Alberta (Canada) officials say the complexity of dealing with a Chinese state-owned corporation is the reasoning behind the long delay in prosecuting companies charged in the deaths of two oil sands workers, according to The Canadian Press.
"In this specific case, there are multiple parties involved, one of which is located outside of Canada and maintains that they have not been served with charges," according to Chris Chodan, a spokesman for Alberta Occupational Health and Safety. (WCxKit)
Genboa Ge and Hongliang Lui, both temporary foreign workers, died on April 24, 2007, when the oil tank they were working on near Fort McMurray collapsed. Other workers suffered injuries in the accident.
Sinopec Shanghai Engineering Company Ltd., SSEC Canada Ltd., and Canadian Natural Resources Ltd. face 53 charges in the deaths under Alberta's Occupational Health and Safety Act.
SSEC and Canadian National Resources are slated to go to trial on October 3, 2011 — nearly 4½ years after the workers died — the longest delay in Alberta for such a prosecution. (WCxKit)
There is still no court date set for Sinopec due to the fact the corporation's senior managers in China have not been served with legal papers.
The Alberta government claims the delay has nothing to do with the fact that another division of Sinopec — Sinopec International Petroleum Exploration and Production Co.— is investing in the oil sands, including a $4.65 billion U.S. stake in Syncrude that was approved by Ottawa in June.
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, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: Info@ReduceYourWorkersComp.com or 860-553-6604.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
Ergonomics, per the U.S. Department of Labor, is the science of fitting workplace conditions and job demands to the capabilities of the working population. This is important to workers compensation because the most prevalent type of injury is musculoskeletal disorders. In occupations involving manual labor, musculoskeletal disorders often equal 50% or more of the workers comp claims that are filed. Per OSHA, improper ergonomics is the single largest cause of severe injuries.
Many of the musculoskeletal injuries involve cumulative wear and tear creating a condition known as cumulative trauma disorder (CTD). CTD encompasses various types of workers comp injuries from carpal tunnel syndrome to tendonitis to back injuries. (In some jurisdictions, the terminology of repetitive strain injuries (RSI) is used for cumulative wear and tear. In this blog we will use CTD, but if you are more familiar with RSI, feel free to read RSI wherever you see the letters CTD.) (WCxKit)
CTD is caused by ergonomic risk factors of force, repetitive motion, posture, vibration and cold. These frequently occur when there is:
1. manual labor involving frequent or heavy lifting,
2. hand tool usage,
3. pulling, pushing and carrying of heavy objects,
4. awkward postures,
5. prolonged exertion of the hands,
6. prolonged equipment operation.
Many manual labor jobs include more than one risk factor. The more risk factors the employee is exposed to, the higher the probability of the employee developing CTD. The longer the duration of the exposure, the greater the intensity of the exposure and the more frequent the exposure, the sooner the employee will develop a CTD workers comp claim.
To combat the risk of a CTD developing, the employer should develop an ergonomically correct process for each job. Or, stated another way – employer should search for ways to make the job fit the employee rather than trying to force the employee to fit the job. The proper, ergonomically correct way of doing the job should be incorporated into the employer's
safety program.
It is not enough to advise employees they need to do their job in an ergonomically correct manner. Proper training is essential for the ergonomics program to work. ALL employees should be trained:
1. To recognize activities that expose them to CTD injury.
2. To understand the ways to do their job in the most ergonomically correct manner.
3. To identify the symptoms and signs of CTD.
Most manual labor jobs can be altered to reduce or eliminate risk factors. For instance, instead of the employee trying to carry a heavy load, a forklift can move the heavy item (often faster with an increase in productivity). Another example would be the worker on manual scaffolding who has to bend over frequently over materials. Adjustable scaffolding can be used to minimize the constant bending.
Employees should be provided with a full explanation as to why the way they do their job is being changed. When employees are involved in the changes and understand how they will benefit from using ergonomically correct ways of performing their job, they will be more motivated and have higher job satisfaction. (WCxKit)
The employer's management team should emphasis to the work force that the safety program includes proper ergonomics. The employer can encourage proper ergonomics by:
1. Committing the resources to bring in outside experts, if needed.
2. Training the employees in the ergonomically correct way of performing their job.
3. Issuing a policy statement reflecting the company's commitment to proper ergonomics on the job.
4. Provide work breaks or changes in work assignments when there are ergonomic concerns.
5. Obtaining the support of the labor union in protecting the employees from CTD.
6. Incorporating proper ergonomics into the department's supervisor performance evaluation.
7. Giving priority status to ergonomics when dealing with productivity, quality assurance and cost reduction issues.
Workers compensation claims by manual laborers can be significantly decreased in both the number of claims and the severity of claims by the proper use of ergonomics in lifting, pushing, pulling, carrying and tool usage. The reduction in work comp claims will far exceed the cost of training the employees to do their jobs in an ergonomically correct manner.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing.
Contact: RShafer@ReduceYourWorkersComp.com or 860-553-6604.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
For the year 2000, the National Insurance Crime Bureau estimated workers compensation fraud was the fastest growing insurance scam in the U.S. and was costing the industry $5 BILLION PER YEAR. Yes, that’s billion, with a B.
As a point of comparison, in spring of 2010, Giorgio Armani was estimated to be worth $5.3 billion. Richard Branson of Virgin Airlines fame? A mere $4 billion.
In Pennsylvania, the Insurance Fraud Prevention Authority (IFPA) provides some astounding data. In 1997, Pennsylvania ranked second-highest in the incidence of workers comp fraud, at a cost of $180 MILLION PER YEAR. (WCxKit)
And – are you ready for this? –in 2008, 69% of arrests for workers comp insurance fraud were against the EMPLOYERS for failing to carry the required insurance. Didn’t see that one coming, did you?
The most common types of fraud, as per the Pennsylvania IFPA are:
Individual
1. faking an injury at work to get paid time off
2. exaggerating the severity of a legitimate injury to get additional time off work with benefits
3. reporting an injury as work-related when it actually occurred elsewhere
4. accepting alternate employment and not reporting it to the insurance company, concealing income from another job, or lying about being able to return to work
Employer
1. understating the company payroll to reduce insurance premiums
2. claiming employees as independent contractors
3. lying about employee classification codes to lower premiums
4. failure to carry workers’ compensation insurance
Some prevention guidelines
To decrease individual fraud, the employer should follow the following procedures:
1. Report ALL injuries as soon as possible
2. Provide information to all injured workers specifying their rights and responsibilities in the workers compensation process and advise them every claim will be investigated
3. Follow your established reporting procedure, including reporting all claims to the carrier within ONE business day and to your state workers comp authority
4. Refer all claims to medical case management for nurse triage and recommendations
5. Obtain statements from any witnesses
6. Check to see if the injury was caught on your surveillance devices, if appropriate
7. Take pictures of damaged equipment, e.g., vehicle involved in a collision
8. Make sure your claims handler investigates ALL claims
To avoid employer fraud, all employers must:
1. Carry the required workers compensation insurance. Check with your insurance broker, state workers compensation bureau and/or attorney if you’re unclear.
2. If your employees cross state lines, make sure your workers comp insurance does, too!
3. Periodically review your employee class codes, employment status and company payroll so that you are providing accurate information (WCxKit)
Overall, all parties involved with workers compensation claims need to recognize that any time they provide false information, they are committing an act of insurance fraud, and that the states are taking action against these cases. Ignorance is not a defense, especially for the employer or insurer.
Author: Kelly Haile, RN, CCM, WCCM is an experienced Nurse Case Manager who advocates working closely with each employer to refine their Workers' Comp program to provide better post-injury care, excellent medical case management and timely communication. We provide services primarily in the PA, NJ, DE and MD areas. You can reach Kelly in her role as Director of Case Management at NursePartners, LLC, by phone at 610-323-9800, fax 610-323-8018, Email: khaile@nptrs.com. or www.nursepartners.org/medical-case-managemen.
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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.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
After a man was struck by a piece of metal a stop-work order was issued to a Halifax-area (Canada) business. According to the Canadian Press, the 24-year-old worker suffered serious injuries to his arm after the metal fell on him at Cherubini Metal Works in Dartmouth.
A Labour Department representative said it appears the injured worker was welding a sheet of metal weighing about 20 tons when the jigs supporting it gave way. Kevin Finch said the department issued an immediate stop-work order in relation to the use of jigs lasting until an engineer deems them safe. He said that inspection must be complete by October 8. It is too early to say if charges will be laid against the company, Finch said. (WCxKit)
The department also ordered the company to turn over copies of design documents regarding the use, inspection and maintenance of jigs; any written safe work procedures and inspection reports the company has for jigs; documentation around the training and employment history of the injured worker; a list of witnesses to the accident; and a copy of the findings of the employer's internal investigation of the incident.
In a news release, Cherubini said it is fully co-operating with the investigation.
"Safety is something we work at quite diligently,'' said general manager Steve Ross.
Finch said in November 2009, the Labour Department responded to a safety complaint at Cherubini Metal Works relating to working conditions in a confined space, but no violations were observed.
The department also investigated after a worker broke a foot on the job in May 2009, but no safety violations were found, said Finch.
In 1998, the company was fined $3,000 by the courts after being found guilty of two violations under the Occupational Health and Safety Act in relation to failing to secure properly scaffolding to a building. (WCxKit)
Mary Kingston, a spokeswoman for the Nova Scotia Workers Compensation Board, said Cherubini was never on "the annual list" of companies in the province to receive surcharges or warning notices from the board.
Being "placed on the list" indicates an above-average number of claims for workplace injuries.
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, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: Info@ReduceYourWorkersComp.com or 860-553-6604.
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.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
Arizona Court Says Independent Medical Examiner Owes Duty of Reasonable Care
An Arizona court recently held that even absent a formal doctor-patient relationship, a doctor conducting an independent medical examination owes a duty of reasonable care to his or her patient [Ritchie v. Krasner, 2009 Ariz. App. LEXIS 78 (Ariz. Ct. App. Apr. 21, 2009)]. The Court indicated that an IME doctor has a duty "to conform to the legal standard of reasonable conduct in the light of the apparent risk." Larson’s Workers Compensation Law. See Ch. 112, §
112.02[1][a] n.2.2.
Alabama Claimant Allowed to Sue Doctor For Unauthorized Release of Medical Information
Somewhat similarly, an Alabama court has held that a workers compensation claimant may sue a doctor for unauthorized release of medical information to the employer [Hollander v. Nichols, 2009 Ala. LEXIS 59 (Ala. Mar. 20, 2009)]. (WCxKit)
Plaintiff was terminated from his employment for allegedly asking the doctor to back date a work-release slip related to a workers compensation claim he had filed. In the underlying suit against defendants, he asserted that the doctor breach a duty to him by releasing his medical records to his employer without his permission. The court agreed with plaintiff that the doctor and the clinic failed to demonstrate that they were entitled to the exemption-from-liability provision in Ala. Code § 25-5-77(b) with regard to disclosure of the records as there was no evidence indicating that the employer or plaintiff made a written request for the copies to be provided to the employer. (WCxKit)
Therefore, the trial court erred by granting summary judgment on plaintiff's breach-of-contract claim against those defendants for the alleged unauthorized disclosure of his medical records. The court remanded the case to the trial court for further proceedings. See Larson’s Workers Compensation Law Ch. 112,
§ 12.02 .5.1.http://www.lexisnexis.com/community/workerscompensationlaw/
Copyright 2010 LexisNexis. All rights reserved. This material is excerpted from Larson’s Workers Compensation Law. Reprinted with permission.
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.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
Great Britain’s offshore oil and gas industry has been warned about its safety record as new statistics show increases in major injuries and unplanned hydrocarbon releases.
Figures released by the Health and Safety Executive (HSE) show there were 50 major injuries reported in 2009/10 − up 20 on 2008/09 and higher than the average of 42 over the previous five years. No workers were killed during activities regulated by HSE for the third year running.
The combined fatal and major injury rate almost doubled to 192 per 100,000 workers in 2009/10 compared with 106 in 2008/09 and 156 in 2007/08. (WCxKit)
A marked rise was also recorded in 2009/10 of the combined number of major and significant hydrocarbon releases, regarded as potential precursors to a major incident, with a provisional total of 85. There were 61 in 2008/09 − the lowest since HSE began regulating the industry.
In 2009/10 there was a significant reduction in the minor over-three-day injury rate, maintaining a downward trend – 414 workers per 100,000 reported an injury, compared with 496 in the previous year.
Statistics show 443 dangerous occurrences were reported, 34 fewer than in 2008/09. The main types reported were hydrocarbon releases (42%), failure of equipment offshore (23%) well-related incidents (6%) and failures relating to lifting operations (9%).
Steve Walker, head of HSE's offshore division noted, "I am pleased to see no fatalities for a third consecutive year in the areas we regulate, but the fact that 17 workers tragically died in other offshore related travel incidents in the year is a stark reminder that hazards are ever present offshore.
"Although the overall numbers of injury and dangerous occurrences are comparatively low, considering a workforce of almost 27,000 and the numbers of rigs and the continuous operations undertaken, this does not excuse the fact that the fatal and major injury rate has almost doubled. This year's overall health and safety picture is simply not good enough. The industry has shown it can do better and it must do in future. (WCxKit)
"We will continue to take a tough line on companies who put their workers at risk. The challenge to improve safety will be ever greater as more offshore installations exceed their original design life. Our new inspection initiative will check safety management plans to ensure ageing is being taken into account, but the responsibility for getting safety right in the first place rests where it always has – with the duty holders."
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: RShafer@ReduceYourWorkersComp.com
SUBSCRIBE TO: Workers Comp Resource Center Newsletter
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.
©2010 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 BC Human Rights Tribunal awarded a worker nearly $8,000 after finding complaints of sexual harassment from a co-worker played a role in her termination.
According to Canadian OH&S News in the September 15 ruling, tribunal member Murray Geiger-Adams ordered the worker's employer to pay over $2,900 in lost wages compensation as well as $5,000 for injury to her dignity, feelings and self-respect. The employer, Dave's Custom Metal Works Ltd. in Port Coquitlam, BC, was also required to provide each current employee with a copy of the ruling. (WCxKit)
Corina Soroka was terminated on Sept. 9, 2009 after she complained to plant owner Dave Rouleau about an incident the previous day in which supervisor Ian MacDonnell took her to a home shop to discuss a previous incident. That first event occurred on July 28, 2009, one day after Soroka took time off work because of a crushed finger she suffered while cutting metal at the shop.
After the workplace injury, MacDonnell obtained Soroka's cell phone number, called her and the two workers later exchanged more than two dozen sexually themed text messages. Rouleau issued a verbal disciplinary warning to MacDonnell after he found out about the incident, the decision says. The supervisor also received a disciplinary warning for insubordination on the day Soroka was fired.
"I find that Mr. MacDonnell acted from confused and contradictory motives," Geiger-Adams writes in the decision. "I accept that, on the one hand, he wanted to make things right with Ms Soroka so that they could continue to work together, but that, on the other hand, he continued to press her, against her expressly-stated wishes and feelings, to accept that his interest in her was understandable and even justified. He did so in a setting that he had engineered by using his authority to direct her work – one in which she was isolated and vulnerable," Geiger-Adams writes.
In awarding damages to the worker, the tribunal member found that "sex discrimination was at least part of the reason Rouleau terminated Soroka's employment, but that, even in the absence of the contraventions, Soroka's employment would likely have ended at the end of October, 2009" as it was subject to the availability of work.
In the ruling, Geiger-Adams found that the employer discriminated against the worker in three ways.
First, MacDonnell used his access, through his employment, to Soroka's private cell phone number, in order to contact her at home to "follow up on the sexual and perhaps romantic interest in her he first expressed in the workplace on July 24 . . . even though she immediately made it clear through her text messages that his interest was not reciprocated."
Second, in spite of a verbal reprimand, MacDonnell used his authority as a supervisor to take her away from the workplace to his home, "and there to both threaten to interfere with her employment, and make further inappropriate sexual comments to her." (WCxKit)
Finally, Rouleau decided to "abruptly terminate Soroka's employment when he did in order to 'solve' the problem created for him by MacDonnell's conduct, and Soroka's complaints about that conduct," the decision says.
Geigar-Adams says the plant owner apparently reasoned that, "even though Soroka was the victim of what he twice identified as MacDonnell's inappropriate conduct toward her, her employment was short-term, and it was easier to remove her from the workplace than deal further with the conduct of the perpetrator."
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, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: Info@ReduceYourWorkersComp.com or 860-553-6604.
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©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
As an executive committee member of the Larson’s National Workers’ Compensation Advisory Board, I’ve been given a sneak preview of an excellent new handbook on Medicare Secondary Payer compliance to be published by
LexisNexis, and it's excellent.
The Complete Guide to Medicare Secondary Payer Compliance, Jennifer C. Jordan, Esq., Editor-in-Chief, is a one-of-a-kind resource, combining analysis and practice tips, statutes, public laws, regulations, case summaries with commentary, MMSEA Sec. 111 User Guide, CMS’ MSP manual and memos, Glossary and Acronyms, Life tables, and more, all in one handbook.
MMSEA Section 111
One of the key chapters in the book focuses on MMSEA Section 111 reporting requirements. Among other things the author provides helpful practice tips and insightful commentary along with an explanation of who is required to report and when reporting is necessary. (WCxKit)
Liability Claims and the MSP
Another key chapter in the book addresses the concept of a liability Medicare set-aside arrangement (“LMSA”) and explains how to assess adequately the need for an LMSA. The author takes a no-nonsense approach by dispelling preconceived notions about MSA’s in general before moving into the heart of the issue to help you understand why and when an LMSA might be needed.
Case Commentaries
This book is the only resource I know of that traces the development of case law pertaining to the MSP and MMSEA. Included with each case write up is commentary by Jennifer C. Jordan, the Editor-in-Chief, whose straight-talk is much appreciated when it comes to this illusive area of the law. One recent case that interested me in particular was Seger v. Tank Connection, the first known case in which a federal district court had an opportunity to evaluate MMSEA issues and ruled in the defendant employer’s favor to compel an injured employer to respond to interrogatories about his eligibility for Medicare.
Taking Control of Insurance Settlements
If you want to take control of your insurance settlements, it’s imperative to understand “why CMS wants what it wants,” says the author. I believe this handbook will help both the novice and seasoned professional in their dealings with CMS and to realize that CMS’ preference is not always going to be the only way to achieve MSP compliance. (WCxKit)
For practitioners and consultants there are “practice points” and “special alerts” calling attention to potential pitfalls.
Pre-orders of the book. Click here to view the flyer and ordering information. According to the publisher, the books are scheduled to ship to customers in late October 2010.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing.
Contact: RShafer@ReduceYourWorkersComp.com or 860-553-6604.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
California has the most workers' compensation claims, a reflection of its having the largest labor force of any state. The California workers’ comp system is similar to other states, but does have its own peculiarities (as other states do).
In California, the workers’ comp adjuster must accept or deny the claim within 90 days of the employee filing the claim with the employer. If the claim is not denied within 90 days after it is reported, it cannot be denied later.
Medical Benefits
Just like all other states, California provides the injured employee with all necessary medical care to recover from the injury. The employer selects the medical provider. If the employee is happy with the medical provider, everything is fine. If the employee is unhappy with the employer-selected medical provide, the employee can change the medical provider to one of his/her own selection, 30 days after the injury. This tactic is sometimes called, “going to a plaintiff friendly doctor.”
Another oddity of the California workers’ comp medical benefits statute is the employee can pre-select the treating physician prior to the injury. If the employee is planning the accident, or even if the employee is not planning the accident, the employee can notify the employer in writing of a personal physician who previously treated the employee. The employee then can be treated by his/her personal physician immediately after an accident and does not have to wait 30 days after the accident to change medical providers.
If the employer has established a medical provider network (MPN), approved by the Division of Workers' Compensation (DWC), the employee cannot use a personal physician. The employee can still change physicians after 30 days, but only within the employer's MPN and must remain in the MPN for the duration of the workers’ comp claim.
The MPN must include a mix of doctors expert in general areas of medicine and doctors who specialize in both common occupational injuries and work related illnesses. The doctors of the MPN must follow the medical treatment guidelines established by the DWC. If the employee disagrees with the MPN doctor, the MPN must be have a large enough selection of physicians for the employee to obtain a second, or even a third opinion. If the employee disagrees with all three MPN doctor's opinions, the employee can request an independent medical review.
Indemnity Benefits
California indemnity benefits are divided into two types, temporary disability benefits, and permanent disability (PD) benefits. Temporary disability benefits are divided into two parts, temporary total disability benefits (TTD) and temporary partial disability benefits (TPD).
TTD is paid to the employee for time off work following the accident, after a three-day waiting period. There is no waiting period in California if the employee is immediately hospitalized. If the employee is off work more than fourteen days, the employee is paid retroactively for the first three days of the waiting period.
The amount of TTD benefit payable to the employee is calculated by multiplying the average weekly wage (AWW) by two-thirds. The AWW includes the gross paycheck amount plus the value of employer provided food and lodging. Any overtime compensation, bonuses, or commissions paid to the employee are included in the AWW. If the employee works a second job and is unable to work at the second job because of the injury on the employer's job, the loss earnings from the second job are included in the AWW calculation. The maximum amount of TTD paid to an employee is $728.00 per week.
The TTD benefits payable to the employee end when the employee returns to work, or the employee reaches maximum medical improvement (MMI), or after 104 weeks. [With a date of injury prior to January 1, 2008, the 104 weeks ended two years from the date of the accident. After January 1, 2008, the employee can be paid TTD for any 104 weeks within five years of the date of injury.]
Temporary partial disability benefits are available for workers who can return to work part time before they reach MMI. TPD is paid as a prorated amount of the TTD benefit.
Return to Work
The California workers’ comp statutes encourage employers to bring injured employees back to work. The employers with 50 or more employees, with a return to work program offering injured employees regular or modified duty or alternative work, pay15% lower weekly permanent disability payments once a return to work offer is made. If the employer with 50 or more employees does not make a return to work offer, they pay 15% more in weekly permanent disability benefits. For more information on the California Return To Work requirements, please see: www.dir.ca.gov/dwc/rehab
Permanent Disability
When the injured employee reaches MMI (also known as P&S — permanent and stationary in California workers’ comp lingo), the treating doctor provides a disability rating if the employee has not recovered to 100% of the pre-injury status. California does not use the National Council on Compensation Insurance rating codes used in most states. California has its own rating code system the treating doctors use to determine a disability rating. If the treating doctor determines the employee had a preexisting condition, an apportionment of the rating is assigned to the employee.
Payment of the PD benefits begins when TTD benefits end. This is true even if the final percentage of disability is not agreed to by the workers’ comp adjuster. The PD payments continue until the case is resolved or the adjuster pays the reasonable amount of disability expected. The PD rate is the same as the TTD rate, except the PD rate is capped at $220 per week for disabilities rated under 70% and capped at $270 per week for disabilities rated at 70% and over.
If the employee or the workers’ comp adjuster does not agree with the doctor's permanency rating, either can ask for a Qualified Medical Evaluator (QME). The QME is a doctor approved by the DWC to evaluate permanency ratings. When a QME is requested, the DWC provides the employee with a list of three QMEs approved for the employee's area of the state.
If the employee is not represented by an attorney the employee can select any QME on the list. If the employee is represented, the workers’ comp adjuster and the employee's attorney try to agree to the doctor selected for the rating who is then referred to as the Agreed Medical Evaluator (AME). If the workers’ comp adjuster and the employee's attorney cannot agree on an AME, they each select their own QME to do an evaluation. The two QME reports are compared and negotiated (litigated if necessary) to determine the permanency
impairment rating.
When a permanency rating is finally determined (it sometimes takes a long time in California), the claim can be resolved in two ways. The workers’ comp adjuster and the employee or employee's attorney reach an agreement on the settlement amount. It is then submitted to the DWC where a workers’ comp judge reviews and approves it, if the WC judge agrees with the settlement reached.
Once the claim has DWC approval for settlement, a settlement agreement called a Compromise and Release (C&R) is drawn up. The C&R specifies a lump sum payment for the disability and for future medical care, releasing the workers’ comp insurer from any further obligations for the claim.
If the workers’ comp adjuster and employee/employee's attorney still cannot agree on the resolution of the claim, the matter goes before a Division judge who reviews the claim and makes a ruling called a Findings and Award (F&A). The F&A specifies the amount to be paid for the PD and normally requires the insurer to pay for all future medical care related to the original injury.
Death Benefits
When an employee suffers a fatal injury on the job, reasonable burial expenses up to $5,000 are paid. Dependents are eligible for death benefits. The amount of death benefits depends on the TTD rate, the number of dependents, and the extent of their dependency. The maximum amount payable in death benefits is $160,000 when there are three or more dependents. The maximum death benefit can be exceeded if there continues to be dependent children after the maximum has been reached. (workersxzcompxzkit)
Vocational Rehabilitation Services
California no longer requires vocational rehabilitation services. For all injuries on January 1, 2004, and afterward, the employee can receive a nontransferable voucher worth up to $10,000 for training or skill enhancement to a state approved school. To obtain this voucher, the employee must have a permanent injury, does not return to work within 60 days of the end of TTD and the employer does not offer modified duty.
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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, healthcare, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: Robert_Elliott@ReduceYourWorkersComp.com or 860-553-6604.
WC Calculator: http://www.reduceyourworkerscomp.com/calculator.php
TD Calculator: http://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.
©2010 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 statement from a United Nations body confirming its desire to see the end of asbestos use worldwide is the "death knell" for a substance which claims one life every five minutes around the clock, the global union confederation ITUC has said.
The International Labour Organisation (ILO) recently warned in an official position statement that industry lobbyists pushing asbestos around the world must not claim to have ILO support.
ITUC General Secretary Sharan Burrow said the ILO statement provides welcome support for the global union campaign to see a ban on asbestos worldwide and a just transition to safer, better jobs for displaced asbestos workers. (WCxKit)
"ILO has confirmed that it wants to see the elimination of asbestos use worldwide, full stop," she said. "Coming on the heels of calls for a global ban on asbestos use from major scientific, medical and occupational health groups, this sounds the death knell for the deadly fibre and a fatal blow for the asbestos pushers."
The ILO statement comes at a time the asbestos industry is pressing hard for an expansion of chrysotile (white) asbestos production and sales. All forms of asbestos except for chrysotile are already prohibited worldwide.
Industry lobby group the Chrysotile Institute, which takes a lead in the global promotion of asbestos exports, routinely cites ILO documents and claims they are supportive of its case for continued asbestos use.
The Chrysotile Institute’s "Safe use manual" claims it "builds on the principles of controlled-use embodied in ILO Convention 162, Safety in the Use of Asbestos." The Institute also claims on its Website to have organized training courses "in cooperation" with the ILO "intended to promote the controlled use of chrysotile." And a March 2010 Chrysotile Institute news release headed “Partners in Favour of Chrysotile Fibre” and criticizing those calling for a global asbestos ban said its case was supported by "documents from the World Health Organization and the International Labour Organization among others." (WCxKit)
Concerned at the industry’s repeated misuse of ILO’s name, the Geneva-based body issued the position statement highlighting the UN agency’s commitment to "promoting the elimination of the future use of all forms of asbestos and asbestos-containing materials."Burrow said the ILO position statement could have "life-saving consequences, in reinforcing the union case for a total asbestos ban."
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, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: Info@ReduceYourWorkersComp.com or 860-553-6604.
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