The State of North Carolina and the North Carolina Rate Bureau (NCRB) reached an agreement over North Carolina workers’ compensation rates for next spring. The 2010 filings – which will go into effect on the 1st of April, 2011 – should save businesses approximately $7 million over what they might have had to pay, had the North Carolina Rate Bureau completely gotten its way. Wayne Goodwin, the State’s Insurance Commissioner, agreed that the “slight increase” in North Carolina workers’ compensation employers costs (0.6% for voluntary market loss costs and just a little more than 4% for assigned risk markets) was justified.

The Rate Bureau had hoped for slightly higher increases – 1.2% for the voluntary market costs and 5.5% for the assigned risk markets. The industry argued that it needed a hike in rates because of rising medical costs across the state. But opponents of large increases argued that the number of workers’ comp claims in NC has declined; therefore, rates shouldn’t be bumped too much. The Rate Bureau’s director speculated that the number of claims may have declined because:

A) High risk manufacturing jobs preferentially disappeared during the recent recession.
B) Employers have made strides in making their workplaces safer.

The Rate Bureau believes that employers across North Carolina will pay approximately $1.16 billion in 2011 in premiums alone. While a spokesperson for the NCRB claimed to be “a little bit disappointed” with the final decision, the Bureau didn’t seem too frustrated by the final outcome.

These macroscopic changes to the system may be interesting to policy analysts. But what if you are a worker who has recently been diagnosed with a chronic disease or who just got into a serious accident on the job? Will these rate changes affect you? And if so, how?

The trickle-down effect of major policy changes can be very difficult to detect and to quantify. Rather than getting distracted by macroscopic state rate politics, focus instead on what you need to do maximize your claim and speed up your recovery. If you’ve been having trouble with an employer or an insurance company – for instance, an employer unreasonably denying your benefit request or an insurance company acting in “bad faith” and refusing to pay money owed – consult with a North Carolina workers’ compensation law firm to figure out your best next steps.

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North Carolina Rate Bureau (NCRB)

More about the rate hike

Most cases of fraud – attempting to game the North Carolina workers’ compensation system, for instance – involve a certain degree of subtlety. For instance, this blog recently covered the sad case of a woman who got accused of workers’ comp fraud after she took a job as an exotic dancer to supplement her income – and then got caught by insurance investigators. In that case, what the defendant did was clearly wrong, but her circumstances seemed bleak and thus somewhat sympathetic.

A breaking case out of Massachusetts contains none of that kind of subtlety. According to Fox News in Boston, John Cloutier, a former prison guard who got on workers’ comp after getting injured on the job in July 2008, has been arrested for fraud. An insider tip revealed that he had been running half marathons and marathons – all while claiming that his lower back was permanently injured.

Here is the basic timeline.

* In July 2008, Cloutier allegedly got injured.

* Starting in January 2009, he started collecting workers’ comp benefits. The 45-year old collected $56,000 between last January and this March.

* After being out of work for half a year for his “lower back injury,” Cloutier ran half a marathon and then a full marathon at Walt Disney World in Florida. In September of 2009, Cloutier did it again – he traveled to California and ran another half marathon.

* In the midst of all this running around, Cloutier applied for disability retirement in June 2009 – an arrangement which would give him 72% of his former salary ($62,000) every year for the rest of his life – tax free.

Cloutier was arraigned on October 26 for fraud charges in Massachusetts Suffolk Superior Court and released on his recognizance. His next court appointment is July. If he is convicted of all the charges against him, he could face 5 years in prison as well as array of fines and other penalties.

It’s impossible to tell from a simple news story whether Cloutier actually committed this crime or not. That’s why it’s important not to rush to judgment on a person. But North Carolina workers’ compensation fraud cases (and fraud cases throughout the United States) do drain millions of dollars from the system. This money could otherwise go to people who legitimately struggle with lower back injuries and other occupational illnesses or diseases.

If you or a family member has suffered a problem that’s prevented you from working, connect with an experienced and responsible North Carolina workers’ compensation law firm to discuss potential remedies. A quality firm can help you make sense of your rights and your obligations, keep you strategically focused on maximizing your benefits and minimizing your hassle, and help you defuse constraints that may be preventing you from collecting your benefits.

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John Cloutier legal problems

Another story about the prison guard and his marathon fraud fallout

According to an independent assessment of North Carolina workers’ compensation premium rates (and rates for other states), NC found itself almost exactly at the median once again. In 2008, North Carolina workers’ compensation rates averaged 22nd in the nation. In 2010, NC averaged 23rd – tied with Michigan – with an index rate of $2.12 per $100 of payroll. This year, Montana, Alaska, and Illinois topped the list. Montana employers had to pay $3.33 for every $100 of payroll – a surprisingly high rate for a state that has such a “business friendly” reputation. Alaska and Illinois also topped the $3 mark – Alaska had a $3.10 index rate and Illinois had a $3.05 index rate.

So what were the “best states” for workers’ comp premiums? The three best states were Arkansas, Indiana, and North Dakota, which all had index rates of lower than $1.20 per $100 of payroll. Arkansas employers paid just $1.18; Indiana employers paid $1.16; and North Dakota employers paid a rock bottom of $1.02 per every $100 of payroll.

To give you some perspective… North Dakotan business owners paid less than a third as much as Montana businesses paid in workers’ comp premiums.

North Carolina workers’ compensation statistics can help policy analysts develop effective blueprints to improve the system’s overall conditions. But if you are a struggling, injured worker, how might these numbers be relevant to you?

Truth be told, hurt workers don’t care about statewide trends, rate changes, or any other policy minutiae. They simply want full benefits, less hassle in getting them, and a crystal clear blueprint for how to compel parties that don’t want to pay but should (e.g. uncooperative employers or insurance companies) to make good on their obligations.

If you or somebody you care about has been struggling to make the North Carolina workers’ compensation system work for you, it may behoove you to get in touch today with a credentialed and proven North Carolina workers’ compensation law firm to unpack options, review your strategy, clear up any bureaucratic/logistical obstacles in your way, and reduce the amount of stress that your claim is causing you and your family.

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Montana workers comp premiums going sky-high

More info on state by state premiums

A heartbreaking case out of Montgomery, Alabama has much of the nation, including many top North Carolina workers’ compensation policy analysts, debating the effects and legality of a suit filed by the family of Corporal David Brown, a police officer who got hurt while off duty.

Corporal Brown had been escorting a funeral procession on September 11th, when he got injured. The ambulance that took him away flipped over while carrying to the hospital, injuring Brown further. As of this writing, Brown remains seriously injured. The Corporal had been working for a private funeral home and had been technically off duty (September 11th this year was fell a Saturday). But Brown’s family wants the city to declare that the Corporal was actually “on duty” so he can collect workers comp.

Montgomery Mayor Todd Strange has indicated that the city can’t grant the workers’ comp benefits because state law does not allow it. That said, Mayor Strange indicated that the city would do everything it could to help Brown and his family. Brown reportedly will get retirement benefits for life as well as medical disability retirement benefits and extra leave time. In the Montgomery Advertiser, Mayor Strange said, “we want to do everything conceivable under the law to help him.”

On October 27th, the Brown family filed suit against Montgomery, arguing that the corporal had been working “with permission, knowledge, and approval” of the city’s police department and had been working to help the citizenry of Montgomery while directing traffic for the funeral procession.


This case illustrates nicely how complicated certain North Carolina workers’ compensation cases can become – even when employers (or in this case the Mayor of the City of Montgomery) want to cooperate and provide maximal allowable assistance under the law. In other cases, employers and insurance companies may resist obligations to pay an injured worker and may even skirt the law to get out of paying monies owed.

If you or someone in your family has gotten hurt or ill at a job in the state, a North Carolina workers’ compensation law firm can provide a free and confidential consultation about how you can go about collecting benefits in a fair and timely way. A good team of attorneys can also help you battle back against a bad faith insurer and uncooperative employer.

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Corporal Brown lawsuit

Mayor Strange vs. Brown family

Last week, LAPD Officer Robert Yanez got arrested at police headquarters in downtown L.A. for workers’ comp fraud – provoking a lively debate among policy analysts and other North Carolina workers’ compensation experts. The 38-year-old officer got hurt in October 2008 on the job. After being ordered back to work by his doctor, he allegedly switched physicians and forged/altered his doctor’s notes to continue getting payments.

All told, the 11-year-veteran LAPD officer allegedly did this multiple times – he got charged with six total counts – and cost his department around $7,000. Officer Yanez was held at the Men’s Central Jail in downtown L.A. on $30,000 bail. If convicted, he could face seven years behind bars. According to a statement from the LA County DA’s Division of Healthcare Fraud, investigators discovered “probable cause to believe that Officer Yanez had received benefits to which he was not entitled.” According to news reports, the LA Police Officers Union is not representing him in this case, and Officer Yanez is on home duty until the investigation finishes.

North Carolina workers’ compensation fraud – and workers’ comp fraud throughout the US – drains millions of dollars from the system and creates problems not only for insurance companies and employers but also for employees who have legitimate claims. The workers’ comp system is designed to help legitimately hurt or ill people make ends meet until they can recover. Unfortunately, a few bad apples do take advantage of the system and even resort to explicitly fraudulent activities (such as doctoring a doctor’s note) to avoid having to go back to work.

In response to fraud cases like this one, insurance companies may put in place more cumbersome screening procedures; employers may get more suspicious of workers who make any claims; and injured employees may find it more challenging to make the system work for them.

If you have been unfairly charged with fraud – or if you are dealing with some other issue with your benefits – such as an employer not paying a legitimate claim or an insurance company gumming up your claim by stalling or using bullying tactics – you may benefit significantly from a free consultation with a North Carolina workers’ compensation law firm. Smart attorneys and their associates – who understand the system and the law – can reduce your level of uncertainty and stress and steer you on a course to maximize your recovery and maximize your benefits.

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Veteran LAPD officer accused of workers’ compensation fraud

LAPD officer accused of workers’ comp fraud

According to national media organizations like Bloomberg, sales of North Carolina workers’ compensation policies (and policies for workers’ comp across the country) have fallen significantly. A.M. Best, for instance, says that US workers’ comp policy sales declined by a precipitous 15% from 1999. According to the A.M. Best’s composite index for workers’ comp, sales dropped to just $12.3 billion – down from a high of $21 billion in 2004.

North Carolina workers’ compensation policy analysts believe that the problem might have to do with sluggish growth and a stable but high national unemployment rate (around 9.6% or so, as of August 2010). In other words, insurance companies are likely lowering their rates to compete – and the so-called “jobless recovery” means that employers are not hiring as many people and thus don’t need as many policies. Companies like Travelers, American International Group (AIG), and Liberty Mutual have all reported drops in sales.

Looking at the larger cultural and economic implications here… if you are a worker or employer in North Carolina, what should you make of these numbers? One implication could be that the so-called “jobless recovery” appears to be real – and could be here to stay, for some time. This doesn’t mean that certain sectors of the North Carolina economy will not recover – or that more jobs will not emerge. But it does at least imply that the economic landscape that will inform future North Carolina workers’ compensation policy will likely be very different from the landscape that dominated last decade.

According to anecdotal evidence, one of the most frustrating aspects of the “great recession” of 07-09 and its aftermath – for North Carolina employees and entrepreneurs – is the lack of certainty. In other words, no one knows how our collective political response to the recession will ultimately impact businesses and workers. Nor does anyone know when will things “level out” to the point that employers and employees can plan their mid-term hiring/working strategies.

And against this backdrop of uncertainty and low level panic, many workers find themselves unable to work as much as they had in the past due to injuries, illnesses, or other unfortunate circumstances. For those people, workers’ compensation benefits and unemployment benefits can literally be a lifeline stabilizing their finances and budget.

If you are having difficulty getting or sustaining benefits – due to an employer who won’t cooperate or an insurance company who is giving you trouble on your claim for whatever reason – get quality help developing and executing solutions by talking to a respected North Carolina workers’ compensation law firm.

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Bloomberg article on drop in sales

A.M. Best — official site

Last week, an article on Msnbc.com closely examined a growing concern to potential North Carolina workers’ compensation claimants and others locked in battle with their employers to get compensation for a sickness or injury sustained at work. The issue involves prescription drugs and injuries on the job. If you are on, for instance, an opiate painkiller, such as Oxycodone, and you get into an injury accident at work – such as fall off a ladder or drive an industrial vehicle into an embankment and get whiplash, etc. – your employer can try to deny your North Carolina workers’ compensation charge on the basis that the drugs caused the injury or accident.

The article cites statistics compiled by Quest Diagnostics – a massive diagnostic testing company. According to Quest data, US workers who tested positive for opiates jumped radically in 2009 – by 18%. Since the middle of last decade, the number of workers testing positive for opiates has climbed by 40%. And although pre-employment drug screening tests found that only 0.78% of workers tested positive; post-accident tests found that 3.7% of accident victims tested positive. In the words of the Director of Science and Technology for Employer Solutions for Quest: “our data should be an indicator of concern for both employers and employees regarding the potential impact of these drugs on workers and safety.”

A North Carolina workers’ compensation case from 2009 illustrates the point. In that case, a carpenter fell and got severely hurt. His employer sought to deny his workers’ comp claim because he tested positive for opiates. A court ultimately found in favor of the carpenter’s position because the test did not indicate how much narcotic he had in his body when he fell.

If you or someone you care about faces employer or insurance company scrutiny because you got hurt or sick on the job while on medications (or you tested positive for drugs or alcohol), it’s in your interest to discuss how to proceed with a quality, experienced North Carolina workers’ compensation law firm. If you approach your employer (or the insurance company) improperly – or misrepresent your interests — you could wind up impeding your ability to collect crucial benefits that you need to get healthier and rebuild your career.

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All about Oxycodone

More about prescription drugs and the workplace

The North Carolina Industrial Commission is sponsoring the 15th Annual North Carolina Workers’ Compensation Educational Conference next week from October 13 through 15. The event – which will take place at the Raleigh Convention Center – aims to educate people involved in all different aspects of the state’s workers’ comp system about:

• Policies
• Forms
• Procedures
• Rules

The conference also aims to allow diverse participants to discuss key issues about the system. The NCIC website says that the following participants may gain useful info from this conference:

• Employers
• HR managers
• Attorneys
• Medical providers
• Mediators
• Rehab providers
• Paralegals
• Self-insurers
• Administrators
• Claims adjusters
• Safety managers

Both the Raleigh Marriott City Center and Sheraton Raleigh hotels offer discount conference rates just half a block away from the Raleigh Convention Center (where the conference will be held). According to the NCIC website, the following people will be speaking at the North Carolina Workers’ Compensation Educational Conference:

October 13:

• Pamela Young, the Chair of the NCIC
• Martha Dealy, the President of Kids’ Chance of North Carolina
• Denise Thomas, Consultant
• Kirk Leggott, the NCIC’s Chief Information Officer
• Adolfo Arsuaga, a speaker on Multicultural Issues
• Tracey Weaver, David Gantt, and Henry Byrum, who will talk about Professional Ethics

October 14 (Thursday) two breakout sessions will occur in the morning – one on Rehab Dilemmas and one on “The Workers’ Knee – A Medical Assessment”

In the afternoon, two other breakout sessions will occur: one on “Hot Topics in Claims Administration” and one on “I Know I Can Do It, I Just Don’t Remember How!” held by the NCIC Deputy Commissioners.

October 15 (Friday) you will get to hear more speakers, including:

• Pamela Young, the NCIC Chair
• Wanda Taylor, Keischa Lovelace, and John Schafer, who will talk about Industrial Commission Rule Changes
• Dr. T. Kern Carlton III will talk about Controversies in Chronic Pain
• Johnny Lee will talk about Workplace Violence
• Maggie Bennington and Bruce Hamilton will talk about Case Law Updates

If you or someone you care about has gotten injured or sick at work – and your employer, or relevant insurance company, or another party has not treated you fairly, it may behoove you to discuss what steps to take with a qualified North Carolina workers’ compensation law firm.

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more about the North Carolina Workers’ Compensation Educational Conference

North Carolina Industrial Commission