Every state has its own set of rules and regulations regarding
workers’ compensation. While many states have slight variations, most workers’ compensation
plans require employers to have a policy that covers medical expenses
and a portion of lost wages – usually 2/3 - in the event that an
employee should suffer a work-related injury or illness. In recent years,
however, some states have implemented an “opt-out” arrangement
in which employers can choose to operate without a workers’ compensation
policy in exchange for an alternative benefits plan.
Texas and, up until recently, Oklahoma, have allowed employers to come
up with their own workplace injury plans. While this choice in theory
appears to give employers more choices and freedom, these policies have
ended up creating massive problems for injured employees. These alternative
plans have been known to cover a much smaller range of injuries and impose
unreasonable restrictions, such as shorter compensation durations and
minimal lists of approved doctors. According to
an investigation by NPR and ProPublica, many of these plans outright violate federal law but are left unchallenged
due to their unregulated nature.
For example, U.S. Foods has written a provision into their program that
exempts all diseases or illnesses “regardless of how contracted,”
thereby allowing them to avoid liability for work-related hazards such as
toxic chemical exposure or heatstroke. In another case, Costco offers its employees a maximum
of $600 for hearing aids – despite the fact that the least expensive
model of hearing aids sold at Costco is priced at more than $900.
While employers who have opted out of workers’ compensation may possibly
be sued by an injured worker for civil damages in some instances, many
uninsured employers have their employees waive their right to sue in exchange
for a promise to cover any medical expenses they should incur in the event
of a workplace injury. Employees often reluctantly take this deal, as
they would otherwise be unable to afford their medical treatment while
waiting to pursue legal action.
Are “Opt-Out” Programs Legal?
Considerable controversy has arisen over the lawfulness of opt-out programs.
The United States Department of Labor is currently examining whether or
not these plans violate federal law and, if so, whether possibly they
should be outlawed. The Oklahoma’s Workers’ Compensation Commission
recently declared alternative compensation programs unconstitutional,
citing a case where an injured Dillard’s department store employee
was denied benefits supposedly due to a “pre-existing condition”
when the employee suffered an injury while lifting boxes of shoes. According
to the commission, alternative plans have given employers the power in
essence to act as a legislator and impose unlimited restrictions on which
injuries will be eligible for compensation.
Powerful Workers’ Compensation Advocacy in Atlanta
If you are in need of strong legal advocacy to help you with a workers’
compensation issue of your own, the knowledgeable Atlanta attorney at
Douglas F. Kaleita, P.C. can represent your interests and fight to secure
a favorable outcome on your behalf. With more than 25 years of proven
legal experience, we can maximize your chances of securing the benefits
you deserve and ensure your rights are protected.
If we do not win, you do not pay – call (888) 665-7699 or schedule a free consultation