Workers’ compensation continues to dominate legislative deliberations in most states. Whether the issues are the skyrocketing abuse of opioids by workers’ compensation claimants or the continuing efforts of states to address worker misclassification, one person in center stage of these deliberations is Vermont Representative Bill Botzow. Since 2012, Botzow has served as chair of the National Council of Insurance Legislators’ (NCOIL) workers’ compensation committee, a position that allows him to view workers’ compensation issues from a national perspective.
A visual artist who is a graduate of Princeton University, Botzow has been a member of the Vermont House of Representatives since 2003. Following is an interview with Rep. Botzow in which he responds to questions from Acadia Insurance relating to workers’ compensation.
Acadia: The NCOIL committee you chair recently received accolades for the release of its guidelines on Best Practices to Address Opioid Abuse, Misuse and Diversion. Workers’ compensation stakeholders across the board commended the paper as being a “living document” that can be refined as circumstances change in the world of opioid abuse. What do you see coming next for Best Practices?
Botzow: I would like to see NCOIL continue to reach out to stakeholders we haven’t heard from and ask for their input. For example, public safety will likely have important contributions. We will want to continue to hear from the medical community. They have been very supportive and brought important issues to our attention relating to neonatal treatment of pregnant drug abusers. The overall effort of “Best Practices” needs to be broad, deep and continuous. We also need to assess how the “Best Practices” are being implemented by states and their effectiveness. Ultimately I expect that some of the best practices will evolve into model law.
Acadia: What impacts do you see the Affordable Care Act having on states’ workers’ compensation systems?
Botzow: In Vermont, our Health Care Committee asked for a study and report on the question of workers’ comp being included in our health care reform efforts along with health insurance. For now we have decided that the differences are significant and workers’ comp regulation and oversight should stay with our insurance regulators in the Department of Labor and the Department of Financial Regulation. However, treatment standards as set by medical boards should be evidence-based and consistent, especially regarding pain management. We passed a bill in Vermont last year that does that.
Acadia: What is your position on the inherent conflict of more and more states authorizing medicinal use of marijuana while having laws that preclude the payment of workers’ compensation benefits in accidents involving alcohol or drugs?
Botzow: There are many issues to sort out here. Right now, many aspects of marijuana regulation are in flux and we will have to make sure policies are consistent and effective with the goals of keeping workers safe and getting them back to work. Now we see recreational marijuana becoming legalized in Colorado and Washington. How will this impact the workplace?
Acadia: A New Mexico appellate court recently ordered a workers’ compensation insurer to pay for a worker’s use of marijuana. What is your opinion of court decisions such as this?
Botzow: When legislatures find THC—the active ingredient in marijuana—is therapeutic we will have to sort through impacts on the workplace. Looking to Boards of Medical Practice and Departments of Health and ensuring consistency in public policy will be important.
Acadia: Many states continue to grapple with the issue of worker misclassification, the so-called independent contractor issue. Is there any particular state or states that you believe have taken an effective approach to curbing abuses in this area?
Botzow: I do not have a particular state as a model and that would be helpful. In Vermont, we have worked on this issue for a number of years, but have not yet been able to move a bill all the way through the process that satisfactorily addresses the situation. Looking at a registration system whereby true sole proprietors can be certified as such may be a fruitful step. In many circumstances this will give employers certainty when using subcontractors.
Acadia: You are well known for repeatedly commenting that the remedy to curtail increasing workers’ compensation costs is for employers to place more emphasis on workplace safety. Will your committee be looking more closely at this topic at future NCOIL meetings?
Botzow: At the next NCOIL meeting in November in San Francisco the committee will set its work plan for the coming year. I look forward to hearing what members suggest and my thoughts will be in the mix.
Acadia: As you know, Vermont is poised to become the first state to have a single payer health care plan in 2017. What do you believe should become of the state’s workers’ compensation, if anything, under such a system?
Botzow: I don’t see the workers’ compensation system changing that much as this remedy for injured workers will still be based on health care costs and wage replacement. However I do see the possibility of care improvements and cost benefits from better organization of health care delivery.
We have a ways to go on financing and other considerations before single payer will be authorized. There are many checks and balances built into the proposal before it can be implemented such as finding that Vermonters will receive adequate care, that there will not be a negative impact on economic growth and that the system is sustainable. If the single payer proposal can surmount these and other hurdles and be beneficial to Vermonters, it follows that the workers’ comp could also benefit from this reform.
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