CHARLESTON, W.Va. -- More and more injured workers fail to get needed medical treatment under new state rules created after a 2005 law privatized the state's workers' compensation system, lawmakers were told Tuesday evening.
The Legislature's Joint Judiciary Committee held a hearing on Tuesday evening about increasing difficulties many injured workers face today.
Among the new rules is one that makes it illegal for a lawyer to receive a fee for representing injured workers who are trying to get medical benefits.
Pat Maroney, a Charleston lawyer who represents unions and injured workers, told the committee an increasing percentage of all protests challenging the benefit denials today focus on medical benefits.
In 2003, before the new law was passed, 8 percent of all appeals involved denial of medical benefits. Since 2004, Maroney said, that percentage has ranged from 21 percent to 31 percent.
Not everyone dislikes the new rules.
"The system is working fairly well. There has been a tremendous reduction in protests [of benefit denials]," said Tim Huffman, a lawyer for Jackson Kelly and vice chairman of the West Virginia Chamber of Commerce. "In 2005, there were 19,000 protests. By the end of 2009, there will be about 5,800 protests."
Chamber President Steve Roberts, president of the West Virginia Chamber added that his group would be "concerned about anything that might increase costs."
House Majority Whip Mike Caputo, D-Marion, said he frequently talks to small business owners in Fairmont, such as beer distributors and restaurant owners.
"I have not seen anyone whose workers' comp premiums have gone down," he said.
Roberts said premiums have dropped for the large companies who employ half the state's workforce.
The complexity of new rules and regulations also makes it more difficult for physicians to complete paperwork associated with injury claims.
CHARLESTON, W.Va. -- More and more injured workers fail to get needed medical treatment under new state rules created after a 2005 law privatized the state's workers' compensation system, lawmakers were told Tuesday evening.
The Legislature's Joint Judiciary Committee held a hearing on Tuesday evening about increasing difficulties many injured workers face today.
Among the new rules is one that makes it illegal for a lawyer to receive a fee for representing injured workers who are trying to get medical benefits.
Pat Maroney, a Charleston lawyer who represents unions and injured workers, told the committee an increasing percentage of all protests challenging the benefit denials today focus on medical benefits.
In 2003, before the new law was passed, 8 percent of all appeals involved denial of medical benefits. Since 2004, Maroney said, that percentage has ranged from 21 percent to 31 percent.
Not everyone dislikes the new rules.
"The system is working fairly well. There has been a tremendous reduction in protests [of benefit denials]," said Tim Huffman, a lawyer for Jackson Kelly and vice chairman of the West Virginia Chamber of Commerce. "In 2005, there were 19,000 protests. By the end of 2009, there will be about 5,800 protests."
Chamber President Steve Roberts, president of the West Virginia Chamber added that his group would be "concerned about anything that might increase costs."
House Majority Whip Mike Caputo, D-Marion, said he frequently talks to small business owners in Fairmont, such as beer distributors and restaurant owners.
"I have not seen anyone whose workers' comp premiums have gone down," he said.
Roberts said premiums have dropped for the large companies who employ half the state's workforce.
The complexity of new rules and regulations also makes it more difficult for physicians to complete paperwork associated with injury claims.
"We have 36 primary care physicians in Ohio County. But only six of those physicians accept Workers' Compensation patients today," said Sue Howard, a Wheeling lawyer who represents injured workers. "This may be an inadvertent consequence of reform. It needs to be changed."
Howard also said injured workers need lawyers, especially when BrickStreet or another private carrier denies medical treatment recommended by examining physicians.
"Insurance companies have experienced lawyers represent them," she said.
Dr. Patricia Bailey, a psychologist who runs Bailey Behavioral Health in Wheeling, urged legislators to amend the law to allow "licensed psychologists to be included in the group that can make recommendations" for workers' comp benefits.
"In the Northern Panhandle, there are no psychiatrists who will handle workers' compensation. Today, claimants have to travel to Morgantown or Charleston," Bailey said.
Jeff Billeter, who hurt his back working at the Lanam Foundry in New Martinsville, also spoke.
Several physicians and medical specialists recommended surgery to fuse Billeter's spine. But BrickStreet denied coverage and hired Jackson Kelly to defend its denial.
Billeter said he was the "sole provider" for his family and wants to go back to doing his old job. Today, he still works at the foundry, but only does sedentary work.
Steve Moser, vice president of Lanam Foundry, accompanied Billeter at the hearing. Moser also believes Billeter should have surgery to restore him health.
"I want to be the same man I was two years ago, before I got hurt. I want to get back to work," Billeter said.
Reach Paul J. Nyden at pjny...@wvgazette.com or 304-348-5164.
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Good luck and don't get hurt on the job.
Second, West Virginia got what it deserved: they believed a bunch of crooks who claimed Workers Comp needed to be privatized to survive. As with all insurance industry, no one bothered to look at the books to see if they were telling the truth.
Lastly, Brick street is now able to define what is considered a compensible injury in WV by limiting the pool of doctors a worker is able to see.
Need a doc who can diagnose an occupational disease from long term exposure to Perchloroethylene? Too bad. Comp wont pay for it and most docs are not willing or able to fight Comp for 8 or more years so they can be denied payment for treating the patient.
At a public forum at Tamarak prior to privitization I asked Burton if Comp would pay for medical services to treat a disease not recognized by comp docs. He pretended not to understand the question. Now I know why: Money!!!