Ohio BWC Approved for Safety Intervention Grants

Grants to help focus in more on workplace safety are going a long way in Ohio.

 
The Ohio Bureau of Workers Compensation (BWC) recently approved 118 safety intervention grants for Ohio employers totaling $3,499,148 in September and October. BWC designed the Safety Intervention Grant Program to assist Ohio employers in reducing illnesses and injuries and to create a partnership with them to establish best practices for accident and injury prevention.

 
“The items employers are purchasing with these grants can help automate processes to improve productivity and make their workers’ jobs safer,” said BWC Administrator/CEO Steve Buehrer. “Employers that take advantage of the safety grant program are taking proactive steps to protect their workers and are often able to lower their workers’ compensation costs by reducing on the job injuries.”

 
Public and private employers from nine different industries in 51 counties were approved for the grants. A full listing by month of entities approved for grants with a summary of what intervention the money will go to is attached and can be seen online here.

 

Data Reports Note How Well Interventions Work

 
Ohio private and public employers are eligible for safety intervention grants, which include a 3-to-1 matching amount up to a maximum of $40,000. Quarterly data reports and follow-up case studies help BWC determine the effectiveness of employers’ safety interventions and establish best practices.

 

Learn more about the Safety Intervention Grant Program and best practices at bwc.ohio.gov and view the stories of previous grant recipients on BWC’s YouTube channel.

 

 

 

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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Implementing Safety Training Guidelines in The Workplace

The responsibilities that come with running a company are endless.  These duties include budgeting, human resource decision and making a profit.  Due to all of these demands, the goal of work environment safety must never get lost.  It is essential to implement effective safety training guidelines to keep your employees safe and free from hazards.

 

 

Promoting a Culture of Safety

 

The goal of any business owner should be to have a safe work environment that allows his or her employees to prosper and be in safe surroundings.  The reality of the situation is that this noble goal can be forgotten as deadlines near and demands or pressures of the business grow.  Instead of ignoring these goals, owners of businesses need to be mindful of the human element that makes their businesses successful.  Emphasis should be placed on the following simple guidelines.

 

  • Focus on workplace ergonomics. Employees that work in static positions are prone to severe or disabling injuries.  This is especially true when people are performing repetitive activities or motions during their work experience.  A review of all work activities should be made on a regular basis.  This should also include the ability for employees to change positions or work duties frequently.  This not only promotes a safer work environment, but also certain intangibles such as cross training, which can increase efficiency.

 

  • Allow for regular work breaks. Too often it is easy for people to get into the mindset that work breaks diminish workplace efficiency.  However, studies indicate the “law of diminishing returns” is present in work places where employees engage in repetitive work duties for extended periods.  Allowing for work breaks keep the workplace labor force motivated, improves morale and can increase productive in the long term.

 

  • Allow only proper use of machinery or tools. During the course of work, machinery or tools are sometimes modified to assist employees in performing work activities.  Many common “modifications” include the removal of guards or other safety equipment.  These practices should be explicitly discouraged.  Management should never turn a blind eye to these potentially dangerous, and in some cases, deadly modifications.  Employees should also be reminded how to safely operate equipment on a regular basis through education and in-service training opportunities.

 

  • Promote a stress free workplace environment. In a perfect world there would be no stress in the workplace.  Until that environment arrives, business owners and managers will be faced with challenges to promote a workplace that boosts morale and strives for greatness.  Remember, you cannot make everyone happy, but certain intangible benefits can be offered as part of a package to make the workplace free of outside distractions.

 

 

Incorporate Safety into Workplace Training

 

The Occupational Safety and Health Administration (OSHA) is the agency within the U.S. Department of Labor charged with workplace safety issues.  According to OSHA, the following components should be a part of any workplace-training program:

 

  • Determine whether a worksite problem can be solved by training;
  • Determine what training, if any, is needed;
  • Identify goals and objectives for the training;
  • Design learning activities;
  • Conduct training;
  • Determine the effectiveness of the training; and
  • Revise the training program based on feedback from employees, supervisors, and others.

 

In following the OSHA model for workplace safety, it is important to take additional step to ensure that a program is effective.  The first step to take is to develop safety guidelines and guarantee it is understood by managers and employees.  Once this is accomplished, informational and instructional programs should become incorporated into the initial training of new employees and ongoing education for the entire workforce.  Companies should also remain compliant with federal and state standards, along with educating the workforce on industry best practices.

 

Once a program has been implemented, additional steps can also be taken to improve a program.  According to OSHA, additional steps that improve programs are as follows:

 

  • Determine if specialized training is needed;
  • Identify the training needs within the workforce;
  • Identify safety goals and objectives;
  • Develop ongoing learning activities;
  • Conduct a safety training program consistent with best practices;
  • Evaluate the effectiveness of the program; and
  • Improve your program.

 

Never be afraid to solicit input from the entire workforce on the program.  It is also important to keep them engaged.

 

 

Lead By Example When It Comes to Safety

 

As a leader in the workplace, it is important for management and supervisors to lead by example when it comes to safety.  In addition to following state and federal workplace safety rules, it is paramount that persons in a position of authority set the best example possible.  By taking the time to do this, other employees will take note and do the same.

 

Take the uncommon approach to leadership.  This is something that is earned by making other employees feel a part of the team when it comes to safety.  Put those people first.  Earn the right to be followed when it comes to safety.

 

  • Create a safety committee and comprise the membership of employees from all areas of the company and skill levels. Make sure there is an environment where their input is welcomed and can be shared without fear of reprisal.

 

  • Make managers a visible component of the workplace environment. The issue of safety should be emphasized in daily conversations and team meetings.

 

  • Be proactive on fixing workplace safety issues. When a matter is corrected, make sure it is publicized for all employees.

 

 

Improving Safety Training in Your Company

 

Improving safety in the workplace also can start with the hiring process.  Sometimes the “quick” hire” is not a smart decision.  The results can lead to serious injury or death when hiring incompetent workers.  As part of the screening process, it is important to ask potential employees about their skills and experiences.  Situational questions can also be asked to determine if the prospective employee is aware of potential workplace hazards and has received prior training and instruction on how to deal with volatile or hazardous safety issues before an injury occurs.

 

Another part of having a safe workplace is improving existing courses and content.  It is important for management and people administering courses to review materials and answer the following questions:

 

  • Were any parts of the program content already known or covered in previous courses work?

 

  • What aspects of the training are confusing or hard to understand?

 

  • Is there anything missing from a program that should be covered?

 

  • Are employees actually learning the material and applying it to their daily work tasks and responsibilities?

 

Employees can also be engaged on these questions when they evaluate a workplace safety program.  Additional factors should be examined as part of this process:

 

  • Workplace demographics and understanding what employee profiles are at a greater risk for accident or injury;

 

  • Identify environmental issues that play a role in workplace accidents. This could include seasonal influences or other environmental factors such as heat and cold, or moisture on work surfaces; and

 

  • Hazardous substances in the workplace and additional requirements for the handling of these substances or items.

 

 

Conclusions

 

Workplace safety is an important aspect of running a successful company.  This is accomplished by placing an emphasis on workplace safety and creating an atmosphere that fosters buy-in from all levels of employees.

Illinois Employer Cited, Worker Dies on Job

The death of a worker has led to more than a dozen of citations against an Illinois employer.

 
A U.S. Department of Labor Occupational Safety and Health Administration investigation recently found that Environmental Remediation and Recovery Inc. did not have equipment or trained personnel to rescue a 27-year-old worker promptly who collapsed and later died while cleaning a rail car.

 
OSHA has cited seven willful and 14 serious safety violations, many involving permit-required confined space safety regulations. The company has also been placed in OSHA’s Severe Violator Enforcement Program.

 
OSHA determined that the employee entered a 30,000-gallon rail car on May 20, 2014, and suffered from cardiac arrhythmia. He was unable to exit the rail car on his own. The man had been on the job for about 14 months at the time of the incident.

 
“Permit-required confined spaces put workers at risk for serious injury and illness from hazards,” said Nick Walters, OSHA’s regional administrator in Chicago. “The employer must ensure that safety equipment, such as retrieval lines and proper respiratory protection, is provided to employees and used each time someone enters a confined space. Each year workers are fatally injured when working in confined spaces.”

 
Environmental Remediation failed to monitor permit-required confined spaces; allowed entry when atmospheric conditions were unacceptable; and did not provide personal protective equipment, including self-contained breathing apparatus and respirators. The company also failed to remove defective respirators from use. A confined space is one large enough for workers to enter and perform certain jobs, such as a rail car clean out, but it has limited or restricted means for entry or exit and is not designed for continuous occupancy.

 
Rescue Plan at Issue Too

 
In addition, the company failed to designate trained rescue employees and use a retrieval system attached to the worker to aid in rescue. OSHA cited the company for seven willful violations.

 
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.

 
Additionally, Environmental Remediation failed to comply with respiratory protection requirements, maintain rescue equipment, ensure ventilation equipment was used properly, and provide fall protection for workers at the top of the rail car, which exposed them to falls of 15 feet or more. A total of 14 serious citations were issued for these violations.

 
An OSHA violation is serious if death or serious physical harm could result from a hazard an employer knew or should have known exists.

 
OSHA has proposed fines totaling $188,400.

 
The company was given 15 business days from receipt of its citations and penalties to comply, request an informal conference 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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Five Foods To Forego…Everyday Choices Pose Health Concerns

Experts frequently remind us that fresh fruits and vegetables, especially those that come in rich, vibrant colors, should hold a valued position on our tables at meal time. These foods contain nutrients that are known to stave off serious, debilitating diseases. Unfortunately, many people in our “always on the go” American lifestyles choose convenience over quality.

Experts frequently remind us that fresh fruits and vegetables, especially those that come in rich, vibrant colors, should hold a valued position on our tables at meal time. These foods contain nutrients that are known to stave off serious, debilitating diseases. Unfortunately, many people in our “always on the go” American lifestyles choose convenience over quality.

Eating fruits and veggies is great practice for your good health. Think colorful food selections that grow from the earth.

 

The food you eat should be processed by your body, not a factory. Fill up most of your plate with fruits and veggies and skip the less-than-stellar selections listed below to build your plate for power.

 

The top five foods every consumer should leave off the grocery list:

 

5. Deep Fried Foods:

Cooking at high temperatures can result in the formation of toxic chemical compounds that are not good for your health.

 

4. Processed meats:

The Harvard School of Public Health reports that eating processed meats may increase one’s risk of heart disease and diabetes when a diet consists of regularly eating about 50 grams (1.75 ounces) of processed meat per day. Processed meat includes deli slices, sausage and bacon.

 

3. Soft drinks (diet or regular):

Most sodas contain food dyes and preservatives. It is uncertain how safe these drinks are and they provide very little by way of healthy nutrition and nutrients.

 

2. Condiments in a bag:

Mustard and ketchup in small packets are engineered to remain stable. They contain additives that your body doesn’t need.

 

1. Refined and artificial sweeteners

We don’t know if these substitutes are harmful. Claims are confusing and these substitutes provide no healthy nutrients.

 

Recent  research  has  found  a  possible link between artificial sweeteners and glucose intolerance. The American Heart Association released its recommendations which state that most American women should consume no more than 100 calories in these sweeteners per day (about 6 tea- spoons).

 

The American Heart Association recommends that men consume no more than 150 calories per day (about 9 teaspoons).

29

References:

http://www.ncbi.nlm.nih.gov/pubmed/23335051

http://www.hsph.harvard.edu/news/press-releases/processed-meats-unprocessed-heart-disease-diabetes/

http://www..nature.com/nature/journal/v514/n7521/full/nature13793.htmlpubmed/23335051

 

 

Author: Heather Klaus, Medcor, Wellness Program Manager. Heather oversees Medcor’s internal wellness program for nearly 900 associates nationwide.  She also develops and supports wellness programs for Medcor clients.  Heather is a regular author and contributor to health and wellness blogs, videos and newsletters.  Heather holds a Bachelor’s in Science from Northern Illinois University in Nutrition and Dietetics. She is a certified trainer, fitness instructor and Lifestyle and Weight Management Consultant.  http://www.medcor.com.  Contact: heather.klaus@medcor.com

North Carolina Notes Rate Filing, Fraud Arrest

Officials in the Tar Heel State reported a recent workers compensation rate filing and an arrest involving comp fraud.

 
Insurance Commissioner Wayne Goodwin announced that the Department of Insurance has completed its review of workers comp rate filings from the North Carolina Rate Bureau, the organization that represents the state’s workers comp insurance companies.

 
The rates have been approved as filed and will go into effect April 1, 2015.

 
There will be a 3.4 percent average decrease to loss costs for the voluntary market. There will be an average 4.5 percent decrease in residual market rates.

 
The full filings and settlements are available for public review on the NCDOI website. Visit http://www.ncdoi.com/PC/PC_Filing_Search.aspx and search for Serff Tracking numbers NCRI-129728928 and NCRI-129728930.

 
The Rate Bureau is required to submit workers comp rate filings annually in September.

 
In 2013, a 4.2 percent increase to the voluntary market loss costs and a .3 percent increase to the residual market rates were approved.

 

Fraud Charges Levied Against N.C. Woman

 
Meantime, Goodwin announced the arrest of Roxanne Renee Newton, 29, of Snow Hill; she was charged three counts of insurance fraud, two counts of attempting to obtain property by false pretense and one count of obtaining property by false pretense.

 
Department of Insurance criminal investigators allege that between Aug. 25, 2014, and Sept. 8, 2014, Newton filed fraudulent insurance claims with State National Insurance Company and with her employer’s workers comp carrier for property damage and injuries she claimed occurred in a single-car accident. Newton received $3,514.14 from State National to settle the vehicle damage claim.

 
Newton was arrested on Nov. 7 and placed under a $30,000 bond.

 
The Department of Insurance employs 20 sworn state law enforcement officers dedicated to investigating and prosecuting claims of insurance and bail bonding fraud.

 
Since Goodwin took office in 2009, criminal investigators have made more than 1,000 arrests, resulting in more than 500 criminal convictions with more than 200 cases currently pending court.

 
These efforts have delivered more than $61 million in restitution and recoveries for victims.

 

 

 

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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Injured Worker’s Personal Problems Lead To Dangerous Workers Comp Claims

There are classes of comp claims that start as ordinary reports of injury but quickly turn into claims nightmares. Among these is the younger worker claim in which an otherwise healthy person develops an inexplicably complicated claim. An explanation that needs to be considered is “trouble at home leads to trouble at work”.

 

Younger workers often have not yet gained the life experience to deal with routine problems, especially if they are on their own for the first time. A marriage, rather than being a stabilizing factor, often produces confusion. Your correspondent learned early in his career as a comp lawyer that comp claims are often seen as a good way to get rid of a bad marriage. And not just for younger workers. Mid-life claims often have a similar motivation.

 

 

An Employees Private Life Can Be As Much Of A Problem  As The Injury

 

Anyone can make a situation worse than it is; improvements take skill, especially with claims. The comp investigation process, governed by the carrier, not the employer, is too remote and impersonal to provide the hands-on approach required where an employee’s private life is as much a problem as the injury. This is where sensitive involvement by an employer can prevent a person from using a claim to derail not only a job but a private life.

 

The employer needn’t intrude – or wait until it earns a degree in counseling. Chatting goes a long way. If there are serious personal problems present they will quickly manifest themselves – no matter what the topic of conversation. Your correspondent, as a lawyer handling workers’ claims, learned the value of seemingly idle conversation with clients. Eventually, the true sources of frustration would surface and the relationship would quickly improve.

 

 

Communication Is A Powerful Tool & Neglected Art

 

Conversation is a powerful tool and is a neglected art. Scowling interrogation produces results – but not the kind you want. Communication skills look effortless but are acquired through a lot of practice. Is it worth the effort? Well, what better way to avoid a $100,000+ claim? Litigation is no substitute.

 

 

 

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

 

©2015 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.

Oregon WCD Moves on Industry Notice

Officials with the Oregon Workers Compensation Division (WCD) recently released the following update….

 
To: Insurers, third-party administrators, attorneys, injured workers and WCD all staff

 
Subject: Spurger v. SAIF and interpretation of repetitive use

 
Industry Notice

 
SUMMARY: This industry notice explains the Workers Compensation Division’s implementation of Spurger v. SAIF, 266 Or App 183 (2014), as well as WCD’s interpretation of when a worker is “significantly limited in the repetitive use” of a body part under OAR 436-035-0019(1).

 
BACKGROUND: Under OAR 436-035-0019(1), “[a] worker is entitled to a 5 percent chronic condition impairment value for each applicable body part, when a preponderance of medical opinion establishes that, due to a chronic and permanent medical condition, the worker is significantly limited in the repetitive use” of one or more of the listed body parts.

 
In Spurger, the Court of Appeals held that, when evaluating whether a worker is “significantly limited in the repetitive use” of a body part, the relevant inquiry is whether the limitations described in the medical-opinion evidence show that the worker is significantly limited, and not whether a physician described the limitations as “significant” according to the physician’s understanding of the term. 266 Or App at 192.

 
While Spurger addressed an order issued by the Workers Compensation Board (WCB), the WCD’s evaluation of whether a worker is “significantly limited in the repetitive use” of a body part is controlled by the court’s determination of the proper analysis under OAR 436-035-0019(1).

 
ANALYSIS: This notice explains how WCD will determine “whether the limitations described in the medicalopinion evidence show that the worker is significantly limited” under OAR 436-035-0019(1). “Significantly limited” is defined by neither rule nor statute. Absent statutory and administrative definition, we look to a term’s plain meaning. “Significant” is defined, most relevantly, as “having or expressing a meaning; meaningful” or “important; notable; valuable.” See The American Heritage Dictionary, New College Edition; see also, Webster’s II New College Dictionary. “Limited” is defined as “confined or restricted.” Id.

 
In applying those definitions to OAR 436-035-0019(1), it is necessary to establish when a confinement or restriction to the “repetitive use” of a body part is important, meaningful, or notable. In the context of work restrictions, a repetitive use limitation is generally compensable when the worker is limited to “frequent” repetitive use or action.

 
Although OAR 436-035-0019(1) provides an award for impairment, WCD finds it reasonable to adopt an equivalent standard for the limited purpose of defining when a confinement or restriction is important, meaningful, or notable.

 
Accordingly, WCD will interpret confined or restricted (“limited”) “repetitive use” under OAR 436-035-0019(1) as important, meaningful, or notable (“significant”) when the worker is limited to frequent use of the body part. Consistent with the use of the term in the context of work restrictions; frequent means the ability to use the body part for up to two-thirds of a period of time.

 
IMPLEMENTATION:Based on the above analysis, WCD interprets the relevant inquiry under OAR 436-035-0019(1) as follows: Because of a permanent and chronic condition caused by the compensable injury, is the worker unable to repetitively use the body part for more than two-thirds of a period of time?

 
Any frequency is permissible as long as usage is repeated. Any duration is permissible and any intensity is permissible. However, the confinement or restriction must be caused in part by a permanent and chronic condition resulting from the compensable injury.

 
For example, if a worker is unable to repetitively use a body part for more than two-thirds of a 24-hour period, but the inability is not caused by the compensable injury, the worker does not qualify for a chronic condition impairment value.

 
WCD was to apply the above inquiry to any Notice of Closure received starting Dec. 23, 2014.

 

 

 

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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The MSA Process: To Review Or Not To Review

In William Shakespeare’s play Hamlet, Prince Hamlet of Denmark agonizes over his sanity and speaks one of the most famous lines in English literature, “To be, or not to be, that is the question!”  While the Prince Hamlet could not have known about the perils of the Medicare Secondary Payer Act, he clearly could understand the tribulation of claim handlers as they ponder the issue of submitting a Medicare Set-Aside (MSA) for review and approval.

 

 

What Does CMS Require?

 

According to 42 C.F.R. §411.46 (b) (2), “If a settlement appears to represent an attempt to shift to Medicare the responsibility for payment of medical expenses for the treatment of a work-related condition, the settlement will not be recognized.”  An MSA is a tool that can be used to comply with the Medicare Secondary Payer Act and its regulatory framework.

 

Although Medicare’s warning is serious, it is important to be clear that CMS review of an MSA is never required.  If at the time of settlement, the injured worker is not a Medicare beneficiary, the injured worker or party does not have a reasonable expectation of becoming eligible for Medicare benefits, or if the settlement does not close out future medical care and treatment that is otherwise covered by Medicare, an MSA may not be necessary.  Caution still needs to be used after careful review to determine if the settlement shifts the burden onto Medicare.

 

 

CMS Review Provides Certainty

 

By obtaining approval from the Centers for Medicare and Medicaid Services (CMS) prior to final settlement, all parties receive certainty from future government action or non-recognition of a settlement.  CMS has stated that in workers’ compensation cases, they will only review settlements that meet the following review thresholds:

 

  1. The individual is a Medicare beneficiary at the time of settlement and the total settlement is greater than $25,000, OR
  2. The individual is not a Medicare beneficiary at the time of settlement, but the “total settlement” is over $250,000 AND there is a “reasonable expectation” of Medicare entitlement within 30 months of the settlement date.

 

Settlements not meeting these review thresholds should still consider and protect Medicare’s interests in order to comply with the Medicare Secondary Payer Act.

 

 

Items to Consider in Your Cases

 

Every workers’ compensation case is unique and should be analyzed in its facts and merits.  Medicare Secondary Payer compliance starts with identifying claimants who are Medicare eligible or will be Medicare eligible in the near future.  The following additional steps can also be taken:

 

  1. Have file materials reviewed to determine what services a claimant may require in the future and the projected cost of the treatment. Special consideration should be given to services, treatment modalities and prescription medications covered by Medicare.
  2. Proper preparation for mediation/arbitration and hearing. This includes investigation of Medicare’s conditional payments and considering Medicare’s future interests.  Failing to consider these matters in advance can lead to delay in reaching a settlement.  Given recent case law developments, it is essential that every aspect of Medicare Secondary Payer compliance is discussed and memorized as part of a settlement.  While you cannot plan for every contingency, it is important these matters are discussed so valuable time is not wasted in post-settlement litigation and enforcement.
  3. Determining in advance whether the parties want to seek Medicare approval of a MSA or take other steps to comply with the Medicare Secondary Payer Act. This should be discussed with your clients and the other stakeholders in a settlement.  Once a plan is determined, it is important to cooperate and communicate with all parties in the preparation of a MSA, and its review and approval.

 

 

Author Michael Stack, Principal of Amaxx Risk Solutions, Inc. He is an expert in employer communication systems and helps employers reduce their workers comp costs by 20% to 50%. He resides in the Boston area and works as a Qualified Loss Management Program provider working with high experience modification factor companies in the Massachusetts State Risk Pool.  As the senior editor of Amaxx’s publishing division, Michael is on the cutting edge of innovation and thought leadership in workers compensation cost containment. http://reduceyourworkerscomp.com/about/.  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.

 

 

 

Australian Focus Zeroes in on Forklift Safety

Unfortunately, it sometimes takes the deaths of one or more workers to fully grab the attention of employers and workplace safety officials.

 

Two fatal incidents at the Sydney Markets prompted the fresh-food market to recently impose the strict use of seat belts and rollover protection for all forklifts.

 

The incidents, in 2012 and 2013 which claimed the lives of Filipe Hehea and Mark Rushton respectively, have resulted in the mandatory use of seat belts in forklift trucks at the Sydney Markets and prompted them recently to review their safety standards.

 

Every night around 5,000 workers at the largest fresh-food market in the southern hemisphere move around at a frenzied pace and 850 forklift trucks drive around the 43-hectare sheds in Western Sydney hauling fresh produce from delivery trucks to wholesale stalls and to waiting retailer vans.

 

In June 2012, a forklift driver was crushed by his truck hit a curb and turned over.

 

The investigation conducted by safety watchdog, WorkCover found the incident to be a very unfortunate one.

 

Seven months later, two forklifts collided with one tipping over and killed its driver.

 

The incident is still being investigated by the safety watchdog, the police and the coroner.

 

 

 

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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Top 10 Employer Complaints About Their Adjuster / Carrier

Over the years I have fielded several complaints from employers about their work comp adjuster or carrier in general.  I think at one point or another we have all heard of the same complaints about how a work comp program is run from the carrier side.

 

What I always find amusing is the fact that these employers just sit back and take it.  The reasoning behind this is usually that the employers accept that this is the way they think work comp is supposed to be.  They always hear the same pitch from each carrier:  Said carrier is different, they are aggressive, they are more hands-on, etc.  But in the end, the employer arrives at the same dissatisfaction, and they jump from carrier to carrier and arrive at the same issue time and time again.

 

But this is not the way it has to be.  The agent/broker is supposed to be fielding these issues for the employer, but maybe that does not happen.  I have compiled the most common complaints below.  Remember, if you are dissatisfied with your results, you have the power to correct this issue.  If you complain, and nothing changes, you must continue your search to find the right fit for your work comp program.

 

1. The adjuster does not act fast enough. 

The main complaint here is that if/when an MRI is ordered, there is no reason it should take 2-3 weeks to complete the testing, start the therapy, see a physician, and so on.  I imagine the reason this takes so long is because the adjuster has 200 files to work, and you are low priority on the list.

 

2. The adjuster does not communicate quickly enough, if ever. 

Again same result as above.  The reality is that the adjuster does not have the time to properly work the file.

 

3. The adjuster does not see the red flags about compensability. 

See above again.  Chances are the adjuster takes the easy way out, because they did not properly investigate the claim properly.

 

4. I talk to a different adjuster every time I have an issue. 

Unless you are a large account, it is unlikely you will have a dedicated adjuster assigned to your account.  This means you have to chase down who your adjuster is, understand their style of handling claims, and take the results as they are.  This should not be accepted.

 

5. Billing issues never get resolved. 

This is due to a breakdown in communication between the adjuster and their bill payer vendor.  The backload in billing is because the adjuster is not approving payment of their bills timely, and this leads to rebilling issues and credit report problems for the claimant.  One of the most important things an adjuster will hear is that they have to work their mail every day.  Failure to complete this task will lead to mail and bills piling up for weeks at a time.

 

6. The adjuster is not aggressive enough. 

This comes again from the adjuster not working the file.  If a claim is questionable, the adjuster should know that right away from their investigation.  Sadly, most adjusters will take the easy way out.  A typical excuse is “The medical report says the injury is work related, so it must be work related.”  We all know that the medical aspect of the claim is only one facet of claim investigation.  Is what the claimant told the doctor correct?  Did the mechanism of injury remain consistent?  Did all of the facts line up with the way the employer reported the injury? 

 

7. I am not updated on claims activity.

This is due to adjuster workload again.  Periodic claim reviews will help to alleviate this problem.  But if you demand to be kept up to speed on your most active claims, chances are the adjuster assigned to your account just does not have the time to complete this task.  Ways around this are to ask for weekly updates, but I imagine what you will get will be very concise, and probably not what you are looking for.

 

8. My claim concerns are not being addressed. 

No matter what your issue with a claim, your adjuster should be listening to your take on where the claim is and what should be happening going forward.  If this is not happening, that is a major issue.  I would think this is also due to adjuster workload, but that should not be an excuse.

 

9. We had light duty available but the adjuster did not work to get light duty restrictions. 

This is a very costly error for the adjuster.  If a worker is labeled to be off work, that should mean total bed rest, usually post-operative.  Outside of that, if a worker can work sedentary jobs and the employer has this option open, the adjuster has to do the legwork to get take care this.  This puts the employee back to work, lessens wage loss, and contributes to overall decreased claim expenses.

 

10. I do not like a lot of the vendors being used, but the adjuster told me that I do not have the choice to pick. 

This is true and not true, depending on your program.  In a guaranteed cost program, there is almost never a choice of services, and in a self-insured and self-administered arrangement, you will have full autonomy in who you select. As the size of your deductible increases to $100,000, $250,000, or $500,000, so does your ability to negotiate and choose your vendors.

 

These are 10 examples of common issues I hear between the employer and their carrier or adjuster.  I think the employer has the wrong view with comp programs in general—this is not how it has to be as there are a lot of options.  These issues need to be addressed by the broker.  If your broker is not presenting you with options to correct your issues then maybe it is time to find a new broker.

 

 

 

Author Michael Stack, Principal of Amaxx Risk Solutions, Inc. He is an expert in employer communication systems and helps employers reduce their workers comp costs by 20% to 50%. He resides in the Boston area and works as a Qualified Loss Management Program provider working with high experience modification factor companies in the Massachusetts State Risk Pool.  As the senior editor of Amaxx’s publishing division, Michael is on the cutting edge of innovation and thought leadership in workers compensation cost containment. http://reduceyourworkerscomp.com/about/.  Contact: mstack@reduceyourworkerscomp.com.

 

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