Do you ever wonder what your workers compensation adjuster does all day? If you see the adjuster living easy, you may be surprised. The adjuster's day is full of activities, requiring the adjuster to prioritize which actions are needed the most. Some of the daily routine you would see from the adjusters would include the following activities.
So, what will you see during your visit to the claims office?
1-The phone rings constantly
The typical workers comp adjuster has 100 to 125 indemnity files, depending on the jurisdiction and the experience level of the adjuster. Each of those 100 to 125 files has a claimant, one or more medical providers, and an employer. That alone makes for 300 to 375 plus potential parties that will want to speak with the adjuster. On top of that you have plaintiff attorneys, defense attorneys, triage nurses, nurse case managers, surveillance companies and state work comp boards that may call the adjuster. On a slow day the adjuster may only spend half of her time on the telephone. (WCxKit)
2-The e-mails come in fast
In this day where everyone expects instant service, the use of e-mail to convey messages and documents has surpassed paper mail. With attorneys, employers, employees and nurse case managers sending information by e-mail, it is normal for the adjuster to get 50 to 100 e-mails per day. While many of them can be copied right into the claim file, a significant portion of them require a response or other action by the adjuster.
3-The paper mail is voluminous
While the amount of paper mail has declined over the years, a two inch or five inch stack of new mail to be reviewed each day by the adjuster is still the norm. The mail has to be evaluated and the appropriate response taken on each piece of mail. Sometimes the response is only to send it to be scanned into the electronic file, but often a written reply or a phone call is needed.
Included in the paper mail are the faxes that come in each day. While most attorneys and employers are transmitting documents via e-mail, most medical providers are still using paper forms, paper bills and paper reports. These items are often easier for the medical offices to transmit by fax than by e-mail, so receiving numerous faxes each day add to the paper mail stack.
4-The consultations are frequent
A major portion of those telephone calls mentioned above are for the purpose of making decisions on what to do. The adjuster will often gather information by consulting with others. The adjuster will discuss the claim with the nurse case manager, the defense attorney, the employer, and other sources to make a judgment on the best course of action on a particular claim.
When the adjuster is not on the phone discussing a claim or reading the e-mails or reading the paper mail including faxes, the adjuster will often enter into consultations within the claims office. The adjuster will confer either with her supervisor or fellow adjusters on various aspects of a particular claim to gain insight or opinions of other claim professionals that have dealt with a particular situation or set of facts.
5-The decisions are major
The primary reason the adjuster enters into the consultations noted above is because the decisions the adjuster makes can have an impact on the life of the injured employee and all of the decisions have a financial impact on the employer. If the adjuster makes the wrong decision, either the employee or the employer or both will be hurt financially.
6-The appreciation is missing
While you are sitting there observing what the adjuster does all day, you will notice that the adjuster's job often benefits both the employee and the employer. But it is the rare employer or even the rarer injured employee who expresses any appreciation for the work the adjuster does on the work comp claims. The most the adjuster hopes for is the claims supervisor will say “good job” when the claim is concluded. (WCxKit)
7-The adjusters best practices
While the adjuster is in constant modes of communication as noted above, the adjuster has a set of job requirements that have to be met.
1. Making contact with the employee, the employer and the medical provider on every new claim
2. Responding to all the communications noted above in a timely manner
3. Setting and maintaining accurate reserves on all of the assigned files
4. Making sure all indemnity payments are made timely
5. Making sure all medical bills are paid
6. Keeping in touch with the employees, the employers and the medical providers on a regular basis
7. Submitting the appropriate forms to the state work comp boards/industrial commissions
8. Identifying fraudulent claims
9. Pursuing subrogation when a third party is the cause of the employee's injury
10. Attending mediations, either in person or by phone
11. Evaluating settlement opportunities and decisions
If you sit chair side by the adjuster, do not count on the adjuster having any time for chit chat, so just observe. They will have planned for your visit, and will have time to show you through your files. As you can see from the above the adjuster's job fills the entire day, and then some. If you do sit and observe what the adjuster does all day, you will probably leave amazed at the dedication and hard work of the work comp adjusters.
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. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com.
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 RShafer@ReduceYourWorkersComp.com
The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) recently cited Candler Concrete Products Inc. for 19 safety and health violations following an inspection of the company's Gainesville plant, which was initiated under OSHA's Site-Specific Targeting Program for industries with high occupational injury and illness rates. Proposed penalties total $120,370.
According to a report from OSHA, one willful safety violation with a penalty of $48,400 was cited for requiring employees performing maintenance on vehicles and equipment to work within 3 feet of an open and unguarded pit, exposing them to fall hazards. A willful violation is one committed with intentional knowing or voluntary disregard for the law's requirements, or with plain indifference to worker safety and health. (WCxKit)
Six repeat safety violations with $45,830 in penalties involve failing to remove equipment blocking an exit route, mark signs at fire exit doors, correctly mark a door that could be mistaken for an exit door, provide lockout/tag out training to workers who perform maintenance on machinery and equipment, close an unused opening in an electrical panel, provide outer insulation to an electrical cord attached to a piece of machinery and protect employees from electrical shock hazards.
A repeat violation exists when an employer previously has been cited for the same or a similar violation of a standard, regulation, rule or order at any other facility in federal enforcement states within the last five years. The company had been cited for these same violations following a March 2008 inspection.
Six serious safety violations with penalties of $19,250 involve failing to keep a clean and orderly work site, illuminate an exit sign, maintain an operable emergency pull cable and provide flashback protection for a gas welding torch. Additionally, employees were exposed to fall hazards at two different platforms because the platforms were open-sided or had improper railings. A serious violation occurs when there is substantial probability that death or serious physical harm could result from a hazard about which the employer knew or should have known.
One other-than-serious safety violation with a $1,000 penalty was issued because the company failed to post an annual summary of its injuries and illnesses for 2010. Two other-than serious safety violations with no monetary penalties were cited because the company allowed flexible cords to be used in lieu of permanent wiring and permitted electrical boxes to have openings that resulted in electrical conductors not being protected from abrasion.
An other-than-serious violation is one that has a direct relationship to job safety and health, but probably would not cause death or serious physical harm.
One repeat health violation with a $500 penalty was cited for failing to label and identify the contents of a drum containing hazardous chemicals. A similar violation was cited in a 2008 inspection. One serious health violation with a $5,390 penalty was cited for failing to develop and implement a confined space program to protect employees who did welding in the drum of a concrete truck with minimal ventilation. An other-than-serious health violation with no monetary penalty was cited because the diesel tank label beside the scale house was not legible. (WCxKit)
"An employer's commitment to workers' safety and health must go beyond policies and involve taking real actions that prevent injuries and illnesses," said William Fulcher, director of OSHA's Atlanta-East Area Office. "Management cannot be complacent about eliminating the workplace hazards that OSHA has found here."
Author Robert Elliott, executive vice president, Amaxx Risk 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
According to a recent survey from Littler Mendelson, P.C. (Littler), a nationwide employment and labor law firm representing management, companies are growing increasingly concerned regarding whistle-blowing activity.
An overwhelming majority of respondents (96%) reported they are either very concerned (27%) or moderately concerned (69%) regarding possible whistleblower claims and 73% identified whistleblowing and retaliation as emerging risk areas. (WCxKit)
Survey respondents seem to be anticipating growth in claims as the program develops and the SEC’s new Office of the Whistleblower, which opened its doors in August, continues to gather as many as 100 tips per day, according to SEC officials.
Although an already high percentage of respondents (45%) reported their companies experienced a whistleblower claim in the last 12-24 months, 67% anticipate whistleblower claims to gain steam within the next 12-24 months.
While companies see whistleblowing as a major risk that is likely to grow in the near-term, most of the respondents (65%) reported the companies are only moderately organized to handle whistleblower claims and only 54% were confident that executives in their organizations understand unlawful retaliation concepts and understand how not to engage in such conduct.
After expressing uncertainty as it relates to their current level of preparation, 84% of respondents indicated their companies have taken preventative steps to protect against unlawful retaliation claims and 59% are either undergoing training in the next year or plan to do so. (WCxKit)
Lastly, the survey also revealed concern among respondents that provisions within Dodd-Frank could undermine their present compliance programs. Just 12% reported this was not a concern, while 51% were concerned and 37% remain unclear as to what the impact will be.
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, contactInfo@ReduceYourWorkersComp.com.
Chinese-run copper mining companies in Zambia routinely flout labor laws and regulations designed to protect workers’ safety and the right to organize, according to the group Human Rights Watch in a recent release.
Zambia’s newly elected president, Michael Sata, a longtime critic of the Chinese labor practices, should act on his campaign promises to end the abuse and improve government regulation of the mining industry to ensure that all companies respect Zambia’s labor laws, according to officials with HRW. (WCxKit)
The 122-page report, “You’ll Be Fired If You Refuse’: Labor Abuses in Zambia’s Chinese State-Owned Copper Mines,” details the persistent abuses in Chinese-run mines, including poor health and safety conditions, regular 12-hour and even 18-hour shifts involving arduous labor, and anti-union activities, all in violation of Zambia’s national laws or international labor standards.
The four Chinese-run copper mining companies in Zambia are subsidiaries of China Non-Ferrous Metals Mining Corporation, a state-owned enterprise under the authority of China’s highest executive body. Copper mining is the lifeblood of the Zambian economy, contributing nearly 75 percent of the country’s exports and two-thirds of the central government revenue.
The report is centered on observations conducted during several field missions in November 2010 and July 2011 and draws on more than 170 interviews, including with 95 mine workers from the country’s four Chinese copper operations and 48 mine workers from other multinational copper mining operations. Miners at Chinese-run firms claim they were pleased that the companies had made a major investment in the copper mines and created jobs. However, they described abusive employment conditions that violate national and international standards and fall short of practices among other multinational copper mining companies in the country.
Between Oct. 5 and Oct. 12, 2011, miners at three of the four Chinese-run copper mining operations initiated strikes, hopeful that the new government’s election would create an environment for improved conditions. Production ground to a halt. On Oct. 19, Non-Ferrous China Africa, the longest-operating Chinese-owned copper mine, fired at least 1,000 striking workers. After government pressure in subsequent days, NFCA agreed to reinstate them. Reuters reported that NFCA’s chief executive officer said that the reinstated workers would be screened and the “troublemakers” disciplined.
Miners from the Chinese-owned companies reported consistently poor health and safety standards, including inadequate ventilation that can lead to serious lung diseases, the failure to replace workers’ damaged protective equipment, and routine threats to fire workers who refuse to work in unsafe places underground. These practices, combined with the already dangerous nature of copper mining, cause injuries and other health complications. At times, Chinese managers bribe or threaten miners to keep them from reporting accidents or other problems to the government’s Mines Safety Department, the miners said.
In addition to their poor safety standards, several Chinese-run copper operations in Zambia require miners to work brutally long shifts, despite difficult conditions involving extreme heat and contact with acids and noxious chemicals. Many miners at Sino Metals work five 12-hour shifts a week as well as a sixth 18-hour “change shift” when they rotate from the day shift to the night shift or vice versa. Other miners there described working 365 days without a single day off. Zambian law specifies a 48-hour work week, and every other multinational copper mining company uses 8-hour shifts that comply with this law. Several miners said the long hours contributed to accidents, and many complained about failing to receive proper overtime.
The curtailment of union activity hampers the ability to address these and other issues of concern to workers – particularly pay, which is higher than Zambia’s monthly minimum wage, but much lower than that paid by other multinational copper mining firms in Zambia.
Several Chinese-run operations have prevented workers from exercising their right to join the labor union of their choice through threats and intimidation. Miners in companies run by the Chinese or other multinationals also described retaliation against outspoken union representatives, including docked pay or refusal to renew their contracts. (WCxKit)
Primary responsibility for ensuring that Zambia’s copper mining companies operate in accordance with national and international standards rests with the Zambian government. It has a Mines Safety Department within the Ministry of Mines and Minerals Development that is responsible for enforcing the country’s mining regulations, including on health and safety.
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, contactInfo@ReduceYourWorkersComp.com.
The Federal Employees Compensation Act (FECA) covers 2.7 million federal employees and postal workers and paid out $1.9 billion in wage-loss compensation, impairment and death benefits and $898 million in medical and rehabilitation services and supplies during the 2010 charge back year, which ended June 30, 2010.
There have been no major revisions to the law since 1974. Currently there are two bills pending. Both would put in place a few significant changes. “The Federal Workers Compensation Modernization and Improvement Act” (HR 2465), was passed in the House and has been sent to the Senate Committee on Homeland Security and Government Affairs. Another proposal that originated in the Senate, “The 21st Century Postal Service Act of 2011” (S1789) has made it out of committee. Both include significant provisions related to FECA reform.(WCxKit)
THE 21ST CENTURY POSTAL SERVICE ACT OF 2011 (S 1789)
There are several provisions in the current version of the bill that would have a material impact on the claimants and the manner in which claims are managed. Section 302, Federal Workers Compensation Reforms for Retirement Age Employees, will reduce total available compensation rates and re-define coverage at and beyond retirement age. This particular provision would have a positive effect on cost as well as remove any notion that FECA is a retirement plan.
This legislation also includes provisions that are directly related to case management; one in particular supports increased involvement by the employing agency in managing its’ workers compensation claims. This provision requires an independent medical assessment of disability and potential for return to work for beneficiaries after six months of disability and on a regular basis thereafter.
Currently, federal agencies do not have the authority to schedule or direct the scheduling of independent medical evaluations. They can request that the Department of Labor set up an exam, but the final decision on whether and when to refer for an IME (independent medical evaluation) is in the hands of the claims examiner (DOL). In addition to requiring periodic scheduling of independent medical evaluations by the DOL, the current draft of the proposed legislation provides a mechanism for the employing agency to direct the scheduling of an IME, subject to review of the request by the Secretary of Labor.
The complementary piece of legislation that has passed the House is THE FEDERAL WORKERS COMPENSATION MODERNIZATION AND IMPROVEMENT ACT (HR 2465), which among other things would streamline the claims process for those workers who sustain a traumatic injury in a designated armed conflict zone, would permit physician assistants and nurse practitioners to certify disability for traumatic injuries and ensure that they are reimbursed for their services, and would allow the Department of Labor to verify federal employees salaries against social security administration data, all of which will modernize and streamline administration of FECA benefits.(WCxKit)
PRESCRIPTION OPIOID ABUSE
One significant industry-wide issue that is not explicit to either piece of proposed legislation is prescription opioid abuse. Prescription opioid abuse is being addressed in most workers compensation systems by establishing controls on prescribing with the help of Pharmacy Benefit Management (PBM) programs. In the federal workers compensation system, only the Department of Labor has the authority to adjudicate claims, including those for ancillary services, which limits the employing agency’s ability to control the inappropriate use of pharmaceuticals.
Although federal agencies can, and a few do, hire PBMs to help address the efficacy and cost of prescription drugs, neither the agency nor the PBM have the authority to place any limits on prescribers or fulfillment beyond those established by OWCP, which are extremely limited. It is hard to imagine how the federal workers compensation system, which provides workers compensation coverage for almost 3 million workers, is going to be able to handle the opioid epidemic without a significant change in policy related to the use of formularies and other preventive controls applied at both the benefit level and the point-of-sale.
Authors Lisa M. Firestone, MHSA and Marianne Cloeren, MD, MPH, FACOEM provide services at Managed Care Advisors, Inc. (MCA) an innovative, woman-owned business specializing in workers' compensation, employee health benefits, disability management consulting, and full service workers compensation case management. Based in Bethesda, Maryland, MCA services customers throughout the United States and U.S. Territories. Visit the MCA’s website www.MCACares.com.
Lisa M. Firestone, MHSA is the company’s president and owner and brings her 30 years plus experience to the healthcare industry. She is a recognized expert in the areas of employee benefit program development, evaluation, and strategic planning. She has been actively involved in the evolution of workers’ compensation case management and disability management programs, most recently focusing on the federal workers’ compensation and disability systems. She can be reached at lfirestone@managedcareadvisors.com.
Marianne Cloeren, MD, MPH, FACOEM Medical Director of MCA where she supports the company’s federal workers’ compensation case management services, oversees quality assurance, and develops educational offerings related to disability management and evaluation. Dr. Cloeren’s experience includes managing employee health in the Veterans Administration system, serving as medical director for several companies, and as an occupational medicine physician for the Army’s Center for Health Promotion and Preventive Medicine, where her focus was federal workers’ compensation case management. She can be reached at mcloeren@managedcareadvisors.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.
The former owner of the country’s largest asbestos abatement training school has been sentenced to prison after having fled the United States after her trial in 2008.
According to the Environmental Protection Agency, U.S. District Judge Nathaniel Gorton sentenced Albania Deleon to 87 months in prison to be followed by 3 years of supervised release. She was ordered to pay more than $1.2 million in restitution to the Internal Revenue Service and several hundred thousand dollars to AIM Mutual Insurance Company. (WCxKit)
In 2008, Deleon was convicted of charges including selling training certificates to thousands of illegal aliens who had not taken the mandatory course. She allegedly placed these unqualified people in temporary positions as certified asbestos abatement workers in public buildings.
From approximately 2001 to 2006, Deleon owned and operated Environmental Compliance Training (ECT), a certified asbestos training school located in Methuen, Mass. ECT normally offered training courses on a weekly basis at its Methuen offices, however, many of the recipients of the certificates never took the required course.
Instead, with Deleon’s knowledge and approval, ECT’s office employees issued certificates of course completion to thousands of individuals who did not take the course. These individuals filed the certificates with the Massachusetts Division of Occupational Safety in order to be authorized to work in the asbestos removal industry. Many of the recipients were illegal aliens who wished to skip the four-daylong course so that they would not forego a week’s pay.
Since ECT’s training course records were subject to inspection, Deleon sought to cover up ECT’s practice of issuing certificates to untrained applicants by having the applicants sign final examination answer sheets that already had been completed and graded, which she maintained in ECT’s files. Based on the evidence at trial and information supplied by the Division of Occupation Safety, ECT issued training certificates to more than 2,000 untrained individuals.
Deleon is the fifth environmental criminal captured since the EPA fugitive website was launched in December 2008. (WCxKit)
“Today’s sentence marks the final chapter in bringing Albania Deleon to justice,” said EPA’s Cynthia Giles. “Committing environmental crimes to make a profit that put workers and our communities at risk [carries] serious consequences.”
Author Robert Elliott, executive vice president, Amaxx Risk 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
For workers who spend the days behind the wheel, it would make sense to assume that the thin strip of nylon or polyester that keeps them pinned to their seats in case of a collision is there to keep them safe from harm.
But a Saskatoon Court of Queen's Bench judge recently ruled that buckling up may actually be more dangerous for bus drivers, according to a report from the Canadian OH&S News. In an Oct. 20 decision, Justice Grant Currie overturned Saskatoon bus driver Dean Christianson's traffic court conviction for failing to wear his seatbelt. (WCxKit)
"
His experiences, and those of others that had come to his attention in the course of working in his industry, gave him reason to believe that his safety may be compromised by wearing a seatbelt," Justice Currie wrote. Christianson believed that if passengers on the bus assaulted him, being buckled in would make him less able to defend himself.
In his initial traffic safety court trial, Christianson called violence against transit operators a "growing, nationwide epidemic," noting that he been threatened by three people riding on the bus at the time he was pulled over.
"
As someone who has been spit on, I discovered that you do not know who is going to grab your steering wheel while you're driving or sucker punch you, or stab you, or spit on you. You have no idea who it's coming from," he said. "Some of the drivers have been sucker punched while they are driving and took repetitive blows while trying to get their seatbelt off so they can defend themselves."
Under Saskatchewan's Traffic Safety Act, a bus driver is not required to wear a seatbelt if they have reason to feel it may put them at risk of injury.
The Crown had argued that the exemption only applied when there was a specific risk of injury, but Justice Currie ruled that the regulation could also be applied to a driver who "may be continuously exposed to a compromise of his or her safety on a random basis." (WCxKit)
A Saskatoon civic policy states that all public employees must be buckled in whenever they're behind the wheel of a city vehicle, but the transit union is hoping this ruling will help change that policy, first introduced three years ago.
Author Robert Elliott, executive vice president, Amaxx Risk 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
Workers Compensation Laws change frequently. This is only a summary; a complete copy of the most up-to-date version can be found at: www.WorkCompResearch.com an excellent service.
In Indiana, every employer who has one or more employees, whether full time or part time is required to carry workers compensation insurance. There are some exceptions. Railroad workers, real estate professionals, independent contractors, inmates and volunteers of non-profits are not covered by workers compensation. Employers of casual laborers, household employees, agriculture employees, and migrant farm workers may elect to buy workers compensation insurance. All county and municipal governments, and all school districts must carry workers compensation insurance, but police officers and firefighters may not be covered if they are covered for injury through a pension fund.
Obtaining Coverage
To obtain workers compensation coverage in Indiana, the employer has two options of either
purchasing a workers compensation insurance policy from a state approved insurance company
applying to and being approved for self-insurance status with the Indiana Workers Compensation Board. (WCxKit)
Claim Reporting
The employee must report the injury to the employer as soon as practical after the occurrence. If the injury is reported after 30 days, benefits start as of the date of the notice. If the employee incurs disability of one or more days, the employer is required to report the claim to the Board of Workers Compensation within 7 days. If the employer (insurer) fails to report the claim timely to the board, the employer (insurer) can be fined $500.00.
Medical Benefits
The employer selects the medical provider in Indiana workers compensation claims. The employer is required to provide all reasonable and necessary medical care free of any charges to the employee. There is no time limit on how long medical care can be provided.
In cases involving permanent injury, the Board may order future medical care to limit or reduce the extent of the employee’s injury.
Temporary Total Disability Benefits
The temporary total disability (TTD) benefits are calculated as two-thirds of the employee's average weekly wage over the 52 weeks prior to the date of injury, not counting the week of the injury. The maximum amount of TTD benefits that can be paid is $650.00 per week. There is no automatic cost of living increase. The state minimum weekly benefit is $50.
The first 7 days of disability (the waiting period) is not paid to the injured employee unless the employee is disabled for more than 21 days. TTD benefits can be paid for a maximum of 500 weeks
Temporary Partial Disability Benefits
In Indiana if the employee is able to return to any type of work, but at a lesser rate of pay then the amount the employee was earning prior to the injury, the employee is entitled to temporary partial disability (TPD) benefits. The TPD benefits are paid at two-thirds of the difference between the pre-injury wage and the post-injury wage. The TPD benefits are paid for up to 300 weeks. The TPD benefits plus the post-injury pay rate cannot exceed the state's maximum indemnity benefits rate.
Permanent Partial Impairment
It should be noted that Indiana is one of the few states that does not have a schedule for injuries to limbs, sight, hearing, etc. Instead, the treating physician will assign to the employee a permanent partial impairment rating, with the whole body being considered 100 degrees. Limbs and other body parts are worth so many degrees, and then the number of degrees is multiplied by the percentage of disability. The Board maintains a chart that shows what each degree of injury is worth. Interestingly, with this system, the high wage earner does not receive any more than the low wage number when they have the identical degree of injury. However, if the injured employee has already received in excess of 125 weeks of indemnity compensation, the insurer does receive a partial credit against the PPI award.
Permanent total disability
Indiana permits the employee to collect a maximum of 500 weeks of indemnity benefits for all types of indemnity combined, unless the employee is classified as permanent total disability. If the employee is permanently and totally disability, the state’s second injury fund will pay up to 125 weeks of additional benefits after the insurer has paid for 500 weeks.
Death Benefits
The burial expenses in Indiana are covered for a work-related death up to $7,500. The death benefits for a dependent spouse and children follow the same guidelines as TTD benefits – two-thirds of the average weekly wage – currently a maximum of $650 per week, up to a maximum of 500 weeks, except there is a dollar maximum for death benefits in the amount of $294,000. If the spouse remarries, the spouse receives the lesser of 104 weeks or benefits or the remainder of the 500 weeks. (WCxKit)
Vocational Benefits
The employer is not required to pay for vocational rehabilitation under the Indiana workers compensation act. Injured employees who need vocational rehabilitation can obtain assistance through the Office of Vocational Rehabilitation operated by the State of Indiana.
Author Rebecca Shafer, JD, President of Amaxx Risk 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. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com.
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
Unions from around the world, including the International Metalworkers Federation (IMF) affiliates, recently participated in the ILO Workers Symposium on Policies and Regulations to Combat Precarious Employment. The Symposium produced a set of recommendations on measures that the ILO should take to reduce precarious work and improve conditions for precarious workers.
According to information from the IMF, while trade unions have recognized for a long time the threat that the rapid expansion of precarious work throughout the world poses to workers rights, concerns have been raised that the ILO is not doing enough to protect the rights of precarious workers to join a union and participate in meaningful collective bargaining. In order to put the issue firmly at the center of the ILO's standard setting and enforcement agenda, ACTRAV, the Workers Bureau of the ILO, organized a Worker's Symposium which brought together union representatives from both developing and industrialized countries, the public and the private sector. (WCxKit)
During three days, unions shared information on how worldwide, unimaginable numbers of workers are suffering from precarious, insecure, uncertain and unpredictable working conditions. They discussed how global forces are driving the rapid expansion of precarious work in all countries and in all sectors of the economy and the urgent need for regulatory and policy responses to prevent this.
The aims of the Symposium included determining how existing standards can be better promoted in order to protect the rights of precarious workers as well as identifying gaps in existing international labor protections that could be filled by the development of new standards.
At the conclusion of the Symposium, union representatives called on the ILO to conduct a comprehensive report on the obstacles that prevent precarious workers from being able to bargain collectively with their employer, with a particular focus on the barriers to workers in triangular relationships bargaining with the employer controlling their conditions of work. (WCxKit)
Lastly, they called for ILO action to promote key conventions and recommendations that can improve conditions for precarious workers and pointed to the need for further regulation, particularly to limit temporary employment other than in cases of legitimate need.
Author Robert Elliott, executive vice president, Amaxx Risk 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. He is a contributor to the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com. 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.
Two recent decisions, and an outline posted on the WCB website, indicate that there is a shift in New York workers comp towards employer return to work offers.
The court decisions “Browne v Medford Multicare” and “Smith v TWA, Inc” dealt with workers who refused return to modified work. (WCxKit)
The refusal of the offers was treated in both cases as voluntary withdrawal from the labor market – a conclusion that would have been unthinkable years ago. In addition, the Board has posted a return-to-work guide for employers on its website, another departure from past practices.
The decisions point to the emergence of a very different comp system. In the past, a claimant could refuse all offers of work without jeopardizing further compensation, which led to the final settlements which accounted for 60% of all attorney fees. The new model will substantially reduce comp costs and xmods for proactive employers.
The Board outline of return-to-work proposals makes it clear that, in the future, the worker’s attorney is expected to support prompt return to work even if a settlement fee is lost in the process. Hopefully, the Board will find a way to award fees for cooperating with a return-to-work program. Such cooperation, in the past, has been viewed as worth less than service which led to protracted disability.
Tellingly, the Board sites statistics in its RTW outline which claim that successful work rehabilitation has only a 1% chance of success for an injury which has resulted in two years of lost time. In the past, only disabilities resulting in two years lost time were considered for lump sum settlement. The Board construed years of lost time as a perversely positive result.
But all this is a potential reform. It is only as inevitable as the willingness of employers to become involved and do it right. All the decisions will mean nothing to an employer who imagines that, somehow, a carrier or the Board will do the heavy lifting for it. (WCxKit)
Will all, or even most, employers become “return to work” conscious? No. Certainly not. The chances that a claimant, chosen at random, will work for an employer diligently pursuing ways to reduce employee lost time will be substantially less than 50%, perhaps much less. Even so, the playing field is different. The employer making the effort will achieve the savings. And its workers will share in those savings in a wide variety of ways.
Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100. medsearch7@optonline.net
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.
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