The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) has cited Prolerized New England Co. LLC, doing business as Schnitzer Northeast, for 10 alleged serious violations of workplace safety standards at its Everett recycling facility, where two workers were injured. Proposed penalties total $70,000.
According to OSHA officials, the employees were performing maintenance work inside a large rotating drum used to sort scrap material for recycling when the drum activated, injuring them. OSHA's Andover Area Office conducted an inspection in response to the September incident and identified several serious deficiencies in the facility's hazardous energy control procedures, which should ensure machines are deactivated and their power sources locked out before employees perform maintenance work.(WCxKit)
In this case, the procedures were incomplete and not clearly communicated, training was inadequate, and the procedures were not reviewed to ensure that they were effective and understood by the employees.
The inspection also found that the employees were not trained to work in confined spaces, such as the drum, and were not provided a hot work permit for welding performed in the drum. Finally, the employees were exposed to the hazard of falling into the drum through an unguarded chute opening. OSHA assessed the maximum fine of $7,000 for each of the violations, for a total of $70,000 in fines. A serious violation occurs when there is substantial probability that death or serious physical harm could result from a hazard about which the employer knew or should have known.
"The unexpected startup of machinery during maintenance can injure or kill workers in seconds," said Jeffrey Erskine, OSHA's area director for Essex and Middlesex counties. "Preventing this hazard requires a combination of effective hazard control procedures, training and diligence to ensure that the proper safeguards are in place, in use and understood by workers."(WCxKit)
The company has 15 business days from receipt of its citations and proposed penalties to comply, meet with OSHA's area director or contest the findings to the independent Occupational Safety and Health Review Commission.
OSHA Fines Connecticut Employer for Exposing Workers to Injury
The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) recently cited G.A. Denison & Sons Inc. for 14 alleged willful and serious violations of workplace safety standards at an Old Lyme work site. The New London contractor faces a total of $110,000 in proposed fines, according to an OSHA report.
OSHA's enforcement action follows an inspection opened June 7, when Denison & Sons employees were observed being exposed to falls from heights of 15–26 feet while working without protection on both a scaffold and the roof of a building located at 69 Lyme St. (WCxKit)
In addition, OSHA found employees exposed to fall hazards while improperly climbing ladders and climbing ladders while carrying materials on their shoulders, as well as to head injuries from working without hard hats. These conditions resulted in citations for five willful violations carrying $73,700 in fines. A willful violation is one committed with intentional knowing or voluntary disregard for the law's requirements, or with plain indifference to worker safety and health.
Nine serious violations, with $36,300 in fines, have been cited for several other hazardous conditions, including overloaded scaffolding, a lack of eye protection for employees using nail guns, inadequate scaffold access, a lack of protection against falling objects, and a failure to provide employees with fall protection, scaffold, and ladder training. A serious violation occurs when there is substantial probability that death or serious physical harm could result from a hazard about which the employer knew or should have known. (WCxKit)
OSHA has placed G.A. Denison & Sons in its Severe Violator Enforcement Program, which mandates targeted follow-up inspections to ensure compliance with the law.
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.
2012 is Network Synergy Group (NSG)’s 15th anniversary. Its physical therapy management programs started in 1997 and this year expands to Illinois, Indiana, Louisiana, and Mississippi. NSG now offers a Therapy Management Solution to self-insured employers, insurance companies, and Third Party Administrators throughout those states and others – 25 in all.
According to NSG employees, the company broke the fee-for-service model in which medical providers were rewarded for more, not better, services. “NSG’s idea was simple – realign the financial incentives of the therapy providers to do the right thing, and reward them for providing better care, not more care. This idea would grow into a unique concept known as NSG’s Condition Rate Program,” the company writes.
NSG provides management services for physical therapy, occupational therapy, functional capacity evaluations, work hardening and other medical management services. Having a firm manage providers of these services ensures that networks will be more tightly controlled and follow rigorous guidelines for management, cost and monitoring. It also ensures they will provide a solid return on investment for the money employer's invest in their services.
NSG partners with therapy providers across the country and won the Tampa Bay Chamber of Commerce: Small Business of the Year Finalist in 2010. It also was acquired by GENEX Services, Inc., one of the nation’s leading providers for managed care solutions in 2010.
NSG now offers a Visit Rate model that gives payers and providers a reimbursement method that improves clinical outcomes and results in claims cost reductions. Greg D’Ambrosio, vice president of client services, said, “We are pleased to provide our services in these states with a keen focus on expanding our network nationally in 2012. This product offering allows us to maintain our core philosophy and values while meeting our clients needs to manage therapy on a national level.”(WCxKit)
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.
Winter is knocking at the door. The bitter cold, ice and snow is or will be on the doorstep. If the workplace does a lot of inside and outside work, this can lead to increased risk for injury, and it can start as soon as the workers pull in the parking lot. In most jurisdictions, workers comp coverage begins as soon as those tires cross into the lot from the road that runs outside of it.
With the slick conditions, numerous injuries can occur, ranging from minor slips and falls to major injuries such as broken bones. But do not sit around and wait for the injuries to occur. Below we discuss 5 ways to be prepared for the long winter haul. (WCxKit)
1. Get supplies stocked and ready to rock
Before that winter storm dumps a foot of snow on the doorstep, try not to be caught off guard. If the company is responsible for snow removal and salting, stock up on bags of salt and sand and have them ready to use, near the areas to be applied. Inspect the shovels and brooms for wear and tear and make sure they are in good working order. If using a plow truck for the parking lot, be sure the plow is properly installed and lubricated, and perform yearly maintenance on the vehicle to avoid breakdowns or damage. These may seem like no-brainers, but sometimes when it gets busy around the end of the year these tasks get brushed aside for more important duties, and can be easily forgotten. It is better to be safe than sorry, so be ready should that storm come rolling in. Snow can accumulate in a hurry. For employees who work outside, consider providing ice grips for shoes.
2. Inspect the entryways, stairwells, and mats
People have to enter the building somewhere, so be sure the mats are functional. Some employers have special winter mats, made with extra durable material to stand up to the wear and tear of the outside elements. Non-slip bottoms, and rougher fiber mats can brush that outside snow and salt off of boots and shoes so those materials are not dragged into the work areas. Standing water from melted snow posts a dangerous hazard, and is one of the leading causes of slips and falls. Obviously these falls can result in serious injury, so anything to prevent this is worth the cost.
Most stairwells will be covered in an anti-slip coating, so check and make sure that the surfaces are doing the job they are supposed to do. Also check handrails to make sure they are not loose, so if someone grabs them to prevent from falling the rails do not come off the wall. Again it is common sense, but these checkups usually fall to the bottom of the priority list when busy seasons hit.
3. Have an outside vendor perform the plowing and salting
If you do own the lot and maintain the salting and plowing, consider using an outside vendor to take care of this task. These vendors will carry their own liability insurance policy, and if injury occurs it can shift the risk to them instead of to the employer. But make sure that the vendor does not try to "sneak" in a
hold harmless clause in the contract. If this is the case, the employer agrees to waive any liability towards the vendor, shifting the risk back to the employer for priority coverage.
Most vendors keep the contracts open to negotiation, so have the counsel inspect the contract for loopholes or gaps in coverage should an injury occur. Subrogation is a right in most jurisdictions, and an employer should be able to pursue if any injury does occur within certain circumstances. Most vendors will do their best to get that hold-harmless in there, and wager that almost all vendors that perform snow removal have that wording in all of the contracts. This does not mean the vendors are trying to run away from responsibility, but instead do want to not be held responsible should injury or property damage occur.
4. If leasing the space in a building, review the specifications of who is responsible for injury
If you as an employer are a tenant in a building, or leasing the space for the entire building and parking lot, ask the building manager for a copy of the lease contract and see what exactly the responsibilities are and what the building manager’s are. Do not assume right off the bat that just because leasing a suite in an office building, and the worker falls on the way in, that you are 100% responsible for any injury damages. An opportunity to file a subro claim could be missed with the building’s Carrier. Less often than not these building owners will avoid stepping up to say exactly how the lease breaks down and who exactly has coverage for an injury that occurs before the workers gets to the specific suite. Do some research and find out exactly what scenarios are the employer’s responsibility, and what scenarios will fall under the building manager’s coverage.
5. If inclement weather happens, consider cancelling work for the day
If this is within the means, should a major storm come in and drop a ton of snow, consider a snow day for workers. The world is not going to end to halt operations for one day. If the roads are treacherous, some workers may call in anyway depending on the commute. Work is important and most workers will do their best to report for duties, but it certainly is not worth getting into a serious car accident over. Create a telephone call list so workers can relay the message on to others that work is off for the day or notify employees via twitter, and make sure to have an up-to-date recording on the company phone. That way you are not trying to call everyone at 5am to advise that work is canceled for the day. In the end, if doing this saves someone from a major car accident, it is worth it. I am not saying cancel work every time 4” of snow falls, so set up a parameter. If snow accumulations total over 12” or it is raining and freezing on the roadways creating “black ice” situations, then consider it. Be sure all the workers know about the parameters, so they can have a heads up as well. Create a phone line to call, leaving a message on a general machine so workers can call before leaving for work to see if work was indeed canceled or not. (WCxKit) Make sure there are procedures in place for inclement weather cancelations and late start instructions.
Summary
The winter months statistically create more hazards than the summer months. Snow and ice can lead to dangerous conditions both on the commute to work, and within the workplace itself. Be sure to be prepared for these conditions by performing the tasks listed above. It is far more costly to incur a serious injury, than it is to prevent it.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.
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.
Excellent recordkeeping recently earned the Ohio Bureau of Workers Compensation (BWC) the Auditor of State Award after a review by State Auditor Dave Yost's office returned a clean audit report. The audit was completed by Schneider Downs and accepted by Auditor Yost.
"BWC is committed to safeguarding employer premiums so we have a strong system to care for Ohio's injured workers," said BWC Administrator/CEO Stephen Buehrer. "This recognition reflects the effectiveness of the policies and procedures we have in place to ensure the highest level of transparency and accountability." (WCxKit)
The Auditor of State Award is presented to public entities that meet the following criteria of a "clean" audit report:
1. Must be a GAAP entity without a CAFR (Certified Annual Financial Report) that timely files their financial reports with the Auditor of State
2. The audit report does not contain any findings for recovery, material citations, material weaknesses, significant deficiencies, Single Audit findings or questioned costs
3. The entity's management letter contains no comments related to:
· Ethics referrals
· Questioned costs less than $10,000
· Lack of timely report submission
· Reconciliation
· Failure to obtain a timely Single Audit
· Findings for recovery less than $100
· Public meetings or public records
Author Robert Elliott, executive vice president, Amaxx Risk Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com
The Queensland Government (Australia) is urging employers to ensure safe work practices are in place for moving industrial plant and when using vehicles following a spate of court cases highlighting dangerous incidents throughout the state.
Queensland Industrial Relations Minister Cameron Dick said recent prosecutions by Workplace Health and Safety Qld highlighted the importance of appropriate training and risk management in preventing injuries and fatalities.
"The last few months have seen a spate of prosecutions resolved, with very heavy fines of up to $120,000 imposed," Dick said.
"One of these prosecutions resulted from a fatality at a Mackay scrap metal yard where a 56-year-old worker died from crush injuries.
"Another involved a grader running over a worker at an Atherton construction site and another five prosecutions, related to serious injuries, involved mobile scaffolding or trucks being loaded and unloaded."
Dick noted the fatality and injuries were all the more tragic because they were preventable.
"Workplace Health and Safety Queensland has clear guidelines for preventing incidents of these types," he said.
"Checklists are available for employees or contractors working with moving plant, scaffolding and vehicles. There are checklists for noise; driver fatigue; slips, trips and falls; falls from trucks; access to truck cabins; loading and unloading; lighting; and other risks.” (WCxKit)
According to Dick, Workplace Health and Safety Queensland inspectors are active throughout the industry, auditing workplaces across the state, often targeting these types of operations. But inspectors can't be everywhere, and ultimately employers are responsible for ensuring workplaces are safe for employees."
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. www.LowerWC.com
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@WorkersCompKit.com.
In recent years, the American workplace has been infused with unprecedented levels of hostility — and much of that is due to the deterioration of supervisor-subordinate trust, according to Florida State University researchers.
To better understand this deteriorating relationship, Wayne Hochwarter, the Jim Moran Professor of Business Administration in Florida States College of Business, and research associate Christian Ponder questioned more than 750 mid-level employees to report how often they personally experienced their direct supervisors “Seven Deadly Sins” — wrath/anger, greed, laziness/sloth, pride, lust, envy and gluttony — at work. (WCxKit)
The Seven Deadly Sins is a classification of objectionable behaviors that has been used since early Christian times to educate and instruct followers as it relates to humanity’s tendency to sin.
“We choose these particular behaviorsbecause they have an established history, are familiar to people in both religious and secular settings, and are documented to strain interpersonal relationships at work,” Hochwarter said.
Results indicate malevolent supervisor behaviors in excess of what many might expect:
1. 26 percent of employees said their boss frequently has trouble managing his or her anger (wrath);
2. 27 percent of employees said their boss vigorously pursues undeserved rewards (greed);
3. 41 percent of employees said their boss habitually pushes work on to others rather than doing it himself or herself (laziness);
4. 31 percent of employees said their boss regularly seeks undeserved admiration from others at work (pride);
5. 33 percent of employees said their boss makes sure that others stroke his or her ego on a daily basis (lust);
6. 9 percent of employees said their boss can be counted on to act enviously toward others who experience good things (jealous); and
7. 23 percent of employees said that their boss purposefully hoards resources that could be useful to others at work (gluttony).
Without question, the most frequently reported leader behaviors across genders, industry sectors, and levels of responsibility were pride and laziness. Of little surprise: Results indicated a variety of negative employee outcomes associated with supervisors’ aberrant behavior, including impaired work productivity and poorer heath.
“Employees with leaders who committed these ‘sins’ contributed less effort (40 percent less), felt overloaded as a result of forced responsibility for their supervisor’s work (33 percent more), were less likely to make creative suggestions (66 percent less), and received fewer resources to effectively do their job (60 percent less) than those without this negative type of leadership,” Ponder said.
Also, victims of supervisors self-serving behavior spent considerably more time at work pursuing alternative job opportunities (75 percent more).
In terms of deteriorating health, victimized workers experienced more daily anxiety (50 percent more), less happiness in life (30 percent less), more physical and emotional exhaustion (45 percent more), and more gloominess while on the job (62 percent more).
According to the researchers, the good news is that there still are more considerate managers than selfish ones. However, it is evident that recession-based uncertainty has encouraged many business leaders to pursue self-serving behaviors at the expense of those that are considered mutually beneficial or supportive of organizational goals.
“It is always interesting to see how people react when they feel that their backs are against the wall,” Ponder commented. “Some leaders try to rally the troops, while others decide to go it alone to safeguard what they feel they have.” Perhaps when the cloud of recession fully lifts and job environments become more stable, leaders will focus on employee development rather than self-preservation, he noted.
However, since progress is viewed only in the distant horizon by many experts, employees at all supervisory levels must develop the skills to peacefully co-exist. (WCxKit)
“The consequences of not doing so are increasingly fatal for organizations,” added Hochwarter.
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@WorkersCompKit.com.
When employees file fraudulent workers compensation claims, not only are they stealing from the insurance company, but also indirectly they are stealing from their employer, the shareholders of the employer if a publicly held company, and from their co-workers. The fraudulent workers comp claim is included in the claim history used by the insurance company to set the premium rates for the employer. When the employer pays higher insurance cost due to fraud, there is less money available to invest in the company and to pay the wages and pay raises of the employees of the company.
Nearly 25% of workers comp claims involve some element of fraud, whether it is an outright bogus claim or inflation of an otherwise legitimate claim. The Coalition Against Insurance Fraud estimates workers compensation fraud cost employers $6 billion a year. The National Insurance Crime Bureau recently reported the number of suspicious or questionable claims has increased as the economy has deteriorated. In fact, workers comp fraud is the second largest category of white-collar fraud only behind income tax evasion. Every employer must be vigilant in protecting themselves from the dishonest employees who will attempt to exploit the workers comp claim system. (WCxKit)
There are five common areas of employee workers comp fraud:
1. The total bogus injury. The employee claims a hurt back or neck or other muscle problems for the sole purpose of collecting indemnity benefits.
2. The inflated injury. The employee receives a real job related injury but then tries to extend his/her time off work by pretending the injury is worse than it really is so s/he can collect indemnity benefits.
3. The prior injury. The employee has a real back, shoulder or knee problem from years ago, but now needs additional medical treatment for it.
4. The at-home injury. The employee gets hurt at home, working for someone else or participating in a sports event, and claims s/he got hurt on the job.
5. The malinger. The employee got hurt, got well, but got use to staying home and does not want to come back to work.
There are several courses of action the employer can take to combat workers comp claim fraud. One of the most effective things an employer can do reduce workers comp claim fraud is to have a well publicized and well used transitional duty or light duty return to work program. While a return to work program will not prevent all fraudulent workers comp claims, it will stop many of them.
The dishonest employee who got hurt at home but does not have medical insurance, or has medical insurance with a high deductible, will still file the fraudulent claim that he got hurt at work. However, the dishonest employee who wants to take an extended paid vacation with workers comp indemnity benefits, or the dishonest employee who wants to work at another job while collecting workers comp benefits, will be stopped from doing so by a strong transitional duty program.
In addition to a strong transitional duty program, there are various other steps the employer can take to fight fraudulent claims including:
1. Do not hire employees of questionable character or background. Prior to any offer of employment, thoroughly check the references of the potential employee and their background information.
2. If an employee refuses transitional duty work, or tries transitional duty work for an hour or two, or a day or two and then stops, make an immediate inquiry into what part of the transitional duty job can’t be done. Make arrangements to alter the transitional duty job to fit the complaints. If the employee still refuses the transitional duty work, ask the insurer's claims office to consider surveillance on the employee to be sure the limitations away from work are the same as when at work.
3. Keep an ear open to the rumor mill. Disgruntled employees are far more likely to file a fraudulent workers comp claim then happy employees. Address any legitimate grips or complaints of the employees.
4. Train your supervisors and department managers to recognize the characteristics of claims frequently indicating fraud. Provide the supervisors and department managers with a copy of our blog on Employee Workers Compensation Fraud
5. Make sure all new and current employees are aware of your fraud policy of prosecuting workers comp fraud as a criminal offense. (And back it up! If you have an employee who commits workers comp fraud be sure to fully prosecute. If you want to see the number of your workers comp claims skyrocket, feel sorry for the employee or his family and not prosecute an obviously fraudulent claim).
6. Make sure all employees understand that fraudulent claims come out of the employer’s pocket and reduce the pay raises or bonuses for everyone.
7. When you suspect a workers comp claim may be fraudulent or when you have rumors or evidence that a claim has an element of fraud, contact the workers comp insurer's Special Investigative Unit. They have the expertise and the connections with law enforcement to properly investigate and build the necessary proof to prosecute the fraud.
8. Make it a requirement that the claims handling office of the insurer or third party administrator files an Insurance Services Office index report on every new workers comp claim and does a claims inquiry every six months as long as a claim remains open.
9. Do not make it easy for the employee to file a bogus claim by having a lax safety program. By removing safety hazards from the work place, the employee has fewer options in creating a false injury scenario.
10. Remember many fraudulent claims start out with a real injury. When the employee sees the television commercial with somebody holding fists full of money that attorney so-and-so got them for their workers comp injury, the employee may be tempted to exaggerate his/her own claim. Anytime an employee hires a television attorney, you cannot discuss the claim with the employee, but you can advise the employee of the company’s policy to fight all claims vigorously when an attorney is hired. (WCxKit)
11. Make it a practice to reward fraud tips. Have a publicized program of paying a reward to anyone who reports a workers comp fraud resulting in conviction.
Fighting fraudulent workers comp claims is not easy, but it is absolutely necessary to protect your company's bottom line. Make fraud prevention a component of your integrated workers compensation program.
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@WorkersCompKit.com.
On November 9, 2010 CMS Announced: Revised Implementation Timeline for TPOC Liability Insurance (Including Self-Insurance) Settlements, Judgments, Awards or Other Payments
Medicare has delayed the required submission of Mandatory Insurer Reporting data for all Liability Insurance initial claims reports with no Ongoing Responsibility for Medical (ORM) involvement until 1/1/2012. Liability and Workers' Compensation claims with ORM have not been delayed and will be required to submit claims records in Q1 2011. All claims/settlements involving Medicare beneficiaries during this interim period must comply with the Medicare Secondary Payer Statute (MSP) and will be reported to the Centers for Medicare and Medicaid Services (CMS) if they meet the requirements.
Liability insurance (including self-insurance) Total Payment Obligation to Claimant (TPOCs) must be reported if the TPOC Date is on or after 10/1/2011.
The current rule requiring reporting of Non Group Health Plan (NGHP) TPOC dates as of 10/1/2010 has been changed to 10/1/2011 but only for liability insurance (including self-insurance) TPOCs.
The reporting date requirements for TPOC Dates of 10/1/2010 and thereafter associated with no-fault insurance or workers' compensation claims remain unchanged.
The reporting date requirements as documented in the User Guide for all NGHP ORM remain unchanged.
Initial Claim Input Files for reportable claims continue to be due during the Responsible Reporting Entity (RRE's) assigned file submission timeframe for the first calendar quarter of 2011. RREs that have reportable claims must commence production reporting in first calendar quarter 2011 and will include liability insurance (including self-insurance) TPOC reporting in the first calendar quarter of 2012 for TPOC Dates of 10/1/2011 and thereafter.
Medicare has also extended the Interim Dollar Thresholds for all lines of insurance. The new extension gives relief to settlements in Liability and Workers Compensation cases with TPOC amounts under $5,000 and executed prior to 1/1/2013. The threshold falls to $2,000 in year 2013 to 2014; then drops again to $600 in 2014 through 2015.
CMS cautions that the obligation to protect Medicare's interests remains unchanged in all lines of business. While the reporting dates have been extended regarding Liability claims with TPOC only, workers' compensation cases and No Fault cases are unaffected.
Time during the delay should be aggressively utilized by liability RRE's and TPAs to improve processes and procedures regarding Mandatory Insurer Reporting and Medicare Secondary Payer Compliance.
If you chose a Reporting Agent who has been unable to successfully complete testing of the reporting requirement after more than 2 years of notice and development, now is the time to explore the options and make a change without penalty. Gould & Lamb is prepared to take on additional MIR clients immediately and can successfully integrate both small clients and large clients regardless of needs and system complexities.
Contributed by Gould & Lamb. Contact Kip Daniels, Vice President of Strategic Services, at kip.daniels@gouldandlamb.com or 866-672-3453 x 1077.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
The BC Human Rights Tribunal awarded a worker nearly $8,000 after finding complaints of sexual harassment from a co-worker played a role in her termination.
According to Canadian OH&S News in the September 15 ruling, tribunal member Murray Geiger-Adams ordered the worker's employer to pay over $2,900 in lost wages compensation as well as $5,000 for injury to her dignity, feelings and self-respect. The employer, Dave's Custom Metal Works Ltd. in Port Coquitlam, BC, was also required to provide each current employee with a copy of the ruling. (WCxKit)
Corina Soroka was terminated on Sept. 9, 2009 after she complained to plant owner Dave Rouleau about an incident the previous day in which supervisor Ian MacDonnell took her to a home shop to discuss a previous incident. That first event occurred on July 28, 2009, one day after Soroka took time off work because of a crushed finger she suffered while cutting metal at the shop.
After the workplace injury, MacDonnell obtained Soroka's cell phone number, called her and the two workers later exchanged more than two dozen sexually themed text messages. Rouleau issued a verbal disciplinary warning to MacDonnell after he found out about the incident, the decision says. The supervisor also received a disciplinary warning for insubordination on the day Soroka was fired.
"I find that Mr. MacDonnell acted from confused and contradictory motives," Geiger-Adams writes in the decision. "I accept that, on the one hand, he wanted to make things right with Ms Soroka so that they could continue to work together, but that, on the other hand, he continued to press her, against her expressly-stated wishes and feelings, to accept that his interest in her was understandable and even justified. He did so in a setting that he had engineered by using his authority to direct her work – one in which she was isolated and vulnerable," Geiger-Adams writes.
In awarding damages to the worker, the tribunal member found that "sex discrimination was at least part of the reason Rouleau terminated Soroka's employment, but that, even in the absence of the contraventions, Soroka's employment would likely have ended at the end of October, 2009" as it was subject to the availability of work.
In the ruling, Geiger-Adams found that the employer discriminated against the worker in three ways.
First, MacDonnell used his access, through his employment, to Soroka's private cell phone number, in order to contact her at home to "follow up on the sexual and perhaps romantic interest in her he first expressed in the workplace on July 24 . . . even though she immediately made it clear through her text messages that his interest was not reciprocated."
Second, in spite of a verbal reprimand, MacDonnell used his authority as a supervisor to take her away from the workplace to his home, "and there to both threaten to interfere with her employment, and make further inappropriate sexual comments to her." (WCxKit)
Finally, Rouleau decided to "abruptly terminate Soroka's employment when he did in order to 'solve' the problem created for him by MacDonnell's conduct, and Soroka's complaints about that conduct," the decision says.
Geigar-Adams says the plant owner apparently reasoned that, "even though Soroka was the victim of what he twice identified as MacDonnell's inappropriate conduct toward her, her employment was short-term, and it was easier to remove her from the workplace than deal further with the conduct of the perpetrator."
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.
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©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
We miss our friends and colleagues lost in the World Trade Center on Sept 11, 2001. Marsh and Aon, two industry giants, the largest insurance brokers in the world, both very influential in the field of workers' compensation cost containment, were both located in the World Trade Center Towers. Between the two companies, nearly 600 people were lost. For those of us in the insurance industry, we all knew many people who were killed that day. I am proud to have been an employee of both companies.
While the world was in shock, it was especially difficult for employees of Marsh and Aon. We were calling around to our friends, trying to find out who was missing and who had checked in and were known to be safe. At Aon, Pamela Newman kept me and others informed of who had been located. At Marsh, Jim Connolly was letting me know who had been located. Our boss, Phil, was found. Our other boss, Harry, was not. I had been retired, but went back to work for Aon to complete several projects that had been in process.
Many of the employees traveled, so it wasn't easy to figure out who had been at the office that day, and who had been traveling. The lucky ones were traveling. We lost our bosses, safety and loss control professionals, claims experts, friends we had known during our entire working lives. George, Harry, Bob, Lars, Adam, Richard and many other would not be found. The days that followed were excruciating for the country, but especially difficult for Marsh and Aon as we learned who among our friends and colleagues would not be coming to the office any longer.
Seeing our colleague, Bob Ferris's son hold up a photo of their dad on national television as they hoped he was at a local hospital or someone had seen him, brought unspeakable sorrow. We waited by our phones for calls that never came. It's still hard, some of us do not go into tall buldings, others don't speak about it. We all realize life can change in an instant.
Marsh and Aon have done a remarkable job with their memorial websites. If you care to share the memories of those who have made an imprint on this industry in the past, their websites are below.
Aon Memorial: http://www.legacy.com/aon/Sept11/SearchResult.aspx?location=WTC
Marsh Memorial: http://memorial.mmc.com/
Author: Rebecca Shafer
Posted in
Legal Doctrines, Litigation Management, Management Commitment, Uncategorized |
