There's smoke at the offices of North Dakota's workers compensation program. Is there fire?
The state should resolve to find out.
A recent report by Patrick Springer of Forum Communications documents two instances in which Workforce Safety and Insurance employees questioned the program's procedures.
In one case, the medical director of the workers comp program says he twice resisted pressure by management to get him to change his medical opinions.
In the other, a whistle-blower employee said she suspected fraud when "a nurse case manager's electronic notepad entry, with information favorable to a worker's claim, was ordered deleted," Springer reported.
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Dr. Luis Vilella, the medical director, felt concerned enough about the interference that he recently wrote to the state medical licensing board. He said he was "seeking guidance from officials because he was concerned his medical license could be in jeopardy if he bowed to pressures to alter a medical record," according to the story.
When an experienced physician who's charged with making impartial judgments expresses that kind of worry, alarms should sound. Because whatever the agency is doing to safeguard its medical professionals' independence doesn't seem to be enough.
As Springer notes, Workforce Safety and Insurance has a challenging job. "North Dakota's monopoly workers comp program is charged by law with ensuring benefits claims are handled fairly and with safeguarding the financial health of the fund -- two roles critics say often conflict," he writes.
It's not impossible for an agency to juggle that kind of conflict. But it's vital for safeguards to be in place -- safeguards that make sure the "financial health" or "fiscal prudence" role doesn't unfairly shortchange workers in need.
In WSI's case, internal reviews found no wrongdoing in the complaints cited in the story. But are internal reviews enough?
If it doesn't have one already, North Dakota needs a mechanism for routine external reviews, maybe one that involves spot-checks complete with audits and interviews.
One way or another, WSI employees must be told that integrity -- not money -- is the agency's bottom line. Likewise, the workplace culture must consistently support and reinforce that goal.
Is that happening now? Given the medical director's expressed concerns, North Dakotans have to suspect that the answer is no. Agency officials should take the complaints very seriously, then strive to build a culture in which ethics is Job 1.
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-- Tom Dennis for the Herald
