Opt-In or Opt-Out of Workers’ Compensation

19 Points of Agreement that May Surprise You. By Jeff Pettegrew

During my first year as the Chief Policy Officer for ARAWC, I have immersed myself into the examination of the public policy and practical implications of the alternative workers’ compensation industry. While great minds from leading risk management departments and the insurance industry have been engaged in this discussion for years, I’m eager to share some of the conclusions I’ve drawn after applying my own 35 years of experience in Workers’ Compensation and considering the comments of other professionals I’ve had the pleasure of working with through the years. We know that in any debate, the parties rarely find absolute agreement, but all professionals dedicated to improving the system, whether through traditional workers’ compensation or an alternative injury benefit program, share similar beliefs, goals and the desire to improve and advance.

Here’s a starter list of common goals:

  1. All employees should be eligible for work related injury benefits.
  2. Employers should pay for the cost associated with returning an injured worker to pre-injury status.
  3. Injured workers shouldn’t have to hire an attorney to access benefits.
  4. Government oversight is important.
  5. Injured workers should be treated fairly, with kindness and respect from the professionals ushering workers through the recovery process.
  6. Impersonal communications and complicated processes should be replaced with more personal interactions through phone calls, video chats, personal visits or other means available through technological advances.
  7. Any injured worker recovery system should motivate employers to invest in safety programs, training, supervision and appropriate personal safety equipment in order to prevent serious injuries.
  8. System complexity, delays, and red tape should be reduced.
  9. Anxiety, fears, and mistrust by injured workers interfere with achieving the best outcomes.
  10. All workers should be provided at the time of hire with basic information about what to do if injured on the job.
  11. Prompt reporting of on-the-job accidents, injuries or illnesses and early medical intervention is critical.
  12. Employee, employer or provider fraud will not be tolerated and should be subject to prosecution.
  13. Medical providers should be highly qualified and familiar with employers’ workplace risks, training, and loss control programs.
  14. Misuse of or careless reliance on pain killers and opioids by injured workers or dispensing physicians should not be accepted or tolerated.
  15. Aggravation of pre-existing conditions should be covered.
  16. Post injury wage replacement benefits should be adequate so as to avoid undue financial hardship for injured workers.
  17. The recovery process should emphasize health, wellness and rehabilitation versus impairment and disability.
  18. A responsive work injury system must encourage an ongoing dialogue between the injury worker (and their family), the provider and employer.
  19. Meaningful return to work programs are important strategies in maintaining a healthy connection to the workplace and ultimately returning an injured worker to full time work.

Over the next few months, ARAWC will highlight additional concepts that have been debated or adopted in the alternative workers’ compensation industry in an effort to generate discussion and improve the work injury recovery process. I think we’ll find even more common ground. If you are a professional in the workers’ compensation industry or are interested in advancing the work injury recovery process, I encourage you to follow ARAWC and me on LinkedIn and engage in this important dialogue.

Jeff Pettegrew
Chief Policy Officer
Association of Responsible Alternatives to WC
April 2019