As the Workers Health & Safety Centre points out, these amendments placed significant duties on employers relating to workplace violence and harassment. Top among employer obligations is the requirement to develop and implement workplace violence and harassment policies and program(s). To this end the employer must also provide all workers with information and instruction on the content of the workplace policies, hazard control measures, and other procedures outlined in the program designed to implement the policies. (WCxKit)

 

 

 

 

 

 

The Workers Health & Safety Centre (WHSC) can help as it offers handy compliance checklists for both employers and workers. The WHSC also offers a three-hour Workplace Violence and Harassment Prevention training program designed to help prepare workplaces for a better understanding of workplace violence and harassment and to reach full compliance with the workplace prevention obligations required under the Act. Finally, the WHSC has published fact sheets on workplace and domestic violence relating to the workplace. (WCxKit)

 

 

 

 

Posted in Canada Workers Comp, Safety and Loss Control |

 

 

 

 

 

Some hospitals have finally come to understand the risks their professionals undertake in these jobs and have established "lifting teams." The following links are to the press release and to the published study of the consequences of one such effort: https://www.miamivalleyhospital.org/mvhdefault.aspx?id=10770 and www.innovations.ahrq.gov/content.aspx?id=1813.

 

 

 

 

 

 

 

 

The situation of morbidly obese employees in general is another area where prevention can be fruitful. Osteoarthritis of the knees is virtually universal in long-standing obesity. If such a person is placed in a job requiring frequent squatting or climbing of stairs and ladders, they will develop knee pain and one or more surgical procedures is sure to follow. Somewhat akin to the knee injuries are shoulder injuries. Morbidly obese individuals cannot arise from a chair without using their arms. Shoulders were not designed to be weight-bearing joints, so when they are used for that purpose, they break down. Large rotator cuff tears and shoulder arthritis will develop, and if a shoulder becomes painful in the course of work that stresses that joint, the problem will end up being compensable as well. (WCxKit)

 

 

Please understand – I am not saying that obese individuals should not be hired or that they do not make good employees. Nonetheless, it is in everyone's best interest that the individual's capabilities match the job and the risks he or she is being assigned to undertake. Most companies of any size have employee assistance programs for those who are having problems with abuse of tobacco and other substances. Obesity is the abuse of food. Developing a meaningful incentive program to support and encourage obese employees in the weight loss process  pays off many times over by improving employee health, minimizing lost time from work, cutting down on both workers compensation and health insurance costs, and preventing a lot of personal misery. Besides – it is the right thing to do.
 

 

Posted in Medical Issues, Risk Management, Safety and Loss Control, Wellness Programs and WC |

Often it is assumed the designated adjuster(s) working on your workers compensation files is a good adjuster. But, you know what “they” say about “assuming.” Use these eight tips to judge your adjuster(s) overall ability and effectiveness.

 

 

Track how often the adjuster makes timely contacts. If your Best Practices say claimants, medical providers, and the employee's supervisor must be contacted within 24 hours of the first report of an accident, expect your adjuster to be making timely contacts with all parties at least 90% of the time. The higher the percentage, the better. Timely initial contacts go a long ways toward establishing the future tone of your claims and establish the adjuster as the person in charge. (WCxKit)

 

 

When you look at your loss run and compare what the claim settled for against the claim reserves you gain insight into the ability of the adjuster to evaluate the claim. If you see a lot of reserve changes right before the claim settles, then the adjuster is either inexperienced at evaluating the claim or is indifferent to the impact reserves have on your company. If you see the reserves on the claim were established since the adjuster obtained key medical information on the injured employee, you know the adjuster is looking out for your financial interests.

 

 

Does the adjuster always answer the phone when you call, or do you often have to leave messages and wait a few days to hear back? When you send e-mails, do you get a prompt response, or do you forget what the subject of the e-mail was by the time the adjuster responds? A good adjuster tries to keep you informed about your claims and takes the time to respond to your questions and needs. The quicker the response from the adjuster, the better the adjuster.

 

 

If your employee complains the TTD or TPD check did not arrive on time, then the adjuster is not organized (or may have too many claims to handle properly). You should expect never to hear from an employee about the indemnity check not arriving. If your employees are receiving dunning notices from their doctors on medical bills, then the adjuster is not processing the bills timely. While any adjuster may occasionally have a medical bill or other missed expense, you or your employees should not be constantly getting reminders on medical bills.

 

 

The good adjuster stays in contact with employees out on workers comp. The great adjuster builds rapport with the employees and the employees make an effort to keep their adjuster informed as to their medical progress and their ability to return to work. The poor adjuster has a higher percentage of employees represented by an attorney then the good adjuster. As the percentage of employees represented by attorneys is impacted by the legal climate in your locale, you must consider the results of your adjuster compared to other adjusters in the same locale.

 

 

When you have a question about workers comp in general, the good adjuster can answer it for you, (or at least get you the answer). If the adjuster does not know the answer, or tells you it would be better for you to talk to a workers comp attorney or the adjuster's supervisor, the adjuster's workers comp knowledge is weaker than it should be. The good adjuster knows all the ins and outs of state statutes and is willing to share that information with the employer.

 

 

Often claim offices do not want to talk about their claim quality audit scores. This often arises out of a concern that the employer may not understand that the 100% perfect claim file seldom happens. However, the good workers comp adjuster scores in the 90+ percentile. Ask the adjuster for a copy of the most recent audit score. The good adjuster is glad to share it with you. The weak adjuster probably has reasons why it cannot be shared.

 

 

Every adjuster knows the best file is the closed file. However, it is seldom a good idea to close a file prematurely. The good adjuster makes sure all aspects of the claim are resolved, all medical bill paid, all indemnity checks issued, and all expenses paid before closing the file. If you see more than a few reopened files on the loss run report, than the adjuster is closing claims prematurely. (WCxKit)

 

 

None of these 8 criteria alone indicate a good or poor adjuster. When the adjuster is strong in all 8 areas, you have a great adjuster working your claims. If the adjuster is weak in most of these areas, it is time to consider requesting another adjuster to handle your workers comp claims. Having a strong adjuster on your claim files makes your life easier and saves money. A few select TPA's DO actually "grade" their adjusters, giving monthly bonuses to those that excel, and get high grades – nearing 100.

 

 

Posted in Broker Issues & Relationships, TPA and Claims Administration, WC 101 |

 

 

 

 

 

 

 

 

 

 

 

 

Posted in Safety and Loss Control, Seminars and Courses, WC in Other Countries (International) |

A British worker suffered fatal head injuries recently when he was struck by a steel barrier while carrying out maintenance on a machine.

 

 

Balbir Rayatt, 55, from Ilford, Essex, worked as an engineering and maintenance manager for car mat manufacturer Cannon Automotive Limited in Tottenham, London. (WCxKit)

 

 

On May 20, 2008, Rayatt suffered fatal head injuries when the heavy steel fabrication barrier fell on him while carrying out repairs on a rubber-mixing machine.

 

 

The Health and Safety Executive (HSE) investigation revealed the barrier had been stored vertically and unsecured against rubber compound powder containers. The court heard the firm failed to assess the risks and implement a suitable and sufficient safe system of work for the maintenance of the mixer. 

 

 

City of London Magistrates’ Court heard Cannon Automotive Limited did not supervise, manage, monitor, audit or review its arrangements regarding maintenance operations on the mixer to ensure they met the health and safety standards.

 

 

Cannon Automotive Limited of Tottenham, London, pleaded guilty to breaching Section 2(1) of the Health and Safety at Work etc Act 1974. It was fined a total of $33,266 and ordered to pay costs of $21,836.39.

 

 

Speaking after the prosecution, HSE Inspector Neil Fry noted, "This tragic death was utterly preventable. Poor standards and failure to keep working environments in a good condition are a major cause of these types of incidents and also occupational diseases.

 

 

"Maintenance is a process that affects every aspect of safety and health and when a tragedy such as this occurs it demonstrates the importance of planning when carrying out maintenance work. (WCxKit)

 

 

"Unfortunately it is too late for Mr. Rayatt, but I would hope employers in London and around the UK will take note."

 

 

 

http://corner.advisen.com/partners_wctoolkit_book.html

 

Posted in Medical Issues, Safety and Loss Control, WC in Other Countries (International) |

Wal-Mart Stores Inc. came out on the losing side of its appeal of the majority of a $187.6 million verdict for Pennsylvania hourly workers who allege the world's largest retailer disallowed meal and rest breaks.The case was brought on behalf of some 187,000 present and former Wal-Mart Pennsylvania employees working from 1998 to 2006.They contended the Arkansas-based employer took part in improper practices to enhance productivity, increase profit, and trim expenses.

 

 

According to a report from the Economic Times, the three-judge panel of the Superior Court of Pennsylvania said there was sufficient evidence for Philadelphia jurors in 2006 to conclude that Wal-Mart's practices violated state wage and hour laws. It also claimed Wal-Mart's own internal review brought up violations related to "off-the-clock" work.(WcxKit)

 

 

The record reflects testimony and documentary evidence suggesting that because of pressure from the home office to reduce labor costs and the availability of significant bonuses for managers based on store profitability, Wal-Mart's scheduling program created chronic understaffing, leading to widespread rest-break violations according to the appeals court records.
 

 

It nonetheless instructed the trial court to recalculate a $45.6 million award of legal fees, claiming that court erred by "double-counting" some factors.
 

 

The case was brought by Michelle Braun and Dolores Hummel, who had respectively worked in Wal-Mart and Sam's Club stores in eastern Pennsylvania, and drew on evidence from some 46 million shifts according to court records.(WcxKit)

 

 

Posted in Employment Law Issues, Litigation Management |

Most employers like to think that their workers compensation claims office, whether it is with their workers compensation insurer or with a third party administrator (TPA), has their best interests in mind. In most cases, they do. But, there are areas where the claims office may put their own self interest ahead of the best interest of the customer – you the employer. Here are some of the situations where the claims office does not want you to know what is going on.

 

 

The claims office, whether a part of the work comp insurer or a part of a third party administrator, is in business to make money. The bigger the client, the more money the claims office receives for handling their claims. While large accounts can have some minor impact on the pricing of claims services, the cost to handle a workers compensation claim is roughly the same regardless of whether it comes from the largest account or the smallest account. Hence, the bigger the account the more important it is to the claims office profit. The management of the claims office will strive harder to provide the level of service needed to keep the big accounts happy. If you are a small or middle-size employer, you are often better off being with a smaller insurer or TPA (better to be the medium size fish in the pond, then to be a minnow in the ocean) that provides boutique service and is willing to customize their services. (WCxKit)

 

 

If you report your workers compensation claim and then forget about it, that is usually okay with the adjusters (however, they do love it when you provide a modified duty return to work program which gets the claims closed faster). But, if you have a program where you check the medical status of each injured employee each month until they are back at work, the adjuster(s) soon learn to be up-to-date on the medical status of each of your employees. If you have a monthly round-table discussion on the progress of your larger claims, the adjuster(s) soon know to be sure the claim keeps moving forward so they can report positive results. If you have an independent Best Practices Audit done every six months or annually, the adjuster(s) learn to comply with your Best Practices requirements.

 

 

One of the best ways to minimize the hiccups and hitches in handling your claims is to have a dedicated adjuster(s) assigned to your account. The dedicated adjuster works only on your work comp claim files and soon knows exactly how you want things done. That is great for you, but it creates some staffing issues for the claims office. The number of claim files – the claim volume – fluctuates in the claims office. When the claim volume increases, they want to spread out the additional claims to all their adjusters so they can get additional income without hiring additional people. However, if you have a dedicated adjuster assigned to your account only, they can not assign the additional new files to "your" dedicated adjuster(s). On the flip side, when claim volume decrease and they have to reduce staff, your dedicated adjuster is harder to terminate, as they do want you to be unhappy and take your claims business elsewhere. It is more cost-effective to provide "designated" rather than "dedicated" adjusters. In many cases, it may serve you better to use the designated adjuster model.

 

 

When the claims office provides poor service and the lack of good claim handling skills cause the work comp claim to cost more than it should, the claims office will not call you up and say “sorry, we did a bad job, here is your money back." Both the frequency and the severity of claims is used to calculate your workers compensation premium. When any aspect of the Best Practices is not done, the result is normally a higher claim payment – severity. That “extra” severity is money out of your pocket with future higher workers compensation premiums.

 

 

One of the biggest mistakes the self-insured employer can make is to not have their own set of client instructions. The claims office management will tell you “we have a stringent set of best practices” with the hope that you will let them go their merry way doing things the way they want to do them. When you provide a custom set of client instructions, then the claims office feels a certain amount of pressure to do it your way, especially when you call them on it when they deviate from your client instructions. Your own customized client instructions to do it your way combined with your dedicated adjuster(s) will result in much higher product quality in the claims office.

 

 

To keep the claims office profit at the optimum, the claims office management strives to keep every adjuster with a full case load. Sometimes, the full case load gets a bit too full for the adjusters. When the client has a medical case management program, the triage team or the nurse case manager can provide important information to the adjuster without the adjuster having to take time to develop the information her/his self, and RNs provide additional insight into the medical conditions. The saved phone calls to the medical providers, and the time saved coordinating medical care for the employee makes the life of the work comp adjuster a bit easier, but it is not an easy job!

 

 

As the claims handling world has become computerized (for the most part), a ton of information is now available in the claims management information systems (computers). The insurer or the TPA will usually offer to provide you with the basic loss run. However, with the modern computer systems, you can slice and dice the information just about any way you want. Want to know how many “accidents” are reported on Monday morning? You can a request a computer run by date of loss. Want to know your average number of days of TTD payments? The computers can calculate that. The claims office may not  bring you suggestions on how they can provide you with more information, but if you have an information question that can be measured, ask the claims office to share the information with you.

 

A bi-annual roundtable with your entire claims team (in person, the old-fashioned way) build relationships and provides a forum for adjusters to make suggestions that can improve your workers compensation claims handling program.  

 

 

 

Posted in Coordinating Medical Care, Insurance Issues, Rates, Premiums, Return to Work and Transitional Duty, TPA and Claims Administration |

 

 

According to the ASSE, the bill, entitled “Enhancing Occupational Safety and Health Protections in the 100th Year Act of 2011,” is intended to help improve OSHA and NIOSH capabilities and better encourage employer responsibility for worker safety and health. (WCxKit)

 

 

 

 

 

 

 

 

In his letters, Hill notes that the changes to the OSHA  Act  ASSE offers are structural in nature, meant to help OSHA work better, be more effective in its outreach, and keep up with rapidly advancing knowledge about how to protect workers and workplaces. (WCxKit)

 

 

 

 

Posted in Safety and Loss Control |

 

 

According to a number of media outlets, including The Associated Press and The Miami Herald, Disney recently extended the closure of Primeval Whirl, a spinning coaster in Disney’s Animal Kingdom that has been closed since January for maintenance, until at least September 14, 2011. The reopening of the ride, initially slated for April, already was postponed once, until early June 2011. (WCxKit)

 

 

 

 

 

 

 

 

 

Posted in Litigation Management, Safety and Loss Control |

 

 

Australian Industry Group chief executive, Heather Ridout welcomes the "first big piece in the mosaic of Occupational Health and Safety (OHS) reform” and commended Queensland on the passage of the Work Health and Safety Bill through the state parliament. (WCxKit)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

"Removing the confusion, complexity and duplication caused by Australia's multiple workplace health and safety regimes help save the Queensland economy more than $30 million a year,” Dick said. (WCxKit)

 

 

 

 

Posted in Safety and Loss Control, WC in Other Countries (International) |