Published on:

Investigation: Work Injury “Middlemen” Seeing Huge Profits While Workers Languish

Recently in Las Vegas, reporters described a scene of great excess: Thinly-clothed acrobats performing from ceiling swings, dancers in lingerie on poles shaking to the techno music, actors dressed as aliens looking for a photo op, a live alligator, rock stars performing, waitresses passing out free chocolate truffles and cocktails, designer handbag giveaways, free Hummer limousine rides and more.vagas

These individuals were attending the National Workers’ Compensation Disability Conference Expo – one of about 150 such conferences held annually by the “middlemen” of workers’ compensation. These companies are hired by employers and insurance companies to conduct “cost containment” in workers’ compensation cases.

Services offered are varied, and include claim management and negotiation of medical bills. These firms promise to cut costs for all involved, but in reality, many say they are in fact increasing costs and worse, raising the burden of those who have been hurt at work.

Workers’ compensation is supposed to be straightforward. Worker gets hurt on-the-job. Worker receives immediate medical and wage benefits through the course of recovery. But these firms work to fight claims tooth-and-nail, reducing the amount workers receive – if they receive anything at all. They have culled networks of high-powered defense lawyers, expert medical opinion providers, medical bill review services, occupational medical clinics, labs that drug test injured workers and outside claims shops. 

In fact, as ProPublica recently reported, these companies raked in an estimated $90 billion in 2013. Some companies reported three-fold profits in just a few short years. These profit margins have led to the kinds of lavish parties described.

ProPublica, a non-profit news agency, has in the past detailed how lawmakers, at the behest of powerful industry lobbyists, have slashed payments not only to workers, but doctors and lawyers as well. Meanwhile, these cost containment companies are raking it in. Twenty-six of these firms report hosting lavish golf tournaments each year. Some gave away Apple watches. One offered a free Vespa scooter. Others doled out bottles of bourbon. There have also been free messages, superhero caricature artists and shoeshines.

There is one of these conferences every other day, hosted by firms that wield huge influence over which workers’ compensation claims receive approval and which don’t.

What you won’t see at these conferences? Injured workers. Despite the fact that workers are at the center of these industries, not one injured worker has spoken at any of these conferences.

And what’s perhaps most troubling is that decisions regarding denial of care increasingly aren’t being made by doctors or even the workers’ employers or insurance companies. Instead, these life-altering decisions are made by these so-called “managed care companies,” who employ claims administrators and cost-containment firms, hired by employers. As some familiar with the system have noted, these companies add a “layer of cold bureaucracy” to a system that is already complex and convoluted.

Some companies are spending significantly more on overhead for their premiums than they are on medical care extended to injured workers.

There are those who insist that these firms are beneficial because they “help workers return to work quicker.” But the problem is, the health and well-being of workers is being compromised, and returning to work faster may not always be in their best interest – or in the best interest of their company.

We highlight this case to give you an idea of what you are up against when you file a workers’ compensation claim. You need a legal team with experience to help you fight back.

For information on Atlanta work injury compensation, contact J. Franklin Burns, P.C., at 1-404-303-7770.

Additional Resources:

‘All of this Because Somebody Got Hurt at Work,” Dec. 29, 2015, By Michael Grabell, ProPublica

More Blog Entries:

Chandler v. Atlantic Scrap & Processing – Attendant Care Compensation, Dec. 23, 2015, Atlanta Workers’ Compensation Lawyer Blog