FLORIDA Victims Receive Workers’ Compensation Payments
Tuesday turned out to be a pay day for four Florida residents who were victims of a $2 million workers’ compensation fraud scam. The four were presented checks after not receiving insurance benefits for their work-related injuries because their employers did not carry workers’ compensation insurance.
According to Department of Justice attorneys the scam began eight years ago when companies claiming to offer workers’ compensation insurance collected millions of dollars in premiums from employers.
When government inspectors tried to verify the businesses had coverage for their employees, they discovered the insurer was a fraud, leaving millions of workers uninsured.
All told, 14 people were arrested in the scam and millions of dollars worth of property was seized. The liquidation of those assets is funding the checks for the victims. (workersxzcompxzkit).
Under current Florida law, workers’ compensation insurance fraud is a second-degree felony.
IOWA Increases Worker’ Compensation Benefits Starting in July
Maximum weekly benefits paid to Iowa workers injured on the job will increase beginning on July 1, 2009. On that date, the workers’ compensation maximum weekly benefit for temporary total disability, healing period, permanent total disability and death will rise to $1,413. For permanent partial disability, the weekly maximum will be $1,300.
Author: Robert Elliott, J.D.
Click on these links to try it for yourself.
WC Calculator: www.ReduceYourWorkersComp.com/calculator.php
TD Calculator: www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
WC 101: www.ReduceYourWorkersComp.com/workers_comp.php
Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com
Assistance for Injured Workers When Employers Illegally Uninsured
California’s Department of Industrial Relations (DIR) and the Division of Workers’ Compensation (DWC) have teamed up with the Watsonville-based Workers’ Compensation Enforcement Collaborative (WCEC) to overcome hurdles faced by injured workers seeking benefits when their employers are illegally uninsured.
The DWC’s Information and Assistance (I&A) Unit in Salinas after planning with WCEC members and others this week launched a “customer service initiative” pilot project designed to help injured workers get benefits while shining a spotlight on their illegally uninsured employers.
The focus of the Salinas “customer service initiative” pilot project is to expand existing services to unrepresented injured workers who need help identifying the parties responsible for providing them with workers’ compensation benefits, and in securing benefits from the Uninsured Employers Benefits Trust Fund (UEBTF) should the responsible parties fail to provide necessary coverage.
In addition to receiving supplementary training in investigations, the I&A office in Salinas will have access to Workers’ Compensation Insurance Rating Bureau (WCIRB) coverage information and enhanced resources.
The newly acquired information and resources enable the I&A officer to identify an employer and determine whether the employer has proper insurance coverage. Once an employer is accurately identified, the I&A officer can assist workers and make it easier for them to serve court papers against illegally uninsured employers.
Besides getting benefits to the injured worker, the desired outcome is that uninsured employers will be systematically reported to the Division of Labor Standards Enforcement, the Department of Insurance, and local district attorney’s offices for fraud investigation. (workersxzcompxzkit).
Under California law it is a crime for an employer not to have workers’ compensation insurance or permission to be self-insured. Illegally uninsured employers are subject to prosecution, imprisonment, and penalties.
DWC is collecting information during the Salinas “customer service initiative” pilot project to determine whether similar efforts at other I&A offices across the state would be effective.
Author: Robert Elliott, J.D.
Click on these links to try it for yourself.
WC Calculator: www.ReduceYourWorkersComp.com/calculator.php
TD Calculator: www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
WC 101: www.ReduceYourWorkersComp.com/workers_comp.php
Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com
The Tennessee Occupational Safety and Health Administration (TOSHA) partnered with several construction trade associations across the state on Monday to participate in the statewide Fall Protection Safety Stand Down. Participating employers shut down their jobs on Monday morning to train their employees on fall protection for approximately 45-60 minutes.
Falls are a leading cause of fatalities in construction, accounting for one-third of all deaths across the industry. In 2007, there were 447 fatalities across the United States occurring from falls. Because there is typically a rise in construction accidents during the summer months of June through August, the goal of this event was to raise awareness about the hazards of falling and to review fall protection requirements. (workersxzcompxzkit).
“TOSHA is committed t o helping employees identify fall hazards and select the necessary protection to control or eliminate the hazard,” said James Neeley, Commissioner of the Tennessee Department of Labor and Workforce Development.
Author: Robert Elliott, J.D.
Click on these links to try it for yourself.
WC Calculator: www.ReduceYourWorkersComp.com/calculator.php
TD Calculator: www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
WC 101: www.ReduceYourWorkersComp.com/workers_comp.php
Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com
Texas lawmakers took a huge step in curtailing the activities of today’s ambulance chasers by passing HB 148. The bill, now on its way to Governor Rick Perry for signature, makes it illegal for lawyers, chiropractors and other health professionals to solicit victims of auto accidents or catastrophes by telephone or in person.�
The bill was targeted at telemarketers who contact crash victims by buying accident reports from local police departments. The crash victims are often informed they need to visit a certain chiropractor whether they have been injured or not. While awaiting care, the crash victims are solicited by lawyers or people representing law firms who claim the victims will receive free legal advice.
“It’s all a scam for a very small number of chiropractors, lawyers and others who are out to get as much as they can from an individual’s insurance claim,” says Dennis Devlin, chairman of the Texas Committee on Insurance Fraud. “We owe the bill’s sponsors, Rep. Todd Smith and Sen. Jeff Wentworth, huge praise for passage of this legislation that will curtail this ongoing trail of lies, deception and outright theft.” (workersxzcompxzkit).
Devlin said passage of this legislation was unique in that the insurance industry, the Texas Chiropractor Association and the Texas Trial Lawyers Association all worked together to ensure the its passage.
If convicted, the solicitors would face a Class A misdemeanor for the first offense, but the penalty would increase for any additional convictions. Upon the Governor’s signature, the bill will take affect September 1, 2009.
Author: Robert Elliott, J.D.
Click on these links to try it for yourself.
WC Calculator: www.ReduceYourWorkersComp.com/calculator.php
TD Calculator: www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
WC 101: www.ReduceYourWorkersComp.com/workers_comp.php
Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com
The risk management community is correctly recognized as the driving force behind efforts to reduce the cost of lost-time claims in the past decade. The National Council of Compensation Insurance (NCCI) reports medical costs account for at least two-thirds of all workers’ compensation costs. A decade ago, indemnity costs accounted for sixty percent of total workers’ compensation loss costs. Clearly, through a continued focus on return-to-work programs, employers engineered this dramatic shift.
However, as injury rates have declined workers’ compensation pharmacy costs continue to rise. Recently, PMSI, a pharmacy benefit manager and provider of specialty services for the workers’ compensation market, announced pharmacy spending for workers’ compensation increased by 5.4% in 2008, compared to 3.3% in 2007.
PMSI studied workers’ compensation drug spending trends between 2006 and 2008. They report pharmacy costs now represent approximately 14% percent of the total medical spending in workers’ compensation.
Reasons for the Increased Costs
Pharmaceutical spending is up. While injury rates are down, treating physicians are increasingly prescribing drugs as part of the treatment plan.
Drug prices continue to rise. Wholesale prices continue to increase coupled with a decline in the generic brand of the most prescribed drugs.
The top five drugs prescribed in 2008 remained unchanged from 2007. This group accounted for three-fourths of the total pharmacy costs in 2008.
There is a direct correlation between the age of the claim and the pharmacy costs. The older the claim, the greater the percentage of the total claim pharmacy costs. In fact, NCCI reports in 2007, prescription drug spending in the first year averages only three percent of medical costs, but by year seven that number jumps to almost 31% of overall medical costs.
Antidepressant prescription and use in workers’ comp cases is on the rise.
Suggestions to Mitigate Increased Pharmacy Costs
Develop and implement a pharmacy benefit management plan addressing these issues.
1. Network penetration – how effective? Opportunities for improvement?
2. Generics — look for opportunities to increase substitution.
3. Mail-order — what is the utilization? How can it be increased?
4. Intervention — consider using a third-part pharmacy benefits manager.
Author: Robert Elliott, J.D.
Click on these links to try it for yourself.
WC Calculator: www.ReduceYourWorkersComp.com/calculator.php
TD Calculator: www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
WC 101: www.ReduceYourWorkersComp.com/workers_comp.php
Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com
A Gaithersburg, Maryland-based storage facility will pay $95,000 and furnish other substantial relief to settle a disability discrimination lawsuit filed by the U.S. Equal Employment Opportunity Commission (EEOC),
In its suit (Civil Action No. 8:08-cv-02498-PJM), filed in U.S. District Court for the District of Maryland, Southern Division, the EEOC said that Extra Space Management Inc. unlawfully fired James L. Hill II, a maintenance worker, because of a disability.
Hill, who has a visible disfigurement as a result of sustaining severe burns to his body in a house fire, began working for the company nearly three years ago.
According to the EEOC, although Hill was physically capable and willing to perform all his job duties, he was fired after meeting the acting district manager, who reportedly said that he “noticed he was handicapped, deformed or something,” and “it’s clear he can’t get the job done.”
The Americans With Disabilities Act (ADA) makes it unlawful to discriminate in employment against a qualified individual with a disability. The EEOC filed suit after first attempting to reach a settlement out of court. Extra Space Management did not admit liability in the consent decree resolving the case, which is pending judicial approval. (workersxzcompxzkit)
In addition to the monetary relief to Hill, the consent decree provides that all employees and management staff at the Gaithersburg facility as well as 14 other locations in Maryland and northern Virginia will have at least two hours of training on the requirements and prohibitions of the ADA.
Additionally, all newly hired managers and supervisory personnel will receive ADA training within 30 days after their employment commences.
“Employers must make employment decisions based on the employee’s ability to perform the duties of the job, not because of the prejudices of others,” remarked Debra Lawrence, acting regional attorney of the EEOC’s Philadelphia District, whose jurisdiction includes Maryland.
Author: Dave Thomas is editor of Daily Insurer Blog and a contributor to this blog. Visit him at http://dailyinsurer.blogspot.com/.
Click on these links to try it for yourself.
WC Calculator: www.ReduceYourWorkersComp.com/calculator.php
TD Calculator: www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
WC 101: www.ReduceYourWorkersComp.com/workers_comp.php
Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com
A bill signed last Friday by Florida Governor Charlie Crist has the backing of the state’s insurance
regulator and many business interests, who claim it will reign in lawyer fees.
Crist signed the legislation (HB 903) that will reverse a court ruling and put back in place limits on fees for lawyers who represent workers in compensation appeals related to on-the-job injuries.
According to trial lawyers, however, the bill will be challenged at some point because it takes away an existing provision that says those fees need to be “reasonable.”
It was the reasonableness language which the Florida Supreme Court noted last year when it said no to imposing limits.
On the other side, employers claim the law will reduce the premiums they must pay for workers’ compensation insurance. The bill passed the Florida Senate by a 22-16 vote.
Up until six years ago, Florida had some of the highest rates for workers’ compensation premiums, consistently ranking No. 1 or No. 2 nationwide in workers’ compensation rates. That changed when Florida’s Legislature reigned in the fee limits, which do not apply to lawyers representing insurers and employers.
The new bill is slated to go into effect on July 1.
Author: Robert Elliott
Click on these links to try it for yourself.
WC Calculator: www.ReduceYourWorkersComp.com/calculator.php
TD Calculator: www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
WC 101: www.ReduceYourWorkersComp.com/workers_comp.php
Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com
Employers quickly learn workers’ compensation is full of surprises, nearly all unpleasant. Compensation premiums are a good example. Taking Control of workers compensation is only the first step. As you proceed, you’ll begin to ask questions like why your premiums go up if you have no claims. Ask what your “mod” is. When was the last time there was an independent audit of your premium calculation to see whether your employees might be misclassified and you are entitled to a lower premium?
Private insurance companies are regulated on how they price premiums. The rates are set by a rating board. Large states have their own boards but many smaller states use the National Council on Compensation Insurance (NCCI), located in Boca Raton, Forida, to set rates.
Rates vary according to what industry the business fits into. There are several hundred classifications given designations in the “Standard Industrial Classification” system (SIC code).
Every year, rates for each industrial classification are changed, according to data sent by carriers, self-insured, the compensation board and the insurance department. If an industry has had more claims and longer periods of disability the rate for ALL businesses in that industry rise.
Smaller businesses often go years without a claim. The expectation is the premium should continue to fall. Sometimes, however, it rises anyway. Why?
There is a lower limit to what a premium can be, even without claims. In low-risk, small businesses with no claims, most of the premium pays for necessary administrative handling required regardless of claims. These costs inevitably rise over time. Then there are the raises dictated for the industry as a whole, even for employers with no history of work-related injuries.
Following 9/11, there was an emergency meeting of the New York Compensation Insurance Rating Board to deal with the consequences of the largest workers’ compensation event in history. Nearly all the victims were clerical workers, normally the least expensive for compensation insurance. Nearly all the claims were death claims at maximum rate. Special formulas, never used before or since, had to be created to prevent economic devastation of businesses otherwise not affected. The only solution was to create special surcharges for many other industries throughout the state. (workersxzcompxzkit)
There is a saying among loss-prevention specialists, “It’s hard to improve on zero!” If you indeed have no workplace injuries, check with your carrier to make sure your industrial classification and your reported payroll are correct. Keystroke errors, changing an accounting firm into a medium factory, are to occur. Adding a zero to the total payroll is also a typewriter hazard.
Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100.
Click on these links to try it for yourself.
WC Calculator: www.ReduceYourWorkersComp.com/calculator.php
TD Calculator: www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
WC 101: www.ReduceYourWorkersComp.com/workers_comp.php
Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com
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