Help Prevent Heat-Related Injuries
Extended exposure to heat (inside or out) taxes the body beyond its ability to cool. The effects of heat are magnified in the very young, elderly and those with medical conditions. Employers and employees must become familiar with the signs of heat distress and what actions to take.
LOOK for these Signs and Symptoms
Heat Cramps
Caused by: Excessive sweating and loss of salt due to over activity.
You may experience:
- Muscle spasms of the legs, arms and/or abdomen
Heat Exhaustion
Caused by: Loss of large amounts of fluid and/or salt by sweating
You may experience:
- Clammy and moist skin
- Extreme weakness or fatigue
- Giddiness
- Nausea
- Headache
- Fainting
Heat Stroke (Very Serious)
You may experience:
- Extremely high body temperature (above 103°, orally)
- Red hot and dry skin (no sweating)
- Rapid, strong, pulse
- Throbbing headache
- Dizziness
- Nausea
- Confusion
- Unconsciousness
Prompt assessment of employees experiencing any of these symptoms, and the delivery of appropriate first aid or emergency medical care are advised.
Exposure to environmental heat is also a factor work-related, nonfatal injuries or illnesses requiring days away from work.
Prevention is the best defense against heat-related illnesses. The following tips can aid in protecting employees from extreme heat and health related injuries.
12 Tips to protect employees from extreme heat conditions.
- Drink 16-32 ounces of cool fluids each hour when working outdoors.
- Replace salt and minerals with electrolyte drinks.
- Do not rush. A slower but steady pace reduces stress on the body.
- Avoid working in direct sunlight whenever possible, and take frequent breaks.
- Protect the face and head by wearing a wide-brimmed hat.
- Wear UV-absorbent sunglasses to protect the eyes.
- Perform most strenuous outdoor tasks during the morning, if possible.
- Wear loose-fitting, light weight, light-colored clothing. (workersxzcompxzkit)
- Use a buddy system and check on employees often; monitoring for heat-related symptoms increases the chances of avoiding illness.
- Avoid hot foods and heavy meals, since they add heat to the body.
- Avoid caffeine and alcohol, due to their dehydrating properties.
- AND, if an employee has a known at-risk health condition (ASK!) like a heart problem, allergies or bee/wasp sting reactions CALL 911 IMMEDIATELY! DON’T WAIT!
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©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
$400,000 Workers’ Compensation Scheme Unraveled
The Workers’ Comp Fraud Blotter Update
Employee or employer fraud – which is the greater problem? Double dippers, false claims, misclassification of workers, and payroll underreporting, are just some of the more common types of fraud we read about in the media and government press releases. But complex insurance fraud schemes, such as premium fraud, can cost up to hundreds of millions of dollars. Healthcare provider fraud also generates losses in the millions of dollars. Each week we will survey what the media, state agencies, insurance companies, and others report in terms of workers’ compensation fraud.
A Chicago insurance agent pleaded guilty this month to four Class 3 felony charges in Lake County Court, the Illinois Department of Insurance (IDI) announced today. The insurance agent, licensed by IDI, operated an insurance agency based in Waukegan.
Working with the Waukegan Police Department and the Lake County State’s Attorney’s office, IDI investigators concluded the agent allegedly fabricated false insurance certificates for 22 north suburban businesses and bilked clients for approximately $400,000 he then used for personal expenses.
“Workers’ compensation fraud imposes unnecessary cost on employers and employees, and will be investigated and prosecuted to the fullest extent of the law,” said Michael T. McRaith, Director of the Illinois Department of Insurance. “We commend the Waukegan Police and the Lake County State’s Attorney for the great work and successful collaboration that led to this conviction.”
According to IDI investigators, the agent “willfully forged hundreds” of insurance certificates, misrepresenting that client payments for premiums had been forwarded to insurers for coverage. Investigators also found many of agency clients paid in cash for workers’ compensation coverage, supposedly receiving a lower, discounted premium for these cash payments.
Bogus policies were renewed when clients’ policy periods were near or past the lapse deadline, with clients visiting the agent personally to make cash payments. When clients needed additional proof of insurance for a specific project, a fraudulent certificate was created. As a result of a guilty plea, the agent was sentenced to 30 months probation with the following conditions:
1. Serve a term of periodic imprisonment and follow all rules of periodic imprisonment, for a period of 12 months. Two months to be served as periodic imprisonment and 10 months to be served on electronic home monitoring.
2. The defendant shall be released for work, specifically released as necessary for his limousine work assignments and his license service business.
3. Make restitution in the total amount of $97,136 divided among 24 separate victims.
4. Be subject to random urine and breathalyzer testing.
5. Provide a DNA sample for testing.
The IDI workers’ compensation fraud unit was created in the workers’ compensation reform law passed in 2005. Throughout the state of Illinois, Department investigators work with local law enforcement and prosecutors, as well as the office of Attorney General. (workersxzcompxzkit)
The objective of IDI’s investigative efforts is to reduce the instances of workers’ compensation fraud and, thereby, improve the cost of premiums for employers and the claims-settlement process for injured workers.
This blog originally appeared on the LexisNexis Workers’ Compensation Law Center.
Reposted with Permission Visit LexisNexis for more information and full reports.
http://law.lexisnexis.com/practiceareas/Workers-Compensation-Law-Blog/Workers-Compensation/Workers-Comp-Fraud-Blotter-712009
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©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
Reducing Workers Comp Cost Using Rehabilitation Assessments for Hands
Employers have a vested interest in evaluating injured workers as they make the transition from recovery at home to a transitional duty assignment and return to full duty. There may be a number of elements to consider such as the workers’ psychological disincentive to return to work after an injury, making more money to stay out of work and return and, of course, outright fraud.
Part of assigning an injured worker to transitional duty is the factor of “medical readiness” to assume a modified duty job. Thus, it is important to know an injured worker’s physical capabilities and strengths.
Let’s look at the first area of significant physical assessment.
- Hand Strength
- Isometric Leg Lift and Arm Lift
- Visual Estimation of Effort
Hand Strength Assessments
Hand strength testing is one type of assessment used to classify validity of effort during functional capacity evaluation (FCE). But the hands have extremely dense populations of pressure and stretch receptors and a high number of motor nerves involved in gripping and pinching. These anatomic facts create a biofeedback loop allowing submaximal effort to often go undetected. In fact, “cheating” is undetected at least 30% of the time in “standard” testing protocols using the COV, Bell Curve and Rapid Exchange Grip testing as indices of effort.
To further complicate a “valid” test it’s often proposed non-cooperation can be detected during the (FCE) by quantifying variation between repeated measurements of strength. Typically, the statistic to evaluate variation is the coefficient of variation (COV). The logic starts with a bit of truth: Maximal efforts during strength testing should be highly reproducible. Unfortunately, some are led to believe only maximum efforts are highly reproducible – - simply not true.
There is a one hand strength assessment on the market using standard mechanical gauges shown in controlled study to be highly accurate in classifying good effort as well as in classifying poor effort.
This protocol includes the standard one-handed grip and pinch trials, but has trials involving simultaneous testing of both hands. This is a “distraction-based test” which makes cheating extremely difficult.
Statistical analysis holds up in court, regardless as to the test outcome. The application, available on the Internet, is 99.5% accurate (199 proper classifications in 200 tests). All 100 test sessions in the study with cooperating subjects were properly classified. (workersxzcompxzkit)
In test sessions involving feigning of weakness, 99 out of 100 “cheats” were properly classified.
Study Reference: D. Schapmire, J.D. St. James, R. Townsend, T. Stewart, S. Delheimer, D. Focht. Simultaneous bilateral testing: validation of a new protocol to detect insincere effort during grip and pinch strength testing. J Hand Ther. 2002;15(3):242-50. Schapmire and St. James teamed up with Larry Feeler (Work STEPS) and Joe Kleinkort (Joe Kleinkort, PC), to demonstrate that the hand strength assessment is applicable to a patient population in an article recently accepted for publication.
Author: Darrell Schapmire, MS of X-RTS Software Products & Testing Devices develops distraction-based tests for use in functional capacity evaluations. He can be reached at dschapmire@yahoo.com or http://www.xrts.com/
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©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
When designing training programs for workers comp (or anything else) you need to identify what you want the participants to “do differently” after the training. What do you want the training to accomplish? Do you want the participants to be able to pay a workers’ comp claim or recognize when there is a potentially fraudulent claim? Unless you are self-administered, you want them to do the later. Learning objectives must be developed “around” your objectives.
You’ll need to develop a list of “learner objectives” then develop your training materials to address those objectives. So, first determine your program gaps then design the material. Too often companies call me and ask for ”a training program” and don’t care if it was developed for a different company in a different industry, they say, “just send me a training program”!
Well, while workers’ comp training can be use by different industries, it can only be used when the company gaps are the same. When your divisions take the best practice assessment in Workers Comp Kit, each operating unit will receive separate recommendations. These are the core of your learning objectives. See below. Success Story: In a company with five divisions, all divisions failed Best Practices #85 and 86, so those must be included in training. Four businesses missed Best Practice #5, so you’ll want to address that, also.
The Gap Analysis is a corporate-wide needs assessment that is a roadmap for your training program. Whatever else you cover, you must cover these questions because there may be opportunity for improvement in these areas. Do the assessment, THEN design the training program.
Author: Rebecca Shafer, J.D. Rebecca works with every size company as a coach and consultant. She can be reached at 860-553-6604.
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Do not use this information without independent verification.
All state laws vary.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
Payments in North Carolina per Claim Higher Than Many Other States
Workers’ compensation payments per claim to hospitals in North Carolina (NC) were found to be much higher (and growing rapidly) than typical of other states in a 14-state study by the Workers’ Compensation Research Institute (WCRI).
These results were the main driver of the state’s focus on recent regulation in the form of fee schedule changes, effective in July 2009, lowering reimbursement rates for hospital inpatient and outpatient services and ambulatory surgery centers.
According to the Office of State Budget and Management’s financial impact statement, the fee schedule changed are estimated to reduce costs by $35.4 million (about 10%) of the projected amount for spending on hospitals and ambulatory surgery centers during the 2009 to 2010 fiscal year. The new fee schedule reduces hospital outpatient reimbursement from the current 95% to 79%.
CompScopeTM Medical Benchmarks for North Carolina, 9th Edition, found:
- Medical payments per claim in NC were 13% % higher than the median of the 14 states, because of NC made higher payments to hospital providers and lower payments to non-hospital providers.
- Payments per claim to hospital providers were 43% above the median, the highest among the states studied because NC pays higher hospital outpatient payments per similar services; somewhat higher inpatient payments per claim, and a higher surgery rate.
- A higher surgery rate suggests a different mix of care, leading to a more costly mix of services than in states where hospital providers have a lower surgery rate and provide more primary care.
- The average hospital outpatient payment per service in NC is $361, 58% higher than the median state and nearly $100 higher in the next highest states.
- About 38% of claims with seven days plus of lost time in NC involved surgery, compared to 35% in the 14-state median.
- By contrast, payments per claim to non-hospital providers were typically lower in NC especially for frequently provided services like evaluation and management and physical medicine. The lower prices were in line with the fee schedule, also lower than the median of 42 states, except for surgery.
- Non-hospital services were generally typical of states studied; but NC chiropractor claims were among the lowest, with significantly fewer visits per claim.
- Medical payments per claim grew steadily: 7%-12 % per year from 2001-2005; more slowly in 2006 (5%) on a 12 month average experience.
- Rapid growth for inpatient and outpatient services through 2005 were the main reason for hospital medical cost increases.
- In 2006, hospital outpatient payments were the main increase driver; hospital inpatient payments were stable; payments to nonhospital providers declined 5%. (workersxzcompxzkit)
- Hospital outpatient payments per service rose at double-digit rates for most important service groups in 2006, offset to some extent by a decline in the number of services per claim for many of the groups.
Author: Robert Elliott, J.D.
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The State Board of Workers’ Compensation, following an investigation, alleges a Bainbridge police officer and his mother were responsible for taking tens of thousands of dollars from local businesses and charged them with insurance fraud.
According to WALB-TV, the officer and his mother owned a Bainbridge business providing payroll and insurance services to other area business. The two are accused of collecting more than $22,000 from an Albany business, and using it for their own benefit.
Investigators say the company allegedly pocketed the money from clients after taking fees from a number of individuals and held on to the premiums paid in from September through December of 2008, amounting to more than $30,000.
The company allegedly running this scheme had its compensation insurance policy cancelled for lack of payment, but investigators say the business kept on collecting premium payments and keeping the payments for themselves. (workersxzcompxzkit)
The officer is suspended without pay from the police department, pending the outcome of the case.
Author: Robert Elliott, J.D.
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Do not use this information without independent verification.
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©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
Without proper documentation a company is essentially asking for problems when a work-related injury occurs. Out-of-line workers’ compensation costs can be held in check by carefully recording every thing, step by step when an injury takes place: from the time the injury happens until the employee returns to work either in a transitional duty position or to full duty.
Seven Minimum Steps You Must Take
1. Document the incident in writing. Obtain information about the incident, the injury, and medical attention sought.
2. Complete these documents:
– Post Injury Interview
– Employee Report of Incident
– Witness Report Form
3. All witnesses and any persons who were nearby complete the Witness Report Form.
4. Documents are forwarded to the workers’ compensation manager:
5. Give the injury coordinator all necessary information report the claim.
6. Follow all protocol to identify and correction hazards connected with the injury. (Example: removing or repairing malfunctioning objects or equipment.) (workersxzcompxzkit)
7. Notify the injury coordinator when those steps are completed.
Author: Robert Elliott, J.D.
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Do not use this information without independent verification.
All state laws vary.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact IInfo@WorkersCompKit.com
Here’s what Tom Robinson, J.D., writer for Lexis Nexis Workers Comp Law Center reveals about Iowa Employer’s Suit for Specific Performance of Settlement Agreement Allegedly Reached Over the Telephone . . .
Here’s What Happened
Branson, an assembly repair person employed by Eaton for many years, sustained a work-related rupture of the bicep tendon in his right shoulder. Branson underwent shoulder surgery, was out of work for a few weeks, returned first to light duty and later to regular work.
Branson’s physician initially issued a report indicating Branson had a 16% impairment rating to his right upper extremity and the impairment rating translated to a 10% body-as-a-whole disability rating, later increased by the doctor to 12%.
Unrepresented by counsel at the time, Branson and a representative for the employer’s third-party administrator had at least three phone conversations regarding possible settlement of Branson’s claim. It was undisputed that Branson rejected several prior settlement offers before their telephone conversation on November 12, 2007.
During this final telephone conversation the representative offered to pay Branson the lump sum of $ 26,436.30 to settle his workers’ compensation case on a “closed file basis.” The representative testified in prior conversations he explained to Branson what “closed file basis” meant. Branson testified he did not accept the November 12 settlement offer and specifically told the representative that he thought that offer “was fairer than the last offer,” but he wanted to see the papers on it.
The representative’s version of the conversation was that Branson unconditionally agreed to the settlement offer. The representative forwarded settlement papers to Branson, who then hired an attorney. Branson’s attorney then communicated a rejection of the offer.
Eaton filed the instant civil action requesting specific performance of the agreement and punitive damages. The district court dismissed Eaton’s action and Eaton appealed. (workersxzcompxzkit)
Here’s How the Court Ruled
In Eaton Corp. v. Branson, 2009 Iowa App. LEXIS 577 (June 17, 2009), the Court of Appeals of Iowa affirmed. Observing that the plaintiff’s burden in a suit for specific performance is to prove by clear, satisfactory, and convincing evidence the terms of the contract, the court said that giving weight to the trial court’s credibility determinations, it agreed that this appeared to be a situation where the participants in the phone call were on different wavelengths and may have misunderstood what each other was saying. The appellate court pointed out that the district court had used the common shorthand “meeting of the minds,” that what the phrase really means is that in order to have a contract, there must be a manifestation of mutual assent. Absent such a manifestation, there is no contract. The appellate court agreed that Eaton failed to establish Branson actually accepted the closed file offer on November 12, 2007.
See generally Larson’s Workers’ Compensation Law, §§ 132.01, 132.03.
Tom Robinson, J.D. is the primary upkeep writer for Larson’s Workers’ Compensation Law (LexisNexis) and Larson’s Workers’ Compensation, Desk Edition (LexisNexis). He is a contributing writer for California Compensation Cases (LexisNexis) and Benefits Review Board – Longshore Reporter(LexisNexis), and is a contributing author to New York Workers’ Compensation Handbook(LexisNexis). Tom Robinson is an authority in the area of workers’ compensation and we are happy to have him as a Guest Contributor to Workers’ Comp Kit Blog. Tom can be reached at: compwriter@gmail.com.
http://law.lexisnexis.com/practiceareas/Workers-Compensation
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California Man in Jail
California Insurance Commissioner Steve Poizner reported the arrest of a Santa Paula man, charged with one felony count of insurance fraud.
CDI investigators determined the defendant claimed he was injured on the job while working for Chicago for Ribs in Ventura. The individual was placed on total temporary disability by his doctor, and collected more than $30,000 in disability payments from May 2007 through August 2008.
While collecting total temporary disability payments, he allegedly applied for and obtained a position at Teppan Steak House in Oxnard from December 2007 through August 2008. The defendant allegedly used a fictitious name and social security number when he applied for the job. (workersxzcompxzkit)
He was specifically asked if he was employed while collecting total temporary disability payments at his deposition, and allegedly denied that he was employed.
Author: Robert Elliott, J.D.
WC Best Practices Quick Check: http://www.workerscompkit.com/intro/
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©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
Employers Ask
Q: Do I have to have a written drug test policy?
A: Yes.
Q: Do I have to have state-specific written policies?
A: Yes.
Q: Can’t we just have one that mirrors DOT?
A: No.
The days of simplicity, of a single, one-fits-all approach to drug testing are gone. Multi-state employers can no longer rely upon a single (corporate) workplace drug test policy. There are at least 21 states (and Boulder, CO) requiring or, depending on employer choices, justifing a separate policy.
This need is emphasized by recent court decisions in Connecticut, Minnesota, Oklahoma and Vermont, among others, making it increasingly clear multi-state employers MUST know and follow local rules. This means that “mirroring” DOT may be the biggest mistake an employer can make.
You have to follow the rules that apply to the test being performed, be it DOT-regulated or conducted in a state with its own set of rules.
What are some of those rules? A sample includes the following:
â— 7 states limit discipline for the first positive;
â— 12 states limit random testing to safety-sensitive jobs only;
â— 23 states require either a split sample or retest;
â— 23 states require that tests be conducted per federal DOT or DHHS;
â— 19 states require written notice of a positive test – IA by certified mail;
â— 12 states require that notice/policy be posted;
â— 8 states require initial or annual training/education;
â— 21 states specifically define what a “specimen” is;
â— 18 states have specific alcohol positive levels.
These are but a few of the many state-by-state differences any multi-state employer must take into account regarding who can be tested, when, how, where and for what substances. Additionally many states expect to see their own format (e.g. Florida, Maine) or have specific language (e.g. Missouri, Mississippi) that must appear somewhere in the policy and/or notices to employees and/or applicants. Failure to follow these rules and expectations could result in significant losses if yourthe employer’s policy is challenged.
Some recent cases where employers ignored state rules, tested under their “company” policy and as a result lost when challenged include the following:
Oklahoma: 2009, ConocoPhillips pays $583,413 (over $750,000 with attorney’s fees) for willful violation of Oklahoma’s mandatory statute. Estes v. ConocoPhillips Company, Case No. 05-CV-445-GKF-PJC)
Minnesota: 2008, INGDirect pays punitive damages for not accurately enforcing state law. (Wehlage v. ING BANK, FSB, d/b/a/ ING DIRECT, Case No. 07-CV-1852 (PJS/RLE))
Missouri: 2006, Wal-Mart looses unemployment case because the company policy did not accurately reflect state law. (Gaylord v. Wal-Mart Associates, Inc. and Division of Employment Security, WD 65939)
Connecticut: 1996, Employer failed to consider state law requirements when enforcing its policy. (Doyon v. Home Depot U. S. A., Inc. 850 F. Supp.125).
Additionally, if a test was not performed as required under state or local laws an employer will be unable to defeat an unemployment claim or, worse yet, not be able to defeat a workers’ compensation claim that might have otherwise been easily defended.
The list of states requiring/justifying separate policies and the reason(s) for this are as follows:
1. AL Voluntary DFWA & Presumptive Denial with warnings required
2. AR Voluntary DFWA
3. CO Presumptive Work Comp Denial law
4. CT Mandatory Law (unique criteria)
5. FL Voluntary DFWA (unique criteria)
6. GA Voluntary DFWA (unique criteria)
7. HI Mandatory Law (unique criteria)
8. IA Mandatory Law (unique criteria)
9. ID Voluntary DFWA (unique criteria)
10. ME Mandatory Law (unique criteria)
11. MN Mandatory Law (unique criteria)
12. MO Presumptive Unemployment requirements
13. MS Voluntary DFWA (unique criteria)
14. MT Mandatory Law (unique criteria)
15. OH Voluntary DFWA (unique criteria); Presumptive Work Comp Denial law
16. OK Mandatory Law (unique criteria)
17. RI Mandatory Law (unique criteria)
18. TN Voluntary DFWA (unique criteria)
19. UT Mandatory Law (unique criteria); Presumptive Work Comp Denial law
20. VT Mandatory Law (unique criteria)
21. WY Voluntary DFWA (unique criteria)
22. Boulder, CO, Mandatory Ordinance (unique criteria)
Ten (10) of these states (and Boulder, CO) are mandatory and there is no choice but to have a separate policy because of required language or other criteria.
Frequently, employer operate under the misconception that if they “mirror” federal DOT rules they are somehow safe from liability and can operate from a single company policy. Nothing is further from the truth. There are many ways that following DOT can get you into trouble, such as states only permitting testing if there is suspicion of “impairment” on the job, states requiring different alcohol cutoff levels, states allowing more time to request a split sample to be tested, and many more.
The bottom line, and it really does impact your bottom line, is you must follow the rules that apply to the tests you are conducting. To do otherwise is simply dodging bullets. Find a full description of individual state and territory laws at http://www.reduceyourworkerscomp.com/drug-testing-state-laws.php.
Attorney Judge, JD, LLM can be reached at The Center for Drug Test Information, 877-423-8422. info@centerfordrugtestinformation.com; http://www.centerfordrugtestinformation.com/.
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Do not use this information without independent verification.
All state laws vary.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
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