October 15, 2014


Russell Hutchinson has posted the 219th edition of Cavalcade of Risk at moneyblog. Catch up on various risk-related issues, including reports from New Zealand. Russell is our ongoing global correspondent!

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October 10, 2014


California! Again!

Early this week, Oregon's Department of Consumer and Business Services published its biannual rankings of state workers' comp costs (by the way, did you know that "biannual" means both twice a year and once every two years? English is a funny language). Kudos to Jay Dotter and Mike Manley for once again separating the wheat from the chaff.

Since 2006, we've written about Oregon's rankings, as well as those of the actuarial consulting firm, Actuarial & Technical Solutions (ATS) and the National Foundation for Unemployment Compensation and Workers' Compensation (UWC) headquartered in Washington, DC. If you're so inclined, see our in depth 2006 report, our 2009 report highlighting Massachusetts and our 2010 report.

Following the Oregon release the blogosphere was quick to note that California, leapfrogging Connecticut and Alaska, had won the 2014 gold medal for most costly state in the nation. People, this was not a surprise.

We have been watching the Golden State's periodic workers' comp train wrecks since the late 1980s. Here's how things usually go.

1. Costs go through the roof
2. Vested interests run around with their hair on fire
3. Legislature enacts reforms
4. Costs drop precipitously (everyone takes credit)
5. Lawyers figure out how to outflank the reforms
5. Costs go through the roof
6. Repeat the process

This has happened at least three times in the last 20 years, most notably during the administration of the Terminator, Arnold Schwarzenegger, when annual costs exceeded $29 billion dollars (you read that right). After reform, costs dropped to around $14 billion. Everyone declared victory and left the field until the sky fell again.

Alex Swedlow and the California Workers' Compensation Institute have done a marvelous job tracking costs and, through solid research, shining a light on possible ways to lower costs going forward. Nonetheless, to say that California's workers' compensation costs are continually volatile seems indisputable.

A couple of other notes on the Oregon rankings:

1. Although lagging far behind California, Connecticut retains its place of honor at Number Two in the ranking. It's costs are 155% of the median costs for all states and the District of Columbia;

2. In addition to Connecticut, it's worth noting that four of the other six New England states, Vermont, Maine, New Hampshire and Rhode Island rank in the top 20;

3. And, you might ask, what about the sixth New England state, the Commonwealth of Massachusetts, the home of the bean and the cod. Well, it may be the proverbial broken record, but I'm proud to note that Massachusetts, our home state, at 48th most costly, holds the distinction (again) of being the least costly of any major manufacturing state. This has been the case for the last 15 years. Why other New England states, for that matter all other high cost states, don 't take a leaf from the Massachusetts book is beyond me.

I'm betting that California, the state, which, if it were a country would have the fifth highest GDP in the world, will continue its up and down roller coaster ride as time marches on. It's just too big with too many highly entrenched vested interests to do otherwise.

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October 10, 2014


Joe Paduda has posted this week's Health Wonk Review at Managed Care Matters. In keeping with the overall mission of HWR, he says that there's "lots of health policy stuff, all right here!"

While at Joe's blog, also check out his post on drug formularies . He makes the case that despite progress that payers and PBMs have made in curbing runaway opioid costs, new drug-related issues keep emerging (eg compounding) and tighter controls are needed.

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October 2, 2014


David Williams hosts this weeks Cavalcade of Risk #218 at Health Business Blog - check it out!

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October 2, 2014


OSHA Expands Mandatory Reporting Requirements to Encompass Individual Employee Hospitalizations, Amputations, and Eye Loss
Jason Markel, Hodgson Russ LLP:
"On September 11, 2014, OSHA adopted a final rule that significantly broadens the mandatory reporting requirements, resulting in an amended Section 1904.39 that becomes effective on January 1, 2015. The amended regulation will require employers not only to report deaths within eight hours as before; it also mandates that employers report to their local OSHA office, subject to limited exceptions, all in-patient hospitalizations of an employee, all amputations, and all eye loss incidents within 24 hours of the event. And, of course, these events must also be recorded on the employer's OSHA 300 log."

Changing Soon: OSHA Requirements for Reporting Fatalities and Severe Injuries

Biz groups 'alarmed' by new OSHA rules for workplace accidents

OSHA Will Put Workplace Safety Data Online as 'Nudge' to Employers

Other OSHA News

Top 10 OSHA violations in 2014

OSHA targets companies that punish employees for reporting injuries

OSHA's List of Severe Violators Grows by 23 Percent
There are currently 423 sites in the program. "Launched in 2010, OSHA's Severe Violator Enforcement Program "concentrates resources on inspecting employers who have demonstrated indifference to their OSH Act obligations by willful, repeated or failure-to-abate violations," in the words of the agency."

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September 25, 2014


Billy Wynne has posted the "Thank God It's Recess" edition of Health Wonk Review at Healthcare Lighthouse, a bi-weekly best of the health policy bloggers. Go there now to find out the latest scoop on the Affordable Care Act as the rubber hits the road. Plus, assorted other health policy issues.

In other news:

Happy birthday to us! Worker's Comp Insider is 11 years old this month. Follow us on Twitter too

National Employers Push for Comp Options
Roberto Ceniceros, Risk & Insurance
"National employers already benefiting by opting out of Texas' workers' compensation system are now pushing for "free market alternatives" to traditional state systems across the nation.
They launched a new organization called the Association for Responsible Alternatives to Workers' Compensation. ARAWC plans to lobby state legislators to allow employers to develop new options for delivering medical and wage replacement benefits to injured workers.
Its members include nationwide companies such as Wal-Mart Stores Inc., Lowe's Companies Inc. and Sedgwick Claims Management Services Inc."

Workers' Comp - Feeding the Heroin Dragon
Risk & Insurance, Jason Beans:
"When you start doing some back-of-the-napkin math, you realize that the workers' compensation system's potential contribution to the heroin problem in America is staggering. Bottom line, we need to take ownership - our industry is creating addicts who are creating a massive recurring demand for heroin and other illegal substances."

Drugs and Drinking on the Job in New Mexico
Joan E. Collier, WCI360
"My home state of Florida has a law on the books that says workers' compensation benefits can be denied if an employee is found to have been intoxicated on the job at the time of injury. I've always thought that was sound public policy, so I was surprised to learn that we are decidedly in the minority on this."

Clinical Connections: What's So Special about Specialty Managed Care in Work Comp?
Shelley Boyce, CEO, MedRisk:
"As consolidation limits marketplace choices and as specialization is replaced by generalization, it is critical that buyers remember that expertise and ongoing clinical oversight is more important than ever. Service-specific guidelines, care oversight and outlier identification and management are still the answers to achieving the best patient outcomes. Outcomes, which, in the long-run, will continue to be the right answers for the carriers and payers, for their customers and their injured workers."

Accountable Care and Workers Compensation: Are They Compatible? (PDF)
Jacob Lazarovic, Chief Medical Officer of Broadspire
"Do these alternative medical models offer opportunities to redesign the prevailing model
of delivery and financing in workers compensation? It would seem that bundled arrangements would be easier to implement than population‐based models, and furthermore they would more closely match the nature of WC events which are inherently episodic, not holistic.
Several barriers to WC application of these models exist. Historically, WC has been a volume‐driven, fee‐for‐service model, and expectations and attitudes would need to be reformed. A pattern of micromanagement of all medical services would need to be altered, by increased delegation to provider entities. And the plethora of state regulations, dealing with reimbursement and direction of care, among others, would need to be overhauled to facilitate these approaches."

It's the diagnosis...
Joe Paduda, Managed Care Matters
"If the diagnosis isn't right, there's a pretty good chance the treatment won't be right.
A while back I had an interesting conversation with folks from Best Doctors about this issue, and they provided some interesting statistics about the incidence of misdiagnosis."

Severe black lung reaches near-record levels
Ken Ward, Coal Tattoo
"There's a new paper out this morning that has some scary news about the continued resurgence of black lung disease in the Appalachian coalfields. It focuses on progressive massive fibrosis, or PMF, an advanced, debilitating, and lethal form of coal workers' pneumoconiosis with few treatment options and no cure."

California is the tail that wags the dog
Dave DePaolo, DePaolo's Work Comp World
"Injured workers in California received nearly 20% of the $181.4 billion in medical and indemnity benefits paid by state and federal workers' compensation programs between 2010 and 2012.
In looking at the NASI numbers, the California Workers' Compensation Institute noted that the $11.5 billion paid in medical and indemnity benefits in California was "by far the highest in the nation, exceeding the combined total of New York, Pennsylvania and Florida, which ranked second, third and fourth among all states."

Related: Mark Walls, PropertyCasualty360
The current state of California workers' compensation and a look forward

Insurance Carrier Fraud: Know the Signs
Bill Byington, Missouri Employers Mutual WorkSAFE Center
"When you hear about workers compensation fraud, you usually think about employees and employers filing false claims or falsifying premium. It is important to know that insurance companies can also commit fraud. There are red flags and indicators that policyholders and injured employees need to be aware of when dealing with insurance companies."

NIOSH Celebrates National Farm Safety and Health Week
September 21-27, 2014, is National Farm Safety and Health Week. The National Institute for Occupational Safety and Health (NIOSH) marks this year's theme, Safety Counts: Protecting What Matters, by announcing the new Agriculture, Forestry and Fishing directory page.

Meetings & Conferences
Safety National has a new blog called Conference Chronicles

Register for Business Insurance' 5th annual virtual conference focused on workers comp and safety solutions is scheduled for October 8, a full day of webinars, audience Q&A and networking with peers that can help you better understand and manage the drivers for success in your workers comp and safety programs.

Don't miss out on a discount if you are planning to attend the National Workers' Comp & Disability Conference - if you register by tomorrow, you can save $275. You can learn more about the Nov. 19-21 Las Vegas event at the link above, or follow on Twitter at @wcconf or #NWCDConf

News Briefs

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September 19, 2014


in her post How Americans die on the job, in 5 charts, Danielle Kurtzleben of Vox media analyzes and summarizes data from the Labor' Department's most recent preliminary Census of Fatal Occupational Injuries, 2013 The charts offer a quick look at of some of the most deadly jobs, activities and demographics.

The good news is that fatalities continue trending down, as can be seen in the chart below. In 2013, 4,405 fatal work injuries were recorded in the United States, lower than the 4,628 recorded work fatalities in 2012. The numbers could adjust - final 2013 data isn't released until the late spring of 2015. The Bureau of Labor Statistics says that, "Over the last 5 years, net increases to the preliminary count have averaged 165 cases, ranging from a low of 84 in 2011 to a high of 245 in 2012."


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September 17, 2014


Cavalcade of Risk #217 is live, covering such wide-ranging topics from the Audacity of Dope to the state of the residual property market. Rebecca Shafer hosts at the WC Roundup blog - check it out!

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LexisNexis Workers' Comp Law Center  LexisNexis Top 25 Blogs for Workers' Compensation and Workplace Issues – 2011 Honorees.  LexisNexis Top 25 Blogs for Workers' Compensation and Workplace Issues – 2012 Honorees. LexisNexis Top Blogs for Workers' Compensation and Workplace Issues – 2013 Honorees.
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