Washington State is one of the four remaining monopolistic states (where the state government is the insurer rather than private insurance companies). In the November 2, 2010 election, there was a measure on the state ballot to privatize Washington's workers compensation system, but it was rejected by the voters.
Compulsory Coverage
Employers with one or more employees must have workers compensation insurance for the employee(s). Sole providers, partners, corporate officers, and the manager of a limited liability company may elect to exclude themselves from the workers compensation insurance coverage requirements. Workers compensation coverage is not required for a newspaper carrier, real estate agents or brokers, a beautician or barber renting booth space, a child under age of 18 employed on the family farm, a domestic or gardener for a private home as long as only one person is employed, and a person working for a religious or charitable organization in exchange for sustenance. (WCxKit)
Obtaining Coverage
To obtain workers compensation coverage in Washington, the employer has two options which are:
1. Participate in the state monopolistic workers compensation insurance program administered by the Washington State Fund in the Department of Labor & Industries.
2. Meet standards set by Washington State to be a self-insured employer. (About 400 employers in Washington are self-insured, but they are the largest employers covering between one-fourth and one-third of the total workforce.)
Claim Reporting
The employee must submit to Department of Labor & Industries or the self-insured employer a claim application within one year of the injury or within two years of the doctor's diagnosis of an occupational disease. The medical providers of employees covered through the State Fund are required to submit the Report of Industrial Injury or Occupational Disease. The medical providers to employees of employers who are self-insured are required to submit to the employer the Self Insurer Accident Report. If the employee is unable to return to work, the physician is required to submit the Activity Prescription Form.
Cost of Workers Compensation
Washington is the only state that allows the employers (who purchase workers compensation insurance from the State Fund) to deduct a part of the cost of workers compensation from the employees' wages. The employer can deduct up to half of the cost of the premium portion that pays the medical benefits and the portion of the premium that pays the cost of living increases for the injured workers drawing life-time compensation benefits – known as pensions. Employers must pay the entire portion of the premium that is used to pay lost time compensation and pensions. Overall, employees pay approximately 27 percent of the total work comp premium to the state.
Self-insured employers can deduct from the employees wages: 1) one-half of the Supplemental Pension Fund assessment; 2) one-half of the Asbestos Fund assessment; 3) the self-insurance Overpayment Reimbursement Assessment.
Medical Benefits
The employee selects the medical provider of their choice. If the employee is not satisfied with the medical care provided, the employee can change doctors at will. If the employee is not satisfied with the medical recommendations of the selected medical provider, a second opinion can be obtained if approved by the claims administrator.
All reasonable and necessary medical care is covered by workers compensation. There are no time limitations or monetary limitations on the medical benefits. All billing of medical services by medical providers must be in compliance with the fee schedules published each year by the State Fund.
Temporary Total Disability (TTD)
When an employee in Washington State is certified by the medical provider as unable to return to work, the State Fund or the self-insured employer will pay TTD. The compensation rate varies from 60% to 75% of the gross wages, depending on the employees martial status (or registered domestic partnership) and how many dependents the employee has (60% for the employee, 5% additional for a spouse, and 2% additional for each additional dependent, up to 5 additional dependents).
The maximum amount of TTD benefits that can be paid is 120 percent of the state average monthly wage. The minimum amount of loss time compensation benefits that can be paid is 15 percent of the state average monthly wage. The maximum amount had been recalculated each year, with the new rate going into effect on July 1st. On June 5, 2011 a one-year freeze on time loss benefits was signed into law. The TTD benefit maximum for July 1, 2011, through June 30, 2012, will be the same as the previous year. The monthly dollar maximum TTD benefit for July 1, 2011, through June 30, 2012, is $4,715 and the monthly minimum TTD benefit is $185.
The first 3 days of disability (the waiting period) are not paid to the injured employee unless the employee is disabled for more than 14 days. TTD benefits can be paid for as long as the medical provider keeps the employee off work.
The Stay-at-Work Program instituted by the Labor & Industries office effective June 15, 2011 is taking a very proactive approach to providing modified duty to injured employees. In the new program the Labor and Industries office will reimburse employers for half of the worker's wages while the employee is on working on modified duty. The Stay-at-Work Program is designed to speed workers' recovery, prevent long-term disability, and reduce cost for both the State of Washington and for the employer.
Permanent Partial Disability Benefits
Washington State employees are paid permanent partial disability (PPD) benefits for any permanent disability suffered as the result of an on-the-job injury. Washington State uses a schedule of injuries for limbs, vision and hearing. The total loss of a body part is worth a set dollar amount stated in the schedule. A partial loss is paid as a percentage of the set dollar amount.
For non-scheduled injuries, the maximum period of payments is not specified. The maximum dollar amount for permanent partial disability is currently (February, 2011) $149,116 but subject to change each July 1st. Payments are based on a percentage of disability.
Permanent Total Disability (PTD)
The amount of indemnity compensation for PTD is calculated the same as for TTD. PTD is paid for the balance of the employee's life, but the State Fund or the self-insured employer is allowed an offset for the amount of Social Security benefits the employee receives. PTD benefits are referred to as pension. The injured employees drawing a pension also get an annual cost of living increase. There is no provision in the state workers comp law for a settlement of PTD claims. Therefore, the Washington State Fund has a funding problem now with half of all workers comp payments going to people drawing lifetime pensions.
In an effort to reduce the amount of money being paid for PTD, effective June 15, 2011, workers who are age 55 or older have the option to negotiate a settlement agreement with periodic payments rather than staying in the work comp system or being retrained for another job. The workers who opt for the settlement agreement will continue to be eligible for medical care.
Death Benefits
The burial expenses in Washington State are covered for a work-related death up to $7,709.32. The death benefits for a dependent spouse are 60% of the average monthly wage plus 2% for each dependent child up to 5 children. The maximum and minimum amounts follow the TTD guidelines. There is no lifetime maximum amount or dollar maximum for death benefits. If the spouse remarries, the spouse receives 24 months of death benefits or the lifetime annuity value, if less. Children receive benefits until age 18 or until age 23 if a full-time student. Disabled children can receive death benefits beyond the age of 18.
Vocational Benefits
Washington workers compensation law also includes discretionary vocational benefits (the State Fund or the self-insured employer determines whether or not they will offer vocational benefits). Vocational rehabilitation is in the best interest of the employer and the employee as placement in a new job reduces or eliminates the amount of PPD that will be paid, and stops the employee from making a claim for a lifetime pension (PTD). (WCxKit)
If the injured employee is unable to return to their prior job due to disabilities from the on-the-job injury, and the employee does not have the skills for a different job, a vocational counselor can be assigned to work with the employee. If the employee declines the vocational counseling, medical and indemnity benefits can be terminated. The vocational counselor will develop a training plan that is reviewed and approved by the Department of Labor & Industries. The vocational plan includes a job goal based on the employee's skills, interest and medically documented limitations. It can include schooling or on-the-job training for up two years.
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.
Designated FEMA responder since working with hurricane Katrina, Rita, Ike, and Lili support staff, Medcor, a workers compensation medical care provider, will be providing on-site medical services to support about 360 relief workers in Minot, ND, for the next three months. Relief workers operating from a field operations center help Minot (pronounced “my-not”) residents devastated by flooding. The company has deployed a mobile clinic that includes staff living quarters, office space, and an exam/treatment room.
Medcor executive vice president Curtis Smith said the deployment took place within 72 hours of being asked. This assignment’s staff includes Brian Schroeder and Jodi Meere, paramedics and U.S. Army veterans from Iraq.
Headquarterd in McHenry, Ill, Medcor travels the globe to provide corporations with efficient healthcare. While the company works extensively with off-shore drilling industry, it also provides support to remote scientists in the Amazon jungle, for example. In this latest deployment, Medcor gives flood relief workers in North Dakota appropriate health services which greatly contains their employers workers compensation costs.
Now that floodwaters have dropped below flood stage for the first time since spring, relief workers are able to assist in cleanup and rebuilding Minot. The city experienced extensive damage after the Souris River broke a 130-year high-water record, cresting nearly 13 feet above flood stage. Approximately 11,000 people were evacuated from the Minot area — flooding damaged 4,100 homes in the hundreds of businesses, Smith said. Minot is a city of just over 40,000 people – the fourth largest in the state. It is also known for a U.S. Air Force base 15 miles north of it.
“Relief work is physically demanding in unstable environments, so injuries and exposure hazards do occur. Medcor accompanies the relief workers so the workers do not need to rely on local medical resources which were also affected by the floods,” Smith said via press release. “Having Medcor at the field operations center also frees up local medical resources to focus on providing care to local residents.”(WCxKit)
About Medcor:
Medcor provides telemedicine services to nearly 90,000 worksites in all 50 states and operates 174 on-site workplace clinics. Medcor’s services are available 24/7 for worksites of any size in many industries. Medcor’s services help employers reduce health care costs while improving access to care and outcomes. Medcor is headquartered in McHenry, IL. For more information, visit www.medcor.com or contact Curtis Smith at csmith@medcor.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@ReduceYourWorkersComp.com.
Two health care workers who contracted Clostridium difficile (C. difficile) are the latest victims of the bacterial infection since an outbreak began in three
hospitals in the Niagara, Ontario, region in recent months, according to a report from the Canadian OH&S News. The infection causes severe diarrhea and other intestinal disease and is usually the result of eliminating “good” intestinal bacteria with antibiotics or other treatments.
The Ministry of Labor (MoL) received confirmation of one of the two new cases July 7 and the other shortly afterwards, said Dr. Leon Genesove, chief physician with the MoL. Genesove could not reveal the hospitals where the two employees worked due to confidentiality, but he confirmed they worked in two sites under the St. Catharine’s, Ontario-based Niagara Health System (NHS).(WCxKit)
As of July 20, 24 fatalities related to C. difficile had been reported since the NHS declared an outbreak at St. Catharine’s General Hospital May 28 and at Greater Niagara General Hospital and Welland Hospital June 23. Thirteen fatalities were reported at St. Catharine’s General, four at Greater Niagara General, six at Welland Hospital, and one at Niagara-on-the-Lake Hospital (which is not a site of outbreak), said a notice from the NHS.
MoL inspectors visited NHS sites July 13 and met with the employer and joint health and safety committee representatives to discuss issues relating to the outbreak. "As part of those visits a number of orders were issued to NHS related to updating their measures and procedures for infection prevention and control to protect workers," Dr. Genesove said.
In particular, the orders touched upon hand hygiene and updating workers' training as it relates to C. difficile exposure. Additional orders related to not having food and drinks in clinical areas were also issued.
"C. difficile is a particularly difficult hospital-acquired infection to deal with," said a report from Public Health Ontario (PHO). An Infection Control Resource Team (ICRT) reviewed the outbreak management system at St. Catharine’s General during a site visit June 29.
The report yielded a series of findings and recommendations in the area of infection prevention and control, outbreak management, hand hygiene, environmental cleaning, use of antibiotics and communication. The ICRT team noted that at times, the NHS would cohort suspected and confirmed patients with C. difficile together.
"This practice should be discontinued immediately as [C. difficile] cannot be diagnosed symptomatically and C. difficile may be easily transmitted between undiagnosed diarrheal cohorted patients," the report said. In situations when a shortage of single-room accommodation may require isolated patients to be grouped together, the report recommends grouping patients with C. difficile together as a last resort, as re-infection can occur.
The ICRT team also found that prior to the declaration of the outbreak, transfer of both patients and patient care equipment between units was common. This "increases the risk of spreading C. difficile and its spores, through environmental contamination and unwashed hands," the report states, noting that St. Catharine’s General has since limited the movement of both patients and equipment between units.
A July 21 report by the Ontario Health Coalition (OHC) in Toronto found that Ontario has the fewest hospital beds per person of all provinces in Canada, with hospital occupancy rates near 97.8 percent, compared to 68.2 percent in the United States. "Ontario's hospital occupancy levels are at untenable levels, far above other comparable jurisdictions," Natalie Mehra, director of the coalition, said.
Apart from posing occupational risks to health care workers, the consequences of overcrowded hospitals include inappropriate staffing ratios, increased hospital-acquired infections and backlogged emergency departments, the OHC report concludes.
While outbreaks may occur, "they can also be reliably stopped through early identification and treatment, aggressive environmental cleaning, health care worker hand hygiene, and control of antibiotics," Dr. Michael Gardam, an epidemiologist and researcher for the University of Health Network in Toronto, said in a release from the Ontario Hospital Association.(WCxKit)
The PHO report recommends that all inpatient units in NHS sites affected by the outbreak, including all common areas and nursing units undergo a full terminal clean with a sporicidal agent. Measures that were put in place as part of the outbreak management, such as increasing housekeeping resources and de-cluttering inpatient areas, should be maintained permanently. The report also called for the infection prevention and control manager to be made a full-time position.
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.
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@ReduceYourWorkersComp.com.
If you were the producer of a Broadway show, would your hire a 300-pound ballerina? The idea seems absurd, but most employers shy away from hiring and retaining obese employees. (Obesity discrimination is illegal in Michigan, the District of Columbia, San Francisco, and Santa Cruz, CA). Obesity is not a disability that falls under the Americans with Disabilities Act (ADA) unless is has a proven physiological cause. We do not advocate obesity discrimination, but feel you should be aware that the more obese people you hire and employ, the higher the cost of your workers compensation insurance will be. This is also true in life insurance, one must fall into the appropriate body weight range to qualify for reasonably priced life insurance. Sad but true. And there may be ample justification for such increase in rates.
There are many ways to define obesity. To most people, a “fat person” is someone who weights 50 or 100 pounds more than they do. Medically speaking, a person with a body mass index – BMI (a weight-to-height ratio, calculated by dividing one's weight in kilograms by the square of one's height in meters) of 18.5 to 24.9 is considered to be of normal weight, 25 to 29.9 is considered to be overweight, with 30 and above is considered obese. The doctor once told my husband he was obese which was very surprising because I don't view him as obese — a beer tummy maybe, but certainly not obese to my way of thinking.
In a often-cited Duke University study based on 100 full-time employees with a body mass index of 40, the impact of obesity on the cost of workers compensation is tremendous. Statistics show the impact on workers compensation cost of obese employees who are injured on the job including:
1. Claims: Obese employees have twice as many workers compensation claims (11.65 claims vs. 5.8 claims for non-obese employees.)
2. Lost days from work: Obese employees lose 13 times more work days for their injury (183.63 days vs 14.19 days).
3. Medical cost: Obese employees medical cost is seven times higher ($51,901 vs. $7,503).
4. Indemnity Cost: Obese employees indemnity cost is 11 times higher ($59,178 vs. $5,396).
Another study by researchers at John Hopkins found similar results with a direct correlation between the number of injuries and the amount of obesity, with the odds of injury at work increasing with the waistline. The more obese the employee, the greater the odds the employee would be hurt on the job.
With nearly two-thirds of all American adults either overweight or obese, obesity is now being divided into subgroups with their own definitions including:
1. Overweight – 1 to 29 pounds above normal
2. Obese – 30 to 59 pounds overweight
3. Severely obese – 60 to 99 pounds overweight
4. Morbidly obese – at least 100 pounds overweight
5. Super obese – 200 or more pounds overweight
Per the Center for Disease Control and Prevention, in 2007 about one-fourth (26 percent) of all employees were in the obese or a higher category. It is projected that by the year 2020, 40 percent of men and 43 percent of women will be classified as obese or higher. When you include the overweight people with the obese, by 2020 it is predicted that 70 percent of all employees will be overweight, with the number of overweight people continuing to grow (no pun intended).
What does this mean for workers compensation? Well, any one who has been involved with or who has handled their share of workers compensation claims know the injuries most common to obese employees involve their back, lower extremities (knees and ankles primarily), wrist (carpal tunnel claims and women with obesity “go hand-in-hand”) and hands. Obese employees generally hurt their back when trying to lift heavy weights or lift any weight improperly, and the obese employees hurt their backs, knees and ankles more severely when they slip and fall. Due to their obesity, obese employees have a significantly higher percentage of musculoskeletal injuries than non-obese employees.
The additional strain placed on the employee's musculoskeletal system by the additional weight is only one factor that delays the employee's recovery from an injury. Obese employee's often have other
comorbidity problems besides their weight that delays their recovery from injury. Other medical issues among obese employee's interfering with their recovery include hypertension, heart disease and diabetes. open-ended According to the National Counsel on Compensation Insurance, these comorbidity issues can increase the cost of a work comp claim by an astounding 30 times.
As an employer, there are some steps you can take to reduce the cost of workers compensation related to obesity. The following are some approaches employers have taken to deal with this issue:
1. Health insurance premium discounts for employees with a BMI of 18 to 25.
2. A weight-reduction program offered through your human resources department.
3. Encourage physical activity at work whether it is taking the steps instead of the elevator or parking at the far end of the parking lot.
4. Use weight loss seminars from Weight Watchers or Jenny Craig.
5. On-site or off site fitness centers with free membership or reduced price membership.
6. A fitness program that includes healthy eating, health improvement seminars, exercise classes, and company sponsored athletic teams.
7. Use of the company intranet to post weight loss guides, cooking light suggestions, and any topic on good health.
8. A recognition program for employees who meet a weight-loss goal.
Encouraging your employees to be healthy pays off in lower workers compensation cost and provides for a healthier, happier work force. Insurance companies – yes – the very same ones selling life insurance and workers compensation need to get in line to promote
wellness, health and fitness just as much as any other employer. My daughter worked for an insurance company and the supervisor had a candy dish on her desks, ice-cream sundae Wednesday, birthday cakes often and pot luck Friday once a month. Ice Cream Sundae Wednesday? Ya think everyone was bringing in Frozen Yogurt?
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@ReduceYourWorkersComp.com.
An Albany, N.Y., woman was recently ordered to spend one to three years in state prison, and ordered to pay $43,405 in restitution, based on false claims she made concerning a neck injury, Albany County District Attorney David Soares announced.
Kelly Woods, 23, admitted she lied to doctors, the New York State Insurance Fund, and the State Workers Compensation Board by claiming she was suffering a permanent flexion of her neck at a 90-degree angle.(WCxKit)
She claimed her condition was the result of a workplace accident at a local construction firm based in Colonie, N.Y. Woods was caught during video surveillance moving her head and neck normally, according to prosecutors.(WCxKit)
Soares said Woods later fled to Utah and had to be extradited to New York. In March, she pleaded guilty to third-degree insurance fraud. NYSIF said the prosecution saved more than $591,000 in future benefits.
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.
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@ReduceYourWorkersComp.com.
Cambodian embassy officials in Malaysia are investigating the death of a Cambodian domestic worker earlier in July and plan to interview neighbors of her former employer, the Ministry of Foreign Affairs reported.
Koy Kuong, spokesman for the Ministry of Foreign Affairs, reported that embassy officials had been dispatched to Penang province to investigate the cause of woman’s death, following allegations made recently that she was abused.(WCxKit)
The deceased woman’s aunt, Sorn Chanthy, 38, from Phnom Penh’s Dangkor district, commented she did not believe her 19-year-old niece, Choy Pich, died from pneumonia July 17 as reported by labor recruitment firm AP TSE & C Cambodia Resource Co., Ltd. A medical check conducted prior to her niece leaving for Malaysia in September last year, she remarked, gave her a clean bill of health and the young woman had never previously suffered from any diseases.
Concerns were raised about the maid’s death after an email was sent to news aggregation site Khmerization by a person familiar with the situation.
The email alleging abuse noted the date of death, TSE and the area of Malaysia in which Choy Pich died but incorrectly identified the victim’s name and age. Nevertheless, it sparked rights groups and politicians to seek an investigation into the worker’s death. It also fuelled Sorn Chanthy’s suspicions that abuse, not disease, was the cause of her niece’s demise.(WCxKit)
Seng Sithichey, president of AP TSE & C, reiterated his belief that a medical certificate from Malaysia showed Choy Pich had died from pneumonia and said he was unsure what to do with her body, which would be costly to repatriate.
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.
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@ReduceYourWorkersComp.com.
Social networking, shmocial networking! Who has time!?
At Work Comp Roundup we do all the reading for you and bring you just the important things going on at the 2,000-strong LinkedIn WC group – Workers Compensation Roundtable.(WCxKit)
This week a reader wants to know if friendly first aid is reportable. And another stirs up conversation by asking where to find the number of workers compensation claims filed each year by state. Read ahead to find out what is being discussed:
Lynne Smart, commercial insurance broker at Orca Insurance Services in the San Francisco Bay Area, asks, “I think that putting a splint on a finger, icing it, and telling the employee not to use for a week would be first aid. What do you think?” Some readers think that telling the employee not to use their hand crosses the line in this instance while others say that a one-time visit with a follow up is the definition of first aid. Still others say that it is no longer first aid if the employee misses work for it. Add your comments to the discussion
here.
Bobbijo Werren, account executive at CompManagement, Inc., in the Cleveland/Akron, Ohio area, stirred up discussion when she asked for examples of employer mistakes that resulted in increased claim costs.
Leah Jamison, senior workers compensation claims examiner at CompWest Insurance in the Greater Los Angeles Area offers these three points as an answer:
When John Carrington, an analyst at Hound Partners in the greater New York City area asked where to find the number of workers compensation claims filed each year by state on reader recommended the Workers Compensation Research Institute (WCRI)
website. Others suggested individual state sites, and National Labor & Statistics Bureau, the National Association of Insurance Commissioners (NAICS), or the National Council on Compensation Insurance (NCCI). If you have other ideas, add them
here and help your colleagues out.
Amy Scherer, workers compensation manager, for hhgregg in the Indianapolis, Indiana area is looking for advice on using an injured workers survey/questionnaire to measure customer service to employee and how her company can improve. Add your thoughts
here. Rebecca Shafer mentions that WorkersCompKit is an automated best practive survey that gives a company wide assessment in less than one hour. This tool provides recommendations and an action plan also.
www.WorkersCompKit.com
And
Harold (Butch) Frick, risk management broker and consultant; senior vice president at Lockton Companies in the greater St. Louis area shares an article about safety standards in the food industry.
Gregory Grinberg, a workers compensation defense attorney at Harbinson, Tune, Kasselik in the San Francisco Bay area shares an article about the California WC statute of limitations defense.
Marcus Roland, managing partner at Roland Legal PLLC in the Lexington, Kentucky, area wants to know how workers' compensation ALJs or the equivalent selected/hired in your state? “In Kentucky it's a rather politically driven process. I'm curious to know how other states do it,” he says. Answer him
here.
There is lots more gong on at Linkedin's Workers Compensation Roundtable right now and
right here! Better yet,
invite your friends so they too can become informed on hot topics in the Workers Compensation industry.(WCxKit)
Workers Compensation Roundtable is jointly managed by people dedicated to the concept that workers compensation is a manageable line on your expense ledger, and that informed professionals are empowered achievers. Workers' compensation is not simply a cost of doing business, it is a cost that can be controlled. Beginning with an assessment of cost drivers, benchmarking data, and integrating the solutions, employers can reduce workers' comp costs 20 to 50 percent. With proper information, professionals managing compensation claims can reduce costs and improve outcomes for all stakeholders in the process. This group is for employers, business owners, risk managers, HR managers, insurance executives, and brokers to discuss the obstacles and strategies to overcome them.
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@ReduceYourWorkersComp.com.
There are times while engaged in a workers compensation file that you are better off just settling the file out, redeeming all costs for medical, wages, and future medical exposure. Some files will not necessarily call for a full settlement, maybe it is better to settle either wages or medical, or both, but it has to be done when the scenario calls for it. Some examples are below.
Note: These are general examples, and all actual claim situtations should be reviewed by your legal counsel.
1. The injured worker has been terminated by the employer
The cause of a good percentage of litigated files comes when the employer terminates employment with the claimant during the course of their injury and subsequent rehabilitation. The claimant feels they were terminated unfairly due to their injury, and this will send them directly to a plaintiff attorney. This will open up significant exposure for ongoing wage loss, and it will extend the life of a claim. (WCxKit)
On most occasions you are better off waiting to drop the axe on termination until the claimant has either reached their end of healing, or the end of the case. This way, if you want to settle the file, you can include the voluntary resignation of the claimant from the employment.
Note: consult with legal counsel before settlement, having them review voluntary resignation to make sure it meets requirements of state law as "voluntary" and that it complies with all other requirements.
2. The injured worker has no job to return to within their permanent medical restrictions
This scenario happens a lot when a major surgery or amputation is involved. The job the worker once did can no longer be done by that worker. You have the option of moving the employee to another department or position, but often with smaller companies the option is just not there.
This is a good time to settle the wage portion of a claim. If you know for sure the worker can no longer do the job they once did, and you do not want to spend the cost of vocational retraining or vocational job placement, then you should settle out the wage portion of their claim. Again it is best to wait until their medical situation stabilizes before you approach this topic. You do not want to pursue this too early, as the claimant may try to stretch out their medical recovery, further securing their wage loss benefits and adding to the cost of the claim’s wage loss.
Depending on the job, some claimants will know they have little to no hope of returning back to work at their old position. But not every injured worker is easy to deal with. Changing jobs or losing your job is a major roadblock in a claim, and it can be costly to settle out the wage portion of these claims. But in the long run, it is worth it. Vocational training and placement is not a guarantee, and you do not want to incur those costs and then also have to settle the wage portions out when you cannot find the injured worker a job.
3. The injured worker still works for their employer, but their case is denied coverage under workers compensation
In this case you do not have to settle the wages and medical to include a voluntary resignation, unless you want to add it in. If the adjuster denied the case as being compensable, but the worker filed their claim under their disability coverage, and then filed for hearing after returning to work once released from medical care, this is a case to settle after all the exposure for wage loss and medical bills are gathered.
This case gives you the total exposure, since the lost wages are known, and the medical cost to full duty is known. This is known as a “closed period” settlement.
Typically the adjuster will have to negotiate a lien with the medical carrier, and a compromise will be made on the wage loss the worker incurred. Unless you have a fantastic denial and can take your defense all the way to trial, it is best to make the compromise and settle for a portion of the exposure. This is probably the most common litigation example in the world of workers compensation.
4. The worker's case was disputed by the comp board, and then they were laid off due to workforce reductions. The injured worker was paid unemployment, and their medical carrier paid the medical cost to full duty
Here we have an example of taking a wage loss offset, and negotiating a medical lien. This is a fairly simple case to settle. Most states will allow a claimant to get unemployment pay when they are laid off. Even when they are off on a medical leave. This is a "collateral source benefit" because the employee may be making more when not working than when working.
However, if this person files for litigation, the insurance company can offset what the full-wage loss would have been, so, in essence, they get a credit for the wage loss, and only have to deal with the medical lien from the carrier. These medical carriers are usually easy to negotiate with, and most liens can be settled for easily up to 50 percent of their cost.
Medical carriers will also get a better fee reduction than workers compensation insurance carriers, so not only does the workers compensation carrier get a credit for the unemployment pay the worker received, they also get cheaper medical cost for all the medical expenses the injured worker incurred during their treatment and recovery. These are also usually closed-period settlements, and can be redeemed for a relatively low legal cost.
5. The injured worker files for an occupational injury claim, naming several employers as the defendants
Occupational injury claims are usually filed by seasoned workers who have spent their lives working for several employers. When their shoulder or back finally gives out and they need surgical repair, if they seek out an opinion at a plaintiff attorney’s office. The counsel will usually file a hearing for an occupational injury claim, and they will list all of the claimant’s past employers, since they will assert that each period of employment lead to the accelerated degeneration of the worker’s body, which lead to the ultimate injury they incurred.
In this case, each employer will contribute an amount towards a global settlement. The exposure of each employer will depend on the duration of employment, types of jobs the claimant performed, and the associated risk involved in relation to the injury. The hardest part about these claims is figuring out how much each adjuster should have to contribute. Once the adjuster takes all the past employers and the exposure into consideration, they will nominate a general amount for the represented employer’s exposure, and once all parties agree on all the amounts the case can be settled. It can take some time for all carriers and adjusters to agree, but they eventually get there and the case can be resolved.(WCxKit)
Workers compensation claims are settled all the time, usually for one of the reasons outlined above. As you can see, you have a number of opportunities where a settlement is the best option, and you should discuss with your adjuster if this is the road you should explore, instead of incurring other costs to bring an injured worker back to work at your place of employment. This differs from my normal opinion of bringing every able employee back 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. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
An Oldham, Great Britain company has been sentenced after it ignored two formal warnings, putting its workers lives in danger from poorly maintained and dangerous electrics.
Townfield Manufacturing Co Ltd. was prosecuted by the Health and Safety Executive (HSE) after inspectors uncovered a series of cracked socket casings, exposed conductors and live wires on a visit to its premises in Mount Pleasant Street.
During the same visit on Dec. 15, 2009, inspectors also found that staff at the company was forced to work in gloves and coats because of the near-freezing conditions in the workshop, which had no heating system. Townfield, which manufactures kitchen equipment for takeaway restaurants, was served with two improvement notices, requiring it to make the electrics safe and provide a reasonable working temperature. But when HSE inspectors revisited the site on Feb. 17, 2010, they found that the wall sockets were still unsafe and the company had only provided workers with one stand alone heater, which had barely lifted the temperature.
Townfield Manufacturing Ltd. was found guilty of two breaches of Section 33(1) (g) of the Health and Safety at Work etc Act 1974, by failing to comply with the improvement notices which had been issued. The company was fined $16,363.8 and ordered to pay $ 6,511.24 towards the costs of the prosecution following a trial at Trafford Magistrates' Court in Sale on May 5, 2011, after failing to attend the hearing or enter a plea. (WCxKit)
Around 1,000 electrical accidents at work are reported to HSE each year and about 25 people die of their 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. 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.
Grant Thornton International recently reported the countries of Finland, Sweden, Australia, and Thailand offer some of the best work schedules, while places like Japan, Greece, and Armenia offer tougher scheduling.
A global survey of more than 7,700
businesses in 39 countries reports Finland to be the country with the highest percentage – 92 percent – of companies offering flexible work arrangements in the past year. Sweden placed second with 86 percent of companies offering employees flexibility, while Australia and Thailand tied for third place with 85 percent. (WCxKit)
The top 10 countries for flexible work were rounded out by New Zealand (84 percent), the Netherlands (82 percent), Switzerland (80 percent), the United Kingdom (79 percent), the United States (79 percent) and Ireland (77 percent).
On the other side of things, the survey reports that Japan had the lowest percentage of companies offering flexible work last year at just 18 percent.
The list of 10 countries with lowest percentage of companies providing flexible work arrangements includes: (WCxKit)
1. Japan (18 percent)
2. Greece (26 percent)
3. Armenia (35 percent)
4. Malaysia (39 percent)
5. Turkey (44 percent)
6. Poland (47 percent)
7. Taiwan (49 percent)
8. United Arab Emirates (49 percent)
9. Russia (50 percent)
10. Singapore (50 percent)
The research was carried out primarily by telephone interview with the exception of Japan (postal), Philippines and Armenia (face-to-face), mainland China and India (mixture of face-to-face and telephone) where cultural differences dictate a tailored approach. Telephone interviews enable Grant Thornton International to conduct the exact number of recommended interviews and to be certain that the most appropriate individuals are interviewed in an organization which meets the profile criteria.
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.
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@ReduceYourWorkersComp.com.
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