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Michael B. Stack
on
May 17th, 2012
Minnesota’s Department of Labor and Industry is reporting that the number of paid workers compensation claims in the state dropped 43 percent relative to the number of employees from 1997 to 2010. The annual report on the state's workers comp system underscores the fact that Minnesota workplaces have become safer for employees and comparatively less costly for employers, according to Labor Commissioner Ken Peterson. [WCx]
Following a national trend, the number of claims in Minnesota has been falling since the mid-1990s. In Minnesota, the claim rate dipped from 8.7 per 100 full-time employees in 1997 to 4.9 claims per 100 employees in 2010.
Minnesota law mandates that all employers acquire workers comp insurance or become self-insured. As the expense in training employees has risen, employers have zeroed in on making workplaces safer to protect their investment, according to Peterson. This is in addition to their moral obligation to protect their workers.[WCx]
Among the major findings from the report are:
- The 2010 total workers comp system cost was $1.25 per $100 of payroll, the lowest since 1997.
- Because of the falling claim rate, total benefits, including medical, cash and rehabilitation, fell 6 percent relative to payroll between 1997 and 2010.
- Medical care accounts for the largest share of total system cost, 35 percent; next, insurance expenses, 31 percent; then cash benefits, 30 percent.
- The percentage of claims with disputes rose from 15.5 percent to 21.2 percent from 1997 to 2010, a 37-percent increase.
- The proportion of claimants receiving vocational rehabilitation services increased from 1997 to 2010. This may contribute to the findings of other studies that injured workers in Minnesota get back to work sooner than in most other states.
The purpose of the report is to describe the current status and direction of workers comp in Minnesota and to offer explanations, where possible, for recent developments. It is available online at www.dli.mn.gov/RS/WcSystemReport.asp. Copies of the report may also be obtained by calling (651) 284-5030 or toll-free 1-800-DIAL-DLI (1-800-342-5354).
More on Minnesota's WC Laws and Regulations can be found here in our WC state by state guide .
Author Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. Contact: Mstack@ReduceYourWorkersComp.com.
WORKERS COMP MANAGEMENT MANUAL: www.WCManual.com
MODIFIED DUTY CALCULATOR: www.LowerWC.com/transitional-duty-cost-calculator.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.
Senior Editor
on
May 17th, 2012
OSHA has just put the word out that they will be scrutinizing safety incentives. Does this mean to stop any incentive program? NO, but it is a good time to review present incentive plans or one being considered in order to be sure it does not unintentionally reward non-reporting.
If there is a plan that rewards for low or no reported injuries, those injured will be likely to avoid the standard golden rule of “report any injuries to your supervisor immediately.” The employee who reports an injury and keeps the team from making the grade for an incentive of any type will likely take some real or perceived grief from his co-workers who were not injured. [WCx]
Below are just a few types of incentive programs that can have this effect.
1.The team or department who has the least reported injuries gets a bonus.
2.Employees who have no reported injuries over a set period of time get a bonus.
3.Department heads or supervisors receive a bonus or promotion consideration for lowest number of recordable injuries.
4.Individual employees receive “points” or credits that can be used for time off, material goods, or cash for a time period of no injuries.
Bottom line, these are easy to spot due to the reward for non-reporting. Of course, it is easy to see how these could keep an employee from reporting an injury. This can lead to even greater costs down the road when the injury worsens and the worker can no longer ignore the symptoms.
So what type of incentive program works and will pass the muster with OSHA? Incentives that directly reward the worker for safe actions have many benefits. I have been a long time proponent of this type of incentive.
Incentive Programs
Here are some examples of incentive programs that I have personally witnessed that produce desired outcomes. They are popular with employees, provide some healthy competition for safe and productive work, and have no negatives that OSHA can pick on. The individual type of work, pay level, and other factors will determine which is best for your firm.
o Give front line supervisors some petty cash. When they observe an employee doing things safely or efficiently they can reward directly with cash. This presents an opportunity for rewarding desired good behaviors.
o Choose to print some reward certificates that can be used instead of cash. This way the worker can save up points or “safety bucks” for material goods or other rewards. Remember it is the attachment to reportable injuries that is the problem. As long as desired behaviors are being rewarded and not reportable injuries, you the employer on solid ground.
o I have found that the best way to choose what reward to give for safe actions is to ask the employees. It will be surprising to see the strongest motivators.
o Balance incentive with discipline. If you are using a point system, ensure workers can have points subtracted for things like minor PPE violations. I do warn here this can be tricky, so only use this system for minor issues. More serious violations must remain in the normal company discipline program and be documented as such.
The best source for finding the right reward is with the employees. A quick example is when a safety committee carried out this task and was pleased to find the number one incentive employees desired was a parking spot. This particular firm had the ‘employee parking’ far from the front door and management had several spots near the front. So a weekly contest began for the safest employee. The employee got to park right next to the CEO for that next week. This was nearly 15 years ago, and to this day it is one of the most effective incentives I have encountered. The company was prepared and had authorized several thousand dollars for the incentive program. The moral here is money is not the only motivator; status and recognition are strong motivators as well.
I include a link here to the OSHA Memorandum on incentive programs. http://www.osha.gov/as/opa/whistleblowermemo.html OSHA also goes on to warn about taking action against any worker who is disciplined or let go for being injured on the job. Review the information on whistleblowers; it is clear that this is a major part of this recent action. In the case of whistleblowers this is a whole new subject that will be covered in future issues.
Always maintain a consistent discipline program. I find most companies have a need to upgrade the progressive discipline program and properly document unsafe or unacceptable behavior. Finding the need for a consistent and well documented progressive discipline program is the number one most common problem I find. The root causes for this are many and vary from supervisors who want to be ‘the nice guy,” to lack of management commitment and/or incomplete supervisor training.[WCx]
OSHA will be focusing on this and the edict has come down from above. OSHA is increasing the “heat”. Lack of resources has them looking more to whistleblowers and other credible reports of deficiencies. I see no relief coming. Now is the time to review your entire program. OSHA compliance officers I speak with assure me the pressure is on them to be more aggressive in all areas of enforcement. There has never been a time in my career that I have seen a greater need for tightening up all aspects of your company policies and procedures.
Brian Hill is owner of OshaSure in Birmingham Alabama, and has over 20 years as a workplace safety and risk consultant. Brian was previously a pilot for a major US airline and member of the company’s interdepartmental safety committee. He found his new career in safety after the closing of the airline in 1991. Brian has found the same passion he had for flying in assisting companies with safety, heath and risk issues.
WORKERS COMP MANAGEMENT MANUAL: www.WCManual.com
MODIFIED DUTY CALCULATOR: www.LowerWC.com/transitional-duty-cost-calculator.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.
Rebecca Shafer, J.D.
on
May 16th, 2012
Employers who successfully manage their workers compensation cost understand the importance of a strong Return to Work program. When an employee returns to work as soon as he is medically able, the indemnity payments are decreased, the medical and rehabilitation cost are lower and there is less of a productivity drop for the employer. Returning to work sooner also benefits the employee by restoring a higher level of income, providing a faster physical recovery and promoting the emotional health of the employee.
All of the following suggestions may not apply if you already have a solid return to work program. Utilize the suggestions, recommendations and tips that will improve your Return to Work Program. (WCxKit)
1. ALL transitional duty/modified duty assignments should be temporary. If the transitional duty assignments become permanent assignments, you may create some bogus claims as employees seek the “easier job with the same pay”.
2. Be sure both the employee and the supervisor know and abide by the limitations and restrictions the medical provider has placed on the employee’s light duty work. This will keep the employee from being reinjured and will keep the employee from quitting the light duty job because of the employer’s non-compliance with the light duty restrictions.
3. Make the transitional duty program a part of the business culture. When employees know all injured employees are accommodated and required to work light duty, it eliminates resistance to the return to work program and it reduces the number of bogus claims made for financial reasons.
4. If you have multiple shifts, place the employee on the day shift while they are in the transitional duty program. This allows for easier monitoring of the work the transitional duty employee is performing.
5. Keep all parties involved in the transitional duty program including the employee, the employee’s regular supervisor, the temporary supervisor if different from the regular supervisor and the medical provider. All parties should be informed of any/all changes in the transitional duty work.
6. Work with the union steward to obtain the union’s buy-in of the modified duty positions assigned to the union members.
7. Accommodate the employee’s medical appointments and physical therapy appointments. Pay the employee their regular pay for the time they are at the doctor’s office or the physical therapy facility.
8. Always be on the lookout for jobs and work that could be done by an employee with physical restrictions. When the transitional duty job or task is identified, put the job description and work to be done in writing for when it will be needed.
9.. Do everything possible to keep the employee involved. Integrate the transitional duty position into the mainstream of operations to keep the employee from feeling isolated. Require the employee to attend all staff or unit meetings. Do not assign the employee to a transitional duty job that would be demeaning. (WCxKit)
10. Interview each employee when they are released by their medical provider to return to their regular duty job. Discuss with them what aspects of the transitional duty job they thought were beneficial, what aspects of the transitional duty job that should be changed and what ways could the transitional duty job be improved. You will obtain valuable feedback to make the Return to Work Program stronger and better.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.
Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. Contact: Mstack@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contactInfo@ReduceYourWorkersComp.com.
Robert Elliott, J.D.
on
May 16th, 2012
Workers participating in a "comprehensive" workplace health promotion program had a one-fifth reduction in absenteeism during the first year, according to a study in the April Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).
Led by Maurice Niessen of the NDDO Institute for Prevention and Early Diagnostics, Amsterdam, the researchers evaluated a web-based worksite health promotion project at a large Dutch financial services company. The program used a "computerized knowledge-based reasoning system," which integrated the best available risk prediction equations with research-proven prevention and early diagnostic steps. [WCx]
The program emphasized low-pressure, low-intensity interventions — geared not only to employees' individual health risks, but also to their readiness to make lifestyle changes. Another key feature was assessment of mental health issues leading to burnout, a major cause of work disability in the Netherlands.
Of about 11,250 employees invited, 3,900 enrolled in the program. After one year, the estimated absenteeism rate was approximately four percent for employees who participated in the program versus five percent for nonparticipants. Thus employees participating in the program had a 20 percent reduction in absenteeism in the first year.
A growing number of companies are interested in workplace health promotion programs, with the goal of reducing health risk factors that lead to illness and lost job productivity. Studies of previous programs have not consistently shown reduced rates of absenteeism.
The comprehensive worksite health promotion program evaluated in the new study led to a significant drop in absenteeism rates. In fact, the improvement was achieved faster than expected; one year is not really long enough for lifestyle changes to have a meaningful impact on the risk of chronic diseases. [WCx]
Niessen and colleagues speculate that the program may have improved employees' psychological well-being or stress levels perhaps as a result of making healthy lifestyle changes or getting help with mental health problems.
Author Robert Elliott, executive vice president, Amaxx Risk Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He is an editor and contributor to Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: Info@ReduceYourWorkersComp.com.
Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. Contact: Mstack@ReduceYourWorkersComp.com.
WORKERS COMP MANAGEMENT MANUAL: www.WCManual.com
MODIFIED DUTY CALCULATOR: www.LowerWC.com/transitional-duty-cost-calculator.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.
Robert Elliott, J.D.
on
May 15th, 2012
According to a new report from several Massachusetts agencies, nearly five dozen workers died on the job during the last year in the commonwealth.
The 2012 Dying for Work in Massachusetts: The Loss of Life and Limb in Massachusetts Workplaces report notes that 58 workers died on the job in the commonwealth in 2011; an estimated 580 additional workers died from occupational disease.[WCx]
The report, a collaboration of the Massachusetts AFL-CIO, the Massachusetts Coalition for Occupational Safety and Health (MassCOSH) and the Western Massachusetts Coalition for Occupational Safety and Health (Western MassCOSH), is unveiled each year to reflect on the workers' lost lives and to "renew our commitment to the fight for safe jobs."
Massachusetts' rate of workplace deaths has fluctuated over the past two decades, with no consistent trends indicating either a gain or drop in occupational fatalities, according to the report. 47 workers died on the job in Massachusetts in 2010 and 62 were deceased in 2009.
"What's most distressing about the findings in Dying for Work is the number of preventable accidents that are claiming the lives of so many hard working men and women every year," according to the report's co-author, Marcy Goldstein-Gelb, executive director of MassCOSH. "More disturbing still is that many of these accidents are similar to the accidents that killed workers the year before, and the year before that."
Among the findings from the report include:
* Thirteen firefighters died in the line of duty.
* Eight workers died on the job in the construction industry.
* Twelve workers died from motor vehicle incidents.
* Falls contributed to the deaths of 12 workers in the commonwealth in 2011, including five in the construction industry.
* Six workers died as the result of workplace violence incidents.
* Nine servicemen from Massachusetts died in the War in Afghanistan in 2011.
In addition to facts and figures, the
report also includes portraits of a number of the faces of the fallen workers.[WCx]
Lastly, the Massachusetts AFL-CIO, MassCOSH and Western MassCOSH stressed the need for strengthened OSHA regulations, protections for immigrant workers, toxic chemical regulation improvements, comprehensive worksite safety programs and more.
Author Robert Elliott, executive vice president, Amaxx Risk Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He is an editor and contributor to Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: Info@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.
Rebecca Shafer, J.D.
on
May 15th, 2012
The selection of a third party administrator (TPA) is critical to the success of the claims operation. With the wide variety of TPAs available for self-insured workers compensation insurance programs, determining the best TPA for a program will require an understanding of the difference between TPAs. When issuing a Request For a Proposal (RFP), it is possible to receive numerous proposals from TPAs that differ extensively in skills, qualifications, support services, and price.
Skills
The large national TPAs with an office in every state, or even every large city, may have the size and breadth of operations to have experts in every insurance line. The local and regional TPAs will often specialize in one product line. For example, a TPA that is excellent and has a strong reputation handling property insurance claims may not have the expertise needed in workers compensation claims. When selecting a TPA, a solid, verifiable background in workers compensation is necessary for the self-insured employer’s program. [WCx]
Qualifications
A common mistake self-insured employers make is measuring qualifications of a TPA based on its size. The small TPA with four or five adjusters can be an excellent fit for the mid-size employer which has a limited number of workers compensation claims each month. The small TPA can provide a high level of consistency, for the same designated adjuster will be working all claims. Conversely, a large self-insured employer will need a larger TPA to handle the claims, as the number of additional claims from the large employer could overwhelm the personnel resources of the small TPA.
Any TPA being considered for the self-insured program should have a presence in the state(s) where business takes place. The TPA must understand the specific requirements of the workers compensation laws in the state where the claims occur. This includes both having the state required adjuster’s license for all adjusters and a program of continuing education and training.
Another consideration beyond the licensing and experience of the adjusters in workers compensation is the level of experience in the industry. A TPA that specializes in the handling of workers compensation claims for the manufacturing industry may not have any experience in the trucking industry. Ask the TPA being considered to provide a list of companies they work for in the pertinent industry.
Support Services
A TPA that appears to be the right size, has the right skill set, with experience in your industry still may not be the best TPA to select for a self-insured workers compensation program if it does not have the necessary support services.
The TPA with an established workers compensation claims handling program has built a network of medical providers, triage nurses, nurse case managers, medical fees schedule reviewers, defense attorneys, surveillance companies and IT support. A TPA that thinks the RFP is a good reason to expand into handling workers compensation claims will have a difficult time handling claims without an established support network.
Most locally established TPA’s will have carefully built up a network of support services to cover the services they do not provide. Regardless of the size of the TPA, they will utilize a medical providers network, defense attorneys and surveillance companies that are separate businesses. While large national TPAs will provide their own nurse case managers and medical bill review service, most regional and local TPAs will utilize outside vendors. A review of the support services provided by the TPA or arranged by the TPA is a necessary part of the review process in the selection of the best TPA.
One of the primary reasons for the decline in the number of TPAs available is the cost of technology systems. Each individual claim produces volumes of documents and data. The TPA must have an integrated risk management information system that is compatible with the claims data information system. This includes the ability to accept electronic submission of the First Report of Injury, along with the ability to submit all state forms through the EDI system required by the state.
Price
The pricing structure will vary as there are several pricing structures used by TPAs. Some bill an hourly rate plus out of pocket expenses. This is referred to as time and expense billing. Other TPAs will charge a flat fee per file for each claim they handle, with different flat fees for the complexity of the claim. A third approach is a lump sum program fee where all claims are handled for one set monthly or quarterly payment.
Regardless of the pricing structure offered by the TPA, be sure to ask about what other expenses will be incurred. Ask if there are extra charges for a data and technology interface, as well as if there are additional charges for related in-house services like EDI interface and ISO filings. (WCxKit)
We strongly recommend not to select your TPA solely on price. A TPA that provides the lowest price per claim file will often increase the overall cost far more due to overloading their adjusters with too many claim files. Look at "value" not just "price."
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.
Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their Workers Compensation costs by 20% – 50%. He is a writer, speaker, and website publisher. Contact: Mstack@ReduceYourWorkersComp.com
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.
Rebecca Shafer, J.D.
on
May 14th, 2012
Workers Comp this week provided a lot of fodder for discussion. Here’s a review:
Bison Jam Delays Dr. Glimp at Medcor
Remote medical support may hold down WC costs, but it does invite some interesting circumstances. In early May, Thomas Glimp, MD, Chief Medical Officer, at
Medcor, was late to an important meeting due to a "bison jam" in Yellowstone National Park. Executive Vice President Curtis Smith said
, "We were waiting for our Medcor doctor, Thomas Glimp, to join us on a conference call last week while he was doing some training at the three Medcor-run clinics in Yellowstone National Park… and he was a bit late…. BUT there was good reason… there was a "bison jam" and it's difficult to make a bison move faster.”
Glimp said, “I was trapped on the road in a ‘bison jam’ for 15 minutes. They’re often difficult to influence (not unlike physicians)! There is little to no cell coverage in the park, so I needed a land line to call.”[WCx]
LexisNexis Examines Oklahoma Workers Comp Opt-Out, Benefits Review and More in WC World
The Workers Compensation Law Community Powered by Larsons on LexisNexis compiled a great newsletter evaluating the details of many current
WC cases this week. Sign up for their newsletter
here and get all this and more in your inbox.
1. Robinson offers Post Mortem on OK Opt Out Legislation
Thomas A. Robinson writes
here, the controversial bill that would have allowed
some Oklahoma employers to “opt out” of the state’s traditional workers’ compensation system fell short of having sufficient votes to move legislation through. In his analysis, he says, “A number of the bill’s proponents were crowing about how its passage was a “done deal” and, buoyed on by the Oklahoma success, we’d see a wave of similar legislation in other states. So, we see the importance of counting our chicks only after they’ve hatched. Second, and more importantly, the bill provides us with a provocative example of how states are pulling out all the stops when it comes to attracting and keeping businesses within their borders.”
2. Koenig Offers Update From Benefits Review Board
Karen Koenig, associate general counsel of the Longshore Benefits Review Board at the U.S. Department of Labor writes
here the Board received 201 appeals in cases under the Longshore Act, one more than the year before. In addition to summarizing these appeals, Koenig also includes developments from the DBA.
3. Larsons Spotlight Examines 4 Recent Cases:
Larson’s Spotlight looks at several important events this week,
here.
1.In Maryland, Injuries Sustained While Returning From Physical Therapy Session to Treat the Effects of Earlier Work-Related Injury Are Not Necessarily Compensable.
2. From Iowa, Forty Years of Cigarette Smoking, Not Cold Conditions of the Employer's Meat Packing Facility Caused Claimant's COPD.
3. In Hawaii, Former Employee's Suit Against Co-Employees Related to Allegedly False Claims and Harassment Were Barred By Exclusivity-Claim for Wrongful Termination Not Barred.
4. From Colorado, Offset of Permanent Total Benefits With Old-Age Social Security Payments Was Appropriate.
5. WC Fraud Blotter Looks at Wrist Pain/Facebook Case, More
The blotter takes a look at a case where an employee claimed wrist pain stopped her from processing inmates’ mail and from typing at work, yet records showed frequent texts and Facebook updates. Read more about this case and five others
here.
1. Letter Carrier Fraud, Delivering the Mail Goes To the Dogs.
2. Pasta Alert: The "Noodle" Pleads Not Guilty To Workers' Compensation Fraud .
3. Doctor Indicted For Overbilling Workers' Compensation Insurer Amusement Park Owner Admits to Workers' Compensation Fraud and Tax Evasion .
4. Disability Claimant Caught On Video Working While Collecting Benefits
5. Construction Business Owner Charged With Underreporting Payroll to Workers' Compensation Insurance Carrier.
6. Read about Delaware Decision on Course and Scope
Cassandra Roberts writes
here in Have Crockpot Will Travel, “I had a fall of sorts at work a month ago and a recent MRI now shows fractures of the cuboid and the calcaneous. So, no stilettos for me. And I have a work comp prescription card. Vicodin on someone else's dime. Pretty darn sweet. Accordingly, I now relate to the plight of the injured worker. And the case recently offered up by Henry Davis strikes close to home. Which you will understand even more so when you hear the facts of the case.”
7. No Benefits for Alleged Fume Exposure in Missouri
Martin Klug writes here about a case in which the claimant lost his claim against the second injury fund when he failed to prove an accident that his alleged exposure to muriatic acid fumes caused a heart attack. “The court rejected an argument that the commission must award benefits because the fund did not produce any evidence,” he writes.
8. Court Rules That State Bar’s Professional Liability Fund Is NOT Subject to MMSEA Reporting
Mark Popolizio, of the Crowe Paradis Services Corp. explains the case of Oregon State Bar Professional Liability Fund v. United States Department of Health and Human Services & Kathleen Sebelius,
here. In the case, he writes, “The court … ruled that a legal malpractice policy, which did not provide coverage for bodily or emotional injuries, was not an ‘applicable plan’ subject to Medicare’s mandatory reporting requirements under the Medicare, Medicaid and SCHIP Extension Act of 2007.”
9. Law360 Looks at CA Facebook Privacy Laws
Erin Coe writes about a piece of legislation trying to “block California companies from making employees and future workers disclose their usernames and passwords for Facebook, Twitter and other personal social media accounts that gained unanimous approval Wednesday from a state Assembly panel,”
here.
10. CA Department of Industrial Relations Small Business Portal Up and Running
Check out California’s new site for small businesses
here. They explain “Small businesses are critical to California’s economic recovery and strength, to building America’s future, and to helping the United States compete in today’s global marketplace. Small businesses also represent 99.7 percent of all employer firms and they employ just over half of U.S. workers and pay 44 percent of total U.S. private payroll.”
11. TDI-DWC Gives Authorization to Certify Maximum Medical Improvement (MMI) and Assign an Impairment Rating
The Texas Department of Insurance Division of Workers’ Compensation reminds all workers’ compensation system participants that the Texas Labor Code and TDI-DWC rules impose certain requirements for a doctor to become authorized to certify maximum medical improvement (MMI) and assign impairment ratings for claims in the Texas workers’ compensation system. For more information, look
here.
12. Oklahoma WCC Posts Proposed Change for Rule 23, Eye Impairment
Oklahoma has offered a proposed change for consideration by its supreme court following adoption by the WC court regarding definitions for what constitutes eye impairment.
WorkersCompensation.com Hosts Video Roundup
WorkersCompensation.com has started a weekly video roundup. Check it out
here.
Gould and Lamb Hosting Two Training Sessions
At two casinos in Atlantic City and St. Louis, Gould & Lamb will offer what they call the most comprehensive WC, liability and risk management conferences to date. The sessions will have special focus on Medicare & Medicaid compliance. The Atlantic City conference will be at Bally’s June 18-9 and the St. Louis session will be at Harrah’s Aug. 6-7. For more information, look
here.
[WCx]
The “Jackpot” sessions are being billed, “Don't Gamble on Workers' Compensation, Liability & Medicare/Medicaid Compliance! We have gathered together some of the industry's most respected leaders and experts to provide attendees with two full days of compliance education and training, as well as an exciting look into the future of Medicare/Medicaid Compliance.”
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.
Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their Workers Compensation costs by 20% – 50%. He is a writer, speaker, and website publisher. Contact: Mstack@ReduceYourWorkersComp.com
WORKERS COMP MANAGEMENT MANUAL: www.WCManual.com
MODIFIED DUTY CALCULATOR: www.LowerWC.com/transitional-duty-cost-calculator.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.
Rebecca Shafer, J.D.
on
May 11th, 2012
We all know that the best workers compensation claim is the claim that never happened. We have written various articles on what management can do to prevent claims, including creating and/or improving a safety program. This top down approach is effective and leads to the prevention of accidents. What the top down approach often misses is the importance of having the supervisors actively involved in the safety program. The importance of safety training for the field supervisors or the floor supervisors cannot be overstated.
The safety responsibilities of the lower level management ( the supervisors ) need to be incorporated into the job descriptions just as much as production goals, financial goals or other performance measurements. The safety objectives that should be a part of the job description of every supervisor are (WCxKit)
- Regular inspections of the work area to identify any safety issues
- Responsibility for initiating work orders for safety related repairs
- Responsibility for insuring all needed repairs are completed timely
- Responsibility for identifying areas where improvements of the physical area would reduce risk
- Knowing and complying with all OSHA requirements
- Knowing and complying with all state safety laws
- Enforcing compliance with all safety regulations
- Responsibility for training all new employees on the safe completion of the work
- Responsibility for having monthly safety meetings with the employees in her/her group
- Responsibility for the safe completion of all work
- Responsibility for recording all safety incidents
- Responsibility for reporting all safety incidents to management
- Responsibility for investigating all accidents
- Responsibility for preventing the reoccurrence of similar accidents
- Responsibility for reviewing with management how to improve safety
The supervisor’s performance review should include how well they met the safety goals. Management should avoid the temptation to measure safety solely by the number of injury claims reported. The completion of regular safety inspections, the timeliness of repair orders, the compliance with OSHA and other regulations, the safety training provided to the employees and the recommendations on how to improve safety should be given equal weight with the number of injury claims reported. By placing the emphasis on the prevention of injuries as opposed to the number of injuries, you reduce the temptation of the supervisor to underreport the minor injuries that occur.
An importance safety function of the supervisor is to create a detailed accident report after each injury. A review of the quality of the accident investigations completed by the supervisor should be a part of the each performance review. The supervisor’s manager should check each accident report to determine if the injured employee and the co-workers/witnesses were properly interviewed. The object/ machinery/ equipment involved in the injury should be a part of the accident investigation with a determination if the accident was the employee’s fault or caused by a defect in the object/equipment/ machinery being used. A recommendation by the supervisor on how to prevent a similar accident from occurring in the future should be a part of the report.
Safety reporting is more than completing OSHA forms. It should entail a review of injury accidents by categories determined by management. Sample categories could include employee error, equipment/machinery malfunction and unforeseen. The purpose should be to identify areas where further safety improvements can be made.
The review of the safety work orders for repairs or improvements should also be included in the supervisor’s performance review. The supervisor’s manager should verify the supervisor is identifying and seeking to correct legitimate safety hazards. The accuracy and the effectiveness of the safety work orders will impact the overall outcome of the safety program. (WCxKit)
By integrating safety into the job performance of the supervisors, the compliance level with all safety requirements will improve and the number of workers compensation claims will be reduced.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.
Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their Workers Compensation costs by 20% – 50%. He is a writer, speaker, and website publisher. Contact: Mstack@ReduceYourWorkersComp.com
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.
Robert Elliott, J.D.
on
May 11th, 2012
Ontario recently launched a four-month blitz to ensure students are safe and do not get injured while working on their summer jobs.
Beginning this spring, an enforcement blitz is targeting workplaces where new and young workers are employed. Health and safety inspectors from the Ministry of Labor will check that employers comply with the Occupational Health and Safety Act.[WCx]
The blitz will ensure young workers:
- Are protected by required safety measures, equipment and procedures to prevent injuries
- Are properly instructed, trained and supervised on jobs
- Meet minimum age requirements.
The inspectors will shut down unsafe work sites when necessary and employers could face fines through the Occupational Health and Safety Act.
Protecting young people on the job is part of the McGuinty government's continued commitment to prevent workplace injuries through its Safe at Work Ontario strategy.
Author Robert Elliott, executive vice president, Amaxx Risk Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He is an editor and contributor to Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: Info@ReduceYourWorkersComp.com.
Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their Workers Compensation costs by 20% – 50%. He is a writer, speaker, and website publisher. Contact: Mstack@ReduceYourWorkersComp.com
WORKERS COMP MANAGEMENT MANUAL: www.WCManual.com
MODIFIED DUTY CALCULATOR: www.LowerWC.com/transitional-duty-cost-calculator.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.
Rebecca Shafer, J.D.
on
May 10th, 2012
The cost of insurance fraud including workers compensation, automobile, and home owners insurance is estimated at 80 billion dollars a year. That is enough money to pay the salaries of every CEO of America’s 500 largest companies for the next 16 years!
Insurance fraud is often broken down into two types, intentional fraud and exaggeration fraud. Intentional fraud, also known as hard fraud, is where a person makes a deliberate attempt to fake an insurance claim for the purpose of defrauding the insurance company. For example, a hotel maid is in debt and decides to fake a back injury accident without any witnesses in a hotel room to receive a workers compensation settlement.
Exaggeration fraud, also known as soft fraud, occurs when there is a legitimate insurance claim, but the claimant decides to increase the size of the claim. For example, a construction worker falls off a scaffold and injuries his knee. The worker decides since he is going to be off work anyway to tell the doctor and adjuster he also injured his back. The worker has had back problems for years, but now has a chance to get it taken care of and paid for by the insurance company.
The people who commit workers compensation fraud often think they are just taking money from the “big insurance company”. They do not realize that the insurance company money is collected in the form of insurance premiums from the employers. For the insurance company to stay in business, the cost of insurance fraud is passed from the insurance company to the employers. The more employers have to pay for workers comp premiums, the higher the cost of the product or service the employer produces. The higher premiums force employers to reduce the number of jobs available and reduce the other benefits they provide to the employees.
Dishonest employees are not the only ones committing workers compensation insurance fraud. Employers who underreport the size of their payroll or the number of employees for the purpose of lowering their workers comp premiums are committing fraud. Employers who misclassify workers (for example high-rise window washers who are classified as janitors) are also committing fraud.
Workers compensation fraud is also committed by organized rings of lawyers, doctors, chiropractors, physical therapists and other medical providers. The workers compensation claims they are involved in can be either intentional fraud or exaggeration fraud. The medical treatment is either not provided or is inflated to increase the insurance billing. The amount of permanent partial disability from the injury is overstated for the sole purpose of defrauding the insurance company.
Recently in the insurance news there have been a lot of articles about the run-away cost in workers compensation of prescriptions drugs and narcotics in particular. Prescription fraud is a part of the problem. Employees fake injury claims, and have frequent visits to the doctor, (especially to pain management clinics) not only for the purpose of collecting the indemnity benefits, but also to obtain prescriptions for OxyContin, Vicodin and other narcotics they can sell on the black market. The diversion of narcotics, both for street resale and for recreational use is one of the fastest growing areas of insurance fraud.
Employers should be ever vigilant against the possibility of workers compensation claim fraud. The most common indicators of fraud include (WCxKit)
- Several prior claims
- Accidents without witnesses
- Accidents where the only witness is a friend
- Witness(es) heard but did not see the accident
- Poor attendance record prior to the injury
- Disciplinary action prior to the injury
- Problems with co-workers
- Performing a task that is normally not a part of the job
- In a work area that the employee does not work at
- Upcoming layoff
- Recent termination
- Missed promotion or transfer
- Passed over for a pay raise
- Monday morning accident
- New employee
- Resist light duty work
- Complaints of injury out of proportion to actual injury
- Nature and/or extent of injury is increased after it is originally reported
- It should be noted that none of these indicators is proof of fraud. However, with any of these indicators it is prudent to investigate the workers comp claim thoroughly.
There are steps the employer can take to reduce the cost of workers compensation fraud. The employer who has a strong safety program reduces the scenarios an employee can use to create a fraudulent workers comp claim. A strong and well known return to work program with a transition duty job for every injured employee reduces the financial incentive for workers comp fraud. Any suspected fraudulent claim should be discussed with the claims adjuster and special investigative unit. Any case of proven fraud should be prosecuted to the maximum to prevent copycat claims.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contactInfo@ReduceYourWorkersComp.com.
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