high risk industry. Yet they say resolving the claim is out of their control.

"I've done everything I can do. And I just don't understand why it's taking this long. I really don't and they can't give me an explanation," said Suzette.

You might think it's because the workers comp system is overwhelmed with more on-the-job injuries--but it's just the opposite. The KING 5 Investigators have found the number of accidents and fatalities on the job is dropping, yet more and more cases are taking longer and longer to resolve.

We asked Robert Malooly, who runs the State Workers’ Compensation Program, why that’s happening.

"It's a very difficult problem, there’s no clear answer, there’s no single factor,” he said.

What is clear are the numbers: In 1999, total benefits paid to injured workers totaled $879.9 million. Last year they hit $1.5 billion. That’s an increase of 73 percent.

Proof, say critics, that Washington hands out benefits far too easily.

"You will find employers who say that in every state in the country, and you'll find workers who say Washington is too stingy,” Malooly said.

The median time loss is 40 days for all injured workers.  But there is a disturbing trend for claims that qualify for long-term benefits. Those workers are staying on the state payroll an average of nine months.

The Jacksons' injured granite fabricator is one of those troublesome cases.

We reviewed his file and found that since 2006 the Department of Labor and Industries has paid the injured worker $126,000 in lost wages. The state has also spent more than $20,000 for physical therapists, doctors, specialists and vocational experts - all with the goal of getting him back to work.

But for most of 2009 his doctor was recommending a state pension - lifetime benefits. The doctor wrote that the worker has “difficulty with standing, difficulty with walking…He ambulates with a cane…and needs assistance carrying in his own groceries.”

The Jacksons were skeptical. They took photos of him on a boat docked in the marina, which they sent to Labor and Industries.

"Supposedly he can't even carry his groceries but he can pick up a 5 gallon bucket of water, dump it out bend over to fill it up and carry it back. Not a problem. And later I saw him walking out of the marina up the gang plank. No cane."

An investigator for the department of Labor and Industries did surveillance too and videotaped him working on his boat in his yard. The investigator took video of him going up and down a ladder, walking without a cane, and swinging himself into the boat.

In May, after reviewing the video, the doctor gave the injured worker the green light to work again, but in a sedentary job.

The Department of Labor and Industries is not accusing him of committing fraud. But L & I is concerned that more and more of these cases are lingering, and they need to change that.
 
"We are looking to cut the delays as much as we can. We want workers to get back to work sooner," said Malooly.

The Jacksons' injured worker was advised by his attorney not to talk to us. As for the Jacksons' Workers’ Compensation Rates, they will probably spike again next year because the longer you have a worker off the job with an unresolved claim, the more you pay. But their rates should start dropping in 2012.
 

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