Pill Mills are a Cost Driver in Workers Compensation Claims

The fastest growing area of workers compensation fraud is narcotics abuse. The fake workers comp claim for the purpose of feeding a drug addiction, or for the purpose of obtaining narcotics for resale, is a fast growing problem.  Employers and claim adjusters should proceed with caution when an employee has been given a narcotic prescription, especially when there has not been a recent surgery.

 
The term “pill mills” has been used by law enforcement to describe medical facilities where the primary purpose of the medical facility is to write prescriptions for painkillers.  The U.S. Drug Enforcement Administration (DEA) has been raiding medical facilities in Florida, Georgia, Ohio and other states with mixed results. They close down one pill mill only to have another one pop up. (WCxKit)
 
 
Pill mills often try to camouflage the activity as pain management clinics. There is however some red flags that distinguish a pill mill operation from a legitimate pain management clinic.  Included below are some characteristics of pill mills.
 
-The physician(s) have little training / background in pain management.
-The facility sees a high volume of patients daily.
-The facility provides scant patient examinations before prescribing narcotics.
-The facility both writes the prescription and fills the prescription.
-The facility writes prescriptions for amounts that exceed the manufacturer’s recommendation for maximum usage.
-The price of the prescription is inflated over what the same dosage would cost at a chain drug store.
-The facility operates on a cash-only basis.
-The patients often travel long distances to the facility, even from out of state.
-The facility is often located near an interstate highway for convenience of patients traveling long distances.
-The facility advertises its “services” on Craigslist or other similar Internet sites.
 
 
The abuse of narcotics has gotten so bad that, per the Associated Press, drug overdose deaths have surpassed traffic accidents as the top cause of accidental death in Ohio, Colorado, Massachusetts, New York, Oregon and 11 other states.  According to the Center for Disease Control, 20,000 people a year die from prescription drug overdose.
 
 
Pill mills like the Greater Medical Advance Clinic in Wheelersburg, Ohio are at the center of this epidemic.  According to the arrest documents, the clinic owner, George Marshall Adkins, wore a handgun in the clinic while dispensing tens of thousands of painkillers at inflated prices.
 
 
Employers in Florida should be especially cautious of prescription drug abuse on the workers compensation claims.  According to Florida state officials, 85% of all oxycodone pills sold in the United States come from Florida, with the top 50 medical prescribers of such drugs being located in Florida.
 
Carlos Gonzales in South Florida was arrested for his black market business of selling narcotics.  Gonzales was not an ordinary street level drug dealer.  He was a doctor operating a “pain management center” with numerous workers compensation patients. He lived in a multi-million dollar home with a Mercedes, a Bentley and a Lamborghini parked in the driveway.  The DEA estimated he was making from $13,000 to $20,000 a week writing thousands of prescriptions.
 
 
There are steps an employer can take to stop workers comp fraud / drug abuse through pill mills.  Among the ways the employer can fight workers comp fraud / drug abuse include
 
 
-Operate a drug free workplace – if the employees knows that drug testing for hiring and random drug testing is performed, the employees inclined to abuse drugs (and to file bogus workers comp claims to obtain drugs) will go somewhere else to work until they pull the workers comp fraud.
 
-Drug screen after each injury – a drug screen on the day of the injury should be a part of the immediate medical treatment.  In many states a failed drug screen can be grounds for the denial of the workers comp claim.  In the states where the workers comp claim cannot be denied due to the failed drug screen, the employer will at least know what the employee’s drugs of choice are.
 
-In the states where the employer is allowed to select the medical provider, be sure to do so.  Check the reputation of the medical provider with local defense counsel to eliminate doctors known for over prescribing medications or known for referring employees to questionable pain management clinics.
 
 
-Whenever pain becomes a significant part of the employee’s complaints following an injury, especially pain without visible trauma, a nurse case manager should be assigned to the claim to prevent narcotics abuse.
 
 
-All prescriptions for the injured employee should be filled through a pharmacy benefit manager (PBM).  Any time the employee is exceeding the manufacturer’s recommended maximum dosage, the PBM can review the requested dosage with the medical provider. (WCxKit)
 
 
By taking the above steps, the employer can significantly reduce the number of bogus workers comp claims for the purpose of obtaining narcotics, either for drug abuse or for resale. 
 
 
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 GUIDEBOOK:  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.
 
©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.

National Insurer Sued under ADA For Failure to Hire Methadone User

The U.S. Equal Employment Opportunity Commission (EEOC) has sued a national insurer claiming the firm violated federal law by refusing to hire a North Carolina man after he disclosed he was participating in a methadone treatment program for drug addiction.
 

The suit was
filed in U.S. District Court in Raleigh against United Insurance Co. of America, according to EEOC attorney Lynette Barnes. (WCxKit)
 
 
The complaint argues the firm violated federal disability discrimination law by refusing to hire Craig Burns, 30, who applied for a job in the firm’s Raleigh office in December of 2009. The firm made a conditional offer of employment to Burns the following month, depending upon his passing a drug test.
 
 
The test showed the presence of methadone in his system, so Burns submitted a letter to the firm from his treatment provider saying he was participating in a supervised methadone treatment program and taking legally prescribed medication as part of the treatment, the complaint said. Upon receiving this information, United Insurance notified Barnes he was not eligible to be hired and withdrew the employment offer.
 
 
According to Barnes, the action violates the Americans with Disabilities Act, which protects employees and applicants from discrimination based on their disabilities. A recovering drug addict is covered under the act. (WCxKit)
 
 
The suit seeks back pay, compensation for financial loss, along with punitive damages.
 
 
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.


WORKERS COMP WORKBOOK:
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.

Toronto Public Transit Workers Subject to Random Drug and Alcohol Tests

Public transit workers in Toronto will in the near future be subject to random drug and alcohol testing as the city's transit service was given permission to start testing employees in safety-sensitive positions, according to a report from the Canadian OH&S News.
 
 
The Toronto Transit Commission (TTC) was pushing for random testing to be added to the Fitness for Duty policy because the current policy, which came into effect in 2010, has been ineffective at deterring workplace intoxication, says Brad Ross, director of public communications for the TTC. (WCxKit)
 
 
The current policy allows for workers in safety-sensitive positions – operators, maintenance staff, supervisors and executives – to be tested for alcohol and marijuana, cocaine, opiates, amphetamines and PCP, using breathalyzers and saliva swabs, when there is a reasonable cause or testing post-incident, post-violation, post-treatment and pre-employment.
 
 
Amalgamated Transit Union Local 113, which represents the majority of TTC workers, is already challenging the present policy, and random testing will be added to the grievance, commented Ian Fellows, the union's lawyer in the grievance litigation.
 
 
"It's an invasion of our members' privacy. It treats everybody as if they've done something wrong and it requires them to submit to an invasive procedure," says Fellows. "They've got to offer up a sample of their bodily fluid and their DNA. That's contrary to our agreement and we say the [Ontario] Human Rights Code and the Charter of Rights."
 
 
While specifics regarding how the program would run have not yet been worked out, Ross notes the TTC would work with a third party to develop a testing protocol and it would be at least a few months before a system would be ready to implement.
 
 
"We need to figure out what percentage of employees we'd need to test on an annual basis, but in theory the way it works is you show up for work and the system tells us it's your turn for random testing," he says.
 
 
The saliva swabs, as opposed to the traditional urinalysis when testing for drugs, only show whether a person was impaired when the swab was taken based on a pass/fail threshold, not if they had used drugs in the past. The swabs would be tested by an outside lab, Ross says. "We're interested in ensuring that when you report for work, you're fit for duty, not what you did two days ago or two weeks ago, for that matter."
 
 
This is not the first time the TTC has tried to introduce random drug and alcohol testing. When it first brought the Fitness for Duty policy to its board of directors in September of 2008, random testing was in the policy, but the board refused to give it the green light. However, the board has changed since the policy was first introduced.
 
 
Ross reports that TTC staff felt the random testing policy was needed and would revisit the proposal at a later date. Ross also dismissed a recent incident, where a TTC bus driver was found with marijuana in his possession after a fatal accident, as the reason for trying to reintroduce random testing.
 
 
"There have been a number of public incidents over the last couple of years that have been cause for great concern, and there have been incidents within the organization that have not been public but are a concern as well," he says.
 
 
The number of incidents involving drugs and alcohol has not decreased since the policy was introduced, Ross added.
 
 
Though the TTC has data comparing the number of incidents from 2006 to 2008 and 2008 to present, they are part of the grievance litigation and are not being released to the public. Hearings began in 2011 and are scheduled throughout 2012.
 
 
Random testing brings the TTC, with its 1.6-million riders a day, more in line with public transit services in the United States, where random testing of all workers in the transportation sector is the law. "We are the third largest transit agency in North America after New York and Mexico City, and we feel that this element of the policy is necessary," Ross noted. (WCxKit)
 
 

Windsor's public transit service is the only one in Canada that has implemented random testing, but only for employees who drive routes that cross into Michigan.


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.

 
REDUCE WORK COMP 20-50% (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

Australia Fire Fighters Say Random Drug Alcohol Testing Invasion of Privacy

 
Firefighters describe Australian State Government’s move to introduce random drug and alcohol testing across the brigade as an unnecessary invasion of personal privacy, according to a report from their union.
 
 
Fire Brigade Employees Union State Secretary Jim Casey said the State Government move was unwarranted, given there is no established problem with drug and alcohol abuse among firefighters. (WCxKit)
 
 
“There is absolutely no evidence to suggest firefighters have a problem with substance abuse and, on that basis, we see this as a gratuitous invasion of personal privacy. Nobody asks Mike Gallacher, the NSW Cabinet or their staffers to submit to random drug and alcohol testing,” Casey said. “StateGovernment ministers make multiple-billion dollar policy and investment decisions all the time. How do we know their judgment is not impaired by substance abuse?” he added.
 
 
Casey went on to say the brigade already has effective drug and alcohol protocols in place that are supported by the union. As he sees it, random drug and alcohol tests represent nothing more than a waste of time and money. (WCxKit)
 
 

Firefighters run into burning buildings every day; they’re highly aware of the need to remain sober while on the job,” Casey added.

 
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.


REDUCE WORKERS COMP 20-50%:
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.

How to Build a Workplace Drug and Substance Abuse Policy

Per the US Department of Labors Occupational Safety and Health Administration (OSHA), 74.8% of the illicit drug users are either employed full time or part time. As illicit drugs and alcohol can remain in a persons body for hours or even days after they are used, the person with a substance abuse problem can come to work still under the influence of the drugs or alcohol. Per OSHA, between 10% and 20% of the workers who are killed on the job test positive for drugs or alcohol.
 
A workplace substance abuse policy should be a part of every employers risk management program. The prevention of workplace substance abuse will protect the safety of all employees, and reduce the cost of workers compensation. (WCxKit) 
 
An overall approach to drug-free workplace should include five elements. They are:
1.      Employee education
2.      Supervisor training
3.      Drug testing
4.      Employee assistance
5.      A written substance abuse policy
 
A written workplace substance abuse policy should have a stated goal and purpose. The goal and purpose can be stated as “protecting the safety and health of the workplace” with recognition of drugs and alcohol as being a danger to all employees. 
 
The workplace substance abuse policy should clarify what employees are covered by the policy. To prevent the policy from being ignored, it should apply to all employees, including management. Otherwise, it will be seen as having different standards for 'the workers and 'the management'. The policy should clearly state when it is applicable – all hours on the job and when representing the company in anyway. 
 
The prohibited behavior needs to be clearly stated. The workplace substance abuse policy should state that it is a violation of the policy to use, sell, trade, posses, or to offer to sale illicit drugs, alcohol or any other intoxicants in the workplace. The prohibited behavior should also include being under the influence of illicit drugs, alcohol or any other intoxicants while in the workplace.
 
The workplace substance abuse policy must clearly state the employer has the right to search for substance that violate the policy. It should state that by entering the premise of the employer, all parties consent to searches and inspections. The right to search should be stated as applicable at any time and to include clothing, desk, lockers, wallets, purses, briefcases, lunchboxes, vehicles and equipment.
 
For the workplace substance abuse policy to be effective, it must contain a drug testing component. The drug testing portion of the substance abuse policy should outline how the testing will be administered and when the test can be given – pre-employment, random, post-accident, reasonable suspicion, periodic, etc. 
 
The drug testing portion of the substance abuse policy should state what the consequences are when an employee test positive for drugs whether it is suspension from work until the employee has completed a stated drug treatment program or termination of employment or other disciplinary action by the employer. For job applicants, the failure to pass the pre-employment drug testing should result in the job offer being withdrawn.  
 
Some employers encourage employees to voluntary seek assistance with their drug or alcohol problem. The workplace substance abuse policy can recognize there is treatment available for the addiction and that rehabilitation is possible. The policy can state the employer encourages the employee or family member with an addiction problem to seek the necessary assistance. 
 
The workplace substance abuse policy should advise that all information received by the employer is considered confidential information and will not be shared with anyone who does not have a legitimate need for the information. It should make the appropriate exceptions for medical care, law enforcement and management needs.
 
The policy needs to define the responsibilities of the both the employees and the employer in maintaining a drug-free workplace. This would include employees not reporting to work with any illicit drugs or alcohol in their system and management's responsibility to maintain a safe work place and protect the employees from any employee under the influence of illicit drugs or alcohol. 
 
Communication between the employees and the employer is essential for the workplace substance abuse policy to work. All employees should be provided a copy of the written policy. The policy should be reviewed in orientation with new employees and be incorporated into safety meetings. All employees should receive a copy of the substance abuse policy at least annually. Information on the availability of treatment for alcohol and drug addiction should be made available to everyone. (WCxKit)
 
 As many small businesses will not have the time to carefully write a workplace substance abuse policy, the U.S. Department of Labor provides a free Drug-Free Workplace Policy Builder at www.dol.gov/elaws/asp/drugfree/drugs/screen2.asp . At their website you go through a checklist of features you want in the workplace substance abuse policy for your company. When you finish the checklist, it has a neatly organized, simple but precise workplace substance abuse policy that you can print for use in your company. One of the options when using this interactive program to build your policy is to include a drug testing program; we strongly recommend you do so. By having a workplace substance abuse policy you will have a positive impact on your cost for workers' compensation.

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. www.LowerWC.com
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.

©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
Info@ReduceYourWorkersComp.com.

ABCs of Pennsylvania Workers Compensation

In Pennsylvania, workers compensation insurance is compulsory. You must have workers compensation insurance, if you have one employee, with very few exceptions (coverage for one domestic servant is voluntary and there are some narrow agricultural exceptions).   Waivers are not permitted. Workers compensation insurance can be purchased from a private insurance carrier, the employer may self insure, and workers compensation coverage can be obtained through the state fund.
 
 
Claim Reporting:
The employee must report the injury to the employer within 120 days of the accident, illness or disease. If the employee reports the injury within 21 days of the accident, the indemnity benefits are payable from the date of the accident, if they apply. If the injury is report 22 days to 120 days after it occurred, the indemnity benefits are payable from the date the injury is reported. The employer must report the accident to the Bureau of Workers' Compensation within 21 days to avoid sanctions. (WCxKit)
 
 
Medical Benefits:
Medical expenses including doctor visits, surgical expenses, hospital expenses, prescriptions, mileage expenses, orthopedic devices and durable medical equipment are all covered by Pennsylvania workers compensation coverage. There are no time limits and no monetary limits. A medical fee schedule based on 113% of the 1994 Medicare rates (and adjusted each year since 1994 by the State) is utilized to control the cost of medical care.
 
 
The initial choice of a medical provider is controlled by the employer. The employer provides a panel of at least six designated health care providers of which no more than four can be in a coordinated care organization and no fewer than three must be physicians. To utilize the panel, the employer has to have the employee sign a Rights and Duty form at the time of hire acknowledging the employee must chose from the designated panel if an injury occurs. After 90 days the employee is free to choose his own medical provider, but must notify the employer within 5 days of the first visit to the new physician. If the employer does not have the Rights and Duty form or does not have a panel of designated health care providers, the employee can choose his own medical provider immediately.
 
 
The workers compensation insurance company is limited to requesting two independent medical examinations (IME) of an injured employee each year. If the injured employee does not attend the IME, the insurance company can petition for a suspension of benefits.
 
 
Temporary Total Disability (TTD) Benefits:
The employee's total income over the 52 weeks prior to the injury is used to calculate the average weekly wage. Total income includes overtime pay, vacation pay, bonuses and commissions in addition to the weekly wage. TTD is to two-thirds of the average weekly wage if the average weekly wage is over $633.76 (in 2010, adjusted annually by the State). The TTD benefit can not exceed $845.00 in 2010 (the maximum is adjusted annually by the State). If the average weekly wage in 2010 is between $469.44 and $633.75, the employee will receive a weekly TTD benefit of $422.50.   If the average weekly wage in 2010 is below $469.43, the employee receives 90% of the average weekly wage. (While the State government may have humanitarian intentions in paying the lower income workers 90% of their gross pay, it provides a huge disincentive to return to work when the employee is receiving as much, or more, from work comp then they received before the accident in their net take home pay.)   The state minimum weekly benefit is $50.00.
 
 
The first 7 days of disability (the waiting period) is not paid to the injured employee unless the employee is disabled for more than 14 days. TTD benefits can be paid for the employees lifetime, or to the employees return to work, or to the resolution of the claim through a Compromise & Release Agreement, or to the termination of the benefits by Bureau of Workers' Compensation Judge, or to the modification of benefits to temporary partial.
 
 
Return to Work:
To the credit of the Pennsylvania Department of Labor & Industry, which oversees workers compensation, they have a model Return to Work program that they actively promote. Their recommended return to work program can be viewed at:  http://www.portal.state.pa.us/portal/server.pt?open=514&objID=602303&mode=2
 
 
The Return to Work program recommended by the Pennsylvania Department of Labor & Industry promotes the buy-in of the employee, the employer, the medical providers, the unions and the workers' compensation insurer by explaining how the Return to Work program benefits all parties.
 
 
Our website also has a tremendous amount of information that will benefit the Pennsylvania employer with the creation or management of a Return to Work program. For more information on Pennsylvania Return to Work, please go to: http://reduceyourworkerscomp.com
 
 
Temporary Partial Disability (TPD) Benefits:
TPD is limited to two situations – 1) when the employee is returned to work at a lower rate of pay due to the injury, or 2) when the employee is working reduced hours due to the injury. The employee receives two-thirds of the difference between what he was earning before the injury and what he earns after the injury. TPD is limited to 500 weeks.
 
 
Permanent Partial Disability (PPD) Benefits:
PPD benefits are paid when the employee sustains a permanent loss of function, or scarring and disfigurement of the face and/or neck as the result of a work related injury. Specific loss benefits for body parts are payable based on a stated number of weeks listed in Section 306 of the workers' compensation statute.
 
 
Permanent Total Disability Benefits:
While TTD can go on for a life time in Pennsylvania, and TPD can go on for 500 weeks, there are no statutory permanent total disability benefits in Pennsylvania.
 
 
Death Benefits:
The simple part – there is a $3,000 burial benefit. The complex part – the weekly benefit is a percentage of the average weekly wage (AWW), not to exceed the statewide average weekly wage (as published annually by the State). Dependent children are eligible for weekly benefits until age 18 or age 23 if they are a full time student. If there are no dependent children, the surviving spouse receives 51% of the AWW. If there is one child, the surviving spouse receives 60% of the AWW. If there are two or more dependent children, the surviving spouse receives 66 & 2/3% of the AWW. If there is no surviving spouse, but dependent children, there is a graduated scale with 32% of the AWW for one child, and up to 66 & 2/3% for six or more children, with the benefits being paid to the guardian(s). If the surviving spouse remarries, the surviving spouse is no longer entitled to the death benefits, but the dependent children are. There are also guidelines for paying death benefits to parents and dependent siblings when there is no surviving spouse or dependent children.
 
 
Vocational Rehabilitation:
All that is required for a modification or suspension of benefits is the performance of a labor market survey by a vocational expert to prove the employee's earning capacity. (WCxKit)
 
 
Settlements:
Lump sum settlements are allowed. Compromise and Release Agreements are used to resolve future medical exposure, future indemnity exposure or both. If the parties agree, a structured settlement may be used to pay the claim.   All settlements are subject to the requirements of Medicare.

 

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

 
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.

©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
Info@ReduceYourWorkersComp.com

Challenges When Testing for Prescription Drugs in the Workplace

Recently in the “Commercial Appeal” (TN), quoting from a New York Times article about the trickiness of drug testing when workers take prescriptions drugs the article ended with this quote.

“Given the liability for industrial accidents or product defects or workplace injuries involving prescription drug abuse, employers cannot afford not to address this issue.”
employers cannot afford not to address this issue.”

 

Indeed drug testing in the workplace is challenging given the fact so many people take illegal drugs. Employers have every right to discover who these workers are before a serious workplace injury occurs.

However,
the quote seems to be saying if a person is taking a legal prescription drug(s), albeit those possibly causing impairment leading to an accident in the workplace, such legal use qualifies as “prescription drug abuse.” (WCxKit)


It is a fine
line between maintaining a drug-free workplace understood to mean illegal drug usage and firing someone for taking prescription drugs – some even for injuries sustained in the employer’s workplace.

Statistics show
(Quest Diagnostics) of 500,000 drug tests, use of prescription drugs rose 18% between 2005 and 2009. Opiates were found in those workers following an accident at four times the level than when they were first hired.

That being said
, a leap cannot be made from high usage of prescription drugs to abusive usage of prescription drugs. Some people abuse. Others take their medications appropriately and, yes, the drug is found in their system at testing.

The real questions are
: Are workers taking legal prescription drugs showing evidence of behavior as a result of their medication(s) putting them at a higher risk of a workplace injury? Are workers taking prescription medication actually having more injuries? In other words, is there a quid pro quo?

Employers must
continue to test for drugs in the workplace. In addition to the drug-free policy, they must implement a plan for working with those taking prescription drugs and evaluate each individual on the basis of what is found during the test and the behavior of the worker, taking steps to intervene if unsafe behaviors or potential for accidents are found.

The drug-testing
plan needs openness and communication with employees taking RX meds. A policy must be set as to what will be tolerated within the guidelines of the prescription dosages. Employees must also be open and honest about medications they take — opiates or not —  at the time of drug testing. It’s common knowledge diabetics may experience inconsistent affects from both their disease and the medication they take, even when taken correctly. No employer would be allowed to fire a diabetic if deemed at risk for an injury. They would be required to accommodate.

Someone taking
two Vicodin twice a day, morning and evening, would be expected to have a fixed level of the drug in his/her body. If at testing a person is found to have much high amounts, that’s the time for the employer to step in.

Steps an employer
may consider are counseling, re-assigning the person to a safer job, working with employees and their physicians to substitute or alter the dosage during the workday. Check the laws in your state and the regulations of the American with Disabilities Act. (WCxKit)

It’s much wiser
for employers to be on a sure footing before firing workers who “fail” drug tests for taking legitimate medications than to fight a lawsuit. Indeed, if lower worker comp costs are the goal, lawsuits blow cost right up the scale, big time.


For more information visit
http://reduceyourworkerscomp.com/drug-testing-state-laws.php#axzz14LwH8dOJ


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.
C
ontact:  RShafer@ReduceYourWorkersComp.com or 860-553-6604.
 
FREE TOOLS
WORK COMP CALCULATOR:   http://www.LowerWC.com/calculator.php
 
JOIN
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.
 
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.

Date for Revised Workplace Drug Testing Guidelines Moved

Date for Revised Workplace Drug Testing Guidelines Moved

The effective date of the revised guidelines concerning federal workplace drug testing programs has been pushed back from May 1 to Oct. 1, 2010.

The Department of Health and Human Services (HHS) delayed the effective date to coincide with changes to the Department of Transportation's (DOT) procedures for workplace drug and alcohol testing programs, which are planned to be effective Oct. 1.

The DOT uses the HHS laboratory procedures outlined in the federal guidelines. If HHS were to have moved forward with the May 1 compliance date, laboratories would have needed to keep a dual system for testing DOT-regulated workers and non-DOT-regulated workers. In addition, the National Laboratory Certification Program would face a similar problem with using having to use two sets of criteria. A single effective date would eliminate the confusion of dual systems.

In addition, the extra time allows for updated training in Federal and federally-regulated workplace drug testing programs.

The DOT said it could not reasonably move up its effective date to May 1. The department feared that rushing compliance would cause unnecessary spending and create compliance problems. (workersxzcompxzkit)

The Mandatory Guidelines in the Federal Register (73 FR 71858) sets scientific and technical standards for Federal workplace drug testing programs and outlines the for laboratory certification. The revisions to the guidelines address:

  • How urine samples are collected and tested
  • What the standards for certification of Instrumented Initial Test Facilities (IITF) are
  • What the role of collectors and Medical Review Officers (MRO) are, as well as the standards MROs should follow.

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, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at:  Robert_Elliott@ReduceYourWorkersComp.com or 860-553-6604.

 
Podcast/Webcast: Occupational Health Strategies
Click Here:
   http://www.workerscompkit.com/gallagher/podcast/Occupational_Health_Strategies/index.php

WC Calculator: http://www.reduceyourworkerscomp.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.

© 2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ ReduceYourWorkersComp.com.

Six Things Small Businesses CAN DO to Cut Workers Comp Costs

Workers’ compensation cost control information is readily available for large companies; but what about the small company? 
 
If you own a small business where you are president, risk manager, occasional clerk and occasional janitor all rolled into one, you may not have the financial resources to have an insurance manager or safety supervisor.  
 
Here are some recommendations on how you can control your workers' compensation cost without spending a lot of additional money.
 
1- Avoid Injury Claims
As the owner of a small business you are most likely the one who trains new employees on what to do in their jobs. Make sure the new employee understands how to perform the job in a safe manner. As you train the new hire emphasis all the things the employee can do to avoid on-the-job injury.  Explain to the employee proper lifting techniques, proper use of machinery, and proper use of safety gear. Make sure the employee understands the safety requirements by taking time to observe the new employee in the performance of his/her job duties. Immediately correct any activity by the employee you know is different from the safest way of doing the job.
 
Safety does not stop when you have the new employee trained in job performance. It is crucial to continue to promote safe work habits to prevent employees from being injured. Any time any employee, new or old, is observed acting in any manner that is not in compliance with your safety program, take the time to re-train the employee on safe job performance. To keep a safe work environment the on-going promotion of safety is necessary.
 
2- Drug-free Workplace
By some estimates, up to fifty percent of workers’ comp claims occur because the employee is under the residual effects of illicit drugs or alcohol. By eliminating the effects of drug and/or alcohol abuse the employee is more alert and less likely to commit an act or activity prone to causing an injury.
 
Injuries Happen – Unfortunately!
Despite your best efforts to prevent injuries they do happen. What you do when an injury occurs has a major impact on your future work comp premiums. Make sure all employees know they must report any work related injury as soon as it happens, even on weekends or night shifts. Complete a First Report of Injury state form (obtain a few copies from your insurance broker before any accidents occur) with as many details as you can gather. If you run out of space, attach additional pages.
The more information you provide to the insurance adjuster and to the state board of workers' compensation, the better.   Take pictures of the accident scene. If any of your employees witnessed the accident have them write down a detail description of what they saw and what happened. 
 
Drug Test
As a part of your drug-free workplace policy, administer a required drug, usually done at the time of the employee's initial medical treatment. If the employee wants to delay initial medical treatment, insist the drug test be obtained the same day as the accident. In most states the workers’ comp claim can be either denied or the benefits reduced if the employee is under the influence of illicit drugs or alcohol.
 
3- Initial Medical Treatment
In the states allowing the employer to select the medical provider for the employees' injuries, exercise your choice and do so. Prior to any injury claims, contact your insurance broker and obtain a list your insurance company's preferred work comp medical providers. Post this list in the break room, and/or by the time clock and other places readily available to all employees.   Be sure your injured employee is aware of the medical facility to obtain the initial medical care.
 
4- Prompt Reporting
As soon as you have arranged for the employee's medical treatment and drug test, you should immediately report the work comp claim to the claims office. Provide to the claims office the First Report of Injury form, the pictures of the accident scene, the written statements of the co-workers who witnessed the accident and any other information you have. The more information you can provide to the work comp adjuster, the better job the adjuster can do in managing the claim.
 
5- Return-to-Work Program
After an effective safety program, the next best thing a small employer can do to control work comp cost is to have a Return-to-Work Program. A quick way to increase your work comp premiums is to refuse to allow light duty work. The money the insurance company pays the employee in temporary total disability benefits is calculated into your work comp premiums for the next three or four years.
 
If the employee is not released by the treating physician following the initial medical treatment, contact the employee, the adjuster and the medical provider. Let all three of them know you want and need the employee back at work. Advise each that you are willing to work with any work restrictions the medical provider may impose.
 
Plan ahead for the modified duty for the employee. Arrange for assistance in lifting heavy loads, provide a chair to accommodate standing restrictions, etc. When the employee does return to work on modified duty be sure to comply with the medical provider's restrictions. You do not want to cause the employee to re-injure themselves and be off work even longer than they would have been otherwise.
 
6- Other Ways to Influence your Work Comp Cost
Once you have reported the claim to the claims office, don't stop there. Keep in touch with the adjuster. Know what the adjuster is doing on the work comp claim. 
 
Keep in touch with the employee and know what the employee's medical condition is. Know when the employee is going to be back at work. Let the employee know you value his/her contribution to your company and that you need them back at work.
 
Do not try to be the only safety officer within your company. Build a culture where safety is everyone's responsibility. Let the employees know the more money spent on workers' compensation insurance premiums is less money available for raises and other job benefits. (workersxzcompxzkit)
 
Plan Ahead
If you wait until you have a workers' compensation claim made by an employee to address controlling your work comp cost, you have waited too long. Take the recommendations made here and create a formal business plan on managing and controlling your work comp cost. Use these guidelines to prevent the injuries from occurring and to mitigate their cost when they do occur. 

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, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: Robert_Elliott@ReduceYourWorkersComp.com or 860-553-6604.


Podcast/Webcast: Claim Handling Strategies
Click Here:

http://www.workerscompkit.com/gallagher/podcast/  Claim_Handling_Strategies/index.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.
 
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ ReduceYourWorkersComp.com.

Five Things to Consider to Achieve Higher Productivity with Drug-Free Workplace Programs

It’s a fact —  employers who actively manage their drug-free workplace program benefit from higher productivity, fewer work related accidents, lower absenteeism and lower medical cost (both from medical insurance claims and workers' compensation claims). Unfortunately 38% to 50% of all workers' compensation claims are related to substance abuse according to the Tennessee Department of Labor. At least a dozen states require the workers' compensation insurers to offer your company a premium discount if your company has a drug-free workplace program.
To achieve the benefits of a drug-free workplace, you need a drug-free workplace policy that is properly managed. 
 
Management of a drug-free workplace program should include all of the following:
 
1- A Published Drug-free Workplace Policy
When your company implements a drug-free workplace policy, all current employees and all potential new hires must receive a copy of the drug-free workplace policy with an acknowledgment form. Employees or potential new hires are required to read, sign and date the acknowledgment form. Employers need to communicate to their employees that the acknowledgment form becomes a part of their personnel file.
 
A Drug Testing Program in Hiring
Every time you advertise to hire a new employee whether it is on the internet, newspaper or other media, always include a notice “We drug test all employees.” This approach eliminates many future problems as most regular abusers of drugs or alcohol will not apply for employment at your company.
It is also recommended all job interview locations display a large poster with wording similar to: “We Are a Drug-Free Employer. We Drug Test.” Display the poster where all job applicants cannot fail to miss it.
 
As a condition for employment, a pre-employment drug test should be performed (a few states require the drug test to be performed after they are hired). As a part of the drug-free workplace policy, all new hires must be free from any substance abuse. If the potential employee tests positive for drugs, the offer of employment immediately withdraw the offer of employment. 
 
Never make the mistake of making an exception to the drug-free workplace policy in regards to hiring or employment of a substance abuser. If you do, you have invalidated your drug-free workplace policy, as all substance abusers will want “equal treatment.”
 
All new hire benefit packets given to the employees should include a pamphlet on drug abuse and abuse prevention. The packet serves as a reminder to the new employee that your company continues to place an emphasis on a drug-free workplace after hiring.
 
2- Random Drug Test
Most substance abusers know if they are “clean” for a week or more prior to taking their pre-hire drug test, the urine samples come back negative. They abstain from their bad behaviors prior to your pre-hire drug test, they test negative, you hire them and then they return to their previous substance abuse. The best way to combat this is for the new hire (and all employees) to know random, on-going drug testing is a condition for employment at your company and a positive drug test is grounds for immediate termination.
 
Random testing is a strong deterrent to on-going substance abuse by your employees. It is recommended you drug test at least half of your employees every year with the drug test being performed on a totally random basis. If you test one percent of your employees each week, you will test half of them in each calendar year.
 
As a part of your drug-free workplace policy, the employees grant your company permission to drug test any employee any time there is a reason to suspect drug or alcohol abuse.   Your supervisors and managers should be trained to recognize the symptoms of drug abuse whether they are performance, behavioral or physical in nature.
 
3- Workers' Compensation Claims
Approximately 40 states allow or consider the denial of a workers’ comp claim if the injured employee was under the influence of alcohol or illegal drugs at the time of the work comp injury. Therefore, as a part of your drug-free workplace policy, a drug test should be required at the time of the initial treatment for any work comp injury. (If the employee tests positive for illicit drugs, and you terminate the employee for violation of the drug-free policy, many of the states will consider being under the influence as grounds for termination and will deny unemployment benefits to the terminated employee). 
 
Post accident drug testing does cost money. However the money spent on the drug test is money well spent (remember the 38% to 50% of work comp accidents involve substance abuse). The amount of money saved on work comp claims, appropriately denied due to the employee’s use of illicit drugs or alcohol, far exceed the cost of the drug test.
 
4- Employee Awareness and Education
The poster “We Are a Drug-Free Employer. We Drug Test” or similar posters are not only displayed in the job interview locations within your company, they also are prominently displayed throughout your company. Good locations include in the parking garage or lot, at entrances to your building, in elevators, break rooms, time clock, etc.
 
Provide brochures, pamphlets and CDs on substance abuse prevention to all managers, supervisors and employees on a regular basis, at least yearly.   If you still pay by pay envelope (instead of direct deposit) the brochures can be added to the pay envelope. E-mail is also a very effective way to put the message in front of the employees stating substance abuse is not tolerated.
 
5- Supervisor Training  
Train your managers and supervisors to recognize the symptoms of drug and alcohol abuse. On-going training, at least annually, is key to keeping your managers and supervisors alert to the symptoms of substance abuse. Supervisors and managers with the proper training are then able to identify and deal with the employees suspected of having a substance abuse problem. (workersxzcompxzkit)
 
Summary
A properly managed drug-free workplace policy has a significant positive financial impact on your company. The number and severity of workers' compensation claims will be reduced, lowering the cost of your work comp premiums. In addition to lower work comp cost, you company will experience reduced absenteeism, reduced turnover, better employee morale and lower medical insurance cost.

 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, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: Robert_Elliott@ReduceYourWorkersComp.com or 860-553-6604.


Podcast/Webcast: Claim Handling Strategies
Click Here:

http://www.workerscompkit.com/gallagher/podcast/  Claim_Handling_Strategies/index.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.
 
©2010 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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