The Best Tidbits of News From the Workers Comp Community

 

News From Lexis Nexis:
 
 
 
“The LexisNexis Workers' Compensation Law Community has selected its 2012 honorees. These top blogsites contain some of the best writing out there on workers' compensation and workplace issues. They contain a wealth of information for the workers' compensation community with timely news items, practical information, expert analysis, practice tips, frequent postings, and helpful links to other sites. These blogsites also show us how workplace issues interact with politics and culture. Moreover, they demonstrate how bloggers can impact the world of workers' compensation and workplace issues. View the list of honorees.”
 
 
Deciphering Section 28(b) After Andrepont, by Paul B. Howell, Esq.
“In 1822, a sweaty scientist in a dimly-lit room looked at a rock from Egypt and discovered the key to decoding Egyptian hieroglyphics. 175 years later, a Fifth Circuit Court of Appeals judge with a cup of coffee inSee FMC Corp. v. Perez, 128 F.3d 908, 31 BRBS 162(CRT) (5th Cir. 1997). Read more.”
 
 
 
 
Thousands of federal government employees suffer work-related injuries each year, most of whom recover and return to their pre-injury jobs. There are however, a small percentage of employees who are unable to return to return to their pre-injury jobs due to long-term physical restrictions. Although placement with a federal agency is optimal, it is not always possible, especially at a time when government jobs are being eliminated. This leaves a significant number of individuals with transferable skills, unemployed and heading down a path towards a life of unnecessary long-term disability.  Read more…
 
 
 
 
With more visibility and vulnerability in today’s business landscape due to social media, online commerce and doing business through mobile devices, it only makes sense that there would be more potential risks to a company’s reputation and brand. In fact, now more than ever, executives are attempting to protect their brands from these security threats by being more proactive and looking for blind spots in their risk management program.  Read more…
 
 
 
Austin, TX – Texas recorded a six percent decrease in work-related fatalities in 2011, the second consecutive year of decrease and the lowest level in a decade.  There were 433 fatalities in 2011 compared to the 2010 total of 461 fatalities.  Nationally, there were a preliminary total of 4,609 fatal work injuries in 2011.  Read more…
 

Author 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.comContact mstack@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.

The Best Tidbits of News From the Workers Comp Community

 
Worker's Compensation Expert Rebecca Shafer will be presenting at the 21st Annual National Workers' Compensation and Disability Conference® in Las Vegas, November 7 – 9.
 
Rebecca would like to invite you to join her there and be a part of the nation's leading training event for workers' comp and disability management professionals. And, more importantly, to benefit from all the great strategies and best practices you’ll learn that will help you solve the biggest challenges facing our industry.
 
The organizers have given Rebecca a special discount to offer you– $320.00 off the on-site rate – even larger than the discount advertised in the brochure. You can attend all the sessions and networking events over the two-and-a-half days for only $975.
 
To attend at this special $320.00 discount, register by Oct. 22 using Promo Code SPKR12 (all caps).  Register at www.WCConference.com
 
 
 
News From Lexis Nexis:
 
 
 
The new mobile workforce raises many unique challenges in the world of workers' compensation. With respect to telecommuters, Larson's states: "When reliance is placed upon the status of the home as a place of employment generally, instead of or in addition to the existence of a specific work assignment at the end of the particular homeward trip, three principal indicia may be looked for: the quantity and regularity of work performed at home; the continuing presence of work equipment at home; and special circumstances of the particular employment that make it necessary and not merely personally convenient to work at home." Read more.
 
At the 21st Annual National Workers' Compensation and Disability Conference®, Nov. 7-9, Stuart D. Colburn will speak and moderate onThe New Mobile Workforce. Joining him are Roger A. Levy, Esq. and Alan S. Pierce, Esq. 
 
 
 
It is axiomatic that reliance on lay testimony and administrative expertise is not justified when the medical question is no longer an uncomplicated one and "carries the factfinders into realms that are properly within the province of medical experts". On the other hand, just because a party has a purported export willing to testify as to the medical question at stake, that does not mean the expert is free to express his or her opinion; the opinion must be based generally upon generally accepted scientific and medical standards. Illustrating this important point, a Maryland appellate court recently…read more about this case and other cases on wrongful death, retaliatory discharge, and unexplained fall.”
 
 
 
 
 
The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) has made changes to the TXCOMP Health Care Provider system at http://txcomp.tdi.state.tx.us/twccprovidersolution/home.html that effect health care providers.
 
·         Health care providers’ access to submit applications to be certified as a designated doctor, or apply for recertification has been discontinued.
·         Access to update License/Certifications and Specialties for health care providers who are certified as a designated doctor or have applied to be certified as a designated doctor is restricted to TDI-DWC staff only.  Read More…
 
 

Author 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

 

 


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 News From Around the Net

Input Needed in Providers Opioid Audit
 
The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) acknowledges that prescription drug abuse and misuse, including opioids, is a serious issue in all health care delivery systems, including workers’ compensation.
 
 
The TDI-DWC seeks input and suggestions regarding the development of a new Plan-Based Audit for health care providers prescribing opioids. The Plan-Based Audit sets the scope, methodology, selection criteria, and program area responsibilities as laid out in the Medical Quality Review Procedure. A copy of the proposed Health Care Providers Pain Management Services (Opioid) Plan-Based Audit can be viewed at the TDI website here. [WCx] 
 
 
Broadspire Launches BOLD® Rx Network
 
Broadspire, a Crawford Company and TPA of workers compensation claims, liability claims and medical management services, has launched its BOLD Rx Network to help control the medical costs associated with WC claims. See here for more information.[WCx]
 
 
According to Broadspire, the BOLD Rx Network uses a multi-leveled strategy to achieve superior penetration rates and savings compared to the rest of the industry. “Rather than just partnering with one pharmacy benefit management (PBM) company, as is traditionally seen in the marketplace, Broadspire leverages multiple partners based on the value they bring to clients, creating a stronger pharmacy program,” they write.
 
Federal Court Rejects NLRB Authority to Force Posting of Employee Rights Notice
 
According to a well-written newsletter from McGuireWoods, a world-wide lawfirm with 900 lawyers, in Chamber of Commerce of the U.S., et al. v. NLRB (Dist. S.C., April 13, 2012), a South Carolina federal district court held that the National Labor Relations Board (NLRB or the Board) does not have statutory authority to force employers to post notices that the NLRB claims are designed to inform employees of their rights under the National Labor Relations Act.
 
 
McGuireWoods writes, “The Court’s decision directly conflicts with a recent decision from a separate federal court in the District of Columbia. These developments place all employers covered by the Act in a very difficult position.”
 
 
The regulations are to take effect April 30, 2012. “The conflicting court cases make it unclear whether employers will be required to post the NLRB notices on the current April 30, 2012 deadline. (Click here for more),” they write.
 
 
Columbus Dispatch Notices Lawsuits Against Doctors on Decline
 
Columbus Dispatch reporter Alan Johnson writes here that Ohio’s tort-reform law has reduced closed claims by 41 between 2005 and 2010. He discovered average payments for medical malpractice cases have declined 38 percent over that period.
 
 
Johnson writes, “The legal fight over curbing lawsuits and settlements in medical malpractice cases reached a tipping point in 2003 when the General Assembly passed and Gov. Bob Taft signed Senate Bill 281. The law capped non-economic damages, commonly known as ‘pain and suffering,’ at $500,000 per occurrence.”
 
 
Johnson reports that Tim Maglione, of the Ohio State Medical Association says doctors’ medical malpractice rates have dropped more than 26 percent. “It’s not only good news and a good trend, but it is proof that tort reform accomplished what it set out to do — slow the growth of what we thought were runaway lawsuits and to stabilize the market for physicians,” Maglione said. The numbers have also gone down, he said in the article, because doctors and hospitals are working harder to improve safety and cut down on mistakes. “The best error is the one that never happens.”
 
 
Progressive Medical Releases Annual Workers’ Compensation Medication Trends Report
 
According to Progressive Medical, Inc., WC medication spending declined in 2011. Their annual analysis, found here, reveals changes to medication expense patterns in workers’ compensation claims from 2010 to 2011 for Progressive Medical clients, as well as key factors that may influence future expenditures, such as chronic pain, product mix and government activity.
 
 
Key highlights from the 2012 Workers' Compensation Medication Trend Report include:
  1. Although medication AWP inflation was 5.8 percent in 2011, data shows a 1.3 percent reduction in total medication spend per claim.
  2. There was an overall 3.3 percent decrease in utilization per injured worker from 4.3 percent fewer prescriptions and a 1.1 percent decrease in average days of medication supply received.
  3. Across the industry, narcotics account for 35 percent-40 percent of workers' compensation medication spend while Progressive Medical showed a 3.9 percent decrease in total spending per claim in this drug category. Progressive Medical believes this is due to an emphasis on conducting interventions earlier in the lifecycle of a claim.
 
 
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

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.

Amy Food Cited for Exposing Workers to Unguarded Machinery

The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) recently cited Houston-based Amy Food Inc. with one willful, four serious, and three other-than-serious citations for exposing workers to possible amputation hazards at the company's Houston facility. Proposed penalties total $77,100.  I'd like to think this isn't true – because I'm an Amy's fan – but unfortunately the citation seems to be true.

 

OSHA's Houston South Area Office
initiated a safety inspection on Richey Street following a complaint alleging that several employees had suffered near amputation incidents while operating machinery. The investigation found that not only did the company fail to have an energy control program in place but also machines were not being unplugged from the electrical power source prior to maintenance and servicing. [WCx]

The willful violation has been issued for failing to develop, document, and utilize an energy control program. A willful violation is one committed with intentional, knowing or voluntary disregard for the law's requirements, or with plain indifference to employee safety and health.

The serious violations include failing to provide required machine guarding on chains and sprockets, cover floor holes and openings, and adequately mark exit doors. 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 other-than-serious violations involve inadequate recordkeeping of injuries and illnesses on the OSHA 300 log. An other-than-serious violation is one that has a direct relationship to job safety and health, but probably would not cause death or serious physical harm.

"This company exposed its workers to injuries, including possible amputation hazards, by failing to develop, document, and utilize an energy control program during the maintenance and servicing of machinery," said Mark Briggs, director of OSHA's Houston South Area Office. "Employer disregard for worker safety will not be tolerated." [WCx]

 

The company has 15 business days from receipt of the citations to comply, request an informal conference with OSHA's Houston South area director, or contest the citations and penalties before the independent Occupational Safety and Health Review Commission.

 

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. He is an editor and contributor to Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: Info@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 News in Brief for February 2012

How Can You Find Quality Providers?
According to a recent MedMetrics blog, finding quality providers in your data has never been easier. See the complete blog here.
 
 
Author Karen Wolfe explains in the blog there are several steps, including:
1. Identify and avoid the poorly performing doctors
2. Having good data.
3. Keeping a historic perspective.
4. Provider performance evaluation is essential.
5. Defining good data.
 
6 Record proliferation.
7. Data entry procedures.
8. Provider performance suite.
 
 
To learn more, visit MedMetrics and to learn how, contact KarenWolfe@MedMetrics.org
 

The Texas Department of Insurance Offers New Rulebook
Texas Department of Insurance, Division of Workers’ Compensation just supplemented its Rulebook for 2012-02. It is now available online for amendments and new rules to 28 TAC chapter 180 regarding the monitoring and enforcement authority of the division of workers’ compensation.
 
 
The supplement can be printed from the TDI website here.
 
16th Annual Texas Safety Summit for Employers and Employees April 10-12 in Austin
The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) will host the 16th Annual Workplace Safety Conference, the Texas Safety Summit, on April 10-12, 2012 in Austin at the Doubletree Hotel Austin, 6505 IH-35 North. The TDI-DWC is hosting the conference to help all employers reduce injuries and their associated costs through workplace safety and return-to-work programs, whether or not they subscribe to workers’ compensation insurance.
A pre-conference session entitled Workers' Compensation 101 and Return to Work will be offered from 1 p.m. to 4 p.m. on April 10.
 
 
Conference general sessions include Technology in Collision Reconstruction presented by Clifford McCarter of Rimkus Consulting Group; Occupational Safety and Health Administration (OSHA) Region VI Update presented by John Hermanson, Regional Administrator of OSHA, Region VI; Generational Issues in the Workplace presented by Dr. Richard Lewis of Round Top Consulting Associates; and Personal Fitness for Work presented by Petti Redding of the Redding Group.
 
 
In addition, over 20 breakout sessions are planned to address pertinent issues facing Texas workplaces, including:
Accident/Incident Investigation;
Asbestos Awareness;
Combustible Dust/Respirable Dust;
Components of Effective Safety Programs;
Drug and Alcohol Awareness for Employees;
Effective Safety Committees;
Fatal Driving Distractions;
Federal and State Reporting Requirements;
Fire Safety in the Wild and Urban Interface;
Hazard Communication and Material Safety Data Sheets for Small Employers;
Heat Illness Prevention and Response;
ICS402 Incident Command System (Disaster Planning);
Job Safety Analysis;
Lockout/Tagout;
Management’s Role in Slips, Trips and Falls;
Material Handling;
Office of Injured Employee Counsel;
Personal Protective Equipment: Employer Responsibilities;
Tips for Safety Trainers;
Top Ten New Traffic Laws;
Uses of Injury/Illness Data Requested by OSHA and the Bureau of Labor Statistics (BLS);
Traffic Work Zone Safety; and
Workplace Violence Prevention
 
 
Conference rates for hotel reservations are available at the Doubletree Hotel until March 19 or until the conference block of rooms is full. To make hotel reservations, call the hotel at 512-454-3737 and reference “Texas Safety Summit” or register online using the Doubletree Hotel website here.
 

Texas Supreme Court Grants Rehearing in Ruttiger Case
Feb. 22, the Texas Supreme Court issued its long-anticipated option in Texas Mutual Insurance Co. v. Ruttiger. A divided Court held that some, but not all, “bad faith” claims based upon alleged violations of the Insurance Code are “at odds with” the works’ compensation system and, thus, may not be presented to, or considered by, the district courts. To read more on this case, click here.
 

Study Provides Baseline to Measure Impact of Reforms on Illinois Workers' Compensation System
A new study, CompScope™ Benchmarks for Illinois, 12th Edition, by the Workers Compensation Research Institute (WCRI) shows baseline data to measure the future impact of 2011 reforms in Illinois, which are designed to ensure that the state’s workers’ compensation costs are reasonable and competitive.
 
 
According to a WCRI release, “The reform legislation addressed key cost drivers in the workers’ compensation system, especially medical prices, by reducing fee schedule rates by 30 percent, introducing preferred provider networks for selecting treating physicians, implementing American Medical Association (AMA) guides for evaluating impairment, and requiring clinical reports by physicians.”
 
 
For more information about WCRI or to purchase this study, visit: http://www.wcrinet.org.
 

The Texas Department of Insurance Shows Proposed Revisions
The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) is accepting comments on proposed revisions to the following employer and self-insured political subdivision forms:
 
 
1. DWC Form-005, Employer Notice of No Coverage or Termination of Coverage;
2. DWC Form-007, Employer’s Report of Non-covered Employee’s Occupational Injury or Disease;
3. DWC Form-020SI, Self-Insured Governmental Entity Coverage Information.
 
 
These proposed form revisions are not a formal proposal and comments received will not be responded to in accordance with the Texas Administrative Procedure Act. The proposed draft form is available from the TDI-DWC website here.
 
 
Informal comments may be submitted to the TDI-DWC by e-mailing
informalrulecomments@tdi.state.tx.us.
 

The Texas Department of Insurance Seeks Comments
The Texas Department of Insurance Division of Workers’ Compensation formally proposed in February new Rules Relating to Notice and Reporting Requirements for Subscribing and Non-Subscribing Employers; and Rules Relating to Notice of a Texas Labor Code §504.053(b)(2) Election by a Self-Insured Political Subdivision.
 
 
TDI-DWC is accepting public comment on the proposals to add new 28 Texas Administrative Code (TAC) §§110.7, 110.103, 110.105, and 160.1, and to amend 28 TAC §§110.1, 110.101, 160.2, and 160.3.
 
 
The proposal relates to various notice and reporting requirements imposed upon subscribing and non-subscribing employers, specifically requirements for notifying the TDI-DWC of non-coverage status, termination of coverage, and occupational injuries, illnesses and fatalities; and requirements for notifying employees of the employer’s coverage status.
 
 
The primary purpose of the proposal is to update and clarify these notice and reporting requirements. The proposal also contains a new rule that would require a self-insured political subdivision that elects to provide medical benefits in accordance with the manner described by Texas Labor Code §504.053(b)(2) to notify the TDI-DWC of its election to provide medical benefits in that manner. [WCx]
 
 
The proposal will be published in the February 24, 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. Public comments may be submitted by e-mailing rulecomments@tdi.state.tx.us.

 

 

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.

Texas Employer Fined Following Drilling Deaths of 2 Workers

The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) has cited Robinson Drilling of Texas Ltd. for eight serious, four repeat and 11 other-than-serious safety and health violations following the death of two workers at the company's work site near Lamesa at Truitt Woods Field, Well No. 1, Rig No. 3.

 
According to a report from OSHA's Lubbock District Office, the agency began its investigation of the incident on June 11. About five employees were performing drilling operations in the area when the kelly bushing, a device that when fitted into the master bushing transmits torque and simultaneously permits vertical movement to make a hole, came apart and fatally struck two employees working on the drill floor. (WCxKit)
 
 
One serious violation related to the incident was cited for failing to prevent "struck-by" injuries, which could have been prevented had the employer adhered to industry practices as enforced by OSHA under the general duty clause.
 
 
The remaining serious violations include failing to provide covers on floor holes to prevent trip hazards, ensure that self-contained breathing apparatus are fully charged, ensure that work surfaces are clean and dry, ensure that stacked materials are blocked to prevent materials from moving when placed on a rack and ensure that flexible cords are used properly. 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 repeat violations include failing to complete the OSHA 301 form; failing to establish a written respiratory protection program and failing to provide strain relief for flexible cords. A repeat violation exists when an employer previously has been cited for the same or a similar violation of a standard, regulation, rule or order at any other facility in federal enforcement states within the last five years. OSHA cited the company for similar violations in 2007 and 2011.
 
 
The other-than-serious violations involve failing to properly complete the OSHA 300 logs for recording injuries and illnesses. An other-than-serious violation is one that has a direct relationship to job safety and health but probably would not cause death or serious physical harm.
 
 
"Two workers lost their lives because Robinson Drilling allowed serious hazards to exist in the workplace," said Joann Figueroa, OSHA's area director in El Paso. "It is the employer's responsibility to follow OSHA standards and ensure that work environments are free from all unnecessary hazards." (WCxKit)
 
 
Proposed penalties total $93,700. Big Spring, Texas-based Robinson Drilling, which employs about 500 workers nationwide, has 15 business days from receipt of these citations to comply, request an informal conference with OSHA's area director in El Paso or contest the citations and proposed penalties before the independent Occupational Safety and Health Review Commission.

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. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.
 

NEW 2012 WORKERS COMP BOOK:  www.WCManual.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 rshafer@reduceyourworkerscomp.com.
 

Texas Man and Maryland Woman Sentenced on Workers Comp Fraud Charges

Texas Mutual Insurance Company reported recently that a Travis County district court sentenced Thomas Mikulenka of League City, Texas on workers compensation fraud-related charges.
 
 
The court sentenced Mikulenka to three years deferred adjudication and 100 hours of community service. Mikulenka was also ordered to pay $7,221 in restitution to Texas Mutual. (WCxKit)
 
 
Mikulenka reported a job-related injury while working as an electrician for IGC Construction, Inc. in Houston. He claimed he was unable to work as a result of the injury, and Texas Mutual began paying income benefits to him.
 
 
Meanwhile, Texas Mutual uncovered evidence that Mikulenka was working as a laborer while receiving income benefits.
 
 
Investigators call this type of scam double-dipping because claimants collect benefits for being too injured to work when, in fact, they are gainfully employed. Texas law requires claimants to contact their workers comp carrier when they return to work. (WCxKit)
 
 
Left unchecked, double-dipping and other workers comp fraud can lead to higher premiums for all Texas employers.
 

 

Maryland Woman Sentenced in Nevada Workers Comp Fraud Case 

A Maryland woman has been sentenced to 2 ½ years in a Nevada state prison for attempting to defraud her employer’s workers compensation insurer of $20,000 while at a professional conference at the Las Vegas Hilton, according to Nevada Attorney General Catherine Cortez Masto’s office.

 
 
Tamara Thompson-Johnson, 45, was ordered to pay $20,000 in restitution, $4,000 in extradition costs and serve 2 ½ years in a Nevada prison after pleading guilty to making false statements to obtain workers comp benefits from her employer, officials say. (WCxKit)
 
 
According to officials, Thompson-Johnson claimed she was injured at the Las Vegas Hilton when a vase, dislodged by an intoxicated person, fell from its pedestal. Although she refused medical treatment at the scene, she reported to security that she had been struck by the vase and checked herself into a hospital.
 
 
The Nevada General Attorney’s office says Thompson-Johnson hired a lawyer and requested a claim for compensation from the Las Vegas Hilton. Her claim was turned down when surveillance footage of the incident surfaced showing that the vase narrowly missed Thompson-Johnson.
 
 
Although her lawyer ceased representing her Thompson-Johnson filed another claim through her employer’s workers comp carrier Travelers Insurance, claiming the vase hit her on the back of her head, neck and back, leaving her disabled. As a result she was paid $20,000 on her fraudulent claim.
 
 
According to the Nevada Attorney General’s office, Thompson-Johnson was extradited from Maryland when she did not appear for court hearings in Las Vegas.
 
 
She pleaded guilty to one felony count of making false statements or representations to garner benefits and was sentenced in November. (WCxKit)
 
 
Along with a 2 ½ year jail sentence, she was ordered to pay $20,435 in full restitution to Travelers Insurance, $4,005 in extradition costs and to reimburse the state $1,000 for costs in connection to the case and was ordered to disclose her conviction to present and future employers and insurers.
 
 
 
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. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.

NEW 2012 WORKERS COMP BOOK:  www.WCManual.com
 
WORK COMP CALCULATOR:  www.LowerWC.com/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.
 
©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

Houston Man Pleads Guilty to Workers Comp Fraud

 
Texas Mutual Insurance Company recently reported that a Travis County district court sentenced Derrick Crockrom of Houston on workers compensation fraud-related charges.
 
 
Crockrom was sentenced to 15 days in jail and two years’ deferred adjudication. He was also ordered to complete 50 hours of community service. Crockrom reported a job-related injury while working as a driver for Best Delivery Systems, Inc. of Houston. He claimed he was unable to work as a result of the injury, and Texas Mutual began paying income benefits to him.(WCxKit)
 
 
Meanwhile, Texas Mutual uncovered evidence Crockrom was working as a broker for a Houston financial company while at the same time receiving income benefits.
 
Investigators call this type of scam double-dipping because the claimant collects benefits for being too injured to work when he or she is, in fact, gainfully employed. Texas law requires claimants to contact their workers’ comp carrier when they return to work. (WCxKit)
 
Left unchecked, double-dipping and other workers comp fraud can lead to higher premiums for all Texas employers.

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. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.


ABCs OF WORKERS COMP MANAGEMENT BOOK:  www.wcmanual.com

WORK COMP CALCULATOR: www
.LowerWC.com/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.
 
©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.

OSHA Proposed Penalties of $949,000 for Texas Employers for Unguarded Machinery Fall Hazards and More

The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) has cited PJ Trailers Manufacturing Co. Inc. and Delco Trailers Co. Inc., a similar company owned by PJ Trailers, for seven willful, 26 serious, nine repeat and four other-than-serious violations.
 
 
According to an agency report, OSHA inspectors found workers exposed to unguarded machinery, fall hazards and accumulations of potentially hazardous dust, among other violations. Proposed penalties total $949,800. (WCxKit)
 
 
"Employers have a responsibility to keep their workers safe and healthy. Willful and repeat citations, as well as significant penalties, reflect the fact that management knew workers were exposed to dangerous conditions yet failed to provide them with basic safety protections. That choice is unacceptable and needlessly placed these workers' health and safety at risk," said Assistant Secretary of Labor for OSHA Dr. David Michaels.
 
 
PJ Trailers Manufacturing and Delco Trailers are commonly owned, with the same president and management. They share a work site, a human resources division and a safety and health manager, and they have interrelated and integrated operations. PJ Trailers and Delco Trailers previously had been cited by OSHA for many of the same hazards that the agency found during its most recent inspection. Although the company had certified abatement of the prior hazardous conditions, many of the fixes were later abandoned to accommodate production. Since 2008, at least 15 workers have suffered eye injuries requiring medical treatment and or days away from work.
 
 
OSHA's Dallas Area Office initiated a safety and health inspection at the company's facility at 1807 Farm to Market 2352 in Sumner following receipt of a complaint that employees were not adequately protected from being injured by rotating machinery parts, and employees were exposed to toxic welding fumes while fabricating trailers and noise levels above approved health standards.
 
 
The willful violations involve failing to provide fall protection for employees working on stacked trailers, provide adequate machine guarding to prevent "caught-in" or "caught-between injuries," provide employees with proper eye protection during cutting and welding operations, and establish and maintain an audiometric testing program. Audiometric testing is required when employees are exposed to high noise levels to determine if their hearing is being adversely affected. A willful violation is one committed with intentional, knowing or voluntary disregard for the law's requirements, or with plain indifference to employee safety and health.
 
 
Repeat violations include failing to ensure that all spray booth areas were kept free from accumulated powder coating, guard several pieces of hazardous machinery, have all necessary lockout/tagout procedures, provide training on existing lockout/tagout procedures to protect employees from hazardous machinery starting up unexpectedly and ensure that medical evaluations were completed to determine employees' ability to use respirators. A repeat violation exists when an employer previously has been cited for the same or a similar violation of a standard, regulation, rule or order at any other facility in federal enforcement states within the last five years. OSHA cited the company in September and October of 2006 and March 2010 for similar violations.
 
 
Serious violations include failing to provide required fall protection, provide training on electrical hazards and prevent exposure to welding fumes in excess of the average allowed during an 8-hour shift. 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.
 
 
Other-than-serious violations include failing to enter recordable injuries and illnesses on the OSHA 300 log within seven calendar days and properly certify the OSHA 300A form or its equivalent. An other-than-serious violation is one that has a direct relationship to job safety and health, but probably would not cause death or serious physical harm. (WCxKit)
 
 
The workers compensation carrier insuring PJ Trailers and Delco Trailers is Farmington Casualty Co.
 
 
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. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.


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WORK COMP CALCULATOR:  www.LowerWC.com/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.
 
©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.

Texas Division of Workers Compensation Approves 14 for Self Insurance

 

pic10The Texas Department of Insurance, Division of Workers Compensation (TDI-DWC) approved one initial application and 13 renewals of certificates of authority, to self-insure for workers compensation claims for a one-year period under the TDI-DWC Self Insurance Program to 14 companies employing approximately 188,000 employees in Texas.

 

 

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.(WCxKit)

 

 

According to the Texas Department of Insurance, certified self-insurance is a program that allows private employers in Texas to self-insure for their workers compensation losses – it is allowed because workers compensation coverage is not mandatory in Texas. Employers wanting to self-insure apply to the TDI-DWC and, if approved, pays its own workers compensation losses.

 

 

The companies affected by the most recent self-insurance certificates are:

  1. AAA Cooper Transportation, Dothan, AL
  2. American Electric Power Company Inc., Heath, OH
  3. Archer-Daniels-Midland Company, Decatur, IL
  4. Baker Concrete Construction Inc., Monroe, OH (new to program)
  5. FedEx Ground Package System, Inc., Pittsburgh, PA
  6. Hyatt Corporation, Chicago, IL
  7. Limited Brands Inc., Columbus, OH
  8. Lockheed Martin Corporation, Fort Worth
  9. Parker-Hannifin Corporation, Cleveland, OH
  10. Poly-America L.P., Grand Prairie
  11. Sam Kane Beef Processors Inc., Corpus Christi
  12. Union Tank Car Company, Chicago, IL
  13. VF Corporation, Greensboro, NC
  14. Wal-Mart Associates Inc., Bentonville, AR

 

 

Among the qualifications for self-insurance in Texas are the following:

  1. A private employer with operations in Texas.
  2. An estimated unmodified manual insurance premium of at least $500,000 in Texas, or at least $10,000,000 nationwide.
  3. Presentation of audited financial statements.
  4. Qualifying Credit/Debt ratings.
  5. A qualifying Tangible Net Worth to Long Term Debt ratio of 1.5 to 1, with Minimum Tangible Net Worth of $5 million.
  6. Posting of a minimum security deposit of $300,000.
  7. Posting of excess insurance in the amount of $5 million per occurrence.
  8. Submission of an “Application for Certificate of Authority” to SIR; and
  9. Payment of a non-refundable $1,000 application fee.

 

In other news, the TDI-DWC will be hosting some educational sessions on pharamacy closed formulary. The sessions are open to are for all Texas workers compensation participants, including health care providers, pharmacists, insurance carriers, claim adjusters, case managers, and attorneys. The free sessions provide information on the new TDI-DWC pharmacy closed formulary rules, adopted in December 2010 for both certified workers compensation network (network) and non-network claims with dates of injury on or after Sept. 1, 2011. The sessions will provide information on the definition and application of both the open and closed formularies.(WCxKit)

For more details, visit the TDI-DWC Events and Training Calendar on the TDI website at www.tdi.texas.gov/wc/events/index.html.

  1.  Abilene  Nov. 10, 2011
  2.  Amarillo Oct. 25, 2011
  3.  Austin  Oct. 20, 2011
  4.  Beaumont Nov. 17, 2011
  5.  Bryan  Nov. 30, 2011
  6.  Corpus Christi Nov. 3, 2011
  7.  Dallas*  Nov. 8, 2011
  8.  El Paso  Oct. 18, 2011
  9.  Houston** Nov. 15, 2011
  10.  Laredo  Nov. 3, 2011
  11.  Lubbock Oct. 25, 2011
  12.  Lufkin  Nov. 17, 2011
  13.  Midland Nov. 10, 2011
  14.  San Angelo Nov. 10, 2011
  15.  San Antonio Oct. 27, 2011
  16.  Tyler  Nove. 30, 2011
  17.  Waco  Nov. 30, 2011
  18.  Weslaco Oct. 25, 2011
  19.  Wichita Falls Nov. 30, 2011

 

This information was provided by attorney Stuart Colburn, a Shareholder at Downs Stanford in Austin, Texas. Colburn has extensive experience in all phases of dispute resolution before the Texas Department of Insurance, Division of Workers Compensation and in district courts across the state. Stuart represents clients regarding workers compensation, non-subscription, subrogation, and bad faith litigation. He is the founder and the first chairman of the State Bar of Texas (SBOT) Workers Compensation Section; course coordinator for the SBOT the Advanced Workers Compensation Seminar; and course coordinator for the Texas Workers Compensation Forum. He can be reached at:  scolburn@downsstanford.com

 

Our WORKERS COMP BOOK:  www.WCManual.com

 

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

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

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

SUBSCRIBE:  Workers Comp Resource Center Newsletter

 

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

 

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