Workplace Safety

By decreasing work time lost from to job-related injuries and illnesses, Return-to-Work (RTW) programs can reduce your insurance costs (Workers Compensation, Disability, and Medical insurance), strengthen workplace morale, boost productivity – and help protect you against ADAAA litigation.

Here are ten common mistakes by businesses when using RTW:

1. Failure to manage the higher number of employees covered by the ADAAA. An expanded definition of disability has increased the number of employees under the ADA to the point that some attorneys advise against fighting disability claims.
2. Insisting on employee release to “full duty” before returning to work. This raises Workers Comp costs and the possibility of the employee not returning to work when medically possible.
3. Ignoring co-morbidities. Health issues that complicate or delay an employee’s recovery (such as diabetes, obesity, and hypertension) can increase Comp claims.
4. Failure to commit the necessary budget or resources. The costs of absences and non-compliance with government rules is usually far higher than that of implementing an RTW.
5. Reluctance to set transitional assignments because employees “might get reinjured.” It’s even riskier to have them stay at home and develop a “disability attitude” that extends the absence and boosts costs.
6. Failure to distinguish “light duty” from “transitional work.” The ADAAA permits employers to reserve less physically demanding or “light-duty” jobs for those with work-related disabilities – and these jobs should be distinct from transitional tasks.
7. Relying on physicians to guide the RTW process. Although physicians are medical experts, they’re not familiar with workplace policies, job demands, and the availability of transitional work.
8. Failure to understand overlapping and conflicting laws. The clashing requirements of insurance companies and state and local governments can be a nightmare.
9. Inability to focus on the goal. An Integrated Benefits Institute study ranked a focus on the employee’s job as the major success factor in successful RTW programs.
10. Believing that Workers Comp settlements resolve other liabilities. One size does not fit all.

Basic health interventions can help your business lower short-term disability rates, while reducing your employees’ time away from work. That’s the bottom line of a nationwide study of 118,000 employees by CIGNA, a major health services company.

CIGNA found that these measures, combined with predictive analytics, cut disability rates by 15% among employees at high risk of suffering disability within in the next 12 months. (The study defined “high risk” as a 10% or greater probability of becoming disabled during this period).

“By identifying workers at high risk of future short-term disability and providing individualized intervention that includes coaching, incentives, and other outreach, our study shows that the onset of disability absence can be reduced measurably, benefiting employers and employees alike,” says Dr. Robert N. Anfield, chief medical officer for CIGNA’s Disability business. Future studies will deal with the impact of intervention on the length of short-term disability, return-to-work rates, and total medical costs.

The company’s Absence Prediction and Prevention program establishes an intervention, led by a nurse/health advocate, that provides:

• Early identification of workers at high risk for future short-term disability.
• Proactive outreach to these employees.
• Clinical Assessment.
• A range of disability absence prevention strategies.

By proactively identifying employees who might be having health problems before their condition worsens and they need to leave work, you can help workers stay healthy and potentially prevent or lessen the impact of injuries or illness – which translates into lower absenteeism, higher productivity, and a healthier bottom line.

It makes sense to develop an absence prevention program that emphasizes preventive health safety training. As always, we stand ready to offer our advice.

Some companies employ workers who work alone or in remote areas where injuries and illnesses can occur, resulting in delays in emergency response or medical assistance. They include people who work outside normal business hours, such as janitors, security guards, special production, plant maintenance or repair staff, delivery truck drivers, and others. Protecting the safety of these lone or remote workers isn’t always easy – but it’s your responsibility.

In some cases, you must monitor the exposure of these workers to identify potential hazards, assess the risks of injury or illness, and take steps to eliminate or control them. Bear in mind that some high-risk activities have safety regulations which require at least one other person to do the job, such as confined space work (defined by OSHA regulations) or electrical work at or near exposed live conductors.

If you have any employees out in the field or working alone, consider what safety measures to take to protect their well-being and security. A well-thought-out safety program for these employees is an essential first step. Hazard control measures might include:

• Safety Awareness information.
• Training.
• Supervision.
• Protective Equipment.
• Communication and Monitoring devices.

Take steps to make sure that these safety control measures remain in effect – and review your plan at regular intervals by doing a risk assessment in areas where employees work alone.

As your professional insurance agents, it’s our responsibility to help you keep all of your workers safe at all times. Give us a call at any time to discuss how we can help.

Third-Party Administrator (TPA) adjusters form the front line of defense against unnecessary claims expenses, including such traditional cost drivers as fraud or opioid pain medication addiction. They’re the ones who determine how soon employees will mend and return to the job, the length of claims, and whether closing a claim will require additional resources, such as attorney involvement. It makes sense that the more closely you monitor the adjusters of your company’s TPA, the lower your Workers Comp claims costs – and premiums.

However, adjusters today are running on overload more than ever. In addition to managing larger caseloads, they face growing real-time information demands, increasing communication speed, and expanding regulations – which distract them from such cost-control practices as staying in contact with injured workers. Says one claims adjustment expert, “The fastest way of getting an injured employee to hire an attorney is making them feel like you don’t really care about their injury. So you end up with a lot more claims than necessary going to attorneys, which leads to higher claim costs.”

It makes sense to work closely with your TPA adjuster by following these guidelines:

1. Interview adjusters before they’re assigned to your company.
2. Review the adjuster’s claims notes on a regular basis.
3. Audit the TPA’s services periodically to make sure that the adjuster is meeting your expectations.
4. Develop close relationships with claims examiners and their supervisors.

We’d be happy to work with you and your TPA adjuster on keeping tabs on your Workers Comp claims costs. Please feel free to get in touch with us.

Everything is not “coming up roses” for a California gardener charged with Workers Compensation fraud and perjury.

Jose Cortez earned his living as a gardener until October 2010, when a large tree branch fell and landed on him during his shift. He was transported to a local hospital and sent home with “minor work restrictions.

Although Cortez filed for Workers Comp, claiming that the injuries sustained that day prevented him from completing his customary work duties, not everyone was convinced. The following year, a tip aroused enough suspicion for his insurance company to initiate video surveillance, which revealed that Cortez was carrying on as if it were business as usual.

In September 2012, investigators from the San Bernardino County District Attorney’s Office Workers’ Compensation Insurance Fraud Unit conducted a criminal investigation, collecting surveillance footage of Cortez, who was still collecting under his claim. On January 21, 2013, prosecutors filed criminal charges against Cortez, resulting in a felony arrest warrant being issued. If convicted, he could enter a system far different from Workers Comp – state prison, where he could serve as many as eight years.

“This type of fraud is harmful because it causes premiums that businesses have to pay to go higher,” says Deputy Assistant District Attorney Scott Byrd. “It drains business profits, which in turn costs honest workers money in raises or other benefits that they may have been eligible to receive.” A word to the wise.

Millions of Americans practice yoga, which combines stretching and strengthening exercises with meditation. Workers Comp experts stress the benefits of this discipline in dealing with a serious problem: the treatment of workers with chronic lower back pain, and arthritic hands due to workplace injuries, whose condition often deteriorate from using high quantities of pain medications.

Yoga can play a key role in “functional restoration programs,” which combine physical therapy, counseling for psycho-social issues, occupational therapy, addiction education, and physical fitness activities. The insurance company might close a claim immediately after completion of the program or it might offer follow-up care. Yoga helps with flexibility, which is part of trying to get patients suffering from chronic-pain issues beyond the “I can’t move” stage. “However you came to chronic pain, you have to figure out some way to not let it drive you,” says Mark Pew, senior vice president of business development for Prium (Duluth, GA), a workers comp utilization review company. “That’s what functional restoration is trying to do – improve your function, which improves your quality of life.”

These programs can cost tens of thousands of dollars for sessions that patients attend daily over several weeks. Results vary: Many patients report improved health and physical abilities, only to relapse with their pain and narcotic use increasing. According to experts, patients must be interested in making lifestyle changes to achieve positive results. Effective programs screen participants for their motivation before admitting them.

Pew is evaluating functional restoration programs based on a set of questions he developed for service providers. The goal is to help Workers Comp payers decide what action to take after utilization review and peer-to-peer discussions with a treating physician have concluded that an injured worker is consuming too many drugs without showing improvement.

With the workforce aging and people retiring later than ever, Workers Compensation experts have been concerned that older workers are more prone than their younger counterparts to suffer expensive injuries. However, new research from the National Council on Compensation Insurance (NCCI) contradicts this conventional wisdom,

After studying the rate at which different age groups suffer injuries, NCCI concluded that, although there is a substantial cost difference between younger and older workers, the split doesn’t lie where you might expect. Workers between 20 and 24 create much lower costs (and fewer days out), but once they reach 35, the costs of their injuries are very similar. These results redefine an “older worker” as someone who grew up listening to Pearl Jam, as well as Elvis.

The bottom line: Your workplace safety program should focus on reducing injury costs for all employees, regardless of age, by following these steps:

1. Develop a written job description for all positions.
2. Give job candidates a “conditional offer of employment” that’s contingent on their physical or mental ability to do the job.
3. Have candidates take a pre-placement medical questionnaire, which allows a physician to ask relevant questions that will let you know if they’re fit for the job
4. Once employees are on the job, make sure that they do their work properly. Unsafe acts in the workplace cause far more injuries than unsafe working conditions. That’s because employees who feel pressured to meet deadlines are more likely to ignore safety guidelines – leading to preventable accidents.

For more information on creating, implementing, and enforcing a comprehensive workplace safety program, please feel free to get in touch with us at any time.

With the workforce aging and people retiring later than ever, Workers Compensation experts have been concerned that older workers are more prone than their younger counterparts to suffer expensive injuries. However, new research from the National Council on Compensation Insurance (NCCI) contradicts this conventional wisdom,

After studying the rate at which different age groups suffer injuries, NCCI concluded that, although there is a substantial cost difference between younger and older workers, the split doesn’t lie where you might expect. Workers between 20 and 24 create much lower costs (and fewer days out), but once they reach 35, the costs of their injuries are very similar. These results redefine an “older worker” as someone who grew up listening to Pearl Jam, as well as Elvis.

The bottom line: Your workplace safety program should focus on reducing injury costs for all employees, regardless of age, by following these steps:

1. Develop a written job description for all positions.
2. Give job candidates a “conditional offer of employment” that’s contingent on their physical or mental ability to do the job.
3. Have candidates take a pre-placement medical questionnaire, which allows a physician to ask relevant questions that will let you know if they’re fit for the job
4. Once employees are on the job, make sure that they do their work properly. Unsafe acts in the workplace cause far more injuries than unsafe working conditions. That’s because employees who feel pressured to meet deadlines are more likely to ignore safety guidelines – leading to preventable accidents.

For more information on creating, implementing, and enforcing a comprehensive workplace safety program, please feel free to get in touch with us at any time.

When you’re fighting a questionable Workers Compensation claim in court, you’ll need to base your defense on a strong administrative foundation.

Effective workplace policies and procedures should include – at a minimum:

• A legally compliant application for hire. What kind of information are you getting from the individual? Do you do background checks? Have you asked the right questions? Do you have enough good information about this individual on the application to help defend yourself, if needed?
• Legally compliant interview process. Recent changes to the Americans with Disabilities Act mean that you’ll need to be careful during job interviews in asking questions about intoxication, for example.
• Post-offer/pre-placement medical exam. Are you using these to look for drug use? Do you meet state or federal requirements? Do you have quality policies and procedures to enforce these standards?
• Legally enforceable drug-screen program. Does your program comply with state and federal regulations? Can you require workers to take a drug screening after an injury? What are the permissible levels of intoxication?

In addition, having effective descriptions and job function analyses will help you in three ways:

1. They work well in the initial hiring process because you can give them to the individual and define the job is to avoid misunderstandings – this will help filter out people who are not well suited for the job.
2. You can give them to a doctor who can determine suitability to perform the job after an injury.
3. Under the Americans with Disabilities Act, you can determine what restrictions a disabled employee might need, and whether this person can perform the essential functions of the job.

Our Workers Compensation specialists stand ready to offer their advice at any time.

A lot of companies say “Safety is our Number One priority.” However, when the chips are down and production needs to increase, safety might suddenly become Number Two.

In an effective workplace health and safety program, the employer places a high priority on a safe workplace, employees participate willingly in keeping themselves safe on the job — and the company’s Workers Comp premiums stay low!

To develop and maintain safety as a “core value” among your employees, we’d recommend following these guidelines:

• Encourage employees to think about safety 24/7.
• Talk about safety all the time.
• Make sure employees work safely. This job falls largely to your supervisors, who need to have good safety attitudes. You and your staff should keep checking up, monitoring performance, and being visible.
• Encourage employee participation, suggestions, questions, and even complaints about unsafe conditions.
• Set an example. If workers see you and your safety staff wearing PPE, following rules, eliminating hazards, and investigating incidents, they’ll follow your lead in taking safety seriously.
• Provide positive feedback for safe performance and attitudes. People love recognition and praise for doing the right thing.
• Correct reported safety hazards immediately. Nothing shows that you have a good safety attitude more than demonstrating that you care and are looking out for your workers.