I have been a peer review doctor for WC. It is a spectacular scam, both by patients and the designated doctors (mainly chiropractors). We need to focus on how to remedy this deplorable system.

Dr Bob

Workman’s Comp has had gotten a lot heat in the past few years and what it needs is some light. Keep up the good work.

The fees are adequate for the medical services provided. HOWEVER, not for the headache and hassle associated with malingering litigious patients. Not to mention medical forms that are nothing like the standard HCFA 1500 used by all other third parties.

Sincerely,

Charles Akins MD

There is the notorious case of the Colorado roofer, reported on 60 Minutes as a story about health insurance, but actually a problem with Colorado workers comp that allowed the roofer (a sub-contractor) to have no insurance, not to be covered by the prime contractor, not to have health insurance, and then to appear on 60 minutes (following a work-related injury) as an example of a problem with the health insurance industry!

As a small employer, I am glad my premiums are not 100% experience rated. I would need to buy additional catastrophic coverage if they were. This is not at all an unusual insurance practice. We are aware of our premiums and take steps to ensure as far as possible a safe workplace (although we are white collar so not too risky). Since many work comp payments are scheduled, integration with discounted fee-for-service networks could be more difficult than you suggest.

Regards,

Ian Duncan, FSA FIA FCIA MAAA

Solucia Inc