ah, pesky government regulations strangling small business!
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Jennifer Mitol
(Jenmitol) - M

Locale: In my dreams....
ah, pesky government regulations strangling small business! on 04/10/2014 14:23:21 MDT Print View

So the state of Texas doesn't require small businesses to have workers compensation insurance; it is one of the ways the state is trying to make it so much easier for companies to come to this state!!!

Well...

I have a new patient who, just before Christmas, had a 400# machine fall on him at work (it was not secured properly). His employer did not have workers compensation insurance (too expensive!), but because it was a work injury, his personal insurance didn't want to cover it. He went two weeks before he finally broke down and went to the emergency room (his employer called his wife and yelled at her for bringing him).

Turns out he has a broken pelvis, fractured femur, and associated soft tissue damage. He can't work, so he no longer has any of his employer's health insurance. His employer isn't paying - they don't want to pay for any further medical care; they are fighting EVERYTHING. Needless to say he and his attorney finally were able to get him to PT for a bit - but the guy needs surgery. They won't even do any more imaging....so unless he pays out of pocket (with what? he's not working....) he gets nothing. Because why? There's no law against being a jerk. And here in Texas, there are no laws requiring employers to have insurance.

So here is an otherwise perfectly healthy 45 year old man, trying to support his family, severely injured at work - but thanks to none of that pesky regulation here in the state of texas to hold down small businesses!, he's going to be a bankrupt, bedridden guy on disability that YOUR tax dollars will pay for.

Isn't Texas great??!!!

Rick Adams
(rickadams100) - M
that sucks on 04/10/2014 14:49:09 MDT Print View

as an employer:

Some kind of workers comp is a good thing. Most of us want to provide for our people, especially when they get hurt on the job. I currently pay $25K a year for this insurance, used to be $120k before w/c reform in CA. These programs tend to get abused for a number of reasons by patients and the medical business. Texas should have a program to cover his care related to the workplace injury and to compensate the employee for lost wages. Just keep the lawyers out.

His employer is a raging ahole. I can't fathom how they sleep at night.

I wonder if there aren't civil damages here. Huge waste of energy and resources to make it happen.

I wonder what the rest of the story is. Hard to phathom this situation with two reasonable parties. Was the employee doing something that he was specifically told not to and therefore has personal responsibility accordding to TX law? I don't know but the whole thing seems weird.

Ian B.
(IDBLOOM) - MLife

Locale: PNW
Re: ah, pesky government regulations strangling small business! on 04/10/2014 14:51:28 MDT Print View

I've seen a similar situation or two here in Washington but for other reasons. The part of Washington I live in is Ag based (with the exception of Hanford). I've had an opportunity to meet status challenged aliens who've been severely injured on the job. In one instance, the young lady fell off of an orchard ladder and, like your client, fractured her pelvis among other things. While she had an opportunity to file L&I, her employer told her to hit the bricks or he'd call La Migra on her.

I met her a few years after the injury and she was still walking around with a walker. If memory serves, she was 30 y/o or a bit younger. Obviously this is not so much a government failure as it is greed and other toxic behavior sometimes present in the private sector. It's very easy to get frustrated with the multiple levels of government but the private sector can be just as effed up sometimes, if not more so.

Sorry to hear about your client and I hope he recovers in time.

David Olsen
(bivysack.com) - F

Locale: Channeled Scablands
Need some union thugs on 04/10/2014 14:52:52 MDT Print View

Vinny and Guido (or Lars and Oly) need to pay Mr cheapskate a visit.

HK Newman
(hknewman) - MLife

Locale: Western US
Situation normal (i.e. FUBAR) on 04/10/2014 15:04:17 MDT Print View

Jennifer, tough break and I had just assumed workers had to be covered by workman's comp via OSHA, etc.... Whoa, something to check on regardless of the state. Good reminder that private insurers do not cover the work environment tho.

More immediately ...

Medically and financially speaking, is there anyway the guy could go across to Mexico to get the surgery? Seriously, that's what my (very Anglo) step-family did in the El Paso region, .. go across to Ciudad Juarez for quality dental, vision, and some surgery* (we are talking Wonderbread Anglo here - border businesses speaks English btw and the docs train in the US). Maybe for oncology I'd stay on the US side but for bone-setting in a non-ER, if uncovered by insurance, I'd make a run for the border (to quote the old TacoBell ad). Set up in San Antonio/Brownsville, El Paso/Las Cruces, Tucson, or San Diego, ... get a cheaper passport card and take the bus or cheap cab over.

*Bonus: once across the border, care can't be tracked.

Katharina ....
(Kat_P) - MLife

Locale: Pacific Coast
Re: Need some union thugs on 04/10/2014 15:10:40 MDT Print View

"Vinny and Guido (or Lars and Oly) need to pay Mr cheapskate a visit."

Thugs are always a good idea.

Rick Adams
(rickadams100) - M
decency on 04/10/2014 15:49:22 MDT Print View

Unfortunately, no test for basic human decency in public or private sector. Some folks get carried away by greed or administrative power.

I'm certain federal workplace laws come in to play here, this guy should call OSHA immediately because it is clearly an unsafe work environment and they might steer him in the right direction re: payment for medical care.

If this is a small business, it sounds very much like they are in financial trouble....likely hasn't paid insurances that most of us wouldn't do business without. The employer is still an ahole........

Jeremy B.
(requiem) - F - M

Locale: Northern California
Re: decency on 04/10/2014 17:25:08 MDT Print View

I wonder if there aren't civil damages here. Huge waste of energy and resources to make it happen.

The phone call to the wife should be treated as a clear message to lawyer up. Just because the business doesn't have insurance, doesn't mean it isn't responsible.

Jennifer Mitol
(Jenmitol) - M

Locale: In my dreams....
Lawyers... on 04/10/2014 20:32:11 MDT Print View

I asked him today if he got a lawyer; he said he did, and the lawyer told him thanks to the workplace laws here in TX he is screwed. The atty told him he has no real recourse, because the TX legislature didn't want to burden businesses with mandatory workers compensation. There literally is no requirement in this state to provide any coverage for workers on the job.

And now that he doesn't have a job (since he can only walk with a walker), he doesn't even have his regular health insurance anymore. He's applying for obamacare and that may be his only recourse at this point.

I suggested he may just need to run up the bills then file for bankruptcy. At least then he can eventually recovery physically and financially. Now he's got nothing.

Jeremy B.
(requiem) - F - M

Locale: Northern California
Re: Lawyers... on 04/10/2014 21:18:47 MDT Print View

That's the odd part; from http://www.twc.state.tx.us/news/efte/workers_compensation.html I see item 3:

Being a "non-subscriber", i.e., going "bare" or without coverage, leaves an employer open to personal injury lawsuits from employees who are injured on the job - the damages and attorney's fees are almost unlimited - in addition, certain defenses available in most personal injury lawsuits, such as assumption of the risk, contributory negligence, "last clear chance", and co-worker negligence, are not available to a non-subscriber in a job injury case.

Per that site, compensation (if the employer had subscribed) would normally apply without regard to fault. (I.e. injuries incurred in the normal course of business would also be covered.)

However, it also makes it quite clear that in the absence of coverage the business is /very/ exposed to personal injury claims and the usual defenses wouldn't be available. E.g. If the machinery was improperly secured by the business, that should be sufficient for a claim. Him knowing the danger and choosing to work with it anyway would normally count against him ("assumption of the risk"), but per the above the business would not be able to use it as a defense.

Of course this is in Texas, I'm not a lawyer, and we certainly don't have all the details, so he may just be out of luck.

Edited for improved comprehensibility

Edited by requiem on 04/11/2014 12:03:31 MDT.

. Kirby
(Kirby805) - F
Re: ah, pesky government regulations strangling small business! on 04/11/2014 08:18:20 MDT Print View

Can't you smell the freedom?

Jennifer Mitol
(Jenmitol) - M

Locale: In my dreams....
Re: Re: Lawyers... on 04/11/2014 13:02:36 MDT Print View

Jeremy - thanks! I'll actually mention that...he's pretty desperate, both physically and financially, so I'll see if he explored that route just yet.

Of course, he may just be focusing on the initial emergency of getting himself treated, but if what you found would apply to him (and why wouldn't it?) then he may have an avenue of some sort.

And yes - I can smell the freedom in this state!!! Rick Perry knows how to do business here!
Woot!

jerry adams
(retiredjerry) - MLife

Locale: Oregon and Washington
Re: Re: Re: Lawyers... on 04/11/2014 16:55:29 MDT Print View

If one state, Texas for example, weakens their laws, then businesses will go there.

Then other states will weaken their laws to keep all the businesses from going to Texas.

Employees end up with less protection.

That is a case where a national law would be better. All states "forced" to protect their workers the same.

Yeah, you have to prevent regulations abusive to employers. I don't know how you accomplish that. Maybe congressmen doing their job? Maybe conservatives that are skeptical of the program identifying problems?

Valerie E
(Wildtowner) - M

Locale: Grand Canyon State
Negligence on 04/11/2014 17:24:22 MDT Print View

What a sad story -- this is why SOME people become lawyers...

Jen, if the machine was not secured properly, that is NEGLIGENCE on the part of the employer. Negligence is not something the employer would be permitted to escape under TX state business laws. Under ANY laws, actually. Only government entities can be excused, by law, from some kinds of negligence.

I think he needs to talk to a Personal Injury lawyer (one that will take the case on contingency). He also needs to get an ACA policy (past the deadline now, but maybe he has a "life event" that would permit him to avoid the deadline?) or consider surgery in Mexico (although if something goes wrong, he will likely be unable to sue for medical negligence - the main reason not to do that!).

I guess as a last-ditch effort, he could go bankrupt... but maybe he could try contacting the local newspaper about his story, and see if that might "light a fire" under his former employer. If he gets publicity, his friends/family might also try to organize a fundraising event (make an appeal to local musicians, etc.). Not the easiest thing to do, but the potential rewards could be significant to ease his situation.

Edited for -- gak -- typo!

Edited by Wildtowner on 04/13/2014 13:56:27 MDT.

Ian B.
(IDBLOOM) - MLife

Locale: PNW
Re: Negligence on 04/11/2014 17:47:05 MDT Print View

I don't have a JD but that's not passing the sniff test. Could be true but not all attorneys are created equal so could be BS too. If it were me, I'd spend more time researching local attorneys for one who has a solid reputation and get a second opinion before throwing in the towel.

Michael L
(mpl_35) - MLife

Locale: The Palouse
Re: Re: Negligence on 04/11/2014 19:50:36 MDT Print View

Lol. Sounds like one side of a story. Working with lawyers and in litigative consulting in TX for almost a decade, I think id have seen this if it was a common problem.

Jennifer, if you hate the business regs so much, I bet you can go work in that paradise that is Chicago....

Jennifer Mitol
(Jenmitol) - M

Locale: In my dreams....
Re: Re: Re: Negligence on 04/11/2014 20:29:33 MDT Print View

Michael, what about this story constitutes "lots of laughs?"

I've only been in TX since September (and I moved from Chicago, by the way...) and I've heard from many folks who've been screwed by no workers compensation. This is just the first case where the guy is pretty much disabled from his injury and his employer is not at all being cooperative.

Michael L
(mpl_35) - MLife

Locale: The Palouse
lol on 04/11/2014 22:27:48 MDT Print View

Its laugh out loud. You are hearing one side of disgruntled injured people. You have been in state half a year - a state that weathered the recession and has a booming economy compared to the rest of the nation - and your bitching and criticizing something you obviously dont have a good grasp of.

Not having workers comp doesnt keep the employer from obligations.

Im also not buying any decent an insurance policy not paying for treatment. I was injured in Texas and they never even asked if it was at work. They paidd the ER visit and PT. The workers comp is for time off or if you cant keep working.


I guess you prefer the work environment in Chicago? IF you have a job there at least you can have workers compmI guess.

Jennifer Mitol
(Jenmitol) - M

Locale: In my dreams....
Re: lol on 04/12/2014 11:52:08 MDT Print View

Michael, I deal with workers compensation all the time. No, it is NOT just for time off - it is the insurance that pays for your medical care. And no insurance company will pay for such things if it is a work-related injury - they may pay in the beginning, but they will try to recoup the payout.

Workers Compensation is who pays me when I treat patients injured at work.

And I didn't say I preferred the work environment in Chicago - I just think the constant preference to employERs over the employEEs in terms of tax and regulation policy is misguided. I mean, when corporate profits are at record highs yet employee compensation has been flat since the 80s - there's a serious problem with that.

Edited by Jenmitol on 04/12/2014 11:52:40 MDT.

Jennifer Mitol
(Jenmitol) - M

Locale: In my dreams....
workers compensation on 04/12/2014 12:02:36 MDT Print View

You can make all kinds of accusations that I don't know what I'm talking about because I've been in TX for 8 months, but what I see in front of me is a guy who was injured at work, seriously, and no one will pay for his treatment. Texas is a "right to work" state, which means, ironically enough, that he has the right to lose his job when he is injured and can no longer perform it.

So...

Not only are we (and his other physicians) being denied for every single intervention we are trying to get for this guy, but now he has the right to be fired (no cause needed here in TX!) and can't even pay out of pocket for it.

I don't care what the employer's side of the story is - i have a guy with a pelvic fracture and we cannot get services paid for. Simple. And trust me, his entire medical team is working REALLY hard to get paid...it's just not happening.

And there is PLENTY written about how the "texas miracle" is a sham:
http://www.washingtonmonthly.com/magazine/march_april_may_2014/features/oops_the_texas_miracle_that_is049289.php?page=all
http://www.economicmodeling.com/2013/11/05/economic-and-job-growth-in-texas-what-the-data-shows/
http://www.washingtonpost.com/opinions/the-sad-facts-behind-rick-perrys-texas-miracle/2011/08/16/gIQAxc3zJJ_story.html
http://www.cbsnews.com/news/the-texas-miracle/