OSHA watch

Interim enforcement guidance on silica standard for construction

The interim enforcement guidance for the Respirable Crystalline Silica in Construction Standard (1926.1153), which is now enforced in full, was issued Oct. 19 in a memorandum to regional administrators. The guidance is intended to help gauge whether employers meet various requirements, including those for inspections and avoiding citations, but does not provide guidance on all of the standard’s provisions. A final compliance directive is in the review process.

Information on silica hazards and related standards are now in one location on the website.


New fact sheets: Zika virus and evaluation of Shipyard Competent Person programs

The fact sheet on the Zika virus details how laboratory exposures occur, often through bodily fluids, and how to prevent exposures.

The Shipyard Competent Person programs fact sheet offers guidance on determining the necessary qualifications of experts who must be employed to determine whether a confined space is safe for workers and prescribe protective measures.


Pennsylvania construction firms join Strategic Partnership program

Shoemaker-Skanska Construction and the Philadelphia Regional Building Trades Council entered into a strategic partnership to protect approximately 300 workers during renovation and construction of a shopping mall complex in Philadelphia. P.J. Dick Incorporated entered into a strategic partnership to protect approximately 200 workers during the construction of an insurance office building in Erie.


Enforcement notes

California

  • HBuilt Inc. in Oakland received two serious citations and $80,000 in penalties for failing to train workers on potential hazards and safe operation of machines, ensure proper machine guarding, and provide workers with gloves designed to prevent cuts.

Georgia

  • Structural Subcontractors Service LLC, a Birmingham-based structural framing company working on a job site in Georgia, faces penalties of $102,669 for exposing workers to fall hazards. Inspectors found workers wearing fall protection harnesses, but were not tied off to prevent a fall. The inspection was initiated as part of a regional emphasis program.

Massachusetts

  • Citations and proposed penalties against Dudley-based Shield Packaging Co. Inc. and two staffing agencies following a May 2016 incident in which an employee was injected with a flammable propellant gas have been settled. The packaging company will pay $150,000, about 50% of the original levy, and the two staffing agencies, Leominster-based ASI Staffing Group Corp. and Worcester-based Southern Mass Staffing, will pay $12,471 and $12,222 respectively. The company also agreed to document that all hazards are corrected, retain a professional engineer to approve the design and installation of a safety interlock on the machine that injured the worker, retain a qualified safety consultant to perform a comprehensive inspection of the plant, and develop a workplace safety and health program, while the staffing agencies also agreed to implement specific comprehensive safety and health measures.

Michigan

  • Ten citations and $102,600 in penalties were issued to SET Enterprises Inc. in New Boston for exposing workers to amputation hazards. Inspectors determined that the company failed to train workers on potential hazards and safe operation of machines, ensure proper machine guarding, and provide workers with gloves designed to prevent cuts.

New York

  • Acme Parts Inc. has agreed to pay $40,000 in penalties after high lead levels were found in the manufacturing facility as well as hire a qualified lead hazards and abatement consultant to evaluate the facility and to recommend improved practices.
  • An administrative law judge affirmed citations issued against Webster-based LM Sanderson Construction Inc. whose employees were photographed working on a site without fall protection and assessed total penalties of $5,600. The employer failed to meet its burden in contending the violation was the result of unpreventable employee misconduct or that literal compliance with the standard’s requirement was infeasible under the circumstances.

Pennsylvania

  • Pittsburgh contractor, Ski Masonry LLC, is facing $201,354 in proposed penalties for exposing workers to fall and electrical hazards after an employee was fatally electrocuted.
  • In response to a complaint, the owner of a New Jersey construction company has been cited for exposing workers to alleged hazards at a Philadelphia job site, including allowing employees to work on a scaffold that was too close to power lines, failure to train on scaffold hazards, not providing hard hats and failing to develop and implement an accident-prevention program. The owner, Vyacheslav Leshko, faces $191,215 in proposed penalties.

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

HR Tip: Failure to pay for pre-shift work can be costly

A recent settlement in a class-action lawsuit, Tompkins v. Farmers Insurance Exchange, is a reminder to all employers about the obligation to pay for pre-shift work under the Fair Labor Standards Act (FLSA) and state laws. A federal court approved a $775,000 settlement for Farmers Insurance’s alleged failure to compensate auto claims representatives, appraisers, and adjusters in several states for pre-shift work.

The alleged unpaid activities included starting up computers and accessing Farmers’ software applications, obtaining daily assignments, determining the locations the workers would need to visit, mapping routes, contacting customers and auto repair facilities, downloading required forms and gathering paperwork, as well as traveling to the workers’ first appointments of the day. The settlement, which was approved by the U.S. District Court for the Eastern District of Pennsylvania, granted both the FLSA collective action and state law class claims and covers nearly 400 current and former employees.

Employers are reminded that activities before the official time a shift begins are compensable if they include tasks the worker is employed to perform or are an “integral and indispensable part of” the job and include mandatory pre-shift meetings. Employers should review policies and practices regarding compensation for pre- and post-shift work, as well as educate managers about the wage laws that require payment for all hours worked.

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

Important takeaways from recent studies and reports

Strategies to reduce costs and risks of musculoskeletal disorders

A report by the Northeast Business Group on Health (NEBGH) urges employers to look at their own experiences with claims, disability, workers’ compensation and health risk assessment data to best prioritize program selection and implementation to better manage MSDs. It addresses several strategies to mitigate cost and health issues and suggests using onsite ergonomics training, online courses on the subject and workplace redesigns. It also suggests new approaches to treatment, such as online pain education, direct access to physical therapy by bypassing physician referrals, and directing employees away from “unnecessary diagnostic imaging and expensive visits to specialists.” Finally, the report examined ways to ensure that if surgery is needed, that the care is performed in an efficient and cost-effective way.

Obesity and worker productivity by occupational class

The Journal of Occupational and Environmental Medicine has published a new study, “Impact of Obesity on Work Productivity in Different US Occupations: Analysis of the National Health and Wellness Survey 2014-2015”, which examines the impacts of obesity by different occupational classes on work productivity and indirect costs of missed work time.

BMI results were as follows:

  • Protective Services: 38% overweight, 39% obese
  • Transportation: 38% overweight, 36% obese
  • Manufacturing: 35% overweight, 30% obese
  • Education: 31% overweight, 30% obese
  • Healthcare: 31% overweight, 30% obese
  • Construction: 38% overweight, 29% obese
  • Hospitality: 32% overweight, 27% obese
  • Arts: 34% overweight, 26% obese
  • Finance: 36% overweight, 25% obese
  • Computer: 36% overweight, 25% obese
  • Legal: 38% overweight, 24% obese
  • Science: 37% overweight, 21% obese

The researchers concluded that there was a positive association between work productivity impairment and increases in BMI class that varied across occupations. Obesity had the greatest impact on work productivity in construction, followed by arts and hospitality, and health care occupations. Work impairment was least impacted by increases in BMI in Finance, Protective Services, Computers, Science, and Legal. It was estimated that the indirect costs associated with the highest BMI group in construction was $12,000 compared to $7,000 for those with normal BMI.

Would your floors pass the slip and fall test? 50% fail

Half of the floors tested for a slip-and-fall study failed to meet safety criteria, suggesting that many fall-prevention programs may overlook the effects of flooring selection and ongoing maintenance on slip resistance, according to a study by CNA Financial Corp.

Given the high frequency of slips and falls, these findings underscore the need for attention to floor safety and regular surface resistance testing to avoid fall accidents and related injuries.

Fatigue costs employers big bucks

Key findings from a recent study on fatigue by the National Safety Council (NSC) include:

  • More than 43 percent of all workers are sleep-deprived, and those most at risk work the night shift, long shifts or irregular shifts. As employees become tired, their safety performance decreases and their risk of accidental injury increases.
  • Missing out on sleep makes it three times as likely to be involved in an accident while driving. Also, missing as little as two hours of sleep is the equivalent of having three beers.
  • Employers can see lost productivity costs of between $1,200 to $3,100 per employee per year.
  • The construction industry has the highest number of on-the-job deaths annually. In a 1,000-employee national construction company, more than 250 are likely to have a sleep disorder, which increases the risk of being killed or hurt on the job.
  • A single employee with obstructive sleep apnea can cost an employer more than $3,000 in excess healthcare costs each year.
  • An employee with untreated insomnia is present but not productive for more than 10 full days of work annually, and accounts for at least $2,000 in excess healthcare costs each year.

Experts say employers can help combat fatigue by offering breaks, scheduling work when employees are most alert, and promoting the importance of sleep.

Workers welcome employers’ help in dealing with stress

Workers want their employers to offer assistance in coping with work-related stress, according to a new report from the American Heart Association’s CEO Roundtable.

The report also concludes that employees think more highly of employers offering resiliency programs. Valued programs include methods for dealing with difficult people, improving physical health, remaining calm under pressure, coping with work-related stress and accurately identifying the causes of work-related problems. It also includes actionable strategies for effective workplace resilience programs.

Supportive communication and work accommodation help older workers return to work

While early supportive contact with injured workers and offers of work accommodation are important to all injured workers, a recent webinar hosted by the Disability Management Employer Coalition (DMEC) and presented by Dr. Glenn Pransky, founder of the highly acclaimed, but now-defunct Center for Disability Research within the Liberty Mutual Research Institute for Safety, noted that these two strategies are particularly effective with older workers.

His research involved workers’ comp cases in New Hampshire related to low back and upper extremity problems. Negative responses, including lack of support, anger, disbelief, blaming the worker, or discouraging the worker from filing a claim resulted in significantly longer disability, and the effect was especially strong among older workers.

Click to hear the DMEC webinar

Loss control rep visits cut lost-time injuries in construction

Visits by insurance loss prevention representatives to construction job sites can lead to fewer workplace injuries, according to a study by a Center for Construction Research and Training supported research team at the University of Minnesota. One contact was associated with a 27% reduction of risk of lost-time injury, two contacts with a 41% reduction of risk, and three or more contacts with a 28% reduction of risk, according to the study. The study also found that these visits are often low cost and that the reduction in lost-time injuries reduced workers’ comp costs.

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

Don’t let your holiday party become a legal liability

No one wants to be a spoil sport. Holiday parties are supposed to be festive and fun, but they can also be a breeding ground for liability under tort, workers’ compensation, sexual harassment, discrimination, and other laws. Planning ahead to minimize exposure can help ensure a lawsuit-free event.

Workers’ Compensation

A North Carolina case last year, Lennon v. N.C. Judicial Dept., illustrates the issues that are common when an employee is injured at an office event. Whether such injuries are covered under workers’ compensation laws will depend on many factors (which can vary by state), but the overriding question is whether the employee was acting in the course and scope of employment at the time of the incident.

In this case, the injured employee worked for the division of the county clerk’s office that was in charge of planning the annual office holiday party. During regular working hours, she designed invitations, arranged for catering, and helped plan the party. She also volunteered to serve as the “emcee” for the event. All employees were invited, but not required to attend, and the cost of the food and venue was paid for by a group of private attorneys who sponsored the party. Even if they did not attend, all employees were expected to contribute $13 to pay for a gift to the clerk of court and for cleaning up after the party.

On the evening of the party, she fell and suffered a fracture of the wrist and coccyx and a tear of her shoulder. She received short-term disability benefits and filed a workers’ comp claim for days missed from work, permanent partial disability, and medical expenses. When the insurance company denied the claim, it went through a series of appeals, which upheld the denial.

The appellate court used a six-question analysis to help determine if the injury arose out of the scope of employment:

  1. Did the employer in fact sponsor the event?
  2. To what extent was attendance really voluntary?
  3. Was there some degree of encouragement to attend, evidenced by such factors as:
    1. taking a record of attendance
    2. paying for the time spent
    3. requiring the employee to work if he did not attend or
    4. maintaining a known custom of attending?
  4. Did the employer finance the occasion to a substantial extent?
  5. Did the employees regard it as an employment benefit to which they were entitled?
  6. Did the employer benefit from the event, not merely in a vague way through better morale or good will, but through such tangible advantages as having an opportunity to make speeches and present awards?

While laws will vary by state, employers who take careful steps to disassociate the event from work and confirm that the venue and service providers are properly licensed will minimize their risk.
Tort

While drinking too much at a holiday party may derail a career, alcohol is at the root of many lawsuits and employers need to take steps to ensure that the revelry does not get out of hand. When excessive drinking occurs, employers can face claims of social host liability, negligence, and respondeat superior, which holds employers responsible for the acts of employees such as DUI cases.

A recent New York case, Gillern v. Mahoney, illustrates the exposure that excessive drinking can cause, even when the employer had no role in the celebration. A number of employees organized a holiday party and when a co-worker became intoxicated, they contacted his wife (also an employee and a nurse) to take him home. When she arrived, they assisted her in getting her inebriated husband into the car. When at home, she let him sleep it off in the car, but later, she found him dead on the car floorboard.

Even though the party was not sanctioned or paid for by the employer, was not held on its property, and all participating employees were off duty, the employer was sued for the worker’s death. Upon appeal, the appellate court found that the action of the co-employees was not the proximate cause of the decedent’s death and the employer and various co-employees could not be held responsible in tort.

It would be an easy solution not to serve alcohol, but that is not always realistic. Employers need to establish limits on the amount and type of alcohol that will be served. Definite “no’s” are an open bar and allowing employees to serve drinks. Limit the number of drinks with a drink ticket system or don’t provide free drinks at all, close the bar early, hold the event off site at establishments with a liquor license and properly trained bartenders, provide plenty of food, and arrange alternative transportation. Be sure management leads by example. Advise employees to be responsible with a statement on the party invitation and/or a written reminder on the responsibilities to drink only in moderation and to avoid driving after drinking.
Harassment

This year, where we seem more divided than ever and some are emboldened to mock or denigrate others, if it can go wrong, it will. In a social situation with alcohol, employees can lose their inhibitions and do offensive things that they wouldn’t normally do in a work environment. Yet, an employee’s diminished capacity is not a defense to claims of harassment or assault and employers could be held responsible because they created the environment for that conduct to take place. Other issues that can lead to lawsuits are a religiously themed party and religious symbolism, hanging mistletoe, inappropriate postings on social media that could lead to claims of a hostile work environment, harassment or discrimination.

While hosting a party off-site can better protect your company, employees can also assume office standards of conduct do not apply. Employers should remind workers that behavior at the party should comport with the same behavior that is acceptable in the workplace and that the same reporting procedures apply should any incidents occur. Make the dress code known and avoid holiday attire or costumes. Remind supervisors and managers to set a professional example, by staying clear of talking about promotions, performance, and other business matters related to individual employees, and not selectively offering personal compliments.
Gift exchanges

Similar to office parties, Secret Santa and Yankee Swaps, and other forms of gift exchange are popular during the holiday season. It’s important to make this voluntary and set parameters for appropriateness, inclusivity, and price.
Nine actions to minimize risk

While each state has its own nuances in the law, employers can best protect themselves with these actions:

  • Hold the party off-site and not during office hours
  • Ensure that attendance is truly voluntary; there is no coercion to attend and no high expectation of attendance
  • Be cautious about inviting vendors, clients or others with whom you have a business relationship
  • Refrain from engaging in business activities, such as speeches and distribution of awards
  • Avoid asking employees to perform specific functions at the party or recognize that in so doing, they could be considered in the scope of employment
  • Limit or do not serve alcohol
  • Remind employees that normal workplace standards of conduct are to be respected, including the use of social media, and immediately stop inappropriate conduct
  • Confirm that the venue is properly licensed
  • Understand your exposure and corresponding insurance coverage

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

Six ways employers unwittingly fuel workplace violence

The statistics are alarming. According to an FBI report, workplace violence impacts almost two million Americans a year, causing an average of 700 homicides. About 18% of violent crimes are committed in the workplace. In addition to the invaluable loss of human life, NIOSH estimates the annual economic cost is $121 billion, not including the immeasurable physical and emotional trauma and morale issues among employees and disruption for the business.

Yet, according to the Bureau of Labor Statistics (BLS), fewer than 30% of private employers have workplace violence prevention programs and only 20% provide workplace violence prevention training. Employers can be reactive rather than proactive, believing an incident cannot occur at their office and don’t seek help until something has happened.

While some associate workplace violence with the high-profile cases covered by the news media, its definition is much broader. The FBI defines workplace violence as “actions or words that endanger or harm another employee or result in other employees having a reasonable belief that they are in danger.” It encompasses bullying, harassment, stalking, robbery, rape, sexual assault, physical assault, as well as shootings, and happens daily.

Generally, it can be grouped into four types:

  1. Violent acts by people who have no other connection with the workplace other than to commit the crime (such as robbery). Convenience stores, gas stations, and liquor stores are at particularly high risk.
  2. Directed at workers by customers, clients, patients, students, inmates or any others for whom an organization provides services. Health care and social assistance sectors are particularly vulnerable.
  3. Violence against coworkers, supervisors or managers by a present or former employee. While some can be random, more often it is a disgruntled employee.
  4. Domestic violence that spills over to the workplace – violence committed in workplace and the perpetrator has a personal relationship with an employee.

Here are six ways employers unwittingly fuel the problem:

  1. Fail to adequately assess all aspects of physical securityConducting a thorough walkthrough at least once during the day and once after dark with a focus on identifying vulnerabilities lays the foundation for a security plan. Where can people enter the building? Are the entrances secured in any way? If electronic access cards are used, are they immediately disabled when an employee leaves the company or loses the card? Where can perpetrators hide to sneak in behind an employee? How do visitors gain access to the building? What about the lighting? If it’s shared space, how is security coordinated? How can employees escape in the event of an incident? What about employees with disabilities? How is after-hour access controlled? Are there security cameras and are they positioned where they are needed? If you have security guards how rigorously do they enforce the rules?Once a security plan is developed, be sure employees have a way to communicate any issues and conduct periodic reviews of the security measures. If an employee reports a former boyfriend is stalking her, is there a way to communicate that information to those in the frontline? If a door is left open, employees may like the convenience of not using their keycards and not report it.
  2. Fail to train managers and supervisors in managing peopleManagers and supervisors often rise through the ranks because of their superior technical skills and strong work ethic. Managing people requires a different skill set and it can be particularly difficult with a troublesome employee. Far more frequent than killing rampages at the office are cases of workplace bullying and workplace assault. Stopping these dangerous situations early can prevent problems from spiraling out of control or turning deadly, yet poorly trained managers can make matters worse by intensifying the sense of persecution felt by the disgruntled employee or ignoring the situation altogether.Managers and supervisors may feel challenged to understand issues employees are experiencing outside the workplace – a divorce, a terminally ill child, financial problems, and so on, while also respecting privacy issues. They should know what to do and who to turn to for assistance.
  3. Fail to foster a culture that encourages reporting of physical and verbal threats and harassmentAll too often after an incident of workplace violence, co-workers describe the perpetrator as belligerent, angry, a bully, misfit, loner and so on, but did not report their concerns.The highly publicized sexual assault allegations made against Hollywood producer Harvey Weinstein and others – including the use of the #MeToo social media hashtag – indicates that sexual misconduct is a regular, but underreported workplace occurrence. They may worry about their job, fear retaliation, believe it’s not their responsibility, don’t want to be viewed as a “tattler,” don’t believe it will escalate, or think the employer will ignore the complaint. Ironically, aggressors count on this behavior.Educating workers on all aspects of workplace violence and training how to spot potential trouble is a good start. Open communications and a clear reporting structure that enables them to report in a non-judgmental way that includes timely feedback and action is essential.
  4. Fail to recognize workplace factors that can trigger violenceStress, downsizing, mergers, feelings of being undervalued or unheard, and rigid management styles are often cited as precursors of workplace violence. Stress is a key trigger, and increased production demands, new technologies, reorganization, and the pressure to be available 24/7 can be overwhelming to some employees. Special programs to help employees manage stress can be helpful and demonstrate support for employees.Yet, the same ‘objective’ stressor at work can trigger an aggressive reaction in one person and not in another. This sometimes leads managers to conclude that a problem is the individual’s – rather than accepting the need to acknowledge and respond to differences in their staff. Yet, often there are early warning indicators, such as a change in attitude or appearance, friction with co-workers, deteriorating performance, excessive complaints, and increased absences. When managers get involved with an open dialogue and provide a plan for support, the likelihood of this escalating to overt threats and aggression decline.
  5. Fail to manage the threat with hiring and firing practicesThere’s no doubt it is difficult to obtain substantial information from past employers, but it’s critical to try. According to reports in the Baltimore Sun, the gunman at the Advanced Granite Solutions company in Maryland had been violent previously at work. An employee at a prior employer filed a peace order against him, alleging that he had punched an employee in the face and had returned later to threaten employees at the place of business.Experts suggest that behavioral-based interviewing can help identify potential problems. This technique involved probing questions that relate to how an individual behaves in the workplace. “Tell me about a situation where you did not agree with a co-worker. How did you handle it? What was the outcome? Were you satisfied with the outcome?” Observing body language also can be revealing. Employers who do not take proper precautions in hiring run the risk of being accused of negligent hiring practices.

    Equally important is managing the termination process. Whether it’s a layoff, non-performance, or just a poor fit, treat the person with dignity and respect and stick to the facts. Be consistent. Keep it short and private. Do it at a time when business impact is minimized. Many experts suggest earlier in the week and definitely not a Friday. Provide information on resources that will be helpful to the employee.

  6. Fail to involve workers in the development of the planWhen employees have a role in developing a plan, they are more likely to take ownership and feel empowered to take action. The group should include individuals from line staff to the highest-ranking management official or an appropriate designee to ensure feedback and representation from the entire workplace. All-employee training sessions designed to educate staff on what workplace violence is, how to look for it, and what actions to take should be conducted regularly.

Employers in every industry need to do a better job at preventing workplace violence. While it is not always possible to prevent violence in the workplace, by preparing and planning ahead, it is possible to minimize the risk and protect employees.

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

Things you should know

NSC debuts Fatigue Cost Calculator for employers

A U.S. employer with 1,000 workers could lose about $1.4 million annually because of the effects of sleep deficiency, according to recent research from the National Safety Council (NSC) and the Brigham Health Sleep Matters Initiative. An estimated 40 percent of the workforce suffers from an undiagnosed sleep-related ailment, such as obstructive sleep apnea or insomnia. Sleep disorders can cause employees to miss work and experience performance and productivity issues, as well as increases in their health costs. They also can lead to work-related incidents and injuries.

Organizations now can see their portion of those costs – and their potential savings by implementing sleep health programs – with the new Fatigue Cost Calculator.

NIOSH launches software platform to monitor health of emergency responders

The National Institute for Occupational Safety and Health (NIOSH) has launched a software platform called ERHMS Info Manager to monitor the health and safety of emergency responders. ERHMS Info Manager tracks and monitors emergency response and recovery worker activities during all phases of emergency response following a natural disaster or other public health emergency.

EMS workers face higher occupational injury rates: NIOSH

Emergency medical services workers have higher rates of work-related injuries than the general workforce and three times the lost workday rate of all private-industry workers, according to a new fact sheet from NIOSH. The fact sheet identifies the actions that caused the most injuries and provides tips to prevent injuries.

Sharp drill bits decrease hazardous exposures during concrete drilling, researchers say

Workers who frequently drill concrete can reduce their exposure to noise, silica and vibration by regularly replacing dull drill bits with new, sharp ones, according to a recent study from the Center for Construction Research and Training, also known as CPWR. In three experiments the research team showed that a worker’s exposure to noise, tool vibration and airborne silica dust increases substantially as a bit wears down from continued use.

NIOSH releases skin-hazard profiles on nine chemicals

NIOSH has published nine new skin notation profiles to “alert workers and employers to the health risks of skin exposures to chemicals in the workplace. The chemicals include:

  • Arsenic and inorganic arsenic containing compounds
  • Disulfoton
  • Heptachlor
  • 1-Bromopropane
  • 2-Hydroxypropyl acrylate
  • Dimethyl sulfate
  • Tetraethyl lead
  • Tetramethyl lead
  • Trichloroethylene

New online toolkit to help keep workers and families safe on the roads

The Network of Employers for Traffic Safety is offering a free online toolkit to help employers keep workers and their families safe on the road.

The toolkit includes an interactive distracted driving self-assessment in which users answer questions about their driving habits. Other resources include fact sheets for employers and employees, pledge cards, a PowerPoint presentation, and graphics for social media and email use.

Coventry 4th and Final Drug Trends Series Report

Coventry has released the fourth and final installment of their 2016 Drug Trends Series, this one focusing on specialty medications and closed formularies. Specialty drugs are not utilized widely in workers’ comp, just 1.1 percent, but they do make up just about 5 percent of overall prescription costs. In the managed care world, utilization of specialty medications rose by 19.4 percent in scripts per claim and they saw a 7.9 percent increase in cost.

State News

California

  • Over 90% of all utilization review physicians’ modifications or denials of treatment that were reviewed by an independent medical review (IMR) doctor in were upheld according to a study by the Oakland-based California Workers’ Compensation Institute. About half of the IMR decisions so far this year were related to pharmaceutical requests and a small number of physicians account for a large portion of the claims.
  • The Workers’ Compensation Insurance Rating Bureau (WCRIB) released a report showing medical payments per claim dropped nine percent from 2014 to 2016. The researchers attribute that to a drop in utilization, there was a 10 percent decrease in paid transactions, but the average payment per paid transaction actually rose 4 percent, from $129 to $134.

New York

  • The Workers’ Compensation Board released new impairment guidelines, just meeting the deadline set by the Legislature last spring. The guidelines are used to determine schedule loss of use awards, which are additional cash payments to workers who have permanent or partial loss of the use of limbs, as well as vision and hearing loss.

North Carolina

  • Rate Bureau proposes 11.3% loss cost decrease. This filing will affect policies that are effective on and after April 1, 2018, and are applicable to new and renewal policies.
  • Employee misclassification complaints are up 644% in first half of 2017, reflecting the state’s crackdown on misclassification, which followed a yearlong investigation by the News & Observer in Raleigh and The Charlotte Observer.
  • Industrial Commission has stopped accepting motions from adjusters. Determining that the filing of motions constitutes the unauthorized practice of law, the Industrial Commission will no longer accept motions for relief filed by insurance adjusters.

Tennessee

  • NCCI recommends 12.2% rate drop. Drops will vary by industry, but most are in double digits.

 

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

HR Tip: Enforcement of joint employer liability for temporary worker safety remains strong

While OSHA has moved away from an enforcement-based strategy on many initiatives, OSHA’s deputy director of the Directorate of Enforcement Programs made it clear at a recent conference that the agency is continuing to enforce joint employer liability for temporary worker safety and plans to issue more guidance for employers. The agency conducted nearly 600 inspections of workplaces with temporary workers in fiscal year 2016 and is continuing to conduct these inspections.

In addition, in every inspection compliance officers are directed to look for the presence of temporary workers and the unique hazards they are exposed to. OSHA has issued seven bulletins providing guidance to employers as part of the temporary worker initiative on injury and illness record-keeping requirements, personal protective equipment, whistleblower protection rights, safety and health training, hazard communication, bloodborne pathogens, and powered industrial trucks training.

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

What works in Workers’ Comp: learning from others

Risk and Insurance has named the 2017 All Stars and the National Safety Council has announced the Rising Stars of Safety. Here are several of their stories that offer ideas and solutions to some common work comp challenges:

Risk and Insurance 2017 All Stars

Helping underwriters understand the risk

Faith Cring, director, Engineering, Environmental, Safety and Insurance, Growmark Inc., recognized that underwriters tend to be city-dwellers and don’t necessarily understand the risks of an agricultural cooperative. So she brings the underwriters out to the country to educate them about pesticide drift claims, grain siloes, and other realities of the agriculture business and doesn’t coach location managers on what to say to underwriters. Her goal is to develop long-term relationships with her carriers, so she can get tailored coverage for her business.

Tackling outstanding claims

When Kevin Moss, Director of Casualty Insurance and Risk, Michelin North America, launched Michelin’s largest comprehensive claim review, he learned that of the company’s 483 open claims, 186 high-value claims accounted for 83 percent of the outstanding liability. The first step was to review all claims and ensure they’re correctly reserved, and then move onto a plan for closure. He worked to make sure top management understood the business case for spending extra money to close a claim, if needed. He also recognized the human side of claim closure, especially for those who had legacy claims involving medical payments dating back to the 60s. In some cases, he went to people’s houses, bringing an annuity expert along, and explaining what settling the claim would mean.

Innovative ergonomic solutions

When Joe J. Mazza, director of risk management and the ADA coordinator at Mira Costa College, found that over a three year period there were nine claims, with an average cost of $19,446, for carpal tunnel syndrome, he knew he had to put a plan in place. He wanted a lasting change, but was working with a small budget ($20,000), so he trained to become an ergonomic evaluator. His hands-on approach enables him to see the whole picture and provide the best solution. And, if he found himself short on finances for a department, he would work with each department head to share the cost. From 2010 to today, the college reduced workers’ comp claims by 47.9%.

Working with adjusters

Tim Liberty, a senior claims consultant, Baldwin Krystyn Sherman Partners, tapped into his past experience as a senior claim specialist for Liberty Mutual to build positive working relationships with adjusters. He recognized that most people don’t like adjusters, but he understood their role and wanted to show them his appreciation. For example, he sent the chief claims officer of a major carrier an email complimenting the work of an adjuster who’d done an excellent job handing a claim and he routinely sends thank you notes to adjusters. Building strong relationships with carriers and adjusters, the company was able to ask for – and get – dedicated adjusters on certain accounts, and acceptance of special claims handling instructions in some cases.

National Safety Council Rising Stars

Raising incident prevention awareness

Lorenzo Drummond,Manager, EH&S, Mylan Pharmaceuticals Inc., led the Incident Prevention Opportunity (IPO) program and exceeded the company goal for each employee to report one IPO by 329 percent. He established a monthly IPO Hero award, that recognized employees monthly for their individual contributions, along with a $25 gift card. Departments were also recognized quarterly for having the most IPOs reported and received a trophy and a meal.

Getting the family involved

Bassma Hegazy, Senior HSE Assistant, Egyptian Liquefied Natural Gas (ELNG), initiated the Children’s Safety Day. The employee’s children spend a day on-site and learn about safety in school, street, playground and kitchen. “The campaign had a tremendous impact on employees and their families; it worked on driving the employees to lead by example and their children to act as safety ambassadors.”

Lowering the Experience Mod

By identifying, analyzing, and targeting the key indicators and root causes of the injuries that were occurring, Travis Keeney, Director of Safety & Training, Tri-City Electric Co., implemented a program that lowered the EMR from 0.93 to 0.58. Key components were targeted training, revising and developing new task procedures, improving PPE, and teaching other managers not to just enforce safety but be coaches to those in the field as well.

Strengthening the safety audit

Awadh Fazal, HSE Manager, Coca-Cola Beverages Pakistan Ltd. initiated management safety audit training for all his peers and management staff, focusing on how to observe unsafe conditions/acts at sites during safety patrols and audits, how to record them, how to make contact with an employee, and how to maintain a strong follow-up until the observation is closed. A WhatsApp group was created for all employees, and it was mandatory for employees to share the status of observations of the group and also report unsafe conditions/acts.

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

Getting employees onboard to new approaches for back pain

Chronic back pain is one of the most persistent and difficult issues to deal with in Workers’ Compensation. With an aging and overweight workforce, it will continue to be a dominant cause of work comp claims. Moreover, about 85 percent of lower-back pain is idiopathic – without a specific or known cause – making it difficult to separate the impact of aging or outside activities from legitimate work-related causes.

Within the last several years, the industry has shifted away from bed rest, medical imaging, pain medications, and surgery to more conservative care, such as exercise, customized ergonomic training, yoga, physical therapy, cognitive behavioral therapy, acupuncture, and anti-inflammatory medications.

A 2014 study by Liberty Mutual’s Institute for Safety found that early use of MRIs on injured workers complaining of back pain may lead to unnecessary procedures and even longer disability periods. Other studies have put the cost of back-pain claims using MRIs at $12,000 more than claims that did not use early MRIs.

In some cases, an MRI can trigger a recommendation of surgery even though the changes can be attributed to a normal result of the aging process. If a physician wants to find an excuse to recommend surgery, it is there. Suddenly, for the employee, the perception of the problem escalates from annoying pain to a catastrophic condition.

In an age of MRI scans, getting employees on board with alternative approaches can be challenging. Understandably, employees are afraid of doing more damage to their spine and movement and exercise can seem counterintuitive. They anticipate worsening of symptoms with certain activities. And for couch potatoes, the prospects of activity can be overwhelming and surgery can be viewed as a cure-all. Changing the mindset is an important first step.

Provide reassurance with carefully chosen words

Speaking at the recent California Workers’ Compensation and Risk Conference, Dr. Jennifer Christian, president and chief medical officer at Wayland, Massachusetts-based Webility Corp., spoke about the power of words. Don’t call it “your injury,” instead, call it “your recovery process.” Don’t say “getting you back to work.” say, “getting your life back to normal.” Don’t ask about pain; ask about progress. She urged employers and claim handlers to be on the front line and help employees overcome their fears about how long they are going to be laid up and how they can manage their job, questions doctors often find difficult to answer.

Make ergonomic training effective

Employees will listen and buy into training if it makes them feel better. A recent article in Business Insurance highlighted a successful tailored ergonomic training program for employees of Greyhound Lines Inc. In 2010, the company saw 745 mostly musculoskeletal injuries. Most were related to material handling issues – pushing, pulling, twisting and lifting.

At the time, its training was a basic lifting program – one size fits all, regardless of what the person did. Today, safety experts study the job and come up with a tailored approach. With this customized program, the number of such claims dropped to 295 in 2016. Employees need motivation to make changes in behavior; feeling better, both on and off their job, is a great motivator.

In the article, ergonomics expert Dennis Downing, CEO of Future Industrial Technologies, Inc., noted some common, yet, ineffective practices. Likening the practice to teaching a child to swim, he said video-based training doesn’t work. You wouldn’t show a child a video, and then toss them in a pool. Offering a free lunch is also a no-no. “We had a hard time figuring out why companies were bribing employees with food,” he said of the common practice of providing ergonomics training – how to better lift, push, pull, and stretch – over a free lunch.

There is no silver bullet

It is going to take a careful assessment of the workplace, the demographics of the employees, and an analysis of the claims related to back pain to craft an effective plan. Whereas some employees may embrace new approaches with simple education, others need a multidisciplinary approach that includes more advanced psychological informed rehabilitation.

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

What employers should expect from an insurance agent

My fellow Institute of WorkComp Professionals educator wrote this article to summarize items that an employer should expect from their insurance agent when it comes to helping the employer to manage their workers compensation insurance program.

By Kevin Ring
Institute of Work Comp Professionals
Editor’s note: Kevin Ring, CWCA, CWCA, MWCA, is Lead Analyst at Institute of WorkComp Professionals, Asheville, NC of which we are a member. It trains and certifies independent insurance agents and their support staff to navigate the complicated workers’ compensation system and act as advocates operating between employers and their insurance companies.
Most workers’ compensation discussions focus on the roles of four active players: injured worker, physician, employer, and insurance company. But what about the insurance agent? Far too often, agents step into the background. There is something wrong with this picture. Workers’ compensation is one coverage area in which insurance agents can effectively demonstrate their value.

Here’s how we work to make a difference for the employers we serve:

Ensure the employee classifications are correct
With an average of 500 to 600 available job classifications, it’s easy for mistakes to occur. For example, a clerical employee (low workers’ comp rate) can be misclassified into one with a higher rate, which increases the cost. This is just one; many others can occur.

In fact, it’s even easier for mistakes to perpetuate themselves. An insurance agent calls on a prospect and asks to submit a quote and the owner agrees, thinking it’s a good idea to shop around. To get the necessary information, the agent asks to see the existing policy, copies the information, and goes back to the office to prepare the quote. If there are mistakes, they keep showing up.

Who is responsible for finding mistakes and correcting them so the employer only pays what is owed? Frankly, it’s the insurance agent who has the account. We’re trained how to find and correct mistakes so employers are not exposed and pay more than necessary.
Help employers develop a physician relationship
When it comes to reducing workers’ comp costs, particularly medical expenses, the importance of employers having a relationship with physicians with work-related injury and illnesses expertise cannot be overstated.

Too often, when an injury occurs, injured employees are sent to their personal doctor, an emergency room, or a nearby walk-in clinic. This can lead to higher costs, delayed return to work, and an increase in the experience mod, which lasts for three years.

If this is to change, it starts with having the right physician relationship. We can help an employer identify physicians with expertise in occupational medicine, go with the employer to interview doctors, develop options for alternate duty, help make sure the selected physician understands the business, the types of work performed, and any other employer expectations so that the physician is prepared when injuries occur.

 

Help an employer develop a process of what to do when employees are injured
What happens when an employee suffers an injury? Depending on the extent of the injury, in many cases employees are sent home and told to take it easy for the day, go to their own doctor, to the emergency room, or walk-in clinic. When you think about it, this is the only time employers give workers a blank check and tell them to go where they please without vetting the vendor.

It’s not good business because the employer has no control over the quality, cost, or outcome of the service. To change this, our task is to help the employer create a process that assures injured employees will receive proper care so they can return to the job as soon as appropriate.

Such a process may come as a surprise to employers who assume the insurance company is in charge. Actually, it’s more like opening the door and letting the fox in the hen house. Since employers are writing the check for their workers’ comp, they need to take charge of the process.
Analyze data to understand and foresee injuries
There’s a wealth of information in workers’ comp loss run reports, as well as OSHA reporting forms. Proactive agents work with employers to identify problem areas, which are often indicators that a larger, costly injury will occur, if changes are not made.
Serve as an effective conduit between the employer and the insurance company
When it comes to insurance, most employers are ill-equipped to have informed conversations with insurance companies. So, they reach out to their insurance agent when there’s a problem.

Today, insurance companies are all about reducing risks. It’s the agent’s role to position the employer in the best possible light with the insurance company to ensure competitive pricing and policy offerings.

Since the insurance agent knows both the employer and the carrier, it’s the agent who is best able to serve as the intermediary between the employer and the insurance company.
Help employers understand the technical nature of insurance language
Like the law, words have meaning in insurance. No one can feel comfortable with insurance unless they learn its language. Therefore, employers immediately file away insurance policies without even looking at them. They drag them out only when there’s a loss.

It doesn’t take a cynic to suggest that some insurance agents may like it this way. It gives them more control. But we recognize that a “secret language” is a barrier in the client relationship. It’s also an opportunity to help employers understand insurance by communicating its complexities simply and clearly. And, it’s worthwhile. No employer wants to be blindsided because they didn’t understand something, particularly when high costs are involved.
Help employers prepare for the workers’ comp premium audit so they pay only what they owe
Employers tend to view a workers’ comp audit as a minor inconvenience. The big question can be where to put the auditor. All of which suggests the annual audit is a low involvement event.

Now, compare this with an IRS audit, when all the stops are pulled out weeks in advance, and carefully choreographed by the accounting firm. No responsible business owner would go into an IRS audit the way most approach a workers’ comp audit that involves substantial sums of money.

It’s in an employer’s best interest to expect the insurance agent to help them prepare for a workers’ comp audit, particularly since auditors work for the insurance company. The agent understands the insurance language and knows the rules. During the weeks leading up to an audit, the agent can review the payroll records, check for incorrect job classifications, determine whether severance pay is excluded from comp, among others. If they find mistakes, they can correct them before the audit takes place.
Review information on employee injuries prior to the “magic moment”
This is the date the insurance company reports the employer’s information to the rating bureau for inclusion on the experience mod. It occurs 18 months from the inception of the account and every 12 months thereafter. Here’s what the report includes:

  • What has been paid thus far on employee injuries
  • What the insurance company has “reserved” (the estimated funds needed to ultimately resolve an employee injury.)

It’s important to review this data carefully. For example, if the reserves are higher than they should be, the employer’s experience mod will go up, which increases the company’s workers’ comp expense. Higher mods can render a business less competitive or, in the case of construction firms, ineligible to bid on certain jobs. The goal is also to make sure cases are not opened that should be closed, and that the reserves are relatively accurate.
Help the employer build a “recovery-at-work” program, so injured employees can be at work, rather than sitting at home
This is also known as “light duty,” “transitional duty,” or “return-to-work.” However, the term recovery-at-work more accurately describes what should happen and lets the injured worker know what to expect.

The recovery-at-work model sends injured employees the message that they are both valued and they can still be productive. Aided by transitional duty job descriptions, the physician can determine if the employee can return to work, along with job restrictions.

If the injured worker is back to work before lost time wage benefits begin, there is less negative impact on the experience mod. This can be a significant cost savings since the average lost time claim in 2016 was $53,000. But it’s also true that injured employees recover faster if they are at work.

Some managers still say, “Give me a whole man or no man.” But, happily more recognize the value of recovery-at-work. The insurance agent can help employers make it work best by identifying appropriate work activities based on physician restrictions, if any.

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