Faulty assumptions only adds insult to injured workers

workcover-myths-misconceptions

We have recently been trolling the net looking for various injured workers’ forums and more hard evidence of the abuses and insults inflicted upon injured workers, by pretty sick workcover insurance companies and draconian workers compensation laws. While we found many “hidden” such forums, packed with horrible stories from ill-treated injured workers; we have also found a number of extremely disturbing forum posts and comments from ignorant, brain-washed, pea-brained and/or biased, ahum, individuals, making faulty and, frankly, dangerous assumptions and comments about what “motivates” injured workers: cheating the system and malingering in order to get a “free ride” or permanent “welfare payments”.

lies-about-workcoverNot only are these false assumptions and statements dangerous, but they have also led to the further erosion of benefits to injured workers. The logic behind? To provide a disincentive that prevents cheating the system and discourages malingering.  We would argue that these are cynical and dismal views taken by certain individuals (incl. politicians) who are obviously poorly schooled in human behaviour and motivation, which encourage the development of systems that use punishment and coercion in order to motivate injured workers.

Faulty assumptions about what motivates injured workers only adds insult to injury

Injured workers forum 1 – Outrageous comment

Whirlpool net forum >>

Posted by “stan4795″ on 6 May 2013

If the bones are broken, etc, he or she will get the workcover payment but until that happens, he or she won’t get it no matter how painful it is. This is because there are too many fakers out there who don’t want to work but receive money and else if they issue payments to people easily, they will be bankrupt.

No normal people will break their own bones just to get regular payments for a year. Else it would be hard to get the job back or other jobs after this.

As our mighty contributor “Harryrort” rightly stated, “Guys please go to whirlpool thread above in wcv3 post and put Stan back into the hole he crawled out of I have already replied to this dickhead who thinks being on workcover benefits is a big holiday WTF!”

Injured workers forum 2 – Outrageous comment

Ozpolitic forum >>

Posted by “Armchair_Politician” on 20 June 2012

Congrats to O’Farrell govt on WorkCover changes!
Jun 20th, 2012 at 8:27pm
 
Congratulations must go to the O’Farrell government on its changes to the WorkCover legislation in NSW. For far too long it has been costing NSW taxpayers far too much due to rorting by individuals who could/should be working but would rather be paid to do nothing. Despite the predictable Union scaremongering, those who need this the most will actually be BETTER OFF under the O’Farrell government’s changes. At present, this scheme is costing NSW around $9 million per day. That’s simply not sustainable. This legislation was originally designed to assist people back to work after injuries/illness, not a permanent welfare payment (except, obviously, for those clearly unable to work again). Premier O’Farrell, bravo!See also a Daily Telegraph editorial on this subject below…NOBODY objects to people being given a fair go. This is particularly the case when someone has suffered a workplace injury and is entitled to a deserved level of compensation.But a fair go is very different from a free ride. As NSW’s workplace compensation arrangements have evolved over decades, they have become increasingly vulnerable to overpayment and excessive timeframes for recovery.Premier Barry O’Farrell is correct when he says the original and proper intention of workers compensation schemes was to assist workers to recover from their injuries and to return to gainful employment.Instead, in too many cases injuries have led to virtual early retirement for the afflicted. The cost to the broader community is outrageous. According to government figures, the state is currently spending $9 million every day on workplace injury compensation.There is another cost involved. That is to the self-respect and dignity of those being paid by the state despite being able to return to some form of work. Our creation of a virtual permanent welfare community is not a cause of pride.At the same time, it is imperative that any reforms of workplace injury compensation laws maintain a fair go for those whose injuries legitimately remove them from all employment opportunities. These people require state care and should not be victimised.Thankfully, Mr O’Farrell has indicated that people whose injuries leave them incapacitated will receive ongoing support. He appears to be striking a decent balance in what can be an extremely emotional area.By contrast, union leaders sound as though they are fighting a battle from the dawn of the industrial age.

According to Unions NSW secretary Mark Lennon, the government’s reforms represent the “biggest attack on working people in 100 years”.

Give us a break, Mr Lennon. That kind of hyperbole helps nobody. It certainly doesn’t help anyone get back to work.

Link: http://www.dailytelegraph.com.au/news/opinion/a-soft-touch-on-compo-adds-insult-…

And he also posted various other nonsense and offensive comments.

Injured workers forum 3 – Outrageous comment

Bubhub

Posted by “Mrs Nietzche”on 31 Oct 2009

As a sidenote, the workcover man also told me that chopped off fingers are their biggest source of fraud. Apparently they can tell the fake claims because the fingers are neatly sliced off.

What the f*ck? Who on earth would want to slice off their finger(s) as to go on workcover?

Perhaps it is time we put the record straight again, and educate those idiots!

According to a number of researchers, including the Australian Productivity Commission, for years the real costs of workers compensation in most states have resulted from the mismanagement of schemes by the government.  Furthermore, research shows that workers compensation schemes across Australia are based on incorrect assumptions about what motivates injured workers.

Research carried out on behalf of the Industrial Health and Research Foundation, in 2011, highlighted a number of false assumptions governing current systems:

Fraudulent claims are overstated

Despite research claims that false claims increase when larger payouts are available, these represent a tiny fraction of overall claims that are legitimate.   Emphasis has been placed on minor increases without considering the fact that many legitimate injuries never reach the claims stage.  The failure to detect false claims is systems issue.  The current assumption is to treat all claims as though they are fraudulent rather than improving the system to detect the small amount of claims that fall into this category

The under-reporting of legitimate claims

Most reported injuries never make it to the claim stage  – in fact, it has been found that many people persevere with injuries to the point of being forced to take time off work for treatment and recovery.  If anything, legitimate claims for workers compensation are under reported.  The current assumption seems to be that workers will make claims for false and or frivolous reasons.

There is no incentive to claim, for most workers

Most workers return to work as soon as their injuries have healed regardless of the issue of economic incentive (previous and more equitable entitlement available) or disincentive (reduced entitlements that reflect disadvantages of the current system).  This suggests that the vast majority of workers are unlikely to make false claims, despite the assumption that false claim costs would skyrocket if larger claims are made available.

Poor claims and injury management process is a major issue

Other factors associated with poor return to work management need to be considered as a major reason for prolonging claims resolution.  Failure by employers, insurers, providers and workplace health and safety all play major roles in successfully managing claim, however, injured workers and their families are routinely penalised by the current system.

Complacency about safety is a myth

There is no evidence to support claims that workers become complacent about  safety when higher rates of compensation are available.  Previous concerns have been based on false assumptions based on questionable research data. Most people simply do not ignore safety in order to qualify for workers compensation.

Adding insult to injury

The stepping down of workers compensation in recent years has exacerbated problems typically associated with injury management and recovery (financial distress, family problems etc).  This has also given rise to secondary injuries (i.e. depression and anxiety) on top of many injuries that were initially physical in nature.   This suggests the likelihood that many short to medium term injuries turning into long-term problems is substantially increased.

The moral hazard, taxpayers pay for negligence

Poor injury management ends up being paid for by taxpayers as more and more injured workers fail to make successful transitions back into the workforce.  Employers routinely view many people who have been unfortunate enough to be on workers compensation as liabilities best avoided, which limits the potential injured workers (especially with long term injuries and psychological injuries) from ever returning to pre-injury employment status and earning capacity.  Many long-term injured workers end up being forced onto unemployment benefits at taxpayer’s expense.  Employers have limited liability and therefore little incentive to take the health, safety and wellbeing on injured workers seriously.

Interestingly, the research focused primarily on physical injuries – however, the growing concern is the increase in psychological injuries, both primary and secondary, resulting from the poor management of claims (not only by insurers, but employers who take a negative view of injured workers).   Reductions in wages, financial pressures, and poor return to work management are all implicated.   The real concern is that given physical injury claims should be relatively straightforward to manage – which it seems is anything but, because the system is more adversarial towards injured workers, in general. The rapid rise in psychological injuries in many workplaces only places greater pressure on the entire system, because the management of psychological injuries are significantly more complex and time consuming to manage than physical injuries.

The rising costs of psychological injuries

Claims data for psychological injury for Australian government organisations over recent years indicates a rise in these types of claims.  Work pressure accounts for around 50 per cent of psychological injury claims. The next most significant category for Australian government organisations is harassment/bullying combined’ – which accounts for around a quarter of psychological injury claims. Of declining importance in recent years is ‘exposure to workplace or occupational violence’ which accounts for only about 10 per cent of psychological injury claims. ‘Exposure to a traumatic event’ (which includes witnessing a fatal or other accident) accounts for less than 5 per cent of psychological injury claims.

According to Comcare, Australia’s federal work health and safety regulator, claims associated with mental stress have risen 54% since 2006-2007.  Work related mental stress is of concern in the Comcare scheme, especially in the APS. The number and proportion of worker’s compensation claims as well as the cost of psychological injury claims, has increased over recent years.

Over the four-year period to 30 June 2010:

  • around 9 per cent of accepted Australian Government premium payer claims were attributed to mental stress; and
  • around 35 per cent of total claim costs related to these claims.

However, the impact of mental stress is even greater when secondary conditions are taken into consideration. There are a number of cases where the initial claim was not caused by mental stress, but the injured worker developed a mental disease as a secondary medical condition. Taking these cases into consideration, over the same period:

  • around 11 per cent of all accepted claims within Australian Government premium payers involved mental disease as either a primary or secondary condition
  • around 43 per cent of the total cost of accepted claims related to these claims.

There also tends to be a limited view of the work capacity of people facing these problems. According to Comcare employers struggle to find suitable duties for people with a psychological injury claim. Those with a psychological injury do not return to work as quickly as those with claims for non-psychological injures. For example, during 2010–11, 49% of the mental stress claims from employees of Australian Government premium payers that involved 4 weeks lost time from work progressed to 26 weeks lost time. This compares to just 23% of all other claims that progressed from 4 to 26 weeks lost time during the same period.

References

Comcare. (2011). Comcare submission to the public hearing: House standing committee on education and employment inquiry into mental health and workplace participation. Australian Government.

Productivity Commission. (2004). National worker’s compensation and occupational health and safety frameworks. Final report.  Australian Government.

Purse, K. (2011).  Provisions of fair and competitive worker’s compensation legislation, University of South Australia.  Research funded by the Industrial Health and Research Foundation

 

And we may want to post on those forums the workcover MYTHS as well! We would be grateful if any of our readers and contributors could help us set the record straight, post the FACTS in reply to outrageous comments and to refer injured workers to aworkcovervictimsdiary.com and like-minded sites.

 

Additional Forums and sites sourced

 

[Post by Trinny and WCV]



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12 Responses to “Faulty assumptions only adds insult to injured workers”

  1. Great article. Whenever I hear the sound, read the words of somebody rigidly demonising the injured worker, all I hear is the sound of unhappiness and envy. Who would be so stupid as to think injured workers want to rort the system. Most of us with any experience of it simply want to smash it as you would crush a cockroach!

    Injured workers find only poverty and waste in the current Workover systems. Workers compensation was set up to compensate and rehabilitate workers injured during the course of their employment. It was meant to soften the costs to the bosses of injured workers suing them under civil law. It started as a rip off of workers, and it has become much worse. I think we could honestly say that the Workover is killing some injured workers.

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    • Well Said.

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    • Injured workers needs to start posting on sites like whirlpool to be heard. I am sure there are hunderds of people who feel O’Farrel’s new Workcover legislation is sick and perverse and only geared to make money for O’Farrrel’s  friends, ie the big insurance companies , who are not even Aussie institutions.

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      • Carol isn’t always possible to tell your story or dealing with those trolls on whirlpool most probably they work for the corrupted system. Also posting on forums like whirlpool expose injured workers to even more bullying and harassment behaviour. Injured workers are almost always bullied and harassed at work place then again bullied and harassed by the workcover first in the list is the insurance company. Depression, anxiety, post trauma related issues including suicidal attempts prevent the injured worker from even thinking about what has happened. I think that your idea of posting on more forums if great because it increases awareness among people but it’s a risky option especially when you’ll most probably have to go to Court and fight for your rights.

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        Xchangingvictim May 7, 2013 at 5:54 pm
        • I think I know what you are saying but nothing will ever change if people don’t start fighting for their rights. This forum needs to become a political force. Injured workers are voters and they have rights too. Where is Shorten or Gillard on this? I thught the Labor Party was the Workers ‘ party

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  2. Injured workers need to start lobbying now. The elections are coming and O’Farrel and Abbott are both from the same disgusting mold. Their motto is squash the workers to inflate the owners.

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  3. One thing that has always annoyed me is the assumption that tax payers are solely paying for Workers Comp, they are not. It is the employer who pays premiums to insurance companies and insurance companies who raise premiums if an employer has more than  the number of acceptable claims. The more claims, the higher the premium. Workcover is funded by the government, but it is the insurance companies who make the profits. Why is there no public outrage at employers who have multiple claims? Could they be abusing safety laws? That question is never asked by the media or the ‘blame the victim’ nasties that seem to abound these days. Funny how stories about people being ripped off by insurance companies not covering them for floods, fire etc are supported 100% by the public, bad, bad insurance companies !!!! Then we have Workers Comp where insurance companies are the ‘good guys’ and the injured worker the criminal. Totally ignorant, totally heartless, totally gullible, totally repugnant people, they are the ones in the forums spreading bile. I only hope that one day it happens to them

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    • Taxpayers to a large extent do pay for workers compensation – they wear the costs for all public sector employees.

      Yes, if a private sector employer has a worker who makes a claim, that employers premium goes up and that cost is born by reduced profit to that company’s owners/shareholders. So in the private sector the cost of the premium and increases due to increasing incidents of claims is born solely by the owners/shareholders, and thus is of no interest or impact on the general public. However, in the public sector the cost of premiums is born entirely by the taxpayer. The workcover premiums paid by government departments and government agencies are massive and the public sector, for whatever reason, has disproportionally high volume and cost of claims compared to the private sector, so every time a public servant or public sector worker makes a claim their employer (government dept or agency) premium goes up and that has to be funded by taxpayers either by increased taxation or reduced government services. And the general public will always have opinions (as they are entitled to) on whether they see or believe their tax dollars are being used effectively, wasted or whatever.

      But I would have thought that there was already more than sufficient “public outrage” and media scrutiny about the causes and level of claims in the public sector already. So I am confused by your comments? Are your suggesting that there should be even greater public outrage and scrutiny of public sector claims???

      The general public’s dislike and distrust of insurance companies does not really translate to workers compensation as workers compensation in each State is a statutory scheme that is outsourced to various claims agents (who some just happen to be insurance companies, some are not) just to manage at a transactional level. And many people would not even know, until they have to make a claim, that they even have to lodge their claim with a claims agent. Many probably just assume it is government agency Workcover/Worksafe that handles the claims directly.

      With workers comp, claims agents/insurers role is just to be really useless, incompetent and dishonest twats that injured workers have to go through and deal with to access the statutory scheme. The claims agents don’t determine the premiums, the rates are determined at the scheme level by the government actuaries that run the actual the scheme pool of funds. The claims agents are just paid transaction, management and performance fees to issue the premium notices, collect the premiums on behalf of Workcover, manage the claims etc. The claims agents does not keep the premium or any portion of it. Nor do the claims agents make any money out of the claims; they are just paid to manage the claims process.  The claims agents make their profit only out of the fees they are paid to manage the various processes less the cost of wages/overheads etc of the agent to perform those process; which is why they manage claims on the cheap and dirty with as little resources as possible and employ claims managers with little or no experience because their salaries cost less than hiring properly competent and experienced claims managers – as this is the only way they can make/increase their profit. The claims agent/insurers make no profit from the premiums charged to employers nor from the amount of claims/benefits that are or are not paid out to injured workers.

      So whilst its in fact the claims agents that cause injured workers the most problems and grief, to the general public the claims agent is pretty invisible and irrelevant when thinking about worker compensation and so its near impossible to generate any community anger and outrage about the way they treat inured workers.

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  4. Yes, I would wish it on the bigots too Bunny. I’ve been on Whirlpool a couple of times, there’s definitely the odd crank, but there are also a lot of people who are thinking about the situation a bit. It’s good for us to go on those sites and take up the arguments, tell our stories, whatever’s needed to convince people that this stigmatisation of injured workers is nothing but a red herring to hide all the parasites supping at the Workover trough.

    What about having an Injured Workers Conference to bring us together so we can collectively plan a political process that we can sustain given our injuries. Could we hold such a thing online? It would be good for the political process to happen at the National level, as really, it is ridiculous to have all these differences that having state based systems produces. Also, they’re gradually all moving together into a form and shape of the very worst kind for Injured Workers of course. Having only one system makes all sorts of sense. It also means we only need one campaign, united, not one campaign to sort out each and every state system.

    We don’t have money to spend on PR but there’s heaps of creative ways to get that stuff happening. Injured workers who feel able (given health and legal issues) could approach their local newspapers and ask them to do a story about their experiences as an Injured Worker. Those of us who are still in a Union could submit our story of being an Injured Worker to the Union Newsletter. Some of our stories in New Idea or other mags even. We could ask our Unions to raise the matter of the failure of Workcover to compensate, rehabilitate and return to work Injured Workers with their peak bodies. We could demand a Royal Commission into the Workcover systems in Australia by joining in with and supporting and organising round the one that already exists.

    I’m sure others have loads of good Campaign ideas to share.

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  5. My point Carol is that the Insurance companies make profits out of Workers Compensation otherwise as a business they would not be involved.  I never distinguished between public and private so I think you have misunderstood what I am saying, it is certainly not ‘greater scrutiny of public claims’ as ‘public’was never stated. The bottom line is that the public believe that ALL claims are funded by the taxpayer and this is definitely not the case. It is also worth remembering that government workers are covered by WC insurance which would be factored into their wages by the government, that is a cost of employment and as this government has effectively reduced the real value of public workers earnings (restricting them to 2.5% pay increases and also foreshadowing using any increase to pay for employer contributions to superannuation), it is grossly unfair for the public (manipulated by the media) to assume that their ‘taxpayer’ dollars are being wasted on injured workers. They need to be educated about this, we need to get the word out and Pauline, I love your idea

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  6. The Workover’s really big impost on taxpayers seems to be through the many seriously injured workers who end up dependent on the Disability Support Pension for the rest of their lives.

    Carol, thanks for your informative description of how the Claims Management System works. Where do the “bonuses” that CGU ripped off fit in this picture?

    Also, the system collects $1.9 billion annually in premiums from the employers. That a big trough of money. It’s how that trough is being used that is the problem.

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  7. Have just been back to that thread on Whirlpool, and the discussion has taken a turn for the better. More people expressing concern with theirs or other’s experience of the Workover. Link below if anyone is keen to join in.

    http://forums.whirlpool.net.au/forum-replies.cfm?t=1984373&p=-1&#bottom

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    Pauline Pope May 8, 2013 at 3:57 pm