Questions and Answers

2000 ◽  
Vol 5 (1) ◽  
pp. 7-7, 12
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage
Keyword(s):  
Prince Edward Island ◽  
Social Insurance ◽  
Workers Compensation ◽  
Injured Worker ◽  
Earning Capacity ◽  
Questions And Answers

Abstract Workers’ compensation in Canada is a legislated system of social insurance that is funded by assessments levied on employers. Thirteen established Workers’ Compensation Board (WCB) systems have regional jurisdiction and responsibility for administering and adjudicating compensation for the injured worker. Disability awards for certain injuries are determined by statute; others are determined using an acceptable reference or impairment schedule such as the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). On August 22, 1960, Dr D. E. Bell presented to the Association of Workers’ Compensation Boards of Canada an impairment rating schedule to represent the loss of earning capacity and fulfill the spirit of workers’ compensation. Dr Bell's schedule has served as the basis for many Canadian WCB Primary Rating Schedules. Most jurisdictions refer to the AMA Guides in instances when the primary schedule is inadequate. A table in this article lists the current primary and secondary schedules for assessment of impairment in Canada; another table shows the differences in the ratings between Dr Bell's schedule and the AMA Guides. The AMA Guides is used principally only in Yukon and Prince Edward Island and is used for impairment estimations of more complicated injuries in all regions but Quebec.

Deeming Laws and Practices as Violations of the Rights of People With Work-Acquired Disabilities in Canada

2019 ◽  
Vol 29 (4) ◽  
pp. 536-544
Author(s):  
Jeffrey Hilgert ◽  
◽  
Keyword(s):  
Human Rights ◽  
United Nations ◽  
Social Insurance ◽  
General Meeting ◽  
Injured Worker ◽  
Persons With Disabilities ◽  
Work Related ◽  
International Labor ◽  
The United Nations ◽  
Human Rights Standards

The Ontario Network of Injured Workers’ Groups in Canada is leading a multiyear campaign called Workers’ Comp is a Right to reform the provincial workers’ injury compensation system and to fight back against regressive changes made to the system over several decades. At their Annual General Meeting in Toronto held in June 2019, delegates voted unanimously to make this submission to the United Nations Committee on the Rights of Persons with Disabilities as a part of the regular supervisory process under the United Nations Convention on the Rights of Persons with Disabilities. The subject is income deeming “phantom jobs” to injured worker claimants with income replacement benefits. The document illustrates how Canadian injured worker groups have activated a human rights lens and references international labor and human rights standards concerning social insurance and income replacement benefits for work-related injury and illness.

scholarly journals Social Insurance and Truncated Benefits: Measuring the Impacts of Workers' Compensation

2012 ◽  
Vol 2012 ◽  
pp. 1-21
Author(s):  
Samuel K. Allen
Keyword(s):  
Social Insurance ◽  
Census Data ◽  
Estimation Problem ◽  
Workers Compensation ◽  
Individual Level ◽  
New Strategy ◽  
Lower Wage ◽  
Indirect Impacts ◽  
Over Time

This study addresses the indirect impacts of state-mandated workers' compensation benefits on workers' wages. The benefit structure of workers' compensation causes a fundamental estimation problem. I develop a new strategy to limit the biases inherent in earlier models. I utilize individual-level census data (between 1940 and 1990) to exploit benefit variation that occurs both across states and within the fifty states over time. The results suggest that wage offsets are not constant across time and may be larger for workers at lower-wage levels.

Workers' Compensation

2013 ◽  
Author(s):  
Paul Terrell
Keyword(s):  
Federal Government ◽  
Social Insurance ◽  
District Of Columbia ◽  
Economic Consequences ◽  
Workers Compensation

Workers' Compensation is a form of social insurance financed and administered by each of the 50 states, the federal government (for federal workers), and the District of Columbia that protects workers and their families from some of the economic consequences of workplace-related accidents and illnesses.

Literature Review

1997 ◽  
Vol 2 (1) ◽  
pp. 4-8
Author(s):  
James B. Talmage
Keyword(s):  
Workers Compensation ◽  
Body Parts ◽  
Injured Worker ◽  
Disability Benefits ◽  
Fourth Edition ◽  
Permanent Disability ◽  
Work Related ◽  
Work Related Injury ◽  
Whole Person ◽  
Compensation Law

Abstract Evaluating physicians should understand how their impairment evaluations are used, and to these ends Section 1.5 of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, discusses impairment and workers’ compensation. Permanent disability rewards may be paid according to a schedule that associates impairments of certain body parts, functions, or systems (eg, amputation or loss of sight or hearing) with specific awards. Typically, a schedule in the workers’ compensation law equates disability and a maximum number of weeks of benefits, but what occurs when an injured worker has both scheduled and unscheduled injuries? Under Colorado statute, scheduled injuries involve those to the neck, head, torso, and any injury not specifically enumerated in the statutory schedule. Because schedules usually do not cover all conditions following injuries, nonscheduled awards are available and are based on the extent of impairment, the nature of the injury, and the employee's occupation, experience, training, and age. The Colorado Supreme Court ruled that when a work-related injury results in both a scheduled and a nonscheduled injury, the scheduled injury must be converted to a whole person impairment rating and combined with the nonscheduled injury's whole person impairment when calculating permanent disability benefits. In its decision, the court relied heavily on and cited provisions in the AMA Guides.

U.S. Industries v. Director: “Claim” Versus “Condition” in the Analysis of Workers' Compensation Cases

1986 ◽  
Vol 12 (2) ◽  
pp. 273-303
Author(s):  
Jordan Yospe
Keyword(s):  
Supreme Court ◽  
Social Insurance ◽  
Compensation System ◽  
Workers Compensation ◽  
Statutory Interpretation ◽  
Disability Benefits ◽  
The Supreme Court ◽  
Disability Claim ◽  
At Home

AbstractUnder most workers' compensation statutes, an injury must “arise out of” and “in the course of” employment in order to qualify as a compensable disability. In U.S. Industries v. Director, the Supreme Court held that the Longshoremen's and Harbor Workers' Compensation Act must be strictly construed to avoid transforming the compensation system into a form of social insurance. In U.S. Industries, the Court denied a disability claim based on an arthritic condition which was manifested while the worker was at home in bed. This Note contends that the Supreme Court neglected to consider pertinent medical realities when analyzing the causation question. Thus, the decision undermines the overall rationale behind workers' compensation legislation. Nonetheless, the Note argues that the case does not relax the requirement of adequately scrutinizing the causative elements underlying any reasonable claim for disability benefits. An analysis adequately accommodating both medical and legal facts, instead of relying upon the vagaries of statutory interpretation, is necessary to improve the efficiency and fairness of workers' compensation disability determinations.

scholarly journals Access to care for workers’ compensation patients in dense and sparse population centers

2021 ◽  
Vol 12 (3) ◽  
pp. 50-52
Author(s):  
Blair A Skylar M Rhode ◽  
Skylar M Rhode Skylar M Rhode
Keyword(s):  
Primary Care ◽  
Access To Care ◽  
Case Series ◽  
Cook County ◽  
Primary Care Doctor ◽  
Workers Compensation ◽  
Injured Worker ◽  
Claim Number ◽  
Orthopedic Care ◽  
Gain Access

Background: Workers’ compensation was originated to provide a no-fault, timely access to appropriate medical care. Unfortunately, we have found that the system fails the injured worker in certain environments. By implementing procedural roadblocks in the form of initial claim denial and delay methods, the injured worker finds himself/herself in a battle of attrition. By delaying treatment and compensation benefits, the injured workers are “starved out” of their access to care and often walk away from their claim or accept a payout without treatment. Methods: We performed a randomized, consecutive case-series where 300 hypothetical patients called medical offices to attempt to arrange a physician consultation. We analyzed the ability of a patient to gain access (an appointment) to a primary care (N=100), orthopedic (N=100) and neurology (N=100) physician after stating that they were injured at work. We analyzed two cohorts, one as an injured worker that was given a claim number (N=150) and the other that was injured at work but not yet given a claim number (N=150). Conclusion: This study demonstrates how difficult it is to gain access to care as an injured worker. An injured worker in a low densely populated area without a claim number was unable to gain access to a primary care doctor in our cohort (100% denial rate). Even a patient with an accepted claim number in densely populated Cook County, IL had a 52% chance of being denied access to care with an orthopedic surgeon while a patient without a claim number had an 84% chance of being denied access to orthopedic care.

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