Legal Corner

Workers’ Compensation
ABC test applies only to wage order claims – California

Earlier this year, the Supreme Court issued a groundbreaking decision when it adopted a new legal standard known as the “ABC Test,” making it much more difficult for businesses to classify workers as independent contractors. The Dynamax vs The Superior Court of Los Angeles County case was decided for the purposes of the state’s wage orders, but some speculated it might be applied more broadly.

Recently, in Garcia v. Border Transportation Group, a Court of Appeals held that the new test is limited to claims arising under the California Wage Orders, and that other claims continue to be governed by the prior (and more employer-friendly) standard known as the Borello test. It noted: “Dynamex did not purport to replace the Borello standard in every instance where a worker must be classified as either an independent contractor or an employee for purposes of enforcing California’s labor protections…[The California Supreme Court] did not reject Borello, which articulated a multifactor test for determining employment status under the Worker’s Compensation Act.”

No coverage for injury that occurred before issuance of policy – Florida

An insurance broker scrambled to get a policy in place for an uninsured employer dated the same day of an employee injury without disclosing the incident to the insurance carrier. In Normandy Ins. Co. v. Sorto, an appellate court ruled that there could be no coverage because insurance laws preclude coverage for losses that have already taken place. The court noted agreement to assume a known loss is not insurance. Insurance is to provide protection against risk. One cannot insure against known losses; there is no risk.

Lunch break injury not compensable – Georgia

In Frett v. State Farm Employee Workers’ Comp., an insurance claims associate had a scheduled lunch break and walked to the break room to microwave her lunch, which she intended to eat outside. In the breakroom, she fell in a puddle of water and a manager instructed her to complete an incident report. While an administrative law judge granted benefits, the State Board of Workers’ Compensation reversed and a superior court judge affirmed the denial.

The board found the injury did not arise out of her employment because it occurred while she was on a regularly scheduled break and while she was leaving to attend to “a purely personal matter.” While there was precedent for compensability when a worker is entering or exiting the employer’s property, even during break times, the court said this was a mistake and disapproved of its prior decisions.

Injured employee has right to sue employer under retaliatory discharge statute – Massachusetts

In Bermudez v. Dielectrics, Inc., a worker was placed by a temporary employment agency in a manufacturing facility. She sustained work-related injuries when one of the manufacturer’s employees negligently operated a forklift and several large metal sheets fell on her foot. She received work comp benefits from the employment agency and returned to work at the manufacturer eight weeks later. A few months later, she was hired as a full-time employee at the plant.

Eighteen months later, she filed a third-party action for negligence against the manufacturer and the forklift operator. Two months later she was terminated and she sued.

While a trial judge ruled in favor of the company, an appeals court found that the workers’ compensation law specifically says a worker can initiate a third-party action in addition to receiving benefits through the comp system and that a 1971 amendment eliminated the election of remedies concept (comp remedy or a civil claim). The worker had a right to file her third-party action and she could not be fired for doing so.

Worker on business trip who witnessed killings at a restaurant awarded benefits for PTSD – Michigan

In Dickey v. Delphi Automotive Systems LLC., an employee was at a restaurant in Mexico with clients and workers when he witnessed gunmen kill several people in the restaurant. When he returned to Detroit, he was diagnosed with PTSD. The Commission held it was logical to conclude that one who witnesses a horrific, stressful, and traumatizing event such as a multiple murder could possibly be afflicted with PTSD and that the award of benefits was reasonable. The employer’s examining doctor found that his symptoms were related to the side effects from the medicine he was taking, but the magistrate relied on the opinion of the treating doctors, who were actually increasing the worker’s medications.

Murder of worker by co-worker not work related – Michigan

In Williams v. Park Family Health Care PC, a worker was killed by a co-worker who she previously dated. She had broken off the relationship because he was married and not seeking a divorce. He let himself into the building, killed the worker, set the building on fire, and killed himself.

While the court found the death occurred in the course of employment, it did not arise out of her employment. The feud was personal and not connected to her employment.

Devastating stroke after reaching MMI does not affect permanent total disability benefits – Nebraska

In Krause v. Five Star Quality Care, a housekeeper fell and fractured her right femur. After her surgery she attempted to return to work, but experienced too much pain. About 2.5 years later, she filed a petition in Workers’ Compensation Court seeking temporary and permanent disability benefits. Approximately three weeks later, she suffered a massive stroke that left her incapacitated.

The compensation court, finding that the stroke was unrelated to the work injury or treatment, found she had reached maximum medical improvement prior to her stroke and awarded her permanent total disability benefits (PTD). The company argued that the stroke cut off her entitlement to PTD benefits. The court disagreed, noting that her work-related disability did not cease once she had the stroke.

Treatment guidelines apply to out-of-state providers – New York

In Matter of Gasparro v. Hospice of Dutchess County, a home health aide sustained work-related injuries to her lower back and buttocks while employed in New York and was given a nonscheduled permanent partial disability classification. Ten years later, she moved to Nevada.

Several years later, the workers’ compensation carrier objected to payment of various medical charges from a pain management specialist in Nevada. A workers’ compensation law judge ruled in favor of the medical provider, but the Workers’ Compensation Board reversed and the appellate court agreed.

Although the Board had departed from its prior decisions on the issue, the appellate court found it was rational to require medical treatment be in compliance with the guidelines.

Unreasonable deviation from employment nixes benefits – New York

In Matter of Button v. Button, a farmhand was seriously injured in a vehicular accident as he crossed a road on an employer-owned all-terrain vehicle (ATV) from his employer-provided residence to the farm itself. His residence was across the road from the farm and his girlfriend was moving in that day. He stopped at the house and grabbed a beer and the accident occurred on the way back to the farm.

His comp claim was denied by a judge because he was engaged in a prohibited activity at the time of the accident (drinking) and, therefore, his injuries did not arise out of and in the course of employment. The Board affirmed as did the appellate court, noting there was a verbal warning about drinking on the job and that other employees testified the consumption of alcohol at work was prohibited.

Workers’ Compensation Board must determine if worker is independent contractor – New York

In Findlater v Catering by Michael Schick, Inc., a state appellate court held that a trial court’s finding that a worker was an independent contractor, and not an employee, must be reversed. It found that employment issues must be decided by the Workers’ Compensation Board and the court erred by not holding the matter in abeyance pending a final resolution.

Volunteer can pursue personal injury suit in spite of liability waiver – New York

In Richardson v. Island Harvest, an unpaid volunteer worked as warehouse assistant and signed an agreement, which stipulated he was a volunteer and would not attempt to hold the organization liable for any bodily injuries he suffered in the course of his volunteer activities. He was struck by a forklift being operated by an employee and filed a personal injury suit. While a county Supreme Court Justice granted summary judgment to the organization, an Appellate Court reversed.

“New York courts have long found agreements between an employer and an employee attempting to exonerate the employer from liability for future negligence whether of itself or its employees or limiting its liability on account of such negligence void as against public policy,” the Appellate Division said.

Insurer cannot sue third-party without involvement of injured worker – Pennsylvania

An employee of Reliance Sourcing, Inc, which was insured by The Hartford, was standing in the parking lot of Thrifty Rental Car when she was struck by a rental vehicle. The Hartford paid over $59,000 in medical and wage benefits and sought to sue the responsible parties for damages. The employee did not join in the insurer’s action, did not assign her cause of action to the insurer, and did not seek to recover damages independently.

While the defendants argued The Hartford had no independent ability to commence a subrogation claim directly against them, The Hartford argued it had filed the suit “on behalf of” the employee. In a divided decision, the Supreme Court ruled that absent the injured employee’s assignment or voluntary participation as a plaintiff, the insurer may not enforce its right to subrogation by filing an action directly against the tortfeasor. – The Hartford Insurance Group on behalf of Chunli Chen v. Kafumba Kamara, Thrifty Car Rental and Rental Car Finance Group.

Widow denied benefits for husband’s pancreatic cancer – Tennessee

In Alcoa v. McCroskey, the Supreme Court of Tennessee Special Workers’ Compensation Appeals Panel ruled that a widow failed to prove her husband’s cancer was caused by his occupational exposure to coal tar pitch, affirming the decision of a trial judge. The judge found Alcoa’s expert to be more persuasive than the widow’s expert, who relied upon a single medical article, yet that article expressly noted its evidentiary deficiencies. The employer’s expert testified that the employee possessed recognized risk factors for the development of pancreatic cancer that were wholly unrelated to his work exposure to coal tar pitch.

Department-approved settlement not sufficient to compel treatment – Tennessee

In Hurst v. Claiborne County Hospital and Nursing Home, a paramedic was injured in an ambulance accident and also alleged a psychological injury from an October 2000 incident when she encountered a severely abused infant. The claim was settled, but the agreement only addressed her psychological injury. No reference was made to the ambulance accident.

After the settlement was finalized, she filed a new claim seeking benefits for the injuries incurred in the ambulance accident. She settled the claim in exchange for the payment of permanent partial disability benefits and the promise of payment for future medical directly related to her injuries. The Department of Labor and Workforce Development signed off on the settlement, not a judge. Seven years later, she filed a motion to compel payment for medical care which a trial judge granted.

On appeal, the hospital argued that the judge lacked jurisdiction since there was no court order awarding her a right to medical treatment for her physical injuries. The Supreme Court of Tennessee’s Special Workers’ Compensation Appeals Panel found the version of the Workers’ Compensation Law applicable to the 2001 car accident did not provide any mechanism for the enforcement of a department-approved agreement that had not been approved by a judge.

Worker loses benefits for failure to attend FCE sessions – Virginia

On three occasions over a four-month period of time, an employee cancelled a scheduled (and rescheduled) functional capacity evaluation (FCE) session. The employer filed a request to terminate benefits. Although the worker did appear for a FCE one week after the hearing, the worker took no action in the nearly seven-month period between the time the employer filed the request and the date of the hearing. In DeVaughn v. Fairfax County Public Schools, the Court of Appeals upheld the decision of the Workers’ Compensation Commission that there were no mitigating circumstances excusing her lack of effort and no basis for a finding of good faith.

Drivers failure to chock wheel nixes benefits – Virginia

In Callahan v. Rappahannock Goodwill, an appellate court affirmed a finding by the state’s Workers’ Compensation Commission that a truck driver willfully violated safety rules when he failed to chock the wheel on the employer’s truck during a stop and, hence, could not receive benefits for the injuries he sustained. The record supported that the safety rules were communicated through several methods to the driver and the physical evidence supported the finding that the wheels were not chocked.

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

Seven emerging risks and trends to watch

Often employers don’t give emerging trends the same importance as existing practices. Here are seven emerging trends to put on your radar screen:

  1. Temporary workersWhether it’s to meet peaks in demand, a screening process for temp-to-permanent employee, or to tap a unique skill or talent, temporary workers are a vital part of today’s workforce. They also present unique risks for employers. Temp workers are less likely to return to work following an injury and are almost three times as likely to suffer non-fatal occupational injuries than direct hire employees according to a study by University of Illinois at Chicago’s School of Public Health.

    Further, classification of workers as employees or independent contractors remains a thorny legal issue. Insurers are also scrutinizing classification of workers particularly in franchises, the gig economy, and trucking industry. Despite the administration change, OSHA remains committed to overseeing and enforcing temporary workers rights.

    Keeping temporary workers safe and understanding agency/employer responsibilities is a constant challenge. While there is a tendency to be laxer with temporary workers, they need to be vetted and trained as if they would be there permanently. Expectations need to be clearly communicated. Some employers have found “buddy systems” and visual identification effective.

  2. Medical and recreational marijuanaConflicting laws, inconsistent legal rulings, zero tolerance drug policies, differing opinions about the use of marijuana as a viable alternative to relieve chronic pain, and reimbursement issues make marijuana a hot-button headache for employers. Court decisions about reimbursement for medical marijuana have been all over the place. A handful of states have found, and continue to find, that it is reimbursable (CT, MN, NJ, NM, and NY).

    While many courts have ruled that employers with drug-free workplace policies can terminate an employee who tests positive for marijuana, Massachusetts companies cannot fire employees who have a prescription for medical marijuana simply because they use the drug, but must attempt to negotiate a mutually acceptable arrangement with each medical marijuana patient they employ.

    With a tight labor market, companies lament that too many applicants test positive for marijuana during pre-employment screening, causing some to relax the practice. Others grappling with marijuana look at job functions and do not hire someone in a safety-sensitive position if they have a medical marijuana card or prohibit certified users from performing certain safety-sensitive jobs while “under the influence” of medical marijuana. Post-accident drug testing is also challenging for employers as is modified duty for injured workers treating with medical marijuana.

    A new year is a good time to review your written drug policies, clearly communication expectations and company rules to all employees, and be sure supervisors know how to recognize signs of impairment. Employers are responsible for providing their employees a safe working environment and this is one of the more vexing areas. Don’t go it alone; consult with legal counsel and insurance carriers that can help navigate the complexity.

  3. Mental health and PTSDThe debate about mental health coverage under workers’ comp is not new, but continues to gain traction with rising incidents of workplace violence, PTSD, efforts to reduce the stigma associated with mental health, and general concern of stress in the workplace. Workers’ Comp compensability for mental-mental and mental-physical injuries, either by statute, regulation, and/or case law vary widely by state and many states are reexamining their statutes, particularly for first responders.

    Moreover, the effect of depression, anxiety, and other mental health issues on delayed return to work, increased claims costs, and workplace violence are being addressed in return to work efforts and employee assistance programs. Increasingly, mental health is also being incorporated into health and wellness programs.

  4. Ergonomics and wearablesA recent survey by Marsh Risk Consulting (MRC) found that companies are not doing enough to tackle emerging risks, including ergonomics and wearables. Ergonomics typically is one of the top three causes of workplace injuries, but advances in technology offer opportunities to manage and mitigate the risks. Wearables can measure body stresses and provide data, alerts and real-time monitoring to modify behavior and enable managers or other senior workers to make corrections before an injury occurs. They can also provide data for potential engineering and productivity improvements.

    While wearables are here to stay, they need to be integrated strategically. Some things to consider are how they complement existing safety efforts and culture, the cost-benefits, and the risks. Data privacy risks, ethical considerations, and liability exposures for employers all need to be considered when implementing programs using wearables. As with the introduction of any new technologies, employee acceptance is key.

  5. Robotic and human interactionAnother emerging risk needing more attention identified in the MRC survey is the rapid growth in collaborative and mobile autonomous robots that is increasing the threat of injury from human and robot interaction. Whereas robots used to work in isolation, technology has evolved so that many now work alongside humans. A common myth is that the collaborative robot is safe out of the box, yet the manufacturer does not control how it is programmed or used. Every collaborative robot system is unique and the risks must be assessed.

    In addition, employees may resist the introduction of such systems, particularly when they fear losing their job. Smart employers prepare employees for the future of work by systematically and intentionally reskilling and upskilling them.

  6. Alternatives for pain management and the opioid prescription drug crisis2018 was an active year for state legislation regarding prescription drugs in workers’ compensation and more is expected in 2019 to stem the opioid crisis. The industry has seen positive results and continues to seek new ways to address the problem.

    A Hartford survey on opioids in the workplace had troubling results. Over three-quarter of workers don’t feel trained to help colleagues navigate addiction, 64% of human resource professionals say they are unprepared to handle opioid addiction, and only 34% of workers feel the company has the resources to deal with the problem.

    Employers need to step up by educating employees about the risks of the misuse of opioids, identifying those at risk of misuse and getting appropriate help, assessing current workplace drug policies and scope of drug testing, and strengthening employee assistance programs. In addition, working to expand coverage of alternatives for pain management that offer a more holistic approach, such as cognitive behavioral therapy (CBT), mindfulness, physical and occupational therapy, relaxation training, and exercise will help employees gain confidence in their ability to manage their pain.

    Some employers use telemedicine to keep employees engaged with virtual face-to-face meetings between patients and psychologists. Medical marijuana may hold promise for the future, but science is too limited and it remains classified as a Schedule I drug under federal law. It behooves employers to stay abreast of new developments.

  7. Natural disastersThe country has seen its share of devastation this year and the recent dire report on climate change from the US Global Change Research Program suggests it will continue on an increasing scale. For those affected, the implications for workers’ comp are huge – expediting benefit payments and medical care to injured workers directly affected, workplace injuries during disaster recovery, and disruption of business operations. The National Council on Compensation Insurance (NCCI) states that when a natural disaster creates a temporary interruption of normal business activities, this can validate a change in an insured’s operations, and can prompt carriers to consider a change in governing classifications if the employer continues to pay its employees while they are unable to work.

    Businesses should always expect the unexpected. Staying ahead of risks during disasters requires an assessment of the unique risks that can potentially arise in your location and developing a comprehensive plan that addresses employees, infrastructure, and business continuity.

Employers that move beyond the familiar traditional issues and anticipate and address emerging risks become industry leaders.

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

 

The possibilities of telemedicine in workers’ comp

While more and more insurers are offering telehealth as part of their health plans, the highly regulated workers’ comp industry is just getting its feet wet. Telemedicine is the use of electronic communication technologies to provide medical services to injured workers without an in-person visit. This fast-paced, instant ability to connect with a medical professional can help a claim to start out right and stay on track. It can be utilized for a range of physician-led services, including initial injury treatment, specialty consultations and follow-up care.

There are several advantages:

  • Immediate attention to minor injuries
  • Fewer emergency room visits
  • More physician and specialist availability
  • Ideal for rural and remote areas
  • Removes transportation obstacles
  • Fewer missed appointments
  • “Stay-at-work” visits improve early return-to-work
  • Aid in management of chronic conditions
  • Initial assessment and evaluation for injuries when access to immediate medical care is limited, such as overnight shifts and remote travel
  • Lower costs

Yet, there are a number of barriers:

  • Employee uneasiness with receiving remote care from an unfamiliar provider
  • Physical examination limited
  • Jurisdictional and regulatory issues
  • Lack of physician fee schedules for telemedicine
  • Start-up technology costs
  • Cybersecurity threats
  • Lack of regulations and policies for licensing and privacy
  • Misdiagnosis

Telemedicine is designed to supplement, not replace, in-person care. For some injured workers, it may be a viable option. As this continues to take hold in workers’ comp, strategies to address the barriers are developing. The types of telemedicine services covered, provider requirements, and reimbursements vary across states and continue to evolve.

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

Determining the risks of delayed recovery

One of the most perplexing problems in workers’ comp is delayed recovery, or relatively minor claims that become long-term, costly claims. Often the claims go unnoticed until significant dollars are spent on procedures, surgeries, and medications for an injury that should have healed long ago. While these claims may only represent 6 – 10% of all claims, they can consume 80 percent or more of medical and indemnity resources, according to Integrated Medical Case Solutions.

Yet, if identified early, proper intervention prevents the delayed recovery. Research suggests that psychosocial factors play a large role in these “creeping catastrophic claims.”

Pioneers of diagnosing and treating injured workers with psychosocial risk factors, Michael Coupland, the CEO and Network Medical Director of Integrated Medical Case Solutions, and Steven Litton developed a simple pain screening questionnaire (PSQ). Though widely used in Canada and several other countries, it is just starting to catch on with the U.S. workers’ compensation system, according to an article in Property Casualty 360°.

It includes ten questions or statements related to the injured worker’s pain attitudes, beliefs and perceptions, which the injured worker rates on a scale of 1 to 10. The article notes that one of Coupland’s favorite questions is ‘I should not do my normal work with this amount of pain,’ which gives insight into work attitudes, catastrophic thinking, and fear-avoidance behavior.

Physicians focus on the pain and physical diagnosis and prescribe MRIs, tests, surgeries, and even opioids. Costs escalate with little relief of pain. The underlying psychosocial factors go untreated and include:

  • Catastrophic thinking – or OMG! Thoughts. Despite the injury or illness, people believe they are beyond the ability to recover.
  • Fear avoidance. Workers are so concerned about further injuries, they avoid doing anything that might exacerbate the pain.
  • Anger and perceived injustice. Regardless of how long someone has worked at their company, they feel a disservice has been done to them.
  • External focus of control. Workers rely on their medical providers and others to fix them, rather than taking any responsibility for their own recovery.

Since 2013, Albertsons Safeway has used the test to determine the risk level of delayed recovery, giving it to all injured workers with indemnity claims two weeks post injury. According to a blog post by the IMCS Group, the average amount paid per claim rose exponentially with risk level. Looking at data from the 2013 – 2015:

Risk Level # of Injured Workers Average Amount Paid
Low 1,031 $2,059
Low-Moderate 307 $10,759
Moderate 145 $21,783
High 192 $26,212
Very High 148 $39,967

The injured workers who scored high or very high were given the opportunity to undergo cognitive behavioral therapy (CBT). About half agreed to do so. Unlike traditional psychotherapy, CBT is brief. The goal is for injured workers to cope with their pain, rather than be cured of it.

The blog post, Early CBT Intervention Changes Lives, Saves Money for WC Payers, explains the company created three groups of injured workers that had scored as high-risk on the PSQ to test the effectiveness of the CBT intervention. One group that participated in the CBT program; a second group that chose not to participate; and a third group of injured workers that had not been offered CBT.

Here are the results:

Group Average Total Paid
Participated in CBT $36,629
Did not participate $44,356
Were not referred to CBT $73,488

Those who engaged in CBT returned to work much sooner than those in either of the other two groups. According to an Albertsons Safeway representative, the program resulted in an estimated 30 percent reduction in total claims cost.

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

Top reasons for serious workplace injuries and large workers’ comp losses

Liberty Mutual Workplace Safety Index

Produced annually, the Liberty Mutual Workplace Safety Index identifies the leading causes of the most disabling non-fatal workplace injuries (resulting in six or more days of lost time) and ranks them by total Workers’ Compensation costs. The top five causes that accounted for 68.9% of the total injuries occurring in 2015 (most recent data available) were: 1) overexertion involving outside source, 2) falls to lower level, 3) falls to same level, 4) struck by object or equipment, and 5) other exertions or bodily reactions.

For the fourth consecutive year, overexertion involving outside sources topped the list, accounting for almost a quarter of the losses, at $13.7 billion per year. This event category includes injuries related to lifting, pushing, pulling, holding, carrying, or throwing objects. Rounding out the top ten are: roadway incidents involving motorized land vehicle, slip or trip without a fall, caught in or compressed by equipment or object, struck against equipment or object, and repetitive motions involving micro-tasks.

These top ten accounted for $52 billion a year in medical and lost wage costs for businesses. While the number of injuries decreased 1.5 percent, the costs increased 2.9 percent. The total cost of all disabling injuries and illnesses was nearly $60 billion per year.

Combined with your company’s worker injury data, the information can help prioritize preventive measures and training needs.

 

Safety National review of high cost claims

When one thinks about high cost workers’ comp claims, it’s natural to focus on catastrophic claims. These claims include severe burns, brain injuries, spinal cord injuries and significant amputations, which are devastating for all involved. According to Safety National’s claims data, five accident causes accounted for 86% of our catastrophic injury claims:

  • 24% – Motor Vehicle Accident
  • 24% – Fall
  • 20% – Struck By
  • 10% – Act of Crime
  • 8% – Burn

Yet, the recent review of Safety National’s large loss claims by Mark Walls, Vice President of Communications & Strategic Analysis, and Stephen Peacock, Assistant Vice President – Claims, found there were significantly more “developmental” claims that crossed the $1 million threshold, used to define “large loss.” Developmental claims are routine claims that continue to develop over time, including back, shoulder and knee injuries. In this review, they represented about two-thirds of all large-loss claims. In many cases, there were opportunities to resolve the claims before they morphed into large losses, yet failure to recognize the loss potential and intervene earlier opened a Pandora’s Box.

Multiple failed surgeries was the most-common reason for escalating costs in these claims, followed by prescription opioid medications. Both catastrophic and developmental claims have extremely long tails and can remain open for 30 years or longer. The data clearly shows that every claim warrants attention and a comprehensive claims management program is critical to preventing routine claims from morphing to large losses.

 

NCCI Annual Issues Symposium – Mega Loss in Work Comp: How Medical and Treatment Advances Affect Life Expectancy

At the recent NCCI Annual Issues Symposium, presenters lauded the incredible medical advances that have enabled seriously injured workers to survive and survive longer and addressed how to improve outcomes related to these so-called work comp megaloss claims. Dr. Michael Choo and Scott Goll from Paradigm Outcomes discussed trends in mega losses (defined as claims with total incurred greater than $1 million) that average $3.2 million an incident in medical costs alone but can have costs up toward $20 million.

An analysis of Paradigm data showed that 51 to 60-year-olds represented the highest percentage of these claims and males surpassed females for accident rates. The leading causes included vehicle accidents, being struck by an object, and fall-slip-trip injuries. Burns and infections were among the most common medical afflictions.

While some of the cost drivers reflect medical advances, such as more frequent replacement of prosthetics with more high-tech components, innovative laser treatment for scars, and long-term care programs for brain and spinal cord injuries, up-charging for certain medical treatments, adverse events following treatment such as hospital infections, and co-morbidities also drive costs.

According to Dr. Choo these factors can best be mitigated with:

  • Expertise: It takes a team to have the knowledge and skills to ensure a high-quality outcome.
  • Experience: People with experience can tell you what works and what doesn’t.
  • Embracing Outcomes: Help providers focus on outcomes rather than optimizing revenues.

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