Sunday, August 17, 2008

Workers’ compensation denials in North Dakota Point To Systemic Problem

A consultant has recommended that the people who handle workers’ compensation claims in North Dakota should be allowed more discretion in deciding whether injured workers qualify for benefits. After reviewing workers’ compensation case files, Marsh USA determined that 14 percent of people who were denied workers’ comp benefits in North Dakota should have received them. A majority of those denied claims involved pre-existing conditions that became worse as a result of the employee’s job.

    “We felt those claims could have been accepted based on our opinion,” [consultant Anthony] Walker said.

    Several states have laws that give claims handlers more discretion in deciding claims involving pre-existing conditions, within certain parameters, he added…

    The discussion about how much discretion claims handlers should have came as injured workers testified about their experiences with what they portrayed as a bureaucracy that could be indifferent or even adversarial when dealing with their disability benefits. A common theme involved workers’ criticism of the agency’s reliance on so-called independent medical examiners who recommended denying their benefits based on incomplete medical information and cursory examinations that contradicted the advice of their treating physicians.

The consultant’s report is adding fuel to many workers’ assertion that the workers’ compensation system in North Dakota should be reformed.

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