HELENA — It's not just for bricklayers with blown knees or loggers with severed toes.
Workers compensation insurance takes care of stock boys with pulled backs and nurses who contract their patients’ diseases. Most employers pay for it, and thousands of Montana workers might someday have to rely on it.
But Montana's system is broken, say business owners and many lawmakers. Its rates, among the nation’s highest, siphon away precious profits and scare off prospective business ventures.
The high cost is the son of many fathers. If you think of it as car insurance, Montana is an 18-year-old male with a lead foot and a fast car — he's on the high-risk plan.
Studies show that Montanans get hurt more seriously and more often. They also remain off-the-job longer than workers in many other states. Medical costs are high as well, though providers say charges are low compared to surrounding states.
Whatever the problem’s causes, Greg Heartz just wants help. The Polson grocer said he has done all he can to bring down premiums through safety incentives and worker training programs. He wants the Legislature to lower his costs.
He’s not alone. Reforming work comp is one of business’s top priorities this legislative session. Gov. Brian Schweitzer is pushing it hard. Labor unions concede changes are in order.
Legislators are listening. Two major competing bills are shouldering their way through the 2011 session to answer the concerns of Heartz and hundreds of other employers.
One business’s costs
Heartz owns six grocery stores, five in Montana and one in Idaho. A decade ago, he said, work comp was among his top 15 biggest costs; now it's in his top five. He pays more for work comp, he added, than he pays in taxes – and the most dangerous tool his workers carry is a box knife.
But even though grocers don't face the dangers that loggers and miners do, costs still add up. A lower back injury suffered by one of Heartz’s workers cost $172,000, he said.
Overall, Heartz reckons work comp premiums account for more than 6 percent of his total payroll in Montana. Coverage for his Idaho store costs half of that, he added.
The first reform bill, House Bill 334, by Rep. Scott Reichner, R-Bigfork, looks to shrink rates by closing claims after five years, with an extension of two years if the worker needs surgery.
The bill would raise the level of impairment for which workers could collect payments for lost wages, and it would exclude some injuries from qualifying for any benefit at all. It also requires that injured workers get treatment from a list of state-approved physicians.
Reichner said such changes could cut rates immediately by as much as 40 percent, with savings estimates ranging from $80 million to $180 million a year.
He said the big losers would be Montana's neighboring states, who stand to lose businesses that previously chose to locate there due to lower work comp costs.
But workers, who long ago traded their right to sue for a guarantee of limited compensation for on-the-job injuries, are wary.
Barb Swehla of the Montana Nurses Association sees Reichner’s bill as another in a long series of attempts to cut premiums at the expense of employees. “We really believe that House Bill 334 is devastating to the injured worker,” she said.
In Montana, nursing accounts for the second highest number of work comp claims. Most nurses are women who are often called to lift or move patients much larger than themselves. Back and shoulder injuries are common, said Swehla, whose own back problems forced her to quit working directly with patients.
Nurses also face the possibility of contracting diseases such as hepatitis, tuberculosis and, in rare cases, HIV. What happens to them, Swehla asked, when Reichner’s five-year limit on claims runs out?
The session’s other major work comp bill, Senate Bill 243, is sponsored by Sen. Ryan Zinke, R-Whitefish. It stems from a four-year study by a committee of lawmakers and representatives from labor and management. Zinke, a former Navy SEAL, served a two-year hitch on the panel. Even he found the subject harrowing.
Like the House bill, SB 243 puts a time limit on benefits, with exceptions for unusual cases. But whereas Reichner’s bill focuses on limiting workers’ benefits, Zinke’s bill keys on restricting payments to health-care providers.
Specifically, Zinke would limit payments to no more than 165 percent of what Medicare would pay for the same procedure.
Health care providers don’t like that, arguing that it would prevent them from recovering the costs they bear in dealing with work comp patients, costs that include additional paperwork, procedures and bureaucracy. If Zinke’s bill becomes law, they warn, physicians and other health-care providers may shun work comp patients.
But Zinke said that if the paperwork and procedural requirements are the problem, legislators should cut red tape before they cut benefits.
Both bills offer treatment guidelines for physicians to follow in handling claims, and both offer plans to help workers get back to work quickly.
Because 95 percent of work comp injuries are healed as well as they're going to be at five years, Zinke said he's open to a five-year limit on payments, provided officials can make exceptions in special cases, such as nurses who contract lifelong diseases.
The road ahead
Both bills are advancing. It’s likely that whatever emerges this session will be a mix of the two, with other ideas tossed in.
Rep. Chuck Hunter, D-Helena, has been around the work comp issue for more than 20 years, first as an administrator in state government and then as a lawmaker. He served on the group that produced Zinke’s bill, SB 243.
He strongly opposes forcing injured workers to choose from a select list of physicians. He also objects to strict time limits on claims without considering special cases. He said he would fight any absolute ban on subsidizing workers’ lost wages based on the type of injury. He agrees with Zinke that a toe injury could have vastly different consequences for a logger and a ballerina.
However, he said, between the two bills lies the potential to fix some of the major causes of Montana’s high work comp rates: medical costs, unending duration of some claims, long absences from work and unnecessary payment of lost-wage subsidies to those who are not truly impaired.
His biggest concern is the ongoing need to promote safety on the job. That’s why he’s pushing legislation to continue funding a program that helps employers make their workplaces safer.
With both measures rushing to the Senate, Zinke said it is his goal to see that a solid compromise eventually lands on Gov. Schweitzer’s desk.
“I want to give the governor one good bill to sign,” he said. “I'm working with (Reichner). It's just the Senate is a little different and I have a slightly different approach. My approach is a little more cautious, and I don't want to have an unintended consequence.”
Each party will have to give a little, he said, but he hopes that in the end no workers will be prevented from getting care they truly need and that all businesses will get the relief they’ve asked for.
(Reporter Cody Bloomsburg can be reached at (208) 816-0809 or by e-mail at email@example.com)