Debate Over Workers’ Comp System Rages On

Like those who testified before the Council on California Competitiveness, “Workers’ Comp Blues” (March 23), I see a need for reform. But my perspective is from the vantage of the injured worker.

I am a psychiatrist who is sometimes called upon to evaluate workers claiming psychiatric injury. The present system serves neither injured workers nor employers very well.

Fraud and abuse do exist. But abuses also exist on the part of those who deny legitimate claims. The minimum rate law contributes to the high cost to employers. Insurers are guaranteed 30% of the workers’ compensation dollar to cover overhead and profit.

Because 98% of all psychiatric injury claims are contested and litigated, there are unconscionable delays in getting patients treatment for injuries that get worse with delay.

We support vigorous prosecution of fraud. We want “mills” out of business so that legitimately injured workers are not tainted by their stain.

Neither the minimum rate guarantee nor administrative costs have been addressed as cost contributors. It would seem reasonable that these two areas be reviewed when reforms are advocated.

The practice by insurers of contesting and litigating almost every psychiatric claim means that an injured worker may wait years before receiving necessary treatment. Early intervention could have significantly reduced treatment costs and ultimate impairment. The cost in terms of human suffering is considerable.

In the work environment, “stress” is not the issue, as almost everyone experiences stress. Psychiatric injury is the issue. Claimants in the workers’ compensation system must prove psychiatric injury--which makes up 2.3% of total cases in the system.

As an aside, I note that the two employers in the story show a pattern of claims in this area. It may be that these claims are abusive and should be prosecuted, or it may be that an internal workplace audit could pinpoint and eliminate conditions that cause repeated claims.

THOMAS E. PRESTON M.D.

Los Angeles

The writer is chairman of the Workers’ Compensation Committee of the Southern California Psychiatric Society.