City Desk

D.C. Wants to Know: Workers’ Comp or Workers’ Con?

As you might have noticed by now, the D.C. government is watching its wallet. So District officials are planning to keep closer tabs on a character who at times inspires pity, at other times suspicion: The injured city worker.

One of them, Gaynell Nixon, tries not to go downstairs. When she absolutely has to descend the stairs of her two-story home in Brandywine, Md., it's a production. She has to hold on to the banister with both hands, and move turtle slow. Her husband remodeled the banister with handholds, which helps, but the whole process is still exhausting.

Back in the winter of 1996, Nixon was a lot more spry. One day, working as a housing manager for the D.C. Housing Authority, she put that spryness to work. A snowstorm had hit, and Nixon remembers that a cash-strapped District government didn't have enough money to clear the walks in front of her East Capitol Street office. When she encountered a particularly deep patch of snow, she leaped over. She landed in a hole. It was shallow, but enough to damage her right foot. For 14 years, Nixon has been on workers' compensation.

According to the Office of Risk Management, which oversees the city's workers' comp program, in fiscal year 2010, there were 2,140 claims being paid out by the D.C. government. Though some of the claims only cover medical costs, the District paid over $24 million for its weakened workers last year.

To listen to risk management boss Phillip A. Lattimore, that's about to change. One of the goals of Mayor Vince Gray's administration, he says in a statement, is to "reduce the number of employees who are on workers' compensation." The administration believes that it can save millions.

To that end, Lattimore says his office will "soon" be instituting a new back-to-work program. The program will, among other things, "require workers to submit an annual affidavit of earnings." The city will then figure out if there "should be a reduction or termination of workers' compensation benefits in light of an employee's ability to work.” In other words, if the District catches a worker doing more part-time work than they're supposed to be able to do, they'll be cut off. Similar programs have been tried before, but Gray has proposed bolstering this one with a $1 million budget.

Eric May, a lawyer who has represented private-sector workers in compensation claims, doesn't disagree with the effort: "I think that it's a good concept if they can apply it well."

Nearly 400 D.C. government workers who are on workers' compensation still technically have positions with the District, according to public records. They're listed on the District's payroll tally because the city hopes they'll eventually come back. Their salaries show that nine made over $100,000 before they went out, and 21 made over $70,000. The top earner on the list made $197,000. The employees can be paid up to 75 percent of their annual salary, but under city law, can't be paid more than about $5,000 a month, or $60,000 a year.

Laura Duncan, a doctor who once worked for St. Elizabeths Hospital, is the workers' comp recipient who once pulled down $197,000. She says she hasn't had much contact with the city and that the program has been poorly managed. "The District government got so many problems," she says. "They got them in house, out house, and no house." Duncan says she's not able to work because of several soft tissue injuries.

Duncan isn't fibbing about D.C.'s workers' comp apparatus, technically known as the Disability Compensation Program, having problems. The D.C. Auditor accused ORM of having shoddy oversight of the fund that supplies workers' comp money, in a March report. But the agency has new leadership now, and a back-to-work effort that would require healthy workers to return would make that leadership look fiscally responsible in the wake of the previous mess.

The D.C. Employment Justice Center thinks so, too. In a statement, the activists say they generally support "the idea of returning injured workers who are able to work to jobs." But they're more interested in the survival of those who are truly hurt: "We are concerned that $1 million is being paid to fund this program instead of to individuals who need life sustaining medical treatment and poverty preventing wage replacement."

Nixon says that's right. "People think everyone on workers' compensation is frauding the system," she says. She points out that most of those on workers' comp are actually struggling to get medical care and financial support from a city that regularly denies it. Nixon, herself, isn't exactly making out like a bandit: She receives a $160 check every two weeks, she says.

City officials weren't able to supply a breakdown of who's getting what. But the risk management office says that for 2010, the average cost per injury per claim was $11,565.87. That doesn't exactly sound like a windfall; in most cases, it's barely a year's worth of rent.

Photo by Matt Dunn

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  • Andy

    Why is it that when governments need to cut budgets so many want to look at minor programs that actually have minimal overall budgetary implications, yet may be absolutely critical to the people receiving the benefits? DC Worker's Compensation is not in the same league as Federal Medicare. The DC program is not even a blip on the District's multi-billion dollar budget, but it is absolutely life saving to the people that depend on it.

    Is there some abuse? Sure. Name one program in the public OR PRIVATE sector that does not suffer from some less than perfect management (agreed, the life insurance scam was not a minor issue!). However, particularly for the people that depend on the DC Disability Compensation program on a long term basis, the program is vital and the overwhelming majority of people that are on it truly need the benefits. Unfortunately, the very people that often depend upon such a program the most are the ones that are most penalized by what seem to be the periodic hunts for abusers. This process benefits no one - not the worker, the District, or the taxpayer.

    Yes, the District needs to review injury claims carefully. But, once it does it does not help to then periodically call in to question all those whose cases have been fully and carefully reviewed in the past. I know no one that really enjoys having been forced to leave work early because they are injured and no longer able to perform on a daily basis. We should not continually impugn the reputations of the many, many honest people that have been forced into the disability program, simply because of the few that may take advantage of the program.

    When people that truly need the program are forced to go through the rigors of proving their cases on a repeated basis, both they and the city incur needless hardship and costs. An injured worker with a long term problem is essentially repeatedly subjected to "double jeopardy." Even after they may have previously proved their cases medically and before Administrative Law Judges holding extended hearings, they are called back to start the process all over again with new medical examinations in front of city-designated doctors, new claims adjusters that are inclined to think that everyone is a crook, and ultimately new hearings. This process can impose severe costs on the worker for the lawyers, hearings, and denied benefits, and it is do doubt costly for the city, too.

  • dixie

    DC Govt needs to remove the stone from its eyes before they can see to remove the speck out of injured workers eyes.

    1.For the last 17 yrs, DC Govt has been knowingly defrauding injured workers in both the private and public sectors. Voilating their own laws to steal 50% - 60% of travel expenses from injured workers. The travel expenses for private sector injured workers, have not been adjusted for inflation for 17 years, even though their cost of medical travel has nothing to do with DC Budget.

    2. Fraud at the Office of workers compensation has skyrocketted in the last 12 years. Judges blatantly commit fraud on behalf of DC Govt and private sector employers. Even though WC is supposed to be a humanitarian one, Judges are encouraged to do all they can to deny claims. Judges have employers attorneys on speed dial.

    3. A judge's role is to apply all laws to the facts of a case without favor or bias, BUT ALJ's at the DC OWC, are instructed to; "First, question the credibility of the claimant, this will make it easier to deny a claim; ignore the law; mix up case numbers, so cases get lost in the system; defer to employers attorneys when in doubt".

    4. Those who represent themselves or are represented by inexperienced attorneys are the victims of the blatant fraud.

    5. if Mayor Gray wants to stop fraud, in Workers Compensation in DC. he should look at DC Govt first. thats where the fraud is. Not the injured workers.

    6.If DC can afford Lincoln Navigators for Kwame Brown, and pay employees above salary caps, they sure can afford the mandated extra $0.30 per mile for medical travel expenses for injured workers.