‘Demolition’ of Workers’ Comp Limits Access to Home Health Aides

Dozens of states have drastically cut workers’ compensation benefits in the last decade, in some cases making it impossible for severely injured people to receive needed home health care, according to findings published Wednesday by NPR and investigative journalism organization ProPublica.

The erosion of workers’ comp benefits has been taking place over decades, but recently was fueled by the economic collapse between 2007 and 2009, the reporters found after delving into insurance data, state laws and medical and court records. To drive economic growth, states have loosened the laws governing employers’ responsibilities to pay for the care and living expenses of people hurt on the job. This has occurred in 33 states since 2003, ProPublica’s Michael Grabell and NPR’s Howard Berkes reported.

In their story, they focused on Joel Ramirez, who was partially paralyzed in a warehouse accident and then temporarily lost his home health aide due to a change in California law that took effect in 2013. Under this law, a physician who never personally examined Ramirez filed a review of his medical records, which caused his insurer to revoke his existing home health benefits.


Without a care aide, Ramirez endured indignities related to his bodily functions, his wife quit a job to care for him, and his daughter left college to provide financial help, according to Grabell and Berkes. 

A judge ultimately ordered the insurance company to restore the aide. However, there have been a number of similar cases in California, prompting planned changes in the state’s workers’ comp home health guideline.

Federal oversight of workers’ comp has been lacking, but the ProPublica/NPR findings have earned the attention of some Washington lawmakers, including Sen. Bob Casey (D-PA).


“The fact that a number of states have moved in this direction is disturbing and it should be unacceptable to people in both political parties,” Casey told the reporters.

Written by Tim Mullaney