Understanding Federal Workers’ Compensation Claims

Federal workers’ compensation claims are a growing area of business for many third party administration companies.  With this growth comes an opportunity for team members to learn a new line of work and enhance the services they provide.

 

 

Quick Background on Federal Work Comp

 

The federal workers’ compensation system was established in the early 1900s to deal with work-related injuries sustained by federal employees.  This program is administered under the Federal Employees Workers’ Compensation Act, and covers all federal government disability insurance in the United States.

 

Like state-based workers’ compensation programs, this law covers a variety of indemnity and medical benefits.  Federal workers with compensable injuries in the workplace are also entitled to various vocational rehabilitation benefits.

 

 

 

How the Federal Workers’ Compensation Operates

 

The federal workers’ compensation program is the responsibility of the Office of Workers’ Compensation Programs (OWCP) within the United States Department of Labor.  This office administers the benefits federal workers are entitled to if they claim to or have in fact sustained a compensable workplace injury.  Other groups of federal workers’ compensation programs include the following:

 

  • Energy Employees Occupational Illness Compensation Program;
  • Federal Employees’ Compensation Program;
  • Longshore and Harbor Workers’ Compensation Program; and
  • Black Lung Benefits Program.

 

 

Understanding Federal Workers’ Compensation Benefits

 

Injured workers under the above programs are entitled to various benefits that are often found in state workers’ compensation programs.  The difference lies in the determination and payment lengths of these benefits.

 

  • Continuation of Pay or “COP” is defined under 20 C.F.R. §10.200 and serves as an injured workers wage loss benefits. For most federal work injuries, the injured party is entitled to 100% of their regular pay for a period no longer than 45 calendar days as long as the person is disabled.  This percentage is then reduced and the employee continues to receive either total or partial disability benefits until they are reassigned or fully return to work.  Unlike their state counterparts, COP is considered “compensation” and therefore taxable under the Internal Revenue Code.  It is also subject to retirement and other deductions.

 

  • Medical Benefits. Under the federal workers’ compensation scheme, an injured work is entitled to choose the primary doctor of their choice without objection. The ability to change doctors is limited for subsequent changes.  The workers’ compensation plan pays for all reasonable and necessary medical treatment provided it is causally related to the work injury.

 

  • Vocational Rehabilitation. Injured workers under the federal framework are also expected to make efforts to either return to their pre-injury work, or accept a comparable assignment within their work restrictions.  Issues regarding return to work can include assignments to a different work shift or other differentiating characteristics.

 

There are also various other factors to consider when dealing with federal workers’ compensation benefits.  These factors include the pay grade of an employee, length of service within the federal government and the nature of their work.

 

 

Other Factors to Consider

 

Dealing with federal workers’ compensation matters presents additional issues for parties involved in these cases.  This includes strict limitations on the ability of employees to have their benefits discounted or terminated.  The use of other traditional methods of cost containment such as utilization review and independent medical examinations is also limited based on statute and practice.  If one is not familiar with these practices, it is important to consult an expert or attorney.

 

 

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

 

 

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

 

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

 

D-Day and Workers Compensation Claims

This past Friday, June 6th marked the 70th anniversary of the D-Day landings. Justifiably, the focus of attention was on the hundreds of thousands of service personnel who participated. What is rarely discussed are the hundreds of thousands of civilian employees participating in or near the combat areas and sustaining many casualties resulting in death or injury.

 
Civilian Casualties Were Not Considered Compensable Prior to Defense Based Act

 

Prior to, and in the early days of, WWII, civilian casualties during war, or by terrorists were not considered compensable as workplace injuries because of the exclusion from insurance contracts for acts of the “common enemy”. That was, in the US, largely rectified by the Defense Base Act, enacted on 8/16/41, which gave broad federal workers comp coverage to workers, overseas and otherwise, who were working under a defense contract. That would also include Red Cross workers and USO entertainers (think Bob Hope and his troupe).

 

 

Higher Percentage of Civilian Merchant Marines Killed Than Marine Corps

 

The Merchant Marine, however, fell through the cracks. Although a greater percentage of mariners were killed than those in the Marine Corps (3.9% and 2.94%, respectively) the merchant mariners were not given veteran status until 1988. Since they were paid civilian wages, far higher than the military, and had the right to refuse a voyage that they considered too dangerous, they were considered “civilians”. But the Jones Act, under which they were covered, was only for negligence on the part of the ship owners and the Defense Base Act did not cover them.

 

Civilians could also be found serving in unlikely places. One of the aircraft carriers in the Battle of Midway had to be sent while its repairs were not yet completed from the Battle of the Coral Sea. As a result, civilian workers were kept aboard and were still completing repairs as the ship sailed into battle.

 

Red Cross workers do not appear to have been disembarked during D-Day but they were surely aboard the ships already at sea for the follow up landings.

 

Reading work comp court decisions during and after WWII, one is struck by the nearly complete silence on the war, almost as if it hadn’t happened. That can be due to the fact that injuries in the combat zone had few ways in which they could NOT be compensable and therefore didn’t make it into court decisions. In addition, there was a war-time culture that simply would not deny a trivial compensation claim in an environment of extreme sacrifice being the common experience.

 

 

Courts Should Not Be Blind To What Is Obvious To All

 

For this author, the Defense Base Act was his first comp appeal victory, while still a law student. The plaintiff was driven into extreme stress reactions, physical and mental, while serving as the construction foreman in the desert in the Horn of Africa in 1970. Every night, bandits raided his base, stealing the supplies. The work was supervised by the US Army Corps of Engineers but the contract was issued as a foreign aid agricultural assistance program. The base was a listening post for oil tankers entering and leaving the Red Sea.

 

The court agreed with the law student and quoted Justice Oliver Wendell Holmes that “Courts should not be blind to what is obvious to all.”

 

To all those in the landings of June 6, 1944…………THANKS!!

 

 

Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100. medsearch7@optonline.net

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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

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

WC GROUP:  http://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, attorney, or qualified professional.

Know Your Federal Acts in Workers Compensation: ADA, ERISA, FMLA

The various aspects of hiring, accommodating, providing modified duty in the case of workers’ compensation and firing an employee with a disability can be tricky. But being informed and communicating policies clearly takes the mystery out of managing disabled workers and those who may become disabled following a work-related injury.

 

 

Americans with Disabilities Act (ADA)

 

Title I of the Americans with Disabilities Act of 1990 prohibits private employers, state and local governments, employment agencies and labor unions from discriminating against qualified individuals with disabilities in job application procedures, hiring, firing, advancement, compensation, job training and other terms, conditions, and privileges of employment. The ADA covers employers with 15 or more employees. It also applies to employment agencies and labor organizations.

 

Disability discrimination occurs:

 

  • when an employer treats a qualified individual with a disability who is an employee or applicant unfavorably because of the disability
  • when an employer treats an applicant or employee less favorably because of a history of a disability
  • or because the employee is believed to have a physical or mental impairment that is not transitory (lasting or expected to last six months or less) and minor (even if the employee does not have such an impairment)
  • when an employer treats an employee differently because of the employee’s relationship with a person with a disability (even though the employee is not disabled)

 

The law requires an employer to provide reasonable accommodation to an employee or job applicant with a disability to perform the “essential functions of the job”, unless doing so would cause “undue hardship.” Undue hardship means a significant difficulty or expense for the employer when considered in light of factors such as the employer’s size, financial resources and the nature and structure of its operation.

 

Reasonable accommodations may include things like:

 

  • making existing facilities used by employees readily accessible to and usable
  • job restructuring
  • modifying work schedules,
  • reassignment to a vacant position
  • acquiring or modifying equipment or devices,
  • adjusting or modifying examinations, training materials, or policies,
  • providing qualified readers or interpreters

 

 

 

Employee Retirement Income Security Act (ERISA)

 

ERISA is administered by the Employee Benefits Security Administration (EBSA). The provisions of Title I of ERISA cover most private sector employee benefit plans. ERISA grants employees several protections such as the right to receive information about their pension or health benefit plans, to participate in timely and fair processes for benefit claims, to elect to temporarily continue group health coverage after losing coverage, to receive certificates verifying health coverage under a plan and to recover benefits due under the plan.

 

Consolidated Omnibus Budget Reconciliation Act (COBRA)

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) includes provisions for continuing health care coverage. These provisions are in Part 6 of Title I of ERISA. They apply to group health plans of employers with 20 or more employees. COBRA gives certain former employees, retirees, spouses, former spouses and dependent children (“qualified beneficiaries”) the right to temporary continuation of health coverage at group rates. This coverage, however, is only available when coverage is lost due to certain specific events (“qualifying events”) such as termination of employment. Group health coverage for COBRA participants is usually more expensive than health coverage for active employees because usually the employer pays a part of the premium for active employees while COBRA participants generally pay the entire premium themselves. Plans must give covered individuals an initial general notice informing them of their rights under COBRA and describing the law.

 

Health Insurance Portability and Accountability Act of 1996 (HIPAA)

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) amended ERISA to provide for improved portability and continuity of health coverage connected with employment. These provisions include rules relating to exclusions of preexisting conditions, special enrollment rights and prohibition of discrimination against individuals based on health status-related factors.

 

 

Family and Medical Leave Act (FMLA)

 

The FMLA is administered by the Wage and Hour Division of the Department of Labor (DOL). The FMLA requires employers that have 50 or more employees to give up to 12 weeks of unpaid, job-protected leave to eligible employees for the birth or adoption of a child or for the serious illness of the employee or a spouse, child or parent. Employers need to be aware of a possible obligation to extend FMLA benefits if an injured worker does not want to participate in the company’s transitional duty (TD) program. On March 8, 2013 statutory amendments to the FMLA involving military families and airline crew became effective.

 

The DOL has an interactive FMLA Advisor tool to help employees and employers understand their rights and responsibilities under the FMLA. The FMLA Advisor can help identify which employers are covered by the law, which employees are eligible for FMLA leave, what entitlements and benefits are provided under the law, and in what situations FMLA leave may be used. http://www.dol.gov/elaws/fmla.htm.

 

It’s important to coordinate your transitional duty (TD), light duty and modified duty policies with ADA and FMLA requirements. Disability and employment laws vary from state to state. Make sure your legal counsel and insurer review all policies and procedures you use for workers’ compensation.

 

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact:RShafer@ReduceYourWorkersComp.com.
Editor Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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

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

WC GROUP:  http://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, attorney, or qualified professional.

 

Maritime Workers, The Jones Act, And Workers Compensation Explained

The Jones Act  

Sailors are covered under the Jones Act. This is a very complex set of maritime laws governing how sailors and many maritime workers get compensated for injuries occurring while serving on vessels at sea.  Originally enacted in 1920 as the Merchant Marine Act, it is known for Senator Wesley Jones, who sponsored it. The law enacted protection to sailors similar to that already in place for railroad workers under the Federal Employment Liability Act (FELA). The law is found at 46 U.S. Code Chapter 18 §688. The new Jones Act was passed by Congress and signed into law in 2006.

The Jones Act is not workers’ compensation, although they are often confused.  Neither is it the same as the Longshore and Harbor Workers’ Compensation Act (LHWCA).

 

Who Qualifies?

The Jones Act generally applies to seamen “permanently assigned” to a vessel. This means that maritime workers must not spend less than 30 percent of their time in the service of a vessel on navigable waters. If so, they are presumed not to be a seaman under the Jones Act.

The Jones Act also covers the dependents of seamen whose death comes from a covered injury. The dependents can bring a wrongful death suit under the Jones Act for the loss of income that was supporting them prior to the seaman’s death.

Maritime workers who do not qualify may be covered under the Longshore and Harbor Workers’ Compensation Act, which provides workers’ compensation to specified employees of private maritime employers who are injured on navigable waters. Navigable waters include places on land that adjoin the water such as docks, piers and places near them like loading and ship building areas.

 

What Is the Court Process?

An action under the Jones Act may be brought either in a U.S. federal court or in a state court.  The seaman is entitled to a jury trial, a right which is not usually afforded in maritime law.

 

How Are Maritime Workers Compensated?

Maritime workers are compensated for work related injuries due to negligence of the ship owner, captain or crew members. They can also bring actions against ship owners for the vessel being unseaworthy. A vessel does not have to be in danger of sinking to be found unseaworthy. Only seamen under the Jones Act can bring a claim of unseaworthiness, not maritime workers covered under the LHWCA. In addition, seamen can bring an action against their employer for a lack of medical care. This is important because a vessel may be a long way from medical care when out at sea.

Benefits are paid for the actual injury and time off work, medical bills, occupational therapy, pain and suffering. Thus the Jones Act provides compensation for both economic and non-economic losses both past and future. Compensation is often higher than “normal” workers’ compensation benefits.

Maritime workers are entitled to “maintenance and cure,” even if they are not covered as seamen by the Jones Act. Maintenance is a daily allowance to replace the wages the maritime worker would have received but for the injury. Cure is the employer’s obligation to provide all necessary medical care, including hospitalization and rehabilitation services. It is possible for seamen to recover under the Jones Act in addition to maintenance and cure.

 

Seek Legal Advice

Before filing a claim several important things must be considered.  Is it a claim for The Jones Act or Longshore and Harbor Workers’ Compensation Act?  There are in excess of 25 different worker categories covered by the Jones Act.  Determining where a worker fits under this very complex and changing maritime law is really the job for a qualified maritime attorney.  Benefits, time and money may be lost if filing mistakes are made.

 

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.

 

©2013 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 


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

Why Workers Comp Laws Are State, Not Federal

 

Current Debate Regarding Single Federal Work Comp Law

 

There currently is a debate in progress regarding the benefits of eliminating state laws and replacing them with a single federal law. However, no one seems to be discussing why comp laws began as state laws and have remained so. Even the federal government has retained non-uniform laws under those areas it controls.

 

There is not one single federal comp law. There is one for federal employees, one for harbor workers, one for residents of the District of Columbia, one for employees of the District of Columbia, and one for each territory, possession or commonwealth of the United States. The federal government could easily consolidate those laws which it adjudicates, but never has done so.

 

 

Eliminate Different Workers Comp Rates

 

One of the arguments in favor of federalization is the elimination of different comp rates. However, the maximum federal employee weekly comp rate is approximately $1436/wk, with annual cost of living increases. That would NOT come down with federalization, and few, if any, states could survive such increases in comp rates.  (The federal government is able to tolerate such rates because of its draconian adjudication procedures, which no union would tolerate in a state system. Most work comp attorneys have handled one federal comp claim – few have handled two.)

 

 

 

Laws Are State For Local Economic & Political Advantages

 

But why did comp laws start, and remain, as state laws? They started as state laws in the first decade of the 20th century because the needs of comp system were drastically different from state to state. New York’s first law only covered heavy factory and construction work. States in the west often excluded farm and ranch work. Each state was drafting its law to conform to economic reality. New York could not afford to have the families of the seriously disabled on public assistance. Wyoming could not risk bankrupting ranches and farms with comp premiums. (People who owned ranches and farms, at the time, often went through periods of what can only be called medically dangerous malnutrition.)

 

The reasons that comp laws remained state laws are for local economic and political advantages. Insurance laws are generally regulated by states, not the federal government. No governor has EVER willingly lessened that economic control, perhaps the largest control of state financial resources available to a governor.

 

In addition, state comp laws have built in advantages for union negotiations on a yearly basis in the state legislatures.

 

 

Opposition from Unions and Insurance Companies to Federalize

 

When national health care was proposed in 1993, there was a tiny period of time where it was suggested that federal health care eliminate the health care provisions of work comp. Persons on the health care task force, mostly academics, were stunned to see that the opposition to federalizing comp came from unions as much as insurance companies.

 

Other nations with comp laws based on the initial British system, Canada and Australia, have also retained laws by province and territory instead of having one national law.

 

Prognosis for the future? More of the same.

 

 

Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100. medsearch7@optonline.net

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 


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

Changes to FECA Reflected at this Year’s Federal Workers’ Compensation Conference

 


 
Senate & House Pass Legislation For First Changes in Almost 40 Years
 
Unlike the laws for state workers’ compensation programs, which have changed, often significantly, over the past several years, the law governing workers’ compensation for civilian Federal employees – including the U.S. Postal Service – has not seen substantial change in almost 40 years. Amid signs that this status quo may be changing – both the Senate and the House have passed separate legislation in this Congress that would amend the Federal Employees’ Compensation Act (FECA).
 
Tighter Budgets Require Changes
 
In 2012, FECA benefits paid to injured employees, their surviving dependents, and their medical providers topped $3 billion for the first time. Those costs are billed to Federal agencies by the U.S. Department of Labor, and Federal agencies must include these bills in their annual appropriation. In an era of tighter budgets, personnel looking for ways to manage those costs will be attending Conference sessions at the 14th Annual Federal Workers’ Compensation Conference that address topics such as: challenging questionable claims, managing complex cases, and offering suitable light or limited duty positions. Speakers at this Conference, who include officials from the Department of Labor and various Federal agencies, as well as physicians and managed care specialists, are subject matter experts on different aspects of case management. In all, 47 separate courses on Federal workers’ compensation management, plus another 19 on Federal occupational safety and health, will be held at this Conference. 
 
Underlying the Conference is speculation that FECA may be amended. The House passed legislation (H.R. 2465) in November of 2011 that would make minor changes in FECA, but the Senate passed legislation in April of 2012 (S. 1789) that would, as part of Postal Service reform, make some significant changes in the benefit rates paid under FECA, including lower rates for retirement-age workers and government-wide application of a 3-day waiting period that currently only applies to Postal Service employees. The fact that the 2012 elections are less than 4 months away leads some to believe that the chances for passage are slim, yet it is remembered that the last major changes in FECA were enacted in September of 1974 – two months before Congressional elections. It is also clear, given such evidence as a Presidential memorandum on Federal injury compensation in July of 2010, the Congressional legislation noted above, and increased attention by the Government Accountability Office which has issued two reports on FECA in the past year, that renewed attention is being focused on this program. Even if no legislation is enacted, however, the FECA program is rapidly evolving; within the past year alone, new regulations became effective, automated document submission began for both employees and employers, and additional fee schedules for medical services were put in place.   The Atlanta Conference will include sessions on several of these recent changes.
 
Atlanta Conference to Include Sessions on Changes
 
The 14th Annual Federal Workers’ Compensation Conference will take place from July 24 – July 27 in Atlanta, GA. For more information please visit http://www.wcconf.org/
 
 
Author Ralph G. Slighter is the Deputy Division Chief of the Injury Compensation and Unemployment Compensation Division (ICUC) for the Department of Defense. He will present at a variety of sessions at the Federal Workers’ Compensation Conference including, “Trends in Society and the Future of Federal Employees Compensation.” For more information on the sessions that Ralph Slighter will be teaching please refer to the conference schedule http://www.wcconf.org/sites/default/files/pdf/program.pdf .

The Best Tidbits of News from the Workers Comp World

Here are the best Tidbits of news from the Workers Comp world this week:

 

Broadspire® Donates $100,000 to the SOS Children's Village


Broadspire, a Crawford Company and leading third party administrator of workers compensation claims, liability claims and medical management services, recently raised $100,000 for the SOS Children’s Village – Florida during its 2012 Charity Golf Tournament. The second annual event, sponsored by 36 of Broadspire’s vendor partners, had record attendance, with 104 golfers enjoying a beautiful day on the course at the Diplomat Resort and Spa in Hollywood, Fla.  Read More…

 

Medcor Client Hosts 112th U.S. Open Golf Tournament

Medcor congratulates its triage client, The Olympic Club, on hosting the 112th U.S. Open Golf Tournament, which took part this weekend in San Francisco.  As they took care of the tournament, Medcor triage nurses were on standby to take care of their employees!  The Olympic Club is the oldest athletic club in the United States and has hosted many local, regional, national and even international championships.Read More…

 

14th Annual Federal Workers Compensation Conference – July 25 – 27th, Atlanta, Georgia

The 2012 14th Annual Federal Workers' Compensation Conference brings together professionals from multiple Federal departments and agencies, including the Department of Veterans Affairs, United States Postal Service, Department of Homeland Security (TSA), Federal Bureau of Prisons, Department of Defense, Social Security Administration and the National Park Service, to name a few.  Read More…

 

Self-Insurance Institute of America, Inc. (SIIA) Schedules Series of Webinars 

The Self-Insurance Institute of America, Inc. (SIIA) has scheduled a series of webinars to update its members on current legislative/regulatory developments related to stop-loss insurance and discuss the association’s response strategy. Participants will also learn how they can support SIIA’s efforts. Read More…

 

News From Lexis Nexis.  

Quoted from weekly Lexis Nexis Newsletter published by Robin E. Kobayashi, JD, Lexis Nexis Legal & Professional Operations,  robin.e.kobayashi@lexisnexis.com



THE GREAT COMPROMISE

Stahl, JohnMany Work-related Disabilities Go Uncompensated: Compromising "The Great Compromise", by John Stahl, Esq. Evidence that many workers' compensation claimants have not received payments under "The Great Compromise" – the bargain that traded the right to sue employers regarding employment-related harm for the right to timely and appropriate benefits – has prompted calls for reform. An article written by Emily A. Spieler and John F. Burton, Jr. in the June 2012 American Journal of Industrial Medicine analyzed this situation.  Read More…



LARSON'S SPOTLIGHT: TORT ACTION

Tom Robinson thumbnail

Survivors of Deceased Employee Allowed to Bring Tort Action Against Uninsured Employer, by Thomas A. Robinson. In a 4-3 decision, the Supreme Court of Missouri recently reversed the decision of a state trial court that had held a workers' compensation award against a statutory employer barred a wrongful death claim against the deceased employee's uninsured employer. Finding that deceased employee's survivors had not made an election of remedies when they obtained the workers' compensation award against the statutory employer, the majority of the state high court held that the plain language of Mo. Rev. Stat. § 287.280.1 allowed…Read more about this case and other cases involving Illegal Aliens, Benefits for Old Workers, and Non-Dependent Spouse.



STUART COLBURN TO SPEAK AT NATIONAL WORKERS' COMP CONFERENCE

LexisNexis has partnered with the National Workers' Compensation Conference to create an enhanced legal track for attorneys and other workers' comp professionals.Stuart Colburn ColorLexisNexis author Stuart Colburn will be speaking on several panels, includingCausation, Misclassification, and the New Mobile Workforce. View the program agenda. Overall, there are 15 members of the Larson's National Workers' Compensation Advisory Board speaking at this event. You don't want to miss this conference! Take advantage of the special discount for all LexisNexis Workers' Compensation Law Community members. Community membership is free at our site.




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.

$39 Million in Illness Compensation Further Clarified

The U.S. Department of Labor said recently it is notifying former Weldon Spring Plant workers in Weldon Spring, Mo., of a change in the status of their work site in connection with the Energy Employees Occupational Illness Compensation Program Act.

 

The department’s Office of Workers Compensation Programs has published a revised list of EEOICPA-covered U.S. Department of Energy facilities in the Federal Register. This update divides the Weldon Spring Plant site into three separate facilities: the Weldon Spring Plant, the Weldon Spring Caffeinate Pits and the Weldon Spring Quarry. [WCx]

 

By dividing the Weldon Spring Plant into three separate DOE facilities, OWCP will be better able to distinguish between the different operational periods of these locations and more reliably obtain employment verification from the many different contractors that performed work at each location.

 

Former Weldon Spring Plant employees may be eligible for EEOICPA compensation and medical benefits if they were diagnosed with a covered illness and worked at one of the three facilities during a period of covered employment.

 

The Labor Department administers Part B of the EEOICPA. Part B covers current and former workers diagnosed with cancer, beryllium disease or silicosis caused by exposure to radiation, beryllium or silica while working directly for the DOE, that department’s contractors or subcontractors, a designated Atomic Weapons Employer or a beryllium vendor. Part E, created by an amendment to the EEOICPA on Oct. 28, 2004, provides federal compensation and medical benefits to DOE contractors and subcontractors who worked at covered facilities and sustained an illness as a result of exposure to toxic substances.[WCx]

 

To date, the department has paid more than $39 million in EEOICPA compensation and medical benefits to 354 Weldon Spring Plant workers and more than $7.9 billion nationwide.

 

For additional information or for claim-filing assistance, individuals can contact the department’s Paducah Resource Center in Kentucky toll-free at 866-534-0599.  See also article on  The Employee Energy Occupational Illness Compensation Program 

 

 

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.

 

Chemical Safety Board Develops New Employee Participation Investigation Policy

 

The U.S. Chemical Safety Board (CSB) reported that it has developed a new policy on employee participation in investigations that the Board hopes will enhance the vital role played by plant workers in determining root causes of incidents and promoting facility safety.
 
 
The policy, which was approved by a unanimous 3-0 vote of the Board earlier this year, follows a roundtable involving accident victims, family members, and worker representatives convened by the CSB. [WCx]
 
 
The new policy implements a key provision of the CSB enabling statute at 42 U.S.C. § 7412(r)(6)(L), which provides that employees and their representatives have similar rights in CSB accident investigations as they do during OSHA inspections under the Occupational Safety and Health Act of 1970.
 
 
The 10 key elements of the new policy include
 
 
  • If the CSB initiates an investigation at a union-represented site, the CSB will promptly identify and notify facility unions of its plans to investigate. At non-union sites, the CSB will seek to identify other employee representatives, such as employee members of any established Health and Safety Committee, or other employee representatives, if possible
  • The CSB will seek participation by contract employees and their representatives, similar to facility employees.
  • The CSB will establish direct, face-to-face communications with employee representatives from the outset of its investigations.
  • The CSB will take measures to avoid interference by any party with the proper exercise of employee participation.
  • CSB investigators will allow and encourage employee representatives to accompany the CSB team during site inspections and tours. Such participation is often critical for understanding complex processes and learning of important safety concerns and hazards.
  • Where necessary to obtain information, CSB investigators will conduct separate meetings with employee representatives.
  • During CSB interviews, any non-supervisory employee may be accompanied by another non-supervisory employee, a personal attorney, or a family member as described in 40 CFR 1610.
  • The CSB will provide employee representatives with the opportunity to review and comment upon evidence and equipment testing protocols and to observe testing, similar to the opportunities for companies and other parties. Employee representatives will also have access to any test results, to an extent equivalent to other parties.
  • The CSB will provide employee representatives with the opportunity to review and comment on the factual accuracy of CSB reports, recommendations, and interim statements of findings prior to public release, to a degree equivalent to any opportunities provided to company representatives.
  • The CSB will monitor the implementation of the policy to ensure that participation by facility employees and representatives in CSB investigations does not result in prohibited whistleblower retaliation under 42 USC § 7622. Documented instances of retaliation will be referred to appropriate federal enforcement agencies.
The CSB is an independent federal agency charged with investigating serious chemical accidents. The agency’s board members are appointed by the president and confirmed by the Senate. CSB investigations look into all aspects of chemical accidents, including physical causes such as equipment failure as well as inadequacies in regulations, industry standards, and safety management systems. [WCx]
 
 
The Board does not issue citations or fines but does make safety recommendations to plants, industry organizations, labor groups, and regulatory agencies such as OSHA and EPA.
 

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.

MSHA Unveils Numbers from Mine Safety Sweeps

The U.S. Department of Labor's Mine Safety and Health Administration (MSHA) recently announced that federal inspectors issued 253 citations, orders and safeguards during special impact inspections conducted at 12 coal mines and four metal/nonmetal mines last month. The coal mines were issued 171 citations, 15 orders and two safeguards, while the metal/nonmetal operations were issued 64 citations and one order.

 
 
These inspections, which began in force following the explosion at the Upper Big Branch Mine, involve mines that merit increased agency attention and enforcement due to their poor compliance history or particular compliance concerns, including high numbers of violations or closure orders; frequent hazard complaints or hotline calls; plan compliance issues; inadequate workplace examinations; a high number of accidents, injuries or illnesses; fatalities; and adverse conditions such as increased methane liberation, faulty roof conditions and inadequate ventilation. [WCx]
 
 
As an example, an impact inspection was conducted during the second shift at Perry County Coal Corp.'s E4-1 Mine in Perry County, Ky. The inspection team, which captured and monitored the phones to prevent advance notice of its arrival, issued 35 citations and three orders. The mine's last impact inspection resulted in 27 citations and one order.
 
 
 
The mine was issued unwarrantable failure orders for noncompliance with the ventilation plan by failing to maintain a sufficient air volume at the end of the wing curtain when more than 18 inches of rock is being mined. (A wing curtain is a piece of flame-resistant brattice cloth used to direct air current to temporarily ventilate faces, seals or other areas of the mine.) This violation exposed miners to the risk of silicosis, black lung, and a potential explosion.
 
 
 
The mine operator also failed to control draw rock that extended from 32 crosscuts outby to the working face (approximately 2,080 feet), which exposed miners to the risk of being struck, injured or killed by pieces of falling roof. The mine operator further failed to maintain a scoop in permissible condition so that it was not a potential ignition source for explosive gases as well as to conduct an adequate weekly examination of the same scoop.
 
 
 
Inspectors also found that the primary and secondary escape ways, along with required lifelines, were improperly maintained, which could severely hamper miners' efforts to evacuate the mine in the event of an emergency.
 
 
 
As a second example MSHA conducted an impact inspection during the second shift at K and D Mining Inc.'s Mine No. 17 in Harlan County, Ky. The inspection team, which captured and monitored the mine phones, issued 21 citations and seven orders. The last impact inspection conducted at this mine resulted in 14 citations and six orders.
 
 
 
During the most recent visit, inspectors observed eight conditions that were the result of unwarrantable failures by the mine operator. Six involved failure to maintain the conveyer belts in safe operating condition and accumulation of combustible materials along the belt lines. Two belt lines were found to have missing or stuck rollers, causing friction and creating the potential for an ignition. Accumulations of combustible material were found along three belt lines, which are required to be examined at each shift.[WCx]
 
 
 
Two 104(d) withdrawal orders were issued for the mine operator's failure to conduct an adequate exam of the section power center, which was found to be improperly maintained. Inspectors found evidence of severe arcing between receptacles on the power center, as well as on the male plugs of electrical equipment.
 
 
 
The mine operator also failed to comply with the roof control plan, according to inspectors. They observed a hill seam (rock fissure) that was tied in with several stress cracks. Inspectors also said the hill seam and stress cracks extended across the pillar line for a distance of approximately 115 feet. The mine operator had not installed additional support as required by the roof control plan.
 
 
 
"While the impact inspection program has resulted in improved compliance in mines across the country, the seriousness of the violations found at these two operations demonstrates why targeted enforcement continues to be necessary to protect the health and safety of miners," said Joseph Main, assistant secretary of labor for mine safety and health. [WCx]
 
 
 
Since April 2010, MSHA has conducted 403 impact inspections, which have resulted in a total of 7,162 citations, 718 orders, and 26 safeguards.
 
 

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.

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