A workers’ comp silver lining to Obamacare?

Is there a silver lining in Obamacare?

There may well be for any employer who deals with a lot of workers’ compensation cases.

According to various experts, the Affordable Care Act should definitely reduce claims because it expands medical coverage to more people.

Historically, the workers’ compensation system for some has been the only way to address temporary and even chronic medical problems, many of which are not work-related.

One such abuse, dubbed “Monday injuries,” involves waiting until the start of the week to blame a non-job-related injury to the workplace.

Workers’ compensation fraud amounts to some $7.2 billion annually, according to the National Insurance Crime Bureau, a figure that includes cheating by employees, employers and providers alike.

However, health insurance industry experts say that as more workers are able to purchase and carry affordable medical insurance through the ACA exchanges, they will use this new coverage – and not the workers’ compensation system – to address their medical needs.   

Thus, “Monday injuries” and other forms of worker-inspired fraud should decrease significantly.

For workers with ailments that require regular treatments over a number of years, there is an issue of convenience, too.

Workers don’t like the lack of control they have in the workers’ compensation system, the result of having to deal with claims handlers and medical claim payment systems and, in some states, having to select physicians from their employer’s medical provider network.

That’s why, when the choice is between health insurance and workers’ compensation coverage, many workers will opt for health insurance.

Beyond a decreased incentive to file questionable workers’ compensation claims, Travelers issued a white paper earlier this year saying the ACA also could lead to:

• Increased wellness.

• Increased fraud detection supported by government funding.

• Fewer emergency room visits.

• A decreased need to over-treat.

About the Author


Lon Matejczyk

Lon is the former publisher of the Colorado Springs Business Journal and Colorado Springs Military Newspaper Group.He has served in leadership roles at various newspapers in Iowa, Florida and Wisconsin. Lon received his Bachelor of Arts in Communications from the University of Wisconsin, Eau Claire and attended the Kellogg Graduate School of Management at Northwestern University. Earlier in his career, Lon spent several years as a sea captain and held a 100-ton Coast Guard license. Lon is a former rugby player, referee and administrator and now coaches under 13 year old kids. Lon has served on the boards of numerous community and business organizations including Colorado Springs Leadership Institute, Peak Venture Group, CS Quality of Life Indicators Business Index Committee, Junior Achievement and is a member of The Colorado Thirty Group.  Lon was given the “Making the Pikes Peak region a better place to live work and play” award by the CS Chamber of Commerce, was the VFW Post 1’s business citizen of the year.