Audit Of Workers’ Comp Awards Sought
Led by S.C. Majority Leader Harvey Peeler, thirteen South Carolina Senators have requested that the Legislative Audit Council conduct a comprehensive investigation into the State’s Workers’ Compensation Commission – a notoriously shady and corrupt state agency that likes to dispense its exorbitant judgments and attorneys’ fees with a bare minimum of public scrutiny.
The focus of a protracted battle between the wealthy trial lawyer lobby and business-friendly, good government reformers, the WCC has repeatedly resisted efforts by Gov. Mark Sanford and others to reign in its excessive judgments.
It has also stonewalled efforts to obtain detailed information about its awards, once demanding hundreds of thousands of dollars to produce these public documents.
Combined with South Carolina’s utterly anemic workers’ comp laws, the effect of these outlandish awards on our state’s business climate has been predictable.
In 2008, South Carolina had the 12th highest workers’ comp premiums in the nation, and our state’s workers’ comp premiums for small businesses ranked 7th in the country, according to industry publications. Our rankings in both of these key categories placed us behind our neighboring states.
How do we turn things around?
Well, in addition to passing better laws and controlling the influence of the Ambulance Chaser Lobby at the State House, we need to peel back the layers at the WCC and break these judgments down one by one.
That’s exactly what this audit would do.
“We desire an inquiry into the operations, systems and management practices of the WCC as they relate to the consistency of workers’ compensation awards and the reasonableness of attorneys’ fee awards,” the Senators’ letter to the Audit Council reads.
It then lists several specific criteria for analyzing awards.
In addition to Peeler, we’d like to send a rare shout-out Senators Ronnie Cromer and Thomas Alexander, two RINOs who momentarily located their pro-business ideology on this issue.
Also on board with the audit are Senators Lee Bright, Kevin Bryant, Paul Campbell, Chip Campsen, Ray Cleary, Tom Davis, Mike Fair, Shane Martin, Mick Mulvaney and Phillip Shoopman.
Props to all, and let’s hope this helps us get to the bottom of one of our state’s costliest scams …
Comments
By Good job, Senate! on May 13th, 2009 at 5:52 pm
Thanks Senators for watching out for the folks who actually pay for the workers’ comp system in this state – taxpayers and businesses.
Also, thanks to FITSNews for continuing to spotlight the issue.
By Soon to be former Workman's Comp Payer on May 13th, 2009 at 6:18 pm
I have a case I would like to see audited. An employee driving home in a company truck after work is stopped at a red light when the vehicle is hit from the rear. All involved decline to seek treatment. Two days later the employee checks in at the emergency room with back pains. Diagnosis is gall stones and surgery is performed to remove her gall bladder. The W/C commission finds this is work related due to being in a company vehicle on the way home and pays $48,000 for treatment and lawyers fees, which is charged against my experience ratings, resulting in premiums going from 88% to 108% of average. My objections that a gall stone was in no way work related were rejected. This was the second W/C claim in my 11 years of operations. It’s just not worth it anymore.
By thinkaboutit on May 13th, 2009 at 9:01 pm
My problem is with the commissioners. look at susan barden. a flack of mcconnnel’s. she went through the last round of worker’s comp reform and then got appointed to the board. what bs. she was nothing more than a senate staff attorney that worked on a bill…come on!!!
By thinkbeforeyouwrite on May 14th, 2009 at 9:00 am
If you are going to single out Commissioners, Susan Barden is the least of your worries. She is professional, courteous and fair. She reads every document submitted and does her job. She is one of the few that “gets it.” Her directives for drafting an Order are certainly more thourough than any other Commissioner. If you got a bad decision from her, it’s probably because you had bad facts or a bad client.
By realitycheck on May 14th, 2009 at 9:25 am
I would like to see anyone actually try to live off a workers’ comp award. I mean…really!! Awards are capped, rates are capped, medical expenditures are capped. The only thing that is not capped are the mouths of the uninformed critics.
By reddrumesq on May 14th, 2009 at 12:10 pm
Just last night at a gathering of South Carolina’s Self-Insurers Association, a group of workers’ comp defense lawyers unanimously agreed that Susan Barden is the Commission’s best asset and most fair Commissioner. Thinkaboutit — you must not practice comp or you did something to really tick her off.
And realitycheck, the no-fault workers’ comp benefits your employer pays you would go a lot further if you didn’t pay your lawyer 33.3% for doing little more than showing up at a 30 minute hearing.
By THOMAS W. GREENE on May 14th, 2009 at 12:23 pm
Here’s a suggestion for all of you complaining about our workers compensation system in South Carolina. Let’s do away with the workers compensation system altogether,and let’s go back to the common law as it existed prior to the advent of workers compensation.
This would mean that any worker injured on the job as result of the employer not providing a safe workplace could bring suit in the Court of Common Pleas where there would be no limit on the amount of damages that the jury could award including pain and suffering damages. In addition an injured worker could choose his or her own treating physician and not be forced to submit to treatment by a company doctor handpicked by the workers compensation insurance carrier.
If an injured worker sustained a total or partial loss of earning capacity the jury could award damages for loss of earnings for the entire life expectancy of the injured worker.South Carolina is only one of two states in the United States that limits a total disability to 500 weeks; the other state is Alabama which limits a total disability award to 400 weeks. All other states provide for a continuation of benefits for as long as the injured worker remains disabled from earning wages.Lets go back to the common law and watch what happens to the liability insurance premiums of employers.
By Earl Capps on May 14th, 2009 at 12:24 pm
Those Senators are smart enough to realize that tort reform isn’t going to solve anything unless you fix the workers comp system itself. It will be interesting to see what comes out of this.
By InTheBiz on May 14th, 2009 at 12:44 pm
While I could agree with “workman’s comp payer” (but who uses the term “workman’s anymore?) that gallstone surgery probably should not be work related, a lot of facts are probably left out that the commissioner relied on. More to the point, it has been clear for some time that the insurance industry wants to change the laws to pay out less to injured workers and trying to reduce attoreny fees only helps because if an injurted worker cannot get legal help, then the insurance company usually wins by default. What people such as “workman’s comp payer” and other employers should be asking is for information on the profit insurance companies make on WC policies and if there is a lot of profit, why aren’t the premimums lowered? I know in other states such as California where a reform package went through in 2004, rates were cut some to employers, but profits by the WC insurance companies went through the roof, so employers (especially small business employers) did not get the full benefit of the reform they supported. What good is reform on “exorbitant” benefits (your term Sic)if the savings almost all goes to the insurance company?
By reddrumesq on May 14th, 2009 at 12:45 pm
Hey Tom, I’m all for a return to the common law — if an employee actually had to prove fault and damages, I’d get a directed verdict on all but about 2 of my 150 workers’ comp files.
By RedBank Bar on May 14th, 2009 at 1:02 pm
The insurance companies paid flacks vote Barden the best? That certainly speaks to her outrageous bias. And courteous? Certainly not the b*tch I’ve seen her be to any claimant who alleged they were hurt.
Bottom line, if we’re going to audit fees, let’s audit the carriers/employers’ fees. Let’s see how the bank tower pigs squeal at that one.
By reddrumesq on May 14th, 2009 at 1:18 pm
RedBank, you obviously don’t know what you are talking about and/or you are Dennis Toney.
All attorneys (claimant and defense) are required to have their fees approved by the WCC and if you spend an afternoon at the State House, its pretty easy to see that it is the claimant’s laywers, not the workers’ compensation lawyers, making the big bucks.
And I am not a flack for any insurance company, as I metioned, it was a group of Self-Insurers.
By realitycheck on May 14th, 2009 at 2:12 pm
reddrumesq…..I’m lost as to why the reaction is to immediately go after the attorney’s fees. If we could always trust the insurance companies to do the right thing, having to hire an attorney and then having to pay our attorney would never happen in the first place. Fact is, cases get denied all the time for stupid reasons. If the case isn’t denied, then inevitably some aspect of treatment gets denied. Insurance companies do not come to the table on that issue with clean hands. I’m sure they would love it if there were no lawyers out there to go to bat for the wellbeing of the injured worker. Oh, wouldn’t it be just great if there were no hinderances for the insurance companies!!
By cadetsuperintendent on May 14th, 2009 at 2:17 pm
The defense lawyers hired by the comp carrier do not have fees
approved by the Commission. NOt that it really matters, but the
statement by reddrum esq. is not accurate. By all means, let’s
have an audit of awards. I think that once the public sees that
the typical comp case is medicals only and that permanent disability
awards are relatively small some of this bogus outrage might be
quelled. And even if it wasn’t, what’s the harm in this information
being public?
By sclawyerIII on May 14th, 2009 at 4:31 pm
Reddrumesq,
Your confidence is impressive, but good luck obtaining summary judgment or directed verdicts from Circuit Judges. 148/150, lol.
By Silence Dogood on May 14th, 2009 at 9:53 pm
FITS,what is “anemic” about our workers’ compensation laws?
Reddrumesq, forgive any lack of legal knowledge on my part here, but you said you would win in 148 of 150 cases if the worker had to prove fault and damages??? Unfortunately on that note failure to follow OSHA standards is negligence per se in most parts of the country – not at issue normally because I thought employers have statutory immunity under work. comp. (from tort negligence). So there is your “fault” aspect of at least more than 2 in 150 cases…damages…just put on your crutch and neck brace.
By Charleston SC on May 15th, 2009 at 5:03 am
Bright isn’t bright. All the more reason to oppose.
By ges on May 15th, 2009 at 2:52 pm
Reddrumesq. i want you as my defense lawyer, who are you?
By reddrumesq on May 15th, 2009 at 3:57 pm
Cadetsuperintendent, before you charge me with making an inaccurate statement, you might want to take a look at 42-15-90 (”Fees for attorneys and pshyicians and charges of hospitals for services under this title SHALL be subject to the APPROVAL OF THE COMMISSION…”) and Regulation 67-1204 (”An attorney shall report and obtain approval of any fee for services renedered in a workers’ compensation claim…”). Again, not that it really matters…
Silence Dogood — the vast majority of workers’ compensation claims do not involve OSHA violations or any negligence on the part of the employer and the typical jury verdict for a soft-tissue injury is far less than a workers’ comp award for a similar injury (and it is certainly easier to prove a workers’ comp claim). It was because of these very facts that the trial lawyer lobby allowed the passage of workers’ compensation laws in the first place and have not since sought their repeal.
By Silence Dogood on May 15th, 2009 at 9:41 pm
Reddrumesq. I do know a few things about comp. and despite the regulation you cited I have never met a defense attorney that puts forth their fees or fee agreements in each case to be approved by the SCWCC.
Do you really think the reason workers’ compensation systems being passed in most states back in the 1930ish was for the sake of the benefit of trial (presumably plaintiff’s) attorneys?
Also, you referenced “typical jury verdict for a soft-tissue injury” being less than in comp. I thought in workers’ compensation you had get an impairment rating per medical guidelines to get paid for a percentage of the part of the body you hurt. Soft tissue damage doesn’t appear like it would garner you an award under S.C. workers’ compensation code unless you could show a loss of earning capacity from it??? I know you can get a mininmal amount of money for scarring, but I imagin when you say soft tissue injury you meant something else.
By reddrumesq on May 15th, 2009 at 11:34 pm
Silence, I’ve submitted my fees for approval by the Commission in every single case I’ve ever handled, as do my partners and associates and every other attorney who practices workers’ compensation in this state, as required by statute. If a defense attorney didn’t submit their fees to the Commission, the Commission would not close the file. You are simply misinformed (as further evinced by your delusional assumption that minor injuries are not compensated under 42-9-30).
By Silence Dogood on May 16th, 2009 at 2:56 pm
Reddrumesq, no need to say I am delusional, my question was about whether or not a “soft tissue” injury would qualify for an impairment rating under the AMA Guidlines, you answer was that I was delusional (I took tht to mean yes). So combining that and you last comment that those awards would earn you a pay out in workers’ comp. under 42-9-30(?) but not in circuit could is just very interesting to me. If I can show fault and damages – in the form of a “soft tissue” injury which results in a permanent impairment rating per the AMA Guidlines you think that would not entitle me to a tort award in circuit court, even though I could get paid at the commmission?
Secondly my comment was tht defense attorney’s in comp. do not submitt their fees with clients for approval at the commission. You simply stated “Silence, I’ve submitted my fees for approval by the Commission in every single case I’ve ever handled, as do my partners and associates and every other attorney who practices workers’ compensation in this state, as required by statute.” So my question is do you practice W.C. defense -if you do, are you seriously telling me that you submitt a Form 61 to the SCWCC in every case you handel, every month, each time you receive a check from the insurer or self insured??? Even though the new Form 61 is much more simple, under the old Form 61 – if you practice defense – that means you not only submitted your monetary to the clients, but also your hourly billing to the client for those bills. Some how red, if you answer yes to tht question, I am not going to feel you are being completely honest.
By Silence Dogood on May 16th, 2009 at 3:01 pm
Reddrumesq. you can actually disregard my last I just read the work. comp. Reg. 67-1204 that you cited in a prior comment and then read the follow Reg. 67-1205 which talks about what constitutes a “reasonable fee,” for anyone who knows anything about law and the w.c. system, just reading 67-1205 will very quickly inform you that the fee petitions are indeed only filed and applicable to agreements between Claimant’s and their attorneys. Therefore red, I now know you are either (a) a Claimant’s attorney or (b) an absolute fraud and liar about submitting your fee petitions to the workers’ compensation commission and…(c) either a paralegal, summer law clerk at firm tht practices work. comp. – maybe a plaintiffs’ firm? or just a smart ass law student who maybe took a semester long seminar on workers’ compensation last year…
By reddrumesq on May 17th, 2009 at 12:23 pm
Hourly attorneys fees are submitted to the Commission on a Form 19 dumbass
By Silence Dogood on May 17th, 2009 at 1:25 pm
Reddrumesq., I have signed enough Form 19 – that were approved by the Commission to know that this is not the case. Furthemore, unless you close every case in a month, then you are not turning in your fees which you bill and are paid each month (or quarter) by your client. Apparently in violation of the statute and reg. you cited. Furthemore, nobody submits their fees which they paid to the hospitals and doctors for approval by the the SCWCC unless they are going back against the SCSIF for reimbursement or need to get the amounts re-priced to keep them within the fee schedule – which to the chagrin of healthcare providers is only 140% of medicare but HASN’T been redone since 2003. NONE of the defense attorneys I spoke to said they are required to turn their fees agreements or amount of fees paid into the Commission for approval.
Sorry Red. Again I am not talking about hourly fees for plaintiff’s attorney, but for defense attorney’s.
By Jolie M on May 18th, 2009 at 4:16 pm
It is amazing to me that so many people that discuss workers comp reform, clearly do not understand the system, the system was designed to help injured workers’ end of story. The Commissioners take the time to read the medical reports that relate to causation and medical reports of the claim. They take all the medical documentation to assess the injury and body part created under the AMA Guidelines. So many people do not understand the time and expertise it takes to be a Commissioner. We have some very fair and impartial Commissioners at the Workers’ Compensation Commission, Commissioner Barden goes way out of way to work over a 40 hour work week along with her colleagues, these people that complain about the system, have never awakened at the crack of dawn and driven all over the state to hear workers compensation claims and then come back very late in the evenings. It is a tireless and thankful job, they direct fair and impartial medical care and treatment for the Claimant’s of South Carolina. Commissioner Lyndon does not even live in Columbia and travels all over the state, he is without a doubt one of the most compassionate and knowledgeable Commissioners, just because some of you may have had a bad experience, one bad apple does not spoil the whole bunch. I think that Commissioners, Beck, Barden, Lyndon, Williams, Huffstetler, Roche and Wilkerson do an outstanding job of claims in this state. Some of you need to attend a seminar on the rules and regulations of workers’ compensation laws. Most people talk out of turn without knowing the facts and situational cases of the Claimants and the medical documentation. Get off your soap box and deal with the real issues and concerns of our State. Certainly, Mr. Peeler has better things to do with his time, like go milk his cows… that would be his area of expertise.. Let the people that know what is going on do there jobs that they took an oath to do.