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Drunk Driving Convictions Impact Employment Related Injuries


New Michigan Ads Shows How DUI Conviction Impacts Employment

A state-wide  advertising blitz and drunk driving crackdown, sponsored by the Michigan Office of Highway Safety Planning (OHSP), Drunk Driving. Over the Limit. Under Arrest starts on August 21, 2009 and runs through September 7, 2009. The federally funded ads are part of a comprehensive advertising campaign.

With safety belt  use at a record high, drunk driving is the top priority for OHSP in 2009 and beyond. Between 2003 and 2008, 2,168 people were killed and 8,914 seriously injured in  alcohol-involved crashes  resulting in an economic cost to the state of more than $12.3 billion.

New television  and radio ads, specifically targeting young men, highlight how a driving while drunken  conviction follows a person for a long time, including the ability to be gainfully employed. And many of the persons convicted are in fact employed, raising the concern that these may occur during work and impact an employer’s workers’ compensation exposure.

The TV spot  features a young man convicted of drunk driving and how the DUI literally follows him around in his daily life. The man, chained to a keg representing the arrest, drags the DUI along with him as he walks through town because he no longer has a license. The “keg and chain”  ad can be viewed at http://www.youtube.com/ohsp

“A drunk driving  arrest doesn’t end with a night in jail,” OHSP Director Michael Prince said. “Convicted drunk drivers can lose their licenses and sometimes their jobs and spend several thousand dollars in fines and fees.” (workersxzcompxzkit)

Also see http://reduceyourworkerscomp.com/drug-testing-state-laws.php for the only FREE set of drug laws covering individual states.

Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: Robert_Elliott@ReduceYourWorkersComp.com or 860-786-8286.

Try Our FREE WC Best Practices Quick Check: http://www.workerscompkit.com/intro/
WC Calculator: www.reduceyourworkerscomp.com/calculator.php
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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

Posted in Drug, Alcohol & Impairment Testing, Litigation Management |


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How ADA and RTW Relate to Workers Compensation PPD Settlements in NY


Section 15(3) (w)  of the New York Work Comp Law, in effect since 3/13/07, provides for lifetime caps on permanent partial disability (PPD) claims. In the past, such claims have accounted for 60%-70% of all attorney fees, without which a comp practice is unsustainable. They also account for the bulk of legal defense fees.

New claims   strategies will quickly appear as the first of the capped claims reach max payment on 7/5/11. Employers can anticipate certain strategies and plan to document levels of disability without carrier involvement  by employing a methodology which conforms to the goals of the Americans with Disabilities Act (ADA).

In New York,  numerous PPD classifications (20,000 settlements/yr ) were a major feature of the law and settlement of such claims was lucrative and essential to the size of the entire system.

However,  high comp rates and a depressed economic market drove Albany to find a method of limiting lifetime benefits. Section 32 settlements, for the first time, permitted future medical to be resolved with a one time lump payment.  Nevertheless, lifetime caps had to be created for the 75% of PPD claims that were never settled.

The caps alter  the strategy of lump-sum and Section 32 settlements. Knowing precisely what the future exposure is and knowing that it will rarely exceed a few years, using the old Board settlement strategies, will disastrously limit attorney fees. It can be anticipated that new strategies will appear and that the principle one will evolve around returning the worker to actual, but low paid, work to lock in a high rate.

Actual work,  as opposed to medical opinion about levels of disability, is presumptively correct as a measure of wage loss. The new statute provides for longer lifetime benefits for workers with higher percentages of wage loss.

An employer  can anticipate the strategy of return to low paid work by proactive return to work offers beginning weeks, instead of years or months, after the injury. Periods of disability following a New York compensation injury have been known to be multiples of what they are for similar injuries which are not work related, but are covered by a disability plan – the difference being attributed to the fact that comp claims frequently end in a large lump-sum where lost time is ongoing.

From the passage  of ADA in 1990, there has been a ticking time bomb created by inconsistent presumptions between ADA and New York work comp. ADA presumes that even the most disabled can work in many capacities given reasonable accommodation. NY work comp for six decades has presumed that even trivial injuries are presumptively totally disabling for years after the accident.

In the 1990s  a case in NY was reported where a worker hearing a somewhat offensive remark made at the water cooler by a co-worker was awarded three years of psychiatric total disability and was given a substantial lump-sum settlement. ADA, in effect at the time, would have concluded there was no disability which could not be cured by moving the co-workers to separate rooms.

The employer,  by offering return to work in a modified position at nearly full pay or higher, can establish a far lower level of workers comp disability by providing, if need be, reasonable accommodations. The work, observed by co-workers and with documentation of pay and accommodation, creates an almost impregnable proof of substantial wage earning capacity. It also creates an ally in the worker’s family, which rarely is supportive of a non-working member following advice to stay out of work in order to maximize a future settlement. (workersxzcompxzkit)

Legal strategies  are generally arrived at in a fact-deficient vacuum. ADA accommodations can fill that vacuum with objective data that will prove invaluable years later when they confront belated efforts to maximize disability.

To be continued:  An analysis of projected legal proceedings.

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.

WC Best Practices Quick Check: http://www.workerscompkit.com/intro/
Workers’ Comp Kit Books & Guides: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
Follow Us On Twitter: www.twitter.com/WorkersCompKit

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

Posted in ADA (Americans with Disabilities Act), Litigation Management, NY Workers Comp Issues, Return to Work and Transitional Duty |


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How to Reduce Workers Comp Costs Reviewing Your Data


We all love stories.  Stories are entertaining, interesting and informative.  So, I am going to tell you a story – all about how to reduce your workers’ compensations from 30% to 60%.  Yes, that’s right.  It’s been proven over and over and over .  .  .

A well designed workers’  compensation programs can cut your costs 305 to 60%. Too often however, those in charge rush to buy the latest new product before they understand the problem. Make sure you understand why your costs are high, then develop a comprehensive solution, A PLAN!   If you want to reduce your losses quickly, don’t take a ‘dart-board’ approach. To reduce your losses, concentrate sufficient resources in the following areas.

The Data Tells a Story – Review Your Data

The first step  is understanding how bad your workers’ compensation losses really are, if in fact they are bad. We know  80% of the cost of WC is losses and 20% is from premium and administrative costs. You must know your loss costs and if you have a problem.

One large entertainment  company I worked with recently thought workers’ compensation costs were too high.  When we compared their costs to national averages we found their costs actually were half the national average. The company failed to develop benchmarks to take into consideration an increase in the number of employees following a recent acquisition.

I recommend  analyzing data to equalize the number of employees. Cost Per Full-time (Equivalent) Employee (FTE) offers a comparison of your company’s divisions regardless of how many full vs. part-time employees each has.  The cost as percentage of payroll and cost as percentage of revenue allow you to compare your company to industry averages and establish baseline averages to use for future determination of progress.  The return-to-work ratio tells what percentage of employees return to work quickly after the accident. Ideally, 90% of injured employees should return to work within the first four days after an accident. This is perhaps the most important measurement because it is indicative of the length of absence in each claim.  (workersxzcompxzkit)

After reviewing  data to determine you starting benchmark, select one or two measurements to convey success and progress to upper management and to employees. No one wants to receive 200 pages of data so make it concise – one page is preferable – with corporate then each business unit’s numbers shown individually. The senior management might prefer the Cost per FTE while the employees may relate better to number of lost workdays in their department. When employees understand workers’ comp costs are consuming their potential raises, they will cooperate.

Author:  Rebecca Shafer, J.D.  Rebecca helps companies reduce workers’ comp costs 20-50%. She has over 20 years of experience and an excellent track record of success. Contact her at RShafer@ReduceYourWorkersComp.com or 860-786-8286

WC Best Practices Quick Check: http://www.workerscompkit.com/intro/
Workers’ Comp Kit Books & Guides: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
Follow Us On Twitter: www.twitter.com/WorkersCompKit

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

Posted in WC 101, Workers Comp Kit |


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The Case of the Erroneous Workers Comp Check


The Workers’ Comp Fraud Blotter Update  a Selection of Interesting Cases

Spend, Spend, Spend!

Recently an  injured worker from Minnesota received his workers’ compensation  settlement check for $55,571.65 and spent all of it but $.94.  And, this is a problem because . . . .?

His actual  settlement was for $23,000 of which he was to receive $13,000.00 after attorney fees.  Apparently it never occurred to the man a mistake was made.  Or maybe it did.

The error was  discovered during an audit by the state’s Department of Labor and Industry. However, an investigator for the Minnesota Department of Commerce Insurance Fraud looking into the matter said the man refused to respond to interview requests. (workersxzcompxzkit)

The alleged  defendant was charged with one count of felony theft and is scheduled to appear in a county district court.

Extracted:  StarTribune, Minneapolis-St. Paul, Minnesota by Pat Pheifer
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-7232009

More FREE tools to try:
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View the Entire Blog: http://blog.reduceyourworkerscomp.com/

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

Posted in Fraud and Abuse, Litigation Management |


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Introducing Managers to Your NEW Workers Comp Program to Win Them Over


Everyone has to start somewhere, right?

When your  company was small, you were able to handle the one or two workers’ compensation cases cropping up now and then.

But, now you’ve grown!  The good news!  The bad news –  as the owner, you don’t have to time to handle every work comp incident so it’s time to implement a specific Workers’ Compensation Program.

The first step  is a letter to all managers explaining the plan and how you expect them to take part in its implementation.  They will, after all, be responsible for directing the nitty-gritties of the new program.

Include these points in your letter.

  1. An explanation  showing how workers’ compensation costs are forcing the company to re-evaluate how injuries and claims are handled.
  2. Note  the company  pays for each claim directly and therefore needs to closely control the costs of workers’ compensation.

Tell the managers the new program will:

  1. Reduce  the number of work-related injuries.
  2. Effectively  manage claims when they occur.
  3. Control  coordination of medical care and follow-up contacts.
  4. Improve  communication with our employees.
  5. Return  injured employees to work as soon as possible.

Let your managers  know you are hiring a Director of Workers’ Compensation to develop a viable and integrated program and  the director will be working with the company’s broker to roll out the new program as soon as possible. (workersxzcompxzkit)

Conclude by  assuring the management team  the program is under your direction and support and  you expect them to give the new team their full support.

Let them  know they are welcome to ask questions and include your contact info.

Author:  Robert Elliott, J.D. Mr. Elliott is Executive Vice President of Amaxx Risk Solutions. He helps companies reduce their workers comp costs including assessing, benchmarking and developing cost containment solutions. He can be contacted at Robert_Elliott@ReduceYourWorkersComp.com www.ReduceYourWorkersComp.com

FREE tools to try:
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 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

Posted in Communication with Employees, Implementation and Rolling Out Your Program, Workers Comp Kit |


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Workers Comp Fraud Extends to Reinsurance Scheme


Some N.C. Employers to Receive Money from Phoenix Fund Fraudulent Reinsurance Scheme

North Carolina  Insurance Commissioner announced the distribution of $6.5 million to 661 former members of the Phoenix Fund Inc.

Distribution checks  will be mailed to employers who were participating members of the Phoenix Fund as of Oct. 17, 2006, the date the Court ordered the Phoenix Fund into rehabilitation. The remaining recovered monies will be used to pay the Fund’s obligations. Any monies remaining after the payment of such obligations will be returned to the same former members in a second and final distribution upon approval of the Court.

The Phoenix Fund was a self-insured group workers’ compensation fund whose members agreed to pool their workers’ comp liabilities rather than seeking coverage in the private market. Self-insured group workers’ comp funds are licensed and regulated by the North Carolina Department of Insurance

After the N.C.  Department of Insurance uncovered a more than $20 million fraudulent reinsurance scheme, leaving several insurance entities, including the Phoenix Fund, without reinsurance, The Phoenix Fund was ordered into rehabilitation in October 2006, by the Wake County Superior Court.  (workersxzcompxzkit)

Since the Phoenix Fund  has been under rehabilitation, the Department has sought and recovered nearly $18 million for the Phoenix Fund from the Fund’s purported reinsurance broker, at the center of the fraudulent reinsurance scheme. The broker pleaded guilty to mail fraud and money laundering and received a sentence of up to 5 years in jail followed by three years of supervised release and was ordered to pay over $19 million in restitution to the Phoenix Fund.

Author Robert Elliott
, senior vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: Robert_Elliott@ReduceYourWorkersComp.com or 860-786-8286.

WC Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
WC Calculator: www.reduceyourworkerscomp.com/calculator.php
TD Calculator:www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
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

Posted in Fraud and Abuse, Insurance Issues, Rates, Premiums |


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Forging Good Relationship With Labor Unions To Better Manage Workers Compensation


Workers' Comp and  Labor Unions  Make a Friend, Not a Foe Labor Unions  should be brought on-board in the workers' compensation arena. After all, a good company cares for its employees and wants them to be treated fairly. Tips in forging good relationships with the unions include: 1. Talk  to representatives from your local unions early in the process. 2. Discuss  the union's policies on seniority and how this could affect injury management. Do they have opinions on this matter? Listen. 3. Does the  union require supplemental pay for the injured? Does this come from the union itself? Be sure to document the answers you receive and be aware of the implications. 4. Transitional duty  is a fundamental part of) getting your injured employee back on the job. Do your unions have policies on working with an injury or post-surgery? A good manager   obtains union buy-in by incorporating their opinions into the process whenever feasible. It is not possible to make everyone happy one hundred percent of the time, but an attempt at seeing issues from all sides is always appreciated and emanates the feeling of control. Proceeding without  any union input when implementing a policy as critical as workers' compensation only presents an "us-them" mentality which can lead to higher long-term costs. Further, it is suggested  the company identify "collateral source benefits" – those perks your company or union offers which may enrich an employee who is not working and develop work-around strategies to facilitate return to work. (workersxzcompxzkit) Author: Robert Elliott, J.D. Contact Robert at Robert_Elliott@ReduceYourWorkersComp.com

Workers' Comp Kit Books & Guides: Corner.advisen.com/wcbooks WC Calculator: www.reduceyourworkerscomp.com/calculator.php WC 101: www.ReduceYourWorkersComp.com/workers_comp.php Follow Us On Twitter: www.twitter.com/WorkersCompKit 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

Posted in Union Issues |


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What Employers Need to Know About Workers Comp and New ADAAA


The American with Disabilities Act (ADA)

ADA, originally signed into law in 1990, prohibits employment-related discrimination against disabled employees and job applicants.

The ADAAA,  effective January 1, 2009, substantially broadened the definition of who may attempt to seek protection under ADA, making it easier for an individual to establish “disabled” for ADA purposes.

“It’s a reasonable  assumption the ADA amendment will likely lead to an increase in the number and variety of workplace accommodation requests. Many employers aren’t sure what to expect and may struggle with putting the necessary pieces in place,” said Dr. Robert Anfield, chief medical officer for CIGNA’s disability programs.

CIGNA Workplace Accommodation Services Program

CIGNA launches  the CIGNA Workplace Accommodation Services program to help disability clients address the new requirements coming from the recently enacted Americans with Disabilities Act Amendments Act (ADAAA).  Most of these services are included at no cost to CIGNA disability plan customers and help employees contribute to their full potential.

According to  a study by the Job Accommodation Network, for every dollar invested in workplace accommodations, employers receive about $10 in return benefits including increased worker productivity and saved costs associated with training a new employee.

As part of CIGNA’s  Workplace Accommodation Services program, employers can access counselors through a toll-free helpline and seek assistance with:

1.  Identifying  at-risk employees who may be headed for disability if steps aren’t taken to prevent it.
2.  Create  well-documented job descriptions assessing an employee’s or applicant’s ability to perform a specific job function.

CIGNA’s vocational  rehabilitation counselors identify ways to keep people at work or return to work after a disability.

Workplace Accommodation Services’ Three Components

1.  ADA Helpline  and association with the Job Accommodation Network (JAN)
Provided  at no cost,  CIGNA’s ADA helpline gives disability clients access to experts who can help them more quickly connect to the right JAN resource and discuss CIGNA programs supporting ADAAA compliance. The helpline is staffed with certified and Masters-prepared vocational rehabilitation counselors, who have also attained Certified ADA Administrator designations and completed professional training from JAN.
2.  Helping employees stay at work
Individuals  with physical and/or psychological limitations associated with a progressive illness or condition sometimes fail to identify warning signs possibily leading to a disability.  CIGNA’s counselors provide expanded intervention services, such as assessments of the employee’s ability to perform tasks required for the job position, ergonomic accommodations and assistance with equipment purchases, and an on-site review of the overall workplace environment. (workersxzcompxzkit)
In addition,  CIGNA’s fee-based Job Analysis Service helps disability clients develop ADAAA-compliant job descriptions after a thorough review a position’s job functions within an organization and a process to identify a job’s physical and cognitive demands. This information helps a disability client objectively assess an employee’s ability to perform specific required functions and make informed job accommodation decisions.
3.  Reasonable Accommodation Benefit
Available  as part of CIGNA’s long-term disability plan coverage, CIGNA can help pay some of the costs required for a job accommodation, such as new equipment or technology that can return an employee to work.

Author Robert Elliott, senior vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: Robert_Elliott@ReduceYourWorkersComp.com or 860-786-8286.

Workers’ Comp Kit Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
WC Calculator: www.reduceyourworkerscomp.com/calculator.php
TD Calculator:www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
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

Posted in ADA (Americans with Disabilities Act), Federal Workers Compensation |


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Ten Ways to Build a Better Relationship with Your Workers Comp Insurance Broker Account Manager


10 Tips to Help You Maximize Results by Partnering with the Account Manager at your insurance broker or agent. Having a great working relationship starts with the selection process and continues throughout the relationship between client and insurance broker.

Today’s unprecedented  global economic conditions have changed the way we work.  Everyone is doing much more, often with much less. Priorities seem to change by the minute, as do deadlines, and expectations keep increasing.  Multi-tasking has taken on a whole new meaning. 

There is a positive  in all of this, however.  Challenges often present us with opportunities to be creative and to look at things in a different light.  Are you getting the maximum possible value, and the best outcomes, from the resources you do have?  Specifically, think about how you interact with your account manager.

Having led  a large third-party administrator account management team, I was deeply involved in many client relationships.  Almost without exception, the strongest, most productive client relationships were those that involved true partnership.  They were a win-win for both parties, and they stood the test of time.

Many of  these relationships did not start out as partnerships, but grew into them with a little investment of time and effort.  There are key components that help foster partnership and collaboration.  Listed below are some of the most important:

1.  Working  knowledge of each other’s organization, including
     a.  Mission,  vision and culture
     b.  Strategic  plan and objectives
     c.  Opportunities  and challenges
     d.  Financial  performance
     e.  Management  team and other key players
     f.  Industry  trends and outlooks

2.  Clearly  articulated and agreed upon objectives, supported by action plans which identify tasks, responsible team members and target dates.

3.  Metrics  to measure outcomes, identify emerging trends and determine levels of success.

4.  Equally  important, celebrating success as a team and building on it.

5.  Open and frequent communication, with prior agreement on the preferred methods (emails, conference calls, in-person meetings or web meetings), how frequently and acceptable response times.

6.  Client  expectations and hot buttons – we all have them.  What are the golden rules that must always be followed?  Some examples:
     a.  Acceptable  number of meeting attendees
     b.  Dress  code at the client’s locations
     c.  Is the  client technology/data driven or technology/data phobic?
     d.  What  is the client’s policy on entertainment and gifts
     e.  Does  the client expect regular executive management contact?�
Some of these  should be common sense, but I have had to do my share of damage control simply because the wrong assumption was made.  Ask and agree beforehand.

7.  A willingness to challenge “We’ve always done it this way.” by asking, “Does this still make sense, and is it the best possible use of resources?”  Go after the low hanging fruit first, such as:
     a.  Routine  meetings, especially if travel is required.
          Can they be done via video or teleconference?
     b.  Claim  reviews – can the frequency be reduced with equal,
          or even better, results?
     c.  Electronic  and paper reports – do a complete inventory of
          who is getting what, and then ask “why,” and if the report is
          even being used.  This is a big area of potential savings.
Regularly  challenging convention is healthy, and it can result in reduced expenses, more resources for critical projects and better outcomes.

8.  Flexibility  and the ability to adapt to changing conditions; think about and develop a Plan B before you need one.

9.  NO SURPRISES!   There is nothing worse than being blindsided.  Err on the side of caution.
10. Respect, courtesy and recognition – If someone has a different opinion, listen and respect it.  If someone does a great job, say so.  If someone makes a mistake, help him learn from it.  (workersxzcompxzkit)

Partnerships create positive energy and help you accomplish more, with less.  And, a true partnership can make the rough patches of road a little easier to navigate.  Now, who wouldn’t welcome that in today’s new work environment?

We welcome  our newest guest-blogger Debra Drinane, ARM. 

Author:  Debra Drinane, ARM, has extensive experience in risk management, claims management and relationship management. She can be reached at debradrinane@att.net.  Visit her at: http:/www.linkedin.com/in/debradrinane.

FREE tools to try:
WC Calculator: www.reduceyourworkerscomp.com/calculator.php
TD Calculator:www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
Follow Us On Twitter: www.twitter.com/WorkersCompKit
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

Posted in Broker Issues & Relationships, Insurance Issues, Rates, Premiums, Risk Management |


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NEW YORK Workers Comp Permanent Disability and Predictable Problems for NY Employers


On March 13, 2007  new methods of dealing with permanent partial disability went into effect. Prior to that date, a worker who had a permanent partial disability could collect weekly benefits for life, if the post-injury earnings were lass than before the accident. Carriers must offer a Section 32 settlement to all claimants who have been classified as permanently disabled

Under the new law,  the maximum number of weeks that will be paid will depend on the severity of the disability – ranging from 225 weeks for least severe ratings to a maximum of 525 weeks for more than 95% loss of earning capacity.

What is Loss of Earning Capacity?  
Loss of “earning capacity” is the difference between wages at the time of the accident and wages after. If there are no wages, the extent of disability is measured by medical and vocational assessments, which account for the bulk of all testimony at the Board.

Therefore,  a worker who does not return to work runs a risk of being rated with a minimal disability, leading to a maximum of 225 weeks of benefits. However, if a worker returns to a low paying job, not necessarily with the same employer, the earnings are PRESUMPTIVELY the correct measure of disability.

What does this mean for the employee?
All lawyers  in work comp in NY know this but in the past did not have to invoke it to obtain substantial awards. Now, however, knowing how to structure return to work can result in more than $180,000 in tax free benefits additional to the worker. A lawyer who does not explain all this to a client runs the risk of a substantial malpractice suit. Such suits were never seen for decades in NY work comp but are now beginning to appear.

What does this mean for the employer?
An employer  who takes an employee back at less than former wages may, in fact, be guaranteeing a maximum award because the differential is greater which establishes a presumption of MORE disability. The employer has nothing to fear from workers trying to reestablish earnings but needs to be wary of return to work with a hidden agenda, especially where a worker readily accepts minimal wages or part-time work. The employer is better off paying the employee their regular salary/wages even if the employee is working in a transitional duty capacity with fewer hours or lower wages.                                      

In 1990 the maximum  compensation rate was substantially raised for new accidents occurring after July 1, 1990. Thousands of workers, out on disability for years, suddenly returned to work shortly after the new law went into effect. They remained at work for a few weeks and then left, filing a new injury claim. As predictable as this was, the Board never disallowed the “new” claims, all of which had prominent law firms as counsel before and after the accident.                                         IP Reg Tag:workersxzcompxzkit

Further articles will discuss what employers can do to deal with these new situations.

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.

TD Calculator:www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
WC 101: www.ReduceYourWorkersComp.com/workers_comp.php
Follow Us On Twitter: www.twitter.com/WorkersCompKit

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

Posted in Litigation Management, NY Workers Comp Issues, Return to Work and Transitional Duty |


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