STORIES such as those highlighted Sunday in The Oklahoman regarding fraud in the state workers' compensation system offer more examples of why wholesale changes to the system are needed.
But they're only small examples, because many experts we've talked to through the years have said the same thing — fraud adds to the workers' comp system's overall costs, and it's a problem that needs to be addressed. But it's not the biggest problem.
The greater problem is the inherently litigious nature of our current system, one in which cases are drawn out for months and sometimes years, involving doctors on both sides and attorneys on both sides and insurance companies, and finally judges who are left to make awards based on the data and claims brought before them.
The size of those awards all too often relates to whether that judge was appointed by a Republican governor or a Democratic governor. Those named to the Oklahoma Workers' Compensation Court by GOP governors issue lesser judgments, generally speaking, than those named by Democrats. “That's just the way it has always been,” one longtime workers' comp attorney said recently.
And awards overall have gone up significantly during the past 15 years, even as the number of claims filed during that time has gone down significantly. So something is out of whack.
The fraud component is certainly distressing. The Oklahoman's Nolan Clay and Randy Ellis reported that Oklahoma Attorney General Scott Pruitt's office has filed more than 50 workers' comp fraud cases in the past three years. Pruitt vows to pursue more. “No fraud is too small,” he said.
Prosecuting those who cheat — workers, employers and attorneys have all been accused — should be a priority. The money lost to fraud contributes to Oklahoma having the sixth-highest workers' comp rates in the nation. These costs are a tremendous burden to businesses, particularly small businesses. They hurt the state's cause when we try to recruit new business.
But cases that don't involve fraud offer plenty of reason why a change away from our court-based system is needed.
Consider the motorcycle police officer who was found to be 41 percent disabled after an accident on the job in 2004. Six years later he had another accident on the job and was awarded more than 70 percent disability — on top of the previous 41 percent. He remains on the same job today.
Or the worker who fell off a tall ladder and severely injured his back. At the hospital he tested positive for methamphetamine, and he admitted having used meth a few days earlier. In work comp cases, the presumption is that if you test positive for illegal drugs, you were under the influence and thus ineligible for benefits. But in this case the judge asked the man if he thought being under the influence had caused the accident. The man said no, and the judge awarded him more than $200,000.
Then of course there's state Rep. Mike Christian, who received $61,560 after claiming — more than a year after the accident — that he had been hurt on the job while in a car accident during his commute. Such injuries usually don't qualify for workers' comp benefits, but the judge said Christian could qualify under an exception in the law. “I'm sure the judgment speaks for itself,” Christian said at the time.
It certainly spoke to the disaster that is our current workers' compensation system. The Legislature is weighing a proposal this session to implement an administrative system. This may not wind up being the perfect fix but it's certainly an improvement over what we have now.