The Walking Wounded Unite: Injured Workers Rescue Themselves

By Cindy Gomez-Schempp (Originally published in the High Plains Reader April, 2008 by Cindy Shawcross*)

Injured workers in North Dakota who feel WSI has failed to provide them with the “sure and certain” relief promised under the law have formed a Support Group. The first meeting was held on March 27th at Hope Lutheran Church with a great turnout from all over North Dakota and Minnesota. The meeting was attended not only by injured workers seeking support and information, but also by their friends and family members. In addition, there were lawyers, legislators, media, and community members concerned about unfair treatment of injured workers.

 The group released a Statement of Purpose saying, “The North Dakota Injured Workers Support Group is set up to help North Dakota workers in two ways. First, provide assistance for injured workers who are currently dealing with WSI. Second, to work for changes in North Dakota laws regarding workers’ compensation so injured workers will receive the sure and certain relief that has been promised to them.”

 Todd Loegering (assisted by his father Sylvan Loegering) founded NDIWSG. An injured worker himself, Todd has great experience dealing with WSI and an even greater interest in ending the abuses of injured workers by the agency. They are very pleased with the interest the support group is creating in North Dakota and Minnesota and the positive response received from legislators, lawyers, and even one member of the WSI board. It makes injured workers (myself included) feel very hopeful about what can be achieved through the combined efforts of its members.

 Currently, the group is focused on circulating petitions for the initiated measure that would provide (1) accountability by returning Workforce Safety & Insurance to the Governor’s supervision and control (2) provide fairness to Workforce Safety & Insurance employees by returning them to the state’s central personnel system; (3) independence to the administrative hearing process by requiring Workforce Safety & Insurance to use independent administrative law judges under the direction of the Office of Administrative Hearings and; (4) procedural fairness to all parties to administrative hearings by requiring that Administrative Law Judge decisions be final, subject to appeal to the District Court. This drive to collect signatures is a crucial first step toward changing WSI. Getting enough signatures will place the measure on the ballot in November. Enough votes in November will enact a new law. People really need to get out and vote for the measure in the upcoming election. Critics of WSI point out that this change is needed because the legislature has not held WSI accountable and feel the power should revert to the Governor. They also point out that WSI needs to abide by the decisions handed down by Administrative Law Judges, since WSI currently can—and does—ignore those decisions; forcing financially strapped injured workers to appeal to a higher court. Persons interested in signing petitions or circulating them should contact Todd Loegering at 701-730-4488 or ndworkcomphelp@gmail.com

 The Injured Worker’s Support Group made some interesting points at their first meeting by highlighting the way the deck is stacked in favor of WSI. They noted that although injured workers do have an appeal process through WSI, the agency hires adverse medical examiners to review claims where they disagree with treating doctor opinions. WSI also now hires their own in-house Administrative Law Judges to hear the claims appeals of injured workers. The group noted that although injured workers can hire their own attorneys, many injured workers cannot afford this costly process and can rarely find an attorney willing to take their case. Having to appeal unfair treatment by WSI has forced most to give up. “Any description of the physical pain, the mental anguish, the financial woes and personal problems that result from this injustice would be inadequate and could fill volumes.” The group also warned that “If you have a job in North Dakota, you are just one injury away from being caught up in these problems. You can protect yourself a little by acting before you are injured. You can help change the system. Contact the Injured Workers Support Group,ndworkcomphelp@gmail.com, to learn how.”

 The group is also urging injured workers and their supporters to turn out in numbers at the next Industry, Business and Labor committee meeting on April 28th at 8:30 a.m. at NDSU Alumni Center (Reimers Conference Room) which will be open to the public. Injured workers will have an opportunity to air their concerns and have the committee review their claims. The committee is requesting that the public focus on informing them about changes they wish to see in the practices and procedures at WSI, as well as possible changes in the law. Although the committee cannot affect the outcome of any injured worker’s claim, they are interested in hearing from as many interested parties as possible. Persons wishing to speak to the committee must contact John Bjornson beforehand at 701-328-2916 or jbjornson@nd.gov.

 Another equally important meeting for injured workers and those who support them is the Worker’s Compensation Review Committee meeting on April 30th at 1:00 p.m. at the Holiday Inn in Fargo. Those interested in speaking with the committee must contact Jennifer Clark of the Legislative Council at 701-328-2916 or jclark@nd.gov.

 Suggested topics of change for the Industry, Business and Labor committee as well as the Worker’s Compensation Review Committee given by members of the Injured Workers Support Group include:

 1) Requiring WSI’s Fraud Investigation Unit to follow through on investigating and punishing employers who do any of the following:

· Fail to file claims of injury reported to them by employees
· Mislead employees into believing their claim has/will be filed when it has not
· Misleading employees that a claim is not/will not be compensable through WSI instead of filing the claim
· Retaliate against employees for filing a claim
· Intentionally lie or mislead doctors, or WSI to obstruct the rightful claim of an injured worker;

2) Reform of the Office of Independent Review (which is essentially an arm of WSI and according to injured workers is ANYTHING but “independent”);
3) Provide that WSI must make decisions of medical necessity and payment for treatment simultaneously;
4) Require WSI to publish and make public a Policy and Procedures Manual and Statement of Benefits similar to those published by other insurance companies (yes, WSI is essentially an insurer for the state);
5) Require WSI to follow its stated policies and procedures uniformly;
6) Implement penalties and fines for abuses of power and injustices by WSI which all other insurance companies are subject to;
7) Provide injured workers with choices of who can perform the so-called “independent” medical examinations WSI frequently requires;
8) Require WSI to provide complete and objective medical information/records to medical examiners, doctors, and any other medical expert they wish to review claims;
9) Require publication of all Safety Grants including criteria for receipt of grant monies and evidence that recipients met the criteria (this should include Hazard Elimination Learning Program and Safety Training Education Program);
10) Allow injured workers to use email and fax services to meet deadlines (reporting, responses, appeals) required by WSI instead of only US Postal Service;
11) Claims analysts should not be allowed to make any determinations about benefits without peer review and should be subject to the same regulatory rules followed by other insurance companies;
12) Require that injured workers receive the same standard of care with WSI preferred providers as they are used to getting from their own medical providers including the judicious use of necessary diagnostic medical tools (i.e., X-rays, MRI’s);
13) Require full disclosure of personal and business relationships between referring and referred medical practitioners when an injured worker is sent from one doctor to another;
14) Require WSI to abide by specified and reasonable timetables to issue decisions, review claims, and issue checks to injured workers/medical providers. These timetables should also be consistent with insurance industry standards;
15) Require WSI to provide a cost-of-living increase or inflation-indexing on disability payments.

Of course, these are only the tip of the proverbial iceberg for changes required within the ailing WSI agency. Hopefully, you the public, will raise your voices and add your own thoughts. We urge you attend our next meeting on Thursday April 24th from 6:00 pm to 8:00 pm at Hope Lutheran Church located at 3636 25th St. So. Fargo, ND.

**Questions and comments: cindy@fmppp.org

*Original publication in HPR under the author’s former last name Shawcross and email. Updates to HPR’s website have inaccurately changed the name of the post publisher and date. Original post date listed above.

**Current contact email updated.

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