Texas Archives - Work Comp Roundup

The Best Tidbits of News From the Workers Comp Community

October 26, 2012 by Michael B. Stack Leave a Comment

News From Lexis Nexis:

1) Top 25 Blogs for Workers' Compensation

“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.”

2) Longshore Act Hieroglyphics

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.”

Managed Care Advisors President Works On Partnership for Employment Initiative

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…

The Reputational Risk and IT Relationship

by Emily Holbrook

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.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.

Policyholders Rewarded for Work Comp Cost Containment with 150 Million in Dividends

August 14, 2012 by Michael B. Stack Leave a Comment

Texas Mutual Insurance Company announced that it has begun distributing $150 million in workers compensation dividends among approximately 40,000 qualifying policyholders.

“As a mutual insurance company, our responsibility is to our policyholders,” said Bob Barnes, chairman of Texas Mutual’s board of directors. “They own the company, and this money belongs to them. We are proud to share Texas Mutual’s success with those who have contributed to that success.”

When publicly traded corporations pay dividends, every stockholder gets a dividend based on the shares they own at that time. When Texas Mutual pays dividends, it rewards specific policyholders who focus on controlling workplace accidents and helping injured workers return to the job.

This marks the 14th consecutive year Texas Mutual has paid dividends to qualifying policyholder owners. By the end of 2012, the company will have paid $1.2 billion in dividends. The majority of that total – more than $1 billion – will have been paid since 2005.

Meantime, the company also reported the sentencing of a worker for workers comp fraud.

According to Texas Mutual, a Travis County court recently sentenced Henry Gomez of Lockhart, Texas on workers comp fraud-related charges. Gomez paid $1,155 in restitution to Texas Mutual and was sentenced to seven months’ deferred adjudication.

Gomez reported a job-related injury while working as a truck driver and supervisor for Wims Environmental, Inc. in Garland, Texas. 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 Gomez was working as a sales consultant for another employer while 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. Left unchecked, double-dipping and other workers comp fraud can lead to higher premiums for all Texas employers.

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.

Filed Under: Workers Comp News Tagged With: Incentives for Workers Comp Cost Containment, Texas, Texas Mutual, Workers Comp Cost Containment, Workers Compensation Cost Containment

Large Explosion Injures 3 Workers, Causes $46K in OSHA Fines

June 5, 2012 by Michael B. Stack Leave a Comment

The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) recently cited High Roller Wells Pearsall SWD No. 1 Ltd. for 10 serious safety violations following an explosion and fire that injured three workers at the company's Pearsall, Texas work site.

The company disposes of hydraulic fracturing fluid and employs about 34 workers at the site, which is located at 3155 Spur 581. At the time of the incident, employees were injecting wastewater underground that was left over from hydraulic fracturing and drilling operations.[WCx]

The violations include failing to ensure that workers are provided with fall protection while working on the tops of tanks, ensuring that equipment and electrical wiring are rated for the environment in which they are being used, taking necessary precautions to prevent possible ignition sources such as sparks or static electricity, conducting a workplace hazard assessment to determine the appropriate personal protective equipment needed, ensuring that there is an emergency action plan in place and providing an eyewash station for employees working around acids.

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.

"Employers are responsible for ensuring that employees are provided a workplace free from recognized hazards," said Jeff Funke, the agency's area director in San Antonio. "If OSHA's standards had been followed, it is possible this unfortunate incident could have been avoided."

Proposed penalties total $46,200 following an inspection by OSHA's San Antonio Area Office that was opened earlier this year.[WCx]

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

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.

Filed Under: Safety and Loss Control Tagged With: High Roller Wells Pearsall SWD No. Ltd., Hydraulic fracturing, OSHA, Texas

Texas Man and Maryland Woman Sentenced on Workers Comp Fraud Charges

January 26, 2012 by Robert Elliott, J.D. Leave a Comment

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

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.

Filed Under: Claim Management, Fight Workers Comp Fraud & Abuse, Medical Issues Tagged With: double-dipping, higher premiums, Legal Issues, Medical Issues, Texas, Texas Employers, Texas Mutual, Texas Workers Comp Issues, Workers Comp Fraud

Texas Division of Workers Compensation Approves 14 for Self Insurance

October 9, 2011 by Stuart Colburn Leave a Comment

The 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:

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

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

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

Abilene Nov. 10, 2011
Amarillo Oct. 25, 2011
Austin Oct. 20, 2011
Beaumont Nov. 17, 2011
Bryan Nov. 30, 2011
Corpus Christi Nov. 3, 2011
Dallas* Nov. 8, 2011
El Paso Oct. 18, 2011
Houston** Nov. 15, 2011
Laredo Nov. 3, 2011
Lubbock Oct. 25, 2011
Lufkin Nov. 17, 2011
Midland Nov. 10, 2011
San Angelo Nov. 10, 2011
San Antonio Oct. 27, 2011
Tyler Nove. 30, 2011
Waco Nov. 30, 2011
Weslaco Oct. 25, 2011
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.

Filed Under: Employment Law Issues, Insurance Issues, Rates, Premiums, Monopolistic States Tagged With: Self-Insurance & Workers Comp, TDI-DWC, Texas, Texas Workers Comp Issues

Division of Workers Compensation System Data Report Available Online

August 15, 2011 by Stuart Colburn Leave a Comment

The Texas Department of Insurance, Division of Workers Compensation (TDI-DWC), is now offering workers compensation system data online.

Interactive tools allow users to create customized graphics and download the charts and data from the on-line site.

On the site, users can find:

Workers compensation claims data.
Income and death benefit information.
Dispute resolution.
Medical fee disputes.
Designated doctor appointments.
Medical benefits.

Rod Bordelon, commissioner of workers compensation said, “We are pleased to provide information in an interactive format that allows system participants to more easily access aggregate claims information.”

The report contains information from 2006 through 2010 and eliminates the need for workers comp system participants to submit open records requests for the information.(WCxKit)

It is available for free here.

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.

Filed Under: Assessment & Diagnostics, Benchmarking & FTE & Operational Comparison Tagged With: Department of Insurance, Online reports, TDI-DWC, Texas, Texas Workers Comp Issues

Texas Pharmacy Formulary Webinar Looks at New Rules

August 11, 2011 by Senior Editor Leave a Comment

Texas often leads the nation in workers compensation cost containment and narcotics legislation. The state recently continued their history of reform by adopting a new pharmaceutical formulary that will reduce the amount of money spent on workers compensation medications and improve the overall health of the state's employees. How does it work? What can you do to remain in compliance?

Broadspire is conducting a webinar to provide answers about the new Texas formulary August 23. Speaking on compliance issues was formulary co-creator Ralph Kendall, PharmD., vice president of clinical services at Healthesystems.

Also Jacob Lazarovic, MD, chief medical officer at Broadspire, will discuss the clinical implications of the formulary and Lynn Sergeant, RN, team manager of utilization management at Broadspire, will be discussing how Broadspire is operationally responding to the formulary.

For 4 p.m. Aug. 23, either click the following link or copy and paste it into your Web browser:

https://crawfordandcompany.webex.com/crawfordandcompany/j.php?ED=165476542&UID=1272468757&RT=MiMxMQ%3D%3D(WCxKit)

For help or support go to https://crawfordandcompany.webex.com/crawfordandcompany/mc click “assistance,” then click “help” or “support.”

Our WC Book: http://www.wcmanual.com
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 or agent about workers comp issues.

Filed Under: Coordinating Medical Care, Implementation and Rolling Out Your Program, Insurance Issues, Rates, Premiums Tagged With: closed formulary, Pharmacy Benefit Management, Texas, Work Comp Webinar

The Best Tidbits of News From the Workers Comp Community

Policyholders Rewarded for Work Comp Cost Containment with 150 Million in Dividends

Large Explosion Injures 3 Workers, Causes $46K in OSHA Fines

Texas Man and Maryland Woman Sentenced on Workers Comp Fraud Charges

Texas Division of Workers Compensation Approves 14 for Self Insurance

Division of Workers Compensation System Data Report Available Online

Texas Pharmacy Formulary Webinar Looks at New Rules

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