Usually workers compensation insurance centers around who is required to buy workers comp insurance and why. And — what happens to employers who fail to do so — they end up in jail, in law suits and pay huge fines. However, there are culturally religious groups who may be exempt from purchasing workers compensation insurance.
One of these groups is the Amish community. Largely an agrarian society, modern times force many Amish off their farms into the “real” world of industry and manufacturing. In Michigan, for example, many own woodworking companies providing services to others in the community at large (not only Amish).
As a community the Amish fought for and received an exemption from paying social security payroll taxes (for themselves and Amish employees) considering it to be an
insurance plan for caring for the elderly, sick and infirmed. Their religious beliefs forbid them to participate in government welfare programs or the paying of insurance for benefits received. Instead they see caring for the older members of the community and other Amish in need, as a religious duty and, in fact, implement numerous methods to provide for needy members. (WCxKit)
The same thinking holds true for buying insurance for workers compensation. Even when an Amish business carries workers comp insurance, it is usually never used as doing so would compromise religious belief.
Many states such as New York, Ohio, Kentucky and Pennsylvania provide a “religious exemption” to the Amish from purchasing workers compensation insurance.
So, what happens if a workplace injury occurs? The Amish pay into a church operated aid fund or, amazing thought – injured workers pay their own medical bills.
According to a recent article in the Philadelphia Inquirer this workers comp exemption is causing a huge uproar in the construction and contracting business since the economy tanked. Non-Amish employers are claiming an “unfair” business advantage, citing the Amish’s ability to provide much lower bids. They say hiring the Amish is comparable to a company outsourcing work to another country.
On the other hand, Amish contractors say they provide a superior product in a very timely manner and experience high customer satisfaction with their work which of course is probably beside the point. In addition, it’s well known the Amish do not pay for all the “perks” of modern life.
Could it be said the main point is: Employers are required to purchase government provided Workers Compensation Insurance to insure injured workers receive care when a workplace injury occurs? Since the Amish community does pay into a fund to take care of their injured workers does not paying the government-mandated WC insurance really give them an advantage? (WCxKit)
Every business has its own unique costs of doing business. Employers must constantly review their workers comp usage, workplace safety, injury rates and return to work policies in addition to other factors designed to reduce their overall cost of doing business of which workers comp can be a huge cost if not properly managed. See:
http://www.LowerWC.com for essential cost cutting tools.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker and Website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. www.LowerWC.com
Contact: RShafer@ReduceYourWorkersComp.com or 860-553-6604.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
Implementation of the Foreign Workers Health Insurance Protection Scheme (Spikpa), to be enforced next month, is far better than the current scheme because of its comprehensive coverage for foreign workers, say officials in Malaysia.
NOTE: Use of the word "scheme" does NOT have a negative connotation when used in remarks about workers compensation in other countries; non-U.S. countries commonly refer to their workers comp systems as "schemes."
According to the Malaysian National News Agency Bernama.com, Health Minister Datuk Seri Liow Tiong Lai said the current Foreign Workers Compensation Scheme (SPPA) emphasized compensation due to illness, injury or death due to accident while at work only. (WCxKit)
"Through Spikpa, foreign workers are eligible for medical protection of up to RM10,000 and are protected against all illnesses, except a few normal illnesses which are normally not covered by any health insurance policy, compared with SPPA which only provides medical protection of RM750 only," he said in a statement.
He said Spikpa would not only overcome errors in unpaid bills at government hospitals, but it also avoids having foreign workers or their employers paying high hospital bills.
"
The government only made it compulsory for employers of estate workers and domestic maids to pay this health insurance premium," he added.
Liow hoped that implementation of Skikpa would realize the government's aspiration to enhance the standard of health of foreign workers in the country.
Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: Info@ReduceYourWorkersComp.com or 860-553-6604.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
Workers Compensation Laws change frequently. This is only a summary; a complete copy of the most up-to-date version can be found at: www.WorkCompResearch.com an excellent service.
In Florida, every employer who has four or more employees, whether full time or part time is required to carry workers compensation insurance. [Corporate officers who have elected to exempt themselves from work comp coverage do not count as an employee]. There are a couple of exceptions to this rule. If you are in the construction industry and have one or more employees, you are required to have work comp coverage. Florida farmers who have more than five regular employees, or twelve or more seasonal workers who are employed for 30 days or more, are required to have work comp coverage.
Obtaining Coverage:
To obtain workers compensation coverage in Florida, the employer has several options including:
1. purchasing a workers compensation insurance policy from a state approved insurance company
2. qualifying as an approved self-insured employer
3. contracting with a professional employer organization [employee leasing] that has a group workers compensation policy
4. purchasing a workers compensation insurance policy from the Joint Underwriting Association, a Florida state agency that sales workers compensation insurance coverage to employers who are unable to obtain coverage in the open market (WCxKit)
Claim Reporting:
The employee must report the injury to the employer within 30 days of the occurrence. If the injury is not reported timely, the insurance carrier has the option to deny the claim. The employer is under a strict time limit of 7 days to report the claim to the insurance carrier. The insurance company then has 3 days to send to the employee an informational brochure which outlines the employees rights and responsibilities under the workers compensation statutes.
Medical Benefits:
The employer selects and authorizes the initial medical provider. All subsequent medical treatment must be at a medical provider approved and authorized by the workers compensation insurance carrier. All authorized medical care and associated expenses (prescriptions, prostheses, mileage reimbursements) are covered by workers compensation.
Temporary Total Disability Benefits:
The temporary total disability (TTD) benefits are calculated as two-thirds of the employees average weekly wage over the 13 weeks prior to the injury, not counting the week the injury occurred. The maximum amount of TTD benefits that can be paid weekly changes every January 1st. The maximum TTD benefits per week for accidents occurring on or after January 1, 2010 is $772.00 per week. The state minimum weekly benefit is $20, which has not changed since 1972.
The first 7 days of disability (the waiting period) is not paid to the injured employee unless the employee is disabled for more than 21 days. TTD benefits can be paid for a maximum of 104 weeks. There is no provision in the Florida law that requires the employer to hold open a job for an employee who is unable to work due to the employee being unable to work. (Holding the position for the employee is the smart thing for the employer to do in most cases).
Temporary Partial Disability Benefits:
Florida work comp also provided for temporary partial disability (TPD). An employee will receive TPD if the medical provider releases the employee to work with restrictions on the number of hours the employee can work. If the employee is unable to earn 80% of his wages prior to the injury, the insurance carrier will pay TPD benefits on the hours the employee is unable to work per week.
Impairment Benefits:
When an employee reaches maximum medical improvement, the medical provider will determine whether or not the employee has any permanent partial disability. If the employee receives a disability rating, the employee is entitled to Impairment Benefits (IB). The amount of IB is one-fourth of the TTD rate plus 1 cent. For example if the weekly TTD rate is $600.00, the IB rate would be $150.01. The number of weeks of IB is determined by a disability scale. A 10% rating on the scale is worth 20 weeks of IB; a 25% rating is worth 85 weeks of IB, while a 50% rating is worth 235 weeks of IB.
Permanent Total Disability Benefits:
Florida has a unique way of determining if an employee who has reached maximum medical improvement has a permanent total disability (PTD). If the employee can be placed in a sedentary job within 50 miles of his residence, the employee is not PTD, unless he has a severe injury as defined by the Florida work comp statutes. Some of the severe injuries include spinal cord injuries that involve paralysis of an arm, leg or the trunk; amputation of a hand, arm, foot or leg; severe brain injury; and, second or third degree burns over 25% of more of the body. If the employee is classified by the Division of Workers Compensation as PTD, the employee will receive PTD benefits which are the same as TTD benefits until the age of 75. If an employee is drawing social security benefits, the PTD benefits are reduced to the point where the social security benefit plus the PTD benefit equals 80% of the average weekly wage earned prior to the injury.
Death Benefits:
If an employee dies as a result of an on-the-job accident within one year of the date of the accident, or if the employee dies as a result of an on-the-job accident within five years with continuous disability, funeral expenses up to $7,500 is covered by workers compensation. The spouse is entitled to 50% of the average weekly wage, not to exceed $772.00 (for calendar year 2010). The spouse plus one child is entitled to two-thirds of the average weekly wage, not to exceed $772 (year 2010). If the employee leaves behind one child as the only beneficiary of death benefits, the child receives one-third of the average weekly wage, not to exceed $772 (year 2010). There is no time limit on how long benefits can be paid, but the maximum amount of death benefits is $150,000 (not including funeral expenses). If the spouse remarries, the spouse receives a lump sum payment of 26 weeks (as long as the $150,000 cap is not exceeded. The spouse is also eligible for tuition benefits at a vocational technical center or community college. (WCxKit)
Vocational Benefits:
If due to the employees on-the-job injury the employee is unable to return to work because of permanent work restrictions, the employee is entitled to assistance from the Workers Compensation Vocational Rehabilitation Section of the Florida Department of Education. At no cost to the employee, the employee can receive vocational counseling, transferable skill analysis, training on job-seeking skills, job placement, on-the-job training and formal retraining.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing.
Contact: RShafer@ReduceYourWorkersComp.com or 860-553-6604.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
Each year you receive your bill for the next workers compensation policy year, and for many of companies, each year the bill is higher than the previous year. As you think about your work comp claims, you realize the claims for the current year were not any worse than they were for last year, or the year before. So why does your workers' compensation premium bill keep going up and up?
When the underwriter at the insurer looks at calculating your premium, they use what is known as an experience modification factor. This factor is a calculation used to raise or lower your premium based on the loss experience your company has had. If the loss experience has improved, the premium charged to your company goes down. If you have had more claims than before or the claim cost has gone up, your premiums go up.
The loss experience is based on two factors, frequency and severity. Now the insurance company does not control frequency of claims, your company controls frequency through how well you manage the safety program. As you think back to the previous years, you think “wait a minute, our safety program is working, the number of claims has declined, so why has my premium gone up?” The answer is the other part of the experience modification factor – the severity of the claims.
There is one thing your insurance broker and your workers compensation insurer will never tell you about the cost of your workers compensation premium. If they do a poor job in handling the claims, and spend more money on the claims than necessary due to a failure to properly investigate the claims or to return the employees to work, you get to pay for their incompetence. The underwriting department does not discount the severity factor because the claims office did a poor job.
If your next thought is: “I'm no expert on how to handle work comp claims, so how would I know if the claims office is doing a good job or overpaying the claims? There are ways you as the employer can gauge the effectiveness of the claims office.
The first thing the employer can do to reduce the severity of the claims is to report them to the claims office immediately. There have been numerous studies that show the longer the delay between the time of the accident and the adjuster contacting the employee, the higher the overall cost of the claim. By reporting the claim to the claims office immediately, you have reduced the amount of time between the accident and the adjuster contacting the employee.
Normally when the adjuster contacts the employee, the adjuster also contacts the employee's supervisor or manager to verify the facts of the accident. If you have a claims coordinator, have the claims coordinator keep track as to when your company hears back from the work comp adjuster. If you do not have a claims coordinator, have the person who reported the claim to the claims office keep track of when you initially hear back from the adjuster. Same day contact from the claims adjuster is best, next day contact is acceptable.
If your thought is: “We never hear from the adjuster after we report the accident,” that is a major sign that the adjuster is not investigating the claims. If the adjuster is not properly investigating the claims, you as the employer pay for it in your experience modification factor when claims that should be denied are paid, or claims that are fraudulent are paid.
There is a sure-fire way the employer can know if the adjuster was in contact with the employee the day the claim was reported to the claims office (or at least the next day). Pick up the telephone and call the employee. Ask the employee how the initial doctors office visit went and what the doctor thinks the employee's prognosis will be. Then an “oh, by the way, have you heard from the insurance adjuster yet?”will quickly tell you if the adjuster has made timely contact with the employee. Do this on ten claims in a row and you will soon know if the adjuster is giving your claims the proper initial claims handling. [Bonus – by contacting the employee you show the employee that the employer does care about their well being, which builds rapport with the employee, and diminishes the chances of the employee hiring an attorney].
If you want to do this on a large scale, the best program I have seen for worker feedback has been developed by Jennifer Christian, M.D., Webility's Distress & Dissatisfaction Detection System (3D's). Contact Doctor Christian at Jennifer.Christian@webility.md and mention you read about it on our blog. This programs helps employers find out early on whether the employee is having a problem and if so they can help fix the problem. Sometimes the problems are with the insurance company handling of the claim. These are easy to fix IF you know about them.
Another definite tip-off that the adjuster is or is not handling the claims properly is when the adjuster calls your office trying to arrange modified duty so the employee can return to work. If in the initial contact from the adjuster you are asked what light duty assignment you can provide the employee, you have an adjuster who is thinking about how to get the employee back to work, which lowers the amount of indemnity payments and the overall cost (severity) of the claim. A good adjuster will continue to explore light duty return to work until the employee is back at work. A poor adjuster will never ask about light duty return to work and will just pay the employee indemnity benefits until the doctor states the employee is fully recovered. When you bargain for lower-priced TPA or insurance claims adjusting services, consider that you want the adjusters to have the resources to DO this work, and offering the lowest possible price may preclude that – no matter what they say at the official presentation.
An easy way to get your work comp adjuster(s) on the ball in their claim handling is to ask for a copy of their service standards (Best Practices) for workers compensation. Advise the adjuster(s) that you will be reviewing your files to see if they are complying with the Best Practices. If by chance you are told they do not have a set of service standards, it is time for you to talk to your broker about finding another insurance company who is concerned about doing a quality claims handling job.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing.
Contact: RShafer@ReduceYourWorkersComp.com or 860-553-6604.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
Nothing is free. There is no free lunch. Someone is paying for it; it just might not be you. There are employees (and people in general) who have an entitlement mentality that has been fostered by politicians and society in general. These people feel they are “owed” something, even if they have not done anything to earn it. This is what my doctor says she sees in her medical practice when I reveal I work "in the workers compensation field." She goes on to explain that daily people sit across the desk and ask to be put on total
disability. She was quite upset by this since she has been working hard for the last 25 years. She welcomes the opportunity to vent about her own experiences. She says, "We're a somethin' for nothin' society."
Unfortunately, way too many employees have no idea of the cost of workers compensation. Employees often think workers compensation insurance is free, as they do not pay anything for the insurance coverage. While they may vaguely know the employer is paying for the coverage, they do not know the true cost of work comp. (WCxKit)
Many an unsophisticated employee will think the employers cost is the hourly rate they receive. The wise employer will educate the employees on their true cost. The employee should know that in addition to their hourly rate, the employer is paying 35% to 40% over the hourly rate to cover the cost of workers compensation, social security, unemployment insurance, medical insurance, dental insurance, life insurance and disability insurance. This is all before the cost of vacations, holidays and sick pay is added to the equation. In addition to all these employer cost, the employer is contributing to a 401k, 403b, or other retirement plans. Plus, there are a few employers who still have defined benefit pension plans where they are funding the employee's retirement.
When an employee, who has the entitlement mentality, is injured on the job, their claim often becomes a much more expensive claim than it should be. As employees pay nothing for workers compensation (one of the very few things in work comp that is the same across all the states), those employees that have the entitlement mentality of something for nothing will often look for the opportunity to abuse the work comp claim system. My doctor says that she "has one employee in particular" who is looking for another job, and she can't wait for her to leave because she is unproductive, but the doctor is afraid to fire her or she'll get sued. What does this say about our society …
While some of the employees with the something for nothing attitude will fake an injury, many of the injury claims start out as legitimate claims. When the employee gets comfortable living on the indemnity benefits paid by the work comp insurer, they decide they do not want to go back to work. They see the TV lawyer advertising the fist full of money they can get for their work comp claim. Or, they hear about a friend of a friend who is living a life of ease and will never have to work again due to their work comp injury. While they may not think of it as fraud, they will do anything they can to delay their
return to work. This can include everything from exaggerating their pain to the doctor to exaggerating the physical demands of their job when they discuss returning to work with their doctor. My doctor says she never gives total disability slips, but she needs information on these employees original job so she knows they can, in fact, safety return to work.
The 'something for nothing' employees paid time off work can often be curtailed or even eliminated by an aggressive return to work program offering modified duty. By getting this worker back on the job before he can settle into the life-without-working routine, the employer can save a lot of workers' compensation cost.
While the employer can often identify the employees who have the something for nothing mentality, there are the employees who never thought of abusing the system until they are off work due to an on-the-job injury. They don't start out faking disability, but do so when neither the employer nor the claims adjuster stays in contact with them. As long as it easy to stay off work, they do. When they start feeling the pressure to return to work by the employer inquiring when they will be back, they end their something for nothing extended time off work.
An experienced work comp adjuster or a knowledgeable claims coordinator with the employer will immediately recognize the “red flag” of the injured employee who states “I don't want something for nothing”. Usually when an employee states this to the work comp adjuster or the employer, it is because they have already been thinking about getting something for nothing. Employers (and work comp claim adjusters, too) need to be exceptionally diligent with the injury claims from employees with the entitlement mentality. (WCxKit)
One of the best ways to combat the entitlement mentality of the something for nothing employee is to educate all employees on the cost of workers' compensation. Employees need to know that the employer takes work comp fraud very seriously and will prosecute any employee who commits fraud. All employees should know that the cost of workers compensation insurance has to be paid for by the employer, and the higher the claim cost, the more the employer pays. When all employees understand that anyone who fakes a claim or stays off work longer than necessary is stealing a part of the pay raises and/or bonuses of their co-workers, the something for nothing mentality can be curtailed.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: RShafer@ReduceYourWorkersComp.com .
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
The cost of drugs is the fastest growing component of medical care cost and often one of the most neglected areas of workers compensation cost control. It is estimated that workers compensation pays $5 billion in drug cost each year. While there are numerous pharmacy benefit managers (PBM) in the work comp arena, they are often either totally ignored or only partially utilized by the insurers, self-insureds and third party administrators (TPA). Other areas of medical cost control like fee bill schedules, medical provider networks, medical management and utilization review get more attention than PBM, but proper utilization of PBM can result in substantial savings in the cost of work comp.
What PBM Can Do?
Unfortunately, many claim adjusters think of PBM only as a way of saving money by getting a discount on the cost of prescriptions. With some PBM that
is all they do. However, if the insurer (or the self-insured employer who is paying attention to the factors in the cost of their work comp coverage) shops around among the PBM providers, they should be able to locate a PBM that has a national presence and a focus on proactive utilization control. Key service points and cost control solutions to consider for a PBM include:
1. The flexibility to coordinate the medical prescription benefit in the most efficient manner between the employee, the pharmacy and the medical provider with minimal involvement of the adjuster
2. The ability to comply with all the workers' compensation rules and regulations of each state, which can vary tremendously from state to state, and to stay current/up to date
3. The technology to process the prescription in real time – without delay when presented by the employee to the pharmacy – with the appropriate pricing (WCxKit)
4. A national network covering most of the 70,000+ pharmacies in the United States. This will provide convenience and hassle-free access for the employees regardless where they live (also to prevent non-compliance with the required use of the PBM). The PBM network should definitely include the three major chains – Walgreens, CVS Pharmacies and Rite-Aid
5. A comprehensive standard formulary that can be customized and injury-specific and/or patient-specific to manage utilization (even customized down to the ICD-9 codes)
6. A pre-negotiated price (network discount) for each drug (a 25% discount off a price that is 50% higher than it should be is not a cost savings)
7. The ability to provide home delivery by the Postal Service, Fed Ex or UPS at minimal extra cost
8. The willingness to provide 24 hours a day, 7 days a week customer support service
9. The ability to identify generic substitution opportunities
10.The identification of newer drugs that provide greater benefit
11.The ability to process – approve or deny – the off-label use of a drug
12.Utilization review — before the prescription is filled - to prevent of overuse of narcotics – consumption faster than manufacturer recommendations or faster than the medical provider's prescription amount
13.The prevention of multi-physician (“doctor shopping”) prescriptions from being processed for the same drugs or duplicate use drugs
14.The prevention of multi-pharmacy involvement in filling the same prescription (for example – the employee takes the paper prescription to one pharmacy to be filled, then called the medical provider, claims to have lost the prescription and has the prescription called into another pharmacy)
15.The technology to recognize when inappropriate or non-compensable medication is being dispensed (for example – a non-injury related medication is being presented to the pharmacy) and the ability to stop it from being filled
16.The ability to be electronically integrated with the insurers', TPAs or self-insured's bill review system to eliminate the manual processing of individual prescription payments
17.The ability to provide ancillary services like durable medical equipment (nice to have, but not absolutely essential)
18.The ability to provide reports on cost savings, utilization and trending
19.The ability to provide correct pricing for any drugs dispensed from the doctor's office which often are over billed
20. Accreditation by the Utilization Review Accreditation Committee reflects the PBM promotes quality and efficiency of health care delivery
A Growing Problem:
The use of PBM does result in a reduction in the abuse of pain medications. However, some employees who become pain medication junkies have found a way to circumvent the PBM. A growing problem is the medical providers who will perform office injections for the employee. The medical provider gets paid for multiple office visits and the pain medication junkie keeps on abusing the pain medication. (WCxKit)
Summary:
The appropriate management of medications by the PBM can lower the overall cost of medical care and shorten the return to work time. The employee benefits from the PBM by receiving the necessary medications locally (or home delivery) while the employer benefits from the employee receiving the appropriate medications in a timely manner. The insurer or self-insured benefit from the medical savings the PBM provides.
Author Rebecca Shafer, President, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Info@ReduceYourWorkersComp.com .
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
By focusing on partnerships and long-term perspective, WCB-Alberta successfully navigated its way through 2009’s challenging and uncertain economic climate.
According to WCB-Alberta, after years of growth, Alberta workers and employers were faced with declining employment and an unpredictable economy. Despite these challenges, WCB-Alberta maintained stable worker benefits and employer premiums.
In presenting WCB-Alberta’s 2009 results to stakeholders at its recent general meeting, Guy Kerr, WCB president and CEO, reiterated the organization’s commitment to balancing the needs of Alberta workers and employers. (WCxKitz)
“We have a responsibility to compensate and rehabilitate covered workers who are injured on the job,” Kerr told stakeholders. “In 2009, WCB and our partners faced immense challenges, but we were prepared with solutions and strategies to maintain stability for both worker benefits and employer premiums while keeping our focus on fairness.”
Alberta’s system shrunk in 2009 with a drop to 1.73 million covered workers (from 1.83) and to 137,000 registered employers (from 140,000). Despite these changes and economic challenges, 93.1% of injured workers successfully returned to work — the highest rate ever.
WCB-Alberta’s 2009 Annual Report provides detailed results. Here are some highlights:
1. The time-lost claim rate decreased to 1.6 per 100 workers.
2. The disabling-injury rate decreased to 2.8 per 100 workers.
3. The system remained financially stable and funded at 128.4%.
Good performance really does matter. Strong operational results combined with solid partnerships allowed WCB-Alberta to withstand external risk. (WCxKitz)
“As a Board, we are satisfied that WCB-Alberta and its partners are moving in the right direction to benefit stakeholders in the long-term,” David Carpenter, chair of the Board of Directors, told stakeholders. “The year 2009 demonstrated that when you plan ahead and make decisions with foresight, you can land on your feet despite what the world throws your way.”
“Looking forward, we are cautiously optimistic of a slow recovery in the Alberta economy,” Kerr added. “We will focus on finding practical yet innovative solutions to working with our partners to return injured workers to work.”
Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: Info@ReduceYourWorkersComp.com or 860-553-6604.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
The Board of Directors of the Yukon Workers Comp Health and Safety Board (Canada) announced that the average assessment rate for 2011 will be significantly lower than the 2010 rate.(WCxKit)
The rate will drop from this year’s level of $2.95 to $2.49 in 2011, a decrease of 15.6% or 46-cents less, per $100 of assessable payroll.
This also means a projected drop in assessment revenues collected in 2011 of just over $4 million.
To be clear, this does not mean an across-the-board decrease in assessment premiums for all employers. Industries that continue to show decreases in the number and severity of injuries are likely to see rate decreases in 2011.
However, those industries who continue to show a lack of due diligence in improving safety and Return-To-Work outcomes in their workplaces are unlikely to see any decreases in their rates.
Specific rates for each of the 69 industries will be announced in the fall.
A major contributing factor to the lower rate is the recent trend in lower claims costs including a 43% reduction in 2009. This puts the time-loss rate per 100 workers covered in 2009 at 2.3. This compares with 2.8 in 2008 and 3 in 2007. The interim goal is a lost-time rate of 1.(WCxKit)
With assistance from its stakeholder partners, this was achieved by a concentrated focus on Return-To-Work – getting injured workers back on the job as safely and quickly as possible, which is good for the employer and aids in the worker’s full recovery. It also shortens the duration or length of time injured workers are receiving time-loss benefits.
YWCHSB has the best results of any jurisdiction in Canada in this category.
The percentage of time-loss claims for which the last payment was made within 90 days from the claim starting was more than 88% in 2009.
Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: Info@ReduceYourWorkersComp.com or 860-553-6604.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
The question has been asked: Are there any situations where the employee might elect not to pursue a workers compensation claim or might not have a workers comp claim for a work related injury? The answer is yes. While it is not common for the employee to choose not to have a workers compensation claim, or does not have a workers comp claim by statute, it does happen.
1-Excluded People (no coverage)
When an employer does not meet the state's requirements for workers comp insurance, the employee might not have a workers comp claim. For instance, in the states requiring employers with three or more employees to carry workers comp insurance, and the employer only has two employees, the injured employee would not be able to pursue a workers comp claim.
When the injured employee is the sole proprietor or a partner in the business, s/he will not be covered for a workers comp injury unless s/he buys a workers comp insurance policy on him/herself (which most sole proprietors do not do). (WCxKit)
Another instance where an employee might not be able to pursue a claim is in the states excluding farm laborers, seasonal workers, domestic servants, real estate agents and direct sellers from coverage under the workers comp statutes. When one of these type employees is injured on the job, they still have the right to bring a lawsuit against the employer if they believe the actions of the employer caused their injuries.
2-Pursuing a Tort Claim (want deeper pocket)
In the states where the workers comp insurer has full right to subrogation recovery, the employee will occasionally chose not to pursue the injury claim against the employer. An example of this would be the injury to the traveling salesperson resulting from an automobile accident. The third party was at fault and the accident occurred in a state where the employer controls the selection of the medical provider and the employer/insurer has full subrogation rights.
An attorney representing the injured employee will often tell the employee they can get a much bigger settlement through the tort system than they can through workers comp. Instead of the employee being treated by the medical provider selected by the employer or the employer's insurance company, the employee is treated by a medical provider selected by the employee's attorney.
The attorney, of course, is recommending the liberal medical provider who will keep the employee coming back for additional treatment for as long as the employee is willing to go to the doctor. The reasoning for this is simple, the longer the employee is off work and the higher the medical bills are, the greater the settlement the employee's attorney can demand from the insurer of the vehicle at fault in the auto accident.
Another example of where an injured employee might want to opt out of filing a workers compensation claim is an injury on a construction site. On a large construction project you often find various subcontractors all working at the same time. This will often result in an employee getting injured due to the negligence of a third party. The employee again will have the choice between pursuing the claim for personal injury against the responsible party or filing a workers compensation injury claim. (Of course, in the states where the right of subrogation has been diminished or taken away from the workers comp insurers, the employee's attorney will often pursue both types of claims simultaneously).
A third example of where an employee might choose to pursue a tort claim rather than a workers comp claim is the delivery person who trips and falls on the defective sidewalk belonging to the business where s/he is making a delivery. While a delivery person has the right to pursue a workers comp claim against the employer, the owner of the property where s/he fell has liability insurance, and the award s/he can collect on the tort claim will surpass what can be collected on a workers comp claim. (WCxKit)
Summary
While it is unusual for the employee to opt out of coverage for a workers comp claim, or for coverage not to apply to the work related injury, it does happen. The wise employer will know when this situation is occurring and keep in close contact with the employee in case the circumstances change.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing.
Contact: RShafer@ReduceYourWorkersComp.com or 860-553-6604.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
Montana is now No.1, but in a category that many people are not hurrying to get into. Woah, Florida, New York, California and all the notoriously "bad" work comp states will be jealous!
The state now has the highest workers compensation premiums in the country, according to a national study released from the Oregon Department of Consumer & Business services.
In light of that report, the Montana Chamber of Commerce issued the following comments
“Montana is a great place to run a business, but being No 1 in workers compensation costs is a big black eye for the state,” Webb Brown, president/CEO of the chamber, said (WCxKit)
In the last decade, the Oregon study has shown Montana moving up in the rankings.
In 2000, Montana had the 12th highest premiums, 10th highest in 2002, eighth highest in 2004, fifth highest in 2006, and the second highest in 2008.
This year, Montana surpassed Alaska to take the top spot. The report shows Montana’s neighbors have some of the cheapest work comp premiums in the country: Idaho – 29th; South Dakota – 28th; Wyoming – 37th; North Dakota – 51st.
"Big problems require big solutions. We know the Legislature will primarily be concerned with balancing the state budget, but workers compensation reform must also be dealt with this session," added Brown. (WCxKit)
The state Legislature plans on tackling workers comp in the upcoming session with a plan that some hope will reduce costs by $150 million.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: RShafer@ReduceYourWorkersComp.com
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
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