The Single Most Comprehensive Workers’ Comp Leading Indicator

Hey there. I’m Michael Stack, CEO of Amaxx and founder of the Amaxx Workers’ Comp Training Center. I grew up a Cubs fan in Valparaiso, Indiana, which is just outside of Chicago. While running a company, and with my wife, raising four kids, sitting down to watch a game very, very rarely makes the top of the priority list, except, of course, when they won the World Series last year. So I don’t have time to do that but I do want to know how well they’re doing. How well is their season going? So, every once in a while I’ll just slip over to ESPN and I’ll check the standings to give indication of how well the season is going and it gives me very comprehensive snapshot look. Turns out they just moved in to first place. So, their season, hopefully, seems to be on the right track.

 

 

Snapshot Leading Indicator of Program Success

 

But, in baseball, just like in workers’ compensation, there are a million statistics that you can track and dive into the most minute detail, but how do you know in work comp how well your program is going? What is that comprehensive, leading indicator to let you know whether or not your program is on the right track?

 

 

Return to Work Ratio

 

I want to introduce you to the return to work ratio and I’m gonna show you how to calculate it. Take a look at this board here. What you’re doing in this ratio is you’re tracking the number and the percentage of your injured workers that return to work within zero to four days. You are tracking the number and percentage of your injured workers that return to work in zero to four days. The best in-class programs will be at 95% or better. The best in-class programs will be at 95% of injured workers returning to work in zero to four days. So, let’s take a look very briefly at this quick example of how you track this and how you calculate it. You’re taking the injury date and you’re comparing it simply to the return to work date. How many days was that individual out of work? So, you can see here very simply on this example. Zero days, three, 20, 30 and 60.

 

Then here’s what you’re going to do with this next. Once you have the information then you graph it in Excel or a similar type program to visually represent in a snapshot, just like looking at the standings how well you’re doing. What you’re shooting for is 95% or better of your employees returning to work within zero to four days. Your programming when you graph it out and the best in-class program will look something like this, the graph that you represent. Where you might be right now is more like this. The vast majority of your employees are coming back to work in 30 days, 45 days, 60 days, 150 days. It doesn’t matter where you start, it’s a matter of understanding where you are, then you can analyze what are those factors that are causing that challenge and you can work to get just one employee back to work one day sooner. Little by little, little by little your graph starts to change from looking something like this, to something like this.

 

 

Most Comprehensive Leading Indicator Available

 

The return to work ratio, the most comprehensive indication of your program. It tracks things like how well you’re reporting your claims, how well are you getting your injured workers to the right medical treatment at the right time, how well are you getting those restrictions from those medical providers and feeding them into your return to work program, how well are you crafting transitional duty jobs and presenting those, communicating them properly to your employees. The return to work ratio factors all of those elements and more. I highly recommend it’s something that you implement and track in your program. Again, I’m Michael Stack with Amaxx and remember your success in workers’ compensation is defined by your integrity, so be great.

 

Learn more with How to Measure Workers’ Comp Success with 5 Critical Metrics.

 

Michael Stack - AmaxxAuthor Michael Stack, Principal, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center. .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

 

©2017 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

8 Steps To Assess Your Workers Comp Program

When you are the one in control of your business’s workers comp program, it is important to assess it periodically to make sure the program is running within reasonable cost to the company.  There are several different steps to take in order to assess costs.  The process may be time consuming, but well worth the effort if it can reduce claims and keep costs to a minimum.

 

Whether you are starting your business’s initial workers comp program or you are new to the already established position, these tips can help lower your workers comp costs.

 

  • Review the current workers comp insurance policy. Check payroll information and class assignments to make sure you are getting the right rate.  If you are unsure, contact your insurance agent or underwriter for clarification.

 

  • Brush up on state and federal laws. Before preparing or revising your workers comp program, be sure your new plan will fall within state and federal guidelines for each of your business’s locations.  Your best option for finding out information is to contact each state’s insurance department.

 

  • Study company loss data. Which areas have the most claims?  Are conditions better in one location than another?  Loss data can sometimes help pinpoint problems that can easily be remedied.

 

  • Prepare self-evaluation questionnaires. Send questionnaires to all employees in every area of the business.  Find out how they feel about company procedures by asking open-ended questions.  Encourage thorough answers by eliminating questions that could be simply answered with a yes or no.   Follow up with phone interviews for more in-depth answers.

 

  • Review company procedures, employee brochures. Be sure that everything used as a teaching tool for employees is up to date and completely pertains to each area of the business.

 

  • Conduct focus groups to find out how employees feel about not only loss procedures, but about working for the company in general. You may find that unhappy employees sometimes use workers comp claims as a way to indirectly express frustration with the job.  Simple changes in employees’ work environments can have a dramatic effect on workers comp costs.  Example: allowing music or having morale boosting events can not only reduce workers comp costs, but could also increase production.

 

  • Utilize your insurance carrier’s loss control department. Your insurance carrier’s loss control department is always available to help.  It is in their best interest as much as yours to keep claims down.  A loss control rep can help assess hazards and offer suggestions to reduce claims and make the workplace much safer.

 

  • Consider an independent consultant. In some cases, it is wise to have an impartial outside source completing evaluations.  However, having an internal source who knows the company inside and out may also be more effective.  Discuss the options with the business’s owners to decide.

 

Once you have all your data including self-evaluations, loss data, current policy review, employee focus group results, etc. you can begin to develop your program so it fits your specific company profile.  Before implementing any program, have it reviewed by your company’s legal counsel.  After the program is developed, be sure to reevaluate periodically to stay up to date on workers comp laws, procedures, and your company’s budget.

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices.

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

Assess 12 Areas To Determine Cause Of High Workers’ Comp Costs

An assessment of your workers’ compensation program is the first phase of developing a program meeting your company’s need to reduce insurance costs so the company can remain competitive in its industry.

 

Solutions and recommendations for changes, upgrades, revisions and current practices must be based on a complete understanding of key cost drivers: those factors which are the root cause of your company’s high costs. Many times, recommendations for change are based on assumption, not facts and therefore may be incorrect.

 

 

Analyze Effectiveness & Integration of Work Comp Components

 

Companies need to review their internal workers’ compensation management systems, their data, their file handling system and as well as vendors like outside medical service providers, investigators and insurance companies. Rather than simply taking an inventory of these items, companies should analyze the effectiveness and integration of these components in their workers’ compensation. program. A company should target its “unique identifiers,” those factors which differentiate its problems from other companies.

 

A thorough review of the level of understanding and awareness of the company management and the perception and attitude of employees is also critical to an effective assessment. In regard to internal control procedures, consider the consistency with which they are applied and look for procedures which are implemented in a timely manner. For example, delays in referring claims to the insurance company and delays in an employee’s return to work may be causes of higher than normal indemnity costs. Delays in referral of cases to a physician reviewer may result in higher medical costs due to unnecessary requests for medical examinations such as IMEs. Good procedures are only good if they are consistently and timely applied.

 

 

Consider Intangible Issues

 

Information should also be considered about more intangible issues such as internal company reporting relationships and duties of personnel having responsibility for workers’ compensation. Basic information about the company, its industry, number and location of employees, makeup of the work force and type of work is essential to a proper assessment. For example, problems associated with off-site employees are different than those associated with employees who are located on-site. Off-site employees such as delivery people, outside sales forces or seasonal construction crews may have little or no supervision, use different transportation modes or be required to carry more tools or materials than employees working in a manufacturing facility.    This impacts the types of workers’ compensation cases and expenses to the company from these employees.

 

 

12 Practices Should Be Reviewed:

 

  • data analysis
  • safety
  • communication
  • training
  • return to work
  • coordination of medical care
  • medical cost containment
  • investigation
  • file reviews
  • hiring
  • account instructions
  • claim handling standards

 

 

Rather than simply taking an “inventory” of these items, companies should analyze the effectiveness and integration of these components in their workers’ compensation program.

 

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment.

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

Conducting an Effective Security Risk Assessment

HIPAA Mandate

 

Congress initiated health care reform during the Obama Administration to provide people with health insurance throughout their employment (i.e., job after job) and to safeguard their medical data through a uniform management of electronically stored data. Rules imposed standards that were promulgated by the Department of Health and Human services, including specifics for managing and protecting health information. The specifics appear as the Health Insurance Portability and Accountability Act (HIPAA). Its Security Rule mandates that those covered by the Act evaluate their health care operation for potential security risk. Healthcare organizations are required to be compliant with HIPAA’s technical, administrative, and physical safeguards. The Office for Civil Rights has provided compliance information.

 

 

 

 

Methodology for Conducting an Effective Security Risk Assessment

 

 

Competing stakeholders utilize a variety of systems to manage data, store the information, and convey the information to users. Classically, these responsibilities have been “delegated” to data managers, but HIPAA stakeholders comprise a much larger concerned group than those who enter or maintain computers and IT data. Security risk can be assigned to multiple stakeholders, but the IT framework must address their access, hardware, software, employee training, and multiple interfacing business models with their internal processes. Risk assessment commences when the value of data is recognized on each level and the vulnerability of storage of information is defined. Managing risks identified will impact costs, productivity of employees, inter-system confidentiality barriers, communication, and decisions about delegating responsibility for continuing risk assessments in the future.

 

 

 

Goals Beyond HIPAA Requirements

 

 

Risk assessment may be impacted by issues beyond just risk. Those issues may foster additional goals for any assessment. For example, a further goal may be to identify points of noncompliance with existing mandates relating to office administrative protocols, technician and user training in data access, storage, actual technical training of technicians, etc. Another goal may relate to compatibility of data management with licensing requirements, limits based on the cultural folkways of the local region precluding effective risk assessment, legal mandates resulting from lawsuit, incident, complaint, etc. The additional goals will help determine whether resources for risk assessment are exclusively in-house or whether external consultants will be required for the risk assessment.

 

 

The Initial Assessment

 

“In broad strokes,” an initial assessment plan will define the present threat status for an organization, provide a framework for development of a continuing risk assessment program, and will typically entail these and additional parameters:

 

  1. Determine specifics of analysis,e.g., HIPAA requirements, objectives, etc.

 

  1. List organizational assets,e.g., system components, networking diagrams, physical hardware and equipment, data storage, types of data, software, existing operational protocols, operating security systems, access and authentication procedures, etc.

 

  1. Determine potential threats to those assets

 

  1. Itemize system vulnerabilities,e.g., people, equipment such as tyvek suits, communications and interfaces, etc.

 

  1. Determine effectiveness of current security.

 

  1. Identify specific levels of risk for problems delineated.

 

  1. Identify interaction effects of organizational assets.

 

  1. Review and modify organizational operations to eliminate potential internal threats.

 

  1. Develop a strategy to ameliorate all potential external threats.

 

  1. Establish a monitoring systemand a risk reassessment schedule.

 

 

Help in the Process

 

It is apparent that doing a risk assessment involves collection of a variety of information, in some cases, “voluminous” data. A number of resources (e.g., a “governmental consultant,” a “systems academic,” an “IT specialist,” a “safety consultant,” etc.) may assist the completion of the risk assessment task. Continuing education for a variety of health and safety professional groups continue to offer coursework on performing risk analysis. Businesses focusing on risk assessment vary from engineering groups, to IT groups, to medical schools, to software companies, etc.

 

 

 

Author Kenneth Overton is a risk management consultant and a former construction supervisor with over 10 years of experience in the industry. He specializes in risk analysis and disaster management.  Contact: kenneth.p.overton@gmail.com

 

Complex Regional Pain Syndrome – Red Alert!

Even when I type those words in the title, I cringe a little bit. But before I start to discuss this topic and what adjusters should do at the first mention of this diagnosis, let me give you my normal disclaimer:

 

I am not a doctor, nor do I claim to be one. I have no formal medical school credits. Please do not consider this medical literature in any way, shape, or form.

 

 

The Mayo clinic describes Complex Regional Pain Syndrome as:

 

Complex regional pain syndrome is an uncommon form of chronic pain that usually affects an arm or a leg. Complex regional pain syndrome typically develops after an injury, surgery, stroke or heart attack, but the pain is out of proportion to the severity of the initial injury.

 

The cause of complex regional pain syndrome isn’t clearly understood.

 

Signs and symptoms of complex regional pain syndrome include:

 

  • Continuous burning or throbbing pain, usually in your arm, leg, hand or foot
  • Sensitivity to touch or cold
  • Swelling of the painful area
  • Changes in skin temperature — at times your skin may be sweaty; at other times it may be cold
  • Changes in skin color, which can range from white and mottled to red or blue
  • Changes in skin texture, which may become tender, thin or shiny in the affected area
  • Changes in hair and nail growth
  • Joint stiffness, swelling and damage
  • Muscle spasms, weakness and loss (atrophy)
  • Decreased ability to move the affected body part

 

Symptoms may change over time and vary from person to person. Most commonly, pain, swelling, redness, noticeable changes in temperature and hypersensitivity (particularly to cold and touch) occur first.

 

For those who may not know, CRPS used to be known as RSD, or Reflex Sympathetic Dystrophy.

 

 

A Real World Example of Complex Regional Pain Syndrome

 

I can also give you a real world example. A friend of mine, who is an insurance attorney, has had to live through this nightmare. But she was not the one diagnosed with it, it was her husband.

 

He stepped on a nail at a construction site. What happened next was 3 years of torture, and his work comp claim spiraled into a disaster. It took a normal, active, hardworking, fun loving husband and reduced him to a secluded and depressed shell of a man. They have now finally settled his work comp claim, but the condition lives on.

 

This did not happen because of adjuster error, or a lack of getting proper treatment. They tried everything. He saw countless doctors and specialists. He tried tons of different medication, most of them leaving him in a drug-induced haze that was so bad he stopped taking them.

 

 

Early Diagnosis of Complex Regional Pain Syndrome Yields Better Results

 

As insurance professionals, we have to be aware of the fact that even the most normal of claims can turn in to a real big claim real fast. In addition to that, we have to fight the fact that some doctors can use this diagnosis to describe pain that they cannot locate or control, be it objective or subjective in nature. This is where adjusters we can utilize their resources.

 

As the Mayo Clinic notes, early diagnosis and treatment of CRPS will yield better success in treating and controlling the symptoms. Most of the time when a claimant starts to have odd pain complaints, the adjuster will consider malingering or secondary gain rather than potential early CRPS symptoms.

 

Some of these symptoms include pain in the opposite limb, uncontrollable pain complaints, and other subjective pain complaints that on the surface seem crazy. If you have a person that had trauma in the left leg, and all of the sudden they have right leg pain complaints, 95% of adjusters will be quick to disregard it as CRPS. Instead they will label the claimant as a malingerer and one that is only interested in trying to extend the life of their work comp claim for whatever reason.

 

But what adjusters should do is set an IME right away, with a doctor that is certified to diagnose this condition. If you are lucky, and CRPS is there, you can catch and treat it right away. If it is not there, then you have at least ruled it out and can address your next step of case defense at that point.

 

 

Adjusters Job is Use Your Resources to Solve the Medical Mystery

 

Not all of your cases with wild pain complaints are going to be diagnosed and certified CRPS claims. In fact, it will probably be a small percentage of them. But the chance is there, and as adjusters you have to step outside of the box and take an outside look at chronic pain complaint cases and consider a potential CRPS diagnosis as the culprit.

 

If CRPS is there and you catch it early, then you have solved the mystery and can start treating it and moving the claim towards a hopeful resolution. If you just ignore it, then you have failed not only the claimant, but your employer as well because you did not do your job.

 

Your job as adjusters is to use your resources to solve the medical mystery and to put the pieces of the puzzle back together to correlate pain complaints back to a work injury. Use the doctors and resources you trust, because either way it is your job to investigate and handle claims accordingly, no matter how crazy the pain complaints may be.

 

 

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.

 

 

Identify Real Cost Drivers in Post Loss Workers Compensation

Best Practices Approach to Post-Loss Costs Containment.

A solid workers’ compensation cost control program requires an employer to first identify the key cost drivers; i.e., those company-specific factors causing workers to stay out of work too long.

Many companies that take a hit or misidentify the causes of their workers’ compensation costs. They start by looking at what their vendors are doing, rather than at their own internal company practices. Employers need to follow a systematic method to diagnose the key real-cost drivers within their company, based on a best practices approach to post-loss (not pre-loss) cost containment. Employers would be wise to write an assessment of their own internal company practices to address post-lost costs containment.

 

Items to Consider Before Writing Your Assessment:

  • What can managers learn from an assessment?
  • What methods could assess a company’s workers’ comp process?
  • What are the benefits of each?
  • What areas should be reviewed?
  • Who should do the assessment and what are the benefits of each?
  • What should a company do AFTER the assessment?

After an assessment, employers need to decide the next steps in reducing workers’ compensation costs.

 

 

Do Not Wait to Take Action

 

Some companies wait until they are in serious trouble before taking action. They think of workers’ compensation as a cost of doing business and do not realize there are things they can do to control costs. Do not to have a perfect system in place before beginning. Often the process of doing the assessment is the start of the process of change.

 

 

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, Director of Operations, 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 or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

 

How to Handle the Worst News in Company History

 

There are fire extinguishers in case a fire starts. We hope one never does, yet the fire extinguishers are kept in good working order and hung in many appropriate places. As well, we keep first aid items available in case of injuries, and we hope we never put them to use.  This is proper planning. At its base is the most elementary of risk management processes. It is on this premise that I write this article. [WCx]
 
 
Today I want to take a short walk with you into the possible outcomes of having employees work in most any environment. Take, for example the office, a very low risk workplace, but none the less there is that potential for serious injury or even a fatality.  I will leave this to you, the reader, to add to this any other potentially increased risk that may occur at a particular place of employment.
 
 
Have you thought about what would happen in the event you, the owner, or CEO, ever gets that dreaded call? The call no one ever wants to hear.  It is from your site or plant foreman and the person can barely get out the words. There is a  worker or workers severely injured or killed at the worksite or plant.
 
 
WHAT DO YOU DO RIGHT NOW? The next actions taken may well mean the very survival of a company decades in the making. As well, with current case law regulatory requirements and court precedents, there may as well be criminal charges at hand.  Am I being theatrical? NO, Unfortunately I deal with just these events several times a year and have seen things go from bad to worse just for the lack of proper action being taken in the beginning.
 
 
What you do, how you do it, and how you respond to those around you is critical at this point. What words you choose and the actions you take at this critical time can make all the difference.  It is difficult to use an example here. Literally thousands of variables exist due to business type and the individual details that would make any real or example based case just a story. [WCx]
 
 
The point is your firm is unique and the situation will be as well. I can offer no checklist other than the basics.
 
 
This is where planning and forethought to your exposures is critical. Every owner or CEO should have a plan that has been thought out before hand and reinforced down the lines of responsibility. Just like the annual fire extinguisher or emergency drill, there has to be a plan. A well conceived plan that is communicated and reinforced with all down line supervisors and management often.  If I were to give you a scenario of an event at a competitor’s firm and ask you what they would need to do (or not do) in the event of a serious situation, you could do a relatively decent job with the details.
 
 
However, this is YOUR firm, it involves YOUR employees. The injured or killed are possibly your close friends or even a family member in the case of many firms.
 
 
 As well as having frank talks with all front line management, you also must have a relationship with a labor law firm and consultant that you can call to action with a single phone call. You likely will be in shock at this time and prone to distracting emotions in a situation that is critical.  For this reason the first action in the plan should be to call the labor law firm with whom there is a prearranged relationship. The firm can handle, and you can refer, any questions requiring immediate answers to them.
 
 
Most likely media will be on site right behind the emergency responders. As part of the action plan the law firm will assist in creating an initial statement that can be drilled into the supervisors and employees. All must be instructed on what to say. A standard that works is: “We have encountered a tragedy, details are not yet available, and I will get with you as soon as I have any answers Nothing more.  Your labor law firm, due to your individual circumstances, may have something different in mind. If so, rely on them.
 
 
Non-management employees must also be given rules. All must understand that company policy is quite strict concerning the importance that they do not say anything to the media. This must be included in your initial new hire training, written in company policy, and reinforced regularly
 
 
I do hope this information will convince all senior management to initiate this kind of planning into your existing emergency procedures. The time to prepare is before you get that call no one wants to get. I do hope that your plan remains just that a plan. [WCx]
 
 
A few reminders:
 
  • Gather senior management and discuss what kinds of incidents your industry is vulnerable to.
     
  • Prepare a written policy for serious incidents.
     
  • Communicate and train all senior management.
     
  • Notify all non-management employees that they are not authorized to speak with media after an event.
     
  • Retain a labor law firm to assist and review procedures.
     
  • If there is an incident, immediately call on the law firm to direct you through any incident. Follow the instructions, remember emotions will be high. A trusted advisor is chosen. Listen to them at this time.
 
Also see our article on Immediate Injury Response for further information.  
 
 
Brian Hill is owner of OshaSure in Birmingham Alabama and has over 20 years as a workplace safety and risk consultant. Brian was previously a pilot for a major US airline and member of the company’s interdepartmental safety committee. He found his new career in safety after the closing of the airline in 1991. Brian has found the same passion he had for flying in assisting companies with safety, heath and risk issues.
For more information click on www.oshasure.com

 


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com
MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

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.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

Workers Compensation This Week In Review

LexisNexis Communities Highlights Hot Topics WC In Reviewpic3

The Workers Compensation Law Community Powered by Larsons on LexisNexis offers an interesting look at WC this week:

 

 

Ronald E. Weiss and Ronald Balter analyze in “New York Workers’ Comp Stakeholders Continue to Absorb 2007 Reform Changes,” found here, “During the past year, stakeholders in the workers’ compensation system in New York have continued to absorb legislative and administrative changes initiated by the 2007 reform. Maximum indemnity rates are now indexed to two-thirds of the State Average Weekly Wage.”

 

 

The Law Community also takes a look at the Workers Compensation Board policy on firearms here by examining what the policy is, how it affects law enforcement and what notification rules are.

 

 

They also take an insightful look into a Florida pizza delivery man who was fired after being robbed. See complete article here. Reporter Michael Miller notes the man is suing Domino’s, his former employer, “claiming (they) cruelly denied him workers’ compensation for his injuries from that night and then unlawfully fired him.”

 

 

In the Pittsburg Post-Gazette, writer Gina Passarell comments on how the Steelers football team does not have to pay attorney fees in a workers’ comp case. The incident (see full story here) is related to a former player’s WC case in which he suffered injuries while with the team. “The team argued he was not ‘disabled’ since he went on to play for other pro teams, the Commonwealth Court has ruled,” Passarell wrote. “Pennsylvania law automatically provides attorney fees to prevailing claimants when employers contest a claim for workers’ compensation benefits, unless that protest is ‘reasonable.’ “

 

 

Working Immigrants Blog Looks at Pew Study

Working Immigrants, a weblog about the business of immigrant work: employment, compensation, legal protections, education, mobility, and public policy writes this week that net migration from Mexico fell to zero.

 

 

“According to a report by the Pew Hispanic Center, ‘The largest wave of immigration in history from a single country to the United States has come to a standstill. After four decades that brought 12 million current immigrants—more than half of whom came illegally—the net migration flow from Mexico to the United States has stopped—and may have reversed, according to a new analysis by the Pew Hispanic Center of multiple government data sets from both countries.’ “The blog takes a deeper look into this study here.

 

 

TDI-DWC Approves 7 Companies to Self-Insure for Workers’ Compensation Claims

According to Stuart Colburn, shareholder in Downs Stanford, P.C. , the Texas Department of Insurance, Division Workers’ Compensation reports here The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) approved seven renewals of the Certificates of Authority for companies to self-insure their workers’ compensation claims for a one-year period under the TDI-DWC Self-Insurance Program. These companies collectively employ approximately 27,900 employees in Texas.

 

 

The report notes, “Under Texas law, certain large, private companies can self-insure for workers’ compensation claims, while retaining the protection of the Texas Workers’ Compensation Act for the company and for its employees. To qualify, a company must have a minimum workers’ compensation insurance unmodified manual premium of $500,000 and meet other requirements subject to annual review.”

 

 

Capital Community College Offers Live Classes in Risk Management

Capital Community College of Hartford, CT is now offering these live instruction classes in ARM:

 

ARM 54: Risk Assessment (PRFD 5359-2176)

Tuesdays/Thursdays from 5 PM – 9 PM

May 8 – June 14, 2012

$699 plus textbook

 

ARM 55: Risk Control (PRFD 5360-2177)

Tuesdays/Thursdays from 5 PM – 9 PM

June 19 – August 2 (excluding July 3 & July 5)

$699 plus textbook

 

ARM 56: Risk Financing (PRFD 5395-3602)

Tuesdays/Thursdays from 5 PM – 9 PM

September 25 – Nov. 1

$699 plus textbook

 

To register by phone, call (860) 906-5130. Contact Carol Vassar-Pettit with questions, cpettit@ccc.commnet.edu.

 

 

Advisen’s Casualty Insights Conference Coming May 1

Register here for keynote speakers, Allied World’s Lou Iglesias, Navigators’ Stan Galanski, and Arch’s Mark Lyons and an all-star Risk Manager panel.

 

 

The casualty conference at the McGraw Hill Conference Center is free for risk managers and insurance buyers; Advisen Clients are $395; general registration is $495. Further, eight CE credits are available for $125.

 

 

Other speakers include: Mitchell J. Auslander of Willkie Farr & Gallagher, Alfred Bergbauer of Marsh and Carmelite Bertaut of Stone Pigman Walther Wittmann LLC

 

 

Broadspire Promotes Erica Fichter to Senior Vice President of Medical Management

Broadspire, a TPA WC claims administrator and medical management service provider, has named Erica Fichter to senior vice president of medical management services.

[WCx]

Fichter will oversee a staff of more than 500 clinical professionals and support personnel located throughout the United States. Broadspire has the fifth largest medical management company in the country, with integrated services including: medical bill review, field and telephonic case management, utilization review, physician review, the BOLD® Network preferred provider offering and chronic pain management. “With this array of services, Broadspire’s cost containment results are typically 10 to 15 percent better than those produced by other TPAs and managed care companies,” they claim.

 

 

Note: If your company has any developments you’d like to share, please send them to us at: mbstack@gmail.com

 

 

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.

 
WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com
MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

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.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

 

Workers Comp News in Review April 1, 2012

 
LexisNexis Work Comp Community This Week In Review
 
The Workers Compensation Law Community Powered by Larsons on LexisNexis offers several great pieces this week:
 
 
First is this article by Roger Levy titled, “U.S. Supreme Court Issues Much Anticipated Decision in Roberts v. Sea-Land Services, Inc.” Levy explains the March U.S. Supreme Court decision answering the question of the meaning of LHWCA Sec. 6(c)'s "newly awarded compensation" clause in its decision in Roberts vs. Sea-Land Services, Inc. “Faced with two choices as to the meaning of the clause, the Court chose the one most favorable to employer/carriers and supported by the Director, Office of Workers Compensation Programs,” Levy writes.[WCx]
 
 
In “Work Loss Data Institute Warns of Fox Guarding the Hen House in State Treatment Guidelines,” by John Stahl, found here, Stahl explains that Phil LeFevre, a senior account executive at the Work Loss Data Institute, recently compared official disability guidelines (ODG) with other workers’ compensation treatment guidelines. “The overall theme was that the ODG provides more objective guidance than individual state systems that often reflect the self-interests of medical providers in that jurisdiction,” he writes.
 
 
Larson’s Spotlight this week narrows in on a recent case in which an injured worker is entitled to additional TTD benefits despite derogatory conduct. The Supreme Court of Arkansas decided in a case where a worker sustained a work-related injury, was placed on light duty for a period of time, and then fired for calling his supervisor an "insulting, derogatory, and vulgar name." Read more about this case and others in the spotlight here.
 
 
WCRI to Host Webinar April 10
The Workers Compensation Research Institute (WCRI) is hosting “Hospital outpatient Costs and the Impact of Fee Schedules” for those looking to control medical care costs for injured workers. The webinar will examine the WCRI study to help attendees make comparisons between “hospital outpatient costs across states, identify key cost drivers, and measure the impact of reforms over time.” The webinar will be from 1 to 2 p.m. EDT, Tuesday, April 10, 2012.
 
 
To learn more about the webinar or to register, go here.
 
 
Managed Care Advisors Asks if FECA Regulations Will Change
In the recent issue of The Advisor, MCA notes that two proposed pieces of legislation would alter the Federal Employees Compensation Act (FECA). “The less controversial of the two, the Federal Workers Compensation Modernization and Improvement Act (HR. 2465), was introduced in the House of Representatives in July of 2011 and is currently pending in the Senate Homeland Security and Governmental Affairs Committee. It includes measures to allow the Department of Labor to cross-match claimants' reported income to Social Security data. It also includes provisions to authorize physician assistants and nurse practitioners to certify traumatic injury and related disability,” the article says.
 
 
Read more here.
 
Study Shows Workers’ Compensation Medical Prices Were Higher without Fee Schedules
A Workers Compensation Research Institute (WCRI) study shows that WC med prices were higher and grew more rapidly in states without medical fee schedules.
 
 
The study, found here, shows prices paid for medical professional services for injured workers were higher and rising faster in states without fee schedules compared with states that have them in place. The information was “designed to help public policymakers and system stakeholders understand how prices paid for medical professional services for injured workers in their states compare with other states and know if prices in their state are rising rapidly or relatively slowly,” according to WCRI.[WCx]
 
 
Dr. Richard Victor, WCRI executive director, said, “In documenting the growing prices paid for the medical care received by injured workers, this unique study also shows the effectiveness of medical fee schedules in controlling those costs.”
 
 

Note: If your company has any developments you'd like to share, please send them to us at: RShafer@ReduceYourWorkersComp.com

 

 

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.

 


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com

VIEW SAMPLES PAGES

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

 

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.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

Workers Compensation Around the U.S. This Week

Work Comp Roundup Wants to Meet You at RIMS Booth 1425
The Philadelphia RIMS 2012 Annual Conference & Exhibition will provide a unique opportunity to gather information and resources to help minimize workers comp costs. This year there are sessions for many experience levels and the exhibit hall will have US! Yes! Held at the Pennsylvania Convention Center located on 1101 Arch Street will be Amaxx and WorkCompRoundup at booth 1425.
 
 
“If anyone wants to stop by to say hello or chat about workers compensation issues, I welcome them to do that,” says Becki Shafer, CEO. “For companies struggling with high WC costs, the exhibit hall is a great place to see all the different solutions that are available in the marketplace and attend seminars. One of the best things I did when I began my career in workers compensation was attend RIMS in Atlanta, it was the first conference on Workers Comp I attended, and I was pleasantly shocked at everything that was available — it was like walking through a supermarket of ideas.”

[WCx]

 
 
Learn more about the convention here.
 
 
Keystone Case Management Could Give you a PINCH this Spring
Keystone Case Management is a young company in the Workers’ Compensation World, says owner and president, Kelly Haile, RN, CCM, WCCM. This team of nurses has developed PINCH, a solution that uses employer education and aggressive case management to help employers and injured workers
 
 
PINCH has resulted in a decrease in claim report numbers, out-of-work time and fewer litigated claims, Haile says. “The program has also shown increased satisfaction by injured employees, and employers are delighted at the clear, consistent and timely information that is provided,” she writes.
 
The company recently announced it is a finalist in Dorland Health’s Case In Point Platinum Awards for Workers’ Compensation Case Management and will be hosting a half-day educational workshop for employers April 4th, 2012 in Drexel Hill, PA. For more information contact info@KeystoneCaseManagement.com or (610) 469-NURSE.
 
 
LexisNexis Communities Offers This Week Work Comp In Review
The Workers Compensation Law Community Powered by Larsons on LexisNexis offers several great pieces this week:
 
 
  1. Larson’s Spotlight, found here, focuses on the following recent cases, compiled by Thomas A. Robinson, staff writer for Larson's Workers' Compensation Law:
 
TN: Truck Driver Deviated From Employment by Leaving Truck to Search for Object With Which to Assault Driving Partner
TN: Court Affirms Denial of Benefits Related to Unexplained Fall to Level Floor
OH: Physician's Opinion Was Not Equivocal Where Physician Modified Opinion in Light of Videotape Evidence of Injured Worker's Capabilities
FL: Judge May Not Sanction Homeless Claimant for Failure to Pay Prevailing Party Costs-Failure to Pay Was Not Willful
 
 
  1. Robin E. Kobayashi writes The Sticky Wicket That Is Home Health Care: Why It’s a Hotly Contested Issue in the Workers’ Compensation Arena
 
The article, found here, asks, “An injured employee’s entitlement to home health care is oftentimes a hotly contested issue in the workers’ compensation arena. Home health care issues can vary in nature. For instance, at what point does the marital obligation cease and the paid nursing services begin?”
 
 
The author looks into these types of issues in Nebraska, Iowa, Arkansas, and California.
 
 
  1. Lastly, the LN Community recommends these WC fraud blogs this week:
 
Workers' Comp Fraud Blotter: Mechanic Covered With Grease Claimed He Was Unemployed and Unable to Work,by LexisNexis Workers' Compensation Law Community Staff. Here.
 
“The Case of the Purple Robe … and a Little Motion Day Magic” in Delaware, by Cassandra Roberts, Esq. Here.
 
Missouri: Employer Penalized for Lapses in Prescription Payments, by Martin Klug, Esq. Found here.
 
 
Broadspire Combats Physician-Dispensed Drugs
In a recent release, Broadspire draws from the Workers Compensation Prescription Drug Study: 2011 Update by Barry Lipton, Chris Laws and Linda Li, National Council on Compensation Insurance, August 2011.
 
 
They write, “The price of physician dispensed drugs increased by 300 percent  between 2005 and 2009. In contrast, the average price of medications dispensed by pharmacies grew by only 23 percent during that same timeframe.”
 
 
The company goes on to say the percentage of workers compensation medical costs going toward physician dispensed prescriptions increased to 28 percent in 2009, up from 23 percent in 2008. “Physician dispensed medications have become prevalent in almost every state,” Broadspire concludes.
 
 
To combat this medical cost driver, Broadspire has created the following jurisdictionally specific strategies:
 
1. Through data mining, Broadspire identifies physicians who are dispensing prescriptions from their offices.
2. Targeted communications are sent to these physicians promoting the clinical safety and efficacy offered by Broadspire’s network of retail pharmacies.
3. Safety checks, through network pharmacies, help physicians ensure medications they prescribe are not duplicated by other physicians and that no adverse drug interactions are present.
4. Case managers visit and communicate with physicians to share the Broadspire message and support the use of network pharmacies.
5. Where jurisdictionally possible, Broadspire re-prices provider-dispensed medications to our network pharmacies contracted rate.
 
 
 
 
Texas Department of Insurance – DWC Seeks Public Comment on Amendment Proposals on MDR
The Texas Department of Insurance Division of Workers’ Compensation is accepting public comments on proposals to amend 28 TAC §§133.307, 133.308, 144.1–144.7 and 144.9–144.16 Regarding MDR of Fee Disputes, MDR by Independent Review Organizations, and Arbitration.
 
 
According to a release, the amendments relate to medical dispute resolution (MDR) activities conducted by the TDI-DWC. “The purpose of these amendments is to conform the rules to various statutory amendments that concern medical fee dispute resolution and the resolution of disputes of independent review organization (IRO) decisions by the TDI-DWC. Specifically, these proposed amendments are necessary to clarify existing rules and implement and enforce statutory provisions of House Bill (HB) 2605 and Senate Bill 809, enacted by the 82nd Legislature, Regular Session, that impact the appeal of medical fee dispute resolution cases and decisions issued by IROs,” it says. [WCx]
 
 
The proposals will publish in the March 23, 2012, issue of the Texas Register and may be viewed on the Secretary of State website at http://www.sos.state.tx.us/texreg/index.shtml once published. A courtesy copy of the proposals is currently available on the TDI website at http://www.tdi.texas.gov/wc/rules/proposedrules/index.html.
 
Note: If your company has any developments you'd like to share, please send them up us at: RShafer@ReduceYourWorkersComp.com

 

 

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.

 


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com

VIEW SAMPLES PAGES
MODIFIED DUTY CALCULATOR:  
www.LowerWC.com/transitional-duty-cost-calculator.php

 

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.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

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