New York Workers Compensation Alliance

Several members of the Workers' Compensation Alliance (WCA) Board of Governors were in attendance at the Workers' Compensation Reform "Roundtable" called by Republican State Senator George Maziarz on 3/13/06. In addition to the very even handed Senator Maziarz, Senators Marcellino, Onorato, Wright and Little were present.

Invited speakers included Denis Hughes of the New York AFL-CIO, Dan Walsh of the Business Council of NY, Richard Bell of the NYS Workers' Compensation Board, Monte Alper of the NY Workers Compensation Rating Board. Peter Molinaro of the NY State Insurance Department and Paul Magaril of the NY State Insurance Fund.

For two hours the participant's debated the pros and cons of Governor Pataki's Workers' Compensation Reform bill which is currently attached to the State Budget. After all was said and done, the following was clear:

1) Workers' Compensation insurance carriers made an 8.7% profit in 2004, compared to 4% in other lines of insurance, according to Mr. Molinaro of the State Insurance Department;

2) Mr. Alper, representing the insurance carriers, disagreed but did not have the exact profit figures;

3) The Senators seemed frustrated that these two State agencies could not agree on the "numbers", and stated that they could not make any rational decisions until the numbers are straightened out;

4) Dan Walsh of the Business Council made an impassioned plea that we must "take the emotion out of workers' compensation" and that permanently disabled workers "need to rise above it - it is all a numbers game". Nearly all the panelists, including the Senators, felt this was improper when we are talking about workers losing arms and legs. Even Mr. Magaril of the State Insurance Fund disagreed with Mr. Walsh on this point;

5) AFL-CIO President Denis Hughes noted that out of every one dollar in premium paid by employers, only 65 cents goes to injured workers. The other 35 cents goes to insurance company profits and administrative costs. He suggested we look to this 35 cents to find savings for employers;

6) Near the end of the hearing, Senator Maziarz stated: "I think I'm speaking for the Senate Majority that "we want to make sure that benefits to permanently disabled workers don't stop". Does this mean the Senate opposes caps on PPD's?

The next "Roundtable" is scheduled for April 10th, at which a representative of the Workers' Compensation Alliance will probably take part.

I'd like to see Mr. Walsh, or one of his family members who are injured on the job, take the "emotion" out of WC. His comments were totally inappropriate and I'm glad to see that others disagreed with his stand on this issue. When a worker is injured, it not only affects the part of the body that is hurt, it also affects the mind. It's hard to take emotion out of it when your only thought is where is my next $$$ coming from. It's been over 3 years in my WC case and it still is not settled. I'm now seeing a psychiatrist for major depression over this and the fact that I have not been able to get the treatment my doctors recommend. Perhaps if they did more about the way the insurers treat injured workers and less on the bottom line of profits, we might have a better system with less payouts as people would be able to return to work sooner without the automatic rejections by the insurance carriers.

Nothing amazes me more than the fact that they want to force workers comp patients into "closed networks" for their prescription medications. This would cost NYS and the insurance companies so much MORE money. These vague "closed networks" are nothing more than Prescription Benefit Administrators (PBM's) such as Express Scripts. These are the very same PBMs that our Attorney General is suing on the behalf of NYS. These are the same PBMs that get hidden rebates from drug companies. Why hasn't anyone asked how these PBM's will help contain costs?