An email joke portraying aboriginals and African-Canadians in a negative light has led to the disciplining of some Parks Canada employees in Manitoba.
According to The Canadian Press, the individuals responsible for the alleged material were quickly and strongly disciplined. (WCxKit)
Cheryl Penny, superintendent at Riding Mountain National Park, says the “shocking and appalling'” email was distributed to 180 workers. Penny says it was pulled from the system as soon as it came to light.
But an aboriginal Parks Canada employee forwarded the email to Rolling River First Nation Chief Wilfred McKay. (WCxKit)
Grand Chief Morris Swan Shannacappo of Manitoba's Southern Chiefs Organization is demanding any Parks Canada worker involved with the email resign or be fired.
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.
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 26-year-old Southern California man skated himself into trouble by claiming his broken elbow was caused by a fall at work when he was actually skateboarding.
Investigators say the individual fell and broke his elbow, then claimed more than $15,000 in workers compensation by stating he stumbled at work. (WCxKit)
The individual is charged with nine felony counts, including making fraudulent statements and lying about his injuries in violation of Insurance Code and grand theft.
According to the Victorville Daily Press, the individual filed for workers comp benefits in 2008 while working for RCR Plumbing & Mechanical. He claimed he was injured at work when he stepped on plumbing fittings on the warehouse floor. (WCxKit)
An investigator with the San BernardinoCounty district attorney's office claims it was later determined the individual fell and fractured his left elbow while skateboarding at his girlfriend's house
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.
The goal of the Nurse Case Manager (NCM) is to assist the injured employee and facilitate the employee's return to work through identification of the medical services needed, the arrangement for those services to be provided, to advocate for the employee's medical needs through communication with all medical providers, and to educate the employee on the employee's role in the recovery process.
The NCM can be employed by the workers compensation insurance carrier, the self-insured employer, the third party administrator or by the medical provider, such as an orthopedist. For the purpose of this blog, we will review the role of the NCM from the perspective of the workers comp insurance carrier.
The title of Nurse Case Manager is the most frequently used name for the role, but like workers comp adjusters are sometimes referred to as claim examiners, there are other names for the NCM. In some insurance companies the role is referred to as the “workers compensation case manager” or “injury management facilitator” or “field case manager” (FCM) if most of the work is done away from the office, or “telephonic case manager” (TCM) if the work is done in the office by using the telephone. (WCxKit)
Note: These are NOT the same as NURSE TRIAGE which is when a claim is reported directly to an RN for suggestions about initial medical treatment.
The NCM is a trained nurse, either a Registered Nurse (RN) or a Licensed Practical Nurse (LPN) before entering the NCM field. Most workers compensation insurance carriers hire experienced NCMs from other areas of the medical field, for instance from a health maintenance organization. The insurance carrier can teach the NCM the basics of workers compensation to which the NCM will add her knowledge of medical management.
It is normal for the NCM of an insurance carrier to have experience in occupational health, medical management, discharge planning and home health care. The role of the NCM is to combine these disciplines to facilitate the employee's return to work in the minimum amount of time without reducing the quality of the medical care. The NCM is a skilled communicator as she is constantly in contact and working with the employees and the medical provider.
The NCM can be brought into the workers comp claim at any point in the life of the claim. Normally, it is the adjuster who determines whether or not a NCM will be utilized on a workers comp claim, but the employer can and should request a NCM if they feel the employee would benefit from the utilization of a NCM.
Different insurance carriers utilize the NCM in different ways. Some insurance carriers rely heavily on a TCM who contacts all parties by telephone, fax or letter. To function as a TCM, the nurse must have excellent telephone skills and interpersonal skills, along with a very in-depth clinical background knowledge. The caseload assigned to a TCM is larger than the caseload assigned to an FCM as the TCM does not have the travel time.
Other insurance carriers prefer to use a FCM. The FCM is often referred to as on-site nurse, as the work is done in person by appointments with the employee, the employer, the medical providers and other vendors. The FCM must have strong interpersonal skills and be able to establish a good rapport with all the parties involved in the medical care. The caseload is lighter than the TCM due to t travel time to appointments.
Many workers compensation insurers use both a TCM and FCM. The TCM is utilized to handle the simpler or less severe workers comp claims. The FCM is utilized on the severe or complex workers comp claims where the on-site case management will be the most beneficial.
The NCM, whether a TCM or FCM, works in conjunction with the claims adjuster. The NCM makes a separate three-point contact (employee, employer, medical provider) from the three-point contact made by the adjuster, as the NCM has a different perspective than the adjuster has in the management of the workers comp claim.
When the NCM makes three-point contact, it is for the purpose of introducing himself/herself and obtaining an understanding of the nature and severity of the claim. The initial contacts assist the NCM in establishing rapport and creating a working relationship with the employee, employer and medical provider(s). It is most beneficial to the employee to know a medical professional will be there to assist them throughout the workers comp process.
The initial interviews also assists the NCM with the initial assessment, coordination, planning and evaluation of the injury and the necessary medical treatment. In conjunction with the medical provider(s) the NCM will formulate a treatment plan. The NCM is then able to determine what barriers exist that would prevent the employee from returning to work. The NCM educates the employee on the benefits of returning to work quickly and facilitates with the employer the accommodations necessary to meet the medical concerns of the physician.
It often takes several contacts with the three parties (employee, employer, medical provider) to coordinate the employee's timely and successful return to work. The more complex or severe the injury, the more times the NCM must be in contact with these three parties. The NCM continues to evaluate the employee's progress and monitors the treatment until the employee is released to return to work. (WCxKit)
The benefits provided by the NCM are many. The return on investment is such that many insurance carriers have shifted from the adjuster bringing the NCM into the claim when needed to an approach of early intervention. Each new workers comp claim is reviewed by a NCM. This allows the NCM to direct and control the medical care from the beginning, preventing many workers comp claims from getting on a treatment track that delays the employee's recovery and return to work.
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
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.
Employers are being urged to make sure safety is always their top priority by a leading Scottish lawyer after a man suffered a serious brain injury at work.
“Businesses may feel as though their current priority should be making ends meet and protecting their bottom line – but their duty to protect their workers never goes away and should remain their top priority,” said Elaine Russell, partner and work accident specialist at the Glasgow office of national law firm Irwin Mitchell. (WCxKit)
Those remarks come as the Health and Safety Executive fined a company for breach of duty after a 49-year-old man was left brain damaged by a falling saw in 2007.
The man was delivering the saws to the Saw Centre in Eglinton Street, Glasgow when one fell off the vehicle, hitting him on the head.
His West Yorkshire-based employer, Joda Freight Limited was fined £5,000 ($7,722) at Glasgow Sheriff Court, after the court found the company did not did not have a reliable system of communication in place to make sure their drivers were informed about the securing and stability of loads.
Russell noted, "A man has been left permanently brain damaged, not because procedures weren't followed, but because they hadn't been installed in the first place. Unfortunately this is not an unusual situation – everyday we deal with people whose lives have been devastated by the effects of accidents at work, which could easily have been prevented by maintaining good health and safety practices. (WCxKit)
"We welcome the HSE's investigation into this matter and hope that lessons can be learnt to prevent further suffering, though sadly no fine will ever demonstrate the devastating impact this injury will have on the employee's life."
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.
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.
Those who commit workers compensation fraud seem to forget that it oftentimes doesn’t go unnoticed, or unpunished. Often co-workers contact anonymouse tip lines to report the situation.
Take for example, surveillance videotape showing a man walking freely for nearly a mile and carrying a walker under his arm before he testified that a job-related injury left him unable to walk or stand unassisted. (WCxKit)
That evidence was part of the information investigators are using in a three-county New York sweep of suspects accused of workers comp fraud.
The suspect is one of seven people arrested. The others include a Rensselaer County woman who cashed checks intended for her deceased father-in-law, a Watervliet man accused of illegally collecting $60,500 and a Middletown business owner.
The arrests are the result of a series of criminal investigations by the New York State Insurance Department's Frauds Bureau and the Office of the Inspector General of the New York State Workers Compensation Board based on referrals from the New York State Insurance Fund (NYSIF).
Insurance Superintendent James Wrynn noted, "These arrests should serve as a warning to others who would steal from the system that there are effective procedures in place to detect workers compensation violations and bring offenders to justice."
The investigations leading to the arrests were prompted after irregularities were discovered during audits of workers comp claims by several of the individuals and routine reviews of workers comp certificates filed by two of the individuals who ran businesses. (WCxKit)
Four of the individuals are charged with workers comp fraud, a Class E felony and they could be sentenced to up to four years in prison if found guilty
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.
We miss our friends and colleagues lost in the World Trade Center on Sept 11, 2001. Marsh and Aon, two industry giants, the largest insurance brokers in the world, both very influential in the field of workers' compensation cost containment, were both located in the World Trade Center Towers. Between the two companies, nearly 600 people were lost. For those of us in the insurance industry, we all knew many people who were killed that day. I am proud to have been an employee of both companies.
While the world was in shock, it was especially difficult for employees of Marsh and Aon. We were calling around to our friends, trying to find out who was missing and who had checked in and were known to be safe. At Aon, Pamela Newman kept me and others informed of who had been located. At Marsh, Jim Connolly was letting me know who had been located. Our boss, Phil, was found. Our other boss, Harry, was not. I had been retired, but went back to work for Aon to complete several projects that had been in process.
Many of the employees traveled, so it wasn't easy to figure out who had been at the office that day, and who had been traveling. The lucky ones were traveling. We lost our bosses, safety and loss control professionals, claims experts, friends we had known during our entire working lives. George, Harry, Bob, Lars, Adam, Richard and many other would not be found. The days that followed were excruciating for the country, but especially difficult for Marsh and Aon as we learned who among our friends and colleagues would not be coming to the office any longer.
Seeing our colleague, Bob Ferris's son hold up a photo of their dad on national television as they hoped he was at a local hospital or someone had seen him, brought unspeakable sorrow. We waited by our phones for calls that never came. It's still hard, some of us do not go into tall buldings, others don't speak about it. We all realize life can change in an instant.
Marsh and Aon have done a remarkable job with their memorial websites. If you care to share the memories of those who have made an imprint on this industry in the past, their websites are below.
Aon Memorial: http://www.legacy.com/aon/Sept11/SearchResult.aspx?location=WTC
Marsh Memorial: http://memorial.mmc.com/
Author: Rebecca Shafer
Some thoughts on whether being "average" is good enough…
What does it cost to buy a bad car? For example, one that will break down 25% more than others. One that will be in more accidents. The “cost” is not the purchase price but the incidental costs of not having a good car.
A good plan for dealing with workers comp is measured by what you don’t see or hear. An accident that didn’t occur leaves little evidence of its non-existence. A person who never left work saves enormous replacement costs, but how do you enter that on the books? (WCxKit)
Measuring work comp, therefore, is almost always done by measuring actual damage. A “good” result is having average amounts of damage. Few operations will commit substantial effort to improving much beyond “average” results even though a small additional effort might put a company in the top 5% of employers.
If a company insists on measuring with a yardstick of negative results, it is worth noting that comp costs worse than average are the best indicator that a business is heading toward catastrophic failure.
Comp costs measure more than accidents. They measure morale, leadership, hiring practices, attention to detail, ability to cope with stress and ability to learn from mistakes.
A proactive, imaginative workers comp program undertaken while comp costs seem to be “average” produce unexpected, positive results throughout a company.
Two areas where improvement can be achieved at little cost are:
1. Better reporting and early sharing of accident information. (WCxKit)
2. Better coordination of comp claims with group medical and STD benefits.
Any executive team that thinks “average” is a good goal should be aware: The Titanic carried more lifeboats than were legally required. It was above “average.”
When purchasing insurance-related products, such as claims handling, keep this in mind.
Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, New York. He is a frequent writer and speaker and has represented employers in the areas of workers compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Contact Attorney Ronca at 631-722-2100.
SUBSCRIBE TO: Workers Comp Kit 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.
Australia’s federal workplace safety regulator Comcare recently launched federal court proceedings against the Customs and Border Protection Service after an employee slipped and fractured both arms while working at the Adelaide International Airport in December 2008.
It’s alleged that Customs contravened federal workplace safety laws by failing to take all reasonably practicable steps to protect the health and safety at work of its employees. (WCxKit)
The proceedings arise from an incident on December 17, 2008 when a Customs employee allegedly slipped on some glue that had been laid on a concrete floor by a contractor engaged by Customs to lay carpet tiles.
The Customs employee sustained fractures to both arms as a result. Comcare understands that at the time of the incident, the construction site was not barricaded and Customs employees were expected to work around the contractors and their tools.
Comcare Work Health and Safety General Manager Neil Quarmby said all federal employers needed to pause and take stock when building work or renovations were carried out.
“Building improvements and renovations are not business as usual, and a thorough risk assessment is required to make sure that work places are healthy and safe for employees when disruption occurs,” Quarmby commented. (WCxKit)
The maximum penalty for this type of legislative breach by a body corporate is $242,000.
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.
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 new study indicates physical fitness protects men who put in long work hours from the heart disease that is associated with putting in overtime.
Unfit men who worked 41 to 45 hours a week were 59% more likely to die from heart disease than men working fewer hours, according to a study published in the medical journal Heart. Their fit counterparts were 45% less apt to die of heart disease and 38% less likely to die of other causes than unfit colleagues, according to the study.
Epidemiologists have long known that putting in extended hours adds to the risk of cardiovascular disease, high blood pressure and diabetes. The study, led by Andreas Holtermann of the National Research Centre for the Working Environment in Copenhagen, is the first to demonstrate that fitness can offer protection from some of these detrimental effects. (WCxKit)
The researchers studied approximately 5,000 healthy men enrolled in a long-term epidemiological project called the Copenhagen Male Study. The scientists used bicycle ergometers to test participants’ fitness levels and questionnaires to come up with their work hours and activity levels.
Even moderate fitness lessened the risk of dying from heart disease compared with men who were unfit and worked long hours. Men who were both unfit and worked more than 45 hours a week demonstrated the worst outcomes: they were more than twice as likely to succumb to heart disease as men working under 40 hours.
The most active men were either engaged in heavy physical work like digging and shoveling, or were active athletes who ran, played tennis or badminton for at least 3 hours a week, according to the study.
Working longer hours puts more pressure on the cardiovascular system because it ratchets up the nervous system, increasing both heart rate and blood pressure. A high level of fitness decreases recovery time and physiological stress during a specific task. (WCxKit)
The study is limited by the fact that the men indicated both their activity levels and work hours, making the reports susceptible to errors, and by the fact that it only includes Caucasian men, according to the researchers.
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.
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.
Recently there has been some chatter on blogs and in the news about nationalization or federalization of workers compensation. Some writers think it would be a great thing, others think it would be a catastrophe, depending on the writer's location on the political spectrum.
There has been talk of a federal workers comp system since 1970 when OSHA was created. The OSHA law created a special commission to study state workers compensation laws. When the study was completed in 1972, the commission did not recommend the nationalization of workers comp. The study did make many recommendations adopted by many states have.
The talk about nationalization of workers comp got a boost in January, 2009 when Congressman Joe Baca, Democrat from California and 18 other ultra-liberal members of the 111th Congress, including Dennis Kucinich of Ohio, introduced House Resolution (HR) 635, to form a National Commission on State Workers Compensation Laws. HR 635 was referred to committee but no further action has been taken. (The same bill was also introduced in the 110th Congress where it died in committee). Some of the current 18 co-sponsors are former plaintiff attorneys. (WCxKit)
The talk of federalization of workers compensation also arose from early on in the health care debate when Senator Jay Rockefeller, Democrat from West Virginia, filed an amendment with the Senate Finance Committee designed to merge auto medical insurance, workers compensation and healthcare into the health coverage plan. This proposal was opposed by the insurance industry and never considered by the Senate Finance Committee.
The people who are promoting federalization of workers compensation point to the problems arising from each jurisdiction having their own workers comp statutes. They point to the European nations with national workers comp. They believe one workers comp system would make administration of workers comp easier for everybody involved. The promoters of federal workers comp point out there is already federal workers compensation for employees covered by the Longshoreman and Harbor Workers Act, for employees of railroads and for federal government employees.
Last year during the debate on overhauling the health care system, the idea of the government being the sole insurer and provider of medical care was dropped early on in the discussion. However, when the health care overhaul bill was passed, it did include the Libby Health Care Plan. It is named after Libby, Montana, where asbestos was mined. The Libby Health Care Plan has Medicare controlling the delivery of medical services to those affected by asbestosis. The Libby Health Care Plan is seen by some as a step toward federalizing workers compensation.
During the height of the clean up of the Gulf of Mexico oil spill, some promoters of nationalization of workers compensation claimed the Gulf Coast states would be unable to handle the huge influx of expected workers comp claims. This reason for federalization of workers comp fell apart as (1) anyone injured while working on a clean-up boat would be covered by another federal law – the Jones Act, and (2) the OSHA mandated precautions taken by the clean-up workers on the beach resulted in few workers comp claims. It is unknown at this time if the clean-up workers on the shore will have future workers comp claims due to the exposure to oil and dispersants.
There is already a federal office for workers compensation in the Department of Labor. The Office of Worker Compensation Programs administers the federal workers comp programs for federal employees, for the Department of Energy and it contractors and subcontractors injured due to radiation exposure, for those employees covered by the Longshoreman and Harbor Workers Act, and the employees covered by the Division of Coal Mine Workers.
Some of the proponents of nationalization of workers comp envision the Department of Labor controlling all workers comp claims. Other proponents of nationalization of workers comp see a system like those used in the monopolistic states, for instance, Ohio.
Many of those opposed to the nationalization of workers compensation point to the problems and cost associated with the Longshoreman and Harbor Workers Compensation Act (LHWCA) – the largest federal workers comp program affecting private employers. The people who opposed the federalization of workers comp point out that under the LHWCA, the program is anti-employer because:
1. The employee is free to select the doctor of his choice (or his attorney's choice) without any input from the employer.
2. The indemnity compensation rate, $1,224.66, is higher than any state rate, and more than double the compensation rate in several states.
3. Return to work programs are difficult to manage when the employees’ indemnity compensation rate is higher than their normal take home pay.
4. There are far more questionable workers comp claims [did the injury happen at work or did the injury occur elsewhere?] under LHWCA due to the generous indemnity benefits.
5. The waiting period for indemnity benefits to start under the LHWCA is 3 days.
Whether you are for or against the nationalization of workers compensation, there are already significant in-roads in to state workers comp by the federal government. The Centers for Medicare and Medicaid Services (CMS) already require certain large workers comp claims to have a Medicare Set-aside Arrangement approved by CMS (the federal government). (WCxKit)
While it is doubtful there will be a nationalization of workers compensation in the near future, it will continue to be a subject discussed by the plaintiff's bar association and other liberal groups. The insurance industry will continue to oppose their elimination from the workers compensation business. The takeover of workers comp by the federal government will remain a subject for political discussion.
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.
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.
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