New York Workers Compensation Alliance

NYCOSH, the pre-eminent occupational and safety organization in New York, just released it's 24 Point Legislative Agenda for 2007 (see below).  It is clear that Joel Shufro of NYCOSH and Dennis Hughes of the  New York State AFL-CIO, understand the historic compromise between workers and employers in New York which has been in effect since 1914.  They won't let permanently disabled workers down.

I wonder if that crusading, letter writing, Scrooge-like insurance broker, Larry Gilroy of NYCAN (New York Workers' Compensation Action Network), is reading...perhaps he needs a visit from Marley's Ghost and learn that  "Mankind is his Business!   The common welfare is his  business. Charity, mercy, forbearance and benevolence are all his business.  The dealings of his trade are but one drop of water in the ocean of his business "  There will be many children of injured workers, bright eyed and expectant, who will be heartbroken this Christmas morn when underneath their trees there is little more than a few trinkets and dead pine needles.  If Scrooge Gilroy has his way, permanently disabled workers will have to resort to poor houses when their benefits run out.  I'm sure that when Governor Spitzer read  A Christmas Carol, he rooted for disabled Tiny Tim rather than that "wrenching, covetous old sinner Scrooge". 

Pardon my Holiday digression. In any case, for those of you who want to know some real facts instead of Mr. Gilroy's insurance company spin, read below :

NYCOSH
Workers Compensation Program
December 20, 2005


1. Increase the maximum wage replacement benefit to 100 percent of the state average weekly wage as recommended by the National Commission on State Workmen’s (sic) Compensation Laws in 1972.


2. Index the maximum wage replacement benefit to increases in the state average weekly wage.

3. Increase the minimum wage replacement benefit to one-quarter of the maximum benefit rate.

4. Increase authorization limits for diagnostic testing and surgical procedures.

5. Require payment of medical bills by private insurance carriers where the claim or compensability of a particular treatment is contested.

6. Streamline existing procedures for reimbursement of private insurers from workers= compensation carriers when the compensability of treatment or diagnostic testing is established.

7. Provide for attorneys fees in cases involving medical treatment only so that workers can secure representation.

8. Define penalties and medical and transportation reimbursement as payments of compensation subject to statutory time limits for payment and penalty.

9. Establish fee schedules for prescription medication and durable medical goods.

10. Permit workers= compensation insurers to negotiate for discounts with prescription medication and durable medical goods providers.

11. Define total disability as the inability of the worker to perform his job or any restricted or light duty job offered to him by the employer.

12. Expedite the finalization of claims by abandoning time lines for the permanency findings in favor of maximum medical improvement.

13. Expand the use of vocational assessment and retraining programs.

14. Increase the amounts of existing statutory penalties, make their use mandatory instead of discretionary, and target conduct such as the frivolous controversy of cases.

15. Reduce time periods for employer and insurer compliance and filing through the expansion of existing electronic filing programs.

16. Make statutory and regulatory changes aimed at reducing adjournments and lack of preparedness, including preclusion of cross-examination in the absence of contradictory evidence.

17. Preclude claimants and carriers from appealing WCL Judge decisions that award benefits at tentative rates pending litigation.

18. Impose a time limit within which decisions must be made when a WCL Judge “reserves decision” to review testimony or consider legal issues.

19. Replace the CIRB with an independent entity empowered to investigate insurer income, expense, and profits.

20. Require insurers or the Board to confirm employer entities, payroll, employee classifications and loss history to ensure correct premium charges.

21. Increase regulation and oversight over self-insured employers and self-insurance trusts.

22. Consider making the New York State Insurance Fund the exclusive workers= compensation insurer in the state.

23. Expand the use of existing workplace safety programs and institute additional workplace safety programs, while providing employers incentives for their use.

24. Expand the scope of WCL Section 8-A concerning World Trade Center claims.

There is "NO DATES or SENATE COMMITTEE SET UP FOR
FRAUD AGAINST INJURED WORKERS and the CORRUPTION that our WC TOLERATES KNOWINGLY.
There is NO ONE to investigate IMES' or SELF INSURERS from BAD FAITH Claims like mine and so many others.
WE NEED HELP ! Many of us went to college to get a great career just to have it taken away by INSURANCE MONGOORS. I was told there are "NO" laws to STOP the Bad Faith , FRAUD from IMES' and the SELF INSURERS.
Does anyone care what is happening to us. Trying to survive on welfare or social security like I . When I was entitled to benefits. I have been on social security and MEDICARE since 2001 , I was 45 y/o. How PATHETIC.
Does anyone care that people lose everything they have worked their ENTIRE LIFE FOR ! Some are in so much pain emotionally and physically they COMMIT SUICIDE.
CORRUPTION and Workers' Compensation REFORM needs to be first and foremost on the AGENDA.The "INJURED WORKERS like I that was refused care , delayed, and benefits, medical NEED YOUR HELP. NOW !
If a worker is disabled for life then either permanent partial disability or Permanent Disability MUST be PAID. That was the law since 1914. Or I submit that I will campaign that injured workers just SUE their employers because workers comp. corruption and allowed FRAUD from IMES' and self insurers will take your life.
I would love to speak as an advocate for Injured Workers if you would like to hear our HORROR STORIES. PLEASE HELP US. I ask that you ALL look at the PROFITS these INSUERS are making from the SUFFERING HARD WORKING INJURED WORKER and premiums from employers. We need someone with COURAGE to step up , just like Attorney General spitzer did. GREAT JOB !
WE NEED AN INVESTIGATION into our allegations. We need OUR LIFE back with some benefits we are entitled too.
Dear GOVERNOR ELIOT SPITZER,Lt. Governor and all elected Senators, 2007 IS HERE, TIME TO GET TO WORK !
I and other "INJURED WORKERS and DISABLED people" helped vote you in office. It was "YOU" that had the COURAGE, STAMINA, and proved to be a tenacious and "HONEST" compassionate man that went after certain insurance companies for what they were doing to the hard working people. It is now that those hard working "INJURED" people like myself need you to stand strong and let all know that you will NOT support any disabled people , or hard working "INJURED WORKER" from New York to end up on the welfare role, Nor allow them from having to go on Social Security and medicare at age 50 like I or any age for that matter. This was do to a corrupt workers' comp. system with corrupt IMES' , INSURERS that are lawless and , Governor Spitzer you are well aware of.
Governor Spitzer I was poor all my life and worked since I was 11 y/o ,I always wanted to be a nurse. At age 36 with three years of very hard work for a nursing degree I full-filled my life dream. I was injured at work in the critical care unit lifting men. Herniated two discs that flattened my spinal cord. My employer , their insurer and the workers' comp. system ignored my pleas and my neurosurgeons URGENT request for neck surgery. Finally over a year went by and a domino effect of many more medical problems( I was healthy before this work injury) and many hearings later and visits to fraudulent pathetic IMES, my medications stopped, medical refused the LAW JUDGE ordered my surgery.
I now SUFFER with many spine, nerve , muscle and CHRONIC PAIN 24/7 because of all the delays, refusals and negligence from ALL forementioned.I wanted to reopen my case because my neurosurgeon found after a horrific myelogram that nerves above my 2 inch plate put in to decompress the spinal cord are now being compressed.According to an IME this is not related to my work injury.My neck surgery was paid by the insurer and the Law Judge ordered it but the nerves above the sight or muscle and nerve damage and PAIN is not related according to a very well PAID fraudulent IME. My case was closed even with many expert doctors evaluations. There is a law that IMES' have to be somewhat consistant with expert or injured workers doctor. I was "REFUSED DUE PROCESS" and no one gives a ....I live solely on social security $853.00 a month. I cry all the time because I miss my career , my patients and my health that I had.
GOVERNOR SPITZER I know you would not tolerate this corruption. I am a critical care nurse and will always be, but I can't tolerate the pain that the system left me with literally totally disabled and without medical care, medications to control my pain,nor any monetary benefits, NONE!. Emotional and physical Pain, like so many others. My case was wrongly closed I should be drawing WC for life. If one's work injury caused by the delays, refusals and negligence of the employer, their insurer or WC then "INJURED WORKERS" are entitled to benefits for life according to the agreement and laws for WC made in 1914. These laws are there they are just NOT being followed. I am ENTITLED to benefits but I will never see a dime and I am a critical care nurse , I knew what they were doing to me.
I pray everyday that you will set the fraudulent IMES' and the EMPLOYERS,WC SYSTEM and INSURANCE mongoors straight.
If I may suggest a panel of trusted people that can follow or study a state that received an "A" in a study that was done and rated on their WC System. IOWA got an "A". I would be glad and willing to speak to you or anyone you choose with suggestions on what needs to change. Appoint me to the Board I will gladly put the system in the right direction.Thank You for your time.
I BEG YOU TO HELP US and STOP the INSURERS from CAPITALIZING off our "PAIN and SUFFERING". Read the studies the insurers PROFITS ARE HUGE from INJURED WORKERS.
I TRUST you Governor Spitzer Lt. Governor David Paterson and all elected senators.
Sincerely,
Donna Gilman RN(disabled by a WC System