Peter Rousmaniere has a column entitled A Voice of the Worker in Risk & Insurance that is well worth reading. He reports on the Workers Compensation Research Institute's (WCRI) study, Outcomes for Injured Workers. The research encompassed 3,000 claimants in California, Massachusetts, Pennsylvania, and Texas. It's one of the first studies from the worker perspective, assessing recovery, return to work, and access to and satisfaction with health care.
There is much in the study that provides a springboard for further study - why are workers more satisfied and why are outcomes better in MA and PA than in CA and TX? Satisfaction and recovery, it appears, do not align with the highest expenditures, for example.
Rousmaniere discusses one disturbing aspect of the study that points to a worker population that is being marginalized:
"Many injured workers never succeed in returning to the wage levels they had achieved before their accidents. The data suggest that the vast majority with less than an eighth grade education do not get close to where they were pre-injury. They account for much of the injured workforce in states like California and Texas, maybe due to the large Hispanic workforces there."
He suggests that, given these circumstances, the most attractive option for these workers might be joining the cash sub-economy or to seeking some form of permanent disability awards.
Rousmaniere suggests that " ... the workers' comp system can respond only so much on behalf of this worker group. The California system's tableau of generous legal and medical benefits for claimants is a mirage. The concept of voc rehab has largely failed as a major solution. What may help are better incentives for the employer to retain the worker from day one of the injury and through, if and when a permanent award is made."
We must ask ourselves if, in these instances, we are fostering a permanently disabled class. Clearly, the most successful outcomes occur when incentives are aligned - worker and employer. Both must have an investment in and commitment to the benefits of recovery and return to work.