Top reasons for serious workplace injuries and large workers’ comp losses

Liberty Mutual Workplace Safety Index

Produced annually, the Liberty Mutual Workplace Safety Index identifies the leading causes of the most disabling non-fatal workplace injuries (resulting in six or more days of lost time) and ranks them by total Workers’ Compensation costs. The top five causes that accounted for 68.9% of the total injuries occurring in 2015 (most recent data available) were: 1) overexertion involving outside source, 2) falls to lower level, 3) falls to same level, 4) struck by object or equipment, and 5) other exertions or bodily reactions.

For the fourth consecutive year, overexertion involving outside sources topped the list, accounting for almost a quarter of the losses, at $13.7 billion per year. This event category includes injuries related to lifting, pushing, pulling, holding, carrying, or throwing objects. Rounding out the top ten are: roadway incidents involving motorized land vehicle, slip or trip without a fall, caught in or compressed by equipment or object, struck against equipment or object, and repetitive motions involving micro-tasks.

These top ten accounted for $52 billion a year in medical and lost wage costs for businesses. While the number of injuries decreased 1.5 percent, the costs increased 2.9 percent. The total cost of all disabling injuries and illnesses was nearly $60 billion per year.

Combined with your company’s worker injury data, the information can help prioritize preventive measures and training needs.

 

Safety National review of high cost claims

When one thinks about high cost workers’ comp claims, it’s natural to focus on catastrophic claims. These claims include severe burns, brain injuries, spinal cord injuries and significant amputations, which are devastating for all involved. According to Safety National’s claims data, five accident causes accounted for 86% of our catastrophic injury claims:

  • 24% – Motor Vehicle Accident
  • 24% – Fall
  • 20% – Struck By
  • 10% – Act of Crime
  • 8% – Burn

Yet, the recent review of Safety National’s large loss claims by Mark Walls, Vice President of Communications & Strategic Analysis, and Stephen Peacock, Assistant Vice President – Claims, found there were significantly more “developmental” claims that crossed the $1 million threshold, used to define “large loss.” Developmental claims are routine claims that continue to develop over time, including back, shoulder and knee injuries. In this review, they represented about two-thirds of all large-loss claims. In many cases, there were opportunities to resolve the claims before they morphed into large losses, yet failure to recognize the loss potential and intervene earlier opened a Pandora’s Box.

Multiple failed surgeries was the most-common reason for escalating costs in these claims, followed by prescription opioid medications. Both catastrophic and developmental claims have extremely long tails and can remain open for 30 years or longer. The data clearly shows that every claim warrants attention and a comprehensive claims management program is critical to preventing routine claims from morphing to large losses.

 

NCCI Annual Issues Symposium – Mega Loss in Work Comp: How Medical and Treatment Advances Affect Life Expectancy

At the recent NCCI Annual Issues Symposium, presenters lauded the incredible medical advances that have enabled seriously injured workers to survive and survive longer and addressed how to improve outcomes related to these so-called work comp megaloss claims. Dr. Michael Choo and Scott Goll from Paradigm Outcomes discussed trends in mega losses (defined as claims with total incurred greater than $1 million) that average $3.2 million an incident in medical costs alone but can have costs up toward $20 million.

An analysis of Paradigm data showed that 51 to 60-year-olds represented the highest percentage of these claims and males surpassed females for accident rates. The leading causes included vehicle accidents, being struck by an object, and fall-slip-trip injuries. Burns and infections were among the most common medical afflictions.

While some of the cost drivers reflect medical advances, such as more frequent replacement of prosthetics with more high-tech components, innovative laser treatment for scars, and long-term care programs for brain and spinal cord injuries, up-charging for certain medical treatments, adverse events following treatment such as hospital infections, and co-morbidities also drive costs.

According to Dr. Choo these factors can best be mitigated with:

  • Expertise: It takes a team to have the knowledge and skills to ensure a high-quality outcome.
  • Experience: People with experience can tell you what works and what doesn’t.
  • Embracing Outcomes: Help providers focus on outcomes rather than optimizing revenues.

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

Workplace injuries peak in the summertime – Eight summer workplace risks

According to the Bureau of Labor Statistics (BLS), more injuries occur during the summer months than at other times of the year. There are several possible explanations for the spike, including severe heat, rising traffic congestion and roadwork, increased construction activity, more inexperienced workers, and insect-borne illnesses. There are also other risks, such as employer-sponsored teams and events and summer interns, that can lead to costly claims.

The safety scenario changes during the summer months and it’s prudent to review the risks with employees and take steps to minimize or eliminate them. Keeping everyone safe will make for a more productive and engaged workforce and lower the costs of claims.

Here are eight risks that occur the most during the summer months:

  1. Heat illnessSteamy summer weather combined with intense physical labor can be a recipe for disaster. Minor heat illness symptoms can quickly progress to heat exhaustion and stroke.

    Employers can reduce the risks by training supervisors and employees about heat illness prevention, providing an adequate water supply and reminding workers to stay hydrated, ready access to shade, periodic rest breaks, acclimatizing workers, adjusting work operations for the level of heat, providing first aid, avoid employees working alone, and monitoring workers.

    Also, a risk profile of the individual workers including age, fitness, experience, weight, medications, heart disease, and high blood pressure can help identify those at greater risk.

    There are many online resources, including OSHA’s Heat Safety Tool and NIOSH’s web pages.

  2. Skin cancerWhile most skin cancers can be prevented, the number of cases continue to increase. According to the CDC, skin cancer costs businesses more than $100 million in lost productivity because of restricted activity or absence from work. In some states, skin cancer is compensable under Workers’ Comp as an occupational illness because of sun exposure on the job.

    To prevent skin cancer and serious sun burns, train employees to wear protective clothing, sunglasses, and a hat that shades the face, ears, and back of neck as well as sun block on exposed skin. Training workers to use the UV Index and modify work schedules to adjust when the index is “high” or “extreme,” increasing the amount of shade with tents, cooling stations, and shelters, offering sunscreen, and providing frequent breaks are integral parts of an effective sun safety program.

  3. Motor vehicle accidentsIncreased travel, inexperienced drivers, road construction, and building activity all contribute to the spike in motor vehicle accidents over the summer. It’s a good time to reinforce the company’s safe driving program, review MVRs to ensure that drivers maintain good driving records, and ensure that the vehicle maintenance and inspection program is working as it should be. Also, be sure new drivers and temporary drivers are properly trained. Daily reminders to drivers to put down distracting devices like cell phones, follow traffic laws, and wear safety belts puts safety at the forefront.
  4. Insect-borne illnessesIn May, the CDC issued a warning about the steep increase in insect-borne illnesses. Illnesses from mosquito, tick, and flea bites have tripled in the U.S., with more than 640,000 cases reported during the 13 years from 2004 through 2016. Nine new germs spread by mosquitoes and ticks were discovered or introduced into the United States during this time. Symptoms of insect-borne disease include body, muscle and joint pain, fever, rash, headaches, stiff neck, fatigue, and paralysis.

    The CDC offers tips to prevent insect stings and bites. Among them:

    • Wear clean, light-colored clothing that covers as much of the body as possible.
    • Bathe daily while avoiding cologne, perfume and perfumed soaps, shampoos and deodorants.
    • Maintain clean work areas.
    • Remain calm around flying insects, as swatting may prompt them to sting.
    • Perform daily skin and clothing checks for ticks, which tend to populate worksites near woods, bushes, high grass or leaf litter.
    • Use insect repellent with 20 percent to 50 percent DEET on exposed skin and clothing, reapplying as necessary.
  5. FallsWhile falls are a workplace danger throughout the year, they increase during the summer months as a result of increased construction activity, more outdoor work, and intense summer storms. Proper footwear and fall protection PPE are good defenses and hazard assessments and regular, site-specific training are paramount. Developing written policies and plans to make safe options readily available, regularly inspecting equipment and repair/replace as needed, and daily safety meetings should be routine.

    Focusing on education and involvement, rather than policing will foster accountability.

  6. Inexperienced workersIn 2013, nearly one-third of the nonfatal occupational injuries or illnesses involving time away from work were suffered by workers with less than one year of service, according to the BLS. Protecting inexperienced workers begins with a risk assessment that goes beyond the identification of hazards and proper guarding of equipment. It should identify the tasks inexperienced workers must NOT do, clearly identifying prohibitions on the use of specific equipment and specified work processes, restricted areas, and activities that can only be done under supervision.

    Other steps include: special training and orientation, adequate, consistent supervision, regular reinforcement of safety procedures, encouragement of incident reporting, and the establishment and enforcement of a drug-free workplace. Similar steps should be taken for temporary and summer workers.

  7. Employer-sponsored sports and eventsWhile most employers sponsor sports teams or activities and family events to build morale, some unwittingly expose themselves to claims that impact workers’ compensation. Whether or not an injury or accident is compensable in workers’ compensation often comes down to a two-part examination of whether the accident was in the “course and scope” of employment, and whether the injury “arose out of” that work.

    Although no one rule fits all and each case will be decided on its merits, emphasizing that the social or recreational activity is strictly voluntary and no compensation is provided for participation will help reduce exposure. Before planning an event, it’s best to discuss your exposure with your insurance broker.

  8. Unpaid internsWhen it comes to unpaid interns, knowing the federal and state laws is key. While some observers are predicting that unpaid internships will increase now that the Department of Labor (DOL) has relaxed its intern compensation standards, there are still standards to be met under the “primary beneficiary test”.

    Also, some state laws are more stringent than the federal law. Recently, a Boston private equity firm agreed to pay more than half a million dollars in penalties and wages in a settlement with the AG’s Office over the employer’s improper classification of employees as interns and its failure to pay those employees minimum wage and to keep proper employment records.

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

Things you should know

Workplace deaths rise and workplace violence is now the second-leading cause

According to Bureau of Labor Statistics data cited in the AFL-CIO’s 2018 edition of Death on the Job: The Toll of Neglect, 5,190 workers were killed on the job in 2016, an increase from the 4,836 deaths the previous year, while the job fatality rate rose to 3.6 from 3.4 per 100,000 workers. Workplace violence is now the second-leading cause of workplace death, rising to 866 worker deaths from 703, and was responsible for more than 27,000 lost-time injuries, according to data featured in the report.

35% of workers’ compensation bills audited contained billing errors

Out of hundreds of thousands of audited workers’ compensation bills, about 35% contained some type of billing error, according to a quarterly trends report from Mitchell International.

The top cause was inappropriate coding, which produced 24% of the mistakes and unbundling of multiple procedures that should have been covered by one comprehensive code accounted for 19% of billing mistakes.

Only 13 states adequately responding to opioid crisis – National Safety Council

The National Safety Council (NSC) released research that shows just 13 states and Washington, D.C., have programs and actions in place to adequately respond to the opioid crisis going on across the country. The states receiving the highest marks of “improving” from the Council are Arizona, Connecticut, Delaware, Washington, D.C., Georgia, Michigan, Nevada, New Hampshire, New Mexico, North Carolina, Ohio, Rhode Island, Virginia and West Virginia. Eight states received a “failing” assessment including Arkansas, Iowa, Kansas, Missouri, Montana, North Dakota, Oregon and Wyoming.

NIOSH answers FAQs on respirator user seal checks

Seal checks should be conducted every time respiratory protection is used on the job, and employers and workers should ensure the equipment is worn properly so an adequate seal is achieved, NIOSH states in a recently published list of frequently asked questions.

NIOSH publishes fact sheet on fatigued driving in oil and gas industry

According to a new NIOSH fact sheet, fatigue caused by a combination of long work hours and lengthy commutes contributes to motor vehicle crashes, the leading cause of death in the oil and gas industry.

New tool allows employers to calculate cost of motor vehicle crashes

Motor vehicle crashes cost U.S. employers up to $47.4 billion annually in direct expenses, according to the Network of Employers for Traffic Safety, which has developed a calculator to help organizations determine their own costs.

It has separate calculators for tabulating on- and off-the-job crashes, as well as one for determining return on investment for employee driving safety programs.

Watchdog group releases list of Dirty Dozen employers

The National Council for Occupational Safety and Health (National COSH) announced their list of the most dangerous employers, called “The Dirty Dozen.” Among those listed: Seattle-based Amazon.com Inc., Mooresville, North Carolina-based Lowes Cos. and Glendale, California-based Dine Brands Global Inc., which owns Applebee’s and International House of Pancakes locations.

CMS finalizes policy changes for Medicare Part D Drug Benefits in 2019 with focus on managing opioid abuse

The policy change addresses the Implementation of the Comprehensive Addiction and Recovery Act of 2016 (CARA), which requires CMS’ regulations to establish a framework that allows Part D Medicare prescription plans to implement drug management programs. Part D plans can limit access to coverage for frequently abused drugs, beginning with the 2019 plan year and CMS will designate opioids and benzodiazepines as frequently abused drugs.

Stakeholders hope that CMS will apply similar thinking to Workers’ Compensation Medicare Set-Aside (WCMSA) approvals in which the beneficiary is treating with high-dosage opioids.

Study: workers exposed to loud noise more likely to have high blood pressure and high cholesterol

A study from the Centers for Disease Control (CDC) was published in this month’s American Journal of Industrial Medicine that indicates workers who are exposed to loud noises at work are more likely to have high blood pressure and high cholesterol.

IRS FAQs on tax credit for paid leave under FMLA

The IRS has issued FAQs, which provide guidance on the new tax credit, available under section 45S of the Internal Revenue Code, for paid leave an employee takes pursuant to the FMLA.

US Supreme Court rules car dealership service advisers exempt from being paid overtime under the Fair Labor Standards Act

The FLSA exempts salesmen from its overtime-pay requirement and “A service adviser is obviously a ‘salesman,'” said the majority opinion in the 5-4 decision in Encino Motorcars L.L.C. v. Navarro et al. This reversed a ruling by the 9th U.S. Circuit Court of Appeals in San Francisco that held the advisers were not exempt from being paid overtime.

Legal experts note that this expands the FLSA’s interpretation more broadly and could have implications for other businesses.

State News

California

  • The Workers Compensation Insurance Rating Bureau (WCIRB) quarterly report for year-end 2017 projects an ultimate accident year combined loss and expense ratio of 92%, which is 5 points higher than that for 2016 as premium levels have lowered while average claim severities increased moderately. More findings.
  • Cal/OSHA reminds employers to protect outdoor workers from heat. The most frequent heat-related violation cited during enforcement inspections is failure to have an effective written heat illness prevention plan specific to the worksite. Additional information about heat illness prevention, including details on upcoming training sessions throughout the state are posted on Cal/OSHA’s Heat Illness Prevention page.
  • The Department of Justice certified that the state’s prescription drug monitoring program is ready for statewide use. Doctors will have to start consulting the program before prescribing controlled substances starting Oct. 2.
  • According to a recent report by the Workers’ Compensation Research Institute (WCRI), the state ranked fourth-highest in terms of average claim costs among 18 states examined and a major contributing factor is the relatively high percentage of claims with more than seven days of lost time.

Florida

  • A new law, HB 21, takes effect July 1 and puts a three-day limit on most prescriptions for acute pain and toughens the drug control monitoring program. The bill also provides for additional treatment opportunities, recovery support services, outreach programs and resources to help law enforcement and first responders to stay safe.

Georgia

  • The State Board of Workers’ Compensation’s latest fee schedule update, which became effective April 1, includes the first-ever dental fee schedule and reimbursement rates for air ambulance services as well as other amendments.

Illinois

  • According to a recent report by WCRI, the average claim cost of $16,625 was the highest among 18 states examined and the percentage of claims with more than seven days of lost time ranked third.

Massachusetts

  • Deaths on the job reached an 11-year high in 2017, an increase attributable to the state’s many construction projects, as well as an increased prevalence of opioid addiction, according to a newly released report.

Michigan

  • Work-related injuries requiring hospitalization increased for the third straight year recent data from Michigan State University shows.

Minnesota

  • The Department of Labor plans to adopt what it calls “cost neutral” changes to workers’ compensation vocational rehabilitation fees and other rules without a public hearing, unless one is requested by at least 25 people, in keeping with state law. Comments can be made until May 31.
  • Paid claims and premiums have dropped significantly in the last 20 years (54 percent relative to the number of full-time-equivalent (FTE) employees from 1996 to 2016), while benefits have risen slightly, according to the Minnesota Workers’ Compensation System Report for 2016.

North Carolina

  • The Supreme Court denied review of an appeal by medical providers who argued that the Industrial Commission violated the state’s Administrative Procedure Act when it adopted an ambulatory surgery fee schedule. The fee schedule that became effective on April 1, 2015, remains in effect.

Tennessee

  • According to a recent report by WCRI, the average total cost per workers’ compensation claim decreased by 6% in 2015, driven by a 24% reduction in permanent partial disability and lump-sum benefit payments.

Wisconsin

  • In an effort to combat the misclassification of workers, the state has netted $1.4 million in unpaid unemployment insurance taxes, interest and associated penalties, according to the state Department of Workforce Development.
  • According to a recent report by WCRI, medical costs in workers’ comp increased five percent per year rising in 2014 with experience through 2017.

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

In the aftermath of an injury or death, know what to say

The collapse of a new fiberglass railing, one day after it was installed in a New York City subway tunnel, sent a 23-year-old worker to his death. The NYC Transit President Andy Byford said it appeared that the railing gave way when the worker leaned on it.

Adding to the tragedy was controversy over a union official who referred to the worker’s size when commenting on the tragedy, according to a report in Industrial Safety and Hygiene News. “He was a big worker and the railing did break,” said Transport Workers Union Local 100 President Tony Utano. The article notes, “That statement about Richard – who was reportedly 6’3” and 270 pounds – infuriated transit employees, who slammed Utano and held a rally at the location where Richards died during which they chanted “Safety first.” Workers reportedly felt the comment blamed the victim and distracted the focus from the MTA’s failing infrastructure.”

Responsible employers develop a plan and train managers and supervisors so that the moment an employee injury occurs, it initiates an appropriate sequence of events. But often missing from this plan is how to handle the situation with employees. It’s important that the response show sensitivity, compassion, and discretion.

In some cases, the employees are ignored and rumors start to fly. Someone self-designates as the spokesperson. In other cases, too much is said and thoughtless comments are made or even well-intentioned remarks are misconstrued. Dealing with trauma is difficult because every incident and every individual’s response is different. Working with local professionals with experience in these matters is a good place to start.

 

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