Using Social Media to Fight Workers Compensation Fraud

Most employees are honest. A few are not. When an employee presents an un-witnessed, subjective injury workers’ compensation claim, the smart employer will encourage the work comp adjuster to verify the validity of the claim.

 

Some bright, but unethical employees will present a bogus injury claim, or attempt to inflate a legitimate injury, and will think about how to cover their fraud tracks. However, most employees who commit workers’ compensation fraud do not maintain their fraudulent façade consistently throughout the course of their insurance claim. Often there is information available in social media that proves the claim is bogus or inflated. The skilled insurance adjuster can frequently uncover information about previous insurance claims or prior medical treatment, but does not have the skill, the time or the capability to do private investigator type work through all the social media sites.

 

 
Investigation Firms Are Many More Times Proficient At Obtain Social Media Information

 

Private investigators are many time more proficient in obtaining beneficial information from social media websites than the work comp adjuster. If the social media information available is unknown to the adjuster, it provides no value. Social media information can have a major impact on the outcome of the workers’ compensation claim, but only if it is known. For example: The employee pursuing the bogus work comp claim will frequently exaggerate his/her physical limitations. The You Tube video of the employee skiing down the most difficult ski slope this side of the Alps is beneficial in controlling the cost of the workers’ compensation claim only if the employer and the adjuster are aware of the video and have obtained a copy of it.

 

With the electronic age, there is a lot of information available, if the person investigating the claim has the electronic capacity and the professional expertise to locate it. While some adjusters are experienced with Facebook and Twitter, it would be a rare adjuster who would be skilled in all the social media sites. Adjusters at insurance companies, third party administrators and self-insured employers normally turn to private investigators to search the numerous social media sites for information about the employee’s true physical status. A private investigator skilled in social media searches will check thefollowing list of sites and more.

 

• Bebo

• Black Planet

• Blogster

• Classmates

• Dating sites

• Facebook

• Faces

• Flickr

• Foursquare

• Fubar

• Google+

• Hotlist

• LinkedIn

• Meetup

• MySpace

• MyYearbook

• PatientsLikeMe

• Pinterest

• Quechup

• Tagged

• Twitter

• You Tube

 
The question is often asked: “What does social media sites like Classmates or dating websites have to do with a workers’ compensation injury?” The answer is employees who are committing workers’ compensation fraud think all they have to do is fool the insurance adjuster into believing they are hurt worse than they are. People have been known to post pictures on school alumni sites, dating sites and other websites of the activities they enjoy doing like rock climbing, sky diving, bowling, etc. These pictures show the employee is capable of physical activity that they have denied to the doctor, the employer and the adjuster.

 

 
Investigators Go Beyond Typical Searching

 

In addition to the above social media websites, a private investigator can often connect information on Craigslist, E-Bay, blogs and personal websites to the injured employee. The information on these websites may or may not be relevant to the work comp claim. For example: The posting for sale of the employee’s barbell weight lifting set on Craigslist may be due to the injury preventing further use of weight lifting equipment, or it may be due to the employee buying a newer, heavier set of weights. An inquiry by the private investigator about the price of the barbell weight set, and why the employee is selling the weight set, will provide the adjuster and employer insight into the validity of the claim.

 

A good private investigator will take the information provided by the adjuster and expand the known information about the employee including alternate addresses, relatives, associates, neighbors, civil and criminal records, property ownership (both residence and other real estate), driver’s license information, professional licenses (barber, plumber, real estate agent, etc.). If the injured employee is really unable to do the physically demanding job he/she had prior to the injury, it is still beneficial to know the employee recently obtain his/her business license to do something else, for example, a taxi driver’s license.

 

 

If It Is Out There, A Good Investigation Firm Will Find It

 

The dishonest employee presenting the bogus work comp claim may realize that he/she cannot post pictures on Facebook doing things the employee has told the doctor he/she cannot do. The good private investigator will check not only the employee’s social media websites, but also the social media websites of relatives and friends. The friend may not know the employee is pursuing a fraudulent work comp claim, and will post a picture of the employee performing an activity the employee maintains he/she cannot do. For example: the employee may claim to the adjuster that he needs a cane just to walk, but the friend may post a picture on the friend’s Facebook page of the employee’s softball game with the employee sliding into second base after running hard to stretch a single into a double.

 

If there is reason to believe the work comp claim is of questionable validity, or reason to question why the employee’s recovery from a valid injury is slower than normal, the employer should consult with the adjuster on having a private investigator to do a social media review. For recommendations and guidance on selecting a qualified private investigation company, please contact us.

 

 

 

Author Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com.  Contact: mstack@reduceyourworkerscomp.com.

 

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

 

Six Arrested in California Workers Comp Fraud Cases

Six individuals in California found themselves on the wrong side of the law recently.

 
On June 6, five suspects associated with three paving companies were arrested in Corona on 24 felony counts of workers compensation insurance fraud, payroll tax evasion, prevailing wage fraud and denying employees workers comp insurance benefits. Losses associated with this case total $7,377,023.

 
“Contractors have an obligation to their employees and to their customers to maintain adequate workers compensation insurance,” said Commissioner Dave Jones. “Dodging this responsibility placed others at great financial risk and resulted in an unfair advantage to under bid professionals that operate above board and within the law.”

 
Three paving and striping companies, Prestige Striping Services, United Paving Co. and Yeguada Trujillo, Inc., owned and operated in Corona, allegedly paid overtime and cash bonuses and then inaccurately reported wages to their workers comp insurance carrier or the Employment Development Department.

 
Officials also discovered that these companies were not paying the required prevailing wages on public works projects and co-mingling their employees with Superior Pavement Markings, Inc., a union company previously owned by Sabas Trujillo.

 
Between June and September 2013, search warrants were served at the businesses and their banks.

 
Based on a review of all the records seized and the Prestige Striping and United Paving employee interviews, it was determined that these companies, along with Yeguada Trujillo, Inc., were committing workers comp insurance fraud, payroll tax evasion, prevailing wage fraud and denying employees workers comp insurance benefits.

 
The loss in workers comp insurance premiums is $1,014,041.66, the loss in payroll tax liabilities is $4,122,660.37and the loss in prevailing wage fraud is $2,240,321.03 for a total loss of$7,377,023.06.

 
Suspects arrested included owner Sabas Trujillo, his brother Rick Trujillo, his brother’s wife Lucia Trujillo, their account manager for United Paving Company, Laura Fitzpatrick and Alex Trujillo the production manager for Prestige Striping were all implicated during the department’s investigation.

 

Plumbing Business Owner Arrested

 
Meantime, Tim Shelley, 57, owner of Tim’s Plumbing was arrested recently on felony charges of workers comp insurance fraud and grand theft.

 
A joint investigation with the Department of Insurance and Humboldt County District Attorney’s Office uncovered Shelley’s multiple illegal business operations, alleged warranty scam and insurance fraud.

 
“Refusing to provide workers compensation insurance can be devastating to employees and it is illegal,” said Insurance Commissioner Jones. “California business owners should know that it is their responsibility to provide workers compensation insurance. We continue to find individuals that choose to disregard the law, but I am committed to working with our law enforcement partners to stop those who commit insurance fraud.”

 
During the course of the investigation, it was discovered that Shelley deliberately failed to obtain workers comp insurance for his employees. There were instances in which employees were injured and were discouraged from claiming workers comp benefits. As a result, severely injured workers were unable to afford their medical costs for treatment and suffered significant financial hardships.

 
Further investigation revealed that Shelley was also allegedly operating a warranty replacement scam. The scam involved removing warranty tags on water heaters installed for customers and then turning in a false warranty claim, Shelley received a number of free replacement units from the manufacturer.

 
Shelley was arrested on June 24.The Humboldt County District Attorney’s Office will be prosecuting the case.

 
If convicted, Shelley faces up to 18 years in state prison and $260,000 in fines.

 

 

 

Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com.  Contact: kstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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Employers, Claims And The Importance Of Information.

Lets start with the good news. Most employers are sitting on enough information to solve nearly all of their comp problems. The bad news is that information is notoriously lazy. Unless the employer takes the trouble to locate it, process it and forward it, the information will stay silent and indifferent to the employer’s rising comp costs.

 
Information That Turned Into Results

 

Two years ago a workers comp decision came down in New York. The case was no different from tens of thousands of others, in New York and nationally, which appear every year but with one difference – someone did something to find information and turn it into results.

 

The facts of the case are so common that normally they attract little attention. The worker had a back claim. Did the worker have any prior back problems? “No”, he said. No problems, no treatment, no lost time. All of which was false.

 

The carrier produced evidence of the prior back problem, treatment and lost time. Confronted, the worker explained that he simply didn’t recall all that. But he lost the claim and all benefits for concealment, even though his latest claim might have been otherwise genuine.

 

What does this have to do with employers? Aren’t the carriers responsible for investigations? Well….yes. Sort of. But a little help from the employer changes everything.

 

The employer usually has dozens of people who know the fabricating worker and speak to him/her daily. The employer also has, usually, a fairly thick file with hundreds of pieces of information of use. Let’s just consider one piece of information and how it can be used – a list of the prior employers on the original job application.

 

In the NY case there is no indication of how the carrier learned of prior back problems. It could have come from a co-worker, a set of charges from a group medical plan, or………..a prior employer.

 
Worst Workers Compensation Problems Are Caused By Worst Employees

 

Chances are that your worst comp problems will be caused by your worst employees. Bad work attitudes are the best predictor are bad claims. And bad attitudes are an en-grained feature which was present with all prior employers.

 

Your correspondent was once head of the legal team for a special investigations unit. It became normal procedure to locate and call prior employers for routine information. If the employer started to laugh when they heard the former employee’s name – bingo! They would inevitably relate tales of prior dubious disability problems.

 

If you carefully read the employer’s first report of injury you will notice that there is no request for a list of prior employers and no request for evidence of fraud. But that doesn’t mean that the employer can’t demonstrate some proactivity. An employer should let a carrier know that it can, and will, if asked, provide information which seems to contradict the size or credibility of a claim. And there is nothing wrong with suggesting that a list of prior employers might be of use.

 

All that information will be of no use unless it is introduced to the right people.

 

 

 

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

 

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Recognize And Prevent Red Flags Of Escalated Work Comp Claim Costs

One of the biggest threats to an employer’s workers compensation cost is often not one bad claim, but an escalated cost an multiple claims.

With that in mind, there are several ways whereby an employer can reduce the chances for leakage and continuously higher claim costs.

 

 

Red Flags Of Escalated Claim Cost

 

At the time a workers compensation adjuster gets their hands on different forms of indemnity claims, they will first place an indemnity reserve on the claim.

 

In instances where workers comp adjusters discover challenges in coming up with the correct reserves deals with the potential problems claims that are dealt with at the on-set of the claim as just another typical claim.

 

Various versions of comp claims that can potentially lead to much higher financial outcomes than first thought are:

 

* Employees with a prior history detailing neck or back injuries;

 

* Claims that deal with back surgery (fusion, laminectomy, etc.) on a person who is involved in manual labor;

 

* Employees who begin things with a hostile attitude toward the employer or the insurer;

 

* Each and any claim with a long time period between the date of the injury and the date the claim is first noted to the business owner;

 

*An employee who is not satisfied with the medical treatment being received and switches doctors more than once. (This is oftentimes done by the worker who is seeking a physician that won’t question the employee’s subjective complaints).

 

* Changing doctors, this after obtaining an attorney, and going with a doctor known in the local insurance field and medical community to be “pro-surgery” or “pro-claimant” by many people;

 

* Any claim where the employee becomes tied to pills;

 

* The employee is closing in on retirement age;

 

* The employer announces an impending work-force reduction, or the employee has just suffered a layoff from work (work comp indemnity checks are typically found to be much higher than unemployment checks);

 

* The employee applies for social security disability (in some cases, this happens prior to the adjuster receiving the medical reports from the treating doctor);

 

* The workers comp check is higher per week than the employee’s prior take home pay (this ties to when home compensation is reduced by union dues, 401K contributions, state income taxes, etc).

 

 

 

Responsibilities of the Adjuster

 

When it comes right down to it, it is the adjuster’s responsibility to look for and handle oversight on these issues when they become known to him or her.

 

If the adjuster does not respond to these types of matters when they first come to the forefront, the claims will fall apart. The translation, it will cost a whole lot more than it should. The risk manager for the employer should step up and take action when the inexperienced adjuster does not see or confront the impending problem.

 

Any time the adjuster, the adjuster’s supervisor or the risk manager witness a potential problem coming to the forefront, they should act immediately. It is much easier to halt a new problem claim from developing into a bad claim than it is stop a bad claim that is well-established.

 

 

 

Always Remember Value of Investigating

 

Last but not least, always keep in mind that many major problems can and could have been lessened or even prevented by initiating an investigation.

 

If something seems suspicious, there is always the chance that it is for a reason. Just like in other circumstances, one who thinks or knows for sure they are being investigated is less likely to move forward with illegal behavior. And if they do continue, your investigation could very well trip them up into making a mistake.

 

 

 

Author Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com.  Contact: mstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

WorkSafe Australia to Inspect Motor Vehicle Repair Businesses

Authorities in Australia are not overlooking the importance of having a safe working environment for those repairing motor vehicles.

 
WorkSafe said recently that it will soon undertake an inspection program to look at safety issues in motor vehicle repair businesses.

 
Throughout the 2014/15 financial year in metropolitan and regional areas, inspectors will look at mechanical repair workplaces, from large chains to small businesses and mechanical workshops in car dealer and vehicle rental premises.

 
WorkSafe Director Joe Attard said recently that motor vehicle repairs had been identified as an industry with a high rate of work-related injuries.“Statistics show that workers in motor vehicle repairs sustain a high number of soft tissue and muscle injuries, as well as lacerations,” Attard said.

 
According to Attard, “WorkSafe inspectors from the Transport Team will be paying particular attention to motor vehicle hoists during this inspection program, and they will also look closely at the safe movement of vehicles in these workplaces and the risks of injury as a result of manual tasks.”

 
Inspectors will work with the aid of a checklist to ensure consistency, and will also look at general areas such as electricity, work at heights, hazardous substances, machinery guarding and slips, trips and falls.

 
Employers to Know what is Required of Them

 
Employer groups and trade unions will be informed of the program, so employers should be aware of what is required of them if visited by a WorkSafe inspector.

 
“This program is part of an ongoing series of proactive inspections aimed at providing employers with information on how to comply with workplace safety and health laws,” Attard commented.
“Raising awareness is the main objective, but inspectors will take enforcement action if they find breaches of the laws.

 
“We firmly believe that raising awareness with proactive programs is the best way in which to lessen the rate of work-related injury and illness,”Attard added.

 

Further information on workplace safety can be obtained on the website at www.worksafe.wa.gov.au.

 

 

 

Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com.  Contact: kstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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Communicate Your Work Comp Program So Employees Use It

Having a great workers’ comp program is meaningless if your employees don’t know about it and use it. To get your employees to know about the program, you have to tell them about it, not just once. After initially delivering the information about your workers’ comp program, you need to reinforce and remind them of its importance. And it is not enough that the employees know about it, they have to be willing and able to use the program you have in place. All necessary information must be readily and easily accessible to all your employees and so familiar to them that they instantly know where to find all necessary information.

 

 
Make the Message Fit the Environment

 

Design your workers’ comp materials to fit the environment. A printed brochure may work for clerical employees who work at a desk and can put them in a file folder. But will a brochure work for a factory floor worker without file space? Probably not. A brochure handed to that worker will likely end up in the round filing cabinet, i.e. a waste receptacle after being piled somewhere with other papers.

 

Think about where your employees work, take breaks, gather and socialize when thinking about how and where to communicate your workers’ comp messages. The delivery of information must take into consideration the location where the communication is occurring. An auto visor packet might be good in a company vehicle. Wallet cards might be good for employees who go into the field. Signs near water coolers and restrooms are good reinforcers. Lamination of the materials is important where there is the potential for dirt or moisture in an environment that can ruin plain paper.

 

 
Combine Methods to Maximize Impact

 

Think about how you want to deliver your message. Using a combination of methods may be the best way to continually drive home your messages. For example, you may want to hand out or mail brochures to new employees with an annual update. Then you can also put up posters throughout the work area and in break rooms, give employees wallet or lanyard cards, and put a zippered three-ring mobile folder in all vehicles and toolboxes.

 

Another constant reminder is a sticker label to be put on telephones. This way the name and numbers of who to call when there is an injury or a claim is called in are immediately accessible to those making the calls.

 

 
Tailor the Message to the Audience

 

Think about your audience when designing your message materials. Do you have non-English speaking workers? Then your materials should also be translated into their first language. Are your employees eighth grade or college graduates? Make sure that your messages are clearly communicated in the simplest language possible. Don’t use several ten-dollar words where one ten-cent one will work. Your materials for your supervisors and upper management can be more in depth than is needed for your line workers. Also, the materials in your employee handbooks and safety plans can have much more detail than is needed in your program posters and wallet cards.

 

 
Make the Messages Easy to Read

 

Are your materials well lit and in big and dark enough font to be easily readable? As any middle aged worker in desperate need of reading glasses will tell you, they cannot see the same font size in a lighter color or that is against a non-contrasting background. Test their readability before their final printing. A clearly worded message won’t be read by employees who can’t easily see it.

 

 

 

 

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 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, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact:RShafer@ReduceYourWorkersComp.com.

 
Editor Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

Massachusetts Employer Cited after Supervisor’s Death

The death of one man on the job has led to a sizable fine for one Massachusetts business.

 
A 35-year-old sanitation supervisor at a New Bedford fish processing plant died on Jan. 16, this after he was caught in the rotating parts of the shucking machine he was cleaning.

 
Following an investigation by the U.S. Department of Labor’s Occupational Safety and Health Administration, his employer, Sea Watch International Ltd., was cited for seven serious safety violations, including failure to implement basic safety procedures to protect workers who service or maintain machines.

 
“This worker should not have died. This death was preventable if the company had implemented the required safety practices,” said Brenda Gordon, OSHA’s area director for southeastern Massachusetts. “It is the employer’s responsibility to ensure that all requirements are met and to take effective action to ensure that these hazards, and the dangers they pose to workers, do not occur again.”

 
The company was cited for failing to implement lockout/tagout procedures that protect workers who clean machinery.

 
The violations include failure to provide a lockout device; incomplete lockout/tagout procedures; not conducting periodic inspections of these procedures to ensure that all requirements were being met; and failure to train all affected sanitation employees in lockout/tagout procedures. OSHA found that plant employees were exposed to fall hazards and were not trained in up-to-date chemical hazard communication methods.

 
OSHA also cited Workforce Unlimited Inc., the Johnston, R.I., temporary employment company that supplied temporary workers to the plant, for three serious violations for lack of lockout/tag-out procedures, lack of chemical hazard communication training and for exposing workers to ladder hazards.

 
Workforce Unlimited Inc. was cited as a joint employer because it had a supervisor on-site with knowledge of the working conditions. 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.

 
Sea Watch employs 15 full-time workers at its New Bedford plant; 185 of the workers at the plant were temporary employees supplied by Workforce Unlimited.

 

Concern Over Injuries, Deaths to Temp Workers

 
Concerned about a growing trend of injuries and deaths involving temporary workers, OSHA launched an initiative in 2013 to address the issue. In every inspection, OSHA inspectors determine if every temporary worker at a work site has received the safety training and protections required by law for the job. If not, the employment agency and host employer may both be cited for violations.

 
“Host employers need to treat temporary workers as they treat existing employees. Temporary staffing agencies and host employers share joint responsibility for temporary employees’ safety and health. It is essential that both employers and staffing agencies comply with all relevant OSHA requirements,” said Robert B. Hooper, OSHA’s acting regional administrator for New England.

 
Proposed fines against Sea Watch total $35,410, while fines against Workforce Unlimited total $9,000. Each company has 15 business days from receipt of its citations and proposed penalties to comply, meet informally with OSHA’s area director, or contest the findings before the independent Occupational Safety and Health Review Commission.

 

 

 

Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com.  Contact: kstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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Injury Prevention: Look In Mirror, “You’re Looking At The Problem”

All injuries are preventable. If you really think about it, if everyone did everything they were supposed to do accidents probably would never happen.

 

Sure equipment fails, or gets worn out and fails, or tires blow out when you run over a nail, but think about it: That nail maybe wouldn’t be on the road if a worker hadn’t left a box of nails on the bed of their truck then drove away with the tailgate down. That machine would not have failed if it were replaced 2 years ago when the maintenance worker told his supervisor that this machine was old, outdated, and had “a few years left.”

 

 
Tracy Morgan Accident, Like Most Accidents, Was Preventable

 

Think about what happened to comedian Tracy Morgan. This is all alleged at the time I write this, but allegedly the semi-truck driver was up for 24 hours before he crashed into the back of Morgan’s limo. The truck driver is a Wal-Mart employee. No doubt he will have a great defense counsel when this goes to trial, but what if that were your truck driver out there that caused this accident? Do you know how many hours your drivers are logging behind the wheel? Are they compliant with all their reporting of work versus rest periods? How can you really prove they are being truthful and honest should this situation result from your employee? If you are not sure, I hope you have deep pockets to provide as good of a defense counsel as this driver is going to get.

 

Time and time again, we see injuries that are preventable. Most of these injuries get chalked up to “operator error” meaning that this worker knew better than to do what they were doing at the time they were injured. This could be from trying to lift too much, or pull too much in one load, or from operating a machine in the improper manner.

 

 

The Belt Sander That Luckily Missed

 

For example, I saw an injury the other day in which one machine operator lucked out. He was using a big stationary belt sander, to clean and smooth the edges on some metal pieces he was working on. This is a vertical sander, meaning the belt runs up and down, and the operator holds the piece of metal and pushes it into the belt to obtain the desired result.

 

Instead of holding the piece vertically like you are supposed to, he was holding it horizontally. When you hold it horizontally, to work on one edge you have to tilt the piece up. What he forgot to realize was by tilting the piece up, his hands were extremely close to the moving belt. The piece caught in the tiny gap between the platform and the belt, and the force of the spinning belt pulled his hands right in to it.

 

He was very lucky in a sense that he escaped with only some bad abrasions and a few fractured fingers. It surely could have been much worse had his fingers been pulled down and jammed into the platform or had he not had gloves on at the time.

 

But questions begged to be asked. Why was he doing this and holding the part horizontally? Who trained him on how to use this sander? Where was his supervisor, and why was he not seen operating this equipment in an unsafe manner?

 

This is a 100% preventable injury. I’m sure the person reading this right now can think of many claims that resulted from something that should have been preventable in the first place. Think of the costs associated with claims that should have never happened in the first place.

 

 

“Operator Error” Should Not Fully Be Blamed On Operator

 
Every risk manager’s excuse is that it was “operator error” or just overall “bad judgment” on the part of the injured worker. But I look at the greater cause of the injury which is the worker themselves. They know better than to use equipment improperly, so why do they do it in the first place?

 

The answer is that nobody has ever caught them cutting corners. Plus even if they were caught, no discipline was ever handed down to them. So if they are not disciplined, what incentive do they have to change their dangerous ways?

 

They are only going to keep getting lucky for so long. Chances are this belt sander guy learned his lesson, and when he is back to work he will use the sander correctly for a while, until he goes back to his old ways.

 

Every single business out there that has employees on the road for any type of business should take this Tracy Morgan accident as a brutal wake-up call. No worker wakes up one day and thinks they are going to get behind the wheel of their truck or car and kill somebody.

 

 

Hold Workers Accountable To Safety And Discipline Unsafe Acts

 

At the end of the day, your workers have to be held accountable for their own actions, and they need to be disciplined for unsafe acts. The chain of command and accountability has to be there. Workers are held accountable for their actions, supervisors are held accountable for their workers under their supervision, and so on up the ladder.

 

The failure is when one level of management does not act properly in stopping an unsafe act to begin with. If you as business owners and decision-makers do not step in, you cannot afford to turn a blind eye to whatever problem you are facing.

 

The cost of replacing an unsafe machine or the cost of making sure your workers are complaint with whatever safety protocol you have is not worth the cost of someone being seriously injured, or worse, losing their life.

 

 

 

Author Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com.  Contact: mstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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

MODIFIED DUTY CALCULATOR:   http://www.LowerWC.com/transitional-duty-cost-calculator.php

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

 

Texas DWC Accepting Comments on Injured Employee Ruling

Officials in the Lone Star State are looking at a ruling that would help injured workers.

 

The Texas Division of Workers Compensation (DWC) noted recently that it is accepting public comment on a rule that will assist injured employees seeking Lifetime Income Benefits in the Texas workers comp system.

 

The rule requires insurance carriers to thoroughly review an injured employee’s eligibility for the benefits in a timely manner. It also sets specific time frames for eligibility reviews when the injured employee requests the benefits.

 

Goal is for Those Injured to Receive Benefits in Timely Manner
“Our main purpose is to ensure that injured employees who qualify for Lifetime Income Benefits receive these benefits in a timely fashion,” said Commissioner of Workers Compensation Rod Bordelon. “With better communication among system participants, I think we get a better system that delivers the benefits that are appropriate without unnecessary delays.”
Under the Texas Labor Code, Lifetime Income Benefits are paid if the injured employee has:
• total and permanent loss of sight in both eyes;
• loss of both feet at or above the ankle;
• loss of both hands at or above the wrist;
• loss of one foot at or above the ankle and the loss of one hand, at or above the wrist;
• an injury to the spine that results in permanent and complete paralysis of both arms, both legs, or one arm and one leg;
• a physically traumatic injury to the brain resulting in incurable insanity or imbecility;
• third degree burns that cover at least 40 percent of the body and require grafting, or
• third degree burns covering the majority of either both hands or one hand and the face.
At the informal draft stage of rule making, DWC invites public comment on rules before the formal proposal stage. Public comments are welcome until July 7, 2014 at 5 p.m. Central Standard Time.

 

Comments may be submitted by e-mailing InformalRuleComments@tdi.texas.gov or by mailing or delivering the comments to:

 

Texas Department of Insurance, Division of Workers Compensation
Maria Jimenez
Workers Compensation Counsel, MS-4D
7551 Metro Center Drive, Suite 100
Austin, Texas 78744-1645

 

 

 

Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com.  Contact: kstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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

MODIFIED DUTY CALCULATOR:   http://www.LowerWC.com/transitional-duty-cost-calculator.php

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

Grief Counseling For Work Comp Saves In More Ways Than One

Severe injuries can take a tremendous personal toll on a work force, as well as the families of the injured worker.  Employers are also recognizing this grief, associated with workers compensation losses, has adverse cost impact on claims. A few cost items are, lost production, extended disability, extra medical treatment, extended weekly benefits, possible need for temporary employees, higher risks for more disabling situations, possible fraud, and potential fellow employee lost production. A total composite list of cost items, both personally and professionally, will show that the dollar value can be very large.

 

 
Types of Workers Compensation Losses Likely to Cause Grief:

 

Losses involving death of an employee, death of a fellow employee, a serious injury, poor injury recovery, amputations, loss of sight, loss of hearing, mental deterioration during disability, depression brought on by the injury, lengthy loss time from work, feelings of inadequacy for not being able to be a family provider, and inability to return to former occupation can bring on the grieving process.

 

In some instances, the death of a fellow employee can be devastating. Certain key persons or very beloved persons can leave a large void by their passing. This can cause group depression that slows production. Depending on the length of time required for the staff to recover from their grief the cost impact can be significant.

 

Employee grief may have impact on the families, friends, and fellow associates.

 

 
The employee’s reactions to handling grief may be subtle, so may not be easily recognized. The employee is usually the last to recognize any problem. On the other end of the spectrum, employee reaction may be strong enough to warrant intervention by a medical provider, or professional grief counselor.

 

Catastrophic work place events caused by fire, explosion, weather, collapse, or other cause failure, can be stunning and devastating. Normal coping mechanisms for grief can totally shut down or be severely delayed. In these instances professional grief counseling is recommended.

 

 
Employer Grief Policy Steps:

 

When an injury involves a death there is little the employer can do to replace the loss for the family. Expressions of sympathy, offers of support, attending the funeral, providing for prompt payment of insurance, as well as corporate and legal benefits, are important as the family goes through a extremely difficult time.

 

Employees suffering from grief issues or problems also need employer intervention. The employer should establish a grief program that includes the following:

 

1. The seven step definitions of the grieving process: Acceptance, Anger, Denial, Depression, Fear, Guilt and Shock. Aside from listing their definition, be alert for their appearance.

 

2. Keep in constant touch with the employee during lost time disability.

 

3. Reinforce all positives when talking to the employee.

 

4. Listen and acknowledge all of the employees concerns.

 

5. Address all of the employees concerns within the employer’s ability to perform.

 

6. Share all common interests of fellow employees. Encourage fellow employees to talk to the injured employee.

 

7. Keep contact with the employee when returning to work.

 

8. If it was necessary for the employee to take another job, be sure to train, praise, and reinforce all accomplishments positively.

 

9. Encourage communication and show real interest in the responses.

 

10. Offer assistance when needed.

 

11. Provide professional grief counseling as needed.

 

12. Be sure the injured employee is welcomed back by fellow employees and made to feel part of the team again.

 

13. Even if the injury may preclude the employee’s participation in a group activity, extend an invitation anyway.

 

14. Allow and participate in fellow employee discussions about any grieving process.

 

Add any other steps that might be needed for employee closure. Remember, grieving employees, no matter what the circumstance, need to get their feelings expressed in order to heal, reach closure, and recover from grieving.

 

 
Summary:

 

The grieving process is very real. It can be triggered by many workers compensation type injuries and death. There is real increased claim cost associated with grief. An employer policy is necessary to address grief in the claim process.

 

Many types of trauma trigger the grieving process. When incidents are catastrophic grief can be so stunning or devastating that professional grief counseling may be needed. Compassion and real concern for all employee well-being during the grieving process is vital.

 

Employees who know their employer is in tune with these principals will heal quicker personally and professionally providing for increased employee morale, better production and employee stability.

 

 

 

Author Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com.  Contact: mstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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

MODIFIED DUTY CALCULATOR:   http://www.LowerWC.com/transitional-duty-cost-calculator.php

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

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