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

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

HR Tip: ABA’s summary of 2016 FMLA cases

Every February, the American Bar Association’s (ABA) Federal Labor Standards Legislation Committee publishes a comprehensive report of FMLA decisions handed down by the federal courts in the previous year. This handy report summarizes every FMLA decision from 2016 in a user-friendly manner.

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

Five ways employers derail claims with poor medical choices

“An injured employee treated by the wrong medical provider is like a stripped down “to save money” fire policy with more exclusions than inclusions. Right doctor. Right time. Right treatment. Always.” – Preston Diamond, Institute of WorkComp Professionals

A poor choice in medical care can break a worker’s compensation case and result in significant higher premiums for several years. While the rules vary, in many states employers have the ability to direct injured employees to a doctor of the employer’s choice. Even if this is not possible, having a relationship with a competent occupational physician who understands your business and can develop confident relationships with employees will help insure your injured employees get the proper care.

Yet, many employers find the process of choosing physicians outside their expertise and defer the choice to insurers or employees. Here are five ways this leads to unnecessary higher claims costs:

  1. Apathetic commitment to Recovery-at-WorkWhile medical treatment guidelines have gained traction in many states, they are only mandatory in a few states and often permit discretion for the treating physician. As a result, there is significant variability in quality of care and outcomes among physicians. Moreover, today many doctors seek to treat workers’ comp injuries because it is more lucrative than healthcare.

    Given the option, employees will choose to go to their primary care doctor who, most likely, will grant their request. Want a few days off for work to rest? Why not grant it when it keeps the patient happy? Yet, those few days can cost the employer big bucks.

    When there is a strong Recovery-at-Work commitment and the injured worker returns to work before becoming eligible for wage benefits, claims are known as medical-only claims. In 39 states (ERA states), medical-only claims are reduced by 70% on the experience modification worksheet, and usually have minimal effect on the final Mod. On the other hand, claims that also include indemnity payments are known as lost-time claims and often have a significant impact on the Mod.

    This hypothetical example gives an idea of the impact on costs. A small claim ($2,791) that included indemnity had a .0360 impact on the Mod and increased the annual premium by $1,771. Since this increase affects the premium for three years, the employer will pay a total of $5,265! A second small claim ($3,230) was medical only and impacted the Mod by .0125, raising the annual premium by $615 and increasing the premium $1,845 over three years.

    It takes more than lip service for physicians to partner with employers effectively in a Recovery-At-Work program. Look for physicians who:

    • Know the state’s Workers’ Comp rules
    • Come and tour your facility to understand the requirements of the job
    • Develop a good understanding of your Recovery-at-Work program and recognize the value of work in the healing process as well as factors that can keep injured employees out of work longer, such as anxiety, family issues, financial issues, and so on
    • Follow best practice guidelines for each type of injury (typically Occupational Medicine doctors)
    • Have strong communication skills with all parties – employer, injured workers, and claims examiner
    • Engage the injured worker in thinking about recovery and what they can do, not what they can’t do
    • Have objective standards to measure outcomes, such as claims duration, total costs, percentage return to full duty within disability guidelines, litigation, recidivism, and patient satisfaction
    • Have strong capabilities, both in-house and referral network, so that wait times are minimized
    • Do not dispense drugs
    • Have a clear policy regarding opioids
  2. Limited or no focus on outcomesWhile there is a growing focus on developing outcome-based networks for workers’ compensation, fee schedules are the norm for controlling costs. When insurers point out “savings” below fee schedules, this can divert employers from focusing on the real issue – how much they are paying. Physicians and hospitals squeezed by the health care system look to maximize revenues from other sources and workers’ comp is one of the most vulnerable.

    The answer is to direct care to providers who have measures of quality and outcome and deliver the best value, by delivering consistently excellent outcomes and competitive pricing. Insurance adjusters often handle upwards of 250 claims at one time; it’s unlikely they are going to have the time to identify the best provider for each of their clients.

  3. Not a good fit for the employer or workforceWhile Occupational Medicine doctors are a good starting point, it makes sense to drill down further. From past claims employers know where their exposures are the greatest and should identify physicians with specific proficiencies needed for the injuries and hazards in their work setting. In addition, if the employer is in a regulated or hazardous industry, the physician must be familiar with regulatory compliance issues.

    There are other considerations as well. If you have a bilingual workforce, the provider staff, including medical staff, should be bilingual. Equally important, the provider must be able to balance patient advocacy with employer concerns. Injured workers will respond positively to a physician if they have trust and believe the physician is their advocate, thus accelerating the return to worker and reducing the likelihood of litigation.

  4. Poor representation in disputed casesContesting cases when it is suspected the injury is not work-related is never easy, particularly when it involves a cumulative trauma injury, pre-existing conditions, or stress. Failing to challenge cases when the injury cause is not work-related leads to paying unwarranted benefits and emboldens others to file similar claims. On the other hand, wrongly challenging injured workers needlessly drives litigation costs up and leads to morale and trust issues among the workforce.

    Doctors are trained to treat injuries; causation is a secondary concern. While many states do not require that medical opinions be expressed with absolute medical certainty, it is expected that opinions be more than mere speculation and there is a probability as to the cause that can be supported.

    A good medical expert will not only be well qualified, but must be able to write a good report that clearly explains their opinions. Understanding how a physician handles disputed cases is key to avoiding unnecessary litigation costs.

  5. Unnecessary use of emergency room servicesWhen injured workers use emergency room services, they are likely to be told to take time off and medical costs are likely to be much higher. The only time an injured employee should go to the emergency room is when there is a 911 emergency or when there are no other available treatment options. Emergency rooms are busy places and their primary task is to make sure people are not in imminent danger. There’s no time to consider Recovery-at-Work possibilities.

    Furthermore, there’s a higher possibility of an inaccurate diagnosis. More than one-third of reports from consulting physicians for orthopedic injuries in emergency rooms were inaccurate, including 30% of open fractures that were described as closed, according to findings detailed in AAOS Now , a publication of the American Academy of Orthopedic Surgeons. According to the author, musculoskeletal conditions, a common workers’ comp injury, are the most commonly missed injuries in emergency departments.

    Emergency departments rarely communicate with the employer, don’t usually set up follow-up visits or provide ongoing care, and common treatment plans often include rest and no work activity for days or weeks following an injury. All of which means delays, lost time, and added cost to the employer.

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

New report weighs in on marijuana’s health benefits – nearly 100 conclusions

A new report from the National Academies of Sciences, Engineering, and Medicine offers a rigorous review of scientific research published since 1999 about the health impacts of cannabis and cannabis-derived products – such as marijuana. It lays out substantial evidence that associates the use of cannabis with the development of psychoses and schizophrenia, but also provides studies that show its potential benefits, such as relief of chronic pain and chemotherapy-induced nausea. Other benefits include: improvement of multiple sclerosis spasticity, improvement of short-term sleep in patients with obstructive sleep apnea, fibromyalgia, chronic pain, and multiple sclerosis, potential improvement of anxiety symptoms, and increasing appetite and decreasing weight loss in patients with HIV and AIDS.

But it also points out potential risks: worsening of respiratory symptoms and more frequent bronchitis with long-term smoking, increase in motor vehicle accidents, low birth weight in offspring of maternal smoker, and higher risk of cannabis overdose in children in states where cannabis is legal.

The report also acknowledges that it has been difficult for researchers to do rigorous research on marijuana, partly because of the federal classification of it as a Schedule 1 substance.

Employer takeaway: This report demonstrates how much more needs to be done – many health questions remain to be answered by better research. The increased legal availability of cannabis products in many states and the uncertain legal landscape has complicated workplace policies. It’s prudent for employers to establish a clear policy and communicate it effectively to employees as well as stay abreast of all legal decisions and regulations in the states where they do business.

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

Looking ahead to 2017 in Workers’ Compensation

It’s been a very healthy workers’ comp market for employers in many states. Those with favorable loss and exposure profiles are renewing with flat or reduced rates. A notable exception is Florida, which may be facing double-digit increases.

While this is good news for employers, changes in the legislative and regulatory landscape, a transforming workforce, a shortage of workers in key industries, technological advances, medical inflation, and the growing demand for data are challenges for employers. Here are four legislative and regulatory matters that employers should follow in 2017:

  1. Shifting legislative and regulatory policies under the Trump administration  Although states determine workers’ comp laws, a Trump presidency is expected to have a significant effect on the federal regulations that impact workers’ safety as well as employers’ regulatory compliance. One common theme through most of Mr. Trump’s campaign was reducing the federal influence in the workplace; many pundits are anticipating seismic shifts in OSHA and DOL regulations. Some regulations to watch include the new electronic recordkeeping and anti-retaliation law, the hospitalization and amputation reporting law, and the Silica rule. Many are also anticipating changes to the automatic cost of living adjustments for fines. A scale back in fine increases may also be on the table, but the penalty change was a statute and it’s not easily rolled back. Expect a shift in the ‘burden of proof’ back to the whistleblower in such cases, which, under the Obama administration, has focused on the secretary of labor finding there is “reasonable cause to believe that retaliation has occurred.”Several other areas of OSHA enforcement are considered to be in Trump’s crosshairs, including the Joint Employer Doctrine, repeat violations, the Severe Violators Enforcement Program (SVEP), and non-company personnel participation (such as union representatives) in inspections. The Fair Pay and Safe Workplaces Executive Order requiring prospective federal contractors to disclose labor law violations and give agencies guidance on how to consider labor violations when awarding federal contracts is expected to be repealed.

    Overall, a Trump administration is expected to shift the Obama focus on enforcement to one of compliance assistance, similar to that of President George W. Bush.

    Another key area to expect changes is immigration reform, which Trump made the centerpiece of his winning campaign. While it’s difficult to predict exactly what changes will be made, there is likely to be an impact on undocumented workers, as well as temporary work visa programs (such as H-1Bs), which allow employers to bring on highly skilled foreign workers. Furthermore, if Trump can persuade industries to bring back jobs that were exported overseas and return jobs to the coal mining industry, there will be implications for workers’ comp.

  2. Expanding legalization of marijuana  Election results also saw the expansion of legalization of both medical and recreational marijuana. California, Massachusetts, and Nevada joined Alaska, Colorado, Oregon, Washington, and the District of Columbia in legalizing the drug for recreational purposes, while Arkansas, Florida, Montana and North Dakota joined 24 other states in legalizing medical marijuana. So medical marijuana is now legal in 28 states, and an additional 16 states have laws that allow for limited medical use of the drug

     

    In most cases, these limited-medical-use laws mean that only a specific type of cannabis extract can be used. The National Conference of State Legislatures provides a summary of the laws.

    At the federal level, marijuana remains classified as a Schedule I substance under the Controlled Substances Act, where Schedule I substances are considered to have a high potential for dependency and no accepted medical use, making distribution of marijuana a federal offense. This status prohibits assigning a National Drug Code (NDC), which presents difficulties in processing medical marijuana transactions.

    While there is limited legal precedent surrounding marijuana and workers’ comp, for the most part, the courts have favored employers. However, in two recent and separate decisions, the Appellate Division of Maine’s Workers’ Compensation Board affirmed two ALJs’ decisions requiring employers to reimburse injured workers for the costs associated with the reasonable and proper use of medical marijuana authorized under the Maine Medical Use of Marijuana Act (MMUMA). It’s important to note that in both cases, the injured workers had tried multiple pain management regimes without success. New Mexico requires employers to reimburse employees for medical marijuana, but many other states have passed legislation with provisions that either implicitly or explicitly exempt insurers or employers from responsibility for reimbursement for medical marijuana.

    When workers are injured and suspected to be under the influence of marijuana, the intoxication defense is more difficult than with alcohol. Drug tests can show whether marijuana is present in someone’s system, but there’s no test to show whether that person is impaired as a result. Traces of the drug can stay in a person’s body up to a month, making it more difficult for employers and insurers to pinpoint when the person smoked or ingested the drug.

    Some employers are abandoning pre-hire drug testing because too many applicants fail. Moreover, no tolerance drug policies are being put to test. Courts have upheld the termination of injured workers who test positive for medical marijuana under drug-free workplace policies, even though many employers struggle with policies to accommodate its use. It’s prudent for employers to establish a clear policy and communicate it effectively to employees.

    This is a fluid area and employers should understand the laws in each of the states where they do business, work with insurance and legal counsel to determine responsibilities related to medical marijuana treatment, and update employee handbooks to clarify company policies related to marijuana, as well as stay abreast of all relevant legal decisions.

  3. Focus on opioids and rising prescription costs  The rising costs of legacy claims for opioid-dependent injured workers are a concern to all parties involved in workers’ comp. Addicted workers are less likely to return to work, costs for opioid addiction treatment are rising, and comp insurers and employers pay benefits to injured workers for longer periods of time, up to and including death benefits to surviving family members if a worker dies from an overdose – as is mandated in several states.Opioid control measures have helped reduce utilization among newer claims, but costs overall are up – a sign that older claims tend to be driving the utilization. Opioid addiction also comes with a host of side effects, which add to the costs of treatment.

    Employers should expect more action from the states on controlling this trend. For example, on October 31, the New York State Workers’ Compensation Board announced a new process for hearings addressing opioid issues relating to the treatment of injured employees. Insurers can request a hearing to consider whether an injured worker should continue to be treated or weaned off opioids.

    Employers should work with their insurance company and advisors to identify claims where there could be opioid abuse. Moreover, to help contain rising medical costs, employers should work to identify the best available physicians in their area to provide care for employees who have suffered work-related injuries and illnesses, and avoid physicians who dispense drugs.

  4. State actions  In 2016, state legislative activity related to workers’ compensation was fairly moderate across the country according to the 2016 Workers’ Compensation Issues Report: Fall Edition by the National Council on Compensation Insurance, Inc. (NCCI). While more than 700 bills addressing workers’ compensation were introduced, only about 10% were enacted and “none of the enacted laws made significant systems changes.” A common thread was increased activity around the gig economy, with several states introducing legislation dealing with “qualified market contractors.” As more and more work is being performed by workers outside of the traditional employer-employee relationship, regulations aimed at improving the safety and benefits for such workers becomes a focal point.Here is a snapshot of some states to watch based on current activity. Please note that the regulatory and legislative landscape changes rapidly, so it is a good idea to stay abreast of proposed changes.
    • Florida – The Associated Industries of Florida and the Florida Chamber of Commerce created task forces to seek legislative action in response to recent Florida Supreme Court rulings and significant rate increases. A circuit court judge has recently blocked the hike in rates because of violations of Florida’s Sunshine Law. The Florida Office of Insurance Regulation filed a notice of appeal on November 28 and the rate hike is scheduled to go into effect while on appeal.
    • Illinois – Governor Rauner is continuing to include workers’ compensation reforms with budget negotiations.
    • North Carolina – A state audit of the Industrial Commission has determined that while the agency has improved its oversight of workers’ compensation claims, it still is not meeting identification and investigative targets. Among the key findings in the latest audit are:
      • The commission continues to struggle to identify all noncompliant employers, including those not having a system to detect noncompliance.
      • The commission is not completing its investigative process in a timely fashion, “making recovery of medical costs and lost wages more difficult for injured workers.”
      • Inadequate oversight of investigation and penalty cancellation process “increases opportunity for noncompliance.”
    • Oklahoma – Proponents of the opt-out law have vowed to fight the Supreme Court’s ruling finding the law unconstitutional. In the meantime, the Supreme Court is developing steps to mandate employers to be compliant with its ruling.
    • Rhode Island – The Department of Labor and Training is developing a proposed rule to add massage therapy guidelines and compound drug reimbursement to its medical fee schedule.
    • Texas – The Division of Workers’ Compensation is proposing an increase in claimant’s attorney fees for the first time in 25 years.

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