Column: Workers' Comp

Opinion | Our Hypocrisy and Callousness Toward Undocumented Workers

By: | July 16, 2018 • 3 min read

Roberto Ceniceros is senior editor at Risk & Insurance® and chair of the National Workers' Compensation and Disability Conference® & Expo. He can be reached at [email protected] Read more of his columns and features.

President Trump’s “zero-tolerance” illegal immigration policy that separated parents from children outraged many Americans.


Disturbingly though, some Americans cheered the action.

Equally disturbing to me is a lack of compassion exhibited by shady employers who knowingly hire undocumented workers then dump them should they get injured on the job.

These employers take advantage of poor people, knowing workers in the country illegally are unlikely to report the employer’s failure to purchase workers’ compensation insurance or provide mandated medical care and indemnity.

Legislation currently before Ohio’s Senate Insurance and Financial Institutions Committee would essentially legalize such practices.

While Ohio businesses and residents rely on undocumented worker labor — evidenced by the recent arrests of more than 200 workers at Ohio meat processing plants and flower nurseries — House Bill 380 would bar “illegal or unauthorized aliens” from receiving workers’ comp benefits.

The bill also calls for granting employers immunity from liability for undocumented worker injuries.

Over the years, insurers, to their credit, have often helped quash similar bills proposed across different states, by arguing such a law would encourage unscrupulous employers to hire more illegal immigrants because they get to forego workers’ comp expenses.

Immigrants are already at a disadvantage when it comes to obtaining workers’ comp benefits that they are legally entitled to.

Workers’ comp claims professionals and nurse case managers tell me that the normal challenges of providing medical care increase when undocumented workers don’t speak English, don’t have valid Social Security numbers, or use pseudonyms.

Their poverty often results in their changing addresses or losing phone service frequently, making them difficult for case managers to locate.

These employers take advantage of poor people, knowing workers in the country illegally are unlikely to report the employer’s failure to purchase workers’ compensation insurance or provide mandated medical care and indemnity.

If they are located, case managers must overcome a heightened sense of mistrust.


All these factors increase the likelihood that undocumented workers won’t receive the level of care they might otherwise get.

It’s reasonable to think fear caused by recent increased immigration enforcement is spreading even more reluctance to seek workplace injury treatment.

A Denver-area doctor who primarily treats workers’ comp claimants, including about 30 percent who only speak Spanish, recently told me that in past years he treated one or two workers per week who couldn’t provide Social Security numbers.

“It becomes pretty clear when someone has no Social Security number and is undocumented,” he said.

“Sometimes they would admit it, or say ‘oh, I don’t have that and it’s somewhere else,’ and they are never able to find it.”

But over the past year or so with increased enforcement of immigration laws those workers aren’t showing up at the doctor’s office. He thinks they are now more afraid that a system they don’t understand will expose their immigration status.

“I was used to seeing several undocumented workers and treating them,” the doctor said.

“The reality, I think, is we are just not seeing them anymore because they are afraid to seek care for their work injuries.”

Some Americans likely will cheer that result. But that reaction is too callous for me to endorse.

Border security and the 11 million undocumented people living in the country are topics our nation should be addressing.

Let’s be honest. We depend on millions of undocumented workers to run the restaurants we dine in, produce the food we consume and construct the buildings we occupy.

It amazes me that some people find it morally acceptable to rely on their labor and then deny them basic medical care when they experience a workplace injury. &

More from Risk & Insurance

More from Risk & Insurance

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.


That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.


Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]