As often stated our articles are usually about workers’ compensation cost containment for employers. So, why do we talk about laws seeming to favor or be directed towards employees?
It’s simple. In accounting there are direct expenses: costs of doing business known about and planned for. Then there are indirect expenses: these costs are somewhat unknown, or if know, the exact amounts are not fixed.
Think of fines, fees, penalties and the time and aggravation of law suits when employers do not obey labor laws and allow acts of discrimination, hostile work environments, unsafe workplace activities, etc. as the “indirect expense” of your workers’ compensation program – not planned but costing BIG BUCKS. And, as mentioned many times – your company is now on the work comp enforcement team’s radar and they are looking at you.
A new law, effective last week in New York, expands protections for workers who exercise their rights under state labor law by increasing the minimum civil penalty against employers who retaliate against employees from $200 to $2,000 and the maximum penalty from $1,000 to $10,000.
In addition, the law allows the Commissioner of Labor to award lost compensation to workers who have been victims of employer retaliation. by Governor David Paterson signed the law on August 26, 2009.
While New York’s labor law has long prohibited employers from retaliating against employees who report violations to the Labor Department, the new law greatly strengthens that protection. Retaliation occurs when employers take adverse action against employees for filing claims or providing information to the Labor Department about violations. Retaliatory acts can include discharge of the employee, demotion, cutting pay, or reassignment to a less desirable work shift or work duties.
Gov. Paterson noted, ”Every worker in New York is afforded basic protections under state labor law – minimum wage, meal breaks and the right to be paid in a timely manner. Oftentimes, when workers are not afforded those rights, many are too apprehensive to come forward due to fear of retaliation by their employers. This law will persuade more workers to come forward, while at the same time ensuring that lawbreaking employers who do retaliate against workers will face stiff penalties.”
This new law is designed to not only protect workers, but also law-abiding employers who are put at a competitive disadvantage by scofflaw employers who grossly underpay their workers or commit other violations of the labor law.
In January 2009, Gov. Paterson announced that through enhanced enforcement of existing labor laws, the Department of Labor collected and disbursed $24.6 million for more than 17,000 workers across the State. These recovered wages represented the largest amount of collected and distributed monies in the Labor Department’s 100 years of existence.
However, increased enforcement also can lead to increased worker retaliation. Since 2007 there have been a number of instances of retaliation. For example, three restaurant workers on Long Island were fired for complaining to the Labor Department about subminimum wages; a backstretch worker from the Saratoga race course was denied a job he had been promised because of his role in the Labor Department investigation of the industry; and a supermarket bagger was discharged after reporting that he got only tips, no wages at all.
If this law had been in effect at the time of these violations, the Department could have imposed as much as $10,000 in civil penalties per violation, rather than the maximum amount of $2,000 available under previous law. (workersxzcompxzkit)
State Senator George Onorato, the chairman of the Senate Standing Committee on Labor added, “All too often, workers who turn to the State Department of Labor to help them recover unpaid wages or receive help with other labor law violations end up getting fired, or are otherwise victims of workplace retaliation – including reduced hours, losses of benefits, and different work assignments – by their employers. Employers who willfully underpay their workers or otherwise violate labor rights and protections must be held accountable for their actions, and worker ‘whistleblowers’ who attempt to stand up for their rights must be able to come forward and seek help without fear of losing their jobs.”
Author Robert Elliott J.D./ Consultant.
He can be contacted at: Robert_Elliott@ReduceYourWorkersComp.com
TO DOWNLOAD OR LISTEN TO FREE AUDIO PODCAST click here: http://www.workerscompkit.com/gallagher/mp3
By: Anthony Van Gorp, private investigator with 25 years experience.
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@ReduceYourWorkersComp.com
Four Things to Coonsider When Settling a Workers Compensation Claim: Future Employment, Future Medical, Voluntary Resignations, Strategy Considerations
1-Availability of Future Employment in the Marketplace
In the industries where employees perform physical labor, one of the obstacles to the successful settlement of the work comp claim is the ability of the employee to return to work with their disability. For instance, the employee’s prior job required the employee to lift 50 pounds, and now the treating physician has given the employee a permanent 25 pounds lifting restriction.
The adjuster needs to work with your workers’ compensation coordinator to determine if there are other positions within your company to which the employee with permanent disability restrictions can transfer. This option is usually much lower in cost than having to retrain the employee to perform another type of work for another employer. Rehabilitation cost can add up quickly with no benefit to your company if you are required to re-train the employee who will then go elsewhere for employment.
2-Voluntary Resignations
If the consensus is the employee will be a continuing problem (either from a work comp standpoint or for other reasons) if the employee returns to your workplace, a voluntary resignation in conjunction with the work comp settlement might be the best approach in those states allowing it. If the employee’s resignation will require additional financial consideration, then the cost and benefits of the employee not returning should be weighted and evaluated.
Some states prohibit the discharge of an employee or the voluntary resignation of an employee in conjunction with the settlement of the work comp claim. Such actions are viewed as a retaliatory discharge and can result in large fines and/or litigation. Therefore, it is essential to know the work comp statutes in the state where you have an employee who you don’t want to return to work. Resource: http://reduceyourworkerscomp.com//laws_and_regulations.php
If voluntary resignation from employment is desired, have your legal department prepare a release of all future claims. Execution of a release should be mandatory; otherwise the employee can take the settlement, then turn around and reapply for a position at your workplace. Make sure to include the provision for releases in your account handling instructions.
3-Value of Future Medical
A tactic commonly used by plaintiff attorneys is to overstate the value of future medical. Your medical director should review any estimate of future medicals over a predetermined limit set by your Risk Management Department. Often it will be necessary for the medical director to consult with both the treating physician and the IME doctor to pinpoint what is necessary and what is fluff in the future medical estimate provided by the plaintiff’s attorney.
Once the medical director establishes what is needed for future medical care, the adjuster and/or defense attorney should resist budging from the amount, even if it necessitates adjudicating that aspect of the claim with the workers’ compensation board.
4-Strengths and Weaknesses of Both Sides
When it comes to settling your workers’ compensation claims, an experienced adjuster who can properly evaluate the pros and cons of the claim is your best asset in obtaining a fair and appropriate financial resolution of the claim. You want an adjuster who will fight the good fight when there are reasons to either deny or mitigate the claim.
You do not want the adjuster who takes an unsustainable position on a claim. On average, this creates more in legal expenses then you save in reduced cost of the claim.
Author: Robert Elliott, Esq., Robert_Elliott@ReduceYourWorkersComp.com
TO DOWNLOAD OR LISTEN TO FREE AUDIO PODCAST click here: http://www.workerscompkit.com/gallagher/mp3
By: private investigator with 25 years experience.
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@ReduceYourWorkersComp.com
MEDICAL CARE COORDINATION Medical care coordination means making sure your injured employees receive the BEST possible medical care. You must make medical care coordination the central focus of your workers' compensation management program, especially if your company does not have a transitional duty program. Medical costs are hovering around 60% of workers' compensation costs, so it's worth it to pay attention to the quality of medical visit. The physician usually decides if and when your employee returns to work and under what restrictions. Therefore, to the extent you can, make sure you obtain the best physician who can provide a smooth resolution of medical problems and the earliest, medically appropriate return to work date for injured employees. When you establish a medical provider arrangement, discuss the cost of medical visits up front. Make sure the doctor is happy with the rate you are paying. If not, you may not get the best quality care, and the doctor certainly won't spend any extra time with your employees. TPA SPECIAL doctors have many different names. Ask your TPA whether they evaluate and designate the best doctors, with the shortest durations, in their network. If so, set up a process so your employees use that network. I recently worked with a company that had high network penetration, but it wasn't the SPECIAL doctors, it was the regular network. If a physician charges more than the standard fee, it is often worth your while to pay the difference because you know you are getting the best, most relevant medical care for your injured employee. Establish working relationships with the medical providers your employees will use throughout the life of their claims. Physician Communication issues fall into three categories chronologically: 1. Before care begins 2. Throughout the course of treatment 3. Until the claim is closed Familiarize yourself with the workings of the treatment facilities and if , in your state, you get to choose, make sure your medical facility has physicians with backgrounds in workers' comp injuries, a good physical therapy unit, providing a variety of follow up treatments. Resource to find out how medical care is selected in your state: http://reduceyourworkerscomp.com/workers-compensation-state-laws-and-regulations.php Make sure physicians and treatment facilities are well versed in using the Workability form and faxing it back in a timely fashion. Make sure they are familiar with your return-to-work program and transitional duty program, so they can work with you to provide the best modified duty job for that injured employee. Their cooperation with your return-to-work program, using your forms, returning your calls and getting medical reports to you in a timely manner is one of the critical points in a cost containment program that can become either a bottleneck or a huge help. Several types of doctors participate in a workers' compensation claim. Each type plays a particular role; you should understand and learn when to best use them. (workersxzcompxzkit) Visit the clinics and hospitals your employees use to ensure these facilities are safe, considerate and adequately staffed. They should also have qualified personnel trained to treat work injuries. Find out who the doctors and other medical personnel are and their specialty areas, so in the event a work related injury occurs, and your injured employee goes to a certain facility, you will be well versed with the doctors there and the kinds of services they can offer. Calendar visits for every 12 months, so you can stay abreast of current staffing. TO DOWNLOAD OR LISTEN TO FREE AUDIO PODCAST click here: http://www.workerscompkit.com/gallagher/mp3 By: Anthony Van Gorp, private investigator with 25 years experience.
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@ReduceYourWorkersComp.com
“Recreational Activity Injury” or “In the Course of Employment Injury”
How Would You Decide: Oregon Worker’s “Saunter” Across Employer’s Parking Lot to Make Bank Deposit Was Not a “Recreational” Activity and Occurred “In the Course of” the Employment, But Case Remanded to Determine if Injury Actually “Arose From the Employment.” Here’s what Tom Robinson, J.D., writer for Lexis Nexis Workers Comp Law Center reports.
Here’s What Happened
During a paid morning break from her work at her employer’s hospital, claimant decided to deposit a personal check at a credit union located at a different part of the employer’s campus. She left the hospital, crossed a street, and started to cut across a parking lot. While in the lot, she slipped on ice and fell, fracturing her right ankle. Claimant filed a workers’ compensation claim and the employer denied it on the ground that the injury did not arise out of and in the course of the employment.
The administrative law judge (ALJ) determined that the injury was compensable and reversed the denial. Agreeing, in relevant part, with a decision by an administrative law judge, the Workers’ Compensation Board determined that because claimant’s errand was not a recreational or social activity performed primarily for her personal pleasure [Ore. Rev. Stat. § 656.005(7)(b)(B)], and because claimant’s employer controlled the parking lot where the fall occurred, the injury was sufficiently work-related to be compensable. The employer appealed.
Here’s What The Court Decided:
In Legacy Health Systems v. Noble, 2009 Ore. App. LEXIS 1814 (Nov. 18, 2009), the Court of Appeals of Oregon agreed that claimant’s injury did not occur during a social or recreational activity and that it occurred “in the course of the employment,” but, because the board failed to determine whether the injury arose “out of” claimant’s employment, the decision was reversed and remanded. Turning first to the issue of social and/or recreational activities, the appellate court observed that as the Supreme Court had explained (in Roberts v. SAIF, 196 Ore. App. 414, 417, 102 P3d 752 (2004), aff’d, 341 Ore. 48, 136 P3d 1105 (2006)), the exclusion for “recreational or social activities” was a legislative reaction to Beneficiaries of McBroom v. Chamber of Commerce, 77 Ore. App. 700, 713 P2d 1095, rev. denied, 301 Ore. 240, 720 P.2d 1279 (1986), a case in which the Court of Appeals found compensable the death of a travelling salesman who, on a business trip to Los Angeles, became extremely inebriated and drowned in his hotel’s hot tub. The appellate court also noted that the typical “recreational activity” case involved “off-the-job group recreational or social activities such as picnics, office parties, or organized or spontaneous sports or games” [Roberts, 196 Ore. App. at 416 (citing cases)].
The appellate court indicated that here, claimant’s activity did not fit the established definition, nor was it the kind of activity that the court had previously recognized as “recreational.” Instead, claimant was walking to the bank, while on the clock. The court stated that by no stretch of the imagination could it conclude that claimant was refreshing her strength and spirits after toil or engaged in play, diversion, or entertainment.
The court continued that to occur “in the course of” employment, “the time, place, and circumstances of the injury must justify connecting the injury to the employment,” that injuries sustained while an employee was going to or coming from the place of employment generally did not occur within the course of employment. One exception, however, related to company parking lots. Generally, an injury sustained on premises controlled by the employer while an employee was coming to or going from work occurs within the “course of employment.” The court also saw no reason to distinguish, for purposes of the parking lot rule, between a worker’s injury while going to or coming from work at the beginning or end of the work day, on the one hand, and an injury incurred while going to or coming from lunch, on the other. Likewise, the court saw no distinction between lunch and a break. (workersxzcompxzkit)
The court observed that in order to prove compensability, however, a claimant must establish both parts of the unitary work-connection test, including whether the injury arose “out of” the employment. Citing various authorities, the court stated that an employer is not liable for any and all injuries to its employee, irrespective of their cause. Nor does the fact that an employee was injured on the premises during working hours, of itself, establish a compensable injury. The employee must still show a causal link between the occurrence of the injury and a risk connected with his or her employment. The court agreed with the employer that neither the ALJ nor the Board addressed the “arising out of” aspect of the work-connection test. The matter had to be remanded, therefore, for such a consideration.
See generally Larson’s Workers’ Compensation Law, §§ 13.04, 13.05, 22.02, 22.03.
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). 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
TO DOWNLOAD OR LISTEN TO FREE AUDIO PODCAST click here: http://www.workerscompkit.com/gallagher/mp3
By: Anthony Van Gorp, private investigator with 25 years experience.
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@ReduceYourWorkersComp.com
NCCI Study Looks at Benefit Increase Impact
In a new study, NCCI uses a “difference in differences” methodology to analyze the impact of benefit changes Oregon and New Mexico. They found for each $1 of direct benefit increase, there is an added $0.54 average cost due to increased claim durations. The results of this analysis provide support for the utilization effects of statutory changes in indemnity benefits.
For Oregon, the 33% increase in the maximum weekly TTD benefit resulted in a 17.5% impact on utilization. This implies a duration/benefit elasticity of 0.53 (17.5%/33.%).
In New Mexico the 7.6% increase in benefit duration in response to a 17.6% increase in the maximum weekly indemnity benefit translates into a duration/benefit elasticity of 0.43 (7.6%/17.6%).
In terms of TTD indemnity costs, both the Oregon (38%) and New Mexico (33%) studies show approximately 35% of the total cost impact can be attributed to a duration utilization effect.
The focus of this research has been on two event studies where TTD benefits had increased. Some might interpret the findings to also conclude that a decrease in TTD indemnity benefits would result in a utilization impact. However, no such analysis was performed to reach such a conclusion.
Note the difference in differences approach used here captures the portion of the utilization effect attributable to changes in duration only. In other words, this method is not suitable for measuring the impact on the frequency of claims that may arise from a statutory indemnity benefit change. However, there are studies indicating that statutory indemnity benefit changes may affect frequency. (workersxzcompxzkit)
NCCI’s estimate of the utilization impact on claim durations from a change in statutory indemnity benefits reasonably agrees with estimates of prior studies, thereby providing additional support for the inclusion of such utilization impacts in legislative cost analyses. Producing more accurate and responsive cost impacts will reportedly enhance the legislative pricing and ratemaking services offered by NCCI, and it will provide valuable information to aid public policy decision making.
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 860-553-6604.
TO DOWNLOAD OR LISTEN TO FREE AUDIO PODCAST click here: http://www.workerscompkit.com/gallagher/mp3
By: Anthony Van Gorp, private investigator with 25 years experience.
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@ReduceYourWorkersComp.com
Quebec Government Holding onto Health Report
For eight months, the Quebec government has been holding on to a report looking into the link between asbestos-related cancer and Canada’s only community that still mines the substance. The Canadian Press reports the study is believed to be the first Canadian research to look at asbestos-related cancer in a specific region, examining the risk of disease in and around Thetford Mines, Quebec.
Quebec‘s public health institute delivered the completed report to regional officials and the provincial Health Department in March. The study, and its potentially alarming conclusions has not, as yet, been made public but officials say it will be this month (December 09).
The mining of asbestos is an intensely sensitive issue in Quebec, where it provides around 400 jobs at the province’s one remaining mine. The industry fiercely defends Quebec asbestos — also called chrysotile — and labels the product perfectly safe as long as precautions are followed.
The provincial government, the Bloc Quebecois and the federal Conservatives all support the asbestos industry’s claims that the product can be used safely. In 2008, Canada’s $100-million asbestos industry exported 175,000 ton of chrysotile — almost all of it to developing nations.
The material, recognized for its heat- and fire-resistant qualities, was widely used in Canada and around the world between the 1950s and the ’70s, often as insulation. Several countries, especially poorer ones, still import asbestos from Canada despite numerous studies linking it to health hazards, including cancer.
Cases of such illness appear to be increasing. Mesothelioma, a lethal cancer linked to asbestos in over 80% of cases, killed 32% more Canadians in 2005 than in 2000, according to Statistics Canada’s the most recent national figures.
In Canada, asbestos-related diseases are the number one workplace killer, striking not only retired miners, but also former ship builders and constructions workers. Across Canada, the number of reported new cases annually of mesothelioma shot up 67% in one and one-half decades — from 276 to 461. (workersxzcompxzkit)
Since it takes 25 to 40 years after exposure for many asbestos-related diseases to surface, experts predict the death toll will continue to climb for years as Canada experiences the lingering effects of its asbestos boom.
“FRAUD PREVENTION” Free AUDIO PODCAST click here: http://www.workerscompkit.com/gallagher/mp3
By: Anthony Van Gorp, private investigator with 25 years experience.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or 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@ReduceYourWorkersComp.com
Medical Issues
Both the work comp adjuster and your work comp coordinator need to have a solid understanding of common medical problems faced by employees recovering from on workplace injuries. When either the adjuster or your work comp coordinator does not understand the nature of an employee’s medical issues they need to either research the medical issue by contacting the treating physician or your insurance company’s/TPA’s medical director BEFORE SETTLING THE CLAIM.
A discussion explains the medical issue and how it will affect the employee long term. A complete understanding of the medical issue(s) facing the employee is necessary for a proper evaluation of the value of the claim. The internet may also be used (judiciously) for research.
Often a stumbling block to the successful settlement of a work comp claim is the lack of understanding by the employee of the medical issue(s) currently being experienced. The nurse case manager on the file should always be present at the employee’s conference with the treating physician when the future prognosis and future treatment and care are discussed. The nurse case manager can assist the employee in obtaining answers to all questions about the medical condition. This helps to alleviate the employee’s fear about the future, making it easier for the adjuster to settle the claim.
Disputed Issues
Disputes are unavoidable in the handling of work comp claims. Disputes arise from almost all aspects of the claim including whether or not the medical issue is work related, the amount of the temporary total disability benefits, the medical benefits provided, the disability rating and the value of future medical benefits. While disputes cannot be totally eliminated, the adjuster can reduce the number of disputed issues and reduce the contentiousness of the disputes.
As part of the Best Practices established by your Risk Management Department, you require the adjuster to make immediate contact on each new claim reported, plus you have required the adjuster to maintain regular contact with the employee throughout the course of the claim.
The employee is primarily concerned about all aspects of the claim being handled promptly and fairly. The rapport built up by your adjuster with the employee through regular contact eliminates many disputes. If the employee contacts the adjuster whenever there is a problem or a question rather than an attorney, the end result of the claim will be much better. If the employee does not hear from the adjuster in months, the employee will have no confidence in being treated fairly by the adjuster to resolved problems.
When the employee is represented by an attorney and a dispute does arise over what will be paid, the adjuster must have a thorough understanding of the work comp laws in their state. http://reduceyourworkerscomp.com//laws_and_regulations.php
Most jurisdictions have previously resolved every imaginable type of dispute over wage benefits. What is and what is not covered can usually be found in either the written statutes or case law. The knowledgeable adjuster can point out to the employee’s attorney the governing law or ruling defining and determining what is owed/not owed. (workersxzcompxzkit)
The area of disputes most often in contention is medical benefits. When the employee’s doctor selected by the employee’s attorney wants to continue treatment beyond what is necessary, or the employee wants to try the latest unproven experimental treatment, it is essential for your IME doctor to be highly proficient in his/her specialty. Your IME doctor must be able to testify if necessary as to why the medical treatment sought by the employee/employee’s attorney is not justifiable.
TO DOWNLOAD OR LISTEN TO FREE AUDIO PODCAST click here: http://www.workerscompkit.com/gallagher/mp3
By: Anthony Van Gorp, private investigator with 25 years experience.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or 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@ReduceYourWorkersComp.com
Better Business Outcomes Linked to Health/Safety Practices
Workplaces committed to integrating health and safety practices into their operations are more likely to enjoy better business outcomes according to a report released today by the New Zealand Department of Labour. “Health and safety investments in the workplace do not compete against investments in productivity,” says Craig Armitage, head of Workplace Health and Safety for the Department of Labour. “The two go hand-in-hand.”
The 2008-09 annual snapshot report on progress in achieving the Workplace Health and Strategy for New Zealand to 2015 demonstrates the varied ways workplaces throughout New Zealand are contributing to good progress in the three key areas of strategic focus
1. Government leadership and practices
2. Preventive workplace cultures
3. Industry leadership and community engagement
“What has become evident is that business leaders need to provide strong, proactive leadership to instill the importance of the health and safety process in their businesses,” Armitage said. “During the year, 120 business leaders met at the Leaders in Health and Safety Summit to consider ways to build a New Zealand workplace safety culture. A high powered, cross-industry group has also been formed, made up of chief executives who recognize the importance and value of healthy and safe workplaces. (workersxzcompxzkit)
“This business leaders’ forum is committed to driving workplace safety through their own organizations and demonstrating to others the value of doing so. They are focusing on practical steps to reduce the $16 billion annual cost of workplace injuries and illnesses.” The snapshot report can be found at www.whss.govt.nz/snapshot08-09/index.html.
Also during the year, there was an operational review of the Workplace Health and Safety Strategy for New Zealand to 2015, mandated when the strategy was launched in 2005. Armitage said the review’s findings confirm the strategy is soundly based. It also identifies new activity in areas with the potential to result in improvements in New Zealand’s health and safety performance. The review’s findings will be released before the end of the year.
TO DOWNLOAD OR LISTEN TO FREE AUDIO PODCAST click here: http://www.workerscompkit.com/gallagher/mp3
By: Anthony Van Gorp, private investigator with 25 years experience.
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@ReduceYourWorkersComp.com
If not properly coordinated, a company's employee benefit and compensation programs may inadvertently serve to extend workers' compensation absences. That happens because there is no incentive to return to work when someone is able to make as much OR MORE when NOT WORKING. When designing your integrated disability managment programs, keep this in mind.
If your projected workers' compensation savings have yet to materialize even though your company has implemented a corporate return-to-work program, multiple employees could be following this pattern: an injured employee receives long-term disability (LTD) in addition to workers' compensation benefits and the total exceeds his pre-injury earnings.
If the employee also had credit disability insurance, his house and car payments would be eliminated as long as he was unable to work. Child care and commuting expenses would also be reduced while your employee stays home. As such, he refuses your offer of a transitional duty job at full salary.
It may be time to examine the impact of collateral resources, often resulting in employees out on workers' compensation receiving more income and benefits than they would have if they were working.
Some disincentives for returning to work:
1. Salary and Wage Continuation: Some companies pay 100% of salary in lieu of having an employee collect workers' compensation for injuries of short duration.
2. Occupational Injury Pay Supplements: Many firms pay supplemental benefits to make up the difference between workers' compensation benefits and regular earnings.
3. Open-Ended Job Return: Instead of holding jobs open indefinitely, employers should hold jobs open for a specific time period.
4. Vacation and Sick Time: Companies frequently allow vacation and sick time to accrue for employees on workers' compensation. Some even allow employees to "borrow" more sick time.
5. Short-Term Disability: In some companies, disabled employees receive STD benefits in lieu of salary after six weeks. But the standard definition for disability may differ from workers' comp, allowing an employee to collect both.
6. Perk Continuation: Employers often maintain ancillary benefits and privileges such as car allowances, club and professional dues, and periodical subscriptions for employees on disability.
7. Loan Protection Policies: Individual insurance policies are available to pay mortgages and consumer loans such as car loans and credit card debts in the case of a disability.
8. Unemployment Compensation: In a few states, an employee receiving workers' comp also can qualify for state unemployment benefits.
9. Pension and Retirement Plans: If these plans do not allow for offset of workers' comp benefits, an employee can receive workers' compensation benefits and a full pension. (workersxzcompxzkit)
10. Product Liability Actions: An employee can file an action against the manufacturer of a product that injured him to collect damages. The employer should seek reimbursement for workers' comp payment from any such settlement.
FREE "FRAUD PREVENTION" AUDIO PODCAST click here: http://www.workerscompkit.com/gallagher/mp3 By: Anthony Van Gorp, private investigator with 25 years experience.
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@ReduceYourWorkersComp.com
Auditors in North Dakota will conduct a fresh review of denied workers’ compensation claims and study the laws defining eligibility for certain benefits.
According to inforum.com, Workforce Safety and Insurance and the state workers’ comp agency, will audit its operations in 2008 and 2009. An independent review in 2008 by the BDMP consulting firm of Portland, Maine, concluded claims analysts appropriately denied claims. The results from the review are expected by late summer.
The performance evaluation, by Sedgewick CMS in Memphis, Tennessee will compare North Dakota’s laws limiting payment of claims for workers with pre-existing conditions or degenerative disease, such as arthritis.
In addition the review will look at:
1. The adequacy of benefits paid to retired injured workers, again in comparison to benefits from other states. In particular, the study will look at how collecting Social Security benefits affects benefits.
2. Permanent partial impairment awards, which require as a qualifying threshold a finding that 16 percent of an injured worker’s body is impaired, a higher standard than once was set by law.
3. Use of prescription narcotics by North Dakota workers compared to use in other states, as well as among localities in the state. The report will include recommendations to “control and address variations” in narcotic prescription rates and treatment methods. (workersxzcompxzkit)
4. Large contracts with vendors to determine if the cost of services was reasonable and whether contracts were appropriately bid and awarded.
“FRAUD PREVENTION” PODCAST
TO DOWNLOAD OR LISTEN TO FREE AUDIO PODCAST click here: http://www.workerscompkit.com/gallagher/mp3
By: Anthony Van Gorp, private investigator with 25 years experience.
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@ReduceYourWorkersComp.com
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