Things you should know

Soap more effective than hand sanitizers in combatting flu

Researchers from the Kyoto Prefectural University of Medicine found that ethanol-based sanitizers can take up to four minutes to disinfect hands that carry the flu virus. The use of soap and water inactivated the virus in the infected mucus within 30 seconds.

The study was published online in mSphere, the journal of the American Society for Microbiology.

CMS Updates WCMSA Reference Guide

CMS has released an updated WCMSA Reference Guide version 3.0. Noteworthy changes are 1) the Amended Review period was extended from 4 to 6 years (Section 16.2), and 2) Effective April 1, 2020, the required language for the signed consent form to submit an MSA to CMS now must include a statement that the WCMSA arrangement need and process has been explained to the claimant and that the claimant approves of the contents of the submission (Section 10.2).

New drug tests in works for measuring medical marijuana impairment

New drug tests that could help employers measure marijuana impairment are expected to hit the market in 2020 and be similar to an alcohol breathalyzer. Researchers from the Swanson School of Engineering at the University of Pittsburgh in Pennsylvania and Hound Labs Inc., based in Oakland, California, are among those working on the testing.

NSC issues policy position on cannabis use while working in a safety sensitive position

The National Safety Council (NSC) released a policy position that it is unsafe to be under the influence of cannabis while working in a safety sensitive position due to the increased risk of injury or death to the operator and others. The NSC defines safety sensitive positions as those that impact the safety of the employee and the safety of others as a result of performing that job.

Opioids cost economy at least $631 billion from 2015 to 2018: Study

study by the Society of Actuaries finds the opioid epidemic cost the U.S. economy at least $631 billion from 2015 to 2018.The costs include healthcare, lost productivity, premature mortality, criminal justice activities, and child and family assistance and education programs. It’s projected that the costs in 2019 will be around $188 billion.

Construction workers most likely to use opioids, cocaine: Study

Construction workers are more likely to use opioids and cocaine than workers in any other profession and were the second most likely to use marijuana (service workers were first), concluded researchers from the Center for Drug Use and HIV/HCV Research at New York University’s College of Global Public Health. The problem creates a vicious cycle: substance abuse may lead to accidents and the associated injuries may lead to higher substance abuse.

Doctors wary of taking opioid patients: Study

Eighty-one percent of primary care physicians surveyed recently said they are reluctant to take on patients who are currently on opioids, according to a new Health Trends™ report from Quest Diagnostics. 72% worry that chronic pain patients will turn to illicit drugs if they do not have access to prescription opioids,

Doctors trust patients, but test results show misuse

The same Health Trends report cited above notes nearly three in four physicians trust their patients to take controlled substances as prescribed, yet half of all patient test results show misuse of these drugs. Non-prescribed gabapentin use is accelerating, growing 40% in the past year, making it the most commonly detected non-prescribed controlled medication in tested patients.

Registration is open for FMCSA drug and alcohol clearinghouse

The Federal Motor Carrier Safety Administration (FMCSA) has opened registration for the long-awaited clearinghouse. The clearinghouse is a secure database that allows FMCSA and others to identify commercial drivers who have violated drug and alcohol testing program requirements in real time. Commercial driver’s license holders, fleets, medical review officers and substance abuse professionals can create an online account.

Two studies address preventing work-related asthma

The National Institute for Occupational Safety and Health (NIOSH) suggests in two studies that work-related asthma can be controlled by controlling exposure to hazardous substances. In the first study, NIOSH investigators focused on the link between cleaning and disinfecting products and various asthma symptoms among healthcare workers. In the second, they looked at the presence of chronic obstructive pulmonary disease (COPD) among people with work-related asthma and those with asthma from other causes.

Sleep deprivation a growing problem: Study

Researchers from Ball State University found that more than 1 out of 3 U.S. working adults aren’t getting enough sleep, and the prevalence of sleep deprivation has increased significantly since 2010. Women have experienced the largest increase. The study notes “Inadequate sleep is associated with mild to severe physical and mental health problems, injury, loss of productivity, and premature mortality.”

The study was published online in the Journal of Community Health.

MSHA reinstates final rule on pre-shift mine examinations

The Mine Safety and Health Administration has reinstated a 2017 rule that requires a competent person to inspect the workplace before a shift rather than when miners begin work, in accordance with an Aug. 23 mandate of the U.S. Court of Appeals for the District of Columbia Circuit. According to a notice in the Federal Register the measure vacates a 2018 amendment to the rule.

State News

California

  • The Governor has signed a bill adding post-traumatic stress disorder suffered on the job as a compensable injury for first responders.
  • Workers compensation inpatient hospital stays dropped by nearly one-third between 2010 and 2018, largely due to a decline in spinal fusions, according to a study by the Workers Compensation Institute (CWCI).
  • Workers’ Compensation Insurance Rating Bureau releases 2019 Policy Year Statistical Report.
  • 94.1% of medical services performed or requested for injured workers were either approved or approved with modifications, according to a CWCI report.

Florida

  • The insurance commissioner refused to accept the NCCI recommended 5.4% rate decrease in 2020 and has proposed a workers’ compensation rate decrease of 7.5% on new and renewal policies.

Massachusetts

  • The Department of Industrial Accidents has posted updates to maximum weekly benefits, cost-of-living adjustments and other payments, including a significant increase in attorneys’ fees.

New York

  • Indemnity, medical and disability claims have remained stable, and more workers are receiving their first indemnity payment within three weeks of an injury, according to a report by the Workers Compensation Research Institute.
  • Large, complex construction sites in New York City must immediately post at their exits multilingual notices about upcoming safety training requirements. Beginning Dec. 1, all workers at these construction sites must have at least 30 hours of site-safety training, while supervisors must have at least 62 hours. A 40-hour training requirement for workers at these sites will go into effect Sept. 1, 2020. More information.

Tennessee

  • The Department of Labor and Workforce Development has proposed rule changes to workers’ compensation appeals procedures, which appear to be extensive, but are intended to make the process easier to navigate. There will be a public hearing on the proposed appeals rules at 1 p.m. Dec. 12 in the Occupational Safety and Health Hearing Room, 220 French Landing Drive, 1-A, in Nashville.

Virginia

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Things you should know

Rating agency reports fifth year of comp profits but forewarns profits are not sustainable

According to Fitch Ratings Inc, the workers’ compensation market is on track for a fifth consecutive year of underwriting profits in 2019, despite recent weakening in market fundamentals. The industry’s statutory combined ratio fell to 86% in 2018, and has averaged 93% annually since 2015, according to the report. However, the report notes several factors that could result in a sudden deterioration in performance including an increase in claims frequency or severity, and new regulatory developments in key states, according to the statement.

NIOSH issues new banding guide for chemicals in the workplace

NIOSH has published a technical report intended to help control chemical exposures in the workplace. The NIOSH Occupational Exposure Banding Process for Chemical Risk Management details a strategy for managing the many chemical substances that don’t have an authoritative occupational exposure limit. Occupational exposure banding is a process that assigns each chemical to a category based on its toxicity and any negative health outcomes associated with exposure to it.

FMCSA seeks to delay two provisions in final rule on CMV driver minimum training

The Federal Motor Carrier Safety Administration is requesting delaying compliance of two provision, which were scheduled to go into effect Feb. 7, 2020. These include requiring training providers to upload certification information into FMCSA’s Training Provider Registry and a provision for state driver licensing agencies to “receive driver-specific [entry-level driver training] information.”

Comments are due Aug. 19.

Another court decision favors MAO right to sue under private cause of action provision

Medicare Advantage Organizations (MAOs) received a favorable ruling on a motion to dismiss the case, MSP Recovery Series, LLC v. Plymouth Rock, in Federal Court in Boston. Since 2012 no court has concluded that MAOs do not have at least some rights under the private cause of action provision.

Study finds adherence to evidenced-based medicine guidelines for lower back pain lowers comp costs

recent study in the Journal of Occupational and Environmental Medicine concluded there is a statistically significant trend in the relationship between adherence to ACOEM guidelines for the initial management of work-related lower back pain and decreasing claim costs. Medical and total costs trended lower by an average $352.90 and $586.20 per unit of compliance score respectively. No outlier cost claims were in the best guidelines compliance groups.

CMS proposed decision to cover acupuncture

The Centers for Medicare & Medicaid Services (CMS) issued a proposed decision to cover acupuncture for Medicare patients with chronic low back pain (cLBP) who are enrolled participants either in clinical trials sponsored by the National Institutes of Health (NIH) or in CMS-approved studies. Currently, acupuncture is not covered by Medicare. The goal of the proposed decision is to provide Medicare patients who suffer from cLBP with access to a nonpharmacologic treatment option and to determine the effectiveness.

NAHB offers resources on managing opioid misuse in residential construction

In response to the particularly heavy impact the opioid crisis is having on the construction industry, the National Association of Home Builders has introduced several free resources intended to help residential construction organizations combat the issue.

These include:

  • An executive training package, including a webinar and other downloadable materials, outlining why industry action is needed
  • Supervisor training packages on workplace interventions and preventing opioid misuse in the industry
  • Fact sheets on the risks associated with taking opioids, and identifying medical and nonmedical opioid
  • Resources on non-opioid alternatives to pain management
  • A state-by-state guide of locally available resources

Study identifies what professions have worst drivers

study of 1.6 million car insurance applications by Cambridge, Massachusetts-based Insurify Insurance Co., an auto insurance comparison website, found that bartenders, ticket sales representatives, and journalists had the most moving violations. The cause? These professions tend to work 55-60 hours per week and sometimes work weekends. In contrast, postmasters and music composers are the best.

Helping employees get more sleep improves productivity: review of research

Basic employer interventions such as educating workers about the importance of sleep and sharing strategies to improve it may result in better sleep habits, increased productivity, and reduced absenteeism, a recent review of research concludes. The studywas published in the April 15 issue of the Journal of Clinical Sleep Medicine.

New video for tower workers explores safe installation, maintenance of small cell antennas

new two-and-a-half-minute video from the National Association of Tower Erectors stresses hazard awareness for technicians who work with small cellular antenna towers on new or existing structures.

State News

California

  • The Workers’ Compensation Insurance Rating Bureau (WCIRB) released its 2019 State of the System report highlighting key metrics of the state’s workers’ compensation system.
  • The Division of Workers’ Compensation posted an order updating the Medical Treatment Utilization Schedule. Treating providers, qualified medical evaluators and agreed medical evaluators, and utilization review and independent medical review physicians can access the MTUS guidelines at no cost by registering for an account here.

Florida

  • The Division of Workers’ Compensation has finalized a rule that defines which injuries “shock the conscience,” as required by legislation passed more than a year ago. The eight injuries deemed to be shocking to the conscience are:
    • Decapitation (full or partial).
    • Degloving.
    • Enucleation.
    • Evisceration.
    • Exposure of the brain, heart, intestines, kidneys, liver or lungs.
    • Impalement.
    • Severance (full or partial).
    • Third-degree burn on 9% or more of the body.

    The Legislature will now be required to give final ratification because the rule is likely to cost municipalities more than $200,000.

Missouri

  • The maximum weekly benefit for temporary total disability, permanent total disability and death benefits rose to $981.65, effective July 1. Permanent partial disability rose to $514.20.

New York

  • Mandated comp coverage for farm laborers under the Farm Laborers Fair Labor Practices Act, which requires farm employers to provide workers compensation for laborers, institutes injury reporting requirements and offers laborers additional protections, takes effect Jan. 1, 2020.

Virginia

  • The Workers’ Compensation Commission released its 2018 Annual Report, which provides a summary of key initiatives, trends, and outcomes.

Wisconsin

  • Commissioner of Insurance approved an overall 8.8% rate decrease for businesses starting Oct. 1, the fourth consecutive year of decreases.


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Things you should know

CDC: Half of workplaces offer health/wellness programs

Almost half of all U.S. worksites offered some type of health promotion or wellness program in 2017, according to a new study, Workplace Health in America 2017. This was the first government survey of workplace health promotion programs in 13 years.

Nationally, almost 30 percent of worksites offered some type of program to address physical activity, fitness, or sedentary behavior. Some 19 percent of worksites offered a program to help employees stop using tobacco products, and about 17 percent of worksites offered a program to address obesity or weight management.

FMCSA delays publication of proposed rule to amend trucker hours-of-service regs

The Federal Motor Carrier Safety Administration (FMCSA) has delayed until further notice the publication of a proposed rule intended to add flexibility to hours-of-service regulations for commercial truck drivers. The proposed rule remains under the Office of Management and Budget review.

NLRB gives employers greater discretion to limit union activity on their premises

The National Labor Relations Board (NLRB) recently issued a decision in UPMC Presbyterian Shadyside that reverses a longstanding precedent and holds that employers no longer have to allow nonemployee union representatives access to public areas of their property unless (1) the union has no other means of communicating with employees or (2) the employer discriminates against the union by allowing access to similar groups.

Study: Energy drinks take toll on heart health

Popular caffeine-packed beverages could affect heart rhythm, according to a new study. Research findings of a recent study published in the Journal of the American Heart Association (AHA) confirm the short-term risk consumers take when consuming energy drinks. Drinking 32 oz. of an energy drink in a 60-minute timeframe directly affected the heart rhythm of the study’s participants, a result bolstered by previous research.


State News

California

  • The Workers’ Compensation Appeals Board is planning to reorganize its Rules of Practice and Procedure, and is seeking comments from system users about other changes that it should consider. Comments can be sent to WCABRules@dir.ca.gov.

Georgia

  • A new law, the Georgia Long-Term Care Background Check Program will take effect Oct. 1, requiring nursing home and other long-term care workers to submit to extensive background checks.

Illinois

  • Illinois became the 11th state to legalize recreational marijuana.

Massachusetts

  • More changes to three key deadlines for the Paid Family Medical Leave (PFML) law.
    • September 30, 2019 – Employers and covered business entities are required to post a notice and provide written notice to their current workforce.
    • October 1, 2019 – Payroll withholdings begin for the October 1 to December 31 quarter.
    • December 20, 2019 – Deadline to file for a private plan exemption for first quarter contributions.
    • January 31, 2020 – First quarterly contribution payment due through MassTaxConnect.

Michigan

  • The governor issued an executive order creating a separate workers’ compensation appeals commission. The action separates the Unemployment Insurance Appeals Commission from the Workers’ Disability Compensation Appeals Commission.

Minnesota

  • Enacted detailed new recordkeeping requirements for employers, effective July 1, 2019, and wage theft protections for employees, effective August 1, 2019. For more information.
  • Department of Labor and Industry is urging all employers to examine their safety programs, after a spike in reported amputations this year.

Missouri

  • Department of Labor is offering confidential safety and health consultations aimed at helping employers build safer workplaces. Businesses must have no more than 250 employees at any one site, and fewer than 500 total employees, to qualify.

New York

  • The Workers’ Compensation Board formally adopted its drug formulary and prescribing rules for injured workers, set to go into effect Jan. 5, 2020.

Tennessee

  • Rejecting the strict “ABC” test adopted by its appellate court, that state has enacted a new law (H.B. 539) adopting a 20-factor test to determine employee-versus-independent contractor status. The new law becomes effective January 1, 2020.
  • An NCCI study found that prescription drug utilization decreased across all categories, regardless of whether they required prior authorization. After the Official Disability Guidelines Workers’ Compensation Drug Formulary was adopted, the utilization of N-drugs, which require prior authorization, dropped by 23.2%.

Virginia

  • On July 1, 2019, a new amendment to Virginia Code Section 8.01-413.1 will take effect, requiring all employers to provide copies of employment records to employees upon written request.


For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit 
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Things you should know

CMS change in Part D Manual suggests increased MSP enforcement

The Centers for Medicare and Medicaid Services (CMS) has amended its Medicare Prescription Drug Benefit Manual (Part D) to add stronger language regarding Medicare Part D sponsors’ secondary payer rights and recovery. A claim for a drug that should be paid as MSP may not be submitted or paid as a primary claim by the Medicare plan. It’s expected that Part D plans will more aggressively assert their secondary payer status, either through coverage denial and/or increased Part D recovery claims regarding workers’ compensation, liability, and other non-group health claims.

NIOSH releases silica monitoring software

NIOSH has unveiled a beta version of an online software tool designed to provide post-shift assessments of mine worker exposure to respirable crystalline silica. The Field Analysis of Silica Tool uses portable infrared technology to analyze exposure to crystalline silica.

New CSB ‘Safety Digest’ and video spotlight winterization safety at chemical, processing facilities

Safety challenges posed by cold weather at refineries, chemical plants and other facilities that handle hazardous materials are addressed in a new Safety Digest and corresponding video from the Chemical Safety Board.

NORA Manufacturing Council unveils website to help with lockout, other energy control programs

The National Occupational Research Agenda Manufacturing Sector Council has created an online resource guide intended to assist organizations in beginning, maintaining or enhancing their hazardous energy control programs.

New for nurses: Online continuing education on preventing MSDs

The Center for the Promotion of Health in the New England Workplace introduced a free online continuing education program intended to help nurses prevent musculoskeletal injuries during clinical care. Ergonomics in Healthcare includes learning modules, case studies, videos, reference materials and guidelines for reducing injuries incurred while treating patients.

FMCSA releases final rule lifting exemptions for truck drivers with diabetes

The Federal Motor Carrier Safety Administration has issued a final rule intended to ease restrictions on commercial motor vehicle drivers whose insulin-treated diabetes mellitus is under control, according to a notice in the Sept. 19 Federal Register. The rule is scheduled to go into effect Nov. 19.

New resources for the construction industry from CPWR

CPWR – The Center for Construction Research and Training (CPWR), a recently launched six new safety resources:

National Safety Council enhances Injury Facts website

The National Safety Council has enhanced the workplace section of its online “Injury Facts” database to help employers better understand the injury rates in their industries and to improve safety measures. Employers can plug in information, such as industry and tasks, to calculate risks, and obtain data on fatality rates and fatigue.

State-by-state map of opioid abuse

FAIR Health, an independent nonprofit that collects data and maintains the country’s largest database of privately billed health insurance claims, published a new white paper on opioid abuse and dependence related to regional and state differences in treatment. It includes a “heat map” to show which areas have higher opioid abuse and dependence claim lines as a percentage of total medical claim lines in 2017.

State News

California

  • Cumulative trauma claim rates have grown by 50% since 2008 and 40% of such claims are filed after an employee is terminated, according to a report by the Workers Compensation Insurance Rating Bureau
  • Medical payments per claim in 2017 decreased, averaging between $5,000 and $10,000 according to the Workers Compensation Research Institute (WCRI)
  • Became the first state to require professional cosmetics manufacturers to disclose ingredients – including hazardous chemicals – on their product labels

Indiana

  • The Department of Insurance has approved a 5.6% loss-cost reduction and an overall rate level decrease of 7.6%, which will take effect Jan. 1
  • Was one of the three states with the highest medical payments per claim in 2017, averaging just below $20,000, in a study of 18 states by WCRI

Michigan

  • The pure premium advisory rate will decrease by 8.3% in 2019, marking the eighth consecutive rate decrease says the Department of Licensing and Regulatory Affairs
  • Medical payments per claim averaged between $5,000 and $10,000 in 2017 according to WCRI

New York

  • Surpassed California as having the highest workers’ compensation costs in the country, according to the Oregon Department of Consumer and Business Service

North Carolina

  • The Insurance Commissioner has approved an average 17.2% decrease in workers’ compensation rates, effective April 1, 2019. For industry groups, the rating bureau’s proposed decrease were an average: 15.8% for manufacturing industry groups, 6.5% decrease for contracting, and 19.3% decrease for the office-clerical and goods-services industries
  • Starting Nov. 1, health care providers must check the state’s prescription drug monitoring system before prescribing a controlled substance to an injured worker
  • Decreases in medical payments per claim in 2017 were the steepest of eighteen states studied by the WCRI at 6% per year

Pennsylvania

  • Gov. Tom Wolf signed into law a bill that reinstates impairment ratings. Under the new law, an employer can request an impairment evaluation where a physician determines the degree of an injured employee’s impairment under the Pennsylvania Workers Compensation Act after the employee was injured for 104 weeks. Doctors are to refer to the “most recent” edition of the American Medical Association’s Guide to the Evaluation of Permanent Impairment
  • Faster-than-typical growth in medical payments per claim was driven by faster growth in hospital outpatient payments per claim according to the WCRI

Tennessee

  • The Workers’ Compensation Advisory Council recommended a 14% decrease in the rate for the voluntary and assigned risk market, rather than the 19.1% recommended by NCCI

Virginia

  • Was one of the three states with the highest medical payments per claim in 2017, averaging just below $20,000, in a study of 18 states by WCRI

Wisconsin

  • In contrast to moderate-to-rapid growth in prior years, the state experienced little growth in medical payments per claim since 2014 according to the WCRI
  • Was one of the three states with the highest medical payments per claim in 2017, averaging just below $20,000, in a study of 18 states by WCRI

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