Things you should know

Return to work more likely with less-invasive back surgery

A recent study of 364 Ohio workers diagnosed with degenerative spinal stenosis who underwent back surgery found that those who underwent primary decompression, a surgical procedure to alleviate pain caused by pinched nerves, had higher return to work rates than those who had the more-invasive, more-expensive fusion surgery. The study was published in July’s Spine medical journal.


Ohio adopts rule requiring initial conservative back treatment

The Ohio Bureau of Workers Compensation’s new spinal fusion rule requires workers to first undergo at least 60 days of comprehensive conservative care, such as physical therapy, chiropractic care and rest, anti-inflammatories, ice and other non-surgical treatments before lumbar surgery. Conditions that require immediate intervention, such as spinal fractures, tumors, infections and functional neurological deficits, are exceptions to the rule.

DOL will again issue opinion letters on FMLA, FLSA and other laws

The U.S. Department of Labor will again issue opinion letters to assist employers and employees in interpreting laws like the FMLA and Fair Labor Standards Act. The DOL has established a new webpage to submit requests for opinion letters and to review old opinion letters.

New I-9s must be used beginning Sept. 18, 2017

USCIS released a revised version of Form I-9, Employment Eligibility Verification, on July 17. Employers can use this revised version or continue using Form I-9 with a revision date of 11/14/16 N through Sept. 17. On Sept. 18, employers must use the revised form with a revision date of 07/17/17 N. Employers must continue following existing storage and retention rules for any previously completed Form I-9. Changes to the form are considered minor.

Free safe driving kit from National Safety Council

The Safe Driving Kit, sponsored by Wheels, Inc., aims to create safer roads and protect employees through multi-media resources and engaging materials. The kit addresses the key contributors to car crashes, including distraction, alcohol, other drugs, fatigue and seatbelt use. It also brings attention to lifesaving technology that helps prevent crashes.

Workers’ comp making more progress in reducing opioid prescriptions

According to research released by the Centers for Disease Control and Prevention (CDC), the average days’ supply per opioid prescription increased from 13 days in 2006 to almost 18 days in 2015. Meanwhile, nearly half of the states included in a study of opioid prescribing in workers’ compensation cases have seen reductions in the frequency and strength of opioids given to injured workers, according to a study released in June by the Cambridge, Massachusetts-based Workers Compensation Research Institute.

More than 1,000 unsafe CMVs pulled from service during ‘Operation Airbrake’

Brake violations prompted the removal of 1,146 commercial motor vehicles from service as part of a recent unannounced, single-day inspection blitz across the United States and Canada on May 3. According to the Commercial Vehicle Safety Alliance (CVSA), 12 percent of CMVs inspected were taken out of service for brake violations, and 21 percent were removed for other violations.

More than half of workers aren’t trained on first aid, CPR: survey

About 10,000 cardiac arrest situations occur in the workplace each year, yet only 45 percent of U.S. employees have been trained in first aid – and only 50 percent of workers know where to find an automated external defibrillator – according to the results of a survey recently conducted by the American Heart Association.

‘Sleeping in’ on weekends may be bad for your health: study

Going to bed later and waking up later on weekends than during the week – also known as social jet lag – may be linked to poor health and higher levels of sleepiness and fatigue, according to the preliminary results of a study conducted by researchers at the University of Arizona. Results showed each hour of social jet lag was linked to an 11.1 percent increase in the chances of developing heart disease. In addition, participants who experienced social jet lag were 28.3 percent more likely to report their health as “fair/poor.” The study abstract was published in an online supplement to the journal Sleep.

Safety measures lacking on plastic injection molding machines, peripheral equipment: study

Factories with plastic injection molding machines that interact with peripheral equipment – such as robots or conveyors – could do more to improve safety, Canadian scientific research organization IRSST concluded in a recent study. The study was published in May along with a technical guide.

State news

New rule requires preauthorization of all compounds, regardless of price – Florida

  • To clear up a “misunderstanding” among stakeholders, the Florida Division of Workers’ Compensation has clarified that all compounded drugs, regardless of cost, are now subject to preauthorization.

Legislators pass budget without workers’ comp reform – Illinois

  • While the state faces one of the highest workers’ compensation insurance rates in the country, legislators were unable to reach a consensus on reforms.

Prescription drug monitoring program implemented – Missouri

  • Missouri was the only state that lacked a prescription drug-monitoring program prior to last month when the governor signed an executive order directing the Department of Health and Senior Services to create a prescription drug-monitoring program.

Workers’ comp rules tightened – Missouri

  • The new legislation redefines “maximum medical improvement (MMI)” as the point when the condition of an injured employee can no longer improve, and bans any claims for benefits beyond that time period. It also puts more emphasis on the employee proving an employer discriminated against them after they filed a workers’ compensation case.

4.5% decrease in workers’ comp for businesses – New York

  • The New York Department of Financial Services has approved the 4.5% workers compensation premium rate decrease recommended by the New York Compensation Insurance Rating Board effective Oct. 1.

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

Four troubling trends threaten worker safety

Despite the remarkable strides that employers have made in reducing workplace injuries, there are several persistent issues that threaten worker safety. Here are four of them:

  1. Disconnect between employer and employee perception of value of productivity over workplace safetyIn a recent survey, Employee Perceptions in Workplace Safety, by the National Safety Council (NSC), over one-third of the employees surveyed claimed that workplace safety is secondary to performing tasks. This perception was even much higher in certain industries: 68% in agriculture, forestry, fishing and hunting; 58% in construction; and 45% in manufacturing or industrial facilities.

    The report also found that 32% of respondents agreed that employees “are afraid to report safety issues,” and 30% agreed “employees are resistant to working safely.” Of those surveyed, 39% agreed that management does only the “minimum required by law” when it comes to employee safety. 32% feel management ignores an employee’s safety performance when determining promotions.

    On the other hand, 71% stated that safety training is part of orientation, and 68% of those surveyed agreed that employees are well trained in emergency practices. 62% say everyone is involved in solving job safety issues. 63% of employees feel they work in areas or at stations that are ergonomically correct.

    Takeaway: Even in companies that have a safety strategy aligned with their organizational goals, there can be a safety-vs.-production dichotomy. This can come from unrealistic deadlines, poor supervision, inadequate communication, lack of accountability, workers’ perception that personal productivity solely drives raises, or a high tolerance for risk among some employees. Find out how your employees view safety and productivity. Are there conflicts, if so, what are they and how do they resolve them? Many successful companies have demonstrated that high value on safety and productivity can co-exist and help achieve long-term profitability.

  2. Motor vehicle crashes are leading cause of workplace fatalities and roadways are getting more dangerousIt’s not falls, fires, explosions, or chemical exposure that kills workers the most on the job; it’s motor vehicle crashes. According to the Bureau of Labor Statistics, Census of Fatal Occupational Injuries Summary, 2015 (latest data available), roadway incident fatalities were up 9 percent from 2014 totals, accounting for over one-quarter of the fatal occupational injuries in 2015.

    Drivers are often lulled into a false sense of security with hands-free and in-vehicle technology. An NSC survey found that 47% of motorists are comfortable texting while driving. There’s also a false sense that summer is a safer time to drive with better weather and road conditions. However more auto accidents occur during the summer time than any other time of the year.

    According to the NSC, the increased serious injuries and fatalities from motor vehicle crashes continue a troubling multiyear surge that experts believe is being fueled, in part, by more people driving while distracted by cellphones, infotainment screens, and other devices. Other factors include an improving economy, lower gas prices, and younger, more inexperienced drivers.

    And then there are the challenges that face the trucking industry. Heavy and tractor-trailer truck drivers incurred 745 fatal work injuries in 2015, the most of any occupation.Truck drivers also had more nonfatal injuries than workers in any other occupation. Half of the nonfatal injuries were serious sprains and strains; this may be attributed to the fact that many truck drivers must unload the goods they transport. A driver shortage, a rapidly aging driver population, as well as issues with driver fatigue, obesity, and other co-morbidities challenge the industry. And in many delivery zones, there has been an increase in pedestrian strikes, not caused by drivers but by distracted pedestrians.

    Takeaway: Any company utilizing vehicles for business purposes – even if those vehicles are employees’ personal cars – can feel the impact of rising accidents. The average work-related motor vehicle injury claim costs $72,540, which is twice as much as other work-related injuries. Those who have not instituted policies to minimize distracted driving need to do so. Random checks on compliance with the policy and discipline for non-compliance are key. Employers can also strengthen hiring practices and use fleet telematics, when appropriate.

    These policies should be regularly communicated to help reinforce the message. There are good public awareness campaigns, including an informative website, distraction.gov, in which employers can download forms to use in obtaining a pledge to not engage in distracting activities while driving. Recently, the NSC created a webinar offering recommendations not only on eliminating distractions in vehicles, but also on how to be alert and react to the actions of other distracted drivers on the road.

  3. Fatalities in construction outpace employment growthThe number of fatalities among construction workers climbed to 985 in 2015 after dipping to 781 in 2011, an increase of 26% compared to employment growth of 16%. Fall-related fatalities increased at a faster pace – rising 36% to 367 in 2015, according to the report by the Center for Construction Research and Training (CPWR).

    Data presented in the report comes from the Bureau of Labor Statistics. Other findings:

    • 55 percent of fatal falls came from heights of 20 feet or less.
    • 33 percent of fatal falls involved falls from roofs, 24 percent involved ladders, and scaffolds and staging accounted for 15 percent.
    • Fatal falls in residential construction rose to 61 in 2015 from 26 in 2011.
    • Roofers continue to experience the highest rate of fatal falls to a lower level: 31.5 per 100,000 full-time workers, although this represents a decrease from 39.9 in 2014.
    • Workers at an increased risk of fatal falls include Hispanic workers, foreign-born workers, and workers 55 years and older.

    Takeaway: The findings in this report emphasize the need to reduce falls and the importance of ongoing vigilance. CPWR, OSHA and NIOSH have a variety of resources available and the Campaign to Prevent falls in construction website includes Eleven Ways to keep your fall prevention program alive all year long.

  4. Impaired workforce: drug use at 12-year highCocaine, marijuana and methamphetamine use continues to climb among workers, though opioid use is down, according to a May 2017 study by New Jersey-based Quest Diagnostics Inc. Cocaine positivity increased 12 percent in 2016, reaching a seven-year high of 0.28 percent, compared to 0.25 percent in 2015, and seven percent among federally-mandated, safety-sensitive workers to 0.28 percent, compared to 0.26 percent in 2015. Marijuana positivity increased dramatically over the last three years with increases in Colorado and Washington double the national average. In oral fluid testing, which detects recent drug use, marijuana positivity increased nearly 75 percent, from 5.1 percent in 2013 to 8.9 percent in 2016.

    Amphetamines (which includes amphetamine and methamphetamine) positivity continued its year-over-year upward trend, increasing more than eight percent in urine testing compared to 2015. Throughout the last decade, this rise has been driven primarily by amphetamine use, which includes certain prescription drugs such as Adderall.

    On a positive note, heroin detection remained flat, while prescription opiate detection declined.

    Takeaway: The efforts to control opiate prescribing in workers’ comp have produced promising results. However, the answer to the problem of drugs in the workplace remains elusive. The regulations governing drug testing are more restrictive, there is no established standard of what constitutes impairment when it comes to marijuana, alternatives to chronic pain treatment are still emerging, and employees often do not understand the perils of some prescription medications. In addition to a carefully crafted drug-free workplace policy, training supervisory staff to identify and know what to do if they suspect an employee has a problem and educating employees on their role in keeping the workplace safe are key.

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

 

Things you should know

Opioid abuse rises with length of prescription

According to a study by the U.S. Centers for Disease Control and Prevention, the risk of opioid abuse rises with lengthy prescriptions. If received a one-day prescription, 6% were still on opioids a year later; when prescribed for 8 days or more, this rises to 13.5%; when prescribed for 31 days or more, it increases to 29.9%.

Blacklisting rule repealed

President Trump repealed the so-called “blacklisting rule” that required federal contractors to disclose labor violations. The executive order had required employers bidding for federal contracts worth at least $500,000 to disclose any of 14 violations of workplace protections during the previous three years.

FMCSA will not reinstate overnight rest regulations for commercial drivers

The Federal Motor Carrier Safety Administration’s (FMCSA) regulation that required CMV (Commercial Motor Vehicle) drivers to take breaks in the hopes of preventing driver fatigue has been suspended since 2014 so that further research could be done to understand the efficacy of the program. A study from the Department of Transportation found that stricter mandated breaks did not do much to reduce driver fatigue or improve safety. Thus, the rule will not come out of suspension.

Study reveals occupations with sleep deprived workers

If your industry is health care, food service, or transportation, your workers are probably not getting adequate sleep, according to a study published March 3 in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report. Workers who averaged fewer than seven hours of sleep per night were classified as having short sleep durations. Occupation groups that failed to average seven hours of sleep included:

  • Communications equipment operators: 58 percent
  • Rail transportation workers: 53 percent
  • Printing workers: 51 percent
  • Plant and system operators: 50 percent
  • Supervisors, food preparation and serving workers: 49 percent
  • Extraction workers: 45 percent
  • Nursing, psychiatric and home health aides: 43 %

The American Academy of Sleep Medicine and the Sleep Research Society recommend that adults 18 to 60 years old get at least seven hours of sleep every day. A lack of sleep can contribute to cardiovascular disease, obesity, diabetes, depression, and other health issues, as well as contribute to more injuries on the job.

NIOSH announces free health screenings for coal miners

A series of free, confidential health screenings will be available for coal miners as part of the NIOSH Coal Workers’ Health Surveillance Program. The first set of screenings will take place from March 26 to April 15 in coal mining regions throughout Alabama. The second set will occur from May 10 to May 31 throughout Indiana and Illinois. Finally, testing will take place from July 30 to Aug. 26 throughout Eastern Kentucky.

NIOSH updates mine hazard assessment software

Mine operators and workers now have access to updated hazard assessment software from NIOSH. According to the agency, EVADE 2.0 – short for Enhanced Video Analysis of Dust Exposures – offers a more comprehensive assessment of the hazards miners face by pulling together video footage and exposure data on dust, diesel and other gases, as well as sound levels.

Study: PT as effective as surgery for carpal tunnel

Physical therapy is as effective as surgery in treating carpal tunnel syndrome, according to a new study published in the Journal of Orthopaedic & Sports Physical Therapy. Researchers in Spain and the United States report that one year following treatment, patients with carpal tunnel syndrome who received physical therapy achieved results comparable to outcomes for patients who had surgery. Further, physical therapy patients saw faster improvements at the one-month mark than did patients treated surgically.

When hospital inspectors are watching, fewer patients die

A recent report in the New York Times cited a study in JAMA Internal Medicine which found death rates dropped when inspectors were onsite. In the non-inspection weeks, the average 30-day death rate was 7.21 percent. But during inspections, the rate fell to 7.03 percent. The difference was greater in teaching hospitals – 6.41 percent when the inspectors were absent, and 5.93 percent during survey weeks. While the difference may seem low, an absolute reduction of only 0.39 percent in the death rate would mean more than 3,500 fewer deaths per year.

Although the reasons for the effect are unclear, it was suggested when docs are being monitored, diligence ramps up.

Wearing eye protection can prevent 90 percent of work-related eye injuries, experts suggest

Ninety percent of on-the-job eye injuries could be avoided if workers wore eye protection, according to the American Academy of Ophthalmology (AAO). AAO offers the following tips for avoiding workplace eyestrain or injury:

  • Wear protective eyewear appropriate for the type of hazard you may encounter
  • Position your computer monitor 25 inches away
  • Follow the 20-20-20 rule: Every 20 minutes, take a break by looking at an object 20 feet away for 20 seconds
  • Reduce glare on your cell phone or digital device
  • Adjust environmental lighting near your workstation

 

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

Legal Corner

ADA
Severe obesity claim of discrimination can proceed

A bus driver of the Chicago Transit Authority sought to return from an extended medical leave and was cleared through a fitness exam to return to work, but failed a safety assessment and was not allowed to return to work. The Authority argued that obesity is not a disability unless it is due to a physiological disorder and the employee had not alleged a physiological disorder.

However, the Court noted that there is a split among Circuit Courts on what is required for obesity to be considered a covered disability. The court did not take a position on what approach is right, but said “[e]ven if Plaintiff is ultimately required to prove that his obesity was caused by a physiological disorder, he was not required to allege the same.” Richardson v. Chicago Transit Authority, 2016 U.S. Dist. LEXIS 143485 (N.D. Ill. 2016)

 

FMLA
Medical privacy protected under FMLA

In Scott Holtrey v. Collier County Board of County Commissioners, the Florida U.S. District Court ruled the employer violated the FMLA when a management-level employee allegedly disclosed the employee’s serious health condition with his genitourinary system to co-workers and subordinates at a staff meeting. The employee became the subject of jokes and obscene gestures. While the County Board argued that the interference claim failed because it granted the employee FMLA leave, the Court disagreed, “The enforcing labor regulation makes clear that confidentiality of medical information is a right provided and protected under the FMLA.”

Doctor’s certification and job description key factors in defining essential functions

A laborer for the City of Red Bank in Tennessee, who rose to the position of Assistant to the Director of Public Works, did significant outdoor work. His job evolved and required different responsibilities, more and more of which were outdoors. He developed skin problems and was diagnosed with lupus. His dermatologist said he needed to be indoors.

After an indefinite FMLA leave lasting six months, he returned to work and bought protective clothing, but it failed to provide adequate protection. He sought another FMLA leave and his doctor ‘s certification emphatically stated that he must work indoors. When it was determined he was not qualified for the two open indoor positions, he was terminated.

The City prevailed at the federal court level, and upon appeal the Sixth Circuit Court of Appeals affirmed that the worker did not show that he could perform the essential functions of his job with or without accommodation. While the employee and the doctor attempted to modify their position after the termination decision, the City had a right to base its decision on the information available at the time of termination. Mathis v. City of Red Bank, 2016 U.S. App. LEXIS 19423 (6th Cir. 2016)

Workers’ Compensation
Michigan federal court reiterates that RICO may not be used for bad faith claims – United States

Citing two earlier precedents, a federal district court sitting in Michigan ruled that racketeering activity leading to a loss or diminution of benefits that a worker expects to receive under a state workers’ compensation system does not constitute an injury to “business or property” under the Racketeer Influenced and Corrupt Organizations (“RICO”) Act. The worker tried to distinguish his case by alleging tortious activity by “independent medical examiners.” Gucwa v. Lawley, 2017 U.S. Dist. LEXIS 8698 (E.D. Mich., Jan. 23, 2017)

Medicare reimbursement is limited to related injuries identified by diagnosis codes – California

The U.S. District Court for the Central District ruled in favor of the California Insurance Guarantee Association (CIGA) in its ongoing challenges against the Centers for Medicare and Medicaid Services (CMS) over the Medicare Secondary Payer (MSP) practices. CIGA faced Medicare Conditional Payment demands for three separate workers’ compensation claims that had settled. Included in the demands were diagnosis codes unrelated to the accident.

CIGA noted to the court that it is not uncommon in conditional payment letters from the CMS for multiple diagnosis codes to appear under a single charge – some of which relate to a medical condition covered by the primary plan, but others that do not. CMS routinely determines if any of the codes relates to a covered condition and seeks reimbursement for the full amount. California Insurance Guarantee Association v Burwell, et al case no. 2:15-cv-0113odw (ffmx)

Broad interpretation of employment finds union responsible for member’s injury – California

In Mason v. S.E.I.U. Local 721, 2016 Cal. Wrk. Comp. P.D. LEXIS 618 (Lexis Advance), the WCAB, reversing the WCJ in a split panel opinion, held that an employee of the County of Los Angeles, Department of Children and Family Services who was a member of S.E.I.U. Local 721 was acting as an employee of S.E.I.U. Local 721 at the time she suffered an injury while participating in a union rally. The WCAB found employment by the union, noting the injured worker was rendering service for “another,” (the union), and that the union provided transportation, food and water while at the rally, and that the services and goods provided by the union were akin to economic substitutes for wages.

Injured worker can’t switch to doctor in different specialty – Florida

In a case of first impression, the Florida 1st District Court of Appeal ruled that a worker exercising his statutory right to a one-time change in physician was not entitled to choose a new doctor in a different specialty simply because the carrier did not respond in a timely fashion. In Retailfirst Insurance Co. v. Davis, an employee who had injured his leg had received authorization for treatment with a family practice physician and later sought authorization for care with an orthopedist. The court noted that procedures exist for such a request.

Change in economic conditions not basis for increased benefits – Illinois

In Murff v. IWCC (City of Chicago), No. 1-16-0005WC, 01.06.2017, an injured worker returned to work in a modified capacity. Later, he was determined to have reached maximum medical improvement and was awarded benefits and continued to work in the modified capacity for about six months. He was then told him that if he could not return to his old job duties, he’d have to go home, so he went on disability leave and filed a claim seeking additional comp benefits.

The Appellate Court upheld the findings of the lower courts that there was no evidence he had not suffered any material change in his physical or mental condition since the award of benefits. An increase in economic disability is not a basis for additional comp benefits.

Lung disease from pigeon droppings lead to lifetime of benefits – Missouri

In Lankford v Newton County an investigator with the county prosecutor’s office would smoke frequently on the courthouse roof, which was a popular place for pigeons. In 2002, he was diagnosed with COPD as a result of ammonia exposure from investigating a meth lab and in December 2007, after undergoing lung surgery, to remove half of his right lung, which contained a nodule that was suspected to be cancerous, he suffered a stroke that left him unable to work.

He filed a workers’ comp claim asserting that he was exposed to pigeon droppings during the course and scope of his employment. Doctors noted that a biopsy of his lung nodule showed the growth contained bacteria and a fungus linked to pigeon droppings. He died of complications and his wife became the claimant. The case was appealed up to the Court of Appeals, but in each case, the award of $167,811.62 in permanent total disability benefits to the deceased worker, as well as more than $500 in lifetime weekly workers compensation benefits to his wife, was approved.

Change in job duties means claim compensable despite pre-existing condition – Missouri

In Clawson v Cassens Transport Company, a union car hauler had a pre-existing knee condition as a result of a work-related accident a few years earlier. After working for 3.5 years after the accident, his workload increased and he began working 6-7 days per week. When he complained of pain in his knee, the employer denied the claim and declined to provide medical treatment. He sought medical treatment on his own, was advised to have surgery and a doctor opined the issue was casually related to the increase in his job duties.

At a hearing, an ALJ found that although there was a pre-existing condition, the prevailing factor in causing his worsening condition was the change/increase in his job duties.

Subcontractor found guilty for worker’s death – Missouri

The U.S. District Court in Kansas City found Pacific-based DNRB Inc., a steel erection company doing business as Fastrack Erectors, guilty in the 2014 death of an employee who fell while working on a warehouse construction project in Kansas City. The court found that “Fastrack was aware of safety violations but willfully ignored them, with tragic results.” Fastrack was a subcontractor to ARCO National Construction – K.C., Inc. and the contract required that personnel who were working or present at heights in excess of six feet shall be provided adequate fall protection and Fastrack failed to do so.

Undocumented worker due comp benefits – New York

A U.S. District Court judge dismissed an insurer’s request to forgo payment of workers’ compensation benefits for an undocumented landscaper’s injury. The insurer, NorGuard Insurance Co., sought a declaratory judgment that it wasn’t obligated to pay medical expenses, indemnity payments or comp benefits because the worker had entered the U.S. illegally.

The court noted that the insurers allegations simply do not “fall within the zone of interests protected by law invoked. Such violations are the concern of the Internal Revenue Service, Homeland Security, and like agencies.”

Opera singer can sue Met for injuries sustained in fall – New York

Finding that her employment contract was with her personal holding company and not the Metropolitan Opera House, an Appellate Court found that a prominent opera singer can sue the famous facility that featured her in over 500 performances. Noting that New York law generally considers a person engaged in the performing arts an employee of the establishment where he or she performed, the exception here was the singer was stipulated to be an employee of another employer. Therefore, the exclusive remedy provisions of workers’ comp do not bar her suit. White v. Metropolitan Opera Assn., Inc., 2017 N.Y. App. Div. LEXIS 90 (Jan. 5, 2017)

No reason to stop compensating attendant care by wife – North Carolina

In Thompson v. International Paper Co., No. COA15-1383, 01/17/2017, a worker was burned over 23% of his body in a work-related accident. His wife took FMLA leave from her job to care for her husband and, when she returned to work, she arranged her schedule to accommodate his medical needs. While the company accepted the burn injuries as compensable, it denied reimbursement for attendant care services provided by his wife. The full Industrial Commission ruled that attendant care by his wife was unnecessary after Dec. 31, 2012, but the appellate panel disagreed. While the need for care may have lessened, treating physicians had found attendant care was medically necessary.

Futility in finding another job allows continuing benefits – North Carolina

In Neckles v. Teeter, a 68-year-old employee who had moved to the U.S. from the Caribbean island nation of Grenada had worked as a meat cutter and suffered an injury to his lower back, right hip, and right arm and leg for which he was compensated and received temporary total disability. A functional capacity evaluation concluded he couldn’t go back to his job as a meat cutter, but he was capable of a job that required light physical demands, however, a vocational rehabilitation specialist determined it would be difficult for him to get any job.

Three years later, the employer filed a form alleging the worker was no longer disabled. After a series of appeals, the Court of Appeals ruled that the worker should continue to receive TTD benefits and coverage of medical expenses. According to the court, it was necessary to look at the totality of the evidence, including age, education, work experience, work restrictions for the compensable injury, other unrelated health conditions (i.e., diabetes, gout, and angina), and trouble communicating (a thick accent).

IRE that didn’t consider worker’s psyche invalidated – Pennsylvania

A divided Supreme Court ruled that an impairment rating evaluation (IRE) that failed to consider a worker’s psychological injuries from an industrial accident was invalid, noting an IRE doctor must consider all conditions that he or she believes are related to the worker’s injury, not just those that are designated in the notice of compensation payable (the “NCP”.)

In this case, an employee suffered an electric shock and received 104 weeks of temporary total disability benefits at which time the employer requested an IRE. The doctor assigned a 6% permanent impairment rating, but the employee argued his compensable injury included damage to his psyche as well as his hands. A workers’ compensation judge found the worker had adjustment disorder and post-traumatic stress disorder that were compensable consequences of the accident. While the Workers’ Compensation Appeal Board and the Commonwealth Court reversed this decision, the Supreme Court overturned their ruling, noting that the IRE doctor must determine the level of impairment and in this case did not assess psychological conditions, nor determine whether those conditions were fairly attributable to the accident. Duffey v. Workers’ Compensation Appeal Board (Trola-Dyne, Inc.)

Supreme Court affirms franchisors do not employ their franchisees’ employees – Pennsylvania

In Saladworks, LLC v. W.C.A.B. (Gaudioso), the question revolved around whether the franchisor, Saladworks, was a statutory employer. Under Pennsylvania law, when an employee is unable to recover from its direct employer, the employee can file a workers’ compensation claim against a “statutory employer.” A Workers’ Compensation Judge initially held that Saladworks was not a statutory employer, however, the Workers’ Compensation Appeal Board reversed that decision. On appeal, the Commonwealth Court reversed the Board’s decision recognizing the difference between Saladworks’ business model and the business engaged in by its franchisee. The Supreme Court dismissed the appeal, effectively upholding the Commonwealth Court’s decision.

Penny wise and pound foolish: attorney’s fees of $27,000 awarded for $187 medical claim – Tennessee

In Grissom v. UPS, 2017 Tenn. LEXIS 4 (Jan. 9, 2017), the Special Workers’ Compensation Appeals Panel of the Supreme Court affirmed a trial court’s award of attorney’s fees and expenses in the amount of $27,353.63, in connection with an employee’s petition to compel the employer to pay $187 for two trigger point injections. The workers’ compensation carrier had sought a peer utilization review (UR), although it had paid for earlier injections. An authorized physician provided the injections to the injured employee, but the UR provider found the injections unnecessary. Following a hearing, the trial court disagreed.

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

Truckers’ medical conditions can increase crash risk

Commercial truck drivers who have at least three health issues can quadruple their crash risk compared to healthier drivers, according to a study from the University of Utah School of Medicine. Researchers examined medical records for nearly 50,000 commercial truck drivers, 34 percent of whom had signs of one or more health issues associated with poor driving performance, such as heart disease, low back pain and diabetes.

The crash rate involving injury among all drivers was 29 per 100 million miles traveled. The rate rose to 93 per 100 million miles traveled for drivers with at least three ailments. Researchers took into account other factors that can impact driving abilities, such as age and amount of commercial driving experience.

The study was published online Jan. 10 in the Journal of Occupational and Environmental Medicine.

Employee takeaway: It is well documented that truck drivers often have difficulty staying healthy because they tend to sit for long periods of time and sleep and eat poorly. With the industry facing a critical shortage of drivers, employers need to do all they can to keep their drivers healthy. There are a host of tools available to help drivers, including smart phone apps with guidance about nutrition and exercise on the road, customized in-house wellness programs, bio-screenings, coaching, sleep apnea testing and treatment, encouraging brown bagging and walking or bicycling during breaks, and so on. Some companies are ramping up their new-hire pain diagnostics, so they have a baseline for whether a new driver has pre-existing muscle pain. In an industry of high turnover and high claims, this puts the driver on notice and effectively deters claims.

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

Deadly Skyline: An annual report on construction fatalities in New York State

According to the report “Deadly Skyline: An Annual Report on Construction Fatalities in New York State,” from the New York Committee for Occupational Safety and Health, 464 construction workers died in New York between 2006 and 2015, and fatality rates have trended up 40% between 2011 and 2015. Falls are the leading cause of fatalities, accounting for 49% of construction deaths in the state and 59% in the city.

“Employing approximately (4%) of the state’s workforce, the construction industry sees one-fifth of workplace fatalities,” the report said. In addition, OSHA found safety violations at two-thirds of the site inspections it conducted in New York in 2014. A high percentage of sites where fatalities occurred – 87% in 2014 and 90% in 2015 – were found to have safety violations when inspected by OSHA. The report also noted non-union construction sites were especially dangerous for workers. Eighty percent of construction fatalities occurred at non-union sites in 2014, and 74% of fatalities were at non-union sites in 2015.

Latino workers also face a disproportionate risk of dying in construction incidents; 57% of construction workers who died in 2015 were Latino even though they comprise only 30% of the construction workforce.

Employer takeaway: Construction is the most dangerous industry in the country with the highest number of fatalities. In addition to tougher legislation and higher penalties, NYCOSH’s recommends:

  • require OSHA’s 10-Hour Construction training program or equivalent training for all construction workers as well as apprenticeship programs on large sites
  • preservation of New York’s Scaffold Safety Law, which holds building site owners and employers liable for worker injuries and deaths resulting from unsafe conditions at elevated worksites
  • expanded monitoring and enforcement of construction sites, including criminal prosecution of contractors, and revocation of licenses and permits for contractors convicted of a felony related to a worker fatality

 

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

Pressure to meet earnings expectations negatively impacts worker safety

New research in the Journal of Accounting and Economics, “Earnings expectations and employee safety” examined the relation between workplace safety and managers’ attempts to meet earnings expectations. The finding: significantly higher injury/illness rates in firms that meet or just beat analyst forecasts compared to firms that miss or comfortably beat analyst forecasts.

Changes in operations or production, specifically increased workloads and abnormal reductions of discretionary expenses, that are meant to increase earnings impacted the number of workplace injuries. The relation between benchmark beating and workplace injuries is stronger when there is less union presence, when workers’ compensation premiums are less sensitive to injury claims, and among firms with less government business.

Employer takeaway: When pressure is applied on managers to meet earning expectations, they can detract from safety by increasing workloads, hours, speed of workflow or cutting corners. Contrast these findings to a study published in the January 2016 issue of the Journal of Occupational and Environmental Medicine (JOEM), that found 17 publicly held companies with strong health and/or safety programs significantly outperformed other companies in the stock market. Two additional studies also found that financially sound, high-performing companies invest in employee health and safety. Rather than deviate from normal business practices to meet earnings expectations in the short-term, these companies have an ongoing, long-term commitment to a healthy and safe workforce that tangibly contributes to the bottom line.

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

Top 10 Non-Fatal Work Related Injuries

Overexertion tops list of serious, nonfatal work injuries for third straight year – Liberty Mutual

The 2017 Liberty Mutual Workplace Safety Index uses Liberty Mutual workers’ comp claims data, as well as information from the U.S. Bureau of Labor Statistics and the Washington-based National Academy of Social Insurance, to determine the costliest workplace injuries and those that result in employees missing six or more days of work.

For 2014, the injuries cost employers more than one billion dollars a week, or close to $60 billion a year.

The top ten include:

  1. Overexertion ($13.79B) 23%
  2. Falls on same level ($10.62B) 17.7%
  3. Falls to lower level ($5.50B) 9.2%
  4. Struck by object or equipment ($4.43B) 7.4%
  5. Other exertions or bodily reactions ($3.89B) 6.5%
  6. Roadway incidents involving motorized land vehicle ($3.70B) 6.2%
  7. Slip or trip without falling ($2.30B) 3.8%
  8. Caught in or compressed by equipment or objects ($1.95B) 3.3%
  9. Struck against equipment or object ($1.94B) 3.2%
  10. Repetitive motions involving micro-tasks ($1.81B) 3.0%

While overexertion, which includes lifting, pushing, pulling and other actions involving objects did decrease somewhat from 2013, falls on the same level and roadway incidents continue to trend upward.

Employer takeaway: Many employers have done a good job of implementing safety measures, adopting automation and new processes that reduce injuries, and fostering a strong safety culture, but injuries still happen. Understanding injury causation is a complex process. Factors ranging from human error, unsafe behavior, stress, and inadequate skills to unsafe conditions, insufficient training, faulty equipment, lack of supervision and so on come into play. Analyzing data to discover trends and problem spots that are driving the serious workplace injuries can help develop safety programs that target those causes. Moreover, employers have found success by increasingly involving employees in safety leadership, encouraging workers to be the “eyes and ears” of safe working practices, including the authority to stop work without fear of repercussion.

Related article: Overexertion accounts for more than 25% of the top ten injury costs: Liberty Mutual WorkComp Adv!sory – December 2015

 

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

Things you should know

DOL website has new section on worker misclassification

The DOL has compiled information on worker misclassification on a new section of its website.

Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) “Re- Review” process

In Calendar year 2017, CMS expects to update its existing re-review process to address situations where CMS has provided an approved amount, but settlement has not occurred and the medical care that supported the approved amount has changed substantially.

Workplace deaths up in 2015

According to the Department of Labor, 4,836 fatal work injuries were recorded in 2015, a slight increase from the 4,821 fatal injuries in 2014. 2,054 of these involved transportation incidents, with roadway incidents accounting for 26 percent of all fatal work injuries. Almost half of these fatalities involved some kind of tractor-trailer truck. The information includes U.S. workplace deaths resulting from traumatic events but does not include workers who die from long-term exposure to workplace hazards, such as toxic chemicals.

MSD checklists by industry

The Safety & Health Assessment & Research for Prevention Program at the Washington State Department of Labor & Industries has released six industry-specific checklists and summary reports aimed at helping employers identify risk factors that may contribute to work-related musculoskeletal disorders. The checklists are available for agriculture, construction, healthcare, manufacturing, services, and wholesale and retail trade.

US tops lists for days lost and highest costs of sleepy workers

Lack of sleep among U.S. workers results in an increased risk of death and the loss of 1.2 million working days per year, and costs the economy up to $411 billion annually, according to a new report from RAND Europe. Researchers said workers who increase their sleep duration to between six hours and seven hours per night could bring an additional $226.4 billion to the economy. The researchers recommended that employers understand the importance of sleep and promote it, create brighter workplaces, provide settings for naps, and discourage lengthy use of electronic devices after work.

FMCSA to establish database of CMV drivers who fail drug, alcohol tests

Commercial motor vehicle drivers who fail a drug and alcohol test will be listed on a national clearinghouse to be created by the Federal Motor Carrier Safety Administration (FMCSA), according to a final rule published Dec. 5. Motor carriers will need to search the system for information related to current and prospective employees who might have unresolved violations that prohibit them from driving. Employers and medical review officers also will be required to report information about drivers who test positive for drugs or alcohol, refuse to comply with drug and alcohol testing, or participate in the return-to-duty drug and alcohol rehabilitation process.

FMCSA to develop minimum training standards for entry-level CMV drivers

Entry-level commercial truck and bus drivers seeking a commercial driver’s license or select endorsements will soon face national minimum training requirements under a final rule. The new rule will apply to first-time CDL applicants; drivers seeking to upgrade their CDL to another classification; and drivers seeking an endorsement for hazardous materials, passenger or school bus operations for the first time.

Workplace weight loss programs lower health care costs, improve quality of life: study

People who participate in a weight management program at work experience lower health care costs and better quality of life, according to a study from the University of Nebraska Medical Center. Researchers examined data on 1,500 University of Minnesota workers who attended group meetings about weight management over a three-year period. Participants typically were older women who had a higher body mass index and were more likely to have a chronic disease. The average annual savings in health care costs was $876 per participant.

 

State News
California

Starting July 1, doctors who wish to repeatedly prescribe opioids to injured workers will have to subject the claim to a review process, according to an overview of the proposed workers’ compensation prescription drug formulary set to go into effect next summer.

Illinois

A new rule requiring some Illinois employers to provide collateral for large-deductible workers compensation policies was approved. The rule implements Senate Bill 1805/Public Act 099-0369.

Massachusetts

A new pilot program is aimed at helping injured workers get pain management treatment after settling workers’ compensation claim. The voluntary program is designed for individuals with settled cases, who are still being treated with opioids, but the insurance company seeks to stop payment for continued use of opioids.

New York

New health insurance reforms that went into effect Jan.1 and target the heroin and opioid epidemic require small and large group health plans, and individual plans, to cover inpatient treatment for New Yorkers suffering from opioid addiction.

For Cutting-Edge Strategies on Managing Risks and slashing Insurance Costs visit www.PremiumReductionCenter.com

New studies and surveys

Experience, risk-taking major factors in industrial accidents

Although industrial accidents have declined sharply over the past 20 years, a recent survey by The Golden Triangle Business Roundtable, a Texas trade association, found “risk-taking” continues to be a factor in deaths and injuries. Among workers involved in the incidents, 43 percent had fewer than five years in their crafts and 34 percent had between five and 10 years of experience.

Where incidents have occurred in the 20 years of surveys, 42 percent were at refineries and 21 percent were at chemical plants. Men accounted for 96 percent of the incidents, and two-thirds of them involved men aged 18 to 40 years old. Pipe fitters and laborers accounted for 30 percent of the accidents and 77 percent were in their craft for fewer than 10 years.

Takeaway: While an intensive training program for new and young workers is critical, it is not enough. An on-going mentoring program that emphasizes awareness of the surrounding physical hazards, potential dangers, and good decision-making is key, particularly for less experienced workers who are prone to risk-taking.


Emerging trends and challenges: National Safety Survey

Every year, EHS Today surveys its readers to discover emerging trends and challenges. The major findings of the survey of the nearly 1,000 EHS (environment, health and safety) professionals include:

Leading indicators

Leading indicators are where’s it at in 2016 and those that are most tracked include:

  • Near misses (85.66%)
  • Employee audits/observations (82.87%)
  • Participation in safety training (80.88%)
  • Inspections and their results (79.58%)
  • Participation in safety meetings (69.72%)
  • Facility housekeeping (64.54%)

Others included: participation in safety committees (64.14%), overall employee engagement in safety (60.56%), safety action plans execution (58.17%), equipment/machinery maintenance (51.79%), safety perception surveys and follow up (37.85%), and permit deviation (21.91%).

Top injuries

Cuts, lacerations, and punctures topped the list of most common type of injuries – 53.74%. This was followed by strains, sprains, and tears (52.04%), slips, trips, and falls (47.96%), back injuries (26.53%) and repetitive stress and musculoskeletal injuries (23.47%).

PPE purchases

The two factors most considered when purchasing PPE are certification levels/ratings (55.18%) and price (47.83%). This was closely followed by employee recommendations (41.47%). Hand protection dominates the PPE market, accounting for over 23 percent of the overall protective equipment revenue in 2015.

 

Untreated sleep apnea deadly for commercial drivers

Research from the National Transportation Safety Board revealed that fatigue was the most frequently cited cause of heavy truck accidents, accounting for 30-40 percent, and was also the cause of 31 percent of the 182 fatal-to-the-truck-driver accidents studied.

Sedentary lifestyles and a tendency toward a high body mass index (BMI) put commercial drivers at a greater risk than non-commercial drivers of developing dangerous sleep disorders. While commercial truck drivers are required by the Federal Motor Carrier Safety Administration to undergo regular medical exams to spot dangerous medical conditions, many sleep disorders still go undiagnosed, or worse, ignored.

When the human body is deprived of sleep, cognitive performance begins to suffer almost immediately. Sleep deprivation problems can include a decrease in alertness and an inability to perform; cognitive as well as memory difficulties; and an increased risk of involvement in a motor vehicle or workplace accident.

While individuals of all ages can develop sleep apnea, common sleep apnea risk factors include:

  • Obesity/high BMI
  • Heavy snoring
  • Large neck circumference
  • High blood pressure
  • Diabetes
  • Male
  • Middle to older age
  • Smoking
  • Alcohol or sedative use
  • Difficulty breathing through the nose

 

Tractor-trailer truck drivers at increased risk of injury, death

According to a recent blog post from the Department of Labor (DOL), one out of six U.S. American workers killed on the job is a tractor-trailer truck driver. A total of 761 tractor-trailer truck drivers were killed in 2014.

Tractor-trailer truck drivers are three times more likely than the typical American worker to have an injury or illness that required days off from work. Injuries from slips, trips and falls were the most common cause of missed workdays, followed by overexertion injuries caused by tasks such as loading and unloading cargo, pushing and pulling containers, and entering and exiting the vehicle.

When truck drivers get hurt on the job it takes them longer to recover. Approximately half of all truck drivers needed at least 20 days away from work to recover from an incident; 42 percent of tractor-trailer drivers required at least 31 days.

 

Obstructed breathing more common in certain jobs

Airway obstruction, which can signify lung diseases such as asthma or chronic obstructive pulmonary disease (COPD), was more common among workers in construction and oil and gas extraction than in other industry, investigators at the National Institute for Occupational Safety and Health (NIOSH) reported after analyzing results from a nationwide survey. These findings underscore the importance of monitoring the lung function of workers in high-risk jobs. Investigators found that the highest rates of airway obstruction were in jobs related to installation, maintenance, and repair; construction; and oil and gas extraction. More than one-fifth of study participants in these jobs had airway obstruction. In other findings, cigarette smoking, even prior to the study, also correlated with a high risk of airway obstruction.

 

Michigan survey suggests medical marijuana can aid in decreasing opioid use to treat chronic pain

In “Medical Cannabis Use Is Associated With Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients With Chronic Pain,” published in the June 2016 issue of The Journal of Pain, researchers from the University of Michigan surveyed users of medical marijuana looking for some insight into the relationship between medical marijuana use and alternatives such as opioids for chronic pain management. While researchers acknowledge limitations of the study and need for more research, their findings suggest that using medical cannabis for chronic pain treatment may benefit some patients with improvement in quality of life, better side effect profile, and decreased opioid use.

 

Study finds nearly 30 pesticides that make farmers wheeze

More than two dozen pesticides – including the most commonly used herbicide – are associated with respiratory wheeze among male farmers, according to a recent study from North Carolina State University. For the study, researchers defined allergic wheeze as cases in which farmers reported wheezing along with doctor-diagnosed hay fever and non-allergic wheeze as cases in which wheezing with no hay fever was reported. Wheezing indicates airway problems and can lead to more serious health issues.

Among the 78 pesticides listed were 45 herbicides and plant growth regulators and 25 insecticides. Twenty-nine pesticides were associated with at least one type of wheeze, and 11 were associated with both types, including Glyphosate, the world’s most popular herbicide.

The study was published online July 8 in the journal, Environmental Health Perspectives

For Cutting-Edge Strategies on slashing Workers’ Compensation Costs visit www.PremiumReductionCenter.com