May 2010 Archives

May 27, 2010

 

Fresh Health Wonk Review - David Williams has posted a packed & pithy edition of Health Wonk Review over at his Health Business Blog - get your biweekly fill of the best of the health policy blogs.

Social media - Peter Rousmaniere has a roundup of some of the best workers' comp social networking on the web at Risk and Insurance - we thank him for including us - check out some of the other resources!

Surgical implants - As Joe Paduda is consistently excellent about pointing out, when it comes to work comp medical costs, the devil is in the details. In a recent post, Joe tackles the high cost of surgical implants - a cost that is far higher under workers comp than under group health - and explains payer approaches to resolving the problem, and why they fall short. His advice? "Don't reimburse based on the invoice. Period."

Oil spill safety resources

State comp agencies - Roberto Ceniceros posts about struggling comp agencies on his Comp Time blog, a followup to a more in-depth article about how states' financial woes are squeezing comp systems that appeared in Business Insurance. The recession has decreased payrolls, adding further momentum to the drop in frequency and theoretically resulting in fewer claims to process. But some employers report that state work comp cutbacks are impacting their ability to resolve claims. Some risk managers say that the shortage of administrative judges means that claims take longer to resolve, hearings are delayed, and litigation costs are higher, among other effects.

EBT cards spark suit - In Ohio, the Bureau of Workers Comp is paying workers comp benefits via a Chase debit card. A class action suit has been filed by employees who say that Chase is charging fees if they make more than one withdrawal a month. Many state agencies are using such cards for food stamps and other social programs but we were unaware that they are being used for workers comp. As one of just a handful of monopolistic states, Ohio is the exclusive provider of workers comp, so it makes sense that the state would want to cut administrative costs. Check out the 2004 white paper by the California Commission on Health and Safety and Workers' Compensation: the Cost/Benefit of Implementing Electronic Deposit for Unemployment and Disability Benefits in the State of California.

Heat wave - If the recent record high temperatures in the northeast are any indicator, it could be a long hot summer. The Texas Division of Workers Compensation reminds employers to prevent heat related injuries and offers a good check list of safety tips to prep for extreme heat.

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May 26, 2010

 

On this blog, we are usually speaking to employers or workers. Sometimes we are addressing people in the insurance industry - claims adjusters, safety professionals, insurance geeks, and the like. But today we have a different target audience: parents of teens who are about to embark on their first summer job.

Parents: please do not assume that your kids health and well being will be looked after while on the job - make it your business to dig deeper.

Every year, in some of the most pedestrian-sounding jobs, kids are maimed and killed while working. Who would think that a job in a doughnut shop could lead to a 17-year old drowning in an uncovered cesspool? Or that a summer job on a lawn care crew could result in a 14-year old being killed when pulled into a wood chipper? Some of the most compelling advocates for teen worker safety are teen survivors themselves: Candace Carnahan who lost her leg to a conveyor belt; Kristi Ruth, who lost an arm that was entangled in equipment while working at her family farm; and four kids who tell of their life-changing injuries at summer jobs in a series of powerful videos.

Most dangerous jobs for teens
Millions of teens will be looking to join the work force over the next few months, and with a teen unemployment rate hovering around 30%, there will be strong competition for positions - and some young workers may be tempted to take jobs that could endanger their health. The National Consumers League (NCL), which coordinates the Child Labor Coalition, has issued a report detailing 2010's Five Worst Teen Jobs report to remind teens and parents to be alert and informed about the hidden dangers that many jobs hold.

2010's Five Worst Teen Jobs

  • Traveling Youth Sales Crews

  • Construction and Height Work

  • Outside Helper: Landscaping, Groundskeeping and Lawn Service

  • Agriculture: Harvesting Crops

  • Driver/Operator: Forklifts, Tractors, and ATV's

The article offers information and details about the potential risks and hazards for each of these job categories, as well as common risks that teens face at work. It also offers suggestions for parents on how to be involved in their teens job choices, and what to look for.

More tools for parents
Here are some additional resources to help you keep your teens safe at work:

  • Making sure your teen's job is safe - great advice from the award-winning KidsHealth by Nemours, one of the largest nonprofit organizations devoted to children's health. It includes a list of questions and discussion points to raise with your teen before he or she is hired, advice for checking out the job site, and how to sustain a discussion about work safety once your teen starts the job.

  • Tips for parents with working teens (PDF) - a brief fact sheet with advice from the California Resource Network for Young Workers' Health and Safety

  • Working the Smart Shift: Helping parents help their teens avoid dangerous jobs - Safety guidelines from the Child Labor Coalition, along with a list of telephone numbers for state labor department resources.

  • Do you have a working teen? - advice and resources for parents from the Occupational Health & Safety Administration

  • State Labor Laws - The U.S. Department of Labor offers links to state Labor Departments and state resources

Other teen safety resources

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May 25, 2010

 

The Insider scans the world of risk in a risky world. We try to zero in on hazards that might be overlooked in the rush of daily commerce. In that spirit we bring you the distasteful but necessary tale from the New York Times involving bus drivers in New York City, a number of whom have suffered prolonged disability due to the unsanitary habits of riders.

Unhappy riders may express their displeasure in any number of ways, including the unfortunate choice of spitting on the bus driver. I am sure we all sympathize with these uniformed public servants who are simply doing their jobs. You cannot please everyone all the time, especially in the Big Apple.

It's what happens after these incidents that is really puzzling. One third of all the assaults that prompted a bus operator to take paid leave in 2009 involved spitting, 51 in all. The MTA defines these "spat upon" incidents as assaults. The 51 drivers who went on paid leave after a spitting incident took, on average, 64 days off work -- the equivalent of three months with pay. One driver spent 191 days on paid leave.

Before we jump to conclusions like irate citizens running after a bus, let's listen to John Samuelson, president of the transit union:

"Being spat upon -- having a passenger spit in your face, spit in your mouth, spit in your eye -- is a physically and psychologically traumatic experience. If transit workers are assaulted, they are going to take off whatever amount of time they are going to take off to recuperate." [Emphasis added.]

Mr. Samuelson has given us one of the most compelling definitions of disability I have ever encountered: workers are going to "take off whatever amount of time they are going to take off to recuperate." It's not a matter of medically (or psychologically) necessary time away from work, but the amount of time the worker deems necessary. Who needs a doctor when the drivers are empowered to determine the extent of their own disabilities?

Tough Times, Not-So-Tough Drivers
The MTA is facing a budget shortfall of $400 million. It's tempting to conclude that tightening up a bit on eligibility for "Post Traumatic Spitting Syndrome" (PTSS - you first read about it here!) might help reduce that deficit. Heck, it might even make the riding public a bit more sympathetic to bus operators.

Nancy Shevell, the chairwoman of the transit authority's bus committee, questions whether three months' off is a bit excessive.

"You have to wonder if you can go home and shower off, take a nap, take off the rest of the day and maybe the next day," she said. "When it gets strung out for months, you start to wonder."

As we peruse the annals disability - mostly real and painful, occasionally trumped up - we do indeed begin to wonder who is in control in New York, just who is driving - in this case, not driving - the bus.

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May 24, 2010

 

Joe Cassano, the man who brought insurance giant AIG - and the world economy - to their knees, has dodged the proverbial bullet: he will not be indicted for his actions in the collapse of AIG's Financial Products unit, which he ran until his resignation in 2008. Federal prosecutors searched diligently for evidence of wrong doing. What they found, however, was evidence of cluelessness. Joe Cassano was no crook: he was just a manager in way over his head. He apparently believed that underwriting credit default swaps was relatively risk free. Oh, well, it seemed like a good idea at the time.

If no good deed goes unpunished, incompetence on a cosmic level is not without its rewards: Cassano made about $280 million in eight years of running the FP unit, in addition to receiving a performance bonus of $35 million in his final year with the company. That last payment truly boggles the mind. Cassano was paid for high volume sales of a product that destroyed his company.

Joe Warin and Jim Walden, Cassano's (presumably high paid) attorneys were delighted with the outcome of the investigation:

Although a two-year, intense investigation is tough for anyone, the results are wholly appropriate in light of our client's factual innocence. This result was the product of two things: an innocent client and fair prosecutors and agents. The system worked.

It would be more accurate to say that the system was worked. As was evident in a prior blog, Cassano was not a nice guy who happened to make a mistake. He was a thug dressed up in a fancy suit. Perhaps on some level it's reassuring that his actions were not criminal, that he acted in the expectation that his company would make money. Cassano certainly made an obscene amount of money, but AIG rank and file, the shareholders and the tax payers have to foot the bill for the mistakes of one greedy goon.


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May 20, 2010

 

We've recently been challenging ourselves with OSHA recordable quizzes posted by the smart folks at the Advanced Safety and Health News Blog. We found them interesting enough that over the next few weeks, we will pose the scenarios / questions and you can test your knowledge. Click the headlines to go to the respective blog post and learn the answers.

OSHA Recordkeeping Quiz #10: injured on smoke break
Scenario: An employee reports to work. A few hours later, the employee goes outside for a "smoke break." The employee slips on the ice and injures his back.
Question: Since the employee was not performing a task related to the employee's work, the company has deemed this incident non-work related and therefore not recordable - right or wrong?

OSHA Recordkeeping Quiz #11: injury during seizure
Scenario: You have a 48 year old male employee who reports to work on Wednesday morning and two hours into his work shift he experiences some sort of seizure and falls to the floor. During this event when the employee falls he strikes his head on a work table and receives a laceration on his head that requires six stitches. Further investigation determines the employee has epilepsy and a history of epileptic seizures. The doctor verifies that what this employee experienced was indeed an epileptic seizure. So you determined the event was due to a preexisting non-work related medical condition.
Question: Since the employee struck his head while at work performing work, does the geographical presumption make this event an OSHA recordable?


Recordkeeping Quiz 12: company sponsored meal

Scenario: To celebrate a safety milestone of achieving one million hours worked without an injury, your employer provides a lunch complete with fried chicken, barbequed ribs, hamburgers, and all the trimmings. A few hours later many employees start to exhibit signs of food poisoning. Seventy two of your employees get food poisoning so bad that they must miss the next day of work. Further investigation reveals they received the food poisoning from the potato salad provided by the caterer your company hired for the event.
Question: Do all seventy two of these cases go on your OSHA 300 log as recordable with at least one day away from work (DART case)?

OSHA Recordkeeping Quiz 13: counting time away from work
Scenario: An employee sustained a work-related ankle injury (sprain) and received medical treatment. The employee immediately returned to work with restrictions. The employee's doctor has requested that the employee return for periodic office visits so that he can observe the patient's improvement. The employee's doctor states that on the days the employee has an appointment, the employee is "unable to work that date."
Question: Are the days used by the employee to visit the doctor for follow-up to be considered days away from work?

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May 19, 2010

 

The 105th edition of the Cavalcade of Risk is up. Host Nancy Germond at Insurance Copywriter combines a pessimistic take on liability trends with the necessary humor to make it all tolerable. Check it out here.

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May 18, 2010

 

Arizona has been getting a lot of criticism lately. Frustrated by the federal government's inability to confront the undocumented worker problem, they took matters into their own hands and passed their own law. Now police are required to stop anyone who "looks illegal" and ask for papers. I'm not sure that illegal immigrants from Ireland have much to worry about, but Hispanics - who make up one third of the state's population - had better be careful. The Arizona legislature missed an opportunity by not requiring Hispanics to wear their documents in a packet around their necks. Perhaps they can amend the law.

I have been on board with the need to deal with illegal immigration. Back in 2006 I strongly endorsed the congressional initiative to build a wall at the Mexican border. This new version of the "Great Wall" offered an tremendous opportunity to ineffectively seal the border, build a tourist attraction/theme park and temporarily employ thousands of undocumented workers until the project was finished, at which point we would escort the workers through the wall back to Mexico.

Some people feel that Arizona has created a law that penalizes people simply for looking Hispanic. Others believe that only the federal government has the power to deal with immigration issues. As we await the legal challenges that may or may not resolve the issue, we need to shift gears and recognize an area where the maligned state has actually gotten it right.

Public Versus Private
I am referring, of course, to the decision to privatize the state fund for workers comp insurance. Arizona has provided insurance since 1925 through the State Compensation Fund (SCF). With 40 thousand employers and $191.8 million in premiums, SCF is the largest workers' compensation carrier operating in the state, with a 31.5 percent market share.

One of its subsidiaries, SCF Premier Insurance Co., is the second-largest, with $34.1 million in 2009 direct premiums written. Another subsidiary, SCF Western Insurance Co., is the 10th-largest, with $10.7 million in 2009 direct premiums written. In other words, SCF is by far the dominant player in the insurance market for comp.

Under the recently signed law, SCF will become a mutual fund in 2013. This move should open the door for more carriers to do business in Arizona, which will join the vast majority of states in operating a private insurance system for workers comp. I find it encouraging that in this area, at least, the goal is not to make the rest of us "Arizonians," but to have Arizona join the mainstream of American culture. Bienvenida, las damas y caballeros!


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May 17, 2010

 

Emily Kysel, 24, is highly allergic to a common item: paprika, a spice made from ground bell and chili peppers. Inhaling the colorful spice can send her into shock and could even kill her. "It's like someone poured acid down your throat," she says. So family members raised $10,000 to buy her an allergy-detection dog, a golden retriever named Penny. When sensing the presence of paprika, Penny jumps up on Emily, who then presumably high-tails it out of the area. This might prove socially and professionally awkward, but it apparently works.

The City of Indianapolis's Department of Code Enforcement hired Emily. Well aware of her unusual condition, they approved her bringing Penny to work and alerted supervisors and co-workers to Emily's plight. Employees were asked to forego the paprika on hummus, chili, buffalo chicken wings, etc.

So Emily shows up for work, Penny at her side, and a co-worker immediately has an asthmatic reaction: not to Emily, of course, but to the dog. Emily's boss makes an on-the-spot management decision to void Emily's accommodation; he tells Emily that she cannot bring Penny to work. Forced into the limbo of neither working nor being unemployed, Emily files suit, alleging discrimination and failure to accommodate.

"I was crestfallen, angry," Emily said. "I thought I had jumped through all the hoops to get permission, but then it immediately felt they were favoring this other individual."

Emily points out that the city allows the use of guide dogs for blind individuals - though it appears that no blind folks work in the Department of Code Enforcement.

Christopher Kuczynski, assistant legal counsel for the ADA division of the EEOC, declined to comment on the particulars of this case. But he did say that "what's important when you have two people with disabilities is you don't treat one as inherently more important than the other."

Management Conundrum
So what's a manager to do? Where is the balance between the dog that is needed and the dog that is the problem? Would it be possible to establish a reliable "Paprika free zone" and thus eliminate the need for Penny? (This seems somewhat feasible, although paprika is often a hidden ingredient, as in hotdogs and sausages.) Could Penny perform a spice "sweep" at the beginning of the workday and then go home? (How would workers feel about a dog sniffing their lunches?) Or could they find a hypo-allergenic, paprika sniffing dog (thereby relegating the loyal Penny to the proverbial dustbin of history)?

So many questions, so few answers: this case of dueling disabilities presents an interesting conundrum. By creating a safe workplace for one employee, another employee is put at risk. We note in passing that any allergic reactions - whether involving Emily or the co-worker - would likely be compensable under workers comp. In this particular situation, however, comp appears to be the least of management's worries.

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May 13, 2010

 

The latest edition of the Health Wonk Review is up, hosted by Hank Stern at Insureblog. As usual, there are some fascinating nuggets, including: cancer scare tactics (fear mongering), contaminated meds for kids (fear justified) and the anticipated impact of health reform (a combination of fear mongering and justifiable fears?). Check it out.

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May 12, 2010

 

Massachusetts has the lowest workers comp rates among the major industrial states and just about the lowest rates in the nation. The cost of comp in the other New England states is roughly double that in the Bay state. So you would think that the rates in MA would at best stay the same from year to year, or increase slightly. Well, think again. Martha Coakley (yes, that Martha Coakley), the current and future Attorney General, has brokered a deal for yet another rate reduction: an average of 2.4 percent across all classifications. The insurance industry had argued for an increase of 4.5 percent. I guess they did not exactly convince Martha.

The AG thinks that the insurers are overstating future losses. In my experience with carriers operating in MA, they are actually understating losses, but that's a matter for the actuaries. If, as the AG argues, rates are too high in MA, what can you possibly make of rates in the other New England states and across the country? Are MA employers really that much better at preventing injuries and at getting injured workers back to their jobs? If you buy that argument, I have a nice bridge spanning the Mystic River that you might be interested in owning.

The trends in MA are no different from those across the country: while frequency is down, severity is rising at an alarming rate. In MA, severity is spiraling out of control. The state's generous wage benefit structure, combined with a first rate (and pricy) medical system and a judiciary that tilts strongly toward the injured worker, are making six figure reserves all too common. It's truly puzzling that the AG can look at the performance numbers for the insurance industry and conclude that rates are too high. They are way too low.

Politics: Local and Loco
It's not hard to fathom why an elected official chooses to drive deflated rates even lower. It's politically popular; any rate increase - even the marginal bump proposed by the industry - would be met with howls of outrage from small businesses, who are already under seige in a struggling economy. Strange to say, the depressed cost of comp is subsidizing the otherwise high cost of doing business in MA.

The AG is not finished with her rate scalpel: she thinks a few more points can be carved out next year. It will be fascinating to see how the carriers respond. Not too many folks think there is much money to be made in MA comp. And that rapidly dwindling club is about to get a lot smaller.

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May 11, 2010

 

We've recently been challenging ourselves with OSHA recordable quizzes posted by the smart folks at the Advanced Safety and Health News Blog. We found them interesting enough that over the next few weeks, we will pose the scenarios / questions and you can test your knowledge. Click the headlines to go to the respective blog post and learn the answers.

Recordkeeping Quiz #6: counting days
Scenario: One of your employees injured his foot at work on a Thursday. Your physician said he could not work and scheduled a follow-up appointment on the following Tuesday. The physician would then determine if your employee could return to work or would need to be away longer. The employee was not scheduled to work on Saturday or Sunday, but was scheduled to be at work on Monday.
Question: Since your employee was not scheduled to work on the weekend, do you need to record this time as part of the days away from work?

Recordkeeping Quiz #7: are flu illnesses recordable?
Scenario: Your business is in the middle of flu season and many employees are calling in sick. Two of the employees are claiming that they have been diagnosed by their doctors with the H1N1 flu. They say they contracted the flu at work from a co-worker who was also diagnosed with the H1N1. The two employees want you to record their illnesses because they say they got the flu at work.
Question: Are you required to record these flu related illnesses?

OSHA Recordkeeping Quiz #8: maximum recordable days
Scenario: One of your employees suffered a very serious broken leg due to an accident at work. She had surgery and is in rehabilitation. Her physician cannot give a definite date or even an estimate of when she will be able to return to work. She may be out of work for many months, but is expected to fully recover and be able to work in her job again.
Question: Is there a maximum number of days that should be recorded on the OSHA 300 Log for cases such as this one?

OSHA Recordkeeping Quiz #9: posting the entire 300 Log
Scenario: You are the Safety Manager for your company and are responsible for completing the OSHA 300 Log. It is time for you to have your new Plant Manager sign the "Summary of Work-Related Injuries and Illnesses" Form 300-A so you can post it as required by the standard. You spent quite a bit of time explaining to him how the whole OSHA recordkeeping process works, and he demonstrated quite an interest in what you were doing and the types of injuries your plant was experiencing.
As you are leaving his office, he makes the following statement to you: "When it comes to safety, we have no secrets around here. I think it would be a great idea if you post the entire 300 Log along with the Summary so people see just exactly what type of injuries we are having."
Question: How should you respond to his statement?

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May 10, 2010

 

At its annual conference in Orlando, the National Commission on Compensation Insurance (NCCI) recently presented an overview of the state of workers compensation insurance across the country . Dennis Mealy, NCCI's chief actuary, presented to a standing-room only crowd, which is notable in itself, as the normal crowd for an actuary would fit in the proverbial phone booth.

Anyone with an interest in workers comp should take a peak at Mealy's presentation. As is often the case, viewers will pull out different nuggets, depending upon their points of view. Here's what jumped out at me:

  • From 2008 to 2009 workers comp premiums dropped by 11.8%. No surprise, as premiums are tied to payrolls and the latter have tanked along with the economy. In addition, average premium rates have declined steadily since 2003, as no politician wants to approve a rate hike.
  • Net written premium from 2007 to 2009 is down 23%.
  • The payroll for manufacturing has been on a steady decline over the past two decades.
  • The payrolls for manufacturing and contracting comprise 20% of comp payroll nationwide, but generate 40% of the premium. Again, no surprise, as the manual rates in these areas are higher then the rates in other occupations.
  • Investment gain - the crucial money made off the float of premium dollars - dropped to 7.1% in 2008, after averaging nearly 15% in prior years.
  • The combined ratio for workers comp is running around 110 - in other words, for every dollar insurers collect in premium, they are spending $1.10.
  • Insurers continue to offer premium discounts in order to secure new business or retain existing business (what my colleague Tom Lynch refers to as "eating their young").
  • Frequency of injuries continues to trend downward.
  • The average cost of indemnity per lost-time claim and the average medical cost per claim continue to rise.
There you have it: premium dollars are down, investment returns are down, and losses are up. These days it's not easy making money in workers comp. On the other hand, the economy seems to be recovering; the prospect of virtually universal health coverage could well have a positive impact on comp; and despite all the problems, residual markets remain small.


As is usually the case, insurers are betting that they can beat the odds of a tough market: by writing only the best businesses, by preventing injuries through loss control, by managing claims aggressively and by investing prudently.

There's Always Tomorrow
What you see from the bridge depends upon what you are looking for: where the despairing see reasons for jumping, the optimist simply enjoys the view. The risk transfer business requires optimism (for everyone, that is, except the actuaries). The great insurance wager never really changes: carriers are betting that premium dollars collected will ultimately exceed what they have to pay out in losses. The negative results of the last few years are viewed as an aberation. Just wait 'til Tomorrow:

The sun'll come out
Tomorrow
So ya gotta hang on
'Til tomorrow
Come what may
Tomorrow! Tomorrow!
I love ya Tomorrow!
You're always
A day
A way!

For insurers, that "tomorrow" hopefully includes more favorable rates, improved return on investment, employers truly committed to safer workplaces, employees who really pay attention, and, while we're making a wish list, selfless attorneys. You gotta love tomorrow!


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May 7, 2010

 

We recently blogged the collapse of the self-insurance trust market in New York. When CRM Holdings, a Bermuda based operator of self insurance groups (SIGs), folded like a house of cards, the New York comp board went after the healthy SIGs to cover CRM's liabilities. They hit these innocent folks with a whopping $11 million assessment. As a result, a number of SIGs abandoned the New York market, only to learn two years later that the comp board's assessments were illegal. Oh, well. It seemed like a good idea at the time.

Now we move a few miles to the east and find a similar situation brewing in Connecticut. Municipal Interlocal Risk Management Agency (MIRMA) has been writing comp policies for municipalities since 2002. The great thing about comp is that it's so easy: offer coverage at rates lower than competitors, collect the premiums and pay the claims as they come in. Unfortunately, the premiums MIRMA has been collecting are not covering the claims generated by the insured municipalities. So MIRMA is in the uncomfortable position of trying to collect additional funds from cash-strapped municipalities. For example, North Branford owes $600,000, Westbrook owes $158,000; and Killingworth owes $71,188. In these trying times, that's not exactly chump change.

The legislature passed a bill to give the municipalities more time to come up with the money. The bill would have amended the amount MIRMA was required to keep in its reserves, and thereby allow the towns to pay the amounts they owe, interest free, over four years. Governor Jodi Rell is not buying that approach; she vetoed the bill. The governor issued a statement:

MIRMA has been undercapitalized since its creation. Although it has been given several years to remedy its financial situation, it has failed to do so. Now, providers are not being paid and injured workers are at risk of not being treated. MIRMA can no longer exist in its current state of outright capital inadequacy.

The governor went on to state that MIRMA stopped paying workers' compensation claims simply because it does not have the money to pay, which is "wholly unacceptable." She wrote that MIRMA's deficit has grown by more than 300 percent in the last six years, and is predicted to reach well over $15 million by 2013. That might seem small by CRM standards - their deficit was upwards of $50 million - but then again, Connecticut is a lot smaller than New York.

Untrustworthy Trusts
The governor has ordered a complete review of MIRMA's finances. I could write the report without even looking at the books. In their effort to build market share, MIRMA underpriced their policies. They probably spent a lot on marketing and frills. To balance the books, they under-reserved claims, hoping to cover the cash short-fall by building market share. It worked until it didn't. Now they have run out of money, so they cannot pay the claims. If the auditors have a sense of history, they will conclude that MIRMA operates like a subsidiary of CRM.
NOTE: CRM, still operating in California, appears to be on the ropes.

Connecticut's short term solution - requiring the insured municipalities to come up with the money - is fair, if hardly feasible. At least Connecticut is not going to penalize the municipalities who declined to participate in what appears to be MIRMA's modified Ponzi scheme. That's good. But it remains to be seen how cash-strapped municipalities - already facing substantial budget cuts - are going to come up with these substantial sums of money.

When it comes to self-insurance trusts in the Empire and Nutmeg states, it's time to put away the beer kegs and cancel the golf outing: the party is over.

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May 5, 2010

 

The latest edition of Cavalcade of Risk is up, hosted by Healthcare Economist. The menu is short and sweet, full of tasty morsels. If you have an appetite for risk, you'll want to delve into these items:

  • Did Goldman Sachs do anything wrong?

  • When does a double digit increase in health premiums reach the point of gouging?

  • Does travel insurance cover volcanoes?

  • The answers - or, at a minimum, well-informed opinions, reside here.

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    May 4, 2010

     

    We've recently been challenging ourselves with OSHA recordable quizzes posted by the smart folks at the Advanced Safety and Health News Blog. We found them interesting enough that over the next week or so, we will pose the scenarios / questions and you can test your knowledge. Click the headlines to go to the respective blog post and learn the answers.

    OSHA Recordkeeping Quiz #1: horseplay
    Scenario: Two of your supervisors completed their work for the day and had entered the change trailer to change clothes and proceed home. There was some bantering back and forth concerning how to beat the traffic at shift's end. The discussion escalated into a physical confrontation where one supervisor allegedly pulled a knife and struck the other in the right bicep, causing a laceration that required sutures to close.
    Question: Is the injury the one employee received an OSHA recordable or not?

    OSHA Recordkeeping Quiz #2: go-cart racing
    Scenario: An employee is injured while participating in go-cart racing, which occurred during an off-site company sponsored team-building event. Employees were required to attend the off-site meeting and lunch, but were then free to choose among the following options: (1) participating in the team-building event; (2) returning to the office to finish the work day; or (3) taking a ½-day vacation.
    Questions: Is an injury incurred during the go-cart racing considered to be work-related? Is the answer any different if an employee elects to stay for the go-cart racing but is not required to participate and is injured while watching the racing?

    OSHA Recordkeeping Quiz #3: personal tasks
    Scenario: An employee knits a sweater for her daughter during the lunch break. She lacerates her hand and needed sutures. She is engaged in a personal task.
    Question: Are lunch breaks or other breaks considered "assigned working hours?" Is the case recordable?

    Recordkeeping Quiz #4: injuries in company parking lots
    Scenario 1: Employee A drives to work, parks her car in the company parking lot and is walking across the lot when she is struck by a car driven by employee B, who is commuting to work. Both employees are seriously injured in the accident.
    Scenario 2: Employee C commutes from home to work and parks his personally-owned vehicles in the company controlled parking lot. The employee opened the driver side door and started to exit his car when he caught his right foot on the raised door threshold. The employee subsequently fell onto the parking lot surface and sustained a right knee cap injury that required medical treatment.
    Question: Is either case work-related?

    OSHA Recordkeeping Quiz #5: damage to dentures
    Scenario: One of your employees was hit in the mouth by an object while he was performing his normal work duties. However, his dental bridge was damaged. He has not wanted any medical or dental treatment.
    Question 1: Would damage to a denture in the presence of no other discernible injury be considered a recordable injury requiring entry on the OSHA 300 log even when medical treatment is not administered?
    Question 2: In the context of repair to a denture, what type of activity would be considered medical treatment?
    Question 3: Would simple repair to a denture meet the threshold for the definition of medical treatment?

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    May 3, 2010

     

    Christina Gamble worked at the family friendly Red Robin restaurant in Quakertown PA. She claimed to have fallen and hurt her back. She quit on the spot and went to work for Target, where she worked for two weeks. She filed a workers comp claim for the restaurant injury, which slowly wended its way through the Pennsylvania system until she was awarded benefits nearly a year after the initial injury. Gamble said she was unable to work because standing and changing positions was difficult. She collected over $20,000 in indemnity.

    An anonymous tip sent investigators to C.R. Fanny's Gentleman's Club and Sports Bar in Easton, where Gamble worked out the kinks in her back by removing her clothing and writhing around a pole. C.R. Fanny's (read the name aloud for full effect) is noted for its not-exactly highbrow entertainment such as applesauce and Jello wrestling, along with a "frozen thong contest" that is beyond the descriptive powers of this particular blog.

    Gamble has been indicted for two counts of insurance fraud and theft by deception. She told investigators that she became an exotic dancer because she and her husband were under enormous financial pressures.

    As is so often the case, a number of questions arise:

  • Why was the injury deemed compensable in the first place?

  • With Gamble quitting her job at the restaurant, did anyone at Red Robin or the insurance company pay any attention to this claim?

  • Did Gamble's doctor attempt to test her physical mobility in any way - for example, using the unorthodox "sliding down the back of a chair" test?

  • Lastly, can Gamble find the proverbial Philadelphia lawyer to take her case, arguing, for example, that pole writhing might indeed be appropriate treatment for a gimpy back and that frozen thongs were an ingenious method of applying ice in the general vicinity of the injured body part?
  • Ms. Gamble should have followed immortal Will Rogers's advice on gambling: "Don't gamble; take all your savings and buy some good stock and hold it till it goes up, then sell it. If it don't go up, don't buy it." (I wonder what Will would have thought about AIG...)


    NOTE: Thanks to Pennsylvania reader Rick G. for the heads up on this story.


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