Are Employees Covered when they leave the state? Maybe Not!

You have a workers’ compensation policy that covers your employees. So when your employee travels for work, you assume that they are covered should they be injured while “on the job”. Assuming wrong, and you may be opening up your own checkbook. Where the employee goes to, and how long they are there, does have barring on if your employee’s injury is covered.

On Monday, March 12th, 2018, I posted my monthly Legal Corner blog post about recent case rulings that impact employers when it comes to HR & Safety Compliance as well as Workers’ Compensation. After every blog post I usually receive a dozen or so calls or emails from people that were looking for more information on the subject of the post, however, in this post’s case, I have received a hundreds of questions, from employers to insurance agents, stemming from one specific Workers’ Compensation Case Law Ruling in that Legal Corner post.

Here is the case I referenced: Employer discovers lower quote does not mean same coverage when out of state accident is not covered – Indiana

Custom Mechanical Construction (CMC) is an Indiana-based mechanical contractor but is authorized to do business in Kentucky. Since its establishment in 2005, it had used the same insurance agent and the same carrier for workers’ comp. In 2015, the agent solicited bids from other carriers and secured a $3,000 lower quote. The company claims that it was led to believe that the coverage was the same. When a CMC worker was injured on a job in Kentucky, the carrier filed suit in a federal trial court in Indiana seeking a judicial determination that its policy does not cover claims from Kentucky. CMC counterclaimed that the carrier wrongly and unreasonably denied coverage, and that the broker is liable for failing to procure adequate coverage. The judge found that CMC had no viable claim for bad faith nor negligence and that the broker was not an agent of the carrier. Accident Fund Insurance Co. of America v. Custom Mechanical Construction.

So, does a workers’ compensation policy have a coverage territory/travel restriction? The answer is yes/no.

The Employers Liability portion of the policy provides coverage for suits brought in the USA, its territories or possessions, or Canada. Sounds fair, and aligns with your business auto and general liability policy definitions of a coverage territory. If you are doing business only in the USA and Canada, you might think you are OK. If your employee travel outside of the USA and Canada, even for a day, you need to make sure you have Foreign Voluntary Workers’ Compensation Coverage, and should also make sure you have appropriate liability coverages as well.

However, the Workers’ Compensation portion of the policy does not define a territory, so that sounds even better does it not?  Not really. It does something that should cause all employers to ask more questions. A Workers’ Compensation policy provides statutory coverage for an employer for the specific state(s) listed in 3. A. on the declaration page of the workers’ compensation policy. So two little, abbreviated letters, in one big, multi-page policy actually defines where you have coverage

If you have physical locations in MD, NY and PA, and MD, NY, and PA are listed in 3.A. of your policy, you think you are all set. But what if your employee travels to NJ, VA, DC, NY or OH?

What if you have a telecommuter that works from home in another state? What if you have a employee that lives in OH but works from your PA location, but then travels back into OH for business purposes? This is where things actually get confusing.

With 50 states, and several territories including PR & DC, explaining all possible variations would cause this to be an extremely long blog post, so I am not about to address every issue. Therefore, I am going to point out the key issues you need to look into to make sure you are properly covered. The best thing to do, is to ask questions.

  • Effective Date of the Policy – The workers’ compensation policy defines that you have coverage for the states listed in 3.A. of the declaration page.  It also defines that if on the effective date of the policy.  If you have employee(s) working in another state not listed in 3.A. on your actual renewal date, or have an ongoing operation in another state, you do not have coverage in that state during the remainder of that policy year. It does have a provision to allow you 30 days from the effective date to inform the insurance company.  If you forget, you have an issue.
  • With 50 states, and several territories including PR & DC, each state and territory has their own rules. The two key provisions you need to understand are:
    • Extraterritoriality – what your state’s workers’ compensation laws allows in terms of coverage when an employee leaves the covered state.  A state may provide coverage for an unspecified period of time, or it might allow for a limited number of days such as 30 or 90 days.  If you meet the extraterritoriality provisions, your employee may be covered when out of the covered state
    • Reciprocity – is whether or not the state’s workers’ compensation laws, of the state that the employee is in when injured, allows allow the your policy to provide coverage for the employee in that state while there.  A state’s law may allow another states coverage to ally for an unspecified period of time, or it might allow for a limited number of days such as 30 or 90 days, or not allow any coverage to extend to that state.  Therefore, if that state does not allow your coverage to extend to the state, you would need to add that state as a covered state in 3. A.
    • For example, due to OH reciprocity with PA, a PA based construction employee can work in OH for up to 90 days in any 12 month period before the employer would need to purchase OH workers’ compensation coverage for that PA employee. (Note: an OH BWC employee has recently told me this is now 30 consecutive days.) However, if that PA employee travels to a NY jobsite, even for a day, the employer would need to purchase NY workers compensation due to the NY reciprocity rules.  A similar rule applies to an construction employee going to work in FL.
  • All States Endorsement – Many employers believe they have coverage in every state as some insurance agents leave them to believe that since there may be a provision that says something like “all other states…” is listed in Other States Coverage of 3.C. on the declaration page.  There is no such thing as a “All States Endorsement”. If you look at it closely, at best, it will state “All other states except 3.A and monopolistic states”. Plus, once again, with 50 states, and several territories including PR & DC, each state and territory has their own rules.
    • Other states (“3.C.”) coverage allows the your workers’ compensation policy to comply with the statutory benefits required by the other state where an employee is injured but in which you do not currently have on-going operations, and do not plan to have on-going operations during the policy period.  If you did, doing so would require that state to be scheduled as a primary coverage state in 3. A. Employees injured while working in a listed 3.C. state will receive the benefits under that state’s law if made necessary by law or court decision. Basically, the workers’ compensation policy responds and pays benefits in listed 3.C. states just as if the state was scheduled under 3.A.
    • Monopolistic States – OH, WY, WA, ND – are states that the only way to provide coverage in that state in section 3 of a policy is by purchasing coverage from that state’s workers’ compensation bureau.  No insurance company can provide coverage in those state, however, your states’ extraterritoriality or that monopolistic state’s reciprocity may allow for temporary coverage.
    • However, do not assume that if a state is listed in 3.C. that you have coverage as the listed state my not allow that due to reciprocity rules.  I point out once again, that NY will require a contractor to have NY in 3.A., and not 3. C. for even 1 day of work.
    • Although there might be a small charge on your policy, listing your bordering states, or ones you frequently travel to, might be a good idea.
  • Telecommuting employee – if you have an employee that lives and works from home in another state, although you as an employer do not have a physical location in that state, you do have an ongoing operation in that state.  Therefore, you need to add that state to your policy and list it in 3.A.
  • Employee Residing out of state – you may have an employee that lives in one state, and commutes to your state to work.  If they are injured in your state (listed in 3.A.), than your workers’ compensation policy will respond.  However, if that employee needs to travel back into their state of residency for business purposes, most likely their state’s laws will supersede your state’s laws, or the employee may chose to file for that states benefits especially if they are higher than in your state.  Either way, you may need to have coverage in any state that an employee both resides and works in.
  • Subcontractors
    • Should you hire a subcontractor that is based out of another state, you need to make sure that they have coverage in your state.
    • If you are hiring a subcontractor to work for you at a job in another state, you need to make sure you have coverage in 3.A of that state.  If that subcontractor somehow ends up not having workers’ compensation coverage, you as the hiring “general” contractor would be responsible to provide the statutory coverage in that state.

I cannot spell out every variable that you may be thinking of when it comes to your operations and employee travel, the main point of this post is help to create more awareness that you should not assume that your workers’ compensation will cover your traveling employees. You should speak with a Certified WorkComp Advisor, or an experienced agent, and make sure you get your answers in writing.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

Safety risks soar with workforce shortage

The USG U.S. Chamber of Commerce Commercial Construction Index (CCI) is a quarterly economic index designed to gauge the outlook for, and resulting confidence in, the commercial construction industry. While earlier reports indicated that the shortage of skilled workers affected schedule performance and jobsite efficiency, the September index added a new dimension – 80 percent of contractors agree that the skilled labor shortage also impacts jobsite safety and it’s the number one factor increasing safety risk on the jobsite.

Tighter time schedules are the number two factor and exacerbate the safety risks. Aggressive scheduling may cause contractors to use workers with less experience or training, and can push employees to work longer hours, which can lead to shortcuts and compromised processes.

Addiction and substance abuse issues also decrease worker and jobsite safety. Almost 40% of contractors say they are highly concerned about the safety impacts of worker use/addiction to opioids, followed by alcohol (27%) and marijuana (22%). Notably, the report showed that while nearly two-thirds of contractors have strategies in place to reduce the safety risks presented by alcohol (62 percent) and marijuana (61 percent), only half have strategies to address their top substance of concern: opioids, which is a newer growing concern.

Language barriers also are a leading safety risk, particularly in the Northeast (34%) and West (31%).

 

Strategies to reduce safety risks

To address safety risks caused by workforce shortages, contractors believe the most effective strategies are an improved safety culture and more leadership training.

  • Improving the safety climate on jobsites (63 percent)
  • Improving the firm’s safety culture (58 percent)
  • Providing more leadership training for supervisors (48 percent)
  • Tracking and assessing safety records (34 percent)
  • Using safety-enhancing technologies (33 percent)

General Contractors in the Northeast are relying more than others on leadership training for supervisors. Large contractors are using safety-enhancing technology (47%) more than small contractors (27%).

The study dove deeper into the most impactful way to achieve a strong safety culture. It presented a list of practices associated with a strong safety culture and asked contractors to select those with the highest impact on safety outcomes. Training at all levels topped the list (67%). More than half (53%) of contractors believe that ensuring accountability at all levels has a high impact. Other indicators include improving communication (46 percent), demonstrating management’s commitment to safety (46 percent), improving supervisory leadership (43 percent) and aligning and integrating safety as a value (42 percent).

More general contractors consider empowering and involving employees (58%) and demonstrating management commitment (55%) to have a high impact on safety outcomes, compared with trade contractors (35% and 34%, respectively.)

The top strategies contractors are using to reduce safety risks caused by substance abuse are testing, prescreening before hiring, education, communication oversight by supervisors, zero tolerance policies, counseling, and access to rehab.

The labor shortage in the construction industry is projected to last another three years, requiring increased emphasis on safety training and supervision. Four out of five (80%) contractors said they experienced some competitive advantage from their safety programs, although larger companies with more resources and expertise gain a greater advantage. They cite insurance, liability, and new business as top benefits.

Even a few injuries can push worker comp rates sky high, raise the experience modifier, reduce bidding opportunities, lower morale, and put more pressure on workers who are already expected to do more with less. A renewed emphasis on safety that is inclusive and forward thinking will help curb the risks.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

 

Things you should know

The importance of contractor selection and oversight

The Chemical Safety Board has published a new Safety Digest highlighting insufficient safety requirements in contractor selection and oversight. The digest summarizes separate CSB incident investigations and recommendations from 2007 and 2011 in which the agency concluded that inadequate contractor selection and oversight contributed to a combined 10 fatalities and four injuries.

New hazard alert and toolbox talk on opioid-related overdose deaths in construction

In an effort to raise awareness of opioid-related overdose deaths among construction workers, the Center for Construction Research and Training, CPWR, has published a hazard alert and toolbox talk on the topic. The hazard alert and toolbox talk are available in English and Spanish

ISEA/ANSI 121-2018 first in the industry to address tethering practices

The International Safety Equipment Association (ISEA) and the American National Standards Institute (ANSI) developed the first industry standard to reduce the risk of dropped objects in industrial and occupational settings. The standard, ANSI/ISEA 121-2018, American National Standard for Dropped Object Prevention Solutions, sets the minimum design, performance, labeling, and testing requirements for tethering practices.

The standard contains four active controls, which are:

  • Anchor attachments
  • Tool attachments
  • Tool tethers
  • Containers (buckets, pouches)

ISEA/ANSI 121-2018 is available online from ISEA.

CSB issues investigation update, animated video on Wisconsin refinery explosion, fire

The Chemical Safety Board has released an update of its investigation into an April 26 explosion and fire at the Husky Energy refinery in Superior, WI, as well as an animated video that explores the cause of the incident.

State News

California

  • The Labor Enforcement Task Force (LETF) issued 26 orders shutting down unsafe machines or operations at workplaces it inspected during the fiscal year 2017-2018 and found that 93% of businesses inspected were out of compliance with labor laws.

Florida

  • The National Council on Compensation Insurance (NCCI) is recommending a 13.4% decrease in rates, the second straight year that the rating organization has recommended a reduction in the state.

Illinois

  • Governor vetoed a bill that would have amended workers compensation law in relation to fees and electronic claims.

Minnesota

  • Department of Commerce has approved a 1.2% increase in the overall average pure premium level, effective Jan. 1.

Nebraska

  • Workers’ Compensation Court has redesigned its website, offering the Google platform for forms and distribution of court news. Previously bookmarked links to the court’s website will no longer work, so users are encouraged to delete their old links, then find the updated pages and bookmark them for future use.
  • Hospitals and insurers may now file diagnosis-related group (DRG) reports through the Workers’ Compensation Court’s web application.

North Carolina

  • Industrial Commission announced a $36 increase in the maximum weekly workers’ compensation benefit, starting Jan. 1. The maximum benefit will rise from $992 for this year, to $1,028.

Tennessee

  • The NCCI has proposed a statewide reduction of 19% for average voluntary market loss cost levels. By industry, contracting saw the greatest decrease of 20.7%, office and clerical was next at 20.6%, goods and services at 19.7%, manufacturing at 18% and miscellaneous at 16.8%. The new rates, which are under review, would become effective March 1, 2019.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

Legal Corner

ADA
Failure to accommodate is costly for employers

In Equal Employment Opportunity Commission, Linda K. Atkins v. Dolgencorp L.L.C., dba Dollar General Corp., a federal appeals court affirmed a jury verdict of more than $277,000 to a former diabetic Dollar General worker. She worked the register and was often alone, so she could not leave her station when she experienced a low blood sugar episode. Her manager refused to let her keep a bottle of orange juice at her register, so when she had an attack she took a bottle of juice from the store cooler and drank it, later paying the $1.69 she owed for each bottle and told her manager.

She was fired for violating Dollar General’s “grazing policy,” which forbids employees from consuming merchandise in the store before paying for it. The appeals court affirmed the jury awards of $27,565 in back pay and $250,000 in compensatory damages, and the court awarded her lawyers $445,322 in attorney’s fees and $1,677 in expenses. The jury found Dollar General failed to provide reasonable alternatives to keeping orange juice at her register.

In Stanley Christie v. Georgia-Pacific Co., Ace American Insurance Co., director, Office of Workers’ Compensation Program, the 9th U.S. Circuit Court of Appeals in San Francisco awarded permanent total disability to a man who injured his back working for a large paper company that failed to prove that they provided the employee with adequate accommodations after returning to work. While the company assigned him to a less-demanding warehouse position, the position required some lifting, which was difficult for him.

When he learned that the company was eliminating its early retirement program, he decided to retire because he did not feel he could work in pain for another six years. About two years later, his treating physician said he had reached maximum medical improvement, and he filed a claim seeking permanent total disability benefits under the Longshore and Harbor Workers’ Compensation Act, for which he was eligible.

The DOL’s Benefits Review Board, denied the claim, arguing his loss of wages was due to retirement, not the work injury. A three-judge panel of the 9th Circuit unanimously reversed, noting that his inability to work pushed him to retirement and the company had failed to provide suitable alternative work and had not documented any accommodations.

Workers’ Compensation
Injured worker cannot sue utilization reviewer – California

In King v. Comppartners, Inc., an utilization reviewer denied a treating physician’s request to continue prescribing Klonopin, a psychotropic drug, for an injured employee. The injured worker argued that the reviewer owed him a duty of care and had caused additional injuries by denying the request without authorizing a weaning regimen or warning him of the possible side effects of abruptly ceasing the medication. When he stopped taking the medication, he suffered four seizures.

The case found its way to the state Supreme Court, which found that utilization reviewers, in performing their statutory functions, effectively stood in the shoes of employers. As such, they were provided with the same immunity from tort liability as employers.

Safety consultant owes duty of care – California

In Oscar Peredia et al. v. HR Mobile Services Inc., parents filed a wrongful death claim against HR Mobile Services Inc., a workplace safety adviser for the employer of their son, who died in a work-related accident. The 5th District Court of Appeal found that HR Mobile agreed to assist the employer in carrying out its workplace safety obligations, and accepted a role in conducting safety inspections and safety training. As such, it can be held liable for injuries the third party suffers as a result.

Public employer can fire an injured worker who cannot perform essential job functions – Massachusetts

In Robert McEachen v. Boston Housing Authority (BHA), a carpenter for the Boston Housing Authority was injured and placed on FMLA and medical leave. About a year later, a termination hearing was held with the union and the employee and it was concluded that “he is unable to return to work and cannot perform the essential functions of his job.” The employee did not disagree and argued he could return to work in a modified duty capacity, supervising other carpenters. Such a position did not exist.

When he was terminated, he appealed to the Civil Service Commission, which upheld the BHA decision, noting the employee was unable to perform the essential functions of the job. A three-judge panel of the state appellate court affirmed.

Decision not to use handrail nixes comp claim – Minnesota

The Supreme Court ruled that an employee who fell down a flight of steps while at work is not due workers compensation because she chose not to use a handrail. In Laurie A. Roller-Dick v. CentraCare Health System and SFM Mutual Cos., the employee was leaving work, carrying a plant with both hands,when she fell down a flight of stairs and fractured her ankle. While she argued that her shoe stuck on the non-slip treads on the stairs, the compensation judge held that the injury did not arise out of employment because she failed to establish that the stairs were “more hazardous than stairs she might encounter in everyday life or that her work duties in some way increased her risk of falling as she descended them.”

While it was true that failure to use the handrail increased her risk of falling, there was no work-related reason not to use the handrail. The Workers’ Compensation Court of Appeals overturned the judge’s ruling, arguing that stairs in the workplace are inherently hazardous. However, the Supreme Court disagreed and reinstated the ruling of the compensation judge.

Teacher cannot sue school for injuries incurred when breaking up a fight – Minnesota

In Ekblad v. Independent Sch. Dist. No. 625, the 8th U.S. District Court of Appeals ruled that workers’ comp exclusive remedy bars a teacher from suing the school after he was seriously hurt breaking up a student brawl. The employee argued negligence and negligent supervision as well as failure to provide a safe workplace and a lenient policy toward minority students’ violent misconduct.

The court found that none of the three relevant exceptions to the exclusive remedy provision – the assault exception, the intentional act exception, and the co-employee liability exception – applied in this case.

Employer rebuts 100% industrial loss because employee has marketable skills – Mississippi

In Bridgeman v. SBC Internet Services, a worker suffered a compensable injury, was unable to return to his job that involved climbing utility poles, and he was terminated by his employer. Under law, there is a presumption of 100% industrial loss when the worker proves he can no longer perform his usual employment. This presumption is rebuttable, if the employer can prove the employee could earn the same wages in another position.

If the employer successfully rebuts the presumption, the employee will not recover for a 100% industrial loss of use, but receives a recovery based on the greater of his losses from the medical impairment or the industrial loss-of-use rating. Since the employer presented evidence that the employee had a computer science degree, had been a teacher, and could perform medium to heavy work, an appeals court upheld lower court decisions that granted a 50% industrial loss of use of his arm.

Subject-matter jurisdiction can be challenged at any time – North Carolina

In Burgess v. Smith, a young woman who sold cleaning products door-to-door was killed in a single car accident, driven by her co-worker. Her mother filed a wrongful death suit against the driver and her employer and neither responded to the summons. A trial judge entered a default judgment against the defendants for more than $2 million. Five months later, the employer filed a motion to set aside the default judgment, arguing that she was an employee (although he argued earlier she was an independent contractor) and that the superior court lacked jurisdiction over the claim.

The court of appeals overturned the superior court judge denial, noting that subject-matter jurisdiction may be challenged at any time, even after the default judgment. The court remanded the case with instructions for the judge to determine if there was an employer-employee relationship.

Employee cannot sue employer for failure to provide a stress-free environment – North Carolina

In Jones v. Wells Fargo Co., a former employee argued that the bank and her supervisor failed to provide her with a safe working environment free from mental stress or anxiety and aggravated a pre-existing mental condition, which they knew about. While she argued that the exclusive remedy of workers’ comp did not apply because of “egregious and extreme conduct,” the court disagreed.

Parking lot injury compensable – Pennsylvania

In Piedmont Airlines v. WCAB (Watson), an airline employee fell into a pile of snow in the employee parking lot and broke his finger. The employee parking lot, which was owned and operated by the Department of Aviation, required an identification card for entry and the employer had issued one to the employee.

The Commonwealth Court noted that when an injury does not take place while performing job duties, it is compensable if the injury occurred on the employer’s premises, the worker’s presence on the premises was required by the nature of his employment, and the injury was caused by the condition of the premises or by operation of employer’s business. The court found that all three factors were met and, therefore, the injury was compensable.

Failure to accept modified duty means benefits can be adjusted – Pennsylvania

In Pettine v. WCAB (Verizon Pennsylvania), an employee was struck by a car when marking the road and suffered compensable injuries. He later requested that the claim be expanded to include his back and shoulder. When he declined an offer of a modified job that met his physical restrictions, vocational background, and geographical area, Verizon sought to modify his benefits.

The case went through several appeals, but in each case, the employee’s petition was denied and Verizon’s was granted.

Compromise & Release (C & R) agreement may not be used to avoid paying third party fees – Pennsylvania

In Armour Pharmacy v. Bureau of Workers’ Comp, the terms of a settlement included that the company pay for all necessary medical treatment. Many years after the injury, the company requested a Utilization Review (UR) of a newly prescribed topical cream, which was determined to be reasonable and necessary treatment.

The company then entered into an agreement with the employee that stated its liability for his medical expenses did not include any past, present or future costs for any compounded prescription cream. Several months later, the employee filled another prescription for the same cream, and the company refused to pay the more than $6,000 bill.

The court explained that the C & R bind each other, but cannot release them from liability to an entity who is not a party, in this case, the pharmacy. An employer can challenge a provider’s treatment as neither reasonable nor necessary, only through UR, and the company had not challenged the second prescription.

Benefits for volunteer firefighter overturned – Pennsylvania

In East Hempfield Township v. WCAB, a long-term volunteer firefighter was diagnosed with cancer four years after taking the job with the township. Several years later he filed for workers’ compensation benefits, asserting that his cancer had been caused by his exposure to carcinogens while volunteering for the township.

The case went through several appeals with varying decisions related to whether adequate notice of the claim had been properly given. The burden of proof is on the worker to show that notice was issued within 120 days of the injury, or the date upon which he knew, or should have known, he had a potential claim.

While the employee was diagnosed years earlier, he argued he did not know of the causal link between his cancer and firefighting and filed within 120 days when he received a doctor’s letter noting the connection. The Commonwealth Court found that the relevant inquiry was not when the employee actually knew of the work-relatedness of his injury, but rather when he should have known the work-relatedness through the exercise of reasonable diligence. The case was vacated and remanded.

High court upholds total disability award for trucker with pre-existing degenerative disc disease – Tennessee

In Wesley David Fly v. Mr. Bult’s Inc. et al., the Special Workers’ Compensation Appeals Panel with the Supreme Court affirmed a circuit court ruling that a trucker’s total disability was caused by a workplace injury, not the pre-existing degenerative disc disease, which was discovered at the time of the injury. The court noted that the law requires employers to “take an employee as he is,” and “all reasonable doubts as to the causation of an injury and whether the injury arose out of the employment should be resolved in favor of the employee.”

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

OSHA watch

Compliance date for parts of general industry beryllium standard delayed

The compliance date for certain ancillary provisions in the beryllium standard for general industry is extended to December 12, 2018. The final rule published in the Aug. 9 Federal Register, states that the compliance date applies to requirements for methods of compliance, beryllium work areas, regulated areas, personal protective clothing and equipment, hygiene facilities and practices, housekeeping, communication of hazards, and recordkeeping.

New compliance assistance resources available for Silica Standard

  • A customizable slide presentation can be used to help train construction workers.
  • A five-minute video shows how to protect workers from exposure to silica dust.
  • A series of short videos demonstrates the proper use of specified dust control methods for six common construction tasks.
  • An FAQ page provides answers to frequently asked questions about the Respirable Crystalline Silica Standard for Construction.

Tips on forklift safety and maintenance

New QuickCards are available in English and Spanish to aid employees and employers in the safe operation and proper maintenance of forklifts.

Guidance explains how to use the 300 log to look for trends

That was no accident encourages employers to use the 300 Log not just as a paperwork exercise or a way to look at past performance, but as part of a company’s road map to finding and fixing hazards.

Redesigned regulations webpage provides easier navigation

The Law and Regulations webpage that features information on standards and rulemaking now can be searched by keyword or number and includes the latest updates on active rulemaking. The page also features information buttons to explain regulatory language that may be unfamiliar to some users.

Free workplace violence prevention webinar available online

A free 60-minute webinar on preventing workplace violence in healthcare settings is available from The Joint Commission, a long-standing national alliance partner. The webinar includes an overview of Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers, as well as a discussion of a multi-hospital intervention study that reduced violent events.

Name-and-shame strategy still prevalent in news releases

While the rate of releasing public statements about enforcement actions taken against employers is significantly lower under the Trump administration than the Obama administration (463 a year to about 150), the tone in these press releases has not changed. Most include harsh and embarrassing quotations from senior officials. Stakeholders argue that the press releases are based merely on allegations of violations and are published prior to companies being afforded a hearing.

Enforcement notes

California

  • Roofing contractor, Petersen-Dean, Inc., faces $146,004 in fines for repeat violations of exposing workers to fall hazards.
  • New York-based Outfront Media Inc, an outdoor advertising company, faces proposed penalties of $32,435 for serious safety violations after a worker suffered third-degree burns as well as an inadequate heat illness prevention plan for its outdoor workers.

Florida

  • G&H Underground Construction faces $57,738 in proposed penalties for allowing the use of unguarded machines after an employee suffered a throat laceration at a worksite in St. Augustine.
  • Archer Western Construction Inc., an Atlanta-based company, faces $33,259 in proposed fines for safety violations after two employees suffered fatal injuries while performing trenching activities at a Miami worksite.
  • The Holly Hill-based paving company, Pavemax Corp. faces $16,814 in proposed fines for safety violations after an employee suffered fatal injuries at an Orange City worksite, including failure to train and provide a place of employment free from recognized hazards.

Illinois

  • HB Fuller Company, operating as Adhesive Systems Inc., faces $587,564 in proposed penalties for 18 health and safety violations at its facility in Frankfort. The company was cited for failing to: provide employees with respirator fit tests and respirators appropriate for hazardous atmospheres; require bonding and grounding when transferring flammable liquids; ensure that electrical equipment was approved for use in hazardous atmospheres; and conduct a personal protective equipment assessment.

Mississippi

  • After Nissan North America Inc. contested two violations, an administrative law judge of the OSHRC vacated one serious citation but affirmed the other and assessed a $12,675 penalty. The law judge affirmed the violation of training requirements in an employer’s energy control program after determining that the evidence established that the exposure was reasonably predictable and training the technicians was required.

New York

  • The OSHRC affirmed two serious citations previously vacated by an administrative law judge against a commercial laundry facility, Angelica Textile Services Inc., in Ballston Spa. A single grouped penalty of $7,000 was assessed for inadequate isolation and verification procedures for a permit required confined space and of lockout/tagout procedures. However, the review commission reclassified the penalties as serious rather than repeat violations.

Pennsylvania

  • Grove U.S. LLC. was cited for exposing workers to struck-by hazards after three employees suffered fatal injuries when a 300-ton crane collapsed at the company’s Shady Grove facility. The company faces proposed penalties totaling $14,976, the maximum amount allowed.

Tennessee

  • Day & Zimmerman NPS Inc. faces $71,599 in proposed penalties for exposing employees to electric shock hazards at the Tennessee Valley Authority Sequoyah Nuclear Power Plant in Soddy Daisy.
  • Specialty Tires of Unicoi faces $6,000 in fines after a mechanic was killed when he was caught in the moving arms of an assembly machine. The company was cited for failure to have an energy control procedure and failure to conduct regular inspections of an energy control program and ensuring that employees understand and comply with such a program.
  • M&K Home Improvement faces $51,200 in penalties for exposing workers to fall hazards.

For more information.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

HR Tip: How employers are controlling health benefit costs

According to the nonprofit National Business Group on Health (NBGH) survey 2019 Large Employers’ Health Care Strategy and Plan Design, the cost of employer-sponsored health benefits is expected to near $15,000 per employee in 2019. The survey indicates that many large employers are looking to curb costs with cost-effective service providers such as telehealth options and high-value in-plan provider networks. Other initiatives include focusing on high cost claims, adding a consumer engagement platform, and using targeted specialty pharmacy management for high cost drugs.

The survey also found that employers are dialing back their move to consumer-directed health plans (CDHP), which was attributed to the delay in the “Cadillac tax” under the Affordable Care Act.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

 

Important studies – Top three practices for closing a claim

While workers’ comp is a data-rich industry, it is only beginning to use the data to make better and smarter decisions. Rising Medical Solutions recently released a white paper that condenses the study’s multi-year benchmarking data into the top three practices ‘high performing’ claims organizations use to excel. Performance ratings were based on claims closure ratio, a comparison of opened claims versus closed claims. A claims ratio of 100% means the organization is closing as many claims as they are opening.

Here are the top three practices:

  • Focus on and measure medical management, disability / return-to-work (RTW) management, and compensability investigations While other competencies such as claims reserving and litigation management are important, these three are most critical to claims outcome. An employee’s return to the same or better pre-injury functional capabilities was the number one classification of a “good claims outcome.”

    However, just focusing on these factors is not enough. Higher performing claims organizations are five times more likely to measure their performance in core competencies, six times more likely to measure claim outcomes based on evidence-based treatment guidelines, and 10 times more likely to measure claim outcomes based on evidence-based disability duration guidelines.

  • Invest more in people and claims advocacyAs expected, the high performers cultivate talent by providing more training and career-long learning opportunities, raising performance expectations, fostering communication and critical thinking skills, and making available decision support tools known to improve claims outcome. “At a claim’s outset, the adjuster is uniquely appointed to visualize and predict how the claim will resolve, and then adapt her or his strategy as new information emerges.”

    Particularly important is embracing the historic shift from reactive, compliance-focused models of injured worker interaction to an employee-centric approach, known as claims advocacy. The importance of understanding and engaging the injured worker in the recovery process is a clear competitive advantage.

  • Invest more in advanced tools and technology, including predictive analytics High performers focus on outcome management, rather than process management. They measure medical provider performance and use predictive analytics eight times more than others. While sometimes this has been a much-contested topic, predictive modeling warehouses data on injured workers, uses outcome-based data to improve treatment, and measures success.

    It can reduce claims costs by identifying potential complicating factors and creating a more proactive approach to the ongoing treatment plans. It identifies “routine” claims that have the potential to become complex. The same data and insights can be applied to a return-to-work plan to reduce the risk of re-injury.

 

On-the-job crashes up

Motor vehicle accidents are a troubling trend for the workers’ compensation sector, according to data released recently by the National Council on Compensation Insurance (NCCI). Frequency for on-the-clock car accidents increased 5 percent, in contrast to an overall decline of 17.6 percent for all claims in comp from 2011 to 2016. Alarmingly, over 40% of workers’ compensation fatalities involved a motor vehicle accident.

Other findings included:

  • Motor vehicle claims cost 80% to 100% more than the average claim because they involve severe injuries, such as head, neck and multiple body-part injuries.
  • The rapid expansion of smartphone ownership since 2011 may have been a factor in the rise in accidents.
  • Most accidents are the result of driving as opposed to being hit by a car. From 2000 to 2016, the split of “occupant vs. struck by” claims has remained “very consistent” at about 85% to 15%.
  • Of the top 30 motor-vehicle classes reviewed, including that of trucking, the largest increase in frequency occurred in the “taxicab company” class, with a dramatic rise in frequency more than doubling from 2011 to 2015.

 

Opioids deaths linked to occupations

The opioid-related death rate for those employed in construction and extraction occupations was six times the average rate for all Massachusetts workers, according to a report by the Massachusetts Department of Public Health. The report speculates that the higher rate of work injuries in these fields, as well as low job security, and a lack of paid sick leave could be contributing factors.

The study reviewed death certificates from 2011-2015. Other industries with higher than average rates of opioid-related deaths include farming, fishing, healthcare support occupations, food preparation, and the restaurant industry. The industries with the highest rates also varied by gender: for men, the highest rate was in construction. For women, serving-related jobs, food prep, and healthcare support had the highest rates.

The Department plans a larger study to see if there is a link between workers compensation and overdoses.

 

Opioids still present in polypharmacy claims

Even though efforts in the state to curb opioid prescriptions have had some success, opioids alone are the most prevalent type of drug found in polypharmacy claims that involve five or more concurrent prescriptions, according to a study by the California Workers’ Compensation Institute.

Polypharmacy is the use of multiple drugs at the same time to treat one or more medical conditions in a patient. Oftentimes, they are used to alleviate risks and side effects caused by other drugs, but they can interact poorly and increase the risk of overdosing.

While only 4% of the claims analyzed were considered polypharmacy claims, 91.5% of them involved indemnity payments, 21.5% were at least ten years old, and they more commonly involve older workers. The top diagnostic category for polypharmacy claims (21.3 percent of claims) was back conditions without spinal cord involvement, including back sprains and strains.

 

Employees believe they get fat on the job

A recent survey conducted by Harris Poll on behalf of CareerBuilder found that more than half of U.S. workers consider themselves overweight, and many believe their current job has played a role.

The survey included a representative sample of 1,117 full-time workers from multiple industries and different-sized companies. 45 percent said they gained weight while at their current job, with twenty-six percent gaining more than 10 pounds and 11 percent more than 20 pounds.

Among the reasons cited:

  • Sitting at a desk most of the day (53 percent).
  • Too tired after work to exercise (49 percent).
  • Stress eating (41 percent).
  • No time to exercise before or after work (34 percent).
  • Workplace celebrations (13 percent).
  • Skipping meals because of time constraints (12 percent)

The survey also found that 63 percent of workers eat lunch at their workstation, and 72 percent snack on the job.

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