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Eight Top Things an Employer Can Do Better to Reduce Work Comp Costs


Employers,  including those with a fully insured program have the ability to help reduce their worker's compensation claim costs by working closely with their agent/broker and carrier's claim and loss prevention representatives.  Developing those relationships goes a long way toward reducing costs both pre- and post-loss. 

Encourage  your injured employees to communicate with your carrier's adjuster by promptly responding to their questions and providing the requested information.  Involve your agent or broker and inquire as to whether they have a claim advocate to schedule and attend claim reviews with you.  Whether or not they have claim advocates, your broker or someone from his or her office should be involved with your claims and your account.  The claim review presents an opportunity for your carrier to talk about the status of each claim, the plan going forward and the financials (paid and reserved amounts with reserve rationale) with you and your agent/broker. 

1.  Discuss with  your agent/broker and carrier expenses such as law firms, nurse case management companies, surveillance and medical management vendors and ways to reduce costs. 
2.  Respond  promptly to requests from your carrier for wage statements or other information necessary to adjust the claim properly.
3.  Share  with your carrier information you "hear" including that an injured worker losing time from work may be working elsewhere or active beyond his or her restrictions. 
4.  Educate  your management staff so injury reports are completed and claims reported immediately to your carrier. 
5.  Follow  the recommendations made by your carrier's loss control representative.  They're experts in recognizing hazards and recommending changes that will prevent injuries. 
6.  Implement  a strong early return-to-work program that's actively managed to eliminate to the extent possible lost workdays, and lost-time benefits. 
7.  Engage  all employees to watch for hazards, such as spills on the floor and clean them up before someone slips and falls.
8.  Request  feedback from your carrier and agent concerning your practices relative to reporting and managing claims and loss prevention.  They can help identify and prioritize areas for improvement such as timely reporting, providing documents and information or preventing claims resulting from the same hazard (an area of torn carpet causing tripping).  (workersxzcompxzkit) 9.  Partner  with your agent/broker and carrier to reduce claim frequency and costs.  These business partners should be more than willing to work with you in cost containment and loss reduction efforts. 

By following  these few simple steps you just might be surprised how you can reduce your costs of workers' compensation and provide a safe environment for your employees.

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.

Podcast/Webcast: How To Prevent Fraudulent Workers' Compensation Claims Click here http://www.workerscompkit.com/gallagher/podcast/Fraudulent_Workers_Compensation_Claims/index.php

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 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

Posted in Lowering Premiums & Experience Mod, Risk Management |


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Five Strategies Tried to Avoid Medicare Set Asides


While Medicare Set-Asides (MSAs) are designed to protect Medicare and the claimant, claimants and their attorneys often look for ways around them. Generally, avoiding MSAs is tough to do. 

Strategies Tried to Avoid MSAs

1. There is one approach  to avoiding MSAs that works — go to court or to the work comp board. The Centers for Medicare and Medicaid Services (CMS) will honor judicial decisions by a court or state work comp boards after a hearing on the merits of a work comp claim. If the court or a state's workers' comp board designates a portion of the funds to future indemnity and a portion to future medical care, then Medicare will accept that designation of funds. The downside to this approach is the insurer and the claimant are not negotiating the settlement.

For CMS to honor
 the court's decision or ruling, it must be solely the court's or work comp board's decision, not the court or work comp board approving a settlement agreement entered into by the claimant and insurer. CMS will not accept the terms of the court or work comp board approved settlement if the amount of the future medical payments are inadequate to cover all future medical expense. CMS takes the position that if Medicare's interest are not protected, then Medicare will not pay for medical services related to the work comp claim until the work comp related medical expenses have exhausted the entire WC settlement, including what was designated as indemnity. If Medicare determines it has paid for a work comp related medical expense, it will seek reimbursement from the claimant and/or the medical provider.

2. Occasionally you will
 have the claimant who really does not want to deal with Medicare or who thinks he can outsmart CMS. The claimant will be willing to waive his interest in any future medical care related to his work comp settlement to reduce or eliminate the portion of the MSA related to medical. The claimant can even go so far as to sign an affidavit or some other legal document asserting Medicare will not be billed for any medical services not included in the MSA. 

This approach will not work
. The Regional Offices (RO) of CMS will not approve work comp claim settlements agreeing not to bill Medicare for future work comp related medical care.

3. Another approach taken
 by some work comp claimants is to refuse to enter into a settlement involving the CMS or a MSA. They take the approach if no one tells CMS about their work comp claim, they will settle now and even settle for a little less. Do not go there! 

The CMS position
 is you are still responsible to comply with the law. When CMS finds out about the work comp claim (and they will), CMS will pursue recovery for the payments they have made for work comp related medical service. When the claimant refuses to settle because of the potential for CMS involvement, your insurer should notify the CMS RO. The RO will send the claimant a certified letter asserting their interest in the WC settlement. The RO will quote the statute's book and verse to the claimant. 

Again, CMS
 will take the position that if Medicare's interest is not protected, they can refuse to pay for medical services related to the work comp claim until the work comp related medical expenses have exhausted the entire WC settlement, including what was designated as indemnity.

4. A favorite approach
 of some claimant attorneys is to go the structured settlement route in an effort to circumvent the CMS and the need for a MSA. For example, they put forth that the cost to purchase the structured settlement is $200,000 and that the claimant is not yet enrolled in Medicare. The proposed structured settlement is $50,000 now and $20,000 per year for 15 years, or a total payout by the structured settlement of $350,000 ($20K X 15 yrs = $300,000, + $50K).  

This will not work
 either if the claimant has a “reasonable expectation” of enrolling in Medicare within the next 30 months. CMS will not look at what is paid today for the structured settlement ($200K), but at the total amount to be paid to the claimant over the life of the structured settlement ($350K).

5. Then there is
 the claimant and his attorney who want the all cash settlement for $250,000.00 and not one penny more (as it would then be greater than $250K and subject to a MSA). However, the insurer (and probably the attorney as well) think the true value of the work comp settlement is $275K. To protect themselves the insurer or the attorney asks the CMS to issue a letter certifying that a MSA is not necessary. 

CMS will not
 issue such a letter. You can still settle for $250K and the claimant will not be subject to protecting Medicare's interest, if at the time of the settlement the claimant has not applied for Medicare and does not have “reasonable expectations” of doing so in the next 30 months. (workersxzcompxzkit)

DO THIS!
The best approach  is not to think of ways around the MSA on your very large work comp claims, but to protect the claimant from future Medicare recovery claims by having the MSA reviewed and approved by CMS. It is CMS's policy to review all proposed work comp settlements within 60 days (it does not always happen!) of all necessary documentation being presented.   Take the time for the CMS approval, in the long run you will be glad you did.

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.

Podcast/Webcast: How To Prevent Fraudulent Workers' Compensation Claims Click Here http://www.workerscompkit.com/gallagher/podcast/Fraudulent_Workers_Compensation_Claims/index.php


FREE WC IQ Test: http://www.workerscompkit.com/intro/
WC Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
TD Calculator: http://www.reduceyourworkerscomp.com/transitional-duty-cost-calculator.php
WC Calculator:
http://www.reduceyourworkerscomp.com/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
Posted in Litigation Management, Medicare Set Asides (MSAs), Settling WC Claims |


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Injuries Arising While Driving For Coffee Arose in Course of Employment


Injuries a New Jersey  foreman plumber suffered while driving for coffee arose in the course of his employment, a New Jersey appellate court recently ruled.
According to  Business Insurance, the January 13 decision by the Superior Court of New Jersey Appellate Division in Jason R. Goodbody* v. Barnickel Enterprises Inc. upheld a Division of Workers’ Compensation finding that Cooper suffered 100% disability as a result of a February 2003 auto accident resulting in compound fractures in both legs and his left arm. Barnickel appealed the division’s judgment, citing the accident occurred while Goodbody was on a personal errand unrelated to his work, irrespective of company authorization to use one of its vehicles.

The accident happened
 shortly after Goodbody left a union hall where he had gone to talk about an upcoming company project with a union instructor. But because the instructor was busy teaching a class, Cooper instead had a coffee break.

The New Jersey
 Appellate Division stated in its ruling that Goodbody, who is an “off-site” employee, i.e., one who does not report to a single job site, could not be expected to “stand like a statue or remain at the union hall with nothing to do for such a period, particularly when there was no coffee available at the site.” (workersxzcompxzkit)

Accidents occurring
 during coffee breaks for off-site employees are equivalent to those suffered by on-site workers and “are minor deviations from employment which permit recovery of workers’ compensation benefits,” the court stated.
*Name changed for privacy.

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.

Podcast/Webcast: How To Prevent Fraudulent Workers' Compensation Claims Click Here http://www.workerscompkit.com/gallagher/podcast/Fraudulent_Workers_Compensation_Claims/index.php

We acce
WC Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
TD Calculator: www.reduceyourworkerscomp.com/transitional-duty-cost-calculator.php
WC Calculator:
http://www.reduceyourworkerscomp.com/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
Posted in Litigation Management, Safety and Loss Control |


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Industry Survey Shows Employers Fall Short in Workers Comp Cost Control


Results of First Industry wide Survey at Best Practices for Post-Loss Cost Control

The first-ever  industry wide survey on best practices for post-loss workers' compensation cost control reveals that most employers are falling short, according to Advisen, which conducted the survey for the Risk & Insurance Management Society.

The 2009 RIMS Benchmark Survey    included for the first time a workers' comp best practices survey. Respondents included 1,127 organizations in the United States and Canada.  

The survey  included ten questions selected from the National Workers' Compensation Management Score assessment survey in the Workers' Comp Kit located at www.ReduceYourWorkersComp.com  from Amaxx Risk Solutions.

Each respondent  received a numerical score, with 26 representing the high possible score. The average score was 11.1.  Only 11%, or 127 respondents, scored in the top category (20 to 26 points) considered to be best-in-class, while 215 organizations scored 0 or below. The companies in the best practice classification represented a broad range of industries including retail, wholesale, healthcare, education, energy, finance, construction and shipyard/aerospace/defense, as well as public entities such as city and local governments. These top-scoring companies are headquartered in the U.S. and Canada; many have both domestic and international operations.

"The top scorers  consistently use nearly every type of resource and tool listed in the survey," said Dave Bradford, editor-in-chief  at Advisen.  "They perform onsite file reviews, have a post-injury response procedure that is consistently applied across all locations, and have return-to-work programs that are implemented at all locations."

Consumer discretionary  companies had the best average score, 13.5.  Financials scored lowest at 8.0.  Nonprofits (10.7) and materials companies (11.2) were in the mid-range among the 12 industry groups.  Several survey questions included: Has a representative of your company reviewed some of your workers' compensation claim files within the last 6 months?  Most companies (65.7%) did the review onsite, 10.6% did not perform file reviews, and the remainder did phone or online reviews.  File reviews are crucial in keeping control over cases, according to Rebecca Shafer, industry expert. How consistently does your company follow written "post-injury response" plans describing procedures within the first 24 hours after an injury?   

Some 60.4% of respondents said they followed a post injury procedure consistently; the remainder said only some locations had these procedures, and others indicated they have no written plans.  No workers' comp program can function well without following a written plan, Shafer said. How consistently does your company follow a return-to-work policy where an injured employee returns to work in a temporary position until they have recovered? 

Almost 60% (58.5%) said they followed a policy in all locations and 26.9% said they followed a policy in some locations. Thus, over 80% of companies have return-to-work policies, at least at some locations. Although this leaves room for improvement in this best practice area, it serves as a benchmark for companies without a return-to-work program, that the majority of companies have such a program. Do your operating units visit the medical facilities where your employees receive medical care for occupational injuries? 

Only 19.2% of respondents said they did so consistently, even though this is an excellent opportunity to establish rapport with the doctor, explain what the company does, and show the doctor the transitional duty jobs performed at your workplace. Additional survey  questions let companies know what others in the industry are doing to control workers' comp costs. The questions above are merely samples illustrating the valuable information inside the complete survey.

(workersxzcompxzkit) The 2009 RIMS Benchmark Survey  can be purchased from Advisen at http://corner.advisen.com  It is an opportunity to learn what other companies do to reduce their workers' compensation programs. For free workers' compensation tools go to: http://corner.advisen.com/wc_free_tools.html. For free workers' compensation cost containment podcasts, go to:  http://corner.advisen.com/wc_podcast.html

Podcast/Webcast: How To Prevent Fraudulent Workers' Compensation Claims Click here  http://www.workerscompkit.com/gallagher/podcast/Fraudulent_Workers_Compensation_Claims/index.php

 
TD Calculator: www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
WC Calculator: http://www.reduceyourworkerscomp.com/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

Posted in Assessment & Diagnostics, Benchmarking & FTE & Operational Comparison, Professional Development Issues, Risk Management |


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Australia Workers Comp Uses Integrated Approach to Wellness


Government officials  in Victoria, Australia are using Work Health,  a five-year, $218 million program designed to improve  the health and wellbeing of Victorian workers.
Officials say  the program represents a significant new investment in the health and safety of Victoria’s workers and a major contribution to the Victorian Government’s action on chronic disease prevention.
 
Over the  next five years, every workplace in Victoria will have the opportunity to take an active part in health programs in the workplace. Programs for workers will include workplace-based health checks and information, as well as access to advice and education programs to help workers reduce their risk of chronic disease.
 
Over time, the WorkHealth   initiative aims to reduce absenteeism, improve productivity, reduce injuries and reduce the burden on the Victorian health system. (workersxzcompxzkit)
 
Employers are  eligible to apply for worker health checks if they are a Victorian business or have Victorian-based operations and pay a WorkSafe Injury Insurance premium, or are an approved WorkSafe self-insurer.
 
Visit www.workhalth.vic.gov.au    and quote their promotional code 1011 in your worker health check / grant application.

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.

Podcast/Webcast: How To Prevent Fraudulent Workers' Compensation Claims Click Here http://www.workerscompkit.com/gallagher/podcast/

Fraudulent_Workers_Compensation_Claims/index.php


FREE WC IQ Test: http://www.workerscompkit.com/intro/
WC Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
TD Calculator: www.reduceyourworkerscomp.com/transitional-duty-cost-calculator.php
WC Calculator:
http://www.reduceyourworkerscomp.com/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
Posted in Safety and Loss Control, WC in Other Countries (International) |


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Adjuster Control and Guidance in Workers Comp Claims


Adjuster Control and Guidance
One of the  most frequent concerns heard about insurance companies is they settled a claim without the companies input. To make sure this doesn't happen, include in the account instructions information stating your company has "settlement authority."  

The workers'  compensation coordinator should know the capability and skill level of the adjuster(s) assigned to your program.  If your insurance company or your TPA has a revolving door of adjusters, or if the insurance company/TPA is using your program to train their trainees, it is time to get another insurance company or TPA.   The selection of experienced adjusters for your program will be cost beneficial. 

While you want experienced adjusters handling your claims for your company, you do not want the experienced adjuster who has learned every "short-cut" and takes every "short cut" on your claim files.  These "short cut" adjusters are not taking pride in the quality of their work product and often are more concerned about getting the claim closed and off their desk than anything else.  The extent of their investigation will be limited and their settlement evaluations will be higher than the other adjusters in their office.  Your company needs to insist on the right to approve/disapprove the adjusters handling your claims.

Your workers'  compensation coordinator needs to have access to the claims handling system of the adjusters, thus allowing your company to monitor the status of the serious claims or all claims if you elect to do so.  Your workers' compensation coordinator will be able to see which adjusters are complying with the Best Practices for claim handling, and which adjusters are not complying with the Best Practices. You can then have the adjusters who are not doing their best on your claims to correct their claim handling ways or be removed from handling your work comp claims.

Once you have  a team of experienced adjusters complying with the Best Practices, your workers' compensation coordinator needs to maintain regular contact with the adjusters by either telephone, e-mail, or direct input of instructional notes in the claim file system.

When a conflict  with an adjuster arises, for example the adjuster wants to settle the claim and your company does not believe the claim is legitimate, remember it is your company's money paying for the claim, whether it is through self-funding or higher premiums.  Your company should insist at the time the program is set-up n the  right to make the final decision on whether or not a claim is paid.  (There are a few states where the employer's right to have input into the handling or settlement of claims has been taken away by state statutes, so know the work comp statutes of the states where you will have claims).  (workersxzcompxzkit)

Unfortunately, many TPAs and some insurance companies have the bad practice of setting quotas for the number of claims closed each month or quarter. While the claim "closing quota" may be good for the TPA or the insurance company, it may not be good for your company.  If you review your claim loss run, and you notice you have a disproportionate number of claims closing in the last week of the month, you may have a problem with a closing quota.  If the adjuster is "paying a little extra" to get the claim closed now, those "little extras" will soon add up to higher premiums for your 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 860-553-6604.

"FRAUD PREVENTION" PODCAST click here: http://www.workerscompkit.com/gallagher/mp3 By: Private investigator with 25 years experience.

FREE WC IQ Test: http://www.workerscompkit.com/intro/
WC Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.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 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

Posted in Settling WC Claims |


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New York Prison Guard Indicted on Workers Comp Fraud


New York authorities  report that an Attica Correctional Facility officer lied about being disabled and continued working at a side job while collecting benefits for a year. 

According to a
 24-count indictment filed in Genesee County Court, the suspect, who is from Batavia, is charged with a pair of  third-degree grand larceny counts for stealing more than $3,000 in workers’ compensation benefits, seven counts of offering a false instrument for filing, one count of insurance fraud and 14 violations of the state workers’ comp laws.

The indictment
 accuses the individual of filing a number of false documents between October 2008 and October 2009 stating he was "totally disabled." The most serious charges, grand larceny and insurance fraud, are class D felonies which can lead up to seven years in state prison.
(workersxzcompxzkit)

The suspect
 was taken into custody by state police in October. Investigators at the time indicated he was working while on disability, plowing driveways and sealing parking lots in the city.
 

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

Podcast/Webcast: How To Prevent Fraudulent Workers' Compensation Claims Click Here http://www.workerscompkit.com/gallagher/podcast/Fraudulent_Workers_Compensation_Claims/index.php


FREE WC IQ Test: http://www.workerscompkit.com/intro/
WC Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
TD Calculator: www.reduceyourworkerscomp.com/transitional-duty-cost-calculator.php
WC Calculator:
http://www.reduceyourworkerscomp.com/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
Posted in Fraud and Abuse |


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Prescription Monitoring Programs and Workers Comp


The medical costs  resulting from workers’ compensation claims have risen for decades and now exceed indemnity costs. Prescriptions represent a significant portion of those medical costs and with maintenance drugs, many claims carry lifetime cost potential at a very high price. Pharmacy Benefit Management companies (PBMs) go a long way toward controlling costs by establishing formularies specifying which drugs will be authorized and requiring generics when possible. Mail order services offered by the PBM can also save money. 

Another area
 for control of potentially addictive medications considered “controlled substances” that are part of a particular class of drugs rests in legislation enacted at the state level by way of a Prescription Monitoring Program (PMP). Prescribing physicians and dispensing pharmacists subscribe and participate in these programs designed to prevent the abuse or misuse of certain medications. 

Currently
, 38 states have PMPs in place or in progress.   The 32 states with operational programs include AL, AZ, CA, CO, CT, HI, ID, IL, IN, KY, LA, ME, MA, MI, MS, NV, NM, NY, NC, ND, OH, OK, PN, RI, SC, TN, TX, UT, VA, WA, WV and WY. The 6 pending full operation are AK, IA, KS, MN, NJ and VT.   See:

The way the program
 works is the participating prescribing physician and dispensing pharmacist are required to report weekly to the PMP all applicable drugs within certain classes prescribed or dispensed that week. The prescribing physician and dispensing pharmacist have access to the patients’ drug history of the applicable “controlled substances” so that they’re able to detect “Dr. Shopping” for the “controlled substances” from multiple sources.  

The pharmacist
 or physician uses this information for early identification of patients at risk for addiction and to initiate appropriate medical intervention. This is not a mandatory program in all states for prescribing physicians and dispensing pharmacists. There are states planning to implement interstate agreements to share prescription information with neighboring states to identify doctor shopping patients who cross state lines. (workersxzcompxzkit)

How can this help
 your workers’ compensation costs? Encourage your occupational medicine providers and specialists utilized in treating your injured employees to participate in this program. If you have injured workers with a substance abuse problem, the physician should be able to detect the problem and take appropriate steps in getting your employee the help he or she needs to remain a successful and productive member of your workforce.
Resourcehttp://reduceyourworkerscomp.com/drug-testing-state-laws.php

Podcast/Webcast: How To Prevent Fraudulent Workers' Compensation Claims Click Here http://www.workerscompkit.com/gallagher/podcast/Fraudulent_Workers_Compensation_Claims/index.php

We accept articles about WC cost containment. Contact us at: Info@WorkersCompKit.com.
 
FREE WC IQ Test: http://www.workerscompkit.com/intro/
WC Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
TD Calculator: www.reduceyourworkerscomp.com/transitional-duty-cost-calculator.php
WC Calculator:
http://www.reduceyourworkerscomp.com/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
Posted in Coordinating Medical Care, Medical Cost Containment & Managed Care |


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School District Looks at Drug Testing Policy Following Teacher Death


Officials in one  Pennsylvania school district are looking at a wide-ranging drug testing policy for its employees following the death last month of a district teacher. 

According to
  Allentown's Morning Call, officials have shown interest in a policy that would include pre-employment testing of prospective teachers along with administrative and custodial staff and the bus driving corps. They're also are reportedly looking to explore conducting random drug testing of current employees.

In December
,  a high school biology teacher was discovered dead on the bedroom floor of an apartment with several bags of suspected heroin and drug paraphernalia nearby. Her death remains under investigation as the coroner's office awaits the results of toxicology tests before reporting the cause of death.

At the time
,  school officials reported they were unaware of any drug use by the teacher and report no evidence of widespread drug issues among staff. (workersxzcompxzkit)

Any random
 drug testing that would be slated for current staff would likely require approval from the teachers union.

Resource: http://reduceyourworkerscomp.com/drug-testing-state-laws.php

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.

Podcast/Webcast: How To Prevent Fraudulent Workers' Compensation Claims Click Here http://www.workerscompkit.com/gallagher/podcast/

Fraudulent_Workers_Compensation_Claims/index.php

We accept articles about WC cost containment. Contact us at: Info@WorkersCompKit.com.
 
WC Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
TD Calculator: www.reduceyourworkerscomp.com/transitional-duty-cost-calculator.php
WC Calculator:
http://www.reduceyourworkerscomp.com/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
Posted in Drug, Alcohol & Impairment Testing |


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How Videotape Captured REAL Capabilities of Injured Worker


Videotape Evidence Undermines Tennessee EMT's Claim for Permanent Disability

Here’s What Happened:
Lesko, an EMT/paramedic,  injured her lower back while assisting in moving a patient on a stretcher from a wooded area. She was seen and treated by a host of medical professionals who generally prescribed conservative treatment, pain medication and physical therapy. One of the doctors Lesko saw was a physiatrist. Lesko generally complained of pain, showed a very slow and "bizarre" gait, and indicated she had experienced other difficulties. Tests revealed some normal degenerative changes in her back, but nothing conclusive. 
Several physicians  indicated that "symptom magnification" appeared to be present. Prior to her last visit to the physiatrist, the latter viewed part of a private investigator's videotape recording that showed Lesko enter and exit her physical therapy facility with a slow, labored gait, but later showed Lesko shopping, walking normally, and unloading two bulky items from her car, all without apparent pain or difficulty. The doctor opined that Lesko's movements captured on the videotape were inconsistent with the symptoms she exhibited at the doctor's office. Lesko contended she suffered permanent disability as a result of the work-related injury. The trial court ruled that she had no such disability and Lesko appealed.

Here's What The Court Decided:

In Lesko v. Tennessee Sch. Bd., 2010 Tenn. Dist. LEXIS 29  (Jan. 22, 2010), the Supreme Court of Tennessee, Special Workers' Compensation Appeals Panel, held there had been no error. The court reasoned that while the trial court made no findings as to Lesko's credibility, its discussion of the many conflicts between Lesko's testimony and other evidence in the case amounted to a de facto finding that Lesko's credibility had been diminished. The court observed that the only physician who testified that Lesko had any level of permanent injury had based that testimony on Lesko's subjective complaints. (workersxzcompxzkit)

The court noted
 that video and photographic evidence produced by the employer cast doubt upon Lesko's credibility in general, and the accuracy of those statements in particular. Because Lesko's statements were the factual basis for her expert's opinion, the accuracy of that opinion was also questionable.   The court indicated that under the circumstances, it was unable to conclude that the evidence preponderated against the trial court's decision to give greater weight to the testimony of the physiatrist, or its finding that Lesko had not sustained a permanent disability. 
See generally  Larson's Workers' Compensation Law, § 127.10.

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

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