Leakage in workers compensation is defined as the difference between what was paid on the claim and the amount the adjuster
should have spent on the claim.
Leakage is lost dollars through over payment of medical expenses, indemnity benefits, and claims handling cost — all ultimately resulting in higher workers compensation premiums for the employer.
Leakage can be divided into two types: hard and soft leakage. Hard leakage occurs when there is no doubt the payment should
not have been made. Examples of this would include no coverage, a payment that is not owed, or an unquestionable overpayment. Soft
leakage is more subjective, for instance; the payment of a questionable compensability claim or the high negotiated settlement. (WCxKit)
Adjusters, supervisors, and claim managers are normally reluctant to admit they have made monetary mistakes. File reviews by the supervisor or manager will focus on the adjuster's compliance with service standards set forth by the claims office. These internal file reviews are checking criteria and grading the process, they are not looking for financial mistakes – leakage.
An independent claims auditor on the other hand does not have to worry about the impression made on management when leakage is identified. The independent claims auditor can be totally objective in the review of the claim file. From the claims auditor's perspective, the auditor is assisting the claims office to identify areas where they have made financial mistakes and will provide them guidance to avoid the same mistakes in the future. Plus, in some situations part or all of the leakage can be recovered.
When the claims auditor reviews the claim files, the auditor will pinpoint both hard leakage and soft leakage.
18 financial areas reviewed by an independent auditor:
1. The accuracy of the average weekly wage calculation.
2. Accuracy of the weekly indemnity calculation.
3. The payment of the correct number of lost work days, including the waiting period and the retroactive period.
4. The continuation of indemnity benefits after the employee has returned to work.
5. Failure to arrange modified duty when the medical provider permits the employee to return to work with restrictions.
6. Payment of the same medical bills more than once.
7. Payment of medical bills without the appropriate fee schedule reductions.
8. The over- or under-utilization of medical case management.
9. Identification of subrogation opportunities and the pursuit of subrogation.
10. The proper application of offsets including social security, unemployment benefits, and other types of governmental compensation.
11. Proper use of utilization reviews for pre-certification of treatment, concurrent treatment, and retrospective reviews.
12. Management of defense counsel.
13. Settlement of disputed cases at the optimum cost point.
14. Payment of claims that are not compensable.
15. The failure to recover reinsurance for claims that exceed the self-insurance retention.
16. The failure to appropriately evaluate the disability rating.
17. Failure to appropriately evaluate the value of future medical benefits when settling a claim.
18. The failure to properly reserve the claim for medical, indemnity, and expense.
It should be noted that even the most experienced workers compensation claims auditor will not uncover ever occurrence of leakage.
Every leakage audit will identify “loss economic opportunities” (insurance talk for the failure to save money.) The leakage amount will vary from only two to three percent of the dollars spent in an excellently managed and operated claims office to a more disheartening 10 to 15 percent of the dollars spent in the poorly operated claims office. However, for a small claims office that pays out $50 million a year, a 2 percent leakage is $1 million. If the same claims office has a 10 percent leakage, that is a hefty $5 million lost. Leakage is often the difference between an insurer and self-insurer making or losing money on their claims program. (WCxKit)
Due to the many ways
leakage can occur, a claims leakage audit has to be conducted by an auditor with a high level of expertise in workers compensation. The inexperienced auditor may recognize some of the mistakes and missed opportunities to favorably impact the claim's overall cost, but it takes an experienced professional to identify most of the leakage in a claims office operation. If you would like to get an idea of the amount of leakage that is occurring in your claims operation, please contact us. We have experienced claims auditors that can help you identify the leakage in your claims operation.
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. See www.LowerWC.com for more information. Contact: RShafer@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.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
Three Sheffield, Great Britain workers nearly became incapacitated from fumes when a decontamination unit began to fill with deadly carbon monoxide, a court heard recently.
The men were part of a five-strong team working in an asbestos enclosure on a demolition site in Huddersfield in November 2009. After working for 90 minutes, each departed the enclosure to go one at a time through a three-stage decontamination unit (DCU).
Huddersfield Magistrates Court heard the workers would begin at the dirty end of the DCU and disposes of overalls, enter a second stage including showers and washing of their respiratory equipment, prior to reaching the final clean section to finish and change into normal clothes. (WCxKit)
The Health and Safety Executive (HSE) prosecuting told the court the first pair of workers passed through each of the stages successfully but the next three men were nearly overcome by dizziness and nausea. All three were sent to hospital where tests indicated they had suffered carbon monoxide poisoning.
The three workers were treated with high-flow oxygen therapy at Huddersfield Royal Infirmary and released later the same day.
The court heard the DCU used a gas boiler to provide hot water for the shower. HSE tests on the boiler showed poor maintenance meant it was pumping out high levels of carbon monoxide. Also, a door seal and lock between the boiler compartment and clean sections of the unit were damaged, leading to poisonous gases being drawn into the clean end. (WCxKit)
The contractor and owner of the DCU, Newlincs Services Ltd, of Dudley Street, Grimsby, pleaded guilty to breaching Section 2 (1) of the Health & Safety at Work etc Act 1974. The company was fined $8200.25 and ordered to pay $5871.2 in costs.
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. See www.LowerWC.com for more information. 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.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
The U.S. Department of Transportations Federal Motor Carrier Safety Administration (FMCSA) has come to a settlement agreement with a trio of trucking associations that will commence litigation over information published on the website of FMCSAs motor carrier enforcement program, Compliance Safety Accountability (CSA).
"CSA is a safety-critical program that helps to reduce commercial motor vehicle-related crashes and save lives," said FMCSA Administrator Anne Ferro. "Through this settlement agreement, we addressed the concerns raised by petitioners without compromising the CSA program and its safety benefits." (WCxKit)
The National Association of Small Trucking Companies, Inc. (NASTC), the Expedite Alliance of North America (TEANA) and the Air & Expedited Motor Carriers Association (AEMCA) filed suit last November, challenging FMCSAs CSA program.
Under the agreement, FMCSA will make changes to CSAs Safety Measurement System (SMS) public website to address concerns regarding the display of information on a commercial motor carriers' safety performance.
The key changes that FMCSA will make to the SMS public Web site by March 25 are as follows:
1. Replace any ALERT symbol currently displayed in orange on the SMS website with the symbol of the exclamation mark inside a yellow triangle.
2. Revise the disclaimer language on the SMS website to read:
"The data in the
Safety Measurement System (SMS) is performance data used by the Agency and enforcement community. A "Yellow Triangle" symbol, based on that data, indicates that FMCSA may prioritize a motor carrier for further monitoring. The "Yellow Triangle" symbol is not intended to imply any federal safety rating of the carrier pursuant to 49 USC 31144. Readers should not draw conclusions about a carrier's overall safety condition simply based on the data displayed in this system. Unless a motor carrier in the SMS has received an UNSATISFACTORY safety rating pursuant to 49 CFR Part 385, or has otherwise been ordered to discontinue operations by the FMCSA, it is authorized to operate on the nations roadways. Motor carrier safety ratings are available at http://safer.fmcsa.dot.gov and motor carrier licensing and insurance status are available at http://li-public.fmcsa.dot.gov."
In December of 2010, FMCSA unveiled its CSA enforcement program that is used to analyze all safety-based violations from roadside inspections and crashes to measure a commercial motor carriers on-road safety performance. (WCxKit)
CSA permits FMCSA to reach more carriers earlier and deploy a range of corrective interventions to address a carriers specific safety problems before crashes can occur.
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. See www.LowerWC.com for more information. 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.
©2011 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 Chairman of the WorkCover Western Australia Board, Greg Joyce, recently announced the 2011/12 recommended premium rates for compulsory workers compensation insurance in Western Australia.
Joyce said that the average recommended premium rate would be 1.547% of total wages for 2011/12 up from 1.497% of total wages for 2010/11, and representing an overall increase of 3.3%. (WCxKit)
“This represents a modest increase over the 2010/11 rate”, said Joyce. “Western Australia has experienced historically low recommended premium rates over the past few years”, he said, “and this trend continues despite the small increase this year”.
The recommended premium rates are independently calculated by the workers comp scheme actuary, PricewaterhouseCoopers. The rates are based on data provided by insurers, as well as broader economic factors such as movements in wages.
This year’s 3.3% increase is largely due to workers comp claims costs growing more than wages, reversing the trend of recent years when wages grew much faster than claim costs. Increased costs associated with lump sum settlements also contributed to the increase.
The increase is not applied uniformly across all 480 premium rating classifications; premium rates in 195 industry classes will decrease, 264 will increase and 21 will remain unchanged, reflecting the performance of individual industries. (WCxKit)
Joyce said that the 2011/12 recommended premium rates take into account the latest available data on claims experience and future wage and employment growth.
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. See www.LowerWC.com for more information. 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.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
Factories are often thought of as dangerous places to work. But, that is wrong if the factory has a proper safety program in place. The creation of a safety program for a factory is not much more difficult that creating a safety program for any other type of business.
The success of any safety program relies on the emphasis safety is given within the company. A company culture of safety that originates with the senior management of the company, with the safety culture being promoted all the way down through the ranks of the company, will have a major impact on the safety record of a factory. (WCxKit)
The safety guidelines for factories are similar to the safety guidelines in many other industries. Key factory safety guidelines include:
1. All employees will wear all required safety gear, safety glasses, and safety clothing for their job/position while at their workstation.
2. All employees working around moving machinery are prohibited from wearing loose clothing or loose jewelry.
3. All employees working around moving machinery must have long hair tied back where it can not fall forward or be caught in the machinery.
4. All tools will be in use or will be stored at their proper location at all times, no tools are to be left in any location where they are not being used or being stored.
5. All equipment, tools and machinery are to be kept clean and in full working condition, with any defects being immediately reported to maintenance.
6. The instruction manuals for all machinery must be readily available for review.
7. All equipment and machinery is to be shut down when not in use.
8. All presses and machinery will require two hand operation to keep fingers and hands away from moving part.
9. All machinery is to have the manufacturer's installed safety guards.
10. No machinery is to be modified by any employee who is not specifically trained in the technical aspects of the machinery.
11. All work areas are to be kept properly lit when anyone is working.
12. All work areas are to be kept properly ventilated.
13. All areas of the factory are be kept clean and organized.
14. Anyone working in the factory under the influence of drugs or alcohol will be immediately terminated.
The safety officer for the factory should require every job to have a job hazards analysis with each employee performing that job being trained in recognizing the hazards to which they can be exposed and being trained on how they can safely eliminate or reduce those hazards. Each job should have a safety checklist with the employee being able to obtain a 100% grade on test questions about the requirements of their safety checklist.
All employees conducting work that requires specific OSHA training must be required to complete the OSHA training before they can start work in the factory.
The factory safety officer should perform frequent factory inspections to identify any hazards the employees might have missed. Any identified hazards should be immediately addressed and corrected. The safety officer should also hold regular scheduled safety training classes as well as requiring safety classes for all new hires before they can do any work in the factory.
Fire drills and other emergency evacuation drills should be conducted to ensure all employees know how to quickly and safely leave the building. As a part of all emergency drills, the employees need to know whether to shut down their machinery or to leave it running when they evacuate the building. As a part of the fire and emergency evacuation drills, all employees need to know where the fire extinguishers, fire hoses and other emergency equipment is located, and how to use the equipment in an emergency. (WCxKit)
The establishment of a strong safety program within the employer's factory will result in a significant reduction in the number of workers compensation claims and their resulting cost. If you need any assistance in establishing your factory's safety program, our website has extensive information about building a safety program.
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. See www.LowerWC.com for more information. 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.
©2011 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 editorial staff at Amaxx Risk Solutions, Inc., the home of
LowerWC.com and
Workers Comp Kit was surprised yesterday morning (March 19, 2011) by a Hartford
Courant article citing our president, Rebecca Shafer, J.D., as “The Go-To Guru On Workers Comp.”
When I asked Becki how she “forgot” to mention this to us she said, as always, “You know, I prefer to call attention to our resource center and not myself personally.”
The Courant’s Q&A covered Becki’s professional experience and prominent clients she has worked with over the years noting the patented development of our web-based workers comp cost containment system, saying:
“She has patented an automated Web-based cost-containment system,
Workers Comp Kit, which includes a best-practice assessment and scoring system, and the ability to calculate benchmarks instantly using various data.”
The article resulted from her selection as a Lexis Nexis Notable Person and her work on
Lexis Nexis Workers Compensation Law Community Executive Committee with Attorneys Lex Larson, Tom Robinson, Robin Kobyashi, Stuart Colburn and Brad Bleakney.
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.
©2011 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 Boston police officer recently ended up on the wrong side of the law.
According to authorities, the detective, once honored as a department "top cop'' for locating a missing baby, pled guilty to federal charges of faking injuries in order to obtain disability payments. (WCxKit)
Eliezer Gonzalez, 49, recently changed his plea to guilty to 34 counts of mail fraud.
According to prosecutors, Gonzalez "greatly exaggerated and falsified both his injuries and ongoing physical issues.''
Surveillance tapes caught Gonzalez arriving at medical appointments walking slowly with a cane and accompanied by someone to assist him. But he was videotaped walking and acting just fine, even riding a motor scooter and sightseeing with friends in Vietnam.
According to Gonzalez, he suffered a back injury in 2007 when he was tossed on a cement floor while struggling with a suspect. (WCxKit)
Gonzalez faces up to 20 years in prison when he is sentenced June 3.
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. See www.LowerWC.com for more information. 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.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
Taming Federal Workers Compensation (FECA) with Medical Expertise
I had an interest in learning more about how Federal workers compensation cost controls operate, so I asked Lisa Firestone, owner of Medical Care Advisors (MCA), what type of cost containment can be done on the federal side of workers compensation. Here’s what she told me.
After spending years in the alphabet soup of federal contracting, Managed Care Advisors (MCA) has thrown its hat in the ring of acronyms-as-words with CARE: Concentrated Action for Recovery and Employment. They take a special approach to nurse case management.
One of the tools utilizing the skills of the multi-team approach in the federal sector includes the CARE team meeting face-to-face with the relevant representatives of the Department of Labor’s Office of Workers’ Compensation Programs (OWCP). In the federal sector, the OWCP is responsible for the official adjudication of claims. This contact drives case progression in three deliberate phases:
1. Before – Case summaries are submitted to the assigned OWCP Claims Examiners prior to a meeting. While offered as a form of preparation, this step sometimes prompts action and resolution for cases even before the CARE team arrives.
2. During – The meeting itself provides a platform for clear communication, and brainstorming for case resolution. Simply put – no one has to play phone tag. What might have taken months to happen before can now be decided in minutes.
3. After – Most importantly, these meetings help establish rapport between a Federal Agency client and an OWCP Claims Examiner and other members of the claims staff up to the level of the District Director. When a Claims Examiner has a to-do list a mile long, being able to put a face with a name can be the difference between getting squeezed in today and waiting three weeks for a reply.
"The CARE unit of nurse case managers focuses on resolving our clients' long term cases," says Firestone, including those on the federal workers’ compensation periodic roll. While management of older cases has always been an integral aspect of MCA's approach to case management, CARE is another step along the evolution of that commitment, she explains. The CARE team brings industry best practices to bear on these challenging cases.
I asked her "What do you do with a case of 1-30 years?" and she explained that while every case is different, a CARE nurse often begins with a methodical review of case records ranging from one to 30 years of treatment and administration, with emphasis on identification of obstacles to resolution. This information is often distilled into a one-page summary, which can immediately bring any stakeholder in the case up to speed. The CARE team then works with the client to formulate a resolution strategy. While plans are a good starting point, the CARE unit's real strength is finding creative ways to jump-start these stalled cases, and following through on identified plans and actions.
Since many of these cases involve ongoing lost time days, MCA’s approach to case management stresses objective verification of total disability, analysis of medical care utilization, empowerment of the injured worker, and clarification with employer and claims team that appropriate benefits are being provided and administered. The result of this team approach is reliable cost control. CARE nurses maintain the integrity of the injured worker and treating provider’s roles while analyzing objective data.
CARE nurses are able to progress these cases by using a variety of techniques. Telephonic contact with the injured worker ensures commitment to the healing process, and fosters a positive mindset for increased activity, including returning to work. Case reviews by the MCA Medical Director, an MD, identify gaps in medical reasoning, and avenues for case progression. Written contact with the treating provider opens communication and can lead to appropriate reductions of restrictions.
Lisa Firestone is an owner of Managed Care Advisors, Inc. (MCA) is an innovative, woman-owned small business enterprise specializing in managed care, employee health benefits and workers compensation consulting and case management services. Contact
http://www.managedcareadvisors.com/
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. See www.LowerWC.com for more information. Contact:RShafer@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.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
Sometimes, employers and TPAs must deny benefits. Here's why.
Contrary to the opinions of plaintiff attorneys, there are valid reasons workers compensation benefits should be denied. The following are ten common reasons workers comp benefits may be denied, but there are other justifiable reasons to deny workers comp benefits. This discussion is general in nature and will not apply to all jurisdictions, but generally will apply to most states. It's important to pay legitiamet claims quickly – these claims are considered "compensable." Claims that are not compensable must be denied by law.
1. Injury Happens Away From Work
One of the most common types of workers compensation fraud is when an employee alleges an injury happened at work when it actually occurred away from the job. When the employer's investigation or the claims adjuster's investigation reflects the injury occurred at a time the employee was not on the job, the workers comp claim should be denied. For an injury to be covered by workers comp, it must occur during the work period and at a location of the employers' where the employee would be performing the job duties of the employer. (WcxKit)
2. Traveling to/from Work
When the employee works at a fixed location, injuries that occur while the employee is traveling to or from work are not normally covered by workers comp. An injury on the way to work or from work can be covered if the employee is in the process of providing a benefit to the employer. For instance, an errand picking up supplies at the office supply store, when an injury occurs. However, if the employee is traveling to or from work for the employee's own benefit, the workers comp claim will be denied.
3. Not Medically Justifiable
When employees reach their maximum medical improvement, they are normally released by the medical provider to return to work, if they have not already returned to work. When the employee does not want to return to work for whatever reason, they may seek to continue their medical treatment. If their treating doctor allows them to remain off work, often an independent medical examination will confirm their continuing to seek medical treatment and to stay off work is not medically justifiable. At this point the adjuster will deny further workers comp benefits.
4. Late Notice of Injury
Every state requires the injured employee to give notice to the employer in a timely manner from when the employee is aware of the injury or occupational disease. What is timely varies greatly from “immediately” in Washington State and West Virginia to two years in New Hampshire. (Most states have a longer time frame for latent injuries and occupational diseases like asbestosis). If the employee does not report the injury timely, and does not have an excusable reason, the workers comp claim can be denied.
5. Treated with an Unapproved Medical Provider
In approximately half of the states, the employer selects the medical provider for the treatment of the employee's injuries. When the employee elects to treat at an unapproved medical provider, the workers comp benefits should be denied.
6. No Medical Treatment
If an employee calls in to work with an excuse like “I can't come in to work today, because I hurt my back yesterday on the job,” there are no workers comp benefits when there is no medical treatment. Regardless of how many days the employee claims he stayed home in bed while his back got better, it is not a workers comp claim. There must be medical treatment to verify the nature and extent of the injury, or indemnity benefits will be denied, even when employee remains off work longer than the state's waiting period.
7. Insufficient Documentation the Injury is Work Related
While most non-medically trained people will think injuries like carpal tunnel are always work related, that is not always the case. Carpal tunnel, hearing loss and other progressive injuries are often a function of aging or other non-work related factors… If the medical provider is unable to determine whether the injury occurred as a result of the work done by the employee or is due to non-employment related causes, the workers comp claim will normally be denied. When there is insufficient documentation the injury is work related, the employee will often seek additional medical evaluation until a definite determination of the cause of the injury can be made.
8. Pre-existing Condition
Various jurisdictions will not consider the aggravation of a pre-existing condition as a workers comp claim. For instance, the employee has degenerative disc disease of the lumbar spine. The normal activities of the employee's job aggravates the degenerative disc disease causing the employee to have back pain. If there is no specific event, which causes pain from the pre-existing degenerative disc disease when a workers comp claim is brought, it is denied.
9. Intoxicated
Most states allow the workers comp insurer to deny a claim if the employee is intoxicated at the time of the injury and the intoxication was a contributing factor in the accident that caused the injury. A positive drug test or a positive blood alcohol test is needed for the insurer to deny the workers comp claim. If you suspect your employee is under the influence of drugs or alcohol at the time of the accident, request the emergency clinic or other medical provider to perform a drug test and a blood alcohol test in conjunction with their emergency medical care. (WcxKitz)
10. Horseplay, Rough Housing and Practical Jokes
When the employee is the perpetrator of horseplay, rough housing or a practical joke, and the horseplay, rough housing or practical joke backfires on the employee and the employee gets hurt, in most jurisdictions there is no workers comp benefits available. Any claim brought by an employee is denied, because the horseplay, rough housing, or practical joke has no benefit to the employer and the employee is not considered as being on the job.
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. See www.LowerWC.com for more information. 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.
©2011 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 Minnesota Department of Human Services has been ordered to pay $467,000 to resolve age-discrimination claims filed on behalf of 29 individuals who were turned down for employer contributions for retiree health and dental insurance.
The Star-Tribune reports the consent decree entered by U.S. District Judge David Doty also mandates the department to pay future premium costs for anyone still entitled to receive them. (WCxKit)
The U.S. Equal Employment Opportunity Commission (EEOC) had sued the department over the plan and contended that an employee retiring at 55 got employer contributions for health and dental insurance until 65, but an employee retiring after 55 received no such contributions.
Ten months ago, a similar order was issued against the Minnesota Department of Corrections. In that case, the Minnesota Department of Corrections was told it must pay $724,000 to 35 retirees. (WCxKit)
"The EEOC litigated and won on the issue of the illegality of this incentive plan," the EEOCs regional attorney in Chicago, John Hendrickson, said recently in announcing the order. "We will continue to be on the lookout for similar plans, which essentially end up punishing people who want to work after a certain age."
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. See www.LowerWC.com for more information. 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.
©2011 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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