Declarations making it easier to protect the rights of Guatemalan and Nicaraguan citizens who work in the United States were recently signed by Secretary of Labor Hilda Solis, Guatemalan Ambassador Francisco Villagrán De Léon, and Nicaraguan Ambassador Francisco Campbell.

 

 

"Individuals from Guatemala and Nicaragua make important contributions to the U.S. economy, and their workplace rights should be protected," Solis said. "I am pleased that the U.S., Guatemalan, and Nicaraguan governments are working together to help make that happen." (WCxKit)

 

 

According to a report from OSHA, the declarations enable the regional enforcement offices of the U.S. Department of Labor, Occupational Safety and Health Administration and Wage and Hour Division to cooperate with local Guatemalan and Nicaraguan embassies and consulates to distribute information to migrant workers about U.S. health, safety, and wage laws. Training will also be provided to migrant workers and their employers.

 

 

In conjunction with the declarations, letters of agreement were signed by the two agencies. The Wage and Hour Division is now able to protect migrant workers in low-wage industries such as hospitality and agriculture. OSHA continues efforts to improve workplace safety and health conditions while simultaneously providing outreach and assistance to Spanish-speaking workers and employers. (WCxKit)

 

 

Additionally, through these agencies, the Labor Department is better able to identify problems experienced by migrant workers and to target labor law enforcement efforts. OSHA, for example, plans to provide a toll-free telephone number staffed by multilingual operators who are ready, day and night, to receive calls from migrant workers about safety and health issues.

 

 

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

 

 

According to a report from the Communications Workers Union (CWU), the dispute began over management misuse of information from tracking devices in engineers' vans. Cases have allegedly emerged where managers have trawled detailed data to find tiny discrepancies in order to victimize, discipline or sack staff. (WCxKit)

 

 

Dave Ward, CWU deputy general secretary, added, "Romec's aggressive behavior toward experienced engineering staff is shocking. We urge the company to put its energy into resolving this situation instead of further intimidating staff. This will only be resolved through talks and that is where we want to be." (WCxKit)

 

 

Posted in Communication with Employees, Employment Law Issues, Management Commitment, Union Issues |

The majority of quarter-million dollar and half-million dollar workers compensation claims have a secondary medical issue that complicates recovery and extends the length of time the employee is disabled. Personal medical problems such as obesity, smoking, poor physical condition and diabetes often complicate severe injuries, especially those involving surgical repair, making recovery more difficult, longer and expensive.

 

 

A 300-plus-pound employee who must lose 50 pounds before surgical repair of a herniated disc can easily add six months of temporary total disability benefits and six months of doctor visit to overall claim costs. In most jurisdictions, state workers compensation laws take the employee the way you hired them; often referred to as, “You touch it, you bought it.” That the employee has a pre-existing medical issue does not excuse the employer from having to pay all medical care for injury and indemnity benefits until the employee can return to work (or until indemnity benefits reaches the state maximum time limit for draw.)(WCxKit)

 

 

Obese employees with medical problems are not the only ones who increase workers compensation claim cost. A 6-foot-tall, 140-pound man smoking a pack of cigarettes each day will find a fractured ankle (or any other bone) takes much longer to heal in a smoker than in a non-smoker. Cervical and lumbar fusions often fail in the heavy smoker as the two bones do not grow together. A failed fusion in a person who smokes can add from months to a year to the life of the workers compensation claim, and increase the employee’s permanent impairment rating.

 

 

Most employers totally separate their health insurance program from their workers compensation insurance program with the human resources/benefits department handling the health insurance program and the risk management department dealing with the workers comp insurance program. If your health insurance and workers comp programs are handled separately, we recommend the two departments work together to institute a wellness program, or to improve the existing wellness program, for the simple reason that healthier employees have fewer insurance and workers compensation claims.

 

 

If you are thinking, “Okay, I understand that unhealthy employees take longer to recover from their work comp injuries, but how does a wellness program create fewer workers comp claims?” the answer is employees who are not in good physical condition are much more prone to strains and sprains than employees who are physically fit. For example, picking up and moving a 50-pound object does not create a problem for the physically fit employee who has muscles that are properly toned. The same 50-pound object creates a herniated disc in the employee who does not have developed back muscles to support the spine.

 

 

A study completed by the John Hopkins University Medical Center of employees at eight aluminum plants found that 85 percent of those injured were overweight or obese. There is also the often-cited Duke University study that documented obese employees have twice the number of injury claims per 100 employees as non-obese employees, lose 13 times as many work days, with indemnity cost being 11 times higher, and medical cost being seven times higher.
(For more detail look http://www.dukehealth.org/health_library/news/10044.The savings in this one area of wellness will greatly exceed the cost of the wellness program.)

 

 

One study showed that for every $1 spent on wellness programs, there was an overall reduction in medical care cost of $3 to $4. That is a return on investment that can not be ignored. By eliminating employee’s unhealthy habits, both parties benefit. Not only does the employer benefit by lower insurance cost, but the employer also benefits from higher productivity, as the employee is on the job working, not at home recovering from an illness or an injury.

 

 

By having an integrated, comprehensive wellness program you are taking a holistic approach to the employee's health and the impact it has on the employer. With the ever-rising cost of medical care, whether for health insurance claims or workers compensation claims, the need for a strong wellness program in your company will continue to grow.(WCxKit)

 

 

We recommend you do your employees and your company a big favor by starting or by improving your wellness program. There are a tremendous amount of resources on the Internet on wellness programs. We are also here to assist you in any way we can, so please contact us in regard to your questions about wellness programs.

 

 

Posted in Management Commitment, Risk Management, Wellness Programs and WC |

Since NFL means National Football League, those in the workers compensation industry may be wondering why retired players filed their class-action lawsuit in just California. Seventy-five retired National Football League players are suing the NFL citing mismanagement of concussions and willful concealment of evidence of the long-term effects of head injuries which led to the players’ current brain damage.

 

 

Ari Rosenstein of CPRhr, a California human resources outsourcing and professional employer organization (PEO) firm, explains in the company’s Small Biz HR Blog how confusing workers compensation laws there make it an attractive place for lawsuits.(WCxKit)

 

 

His most recent article, offers five lessons the workers compensation industry can learn from this likely-to-be costly workplace injury case.

 

 

“California is notorious for being one-sided in its support of employees’ work comp claims. NFL players recognize they will receive higher benefits for filing an injury in California, over other states in the country,” he writes. For this reason, team owners encourage players to file workers comp claims in their home states.

 

 

Rosenstein writes, “Despite bearing some of the most employee-favorable workmans’ comp policies, and some of the most expensive insurance costs in the country, California employers have a lot they can learn from the NFL in the areas of managing workplace safety, reducing claims, and being proactive in keeping insurance costs to a minimum.”

 

 

1.      Just as safety is the number one priority in football, so too, business owners should purchase necessary protective gear and educate staff on usage.

2.      Just a football players train several days each week, so should employees in other fields be trained constantly on handling equipment and proper machinery use. “An educated workforce will produce higher quality work with fewer workplace injuries,” Rosenstein writes.

3.      Basic drills, exercise, and maintaining overall health and fitness are a priority for athletes because the player with better health is a greater contributor to the team. Likewise, employers need to create a healthy work environment, which may include healthful snacks in the vending machines or incentives for exercising. Flexible work environments that promote a healthy work/life balance create productive and less accident-prone employees.

4.      The workplace floor has to be as clean as a football field – or the game stops immediately. Prevent injuries before they happen.

5.      Keep safety at the forefront; it doesn’t happen by itself. Directives to use safety equipment or stretch before each “game” has to come from the top down.

 

Ari Rosenstein of CPEhr, a California human resources outsourcing and professional employer organization (PEO) firm, writes for the company’s Small Biz HR Blog. His article can be found here, We appreciate Ari's guest contribution.

Our WC Book:  http://www.wcmanual.com
WORK COMP CALCULATOR: http://www.LowerWC.com/calculator.php

Posted in Litigation Management, Risk Management, Safety and Loss Control |

By requiring preauthorization for occupational therapy services, spinal surgery, and work hardening and conditioning services, a study showed three Texas reforms from the early 2000s lowered medical costs without hurting injured workers’ return to work.

 

 

The Workers Compensation Research Institute (WCRI) study, Impact of Preauthorization on Medical Care in Texas, found when an insurer requires preauthorization there was a seven percent reduction in the number of injured workers receiving physical medicine and occupational therapy. Further, there was a 39 percent reduction in the number of visits per worker. Preauthorization also reduced the number of patients receiving more than 15 visits for physical medicine services.

 

 

According to the study’s abstract, “Texas policymakers enacted several reforms that were intended to give payors additional tools to manage medical care, patient outcomes, and costs. One class of reforms requires preauthorization by the payor for certain types of medical treatments and services.”

 

 

Among the workers compensation rules in Texas, an injured employee is required to receive approval from the insurance carrier before receiving occupational therapy services, spinal surgery, and work hardening and conditioning services.

 

 

To complete the study, WCRI used medical billing data for two sets of claims — one prior to the effective date of the preauthorization reform and one after. The abstract says, “For each type of medical care, WCRI measured changes in utilization after the preauthorization reforms. … WCRI also studied changes in disability duration and return-to-work as measured by the days in which an injured worker received temporary disability payments.”

 

 

1.      What impact does preauthorization have on reducing medical visits?

2.      Does preauthorization hamper return to work?

3.      Did preauthorization create a delay in spinal surgeries for injured workers?

 

 

1.      Return to work did not change significantly over the time period for injured workers who received physical medicine services.

2.      There was a 21 percent reduction in the number of injured workers receiving work hardening and work conditioning services, but not significant changes in the number of visits and services per visit.

3.      Time to surgery was shorter among injured workers who received spinal surgery after preauthorization was effective.

 

 

You can read more about the study here.

 

 

Posted in Benchmarking & FTE & Operational Comparison, Medical Cost Containment & Managed Care |

Hospital and health care employers were reminded recently that hazardous drugs such as antineoplastic drugs could pose serious job-related health risks to workers if proper precautions are not used in handling the drugs.

 

 

The National Institute for Occupational Safety and Health (NIOSH), the Occupational Safety and Health Administration (OSHA), and The Joint Commission highlighted the need for safe practices in a letter to hospitals in the U.S. (WCxKit)

 

 

Drugs used for chemotherapy, antiviral treatments, hormone regimens, and other applications have potential for serious adverse occupational health effects, the agencies said. Irreversible effects from work-related exposures even at low levels, without taking appropriate precautions, can include cancer, reproductive and developmental problems, allergic reactions, and others.

 

 

"Potent therapy drugs can have great benefit for patients when used in proper regimens, where doses are controlled and risks are minimized. But they can also have serious consequences to the workers who handle, dispense, mix, apply, and dispose of them without proper controls and training," said NIOSH Director John Howard, M.D. "We are pleased to join with our partners to remind hospital employers that protecting the health of their employees is vitally important."

 

 

“Substances that present a potential health hazard to workers must be included in an employer's hazard communication program, and it should be readily available and accessible to all including temporary workers, contractors, and trainees, added David Michaels, Assistant Secretary of Labor for OSHA. “We encourage employers to address safe drug handling by committing their management staff to taking a leadership role identifying and remediating hazards, offering employee training, and evaluating workplace injury and illness prevention programs for continuous improvement.”

 

 

In their letter to hospital employers, NIOSH, OSHA, and The Joint Commission encouraged employers to:

 

 

 

 

A list of hazardous drugs can be found in a NIOSH document, "NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings, 2010" (www.cdc.gov/niosh/docs/2010-167/) . The list was updated as part of an earlier document, "NIOSH Alert: Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Healthcare Settings," which provides guidance on protecting healthcare employees from hazardous exposures (www.cdc.gov/niosh/docs/2004-165/).

 

More information on identifying hazards, determining appropriate controls, and applying safe practices can be found in a NIOSH webpage on hazardous drug exposures in healthcare (www.cdc.gov/niosh/topics/hazdrug/) and an OSHA webpage on hazardous drug safety and health at www.osha.gov/SLTC/hazardousdrugs

 

Posted in Medical Issues, Safety and Loss Control |

The government of Nova Scotia is sending a safety message to employers, parents, and students as young people wrap up school terms and begin summer jobs during vacation, according to information from the Canadian OH&S News.

 

 

Last year, 3,665 young workers under 25 years of age reported claims to the Workers Compensation Board (WCB) of Nova Scotia.(WCxKit)

 

 

"Parents or guardians play a very important role in keeping young workers safe," said WCB spokeswoman Joanne Elliott in Halifax. "They should have a conversation with young workers that encourages them to approach safety in the workplace."

 

 

Data from Statistic Canada's 2006 Census indicates that retail salespersons, cashiers, food counter attendants or kitchen helpers, and customer service, information and related clerks are the jobs most commonly undertaken by Nova Scotians aged 15 to 24.

 

 

Information from the WCB indicates that injuries peak during summer months. This peak is particularly evident for young workers. Almost 300 time-loss claims in 2010 occurred in May through August, nearly half of all young worker time-loss injuries. July and August report the highest claims among young workers as students venture into summer employment.

 

 

Parents or guardians should not assume that their kids work in safe environments, have received proper training, or that they will voice their concerns to employers, Elliott said. "When they are hired, find out as much as possible about their jobs," she advised, citing research that shows young and new workers are five times more likely to be hurt in the first month than workers who have been in their current jobs for more than a year.

 

 

Specific questions relating to the work they do, the training and information they have received, who their supervisor is and what instructions they provide, can help parents assess whether or not the job poses a risk to these young workers, says Labor and Advanced Education spokesman Brian Taylor in Halifax.(WCxKit)

 

 

"If the answers that parents get to the previous questions raise issues, they should be explored further," Taylor added. "Information and level of supervision are two important issues that should never be taken for granted."

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

More than 13,000 people injured themselves skiing or snowboarding last year, which is the equivalent of approximately 106 injuries a day during the ski season, according to a report from New Zealand’s Accident Compensation Corporation (ACC).

 

 

ACC received nearly 7,600 claims for ski-related injuries and about 5,600 claims from snow boarding-related injuries. (WCxKit)

 

 

Otago saw the most injury claims (6,400), followed by Manawatu-Wanganui (2,764) and Canterbury (1,738).

 

 

Now the snow has arrived, ACC wants people to enjoy the ski season and stay injury free. “Skiing and snow boarding are great ways to get fit and have fun. But every winter thousands of people suffer from preventable strains, sprains, and other injuries sustained on the slopes,” said ACC injury prevention manager Peter Wood. “Injuries can be prevented by being in peak condition before you hit the slopes. Hill running, walking, and cycling are good general exercises for the muscles you use in skiing or snow boarding,” he added.

 

 

Strains, sprains, and bruising are the most common type of injury for skiers, according to ACC statistics, and the body parts they are most likely to injure are the knees, suggesting that many injuries are as a result of falls.

 

 

Snowboarders are more likely to hurt their wrists and suffer from fractures or dislocations. Knowing how to fall can cut your chances of actually getting hurt. “We all fall over at some stage so it is good to know how to fall safely as this can make the difference between a spot of embarrassment and a painful injury that prevents you from enjoying this winter’s ski season,” Wood said.

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

Stephen Buehrer , the Ohio bureau of workers compensation (BWC) administrator and CEO announced 11 individuals were convicted of or pleaded guilty to charges related to defrauding Ohio’s workers comp system during June.

 

 

Court actions are the result of investigations conducted by BWC’s Special Investigations Department (SID), which works to deter, detect, investigate, and prosecute workers compensation fraud.(WCxKit)

 

 

BWC launched a Special Investigations Facebook page at: www.facebook.com/ohiobwcfraud. It includes news on recent investigatory action, a most-wanted section and a link to report fraud. Following is a sampling of cases that resulted in a guilty plea or conviction during June.

 

 

Sharlyn Adams of Cincinnati, pleaded guilty to one misdemeanor count of workers compensation fraud for working while receiving benefits. Investigators found that Adams had returned to work while receiving Temporary Total Disability benefits for performing the same type of work she was performing at the time of her industrial injury. While collecting disability, Adams was working for the Catholic Residential Services Nursing Home. Adams was sentenced to 180 days in jail suspended and she was placed on probation for five years. She was also ordered to pay restitution of $3,661.29 and an additional $1,000 for investigative costs.

 

 

John Bou-Sliman pleaded guilty to one count of workers compensation fraud for failing to make premium payments and maintain coverage for his restaurant business, The Jolly Roger. His workers compensation policy lapsed in September 2007 after his premium check bounced. Bou-Sliman was informed of his lapsed status and when agents later served him with a second notice, he assured them he would take the necessary steps to make the payment and have his policy reinstated. He failed to make any new payments within the allocated time frame and the policy lapsed. June 14, 2011, Bou-Sliman pleaded guilty as part of a plea deal. Sentencing has been scheduled for Aug. 8, 2011.

 

 

William Burchfield was sentenced for workers compensation fraud for operating without coverage. Burchfield, owner of Elite Sewer and Septic, allowed his policy to lapse in 2007 and failed to have it reinstated even after attempts by BWC agents to assist him in returning to compliance. A judge found Burchfield guilty June 27 and ordered him to pay restitution to BWC in the amount of $300 per month beginning July 28. The judge also ordered five years probation, a suspended jail sentence of 90 days, and ordered him to pay $100 in fines and $95 in court costs.

 

 

James Goloversic pleaded guilty to workers compensation fraud and two counts of deception to obtain a dangerous drug for using multiple doctors and multiple pharmacies to obtain narcotics. An investigation found Goloversic was obtaining prescriptions from physicians who were not aware he was seeking narcotics from other physicians. Goloversic utilized multiple pharmacies in order to conceal his deception. Goloversic was sentenced June 28 to three years of community control and ordered to pay court costs. The court further ordered that Goloversic must consult only his treating physician if he wishes to seek any narcotic for pain. If he violates the conditions of his community control, he will serve three and a half years in prison.

 

 

James Hale, owner of Jimmy’s Pizza, was sentenced for operating his business without a workers compensation policy. Hale failed to obtain a policy even after BWC agents advised him of his obligation to do so. June 2, 2011, Hale pleaded guilty to one count of failure to comply, a second degree misdemeanor. He was ordered to pay $1,980.67 restitution, in addition to a $200 fine. Hale was also sentenced to 90 days jail suspended, one year probation, and was ordered to remain in compliance with all BWC laws and regulations.

 

 

April Hupp pleaded guilty to one count of workers compensation fraud for working while receiving benefits. SID received an allegation from an employer who received an anonymous tip that Hupp was operating a cleaning business and was babysitting. Investigators found Hupp was employed as a house cleaner and babysitter while receiving temporary total disability benefits. She was ordered to pay restitution of $5,973.51, sentenced to 11 months in prison, suspended, and placed on three years of probation. She was also ordered to obtain employment and perform 40 hours of community service.

 

 

Bradford Pirigyi pleaded guilty to four counts of deception to obtain dangerous drugs, all felonies of the fifth degree. SID opened an investigation when Pirigyi filed a claim against an employer BWC was not able to locate and BWC received a request from a doctor for approval to conduct an MRI for an injury unrelated to a Pirigyi’s allowed claim. The doctor’s office indicated Pirigyi advised them that his claim was for a separate injury he sustained while employed with a construction company. Investigators found Pirigyi sought treatment at several different hospitals and doctor’s offices, and attempted to file workers compensation claims against businesses that did not exist in order to obtain prescription narcotics. Pirigyi asked for narcotic pain medication during some of the visits. Each claim and the bills related to those claims were denied by the BWC. Sentencing is not yet scheduled.(WCxKit)

 

 

Jeffrey D. Volz entered a guilty plea to one count of workers compensation fraud for working while receiving benefits. SID opened an investigation into Volz after receiving an allegation from TS Tech, Inc. that Volz was working while receiving temporary total disability benefits. An investigation confirmed that Volz was employed by Teleperformance, Acloche and Work Force Network, and knowingly concealed his return to work so that he would continue to receive those benefits. Volz appeared in court with a certified check in the amount of $5,623.98 to cover restitution. The judge sentenced Volz to a term of three months of suspended incarceration and he must pay $700 for investigative costs. The incarceration sentence will be imposed if does not pay within six months.

Posted in Fraud and Abuse |

The Workers Compensation Research Institute (WCRI) reports this week in Prescription Benchmarks for Florida – 2nd Edition that physician dispensing is driving up prescription costs in Florida.

 

 

The study looked at the costs, prices, and distribution of drugs in the state and took a closer look at doctors dispensing medicine there. Findings showed the average payment per claim for prescription drugs in Florida’s workers compensation system was $536. This is 45 percent higher than the median of the states in the study making it number two out of 17 states. The last two years of the study showed an increase of 14 percent in average cost per claim though they were stable in other states in the study.

 

 

Legislation regarding physician dispensing was vetoed in 2010. Advocates of physician dispensing say it saves money because doctors are more likely to prescribe generics. Advocates also say that patient compliance, and, therefore, positive outcomes are more likely when doctors are doing the drug dispensing.

 

 

But the study showed this was not the case – generics were prescribed equally from both doctors and pharmacies. Further, even when using generics, the cost per pill was higher at the doctor’s office.

 

 

Higher and growing costs of prescription drugs in Florida were largely due to more frequent and higher-priced physician dispensing, the study indicates. “Physician-dispensing in Florida’s workers’ compensation system has been taking an increasingly larger share of prescription payments. The percentage of prescription payments for physician-dispensed prescriptions in Florida increased from 17 to 46 percent over a four year period,” according to the WCRI report.

 

WCRI’s 17-state study also provides some evidence that helps address concerns about legislation (H.B. 5603), passed in 2010, but later vetoed, that would limit reimbursement rates for physician-dispensed prescriptions to the same level as pharmacies for the same medications.

 

 

1.      Physician-dispensers received 46 percent of prescription payments in the state.

2.      Average price paid to Florida pharmacies increased by 3 percent over the course of the study.

3.      California passed legislation regulating doctor dispensing and saw a large drop in cost per pill of physician-prescribed muscle relaxants. And physicians prescribed more non-repackaged drugs.

 

 

The 17 states included in this study are California, Florida, Illinois, Indiana, Iowa, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Carolina, Pennsylvania, Tennessee, Texas, and Wisconsin.(WCxKit)

 

 

WCRI is based in Cambridge, MA and is a nonpartisan, not-for-profit membership organization supported in its public policy research by employers, insurers, insurance regulators and state regulatory agencies, as well as several state labor organizations.

 

 Our WC Book:  http://www.wcmanual.com

WORK COMP CALCULATOR: http://www.LowerWC.com/calculator.php

Posted in Assessment & Diagnostics, Medical Cost Containment & Managed Care |