The U.S. Equal Employment Opportunity Commission (EEOC) has released the Annual Report on the Federal Work Force for Fiscal Year (FY) 2008, showing small increases in discrimination complaint filings against federal agencies and average complaint processing time government-wide.
The annual report informs and advises the President and the Congress on the state of equal employment opportunity (EEO) throughout the federal government. Data in the report, available online at http://www.eeoc.gov, are presented both in individual agency profiles and in government-wide aggregate form.
According to the comprehensive report, 16,752 complaints alleging employment discrimination were filed against the federal government in FY 2008, up 2.4% from the prior year.
Complaints were filed against agencies on the basis of race, color, sex, national origin, religion, age, disability and reprisal. Pre-complaint counseling and alternative dispute resolution (ADR) programs addressed many employee concerns before they resulted in formal complaints. Of the 38,898 instances of counseling in FY 2008, more than half did not result in a formal complaint being filed.
Agencies completed a total of 11,157 EEO complaint investigations in FY 2008 with an average processing time of 180 days, an increase of four days from FY 2007. Of the 7,538 cases closed on the merits, 2.5% resulted in findings of unlawful discrimination. In addition, the parties entered into settlements in 3,249 complaints, or 19.5% of the total complaint closures. Agencies paid out a total of over $50 million in monetary benefits to complainants (including appellate decisions). (workersxzcompxzkit)
“Federal agencies must step up their efforts to improve complaint processing time, while also focusing on quality results,” said EEOC Acting Chairman Stuart Ishimaru. “The Commission continues to assist agencies in creating model EEO programs and implementing best practices to promote an inclusive, discrimination-free federal workplace.”
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.
We are accepting short articles* (300-800 words) on WC cost containment. Contact us at: Info@WorkersCompKit.com. *Non-compensable.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker about workers’ comp issues.
©2009 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
Stopping Fraud with Video Proof
6 Action Steps to Use When Contacting the Physician
When an employee makes a work-related injury that limits his/her ability to work, it’s time for documentation.
When said employee is observed elsewhere doing the very things they say they cannot do, it’s time for investigation. Make sure to do enough investigation so you record the activities over a long(ish) period of time. This is to avoid what is known as “good day, bad day syndrome” — meaning the employee has some good days and some bad days. If you have only a brief snapshot of activities, it is not an indication of overall condition and in a hearing the judge may rule the evidence is not enough to prove inconsistent activity.
And when an investigation provides video of fraud, it’s time to remedy the situation.
Here’s what to do:
1. Send your video proof first class mail, certified and return-receipt requested to the employee’s doctor and include all your contact information, employee name and claim number. Or, take it to your company’s consulting doctor, also called a medical advisor or peer-to-peer, and meet with him/her first to share the information and discuss whether the activity (if prolonged) is contrary to what you are being told about their abilities
2. Explain the situation to the physician that has given a prognosis of “not able to work”, this is usually the employee’s treating physician. Say something like, “You indicated on a Disability Form provided to Mr. Hayes he was unable to work because he had very limited range of motion in both arms. In light of the investigation videotape and report enclosed would you please review the situation and determine whether Mr. Hayes’ range of motion is still very limited. Our investigators observed Mr. Hayes on five consecutive days one week and several days the following week, doing landscape work with a local landscaping company. Additionally, over the weekend he was observed riding his motorcycle for several hours at a time. He was doing these activities with no apparent physical or medical limitations.” (workersxzcompxzkit)
Also in this letter, you should:
3. Ask the physician if he or she agrees the employee is now able to perform his original job as XXX and request an amendment of the work ability form report to indicate such and fax it immediately to your office.
4. Enclose a new Work Ability Form for the doctor to amend with the new, proper physical restrictions, if any.
5. Include your phone number and encourage the physician to call with questions.
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.
Visit Our Websites:
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. You should consult with your insurance broker or agent about workers’ comp issues.
©2009 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
Nurse case managers (NCMs) coordinate medical care and determine extent of disability. However, there are times when the NCM doesn’t serve a specific purpose and is assigned to the claim to get the claim moving. At times, NCM’s are used to do some of the tasks adjusters are supposed to do. Your job is to clarify when nurse case management is warranted and useful.
The injury coordinator can evaluate these aspects of both telephonic case management and field-based case management first of all by writing or emailing the adjuster and stating the above.
Also, the injury coordinator should know whether your NCM is an RN or an LPN. You should be charged less for an LPN or a NCM with less experience or fewer credentials. Note: NCM fees range from $85 to $100 per hour, or a flat fee of $450 for the first 30 days then $150 for the next 30 days.
1. Require the NCM to provide you with frequent updates. If you review the insurer’s file notes online and do not see NCM notes, contact the NCM to provide an update.
2. Ask your third party administrator or adjuster to work with you to determine when the use of nurses serves to resolve claims quickly and ensures good quality medical care for the employees.
Ask the following:
1. Do you have any suggestions of when we should use nurses, what types of claims?
2. Can we get a list of all claims which have NCM assigned?
3. Shall we touch base about this on our regular risk management conference call?
Do make use of a nurse care manager:
1. In complex cases with multiple provider coordination.
2. In new lost-time claims if the length of time out of work is disproportionate to the injury.
3. When an employee is missing medical appointments.
4. When surgery, including arthroscopy, is anticipated.
5. For all hospitalizations.
6. If there is diagnostic testing including MRIs, CAT scans, or myelograms.
7. For severe injuries including: severe eye injuries, severs lacerations, back and knee injuries, cumulative trauma cases and severe sprains, strains or dislocations. (workersxzcompxzkit)
8. And remember: Not all nurse case managers are equally effective. If your assigned NCM is not effective, ask for a replacement.
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.
TD Calculator:www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
WC 101: www.ReduceYourWorkersComp.com/workers_comp.php
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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.
©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
Fact: Workers’ Compensation Insurance is a type of “property and casualty” business insurance required in all states, except Texas where an employer may opt out. It is referred to as a “line” of insurance coverage and is purchased from an insurance agent or broker. For detailed information about your state’s requirements, contact your INSURANCE broker or agent.
Weekly Fraud Blotter from Lexis/Nexis: September 18, 2009
Three Employers Arrested in Two Days
It is illegal for businesses in Louisiana to misrepresent the status of their employees in an effort to avoid paying workers’ compensation insurance, payroll taxes and other employee-related costs. Employers who fail to comply can be fined up to $250 per employee per incident. Continued non-compliance can result in larger fines, an injunction from doing business in the state or possible jail time.
Agents with the Louisiana Insurance Task Force arrested the owner of a cleaning service on charges of insurance certificate forgery. His arrest follows that of two owners of a drywall business on charges of felony theft and workers’ compensation premium fraud totaling an estimated $1.2 million in unpaid insurance premiums.
“All employers doing business in Louisiana are required to provide workers’ compensation coverage for their employees. Businesses not covering their employees are shortchanging those employees and driving up costs for other businesses,” said Curt Eysink, executive director of the Louisiana Workforce Commission. “This is an important step in creating a level playing field for all businesses to compete fairly.”
The cleaning service owner is accused of altering an expired certificate of insurance to make it appear his company was covered by a workers’ compensation policy in order to maintain his service contract with the State of Louisiana. State contractors are required to have a workers’ compensation policy in effect to qualify for work. The investigation was triggered by a report showing the defendant’s work comp coveraged was cancelled due to non-payment.
Following a tip received by LWC, it was discovered the drywall business owners under reported the number of employees — reporting 35 and a payroll of $145,347, when there are more than 300 and a payroll of $4.2 million. (workersxzcompxzkit)
The Louisiana Workforce Commission has worked throughout the year investigating suspected employer and employee fraud. Through the second quarter of 2009, nearly 1,600 investigations were completed by the LWC Office of Workers’ Compensation Fraud and Compliance Units, with 13 referred to the AG’s office for possible prosecution. More than 10 arrests have been made.
Reposted with Permission Visit LexisNexis for more information and full reports. The latest workers’ comp fraud blotter see http://law.lexisnexis.com/practiceareas/Workers-Compensation-Law-Blog/workers-compensation-fraud-/Workers-Comp-Fraud-Blotter-9182009—Recent-Arrests-Charges–Convictions
Try Our FREE WC IQ Test: http://www.workerscompkit.com/intro/
WC Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
WC Calculator: www.reduceyourworkerscomp.com/calculator.php
NEW ARTICLE: Return to Work in Unionized Companies
http://reduceyourworkerscomp.com//Return-to-Work-Programs-Unionized-Companies.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker about workers’ comp issues.
©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
More Myths & Realities of Workers Comp
Myth: If you have unions, you’ll never lower your workers compensation costs.
REALITY: Negotiating with a union can a successful experience, even if challenging.
Begin with a positive, cooperative, win-win attitude. Sit down and discuss the situation with the bargaining committee; educate them about workers’ comp and the need for transitional duty and they’ll usually facilitate the program.
They need to be aware staying out of work for extended periods of time normally doesn’t help an injured employee heal; in fact, the employee’s health often deteriorates because mental health can be compromised by depression once the employee loses a daily routine and social network.
Focus on the economic consequences and interests of the membership. For instance, if the majority of members are young, emphasize how the extra money helps them pay college tuition for their children. If members are older, emphasize how the savings helps their retirement accounts. Sometimes unions have very creative ideas about how a new transitional duty program can work well, and they’ll make you aware of collateral source benefits needing to be removed. In one instance recently, the union was angry with management because management hadn’t tried to do more to stop several fraudulent claims.
Myth: To get a slow claim “moving,” the best thing to do is request an Independent Medical Evaluation) (IME).
REALITY: Requesting an Independent Medical Evaluation can be a two-edged sword.
If a claim is “stalled,” it’s quite common for the adjuster to recommend getting an IME to get the status of the claimant.
Before a claim is sent for an IME, have your Medical Advisor review the claim, because in some cases, an IME may be effective and warranted, but sometimes a request makes it worse.
It makes is worse when the timing isn’t right, when inadequate medical records are included with the IME packet or when inadequate medical questions are asked of the doctor who is performing the IME.
You might want either consider an Functional Capacity Evaluation (FCE) instead or get a brief surveillance to “see” what capability (or lack of) the claimant has.
Myth: The best way to reduce workers’ compensation costs is to change insurance companies or third-party administrators (TPAs).
REALITY: Wrong! The best way to reduce workers compensation costs is to build a better relationship with your current claims administrator.
The major cause of discontent between carriers and the insured is lack of communication causing a perception of something is being done improperly. For example, in several situations a company believed nurse case management was too expensive; however, upon audit by a medical advisor, it was found nurse case management services should be used MORE, but be brought in earlier. It wasn’t effective when it was used (thus appearing expensive and wasteful) because it was used too late in the process.
Start to build a better relationship by becoming more informed about the services your claims administrator offers. Hold a Vendor Day, and invite your TPA in with every one of their services – leave none out. Ask for samples of reports and deliverables so you can understand the product and know when to request services. Have give out brochures prior to Vendor Day, and read the brochures so you can ask knowledgeable questions about their services during the meeting.
Visit one or two claims offices, and observe the process. Learn the categories of desks at your carrier, for example, are there 4 levels of adjusters or 5? Do adjusters have backup and clerical support to get medical files? Sit at the intake desk, then join the lost time and medical adjusters for a few minutes at their desks. Ask to see what happens to medical bills when they enter the system until the time they are paid and filed.
This will give you a better understanding of how you can interact more effectively, what information adjusters need from you and what information you can provide about your workplace and employees. Finally, invite your adjusters to visit your workplace, so they know what your company does, the types of jobs and skills required of the employees. They can visualize exactly how an injury occurred even if they never visited your work place.
Author: Rebecca Shafer, J.D. consults for mid-market and national accounts focusing on project management, risk management assessments, data review, benchmarking, and development of Workers’ Compensation and Injury Management Programs. Projects focus on development of training and education programs, document design, evaluation and integration of insurance claims administration and TPA services. Contact her are: RShaferB@aol.com.
We are accepting short articles* (200-600 words) on WC cost containment. Contact us at: Info@WorkersCompKit.com. *Non-compensable.
FREE WC IQ Test: http://www.workerscompkit.com/intro/
WC Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker about workers’ comp issues.
©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
The U.S. Equal Employment Opportunity Commission (EEOC) approved a Notice of Proposed Rulemaking (NPRM) revising its regulations to provide that an individual seeking protection under the Americans with Disabilities Act (ADA) establish the disability consistent with the original, expansive intent of Congress when it enacted the ADA in 1990. The NPRM, approved by 2-1 vote, carries a 60-day period for public comment.
The NPRM made several significant changes to the definition of the term “disability” necessitated by enactment of the ADA Amendments Act of 2008. The NPRM is posted on the Commission’s Web site, www.eeoc.gov, along with a question-and-answer guide about the proposal and instructions for submitting public comments.
“Today’s Commission action marks a key step in implementing the landmark Amendments Act, which will smooth the road for those trying to establish disability under the ADA,” said Acting EEOC Chairman Stuart Ishimaru. “The Commission acted following careful and thorough deliberations, and we look forward to reviewing any and all public comments before issuing our final regulation.”
The ADA Amendments Act, effective January 1, 2009, states Congress expects the EEOC to revise its regulations to conform to changes made by the Act, and expressly authorizes the EEOC to do so. The new law rejected the holdings in several Supreme Court decisions and portions of EEOC’s ADA regulations that Congress believed construed the definition of “disability” too narrowly, preventing individuals with impairments such as cancer, diabetes, epilepsy, multiple sclerosis, muscular dystrophy, post-traumatic stress disorder, and bipolar disorder from bringing discrimination claims.
The ADA Amendments Act (ADAAA) and the proposed rule make it easier for an individual alleging employment discrimination based on disability to establish that he or she meets the ADA’s definition of “disability.” The ADA Amendments Act also modifies the Rehabilitation Act of 1973, prohibiting employment discrimination in the federal workforce on the basis of disability. The EEOC voted June 17, 2008 to adopt the rules changes, which then went to the Office of Management and Budget for review, and to federal agencies.
Consistent with the ADAAA, the NPRM emphasizes:
1. the definition of disability — an impairment that poses a substantial limitation in a major life activity — must be construed in favor of broad coverage of individuals to the maximum extent permitted by the terms of the ADA, and should not require extensive analysis.
2. major life activities include “major bodily functions”
3. mitigating measures, such as medications and devices people use to reduce or eliminate the effects of an impairment, are not to be considered when determining whether someone has a disability
4. impairments, episodic or in remission, such as epilepsy, cancer, and many kinds of psychiatric impairments, are disabilities if they “substantially limit” major life activities when active.
The regulation also provides a more straightforward way of demonstrating a substantial limitation in the major life activity of working, and implements the ADAAA’s new standard for determining whether someone is “regarded as” having a disability. (workersxzcompxzkit)
The 60-day public comment period on the proposed rule-making will officially commence upon publication of the NPRM in the Federal Register, expected the week of September 21, 2009.
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.
We are accepting short articles* (200-600 words) on WC cost containment. Contact us at: Info@WorkersCompKit.com. *Non-compensable.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker about workers’ comp issues.
©2009 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
Workers’ Compenstion Insurance is a type of “property and casualty” business insurance required in all states, except Texas where an employer may opt out. It is referred to as a “line” of insurance coverage and is purchased from an insurance agent or broker.
Weekly Fraud Blotter from Lexis/Nexis: September 18, 2009
In another victory for CDI, Insurance Commissioner Steve Poizner announced a former insurance broker was ordered to pay $119,427 restitution to five victims, following a conviction of eight felony counts including elder abuse, grand theft and computer fraud. He was sentenced to serve one year in Los Angeles County Jail on August 12.
“Any agent or broker who attempts to cheat customers by pocketing their premiums and leaving them exposed to losses will face serious consequences,” said Commissioner Poizner. “Jail time, fines and restitution are only the beginning for these unscrupulous criminals.”
According to CDI investigators the conviced broker collected at least $6,895 from five clients between August 2006 and September 2007, for the purpose of purchasing insurance products (homeowners, commercial general liability and workers’ compensation). Although he placed coverage for two clients, he but allegedly failed to remit any premium, resulting in the insurance company sending cancellation notices on both policies. Both of these clients paid premium directly to the insurance company to reinstate their policies.
The broker allegedly failed to place and remit premiums to any insurance company for three other clients and purportedly issued bogus certificates of insurance to two of these clients to give the impression the coverage was legitimate. (workersxzcompxzkit)
The alleged scam was discovered by the son of one of the victims, a senior citizen, who attempted to file a claim when his father’s home was damaged in a fire. This victim had neither received a certificate of insurance nor a policy. It was discovered the defendant failed to place any coverage on the victim’s home, resulting in an uncovered loss to the senior exceeding $110,000.
Reposted with Permission Visit LexisNexis for more information and full reports.
The latest workers’ comp fraud blotter see http://law.lexisnexis.com/practiceareas/Workers-Compensation-Law-Blog/workers-compensation-fraud-/Workers-Comp-Fraud-Blotter-9182009—Recent-Arrests-Charges–Convictions
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker about workers’ comp issues.
©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
A Mississippi human resource manager, charged with conspiracy and employee verification fraud, faces more charges for his alleged role in the employment of illegal immigrants by the company.
According to the Hattiesburg American, the individual in a 12-count superseding indictment handed down by a federal grand jury in Jackson, was charged with an added count of aggravated identity theft. He was already under a 25-count indictment, including one count of conspiracy and two dozen counts of employee verification fraud. The superseding indictment (entirely replacing the initial indictment) charges him with one count of conspiracy, one count of aggravated identity theft and 10 counts of employee verification fraud.
The indictment resulted in a sweep of the plant when 595 illegal immigrants were placed under administrative arrest. Nine of those pleaded guilty to charges of aggravated identity theft.
The conspiracy charge alleges the individual, acting on behalf of the company, oftentimes hired illegal aliens and accepted false identity documents as part of the hiring process.
The employment verification fraud charges allege the employee verified the applicant was eligible to work in the United States, even after he had been alerted by the Social Security Administrations the workers’ Social Security numbers were not valid.
The identity theft charge alleges the employee used the name and Social Security number of one person as identification of another. (workersxzcompxzkit)
If convicted, the alleged defendant could receive up to five years in prison and a fine up to $250,000, on the conspiracy count and on each of the 10 verification fraud counts. The aggravated identity theft charge carries a minimum two-year sentence and a $250,000 fine.
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.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker about workers’ comp issues.
©2009 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
14 Steps To Implementing Your Transitional Duty Program A company's Transitional Duty Program is established to provide continuous employment for employees who cannot perform all job functions temporarily because of a work-related injury or illness.
A good company lets their employees know their goal is to ensure every employee remains an active part of the workforce. The Three Phases of Implementing a TD Policy Explain the TD Work Assignment Include information on compensation benefits to injured workers' compensation Discuss the purpose of periodic reviews Explain the Transitional Work Assignment 1. The company attempts to find a job that is similar to the employee's original job. 2. Participation in the Transitional Duty Program is a condition of employment. 3. If an employee's original job cannot be modified to accommodate transitional duty restrictions or if another job cannot be found at the original work-site then the employee may be transferred to a nearby location for the transitional duty period. 4. All transitional duty assignments occur during regular business hours of the location. 5. If the original job unit cannot accommodate the employee with a transitional duty assignment, the employee works at no cost to the new location. 6. If the employee does not want to perform the transitional duty position offered, eligibility for 12 weeks of unpaid leave under the Family and Medical Leave Act may be possible. 7. However, employees do not receive workers' compensation benefits for FMLA leave. Such employees should consult the Human Resources Department for information about this option. TD Information on Compensation for the Injured Employee 1. Employees on transitional duty assignment are ineligible for overtime. 2. If transitional duty is unavailable, the employee is paid for lost work time in accordance with applicable state law. 3. If transitional duty is available and the employee refuses the assignment, lost wage benefits are denied if allowed under state law, because the employee voluntarily withdrew from the workforce, not because of the injury. The Purpose of Transitional Duty Periodic Review 1. In no case will a transitional duty position last more than 120 days and the employee must always be progressing, improving. 2. When employees reach maximum medical improvement, they return to their original positions. 3. If an employee reaches maximum improvement and is unable to resume the pre-injury position, if required by the Americans with Disabilities Act, the company will offer another position, with or without a reasonable accommodation, if one is available. (workersxzcompxzkit) 4. If no other position is available, the employee will be separated from the company.
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. We are accepting short articles* (200-300 words) on WC cost containment. To: Info@WorkersCompKit.com. *Non-compensable.
WC Best Practices IQ Test: http://www.workerscompkit.com/intro/ WC Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php Return to Work in Unionized Companies http://reduceyourworkerscomp.com//Return-to-Work-Programs-Unionized-Companies.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker about workers' comp issues. ©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
Myths and Realities: Elephant Bites
Myth: Employees stay out of work intentionally because they don't want to go back to work.
REALITY: Employees often don't come back to work because a company won't offer them a transitional duty assignment while they recuperate. While some employees try to stay out of work, that's not always the case. In some situations, where an employer has only a few, narrow job classifications in their operation, there aren't many transitional duty options; in these situations the employer must "think outside the box" to locate jobs not obvious at first glance. Employees are motivated to come back to work because they have friends in the workforce, they need a steady daily routine, and they don't want to become deconditioned while not working. In many cases, employees become depressed with the loss of their routine. Employees need a destination to go to each day!
Myth: Once implemented your workers' compensation premiums will immediately go down.
REALITY: The loss costs (as distinguished from the premium) will fall immediately, but the premiums take several years to fall because they are calculated based on a company's experience modification, usually a 3-year rolling average. As one good year "rolls" into your experience, a bad year drops out so it takes three years for the full benefit of a workers' compensation cost containment program to be reflected in your premiums.
Myth: High workers' compensation costs are caused by aggressive plaintiff's attorneys and laws favoring employees. REALITY: There are many things a company CAN DO, which are within their control, to reduce their costs. These gaps cost companies millions of dollars each year by failing to use the tools already available to them. 1. Inaction and lack of planning, poor communication with the employee, adjuster and medical providers are major gaps driving the cost of workers' compensation higher. 2. Poor workplace morale and failure to take advantage of existing opportunities are other gaps in company processes which drive costs higher. For example, if you operate in a state where employees are allowed to go to the physician of their choice, you can "coach" them to a physician who advocates transitional duty. Some will use the doctor you suggest. If the employee's doctor has visited your operation to see the jobs the employees perform, it can be helpful to build a solid relationship between the company and the treating doctor. So, while it is somwhat true aggressive plaintiffs' lawyers prolong an employees time out of work, thus making the cost of the claim higher, and laws \ viewed as claimant-oriented can drive the cost of a claim higher, it only part of the story.
Myth: Workers' compensation cost containment programs are a "quick fix" to the high costs of workers' compensation. REALITY: An effective workers' compensation cost containment program is a systematic and thorough approach to cost reduction – not a "quick fix." It focuses on multiple areas all tied together with an effective communication strategy. The design and development of a workers' compensation cost containment program can be done within a few months if there are dedicated resources making design and implementation a priority.
Author: Rebecca Shafer, J.D. consults for mid-market and national accounts focusing on project management, risk management assessments, data review, benchmarking, and development of Workers' Compensation and Injury Management Programs. Projects focus on development of training and education programs, document design, evaluation and integration of insurance claims administration and TPA services. Contact her are: RShafer@ReduceYourWorkersComp.com We are accepting short articles* (200-600 words) on WC cost containment. Contact us at: Info@WorkersCompKit.com. *Non-compensable.
WC IQ Test: http://www.workerscompkit.com/intro/ WC Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php NEW Article: Return to Work in Unionized Companies http://reduceyourworkerscomp.com//Return-to-Work-Programs-Unionized-Companies.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker about workers' comp issues. ©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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