Oliver Wendell Holmes Jr. is famous for declaring that the life of the law is experience and not logic.
If one were to attempt to measure the experience of the Pennsylvania Workers’ Compensation Act in the last 30 years of its existence, rarely will you find moments where the interests of injured workers were furthered through legislative action. To the contrary, the life of the law intended to protect injured workers in Pennsylvania has been one attempted dismantling after another.
Recently, however, injured workers were given some encouragement. On April 27, Gov. Tom Wolf vetoed Senate Bill 936, a hotly contested piece of legislation that sought to fundamentally change the way injured workers obtain medical treatment in Pennsylvania. The bill attempted to impose formularies (a form of pre-approved treatment) upon injured workers and their doctors in Pennsylvania and place an additional burden upon doctors to justify treatment they thought appropriate for their patients injured at work but not on the formulary.
The merits/dangers of this bill have been discussed at length in many publications throughout the state. Wolf’s veto preserves the current administration of the workers’ comp system from another attempt to fundamentally change it, but he did not merely veto the bill. In addition to his veto, Wolf offered some action steps towards addressing some of the problems opioids present to our workers’ compensation system.
The important question many people are now asking is how will these suggestions impact the system?
Opioid prescription guidelines and training: In the debate surrounding Senate Bill 936, no credible voice denied the dangers opioids present to injured workers. The critical question was whether the dangers could be addressed through the current structure of the Pa. Workers’ Compensation or whether its administration needed to be altered.
Wolf’s suggestion to implement opioid prescription guidelines for providers and training for workers’ comp judges/providers allows for the preservation of our system, which has preserved the doctor/patient relationship and limited costs for employers/insurers throughout the state. In fact, workers’ compensation rates had been declining for years in Pennsylvania before Senate Bill 936 was introduced. These suggestions preserve our system and its essential promises while attempting to address the opioid challenges within it.
Pain creams: Wolf also indicated that he would order the Department of Labor & Industry to propose regulations that require pharmacies to bill insurance companies for the creams at the ingredient level, instead of the higher prices currently charged. This is a change that, while it does not directly impact injured workers, addresses insurance companies’ main concern: costs.
Legislative action: There is legislation pending that attempts to address the opioid problem. Whatever legislation ultimately moves forward, it can certainly address the opioid problem without dismantling the workers’ compensation act.
Time will tell whether Wolf’s suggestions are appropriate for the problem. However, the Pa. Workers’ Compensation Act dodged another attempt at a fundamental change that would have had a significant impact on the way injured workers obtain medical treatment.
John Frommer is an attorney and certified workers’ compensation specialist with law firm Frommer, D’Amico, Anderson in Susquehanna Township. He can be contacted at email@example.com or www.mycomplawyers.com.