In Oregon’s workers compensation system, insurers and self-insured employers rely on so called independent medical evaluators (IME’s). These are doctors, usually retired from the normal practice of taking care of people, who evaluate injured workers. These doctors provide opinions regarding the compensability (work relatedness) of claims and evaluate the disability that is a consequence of the injury. They are paid for by the carrier.
As you might suspect the opinions they provide are frequently favorable for the defense, and rarely for the worker.
In Oregon, the insurer or self-insured then makes a decision. The worker is allowed to challenge that decision with the case ending up before a neutral Administrative Law Judge. Although the law is skewed toward employers and these doctors are skewed toward employers the worker has a fair forum for the dispute.
Here is an example of a state where that is not true. In Kentucky, the legislature is doing their best to deprive coal miners of benefits, by skewing the law the doctors and the forum against the coal miners. Since coal miners are entitled to federal money as well (Black Lung benefits administered by the Social Security Administration) these people are being deprived of two sets of benefits. (SEE ARTICLE BELOW)
We need to be very careful when industry and/or government tell us that benefits should be reduced or denied, or safety precautions reduced to provide more jobs. There is always a real cost for those reductions, always borne by the people who were injured.
As Black Lung Strikes Younger Coal Miners, Kentucky Restricts Medical Benefits.
Coal is getting harder to get to—and that’s contributing to a respiratory epidemic among miners.
By Austyn Gaffney | nrdc.org
Brandon Crum was a fourth-generation coal miner. As a teenager, he spent his summers, holidays, and weekends working in the coal fields of eastern Kentucky. “I was raised with it,” says Crum. “My grandfather and my father were mine operators. From the time I was six I’ve been riding in bulldozers and cutting machines and scoops.”
He left mining at 21, but Crum didn’t stray too far from his roots. For the past 16 years, he’s been a radiologist and “B reader,” which means he is certified to evaluate chest X-rays for pneumoconiosis, or black lung, a debilitating respiratory disease. Caused by long-term exposure to coal mine dust, black lung is fairly common in coal miners in their sixties and seventies. Crum’s grandfather died from it, and his father has it, too. But in 2014, Crum began noticing a spike in severe black lung cases—and he was seeing them in younger and younger coal workers.
He contacted the National Institute for Occupational Safety and Health (NIOSH), which studied the X-rays of Crum’s patients. After multiple B readers in the region confirmed the diagnoses, Crum and NIOSH published their findings in December 2016. Continued research led NIOSH to conclude that one in five coal miners in central Appalachia has black lung. Even more shocking, one in twenty suffers from progressive massive fibrosis, the most severe form of the disease. Together, Crum and NIOSH uncovered the story of a fatal epidemic in Appalachia’s coal country.
“If one in five people who worked as nurses ended up with an incurable, chronic disease, people would lose their minds. In any other work this would be completely unacceptable,” says Evan Smith, an attorney for the Appalachian Citizens Law Center in Whitesburg, Kentucky. “It’s scary. It’s an incurable disease that will eventually lead to these people suffocating to death.”