The skyrocketing costs of medical treatment for Union members threatens the financial stability of many health and welfare plans. Over the years, Union health and welfare plans have covered members’ medical bills as primary obligations where, in fact, other coverages such as no fault auto insurances, or workers’ compensation benefits, should be considered primary providers of medical treatment.
Because of efforts by workers’ compensation insurance companies claims managers to limit medical treatment available to injured workers, the cost of making up for the inadequate treatment that injured Union members receive, falls back upon the Union itself. This represents nothing less than a Union subsidy of the profits of the workers’ compensation insurance companies.
By way of comparison, recently, the United States General Accountability Office determined that in similar circumstances, Medicare has subsidized the workers’ compensation insurance industry profits of 40 billion dollars over the last 10 years by paying medical bills which should have been submitted to the workers’ compensation carriers.
Unfortunately, for injured working people in New Jersey, the workers’ compensation carrier and/or employer has the right to select the physician and even change physicians in an effort to limit the amount of medical treatment provided to an injured worker. However, injured workers have a recourse for the denial of medical treatment by filing a Claim Petition in the New Jersey Division of Workers’ Compensation. They further have the right to request a Judge of Compensation compel the employer or insurance company to provide medical treatment.
Furthermore, the Union Health and Welfare Plan has the right to submit its bills to the Workers’ Compensation Court to obtain recovery from the workers’ compensation insurance company.
It is, therefore, in the interest of the Union Health and Welfare Plan to encourage all members who suffer significant work related injuries to file a claim in the Workers’ Compensation Court not only to protect the rights of the injured member, but also to protect the rights and financial stability of the Union health and welfare funds.
