05.25.2012By RYAN KNUTSON, PBS Frontline, and LIZ DAY, ProPublica
When federal lawmakers passed landmark legislation creating the Occupational Safety and Health Administration (OSHA), they intended to protect workers by imposing clear, uniform rules on their employers.
The 1970 law assumed that the relationship between companies and the people they hired for dangerous jobs would be straightforward, employer to employee.
No one planned for industries like tower climbing.
Tower climbers, the roughly 10,000 workers who build...
“It ain't over till it's over,” as Yogi Berra said.
True in baseball, true in life, and very true when dealing with the government. In the May issue of Claims Management magazine, Rafael Gonzalez of Gould & Lamb discusses the after-settlement challenges associated with workers’ compensation claimants and Medicare set-asides.
“You’ve settled the file, taken Medicare’s interests into account by having a Medicare Set-Aside put together, sent it to the Center for Medicare and Medicaid Services for approval, and received CMS approval,” Gonzalez says. “You are done, right? You can put the file away and know it will never come back to haunt you. Not so fast.”
Getting workers’ compensation costs under control is a top-down business process. As Calvin Beyer, head of manufacturing for Zurich North America Commercial’s customer industry segments, notes in an article in National Underwriter magazine, “Those in the C-suite need to commit themselves to creating a zero-injury culture at their organizations.”
However, even the most diligent companies will eventually have injured workers. When the best-laid safety plans go awry, companies must be prepared to properly manage claims, and one of the first rules in that is “prompt reporting.”
Is it ever OK for a workers’ compensation claimant to have fun?
Knowing that someone is collecting workers’ compensation benefits and then seeing them hanging out at your favorite fishing hole often brings cries of “Fraud!”
Steve Hanagan, a principal with the law firm of Hanagan & McGovern in Mount Vernon, Ill., points out that perception is not always reality. “When people complain about seeing a worker doing activities they think are inconsistent with being off-work, it is usually based on the belief that the worker is claiming to be incapable of all but the very basic activities of daily living. Normally, this isn’t true,” he writes.
Two executives from the Workers' Compensation Insurance Rating Bureau of California (WCIRB) spoke at a California Department of Insurance (CDI) public hearing this week. President and CEO Bill Mudge and Chief Actuary Dave Bellusci testified before the Insurance Commissioner in support of the WCIRB's July 1, 2012, Pure Premium Rate Filing.
In the filing, which was submitted to the CDI on April 12, the WCIRB proposed advisory pure premium rates that average $2.51 per $100 of payroll, which is 4.1 percent higher...
The North Dakota Bureau of Criminal Investigation is in the midst of an inquiry into the alleged deletion of electronic notepad entries from injured workers’ claims. The story is being reported by INFORUM, a North Dakota news website.
The allegations surfaced in February after a whistleblower employed by the state-run Workforce Safety and Insurance (WSI) claimed she was ordered to delete information “because it ‘weakens’ the agency’s denial of certain claim benefits.” The WSI is overseen by a ten-member board appointed by Gov. Jack Dalrymple. Earned premium for 2011 totaled $191.8 million, covering 21,552 employers.
Now a report to the governor on the “deletion” controversy is stirring still more controversy.
05.11.2012By CHARLENE H. GRAFTON, RN, BS, MS, CCM, QRP
Use of computers and the availability of Internet services has been a boon for businesses in terms of communication, data collection, financial management, and standard office processes. According to a study by the U.S. Bureau of Labor Statistics in 2001, there are 73 million computer users at work in the U.S. Also, 60 to 80 percent of office workers use the data entry portion of the keyboard or a numeric data machine...
The number of paid workers' compensation claims fell 43 percent relative to the number of employees from 1997 to 2010, according to the 2010 Minnesota Workers' Compensation System Report released May 8 by the Minnesota Department of Labor and Industry (DLI).
"Though each workplace accident is one too many, the report underscores that Minnesota's workplaces have become much safer for employees and comparatively less costly for employers since 1997," said Ken Peterson, DLI commissioner. "As has been the case for the past...
A former employee of George’s Chicken in Woodstock, Va., has a bone to pick with her past employer, according to the Northern Virginia Daily. Saying the plant fired her after a workers’ compensation claim in 2009, she is seeking $500,000 in damages, $30,000 in back pay and benefits, and $30,000 per year from the date of the filing.
Faith D. Gilkey was working as a “scaler” at the plant, checking the weight of boxes and ensuring the accuracy of their labels, when she injured her right knee. Medical treatment and light-duty followed. It was during the light-duty that Gilkey “was forced to engage an attorney to protect her interests ... " according to the complaint. The company denies wrongdoing; Gilkey is requesting a jury trial.
05.08.2012By JOAN E. COLLIER
The MIssissippi Legislature has passed SB 2576, which makes significant changes to the state’s workers’ compensation system.
Among its provisions:Requires claimants to provide medical evidence of “direct causal connection” between their jobs and their workers’ compensation claims. Allows employers to order drug and alcohol test if they can demonstrate “reasonable suspicion” that the employee was abusing such substances at the time of the injury. ...
05.04.2012By JOAN E. COLLIER
A report from Washington Roundtable, Benchmarks for a Better Washington, says that Washington is the most expensive state in the nation for workers’ compensation benefits paid per covered worker. In 2009 (the most recent full data available), Washington provided an average of $857.32 per covered worker, nearly twice the national average of $448.94. The group derived its information from the annual study on workers’ compensation benefits in all 50 states from the National Academy of Social Insurance.<...
Julie Ferguson presents a snapshot of NCCI's annual Workers' Compensation Issues Report.
“The Medicare Secondary Payer and Workers’ Compensation Settlement Agreement Act of 2012” has been introduced in the U.S. House of Representatives to clean up some details involving workers’ compensation Medicare set-asides.
The major problem with the current process appears to be delays in the review of proposed set-asides.
"This legislation will provide clear and consistent standards for the CMS administrative process,” said Melissa Shelk, American Insurance Association (AIA) vice president...
05.01.2012By JOAN E. COLLIER
The workers’ compensation community has a new national organization and website to turn to for education, information, and interaction. The Workers’ Compensation Institute (WCI) is a nonprofit, nonpartisan organization dedicated to serving all members of the workers’ compensation community—risk managers, insurers, agents, brokers, employers, employees, and claims, medical, and legal professionals.
The WCI is the organizing sponsor of the annual Workers’ Compensation Educational Conference (WCEC). Held...
The newest research brief from the National Council on Compensation Insurance (NCCI) updates a previous paper published in 2011. While the Workers’ Compensation Temporary Total Disability Indemnity Benefit Duration—2011 Update confirms prior findings that average duration of payments for Temporary Total Disability (TTD) indemnity benefits has been increasing since the onset of the recession in late 2007, there is evidence that the trend might be moderating in 2010.
Countrywide, NCCI’s estimate of ultimate mean duration of...
According to the 2011 Liberty Mutual Workplace Safety Index, the most disabling workplace injuries and illnesses in 2009 amounted to $50.1 billion in direct U.S. workers’ compensation costs. After adjusting for inflation, this year’s costs decreased 6.5 percent from 2008.
Liberty Mutual’s annual Workplace Safety Index identifies the top causes of serious nonfatal workplace injuries based on information from the company’s workers compensation insurance claims, the U.S. Bureau of Labor Statistics (BLS), and...
Cost containment is by far the number one workers’ compensation insurance concern of employers for the next 12 months, according to a study and subsequent media release from Zywave, a Milwaukee-based provider of software-as-a-service solutions for the insurance and financial services industries. Its 2012 P&C Workers' Compensation & Safety Survey, conducted from Jan. 6 to Feb. 24, showed that fifty-nine percent of employers say they are very or somewhat concerned about cost containment in 2012. Employers are also concerned about increasing...
Pennsylvania Auditor General Jack Wagner said in early February that the State Workers' Insurance Fund (SWIF), the largest workers' compensation insurance carrier in Pennsylvania, paid nearly $4.9 million over a two-year period to a Pennsylvania-based claims services and medical management company to help manage operations and save money, but SWIF failed to hold the contractor accountable to terms of the contract and many of the expected outcomes were not achieved.
SWIF operates within and falls directly under...
Nonfatal injuries in Kansas workplaces declined in 2010, according to the Survey of Occupational Injuries and Illnesses conducted by the Kansas Department of Labor (KDOL) and the federal Bureau of Labor Statistics.
Nonfatal workplace injuries and illnesses among private industry employers in Kansas declined in 2010 to a rate of 3.7 cases per 100 equivalent full-time workers, down from 4.1 cases in 2009. Workers in private industries reported an estimated 33,100 nonfatal workplace injuries and illnesses in Kansas in 2010, a decline from 38,200 cases in 2009.<...
PMSI, a national provider of specialty products and services for the workers’ compensation market, has launched a clinical tool that provides a predictive risk assessment for identifying comparative risk across a workers’ compensation population. The Population Risk Scorecard predicts risk for a population with regard to medication-related health outcomes and drug costs, and identifies clinical interventions that will drive down risk and pharmacy spend.
“Our Population Risk Scorecard applies a proprietary set of clinical...