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December 30, 2008

Hispanic employment down, immigrants returning home

“The economic downturn has meant less available work for immigrants and more competition from Americans…. In the third quarter of 2008, 71.3% of Latino immigrant workers were either employed or actively seeking work, compared with 72.4% in the same quarter a year earlier, according to a new study by the Pew Hispanic Center, a nonpartisan research organization. The 1.1-percentage-point drop "marks a substantial decrease in the labor-market participation of Latino immigrants," says Rakesh Kochhar, the Pew economist who prepared the report…."these trends suggest that at least some foreign-born Latinos are not only leaving the labor force but, perhaps, also returning to their countries of origin," the report said.”

Such is a Wall Street Journal article about a Pew Hispanic Center report. Here it is in full:


LOS ANGELES -- A year ago, a day-laborer center adjacent to a Home Depot here teemed with Latin American immigrants who showed up and found a sure day's work painting, gardening or hauling.

These days, more than immigrants are packing the Hollywood Community Job Center: Unemployed Americans are joining them. There's little work for anybody.

"Everybody is coming to look for work," says Rene Jemio, outreach coordinator for the hiring hall. "It's not just your average immigrant anymore; it's African-Americans and whites, too."

For the first time in a decade, unskilled immigrants are competing with Americans for work. And evidence is emerging that tens of thousands of Hispanic immigrants are withdrawing from the labor market as U.S. workers crowd them out of potential jobs. At least some of the foreigners are returning home.

"We see competition from more nonimmigrant workers," says Abel Valenzuela, a professor at the University of California at Los Angeles who studies day laborers. "Employers are also paying less than in previous years," he says.

In the third quarter of 2008, 71.3% of Latino immigrant workers were either employed or actively seeking work, compared with 72.4% in the same quarter a year earlier, according to a new study by the Pew Hispanic Center, a nonpartisan research organization. The 1.1-percentage-point drop "marks a substantial decrease in the labor-market participation of Latino immigrants," says Rakesh Kochhar, the Pew economist who prepared the report.

Since 2003, the labor force participation rate -- the employed or job-seeking share of the population -- among foreign-born Hispanics had been consistently on the rise. The decline in the third quarter of 2008 "is a testament to the character and depth of the current recession triggered by the housing slump," says the Pew report.

"The recession has truly put Hispanic immigrants in a state of flux," says Mr. Kochhar, who based his analysis on data from the Current Population Survey produced jointly by the Bureau of Labor Statistics and the Census Bureau.

At the Hollywood center, even a year ago, contractors and homeowners employed 30 to 40 workers each day. Now, it isn't unusual for only three or four to get hired, organizers say.

In Houston, where post-hurricane cleanup work is drying up, "the situation is getting more difficult by the day," says Salvador Perez, a 45-year-old Mexican day laborer who has been in the U.S. since 2003. "I like this country for the work opportunity, but now I can barely scrape together a few dollars to send home to my family after paying for rent and food."

Latin American workers bore the brunt of the collapse of the construction sector, which employs 20% to 30% of all foreign-born Hispanics in this country. As the housing market tumbled last year, they lost jobs in ever-greater numbers.

Competition has become fierce even in agriculture, where farmers had struggled in recent years to hire enough immigrants to harvest crops, sometimes letting fruit wither on the vine.

Growers across the country are reporting that farmhands are plentiful; in fact, they are turning down potential field workers. "For the first time since 9/11, we have applicants in excess of our requirements," says Bob Gray, chief executive of Duda Farm Fresh Foods Inc., a grower, packer and shipper based in Salinas, Calif.

In particular, Mr. Gray has observed an influx of U.S.-born Latinos and other workers who previously shunned field work. "These are domestic workers who appear to be displacing immigrants," says Mr. Gray.

A similar situation has emerged in U.S. cities from New York to Los Angeles, where unemployed, nonimmigrant laborers are seeking informal work that typically has been performed by low-skilled immigrants that once commanded a 50% premium over the hourly minimum wage.

The unemployment rate for immigrant Latinos was 6.4% in the third quarter of 2008, compared with 4.5% during last year's third quarter. However, the rise in unemployment for this group would have been even greater "if not for the fact that many of these workers withdrew from the labor market," says the Pew report.

If they hadn't exited the U.S. labor market, the Pew study estimates, their unemployment rate for the third quarter would have been 7.8%, 3.3 percentage points higher than the same quarter last year.

Among Hispanic immigrants who entered the U.S. between 1990 and 1999, the survey found that 217,000 quit the labor force between the third quarter of 2007 and the third quarter of 2008. Since population falls as a result of individual death or emigration from the U.S., "these trends suggest that at least some foreign-born Latinos are not only leaving the labor force but, perhaps, also returning to their countries of origin," the report said.

"There is definitely a lot of talk about leaving," says Mr. Jemio, who helps manage the Hollywood day-laborer center. "People are on their last hope."

Write to Miriam Jordan at miriam.jordan@wsj.com

December 27, 2008

Is the Obama team prepared to protect immigrants?

The top level of the Obama team is including people who understand the need to protect the rights of immigrant workers, according to an editorial in the New York Times. “In simplest terms, what Ms. Solis and Mr. Obama seem to know in their gut is this: If you uphold workers’ rights, even for those here illegally, you uphold them for all working Americans. If you ignore and undercut the rights of illegal immigrants, you encourage the exploitation that erodes working conditions and job security everywhere. In a time of economic darkness, the stability and dignity of the work force are especially vital.”

The entire editorial, published December 26:

Getting immigration right

It’s way too early to tell whether the United States under President-elect Barack Obama will restore realism, sanity and lawfulness to its immigration system. But it’s never too early to hope, and the stars seem to be lining up, at least among his cabinet nominees.
Skip to next paragraph

If Mr. Obama’s team is confirmed, the country will have a homeland security secretary, Janet Napolitano of Arizona, and a commerce secretary, Bill Richardson of New Mexico, who understand the border region and share a well-informed disdain for foolish, inadequate enforcement schemes like the Bush administration’s border fence. And it will have a labor secretary, Hilda Solis of California, who, as a state senator and congresswoman, has built a reputation as a staunch defender of immigrants and workers.

The confluence of immigrants and labor is exactly what this country — particularly, and disastrously, the Bush administration — has not been able to figure out.

In simplest terms, what Ms. Solis and Mr. Obama seem to know in their gut is this: If you uphold workers’ rights, even for those here illegally, you uphold them for all working Americans. If you ignore and undercut the rights of illegal immigrants, you encourage the exploitation that erodes working conditions and job security everywhere. In a time of economic darkness, the stability and dignity of the work force are especially vital.

This is why it is so important to reverse the Bush administration’s immigration tactics, which for years have attacked the problem upside down and backward. To appease Republican nativists, it lavished scarce resources solely on hunting down and punishing illegal immigrants. Its campaign of raids, detentions and border fencing was a moral failure. Among other things, it terrorized and broke apart families and led to some gruesome deaths in shoddy prisons. It mocked the American tradition of welcoming and assimilating immigrant workers.

But it also was a strategic failure because it did little or nothing to stem the illegal tide while creating the very conditions under which the off-the-books economy can thrive. Illegal immigrant workers are deterred from forming unions. And without a path to legalization and under the threat of a relentless enforcement-only regime, they cannot assert their rights.

It’s a system that the grubbiest and shabbiest industries and business owners — think of the hellish slaughterhouse in Postville, Iowa, running with immigrant child labor — could not have designed better. Through it all, the Bush administration’s response to criticism has been ever more enforcement.

Ms. Solis, whose father immigrated from Mexico and was a Teamsters shop steward and whose mother, from Nicaragua, worked on an assembly line, promises a clean break from that past. She lives in El Monte, a Los Angeles suburb where two compelling stories of immigrants and labor have emerged in recent years.

The first was tragic: a notorious 1995 raid at a sweatshop where Thai workers were kept in slave conditions behind barbed wire. The second is less well-known but far more encouraging: a present-day hiring site for day laborers at the edge of a Home Depot parking lot. The Latino men who gather in that safe, well-run space uphold an informal minimum wage and protect one another from abusive contractors and wage thieves. It’s good for the store, its customers and the workers.

Ms. Solis is a defender of such sites and has opposed efforts in other cities to enact ordinances to disperse day laborers and force them underground. She understands that if day laborers end up in our suburbs, it is better to give them safe places to gather rather than allow an uncontrolled job bazaar to drive wages and working conditions down.

That’s a bit of local wisdom that deserves to take root in the federal government.

December 22, 2008

28% of workers in New Jersey are immigrants.

They make up 20% of the entire population but more of them are of working age than the bob-immigrant population. Such were the findings of a recent Rutgers University study, reported by the Associated Press.
Immigrants occupy both ends of the workforce. 40% of advance degree holding workers are foreign-born. New Jersey currently ranks third in the nation, behind only Hawaii and California, in the percentage of immigrants to total population.

The study, “Destination New Jersey: How Immigrants Benefit the State Economy, is available here.

December 16, 2008

New court ruling: illegal worker eligible for permanent disability award

As reported by Roberto Ceniceros in Business Insurance Magazine, an Illinois appellate court has ruled that an illegal worker can be awarded permanent disability benefits for a work injury. Some state courts have ruled against permanent awards, or even vocational rehabilitation (a Nebraska case), for illegal workers by observing that these injured workers are not legally able to work. But this court has said that the worker may be able to work elsewhere in a legal status and the disability would prevent that work.

The article in full:

CHICAGO—Employers can't deny permanent total disability benefits for illegal immigrants on the basis that their immigration status would prevent them working in the United States legally, a state appeals court ruled.

In Friday's decision, Illinois' 1st Judicial District Appellate Court also said it agreed with appeals courts across several other states that "have almost uniformly held" that the Immigration Reform and Control Act of 1986 does not preclude awarding workers comp benefits to illegal immigrants.

The case of Economy Packing Co. vs. Illinois Workers' Compensation Commission dealt with Ramona Navarro, a Mexican national who slipped and injured herself in May 2002 while working on an assembly line, court records state.

An arbitrator awarded her temporary total disability benefits of $147 per week for 60 weeks and permanent total disability benefits of $371 per week for life. The arbitrator also ruled Ms. Navarro to be an "odd-lot" worker, meaning she is permanently and totally disabled and her limited skills would prevent her from finding future work.

The Illinois Workers' Compensation Commission and a trial court agreed and Economy appealed. The employer argued that "undocumented aliens" are always unemployable because of immigration law regardless of their physical capabilities. In order to receive permanent total disability benefits under an odd-lot theory, Ms. Navarro therefore needed to prove that she is not employable due to age, training, education or experience, Economy argued.

The appeals court disagreed.

It found that although immigration law prevents Ms. Navarro from legally working in the United States, she would still be able to work elsewhere had she not sustained an injury on the job.

It also found that an employer has the burden of producing "sufficient evidence that suitable jobs would be regularly and continuously available to the undocumented alien but for her legal inability to obtain employment."

December 14, 2008

The Filipino immigrant population

The Migration Policy Institute issued a report this fall on Filipino immigrants. Not surprisingly, the percentage of Filipino immigrant workers who work as nurses is 15%, vastly higher than the percentage of nurses in the entire domestic workforce (about 3 million out of 130 million. By and large, Filipinos often trail behind Mexicans in terms of most in immigrant categories. but they are much more educated than Mexicans. More facts are below.

The number of Filipino immigrants in the United States tripled between 1980 and 2006, from 501,440 to 1.6 million, making them the second largest immigrant group in the United States after Mexican immigrants and ahead of the Chinese, Indian, and Vietnamese foreign born. They are second behind Mexicans in the number of lawful permanent residents (540,000 out of 12.1 million).

Thumbnails: Filipino immigrant women outnumbered men by about three to two in 2006. The majority of Filipino immigrants were naturalized US citizens in 2006. About one-third of Filipino immigrants in 2006 were limited English proficient. Nearly half of Filipino foreign-born adults had a bachelor's or higher degree. Almost one-third of employed Filipino-born women had health-care and related occupations.

More highly educated: In 2006, 49.6 percent of the 1.4 Filipino-born adults age 25 and older had a bachelor's degree or higher compared to 26.7 percent among the 30.9 million foreign-born adults.

On the other end of the education continuum, about 8.9 percent of Filipino immigrants had no high school diploma or the equivalent General Education Diploma (GED), compared to 32.0 percent among all foreign-born adults. About 14.8 percent had a high school diploma or GED compared to 23.8 percent among all foreign-born adults.

Healthcare employment: Among female Filipino-born workers, 15.0 percent reported working as registered nurses, 6.6 percent reported working as other health-care practitioners, 6.6 percent reported working in health-care support occupations, and 1.3 percent reported working as physicians. Compared to other immigrants, Filipino-born male workers age 16 and older employed in the civilian labor force were also more likely to report working in health-care and related occupations.

Filipino immigrants also have the highest percentage of all immigrant nationalities serving or having served in the military.

December 12, 2008

Agriprocessors declared bankruptcy in November

I missed this one – the Postville plant which was raided in May this year (see prior postings) filed on bankruptcy on November 4. It is still operating at a much lower volume. Below is the article about the bankruptcy filing by the Des Moines Register.

Agriprocessors files for bankruptcy after bank seeks to foreclose

ERIN JORDAN • ejordan@dmreg.com • November 5, 2008

A kosher meatpacking plant in Postville filed for bankruptcy Tuesday, blaming a May 12 immigration raid for financial difficulties.

Agriprocessors Inc. filed for Chapter 11 protection in New York, where the headquarters are located. The Postville plant is listed as the company's principal asset.

The company says it owes between 200 and 999 creditors $50 million to $100 million, according to records filed in U.S. District Court. Agriprocessors lists assets of $100 million to $500 million.

The company's board of directors met Tuesday and decided to file for bankruptcy a day before a scheduled hearing on a lawsuit from the company's largest lender, First Bank of St. Louis.

First Bank alleged in a federal lawsuit Friday that Agriprocessors defaulted on a $35 million loan and overstated how much money it had available. The bank is seeking to foreclose on the Postville plant and appoint a third party to oversee the company's assets.

An affidavit filed with the bankruptcy petition says the bankruptcy will temporarily halt the lawsuit.

Plant owner Abraham Rubashkin stated in the affidavit that before the raid, the plant had annual revenue of more than $300 million and employed about 1,000 people. After arrests of about 389 people, the plant is down to 250 to 300 employees, Rubashkin said in the document.

Among the company's largest creditors are Jacobson Staffing Corp.on, of Des Moines, which Agriprocessors owes $845,000. The company owes $806,970 to Weyerhaeuser Paper Co. of Chicago.

Other creditors include Alliant Energy, Postville Farmers Co-op and USDA
Food Safety and Inspections.

Sen. Mark Zieman, R-Postville, was not surprised to learn about the bankruptcy.

"I haven't understood why they didn't do it before," he said. "They've got creditors all over them."

Zieman said he talked with Agriprocessors management over the years about paying bills to construction companies, trucking firms and other businesses who did work for the plant. The May immigration raid exacerbated the company's financial problems, he said.

"I hope we can get a new management team in there so this doesn't close," Zieman said, adding that an Agriprocessors closure would hurt several counties in northeastern Iowa.

Tom Dietrick, who owns Dietrick Turkey Farm in Cedar Falls, said Agriprocessors owes him money for a flock of 20,000 turkeys that Dietrick could not deliver to the plant following the raid.

The plant couldn't accept the turkeys because they didn't have enough workers to process the meat, Dietrick said. The 79-year-old turkey farmer sold some of the birds to other buyers, but the turkeys were older and Dietrick did not recoup his losses, he said.

"The problem I see is that the government waited 15 years to get after them," Dietrick said about the raid.

Agriprocessors came to the Allamakee County town of 2,200 people in the mid 1980s. It changed the landscape of the town from predominantly white rural farmers to a multicultural hub of workers from nearly 20 countries.

December 10, 2008

Changes to H-2A farmworker visa program sought by Bush

The Bush Administration is attempting to make last minute changes to the H-2A agriculture temporary worker program, reportedly be relaxing employer requirements to validate that the employer has tried to hire Americans. The effect of the changes, according to activist groups, will be to lower wages for H-2A workers.

go here at the Farmworker Justice site to learn more.

A look into incarceration of immigrants

The ACLU has filed a suit on behalf of these immigrants, and the Boston Globe wrote an article with interesting information. Average duration of jail time before deportation: 11 months.

The article in full:

ACLU alleges rights abuses

Report: Detained immigrants face harsh conditions
By Maria Sacchetti
Globe Staff / December 10, 2008

Immigrants jailed for deportation in Massachusetts are often subject to harsh conditions, including inadequate medical care, harassment, and overcrowding, the American Civil Liberties Union of Massachusetts said in a report to be released today.

The report alleges that state and county jails and US Immigration and Customs Enforcement are failing to oversee the detainees' treatment.

"There's no one watching over them, so there's no real incentive to make sure that the immigration detainees' rights are protected," said Laura Rótolo, staff attorney at the ACLU of Massachusetts and the lead researcher on the 22-month investigation. "They are not protecting people's fundamental rights."

ICE confirmed that the agency received letters from the ACLU of Massachusetts about its findings, and is in the process of responding fully.

"We take all allegations about conditions of confinement very seriously," said ICE spokeswoman Paula Grenier, who added that the agency follows federal guidelines to ensure that immigrants are treated humanely. "ICE is committed to providing all detainees in our care with humane and safe detention environments and ensuring that adequate medical services are available."

For the report, the ACLU interviewed 40 detainees and corresponded with more than 30 other inmates, spoke with dozens of advocates and lawyers, and reviewed hundreds of government documents obtained through the Freedom of Information Act. The authors of the report called for an end to immigration raids and alternatives to detaining immigrants, such as electronic monitoring bracelets.

As of August 2007, about 800 immigrants and asylum-seekers were in seven county jails, one state facility, and one federal medical center, although the report said none are serving time for crimes. Many detainees have criminal records, but the report's authors estimate that more than half have overstayed a visa, are awaiting a decision on asylum, or sneaked over the border - all civil violations. The cost of housing them is roughly $90 a day to the US government, the report said.

Jessica Vaughan, recently named director of policy studies at the Center for Immigration Studies, said detaining immigrants - especially criminals - is important because it ensures that they will be deported.

"The odds are if we don't detain them that they're not going to be removed," said Vaughan, who is based in Franklin. "Then they become fugitives and they have to be tracked down."

The report documented several cases in which medical care was delayed or denied to immigrants, reportedly because they were about to be deported.

One 43-year-old Pakistani national, the report said, waited five months to have a specialist look at a painful lesion inside his mouth. He was released after the specialist ordered a biopsy, which was never performed, and is still awaiting deportation.

A 27-year-old Liberian national, diagnosed with schizophrenia, bounced among three county jails with a skin condition and dental problems that were left untreated for months.

Some mental health issues were ignored as well, the report found. An immigrant was removed from Bridgewater State Hospital and transferred to New Mexico, and then to Rhode Island, without his medications or health records.

The report was released at a time when ICE is investigating the August death of a 34-year-old Chinese national who allegedly received inadequate care at Wyatt Detention Center in Rhode Island. On Monday, ICE relocated 153 detainees from the center during its review.

Detainees also complained about crowding as well. At one point in Essex County, inmates were sleeping in the gymnasium, though they have since been relocated. The six New England states have space for approximately 1,200 detainees a day, the report said.

Interviewees complained about being assigned to cells with violent criminals and of guards who threatened them with sedation or harassed them if they complained about jail conditions or resisted deportation.

In Suffolk County, two detainees were transferred to Franklin County after complaining to the media about a strip search. A female detainee said she was sent to York, Pa., after she complained about her protracted detention.

Detainees spent an average of 11 months in Massachusetts jails awaiting deportation, Rótolo said, based on her interviews with 40 detainees. One man spent more than five years in jail fighting deportation before he was released to continue battling his case. Three immigrants spent more than two years in jail, and 10 spent more than a year in jail.

Maria Sacchetti can be reached at msacchetti@globe.com.

December 1, 2008

What will the Obama administration do?

Shusterman’s Immigration Update speculates about the incoming administration’s policy on immigration, and forecasts that it will be supportive of expanding the H-1B program (Bill Gate’s programmers). Since the Bush administration has been supportive of H-1B against Congressional resistance, this does not herald a change in White House policy.

Janet Napolitano, governor of Arizona, will head the Department of Homeland Security. Arizona has been perhaps the most contentious state in dealing with illegal immigrants. I hope that she has learned from that how to craft reform legislation that will appeal to moderates. Credibility of enforcement will be a key element in getting a reform bill enacted.

Excerpt from the Update:

We believe that the fact that Hispanics and Asian-Americans voted two-to-one to elect Senator Obama, and supported many other pro-immigration legislators, the new administration and Congress will take steps to acknowledge this support including passage of the DREAM Act and other long-stalled legislation.

President-Elect Obama was not specifically asked his positions on easing immigration restrictions on high-skilled workers. However, just after the election, Computerworld magazine had this to say about Obama's likely policies concerning H-1B visas:

"President-Elect Barack Obama has supported the H-1B visa program and wants to make changes to green cards that would help tech firms. There wasn't much said about this issue during the presidential campaign, especially after Wall Street collapsed. It also never came up in the debates between Obama and Republican John McCain. Now we're in a recession and unemployment is rising. Can Obama push ahead on tech-related immigration issues at this time? He might, and in this FAQ, here's an explanation of how that might happen."

Google's CEO Eric Schimdt, an economic adviser to Obama would clearly like to see the H-1B program expanded according to Computerworld:

"Schmidt laid out a wish list for legislation in the next Congress, with patent reform and loosened standards for allowing foreign graduate students to stay and work in the U.S. at the top of the list. Schmidt's call for allowing more foreign workers to come to the U.S. may conflict with Obama's; the president elect has been cool to the idea of expanding immigration programs such as the H-1B skilled worker program.

The U.S. should want the best and brightest workers to remain here, Schmidt said. Making foreign students go home after educating them is 'bizarre, it's disgusting,' Schmidt said."

Significantly, President-Elect Obama's choice of Arizona Governor Janet Napolitano as the new DHS Secretary may be good news for foreign-born professional workers. Governor Napolitano is clearly in favor of expanding the H-1B program. She signed on to a bipartisan letter to President Bush supporting the expansion of the H-1B program. As Arizona's Governor, she expressed reservations about the building of a fence along the U.S.-Mexican border. She famously stated that deporting 11 million workers was a "joke" and was not "reality-based". However, Napolitano's immigration views are more nuanced than can be explained in a single paragraph. See an excellent analysis of her views at

Medical care for badly injured illegal workers

Robert Ceniceros of Business Insurance has written an informative article about some of the barriers to ensuring that illegal workers who are injured at work obtain the medical care they need. Language barriers, poor housing conditions, false addresses and IDs, and suspicions create problems, according to care managers.

The article:

Illegal workers pose comp care challenges

By Robert Ceniceros

Cultural, administrative issues test case workers

Guiding illegal immigrants injured on the job to appropriate medical care requires workers compensation case managers and claims handlers to take on the role of social worker, detective and translator.

Even delivering indemnity checks often presents additional challenges when injured workers reside in the country illegally, the claims and case managers say.

Still, experts say, comp claims for illegal immigrants must be managed effectively to ensure that treatment is delivered before medical conditions worsen and drive up claims costs, and before attorneys become involved.

Claims managers say they face numerous hurdles when they try to contact illegal immigrants injured at work. Fraudulent Social Security numbers are common, home addresses are wrong, and the workers and their families often are distrustful and unwilling to provide necessary information, fearing immigration authorities may become involved.

Laws in most states, however, mandate that illegal immigrants injured on the job receive the same care and benefits as legal workers.

One common challenge, say nurse case managers who specialize in helping catastrophically injured workers, occurs when assisting undocumented workers return home from a hospital stay.

"You are trying to work on discharge to a particular address and it doesn't exist or it's not the address they are actually living at," said Marlys Severson, president of SCM Associates Inc. and a network manager for Paradigm Management Services L.L.C., a Concord, Calif.-based catastrophic case management company.

"It makes it really tough to try to pull everything together to make for a smooth transition and good medical care," Ms. Severson said.

Impoverished living conditions can make returning patients home medically impossible, said Mary Hawkins, a bilingual catastrophic nurse case manager in Atlanta for Intracorp, a unit of Philadelphia-based unit of CIGNA Corp.

"If they have been living 12 (people) to an apartment, sleeping in shifts on the floor, you can't send someone home with an infection and an open wound," she said. "You can't send someone home who is a new paraplegic (under those conditions.) You can't send someone home who is an amputee."

Catastrophic nurse case managers' responsibilities include visiting the residences of injured workers to verify their home accommodations will be safe for recuperation after leaving treatment.

"I've had instances where I've gone to the house and there are 15 to 20 people who happen to be living with no furniture and you have an injured worker who's laying on the floor on a blanket," Ms. Severson said. And the workers don't have access to social resources available to legal workers.

Living conditions may impede healing and require medical case managers to spend more time educating patients about caring for themselves, said Adolfo Arsuaga, branch manager in Reston, Va., for the Hispanic Resource Center, a unit of Genex Services Inc., a disability management company.

"They do require a little bit more handholding," Mr. Adolfo said.

Providing illegal immigrants with disability payments can present challenges because they don't have appropriate documentation to open a checking account, he said.

In some cases where injured workers' accommodation is not appropriate for their medical condition, insurers pay to rent a new apartment. But finding one can be difficult because some apartment owners demand proof that the injured worker is in the country legally, case managers say.

"Half the time you end up literally having to put them in a hotel room (with accommodations for disabled guests) month after month because they can't sign a lease," Ms. Hawkins said.

Workers comp insurers say they do not ask whether someone is undocumented and claim forms don't require such information. But case managers and claims managers say there are several clues.

The use of multiple Social Security numbers for a single claimant is one tipoff for claims examiners, said Darrell Brown, workers comp practice lead for Sedgwick Claims Management Services Inc. in Long Beach, Calif.

Others agree that multiple Social Security numbers are common.

"We have seen undocumented workers having multiple (Social Security numbers). One for the job, one for the third-party administrator, and one for the health care facility," said Thomas Newman, marketing analyst in Nashville, Tenn. for Alternative Service Concepts L.L.C., a claims management company.

Establishing addresses also can prove challenging for case managers. Financial instability often forces undocumented workers to move frequently. Or they provide false addresses because of their fear of immigration authorities.

Illegal immigrants change telephone numbers frequently, or they may not have a telephone, so case managers visit their homes more regularly to ensure they follow through with treatment.

"There (are) a lot of scenarios involved, but it just makes it really difficult for (health care) coordination (and) getting them to and from their therapy, being able to get them to and from their doctor's appointments, being able to provide them adequate care," said Ms. Severson.

The additional hurdles to providing care to illegal immigrants increases the likelihood that their medical outcomes will not be as successful, claims managers say.

Sometimes the outcomes are heart-wrenching, nurse case managers said.

One worker returned home to Mexico rather than stay in the United States and undergo surgeries that could have restored the sight he lost in one eye, Ms. Severson said.

Distrust and a desire to return home when injured is common, she added. Some undocumented immigrants fear that flying across state lines to medical centers of excellence could expose them to immigration officials so they choose to forgo the specialized care, Ms. Severson said.

Ultimately, resolving claims filed by illegal immigrants requires that claims examiners and others build a trusting relationship with them, said Kimberly George, vp and managed care practice lead for Sedgwick in Chicago.

But earning trust and building a relationship can take "a lot more time, energy, effort and teamwork in order to provide good care for them," Ms. Hawkins said.

"You have to be an investigator, a social worker, a spiritual adviser, a medical coordinator and a translator," said Ms. Hawkins of Intracorp. "You have to speak English, Spanish and medical."