Things you should know

Updated Workers’ Compensation Medicare Set-Aside Reference guide issued

The updated guide, version 2.9, addresses spinal cord stimulators and the inclusion of off-label prescription drugs, particularly Lyrica as well as updating Life Tables and examples of settlements not meeting The Centers for Medicare & Medicaid Services (CMS) review thresholds, but which would still require consideration of Medicare’s interests.

The NGHP User Guide was also updated and CMS will maintain the $750 threshold for no-fault insurance and workers’ compensation settlements, where the no-fault insurer or workers’ compensation entity does not otherwise have ongoing responsibly for medicals.

Some experts suggest that the changes are another indication that CMS intends to make Medicare Secondary Payer (MSP) enforcement a priority in 2019.

New app can help determine what’s allowed in MSAs

The CMS launched its “What’s Covered” app to give consumers more information about their Medicare benefits. It also can be a valuable assist for injured workers with MSAs.

Study: Most manufacturing workers experience fatigue

study by the American Society of Safety Professionals suggests that the automation of manufacturing processes may be contributing to worker fatigue, which was found in 58% of the workers studied. Fatigue monitoring, such as wearables that monitor heart rate, are a possible solution. The report also notes three interventions to help mitigate fatigue: posture variance, chemical supplements and rest breaks.

Work comp insurers cite top concerns

Every year for the past decade, the National Council on Compensation Insurance (NCCI) surveys carrier executives in the workers’ compensation industry to better understand their market perspectives, needs, and challenges. Learn what keeps them up at night.

New guidance for pain management in the age of the opioid epidemic

draft report from the Pain Management Best Practices Inter-Agency Task Force, which acts in an advisory capacity for the federal government, calls for individualized, patient-centered pain management. Public comments are welcome.

Study: Injured workers in the mining and construction industries and those in rural areas more likely to receive opioid prescriptions

study by the Workers Compensation Research Institute (WCRI) found 33% of injured workers employed in mining and 29% in construction received opioids for certain injuries and are more likely to receive higher doses and for longer time periods. The study also found that older workers were more likely to receive opioid prescriptions compared with younger workers, with 49% of injured workers age 49 or older receiving opioids compared to 42% of workers between the ages of 25 and 39.

Meanwhile, a higher percentage – 66% to 79% – of workers who sustained fractures, carpal tunnel and neurologic spine pain received at least one opioid prescription for pain relief. It’s postulated that those in rural areas receive more opioids because there are fewer pain management options available.

New video on performing tower modifications

new video from the National Association of Tower Erectors highlights the importance of understanding and following the proper sequence of performing tower modifications.

Injured Massachusetts teen workers lacked health and safety training: report

Nearly half of the teen workers in Massachusetts who were injured on the job between 2011 and 2015 said they did not receive health and safety training from their employer, according to a Massachusetts Department of Public Health annual report on teen worker safety. Four industries – accommodations and food service (37 percent), retail trade (19), health care and social assistance (11), and construction (4) – accounted for more than 70 percent of all work-related injuries involving teens in the state.

NIOSH releases resources on dampness and mold assessment

NIOSH recently introduced checklists to help employers assess damp areas and identify mold. The Dampness and Mold Assessment Tool has two versions – one for general buildings and one for schools – as well as a four-step assessment cycle.

CPWR releases alert, toolbox talk on lightning safety

Stressing the importance of lightning awareness while working outdoors, the Center for Construction Research and Training (CPWR) has published a hazard alert and toolbox talk addressing the topic.

State News

California

  • Division of Workers’ Compensation has updated its formulary for injured workers to include drugs to treat traumatic brain injury, effective Feb. 15
  • FMCSA granted a petition to pre-empt the state’s meal and rest break rules for commercial motor vehicle drivers

Florida

  • OSHA resumes normal enforcement activity following Hurricane Michael

Massachusetts

  • A new law applies OSHA standards to all public employees, including municipal workers and quasi-public agency workers

Michigan

Minnesota

  • New law recognizes post-traumatic stress disorder as a compensable condition for first responders

New York

  • Governor vetoed bill that would have regulated and permitted acupuncturists to treat injured workers in the state’s workers compensation
  • WC Board launches virtual hearing app, WCB VHC, which is free in the iOS App Store

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

OSHA watch

Maximum penalty of repeat or willful violation rises to $132,598

The cost of non-compliance is on the rise with the annual adjustment for inflation, effective January 24, 2019. The chart below shows the 2019 increases for each type of violation:

Violation Type/Description CFR Citation 2018 Max Penalty 2019 Max Penalty
Serious 29 CFR 1903.15(d)(3) $12,934 $13,260
Other-than-Serious 29 CFR 1903.15(d)(4) $12,934 $13,260
Willful 29 CFR 1903.15(d)(1) $129,336 $132,598
Repeated 29 CFR 1903.15(d)(2) $129,336 $132,598
Posting Requirement 29 CFR 1903.15(d)(6) $12,934 $13,260
Failure to Abate 29 CFR 1903.15(d)(5) $12,934 $13,260

Reminder: Feb. 1 was deadline for posting Form 300A

Each year, from Feb. 1 to April 30, OSHA’s Form 300A, which summarizes job-related injuries and illnesses logged in the prior calendar year, must be displayed in a common area where notices to employees are usually posted. Details can be found in our January 2019 issue.

Final rule on electronic recordkeeping issued

As expected, the final rule eliminates the requirement for establishments with 250 or more employees or those with 20 to 249 employees in certain industries with historically high occupational injury and illness rates to electronically submit information from Form 300 (Log of Work-Related Injuries and Illnesses) and Form 301 (Injury and Illness Incident Report) each year. These establishments are still required to electronically submit information from Form 300A (Summary of Work-Related Injuries and Illnesses). The final rule also requires covered employers to electronically submit their Employer Identification Number with their information from Form 300A.

The deadline for electronic submissions is March 2, 2019. More information.

A lawsuit has already been filed by the Public Citizen Health Research Group, the American Public Health Association and the Council of State and Territorial Epidemiologists arguing the final rule violates of the Administrative Procedure Act.

FAQs on silica standard for general industry published

The FAQs, which include answers to 64 questions organized by topic, provide guidance to employers and workers on the standard’s requirements, including exposure assessments, hazard communication and methods of compliance.

Free compliance assistance resources on falls offered online

To help employers prepare for the sixth annual National Safety Stand-Down to Prevent Falls in Construction, set to take place May 6-10, the following resources are online:

Requirements for trainers in Outreach Training Program revised

Among the 18 changes, which are scheduled to go into effect April 1, is eliminating the 90-day grace period after a trainer card expires, as well as updating the trainer code of conduct and responsibilities.

New safety resource on safe operation of tractors

A new rollover protection brochure provides information in English and Spanish on the safe operation of tractors. It emphasizes the importance of using rollover protective structures and seat belt systems to help reduce worker injuries.

Enforcement notes

California

  • US Postal Service faces fines of $149,664 for not addressing worker safety in high-heat conditions after a mail carrier was found dead in a postal vehicle on a record-setting 117-degree-Fahrenheit day in July.

Florida

  • Compass Group USA Inc., operating as Chartwells Dining, was cited for exposing employees to burn and chemical hazards at its cafeteria in Coral Gables. The company faces $134,880 in penalties for exposing employees to hazards associated with exit routes, failing to provide suitable facilities for quick drenching for employees who work with cleaning chemicals, and for not providing effective training to the employees working with the chemicals.
  • Inspected under the REP for Falls in Construction, Ad-Ler Roofing Inc. was cited for exposing employees to dangerous falls at a Naples residential worksite, one month after similar violations were found at another worksite. The Fort Myers-based contractor faces penalties of $91,466.

Missouri

  • New Haven-based Franklin County Construction LLC faces $56,910 in penalties after an employee suffered fatal fall injuries when a roof truss collapsed.

Nebraska

  • Hastings-based Noah’s Ark Processors is facing $182,926 in penalties after an employee suffered severe burns caused by exposure to anhydrous ammonia at one of its meat processing facilities. Sixteen serious violations were issued relating to process safety management (PSM) program deficiencies, failing to guard roof openings, and electrical safety and lockout/tagout violations.
  • An administrative law judge of the OSHRC affirmed a serious violation and $11,408 penalty after an employee was hospitalized due to an arc flash. Jacobs Field Services’ policy of permitting employees to remove portions of their personal protective equipment after they had determined the load side – but not the line side – of an electrical disconnect box was de-energized violated the statute.

New York

  • St. Louis, Mo-based Western Specialty Contractors is facing criminal charges and $155,204 in penalties for exposing employees to serious injuries. Operated by an untrained employee, an unsecured mini-crane overturned and fell four stories at an NYC worksite.
  • An administrative law judge of the OSHRC affirmed a serious violation against Fairport-based Ontario Exteriors Inc. when a worksite policy that directed its employees to traverse a steep second-story roof without fall protection at the beginning and end of each work day resulted in the injury of one worker. The law judge reduced the fine in half to $1,811 noting that the court believes the company will comply with fall protection requirements in the future.

Pennsylvania

  • Spear Excavating LLC based in Pennsburg was cited for exposing employees to trenching hazards at a worksite in Malvern. The company faces $106,057 in proposed penalties. The inspection was initiated by a complaint.
  • An administrative law judge of the OSHRC affirmed a serious citation and $11,408 fine against Coastal Drilling East LLC after an employee’s finger had to be amputated following a workplace accident. Cited under the general duty clause, the company argued that abatement of the cited condition was infeasible and the violation was the result of unpreventable employee misconduct, but the law judge cited an absence of training, instruction, and supervision and inconsistent enforcement.

Wisconsin

  • Two utility contractors – Bear Communications LLC of Lawrence, Kansas, and subcontractor V C Tech Inc. of Ypsilanti, Michigan – were issued a serious safety violation, and face penalties of $12,934 each – the maximum penalty allowed when they failed to establish the location of underground utilities prior to beginning excavation work. A volunteer firefighter responding to the incident was fatally injured.

For additional information.

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

A new approach to serious injury and fatality prevention

Since the advent of Heinrich’s Injury Pyramid in 1931, it has been generally accepted that there is a predictive relationship between the frequency and types of non-injury, minor injuries and the serious, life-altering or threatening injuries, at the top of the triangle. The safety triangle theorizes that for every major injury there are 29 minor injuries and 300 non-injury incidents. Though this triangle is considered a gold standard, many safety professionals realize that all non-injury or minor incidents are not equal and some have more potential to result in a serious injury or fatality (SIF).

A recent report by the Campbell Institute, Serious Injury and Fatality Prevention: Perspectives and Practices recommends a redesign or enhancement of the model. The new SIF prevention model would look at all incidents – namely, precursors to accidents, recordable injuries, lost-time injuries and fatalities – and seek out those with serious injury and fatalities potential. It encourages organizations to focus on the process factors that lead to SIF, rather than human error, which will always occur. They should focus on repairing gaps in their safety management system, workplace culture, and changing or modifying work processes that eliminate human error.

For example, a workplace with a production problem may ignore or even condone shortcuts and speed, which can lead to bad decisions by workers. A forklift operator may drive too fast and not wear a seatbelt, which can lead to a serious accident. While there can be a tendency to blame the worker, the production demands were the proximate cause and the precursor to the event. According to the author of the paper, Joy Inouye, a key to lowering the fatalities in the workforce lies in an organization’s ability to look inward. “Instead of blaming the worker for not putting on his seatbelt, start to look at those organizational factors that contributed to that.” The report includes examples of companies that have successfully revamped strategies for identifying risk factors.

Trends in injury patterns validate the need for a shift in thinking. While employers have done a good job in reducing the total recordable incident rate, there has been a disturbing increase in the number of workplace fatalities and catastrophic injuries. Diving deeper into near misses and smaller, less serious incidents could help prevent on-the-job deaths or catastrophic injuries. By identifying potential precursors to such events and educating employees about those precursors, companies can focus on eliminating the potential for such incidents to occur.

The report recognizes that isolating incidents with the potential for SIF requires serious groundwork. It suggests next steps like organizing a think-tank that defines “serious injury”, “precursor” and “potential.” To determine whether an incident is a potential SIF or not, it may make sense to define and use a Severity Scale that can be consistently understood by anyone, one that is tied to potential outcomes. For example, most severe could be an injury that would lead to the death of an individual, and the least severe could be first aid and immediate return to work. Including specific injury examples can be helpful.

Implementation raises the bar of safety management and requires a proactive, rather than reactive approach. It will take careful planning – both around the processes used and the responsibilities assigned.

What employers can do

  • Review and evaluate your near miss reporting system
    • Do workers fear the consequences of reporting something they may be blamed for or is there a culture of trust and all workers participate in reporting?
    • Is near miss training part of new hire orientation?
    • Are supervisors and management onboard and do they foster a reporting culture?
    • Is reporting simple and straightforward?
    • Does the report provide a solid log of what leads up to the incident?
    • Is the definition of near miss clear?
    • Is there a thorough investigation that identifies the root cause?
    • Are corrective actions taken and employees notified?
  • Have supervisors explain to employees why the company is focusing on the smaller incidents and near-misses, and how a minor incident can turn major. Explain the importance of looking at potential rather than actual outcomes for minor incidents.
  • Think-outside-the box. A recent article in Risk and Insurance described how Wente Family Estates vineyards teamed up with the criminology department at Holy Names University in Oakland to take a look at workers’ comp data to analyze injuries and near misses, pinpointing problem areas and gathering insight on how to prevent future losses. The idea was based on a partnership between United Airlines and the University of New Haven that used interns from the criminology department as part of a data visualization project, leading to a 23 percent reduction in employee injuries and a 29 percent reduction in aircraft damage on the ground.

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

Things you should know

2018 WorkComp Benchmark Study released

The sixth annual Workers’ Compensation Benchmarking Study Report by Rising Medical Solutions, Inc. focuses on key issues influencing medical management performance and the most potent strategies to address these issues.

BLS report: Fatal injuries remain over 5,000

The number of fatal work injuries dropped slightly in 2017 to 5,147 down from 5,190 in 2016. Fatal falls were at their highest level in the 26-year history of the BLS’s reporting, accounting for 17.2% of employee deaths, while transportation incidents again account for the most deaths with 2,077, or 40.4%.

In 2017, 15.1% of fatally injured workers were age 65 or over – a series high. The number of deaths among Hispanic or Latino workers rose 2.7% to 903 in 2017.

Report: Injured restaurant workers miss an average of 30 days

AmTrust Financial Services Inc., a provider of workers compensation insurance, took a deep dive into common restaurant injuries, lost time, industry loss ratio trends and how to implement loss control best practices in its report, Restaurant Risk Report. Cafés and coffee shops had the highest lost time, on average 45% more time lost than all other restaurant types. Wrist injuries are the biggest danger for coffee shop workers, with “barista wrist” resulting in an average of 366 days to return to work.

Study: Musculoskeletal injuries to long-haul truck drivers

Nearly half of all musculoskeletal injuries reported by long-haul truck drivers are to their arms, backs or necks – the majority being sprains and strains – according to a recent study conducted by researchers from the University of Alabama at Birmingham. Drivers most often were injured because of a fall (38.9 percent) or contact with an object or equipment (33.7 percent).

Of those injured, 53 percent required time away from work, at a rate of 355.4 incidents per 10,000 full-time workers, which is more than double those of other hazardous professions. The researchers said the study suggests the need for injury prevention and interventions and ways to improve recovery when injuries occur.

Report ranks states by risk of violence from Black Friday

A report ranking states by risk of violence during Black Friday was recently released by Reviews.org. Included in the report are the employers that have the most incidents during Black Friday.

State News

Florida

  • Department of Economic Opportunity announced that the statewide average weekly wage paid to injured workers by employers will be $939 starting Jan. 1.

Minnesota

  • A total of 101 fatal work-injuries were recorded in Minnesota in 2017, an increase from the 92 fatal work-injuries in 2016 and 74 fatal work-injuries in 2015. More information

Missouri

  • The Department of Insurance is recommending a 3.5 percent decrease in workers’ compensation insurance loss costs for 2019, the fifth year in a row rates will decrease.

New York

North Carolina

  • The Workers’ Compensation Research Institute’s (WCRI) Benchmark shows that medical payments per workers’ comp claim decreased significantly since 2013, falling 6 percent each year through 2016.
  • The Industrial Commission has finalized settlement agreement rules, The “Group 2” rules aimed to clean up some inconsistent language and streamline the settlement process, as well as clarify wording relating to attorney’s fees. The rules took effect Jan. 1.
  • The Commission approved Group 1 rule changes, which took effect Dec. 1. Medical motions, responses and appeals on medical motions must be submitted electronically and must include the opposing party’s position on the matter.

Pennsylvania

  • Insurance commissioner approved two loss cost reductions that together will amount to a 14.74% decrease, starting Jan. 1. Loss costs are one of many factors that determine premiums for workers’ comp insurance.
  • Department of Labor and Industry reported that the maximum compensation rate will rise by 2.3%, to $1,049 per week, starting Jan. 1. It’s website offers a chart to determine compensation based on the employee’s average weekly wage.
  • Department of Labor and Industry announced that it has adopted the Red Book, published by Truven Health Analytics, to determine the average wholesale price of prescription drugs.

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

OSHA watch

Revised Beryllium Standard for General Industry proposed

The proposed rule, published in the Dec. 11 Federal Register, would revise provisions regarding recordkeeping, personal protective clothing and equipment, written control exposure plans, disposal and recycling, medical surveillance, and hazard communication. It also would change or add six terms in the “definitions” paragraph of its regulations: beryllium sensitization, beryllium work area, chronic beryllium disease, CBD diagnostic center, confirmed positive and dermal contact with beryllium.

Another proposed change is removing Appendix A, which lists suggested controls, and replacing it with a new Appendix A, “Operations for Establishing Beryllium Work Areas.”

The enforcement date for the provisions affected by this proposal was December 12, 2018. While this rulemaking is pending, compliance with the standard as modified by this proposal will be accepted as compliance. The deadline to comment on the proposed rule is Feb. 11.

Initiative to increase awareness of trenching and excavation hazards and solutions launched in southeastern states

As part of the agency’s focus on trenching safety, area offices in Alabama, Florida, Georgia, and Mississippi have launched an initiative to educate employers and workers on trenching safety practices. They are reaching out to excavation employers, industry associations, equipment rental organizations, water utility suppliers, and national and local plumbing companies to educate them to identify trenching hazards. Compliance assistance resources are available on the updated Trenching and Excavation webpage.

CPWR infographic provides trench safety tips

CPWR, The Center for Construction Research and Training, developed an infographic focusing on trench safety, including best practices to protect workers in trenches.

(English / Spanish)

Winter weather resources

The Winter Weather webpage provides information on protecting workers from hazards while working outside during severe cold and snow storms. This guidance includes information on staying safe while clearing snow from walkways and rooftops.

Court ruling: general contractors can be cited for hazardous conditions at multi-employer worksites, even if those conditions do not directly affect their own employees

The U.S. Court of Appeals for the 5th Circuit, which covers Louisiana, Texas and Mississippi, recently overturned a ruling of the OSHRC that Hensel Phelps Construction Co., a general contractor, could not be held liable for violations from one of its subcontractors, under the multi-employer work site policy despite it not having any employees exposed to the hazard.

In Acosta v. Hensel Phelps Construction Co., the Fifth Circuit aligned with seven other federal circuit courts in granting OSHA authority to issue citations to controlling employers.

Certification organization releases employer guides on updated crane operator requirements

The National Commission for the Certification of Crane Operators has published three employer guides on the updated crane operator requirements, which went into effect Dec. 10. The two-page guides address the rule’s training, certification and evaluation regulations.

(Training / Certification / Evaluation)

Area offices must use four-part test when citing respiratory hazards without PELs

Area offices must apply a four-part test before issuing General Duty Clause citations for respiratory hazards that do not have a permissible exposure limit, according to a memorandum sent to regional administrators.

The memo, issued Nov. 2, notes that area offices cannot base a General Duty Clause citation on only a “measured exposure” in excess of an occupational exposure limit or a documented exposure to a “recognized carcinogen.” Instead, they must use the following tests in those situations:

  1. The employer failed to keep the workplace free of a hazard to which employees of that employer were exposed.
  2. The hazard was recognized.
  3. The hazard was causing or was likely to cause death or physical harm.
  4. A feasible and useful method to correct the hazard was available.

Enforcement notes

California

  • Santa Cruz-based Future2 Labs Health Services Inc., a manufacturer of cannabis products faces $50,470 in penalties for 10 violations, following an explosion that left a worker seriously injured.
  • A Riverside construction company, Empire Equipment Services Inc., was cited $66,000 for serious workplace safety violations that resulted in the death of a worker when a 17-foot-deep trench collapsed.
  • The U.S. Army Reserve 63 Regional Support Command at a Sacramento maintenance facility was issued safety violations, after a federal civilian employee was fatally injured when the automated lifting mechanism of a utility vehicle cargo box failed and pinned him between the bed and the vehicle frame
  • Southern California Edison received six citations, totaling $95,435 in penalties, after a worker suffered a serious electric shock. Inspectors determined that the company failed to control hazardous energy, isolate exposed underground cables with protective coverings, and eliminate all possible sources of backfeeding energy.

Florida

  • Jacksonville-based Derek Williams, operating as Elo Restoration Inc., was cited for exposing employees to fall hazards at two separate worksites in St. Augustine and Daytona Beach. Inspected under the Regional Emphasis Program on Falls in Construction, the roofing contractor faces $116,551 in penalties.
  • Elo Restoration was also cited, along with Travis Slaughter, operating as Florida Roofing Experts, Inc., for exposing workers to fall hazards at another St. Augustine worksite. Responding to a complaint of unsafe roofing activities, inspectors determined that the companies failed to ensure workers were attached to a fall protection system. Both companies were issued the maximum allowable penalty of $129,336.
  • L.A. Disaster Relief and Property Maintenance LLC, a property maintenance and land clearing company, faces $94,415 in penalties for failing to implement a hazard communication program after an employee suffered burn injuries at a McDavid worksite.
  • Doral-based Nupress of Miami, Inc., a commercial printer, faces $71,139 in penalties for exposing workers to amputation, electrical, and other hazards.
  • Turnkey Construction Planners Inc., a roofing contractor based in Melbourne, was inspected under the Regional Emphasis Program on Falls in Construction and faces $199,184 in penalties for exposing employees to fall hazards.

Georgia

  • Parts Authority LLC, doing business as Parts Authority Georgia LLC, a wholesale auto and truck parts distributor based in Norcross, faces $133,406 in penalties for exposing employees to fire, electrical shock, and struck-by hazards.

Missouri

  • World Wrecking and Scrap Salvage Services Inc., a demolition company, was cited for failing to provide fall protection after two employees suffered fatal injuries at a demolition site in St. Louis and faces penalties of $23,280.

Nebraska

  • Clearwater-based Thiele Dairy was cited for failure to develop and implement safety and health programs related to grain bin entry after an employee suffered fatal injuries and faces penalties totaling $78,899.

Pennsylvania

  • In Secretary of Labor v. J.D. Eckman Inc., an administrative law judge of the OSHRC vacated citations against the bridge and highway construction company related to a workplace incident in which an employee was fatally struck in a traffic control zone. The citation was issued under the General Duty Clause, which the judge found inapplicable under the circumstances.

For more information.

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

Important takeaways from recent studies and reports

Outlook for workers’ comp is stable, but rising medical and legal costs and payroll threaten profits – AM Best Co. Inc.

Currently, AM Best has a stable outlook on the U.S. workers’ compensation industry, the largest component of the U.S. commercial lines segment. However, the well-known rating agency sees some threatening headwinds that can alter the industry’s course. In 2017, growing payrolls helped offset rate decreases and overall soft-market conditions, according to the report. The agency believes that the use of technology, which has provided greater insights into underwriting, pricing and claims decisions, has helped support the line’s health and will continue to do so.

Despite the positive results, AM Best believes the trend of declining rates likely will trigger profit margin compression, possibly as soon as 2019. Unemployment has decreased steadily since 2010; however, AM Best notes that long unemployment rate declines typically are followed by sharp spikes in unemployment, and believes that workers’ compensation writers should be prepared for a downside scenario as well.

In addition, while there has been a decline in loss frequency, medical cost inflation, as well as the potential for accelerating frequency if employers hire less-qualified candidates are a concern. Rising medical loss cost severity, the declining benefit from prior accident year reserve redundancies and high average settlements on cases stemming from attorneys’ growing involvement and litigation, also put pressure on pricing.

Employer takeaway: The report is good news about the stability of rates in the short term. It also provides insights as to how insurers will be evaluating risk. The continued growth of technology in underwriting and pricing means that a company’s risk profile is critical. Insurance companies have become quite sophisticated and rates will be based on their perception of your risk. The way to get the best rates is to improve your risk profile – not bidding and quoting. There are trends and claims that are red flags for underwriters, including claim severity, high medical costs, and excessive attorney involvement. If you have claims in these categories, it’s a good idea to document special circumstances as well as actions taken to prevent future occurrences.

Employee care concern and satisfaction -WCRI

An average of 10.5% of workers across 15 states never return to work as the result of a workplace injury, and an average of 16.7% reported difficulties getting the health services they wanted or their physicians requested, according to Comparing Outcomes for Injured Workers reports by the Workers Compensation Research Institute (WCRI). Telephone interviews were conducted with close to 10,000 injured workers from 15 states who were hurt at work between 2010 and 2014. The workers interviewed live in Arkansas, Georgia, Kentucky, Florida, Iowa, Indiana, Tennessee, North Carolina, Virginia, Minnesota, Michigan, Pennsylvania, Wisconsin, Massachusetts, and Connecticut.

Among the findings:

  • An average of 10.5% of workers across 15 states never return to work as the result of a workplace injury, and an average of 16.7% reported difficulties getting the health services they wanted or their physicians requested.
  • Between 12% and 21% of injured workers reported “big problems” getting the service they or their primary provider wanted, with 10 of the states falling in the 17% to 18% range. Pennsylvania had the lowest rate of 12%.
  • Between 11% and 20% reported being “very dissatisfied” with their care.
  • Thirteen percent of workers said they did not return to work for at least a month after their injury.
  • Between 6% and 11% of injured workers report a significant loss of income due to injury at the time of the interview.

Employer takeaway: The data reinforces the message that employers must be proactive and vigilant in managing workers’ comp. This is not new “news” – recovery-at-work programs, medical management best practices, and open lines of communications among all stakeholders are the cornerstones of a successful program.

First-ever industry breakdown of drug use in the American workforce – Quest

Quest, a leading drug-testing provider, announces the rate of positive drug test results annually based on an analysis of 10 million urine tests. The new data marks the first time Quest has broken it down by industry.

The rate of positive test results for illicit drugs was highest in retail (5.3%), health care and social assistance (4.7%), and real estate rental and leasing (4.6%) sectors in 2017, while the utilities (2.8%) and finance and insurance (2.6%) sectors had the lowest rates. Drug use by the workforce increased each year, and by double-digits over the two years between 2015 and 2017, in five of 16 major U.S. industry sectors analyzed. The highest rates were in consumer-facing industries.

Marijuana was the most commonly detected substance, with the highest drug positivity rate of all drug classes across the majority of industry sectors. Marijuana positivity was highest in accommodation and food services, at 3.5 percent in 2017, more than 34 percent higher than the national positivity rate of 2.6 percent for the general U.S. workforce.

Employer takeaway: With low unemployment and tight job markets as well as legalized recreational marijuana in many states, many employers have dropped pre-employment drug tests for positions that aren’t safety sensitive. The analysis suggests that employers can’t assume that workforce drug use isn’t an issue in their industry. Employers are responsible for ensuring the safety of workers, customers, and members of the general public and this is one of the more vexing areas. Review your written drug policies, clearly communicate expectations and company rules to all employees, and be sure supervisors know how to recognize signs of impairment.

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

OSHA alert: Injury reporting records take on increased importance and upcoming deadlines

Form 300A posting deadline: February 1, 2019
Electronic rule making update
Form 300A electronic submission deadline: March 2, 2019
How the data is being used: Site-Specific Targeting Initiative

This month, all employers required to keep Form 300, the Injury and Illness Log, should be reviewing the Log to verify that entries are complete and accurate and correcting any deficiencies. Two important dates are approaching. The annual summary of injuries and illnesses recorded on OSHA Form 300A, Summary of Work-Related Injuries and Illnesses, must be posted where notices are customarily located in workplaces, no later than February 1, 2019 and kept in place until April 30.

Under the electronic record-keeping rule, certain employers must submit the form electronically to OSHA by March 2, 2019. And there is now an inspection targeting plan based on the data submitted under this rule, subjecting employers to further scrutiny of their injury and illness rates. Given the potential impact for inspections, employers should carefully ensure they submit accurate records. They should also proactively monitor and address patterns in their injury and illness rates to lower recordable injuries.

Form 300A posting deadline February 1, 2019

When an accident occurs, an employer must document a recordable injury or illness on the OSHA Form 300 log within seven days. Employers should pay careful attention to their logs and the work relatedness of safety incidents, particularly in light of the electronic submission rule. Some employers tend to focus on medical treatment or days away from work, rather than beginning with – was this work-related? The OSHA Regulation 29 C.F.R. §1904.7 contains an in-depth overview of recordable injuries and illnesses. Additional information on determining medical treatment and first aid can be located at 29 C.F.R. §1904.7(b)(5).

Standard interpretations on recordkeeping issued in 2018 include:

  • Prescription medications, such as an Epi-Pen considered medical treatment beyond first-aid. – [1904.7]
  • Clarification on the use of a cold therapy only setting on a therapeutic device is first-aid – [1904.7(b)(5)(ii)]

A Form 300 log is required for each physical establishment location that is expected to be in operation for at least one year. Form 300A summarizes the total number of fatalities, missed workdays, job transfers or restrictions, and injuries and illnesses as recorded on Form 300. Even if there were no recordable incidents in 2018, companies required to maintain records still must post the summary with zeros on the total lines. Copies should be made available to any employee who might not see the summary (such as a remote employee who works from home).

A company executive, as defined by OSHA, must certify the summary. Employers must keep the records for five years following the calendar year covered by them, and if the employer sells the business, he or she must transfer the records to the new owner.

Electronic rule-making update

Last month, the U.S. District Court for the District of Columbia denied the Trump administration’s motion to dismiss litigation challenging OSHA’s decision to suspend parts of its electronic record-keeping rule. Initiated by three public health advocacy groups, Public Citizen Health Research Group, the American Public Health Association and the Council of State and Territorial Epidemiologists, the lawsuit argued that OSHA’s action was not simply an exercise of enforcement discretion, but rather a complete suspension of a regulatory deadline subject to review.

However, importantly, the federal court also denied a preliminary injunction barring OSHA from implementing its planned delay, noting the advocacy groups had not demonstrated that they will suffer irreparable harm absent preliminary injunctive relief. Also, the court decision was not on the merits of the case, but rather on whether the group had standing to sue or the case should be dismissed as OSHA argued.

Originally, as part of its electronic recordkeeping rule, OSHA mandated that certain employers submit 2017 data from Forms 300, 300A and 301. However, on July 30, 2018 a proposed rule officially eliminated the Forms 300 and 301 data submission requirements. While the Fall 2018 Regulatory agenda had predicted that the proposed regulation would go over to OMB’s Office of Information and Regulatory Affairs (OIRA) on time for the standard to be issued in June 2019, the final draft was submitted earlier than expected on December 7, 2018.

But for many employers this proposed rule does not go far enough. Since it does not rescind the agency’s plan to publish employer information, they argue it puts employers at risk for improper disclosure and release of sensitive employer information. Nor does it formally repeal the provisions regarding post-incident drug testing or incentive programs, although an October 2018 memorandum was issued to clarify these provisions. And the anti-retaliation provisions are unchanged.

Form 300A electronic submission deadline: March 2, 2019

Establishments with 250 or more employees that are currently required to keep injury and illness records under the Recordkeeping Standard, as well as establishments with 20-249 employees that are also covered by the Recordkeeping Standard and operating in certain industries with historically high rates of occupational injuries and illnesses are now required to submit their calendar year Form 300A electronically by March 2, 2019.

How the data is being used: Site-Specific Targeting Initiative

On Oct. 16, 2018, OSHA launched a “site-specific targeting” plan, SST-16, that uses employer-submitted data from 2016 to select non-construction worksites for inspections. The SST-16 directs that “OSHA will create inspection lists of establishments with elevated Days Away, Restricted or Transferred (DART) rate, together with a random sample of establishments that did not provide the required 2016 Form 300A data to OSHA.” The employers are chosen using software that randomly selects the establishments.

Although establishments with elevated DART rates and those that did not submit the required data are the primary targets, establishments with lower DART rates can also be inspected. A random sample of low injury rate establishments on the inspection list will be selected to verify data accuracy.

While OSHA inspections are generally unwelcome, SST inspections are particularly onerous. They are unannounced, comprehensive, and can take significant time and resources. They are not limited to recordkeeping practices, potentially hazardous areas, or operations with an elevated DART rate, and often result in substantial citations. Employers that failed to comply with the electronic reporting requirements for 2016 or reported a high elevated DART rate (compared to industry average rates) would be wise to begin preparing for an inspection.

Despite the expectation that the Trump Administration would significantly lessen the burden of data submission requirements on employers, much of it appears here to stay, at least for a while. There have been fewer shifts in OSHA enforcement and rulemaking than expected by experts, who point to the leadership void at the agency. While Scott Mugno’s nomination was sent to the Senate on Nov. 1, 2017, it has been stalled and OSHA still does not have a Senate-approved Assistant Secretary – the longest ever vacancy.

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

OSHA watch

Final rule on crane operator certifications issued

As anticipated, the final rule clarifying certification requirements for crane operators, requires certification by type of crane or type of crane and lifting capacity. “Certification/licensing” must be accomplished via an accredited testing service, an independently audited employer program, military training, or compliance with qualifying state or local licensing requirements. Employers also are required to “train operators as needed to perform assigned crane activities” and provide training when it is necessary to operate new equipment.

Most requirements in the final rule became effective on Dec. 9, 2018. The evaluation and documentation requirements will become effective on Feb. 7, 2019. Employers who have evaluated operators prior to Dec. 9, 2018 will not have to conduct those evaluations again, but have to document when those evaluations were completed.

New publication on lockout/tagout and temporary workers

A new bulletin on lockout/tagout explains the joint responsibility of host employers and staffing agencies to ensure that temporary employees are properly protected against the sudden release of stored energy. Prior to beginning work, both employers should review the task assignments and job hazards to identify, eliminate, and control the release of hazardous energy before workers perform service or maintenance on machinery.

Regional Emphasis Program (REP) in Pacific Northwest for fall protection in construction

Enforcement of the REP, which includes Alaska, Idaho, Oregon and Washington, will begin after a period of outreach and education. Enforcement activities will include “onsite inspections and evaluations of construction operations, working conditions, recordkeeping, and safety and health programs to ensure compliance.”

Cal/OSHA emergency regulations approved for electronic submission form 300A by December 31, 2018

The Office of Administrative Law approved the emergency regulations that businesses required to submit the Cal/OSHA Form 300A online include all establishments with 250 or more employees, unless specifically exempted by section 14300.2 of Title 8 of the California Code of Regulations, and establishments with 20 to 249 employees in the specific industries listed on page 8 of the emergency regulation’s proposed text (including common industries such as manufacturing, grocery stores, department stores, and warehousing and storage).

Enforcement notes

California

  • Oakland-based general contractor, Bay Construction, Inc., was cited for dismantling a trench box while an employee was still working inside and later killed by a loosened support rail. The company was issued nine citations with $141,075 in proposed penalties, including five classified as general, two serious, one serious accident-related and one willful-serious accident-related.
  • Amazon Landscaping Co. faces six citations and $54,750 in penalties after a worker was fatally injured when a rope he had around his body became entangled in the stump grinder and he was pulled into the cutting wheel.
  • After a series of appeals relating to citations issued to Pinnacle Telecommunications Inc. after an employee suffered serious head injuries from a 7-foot fall from a telecommunications structure, the Alameda County Superior Court affirmed that fall-protection safety orders apply to elevated indoor telecommunications structures and the penalty of $25,560.

Florida

  • PGT Industries Inc., operating as CGI Windows and Doors Inc. in Hialeah, was cited for machine guarding hazards after an employee suffered a partial finger amputation while working on an unguarded punch press. The window and door manufacturer faces $398,545 in penalties, including the maximum amount allowed by law for the violations that can cause life-altering injury.
  • Inspected under the REP on falls, Crown Roofing, LLC, was cited for exposing employees to fall hazards, including installing roofing materials without the use of a fall protection system. The roofing contractor was issued the maximum allowable penalty of $129,336.
  • Inspected under the REP on falls, Panama City Framing LLC was cited for exposing employees to fall hazards at a worksite in Panama City. The company faces $113,816 in proposed penalties.
  • Tom Krips Construction Inc. and Etherna Services Inc. were cited after a lattice boom section of a crane fell onto an employee during disassembly, crushing his foot and ankle at a Fort Lauderdale worksite. Tom Krips Construction Inc. faces $29,877 in penalties, and Etherna Services Inc. penalties total $5,174.

Georgia

  • Dollar Tree Distribution Center, Inc., and U.S. Xpress, Inc., were cited for exposing workers to hazards after an employee was fatally struck by a forklift and face penalties of $130,112 and $12,934 respectively. Both companies were cited for failing to ensure that employees wore high-visibility vests while working at night inside the center and Dollar Tree Distribution Center Inc. was also cited for using a vehicle with a non-functioning headlight, failing to guard a nip point on a conveyor discharge belt, and storing unstable materials on racks.

Massachusetts

  • Northeast Framing Inc., based in Lunenberg, was cited for exposing workers to falls and other hazards following an employee’s fatal fall at an East Boston worksite. The company faces $311,330 in penalties, the maximum allowed by law.

Nebraska

  • Rivera Agri Inc., a provider of temporary agricultural labor, was cited for failing to protect employees working in excessive heat after a farmworker succumbed to apparent heat-related symptoms while working in a cornfield near Grand Island. The company was cited for a serious violation of the General Duty Clause, and faces proposed penalties totaling $11,641.

For more information.

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

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

Much needed clarification from OSHA on anti-retaliation provisions

My fellow Certified WorkComp Advisor, Dustin Boss, has allowed me to share his summary of the OSHA anti-retaliation clarification that the U.S. Occupational Health and Safety Administration (OSHA) just issued.

OSHA issued a standard interpretation clarifying its position on the new recordkeeping rule’s anti-retaliation provisions. OSHA’s memorandum essentially “rolls back” its enforcement of the anti-retaliation provisions, particularly concerning safety incentive programs and post-accident drug testing.

Why is this important? Many employers struggled to understand the anti-retaliation provisions since they were published in May 2016 in guidance materials accompanying the new regulations. Up until now, OSHA’s explanations have been extremely vague and confusing. But with this new publication, the confusion ends as the interpretation supersedes all the prior guidance on this topic.

So what changed?

OSHA clarifies that it does not prohibit workplace safety incentive programs or post-incident drug testing. It allows that incentive programs can be an important tool to promote workplace safety and health and encourages programs that reward workers for reporting near-misses or hazards and involvement in a safety and health management system.

OSHA also provides that rate-based incentive programs are permissible under the rule as long as they are not implemented in a manner that discourages reporting. If an employer takes a negative action against an employee under a rate-based incentive program, such as withholding a prize or bonus, or a slice of pizza, because of a reported injury, OSHA will not cite the employer under the anti-retaliation provisions as long as the employer has implemented adequate precautions to ensure that employees feel free to report an injury or illness. It hints that the more “substantial” the reward, then the more the employer may need to do to reassure employees they are free to report without retaliation. In other words, pizza parties are back.

In addition, it states that most instances of workplace drug testing are permissible. Examples of permissible drug-testing include:

  • Random drug testing
  • Drug testing unrelated to the reporting of a work-related injury or illness
  • Drug testing under a state workers’ compensation law
  • Drug testing under other federal law, such as a U.S. Department of Transportation rule
  • Drug testing to evaluate the root cause of a workplace incident that harmed or could have harmed employees. If the employer chooses to use drug testing to investigate the incident, the employer should test all employees whose conduct could have contributed to the incident, not just employees who reported injuries.

What should employers do now?

Employers should keep in mind that the regulations do not mention safety incentive programs or drug testing policies. The discussions about prohibitions on drug testing and incentive programs were included in prior guidance given by OSHA, as is yesterday’s interpretation rolling back that position. Thus, this position could change with the next election. For now, employers have some more certainty that the current OSHA is not going to pursue these types of retaliation claims unless there is some strong indications that the employer took action to discourage reporting.

That said, employers need to remember that the key aspect for determining whether their incentive programs are OSHA “compliant” is to treat all employees in a consistent manner and ensure that employees feel free to report an injury or illness.

Regarding employer drug testing programs, to strike the appropriate balance, drug testing policies should limit post-incident testing to situations in which employee drug use is likely to have contributed to the incident, and for which the drug test can accurately identify impairment caused by drug use.

For additional information, see OSHA’s memorandum entitled, “Clarification of OSHA’s Position on Workplace Safety Incentive Programs and Post-Incident Drug Testing Under 29 C.F.R. § 1904.35(b)(1)(iv).”.

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