The NY Comp Board is progressing on using guidelines to evaluate the extent of permanent disabilities. An objective yardstick can substantially reduce insurance costs by lessening the number of disputes, trials and appeals – provided, of course, that all the major medical problems are covered.
However, it has been noticed by some that although backs, which are responsible for the largest share of comp costs, are covered by the new guidelines, hips, knees and ankles are not. The failure to include these sites could result in more, not less litigation. (WCxKit)
Every NY comp lawyer knows that a back claim necessarily involves a leg claim as well. Back pain often leads to a painful, asymmetric gait which, in time, can lead to problems in precisely the sites not covered by the new guidelines: i.e., the hip knee and ankle.
Attorneys know that it is the areas of uncertainty that lead to the largest awards. Major amputations seldom result in extensive trials since the losses are obvious to all. Pain in a back has, in the past, been the most fruitful source of litigation – and legal fees. But what happens when strict guidelines for evaluation are applied?
If the claim can be remolded into something without guidelines little will be accomplished. This has been seen in the NY comp system for decades. A back claim which, under certain circumstances, would result in little can be quite profitable if it is transformed into a leg claim, precisely what is still possible under the new guidelines. (WCxKit)
Employers will soon be reading of the cost reduction advantages of the new guidelines but will hear little of the many ways the guidelines can be circumvented. Prompt return to work is still the best means of reducing costs, not ever changing yardstick of administrative guidelines.
Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, New York. He is a frequent writer and speaker, and has represented employers in the areas of workers' compensation, Social Security disability, employee disability plans, and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100.
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