WCRI Releases Medical Price Index Data for Three States

The Workers Compensation Research Institute (WCRI) recently released medical price index data geared toward thee specific states. Regardless of where you are based, we all can learn from them.
They are:
 
 
In the Virginia study, WCRI found the 2010 price for non-hospital services was nearly 30 percent higher than the median price in states with fee schedules. The original nine-year study, Medical Price Index for Workers’ Compensation, Third Edition (MPI-WC), showed prices grew much faster than the typical growth rate of 11 percent in states with fee schedules.

The study further showed in Wisconsin, their system had the highest prices and fastest growth in their WCRI’s Medical Price Index. “The price for non-hospital services in Wisconsin in 2010 was the highest of the 25 study states, more than twice the prices in the 25-state median, and nearly 50 percent higher than the median of the 6 states with no fee schedules,” the study says.

A WCRI press release indicated, “The prices in Wisconsin increased 42 percent, much faster compared to median growth rate of 11 percent of the states with fee schedules, also faster than the 28 percent typical growth rate of the states without fee schedules.”(WCxKit)


Lastly, the Indiana portion of the larger study indicated the 2010 price for non-hospital services in that state was the third highest of the 25 study states, more than 50 percent higher than typical prices paid in the study states with fee schedule regulation. The nearly 30 percent growth in Indiana was much faster than the typical growth rate of 11 percent in states with fee schedules, according to a WCRI press release.


ABOUT WCRI:
The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Since 1983, WCRI has been a catalyst for significant improvements in workers’ compensation systems around the world with its objective, credible, and high-quality research. WCRI’s members include employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia and New Zealand.
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 website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com. Contact: RShafer@ReduceYourWorkersComp.com.

CLUES TO WORK COMP COST REDUCTION:  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

Jury Awards $212 Million for Botox Brain Injury

A Virginia jury has awarded $212 million to a man who alleged that side effects of Botox led to him to suffering brain damage. 
 
 
According to Bloomberg News, the lawsuit was filed by 67 year-old Douglas Ray, who alleged that he was disabled by permanent brain damage after receiving Botox injections to treat writer’s cramp in his right hand. The complaint accused Allergan Inc., the manufacturer, of failing to warn about the risk of brain damage from Botox triggering an autoimmune reaction. (WCxKit)
 
 
In late April, a jury in the U.S. District Court for the Eastern District of Virginia in Richmond awarded Ray $12 million in compensatory damages and $200 million in punitive damages. However, Virginia tort reform laws will reportedly cap the punitive damages award at $350,000.
 
 
Botox, which includes limited quantities of the bacteria associated with the development of botulism poisoning, is approved for both cosmetic use to reduce the appearance of wrinkles in the skin and to treat medical conditions such as strabismus (crossed eyes), hyperhidrosis (excess sweating), cervical dystonia (involuntary contractions of the neck muscles) and blepharospasms (involuntary blinking of the eye). However, it also commonly used off-label at high doses to treat stiff and jerky movements associated with cerebral palsy in children.
 
 
A number of Botox problems have been reported among users, where the medication can spread from the area of the injection to other parts of the body. This can result in symptoms of botulism poisoning, such as paralysis, difficulty swallowing, respiratory distress and other issues. These Botox side effects have most commonly been seen among children with cerebral palsy, where the typical Botox dose is substantially larger.
 
 
In October 2010, Allergan pled guilty to charges of illegally marketing Botox and agreed to pay $600 million to settle the charges. (open-ended)
 
 
According to allegations raised in the lawsuit over Botox marketing, the company went as far as training doctors how to bill for unapproved uses and created a Botox Reimbursement Hotline to help doctors get reimbursed for using Botox in ways that have not been sanctioned by the FDA.
 
 
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 or 860-553-6604.

 
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.

Virgina Workers Compensation Basics 101

 ThisTh Workers Compensation Laws change frequently. This is only a summary; a complete copy of the most up-to-date version can be found at: www.WorkCompResearch.com an excellent service.  http://workcompresearch.com/  
 
 
In Virginia, every employer who has three or more employees, whether full-time or part-time, is required to carry workers compensation insurance. Virginia's Workers' Compensation Act includes family members working for the employer, apprentices, minors and illegal immigrants as employees. There are some exceptions – worker compensation coverage is elective for partners, sole providers, and corporate officers. Workers compensation coverage does not apply to independent contractors (including real estate agents), casual workers, domestic workers, and farm workers (unless the employer regularly has three or more employees). Employers with one or two employees may voluntarily obtain workers compensation insurance.
 
 
Obtaining Coverage:
To obtain workers compensation coverage in Virginia, the employer has four options which are:
 
1.      Purchasing a workers compensation insurance policy from an insurance company licensed to do business in Virginia.
 
2.      Obtaining approval from the Virginia's Workers' Compensation Commission to act as an independent self-insurer.
 
3.      Joining a group self-insurance association licensed by the Virginia State Corporation Commission.
 
4.      Having an agreement with a professional employer organization as provided by Virginia statute. (WCxKit)
 
Workers compensation insurance can be purchased at: http://www.workerscompensation.com/insurance/ins_info.php
 
 
Claim Reporting:
The employee must report the injury to the employer in writing within 30 days of the injury and the employee must report the injury to the Virginia Workers Compensation Commission within two years of the occurrence. The employer upon learning of the accident is required to report the workers compensation claim to the insurer within ten days using the Employer's Accident Report (VWC Form No. 3). The insurer then must send in the report of the accident to the Virginia Workers Compensation Commission.
 
 
Medical Benefits:
The employer must provide a panel of at least 3 doctors, who are not affiliated with each other, for the employee to select from. If the employer fails to post a panel of doctor's for the employee to chose from, the employee is allowed to select his own doctor. In an emergency situation, the employee may be treated at any emergency care facility or the emergency room of a hospital. After the initial emergency care, the employee is must select from the employer's panel of medical providers. Once the employee has chosen a doctor from the panel, the doctor can not be changed without the insurance company's approval, unless the Workers' Compensation Commission orders a change of medical providers.
 
 
All medical expenses are covered under Virginia's workers compensation statutes for as long as the employee needs medical care, provided the claim was filed timely. There is no medical fee schedule in Virginia. The initial panel doctor can refer the employee to other medical providers. If the employee does not cooperate with the medical care, indemnity benefits can be suspended.
 
 
Temporary Total Disability Benefits:
The temporary total disability (TTD) benefits are calculated as two-thirds of the employee's average weekly wage. The maximum amount of TTD benefits that can be paid weekly is changed each July 1. There is an automatic cost of living increase on Oct. 1 each year, if the accident occurred prior to July 1of the same year. The maximum TTD benefits per week for injuries is $895 per week. The state minimum weekly benefit is $223.75.
 
The first 7 days of disability (the waiting period) is not paid to the injured employee unless the employee is disabled for more than 21 days. TTD benefits can be paid for a maximum of 500 weeks.
 
Temporary Partial Disability Benefits:
In Virginia, if the employee is able to return to any type of work, but at a lesser rate of pay then the amount the employee was earning prior to the injury, the employee is entitled to temporary partial disability (TPD) benefits. The TPD benefits are paid at two-thirds of the difference between the pre-injury wage and the post-injury wage. The TPD benefits are paid for up to 500 weeks from the date of injury. The TPD benefits plus the post-injury pay rate can not exceed the state's maximum indemnity benefits rate for TTD.
 
Permanent Partial Disability Benefits:
Virginia employees are paid permanent partial disability (PPD) benefits for any permanent disability suffered as the result of an on-the-job injury. Once the employee has reached maximum medical improvement, the employee can be paid PPD, even if back at work.
 
Virginia uses a schedule of injuries for arms, legs, hands, feet, fingers, toes, vision, hearing and severely marked disfigurement of the body. The loss of an arm is worth 200 weeks of indemnity benefits (with a week calculated the same as TTD). For example, if the treating doctor gives the employee a 10 percent disability rating to the arm, and the employee's TTD rate was $600 per week, the employee will receive $12,000 ($600 X 200 X 10%).
 
Injuries to the back and internal organs are not scheduled injuries. When a Virginia employee has a back injury, he or she will continue to collect TTD benefits, up to 500 weeks or until he or she is able to return to work.
 
Permanent Total Disability Benefits:
Virginia permits the employee to collect a maximum of 500 weeks of indemnity benefits for all types of indemnity combined, unless the employee is classified as being permanent and total disabled which is defined as:
 
1.      Paralyzed.
 
2.      Loss of both arms, hands, legs, feet, eyes or any two in the same accident.
 
3.      Severe brain injury that is so severe as to render the employee permanently unemployable.
 
4.      If the employee's injury is designated as a permanent and total disability, the employee can draw indemnity benefits for life.
 
Death Benefits:
The burial expenses in Virginia are covered for a work-related death up to $10,000. The death benefits for a dependent spouse and children follow the same guidelines as TTD benefits – two-thirds of the average weekly wage – currently a maximum of $895 per week, up to a maximum of 500 weeks. The minimum death benefit is 25 percent of the state maximum benefit or the actual wage if less. Spouses who have not been voluntarily deserted or abandoned at the time of the accident, children under the age of 18, children under the age of 23 enrolled full time in an accredited educational institution, any child regardless of age if physically or mentally incapacitated, and parents who are in destitute circumstances, can receive the death benefits.
 
 
Vocational Benefits:
Virginia workers compensation law also includes vocational rehabilitation. If the employee cannot return to the prior employment / job, the insurance company is required to pay all reasonable expenses incurred by the employee in his vocational retraining. If the employee is released to light duty work, the employee must prove that he or she is actively looking for a new job within their limitations, or benefits can be suspended. The employee is required to accept any suitable position offered. (WCxKit)
 
 
NOTE:  State laws change frequently. Nothing in this article is meant as legal guidance. For legal advice on a particular state's most current law, please consult with you legal advisor. To purchase the most up-to-date laws, go to: http://workcompresearch.com/


Author Rebecca Shafer
, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing.  See www.LowerWC.com for more information. Contact:  RShafer@ReduceYourWorkersComp.com or 860-553-6604.

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

©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.

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