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March 12, 2014

 

Four sessions today, beginning with MIT's Jonathon Gruber in a stemwinder. Gruber, one of the principal architects of the Affordable Care Act (ACA), and, with John McDonough, a prime mover in the Massachusetts health care reform of 2006, must spend 80% of his waking hours debunking rumors, which have become urban myths, which have turned into alleged "facts" regarding all things ACA. Witness for the prosecution - Sarah Palin's Death Panels.

Dr. Gruber pointed out that one of the important differences between the Massachusetts reform, which he convincingly demonstrated was the template for the ACA, and the ACA was that Massachusetts did not have to focus on costs, because Ted Kennedy and Governor Mitt Romney had maneuvered to have the costs covered with an annual infusion of $500 million dollars of federal money. The Massachusetts reform could not have happened without this.

Nonetheless, the goal of Romney's reform was to provide health insurance for all of Massachusetts's citizens. And with more than 97% of the population covered, this has happened.

Gruber went on to say that, despite the rocky beginning, the federal exchanges are now running "as they should." He suggested that a prime goal of the ACA, Medicaid expansion, is falling behind expectations, because many of the governors in the southern states have chosen to not participate. In effect, they have turned down 100% federal funding for three years and 90% funding thereafter. Frankly, I consider this an abomination. Millions of Americans will be harmed because of this politically idealogical decision. Perhaps, this will change in the future. One can hope.

Dr. Gruber reminded attendees that it took about three years to find out if the Massachusetts reform was working the way it was supposed to (It was). He suggested that a similar period would have to pass before we know if the ACA has done what it was engineered to do. Until then, we should be "humble" to recognize what we don't know and "patient," because the ACA is a process, not an event.

The rest of the day was devoted to Dr. Carol Telles reporting on the results of health care reforms in Texas, where costs have declined significantly, and Dr. Rebecca Yang reporting on the effects of the Illinois 30% reduction in the medical fee schedule. It appears that in Illinois costs of professional services (primary care and the like) have declined by 24%, but costs of surgical services have risen significantly to a point where they are now 382% higher than Medicare. It would have been nice to know the impact on total health care costs.

I look forward to a stimulating day tomorrow.

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March 12, 2014

 

I'll be live-Tweeting from the WCRI Conference from Wed through Thurs so follow me at Twitter for updates.

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February 28, 2014

 

The Workers Compensation Research Institute is holding its Annual Issues and Research Conference in Boston at the Park Plaza Hotel on 12 and 13 March. This year, the WCRI dives into the healthcare deep end to try to sort truth from fiction and explain how Obamacare intersects with workers comp. Is it consensual pairing or a train wreck? The long and winding road of Public Law 111-148, the Patient Protection and Affordable Care Act, is littered with the carcasses of the true, the half true and the just plain untrue. People can't even seem to agree on how many pages are in the Act (is it 906 or more like 2,400?), or how many pages are in the regulations that followed it (10,000 or 40,000?)

And we all remember those "death panels," too, don't we?

I doubt that WCRI President Dr. Rick Victor will waste much time on pages or death panels, because there are a lot of substantive issues that need exploring and explaining. This year's conference, to quote the WCRI, "will have a focus on the impact of national healthcare reform on state workers compensation systems."

Go here to see the seven different components and the many questions WCRI speakers and panels will try to address. And go here for hotel registration information. WCRI has negotiated a $159 per night room cost. And speaking as a Boston "Homey," I can tell you that the Park Plaza is a very nice place.

I look forward to high level dialogue and debate. Most of workers comp's smartest and best informed people will be there. Will you be among them?

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February 5, 2014

 

Tom Lynch will be attending the 2014 WCRI Annual Issues & Research Conference on March 12-13, 2014 - will you be there? Let us know. He's looking forward to covering some of the events and sessions on the blog. The theme of the conference is an important one: "Upheaval in the Market for Health Care - Facts and Myths."

Love it or hate it, we're undergoing a seismic shift in the nation's health care system and workers' comp is along for the ride. We hope to learn more about the way that this is likely to impact workers comp. Some of the issues the conference plans to address include:

What might the market for and the delivery of health care look like in the U.S. in five years?

What are Accountable Care Organizations and how are they developing?

How might workers' compensation systems be affected . . .

  • Vulnerability to cost shift toward workers' compensation?
  • Opportunities for cost shifting away from workers' compensation?
  • Impact of increasing size and concentration of health care providers?
  • Impact of federal government regulation of medical prices?How will increased coverage affect access to care for injured workers?
  • What are the major unintended consequences to watch out for?
  • In which states are the effects likely to be largest?

Of course, there will be a host of noteworthy speakers presenting research and presentations on other topics as well - you can learn more about the event here.

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February 7, 2013

 

The Insider is very much looking forward to the Workers Compensation Research Institute (WCRI) annual conference, taking place on February 27-28 in the virtual epicenter of wonkiness, Cambridge MA. There is always much food for thought in these annual gatherings of insurance execs, state officials, policy makers, attorneys, medical specialists, employers and safety/loss control practitioners.

This year's agenda has zeroed in on the fundamental medicine-related conundrums facing workers comp systems across the country. All of us in workers comp long for insights into the following:
- Unnecessary medical care and its impact on treatment guidelines. (Back surgery, anyone?)
- Medical price regulation: what are the essential elements of an effective fee schedule? (Beware of the state where the doctors love comp...did someone mention "Connecticut"?)
- The Opioid epidemic: treatment protocols involving the generous and prolonged distribution of opioids are destroying lives across the country. Why are so many doctors so clueless about the proper use of pain killers? Whatever happened to "do no harm"?

WCRI's head honcho, Dr. Richard Victor, will host a discussion on health care policy involving (the presumably liberal) Howard Dean and (the assuredly conservative) Greg Judd. The dialogue might not equal the fireworks of July 4th on the Esplanade, but it might come close. The Insider will be listening closely for any indications of that rarest of phenomena: a common ground.

From Gorilla to ?
Last year, Dr. Victor concluded the conference with a discussion of the "gorilla in the room": the enormous and perhaps insoluble problem of structural unemployment among the 20 million people who lost jobs in the recent recession. For many of these people, especially those in their 50s and 60s, there is little prospect of returning to jobs with anywhere near the same rate of pay as before. Many will find themselves lost in the new economy, cobbling together part-time employment without benefits, while struggling to hold onto housing where mortgages exceed the value of the home. Tough times and, so far, not much in the way of effective solutions.

This year Dr. Victor will have to find some other animal analogy to glean lessons from history: Giraffe in the closet? Rhino in the den? He tells us that the lesson might have something to do with the first century Ephesians, toward whom St. Paul addressed some rather famous snail mail. While some might find such a teaser a bit obscure and full of religious overtones, the Insider looks forward to the story. Indeed, we look forward to this year's entire conference with great anticipation. There are few things better for policy wonks - our people! - than listening to the latest research from WCRI. Diligent note-taking will be in order.

If you count yourself among those with wonkish tendencies and you haven't signed up yet, you'd best jump on it immediately. If you have any questions about the conference, contact Andrew Kenneally at WCRI: 617-661-9274.

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October 23, 2012

 

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We were delighted to learn that we were named as an honoree in the 2012 LexisNexis Top 25 Blogs for Workers' Compensation and Workplace Issues, That's terrific and we appreciate the recognition! In their gracious acknowledgement, they note that Workers' Comp Insider is in its 10th year, and my goodness, that's true - how time flies!

The insurance blog scene was a barren landscape when we launched, a lonely place indeed! Plus, it was months and months before we were able to scare up much of a readership beyond our family members, closest colleagues and a handful of clients. The general reaction was "What the heck is a blog?" or "Who would want to read a diary about workers comp?" But eventually, someone found us - over the last 2,000 days, we've had more than 1.2 million visitors representing 209 countries from Afghanistan to Zimbabwe! Who'da thunk workers comp would have that much appeal?

One of the things that we find particularly gratifying is to see such a robust list of honorees on the LexisNexis list - we are happy to think we had a hand in inspiring that. Congratulations to the other 24 blogs that have also been named. As regular readers know, we're big fans of Joe Paduda and Roberto Ceniceros, who we cite frequently. There are many other blogs on the list that are among our favorites - you will see them in our blogroll in the right-hand sidebar. We're also delighted to find many new-to-us blogs listed that will be fun to explore. We encourage you to visit them all.

We should all feel good that workers comp has such a thriving blog scene -- and we'd be remiss not to point out the important role that the LexisNexis awards have played in fostering and promoting this. If the LexisNexis Workers Compensation Law center isn't in your "favorites" list, it needs to be! A tip of the hat to Robin E. Kobayashi and Ted Zwayer.

And last but not least, a tip of the hat, to you, our readers. You are our raison d'etre and our driving force. Whether you're praising us or panning us, we appreciate it all. Thanks for stopping by, thanks for coming back - group hugs all around! !

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September 4, 2012

 

As a belated tribute to Labor Day, we offer a smorgasbord of items about work, worker safety, and some of our favorite tributes to workers.

Celebrating the American Worker
America at Work - Alan Taylor compiles superlative photo essays for The Atlantic's In Focus series. This collection of images from the recent Recession and its years of uncertainty -- of men and women both at work and out of work in the United States.

Earl Dotter, Photojournalist - A remarkable portfolio of work documenting American workers. In the author's words:
"For more than thirty five years the camera had enabled me to do meaningful work. Starting with Appalachian coal miners, and continuing through the years over a broad array of occupations in all regions of the country, I have observed and documented the working lives of Americans. Standing behind the lens, I have celebrated their accomplishments. I seek out those who are taking steps to improve their lives and their effectiveness at work, and use the camera to engage them by giving testimony to their achievements. The images that result tell of the satisfactions their work brings as well as its everyday challenges."

Lost Labor - For more than 20 years, visual artist Raymon Elozua has been assembling a vast collection of company histories, pamphlets, and technical brochures that document America's industrial history. This site features 155 photos from that collection - images of factories, machinery, and laborers hard at work. Many of the jobs depicted have faded into history. The artist grew up in the South Side of Chicago in the shadow of the giant steel mills and factories. His dad worked at U.S. Steel and his first job was at U.S. Steel, triggering a life long interest in everything about these industrial behemoths, from the architecture to the people who worked the jobs within. His interest in documenting this bygone era of American working life was sparked by the demise of the South Works industries.

Worker Safety
Hard Labor - The Center for Public Integrity says: "Each year, some 4,500 American workers die on the job and 50,000 perish from occupational diseases. Millions more are hurt and sickened at workplaces, and many others are cheated of wages and abused. In the coming months the Center for Public Integrity will publish, under the banner Hard Labor, stories exploring threats to workers -- and the corporate and regulatory factors that endanger them."

In particular, we point you to two recent stories:
Fishing deaths mount, but government slow to cast safety net for deadliest industry

Kentucky death case: Another black eye for state workplace safety enforcement

The Best Reporting on Worker Safety - ProPublica compiled "12 pieces of great reporting on workplace safety: from slaughterhouse diseases to lax regulatory oversight and deadly vats of chocolate."

Workers in Popular Culture

From our archives

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November 21, 2011

 

I spent two very productive days last week at the Workers Comp Research Institute (WCRI) conference in Boston. WCRI plays a unique role in the comp system. Their annual conference, devoid of the usual hucksterism, focuses on the fundamental paradigms of insurance and poses the toughest questions. Some of the answers provided by conference speakers (most of whom are not from WCRI) are both radical and surprising. I find myself relentlessly jotting down notes from topic to topic.

Here are ten paradigm-shifting propositions that I have extracted from my time at the conference. A number of these propositions address the issue of opiate use, perhaps, along with back surgery, the most important cost drivers in the treatment of workplace injuries.
[VERY IMPORTANT DISCLAIMER: These are my interpretations and should not be attributed in any way to WCRI]:

1. Pain is hard to objectify, expensive to treat, and absolutely the wrong focus for treating workplace injuries. Treatment should focus instead on behavioural approaches to pain and the relentless encouraging of maximum feasible physical activity.

2. The comp system, a wonderful success story celebrating its 100th anniversary, is poorly designed to confront the problems in today's fractured and highly unstable economy.

3. Monopolistic systems for comp (only 4 remain) have unique leverage to solve intractible problems such the cost of drugs in the comp system. Washington state has solved the pharma problem through the aggressive use of generic drugs, the limiting of opiate prescriptions and the imposition of a favorable fee schedule. Alas, these solutions are unlikely to work in states with competitive systems.

4. Most prescriptions for opiates in the comp system are unnecessary, ill-advised and poorly managed. [See below.]

5. Virtually all injured workers prescribed opiates should be evaluated for dependency issues prior to beginning an opiate regimen, drug tested prior to receiving opiates and throughout the course of treatment. Without these pre-conditions, opiate use is full of uncertainty and fraught with danger. (Dr. Janet Pearl has a compelling and well-structured approach to the use of opioids in treatment.)

6. Opiates should come with a written contract and a User's Manual. Workers should be tested on their knowledge of the benefits and the risks.

7. Most doctors who prescribe opiates have no idea what they are doing, no idea how to manage opiate-based treatment and no clue about the potential for harm. Medical schools simply do not address these issues.

8. Back pain is virtually universal, the inevitable result of aging, and generally is unrelated to workplace trauma. (You might want to read that again for full effect.) To be sure, this is a controversial assertion and involves a complete paradigm shift. Nonetheless, the idea is well worth scrutiny by all parties involved: doctors, payers, injured workers and their families. Conference speaker Dr. James Rainville asserts, among other things, that exercise is the best treatment for back pain.

9. Medical fee schedules lower costs, except when they don't (e.g.Connecticut, where the schedule appears to be set too high).

10. There is an enormous disconnect between the workers losing their jobs in this recession and the severely limited number of jobs projected for creation over the coming decade. This bodes poorly for the 25 million injured or unemployed workers with obsolete skills who are struggling to return to productive employment.

I recognize that these ideas require much more in the way of detail and documentation. I offer them as a Monday morning stimulant. Consider this posting as a micro-conference on some of the major issues facing the time-worn workers compensation system. I hope it's a list worth a few moments of your time, as you sip your coffee and prepare for the holiday-shortened week ahead.

Special thanks to Andrew Kenneally, WCRI's able communications director, for recognizing that bloggers have a role to play in disseminating information about workers comp research and who invited me to attend the conference. I would also acknowledge Dr. Richard Victor, whose penetrating insights animate the entire WCRI world and whose conference-concluding talk ("The Elephant in the Room") made it well worth the time to stay to the end (see # 10 above).

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November 16, 2011

 

Insurance Writer Nancy Germond hosts this week's edition of Cavalcade of Risk and she has a seasonal theme: The Turkey Edition. Check it out.

Reminder - Tomorrow is Great American Smokeout day. More than 46 million Americans still smoke and if some of them are your employees, it is likely that smoking is taking a financial toll on your organization. It's not too late to remind your employees: here are some printable tools, or you can just email a reminder about 1-800-QUIT-NOW, a free smoker's quit line.

Wellness - Speaking of smoking or any other so-called lifestyle issue that is related to employee health, Roberto Ceniceros recently tackled the topic of wellness programs being adapted for workers comp in an article in Business Insurance, as well as at his blog. He notes a trend toward integrating wellness benefits into workers comp programs, which "...requires employers to transcend traditional corporate silos that typically separate risk management and workers compensation departments from those administering health benefits and nonoccupational disability plans."

Sandy Blunt update - Joe Paduda recently featured a post on progress in clearing Sandy Blunt's name. North Dakota Supreme Court's disciplinary board has recommended that Cynthia M. Feland, the prosecutor in the Blunt case and now a judge, should have her attorney's license suspended for 60-days and be required to pay court costs related to her failure to "... disclose to Michael Hoffman, defense attorney for Charles Blunt, the Wahl memo, and other documents which were evidence or information known to the prosecutor that tended to negate the guilt of the accused..." Next step, new trial? (For more background, see A Good Man Wronged). We had a chance to catch up with Sandy at the Las Vegas Work Comp Expo at the Medata reception. Sandy is serving as Vice President of Insurance Services with Cy King and crew. (Side note: if you are ever invited to a Medata reception, say yes. Three words: "nice people" and "yum.")

Other notes from last week's Las Vegas Workers' Comp Expo - Kudos to Peter Rousmaniere, who collaborated with Sedgwick to produce a great video on the history of workers comp - we'll bring it to you as soon as it's available online.

Our fellow blogger Joe Paduda kicked off the show with an informative opening general session, part of which was a Point/Counterpoint style sparring between Joe and David North of Sedgwick and Davidson Pattiz of Zenith about pricing and billing transparency. You can see Joe's reports from Vegas here and here.

Evan Falchuk was part of a panel on expert physicians. Falchuk is President and Chief Strategy Officer of Best Doctors, an organization that has been making quite a splash on the healthcare side. (Check out Falchuk's blog, See First). While not as widely known as their general healthcare services, Best Doctors also offers services in the workers comp arena, which include help for legacy claims, complex care claims, and cases involving chronic pain, among other services.

Chris Brigham of Impairment Resources made an impassioned presentation on how we can and should be making a commitment to prevent the needless disabling of injured workers. He and his team were also exhibiting, side by side with their partner firm and our neighbor, Insurance Recovery Group, who were touting their subrogation services.

Other sightings: Colleague Jim Paugh was representing his new predictive analytics endeavor, WorkersComp Analytics; Mark Walls was the man of the hour, moderating sessions and hosting a reception for members of his popular linkedIn Work Comp Analysis Group; We also spotted Bob Wilson, another online pioneer, and were fortunate to spend time with Helen Knight of King Knight Communications, arguably the best PR person in workers comp; and a shoutout to Frank Pennachio (erstwhile guest poster) and Susan Toussaint of Work Comp Advisory Group, who we finally met in person. Finally, congrats to Nancy Grover, program chair, along with all the advisors and staff of LRP and Risk & Insurance for putting on a good conference.

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November 3, 2011

 

We all know that people who smoke and/or are obese tend to have more medical problems, of greater duration, compared to people with healthier lifestyles. The higher medical costs associated with smoking and obesity translate into higher cost for insurance. As a result, it is no surprise that there is a strong trend among employers to charge more for the insurance premiums of workers who smoke or who are obese.

The Insurance Journal writes that the use of premium penalties is expected to climb in 2012 to almost 40 percent of large and mid-sized companies, up from 19 percent this year and only 8 percent in 2009. An Aon Hewitt survey released in June found that almost half of employers expect by 2016 to have programs that penalize workers "for not achieving specific health outcomes" such as lowering their weight, up from 10 percent in 2011. The premium surcharges usually come hand-in-hand with incentives to quit smoking and lose weight. Unfortunately, the carrot of incentives, by themselves, have not succeeded in lowering health costs. Hence the big stick.

Taxing the Poor?
As is often the case, lower paid workers bear the brunt of the higher costs. Obesity and smoking often - but not always - accompany lower income lifestyles. Low income workers already pay a larger proportion of their income for health insurance; now they will pay more for the consequences of their smoking (a formidably taxed bad habit) and obesity (the result of poor dietary habits). The working poor often live in neighborhoods with limited fresh foods and nothing much in the way of health clubs - which they can't afford anyway.

There is evidence that the carrot and stick approach actually works. We have written about the Cleveland Clinic, which refuses to hire smokers or obese individuals and which fosters healthy lifestyles among its 40,000 employees. The clinic has seen medical costs grow by only 2 percent this year, far below the national average of 5 to 8 percent.

The Big "But..."
The move to force people into healthy lifestyles does raise a few interesting issues.
1. In cases where obesity or other unhealthy conditions are beyond the control of the individual (genetics, specific diseases, etc.), the higher premiums might be considered discriminatory, although there has been little such litigation to date.
2. Healthy lifestyles (including regular exercise) may well result in higher medical costs for maintaining well-tuned bodies: the ever-growing incidence of knee, hip and shoulder replacements among active people.
2. The goal is to reduce medical expenses, but the leverage exists only with the principal policy holder: there is no way to force other family members to abide by the lifestyle guidelines.
3. The imposition of wellness standards can lead to legitimate privacy issues: for example, holding employees accountable for behavior away from the job (smoking, drinking, eating).

If all goes as planned, medical costs will indeed come down and people will live longer and longer lives. As people with healthy lifestyles live longer, we will have succeeded in transferring costs from private insurers (who cover working people and their families) to social security (which covers retirees). That will require a hike in social security taxes, which the working poor, among others, can ill afford. It seems that every solution carries the seeds of new problems, just as every problem gives rise to new solutions. It is a privilege, of course, just to watch the entire process as it unfolds before us.

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October 17, 2011

 

For over a decade, workers comp insurers have watched profit margins erode, as rates in many states continue their precipitous fall. The mismatch between premiums collected and losses paid out has reached alarming levels, with a projected combined ratio of 121.5 percent for the current year. Even in the best of times for investments, making up 21 percent against losses would be daunting, and these are hardly the best times for money to make money.

The ever-reliable Roberto Ceniceros writes in Business Insurance that the long-awaited upward trend in rates for comp insurance appears to be underway. Among the 38 states directly administered by NCCI, there are requests for modest rate increases in 19; given that the insurance cycle runs from July to June, we can expect to see more states with rate increase requests over the next 9 months. The increases are by no means dramatic (and, some would argue, hardly adequate when measured against insurer losses). The rate increases proposed by NCCI all fall within single digits.

There are a number of reasons for higher insurance losses:
- payrolls are down due to the recession, resulting in lower premiums
- frequency is up - an ominous sign, given that frequency had been declining year after year
- severity continues to increase, as injured workers stay out of work longer and access more exotic treatments
- returning injured employees to their jobs is increasingly difficult in an economy where jobs are disappearing

Insurers Behaving Badly
When contemplating the problems of insurance companies, we must never lose sight of the tendency, as my colleague Tom Lynch puts it, of "insurers eating their young" - in other words, despite the losses, insurance companies persist in offering steep premium discounts, leading state regulators to conclude that they don't really need rate reductions. Insurers continue to hope that their underwriters have a magic touch in finding the good risks and avoiding the bad. With margins as tight as they are, finding a profitable book of business becomes increasingly unlikely, no matter how skilled the underwriting.

A.M. Best projects the short term prospects for comp carriers to be "grim." That is no overstatement. State regulators tend to be slow to respond to requests for higher comp rates. Employers are already struggling in a bad economy and regulators will do everything possible to keep comp costs as low as possible. While the long-term trend of lower rates may finally be nearing an end, the upturn is likely to fall short of what is needed. These are tough times for comp carriers, with no significant relief in sight.

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September 26, 2011

 

It's been over 20 years since NCCI changed the rules relating to the calculation of the experience modification factor. Given that experience modification determines the cost of insurance for all but self-insured employers, these changes require careful scrutiny. While some of the details have not yet been announced, one thing is clear: employers with higher-than-expected losses are likely to pay more for insurance. [NOTE: the Insider apologizes in advance for what is inevitably a rather technical discussion. For readers who would like additional background, check out our 2004 primer here.]

Under the current system, claim dollars - what's been paid and what's been set aside for future payment on each claim - fall into one of three categories:
- Primary losses: the first $5,000 of each claim. These losses carry the most weight and drive up the experience mod much quicker than the losses above $5,000.
- Excess losses: the losses above $5,000 within each claim. These are discounted in the calculation, with as little as 10 percent of the total included in the calculation (depending upon the size of the premium)
- State Rating Point: the cap on individual claim dollars beyond which the losses are excluded from the calculation; this varies from state to state, generally falling between $125,000 and $200,000.

NCCI is expanding primary losses from the current level of $5,000 up to 15,000. This change will take place over a three year period, with the ceiling rising to $10,000 in the first year, $13,500 in the second year and $15,000 in the third year.

Why does this matter? Primary losses are the major cost driver in experience rating. Primary losses are not discounted: they go into the formula dollar for dollar. As a result, employers with moderately large claims (between $5,000 and $25,000) are likely to see an increase in their experience mod.

Expected Losses
Employers who have analyzed their premiums carefully understand that experience rating is essentially a comparison: the individual employer's losses are compared to the losses for other employers performing similar work. The actual comparison is contained in the rates paid for insurance.

For example, in your state the rate for carpenters might be $10.00 per $100.00 of payroll. The total expected losses within this rate might be $5.00 per $100 of payroll. The expected primary losses (called the D Ratio) might be 20 percent of total losses: in this case, $1.00 per $100 of payroll.

As NCCI increases the ceiling for primary losses from $5,000 to $15,000, they must also increase expected primary losses. Unfortunately, they have thus far provided no information on how much expected primary losses (the D ratio) will increase. This number will determine just how much more employers with higher-than-expected losses will pay for insurance. Conversely, the revised D ratio will also determine how much of a discount will be given to employers with lower-than-expected losses. As with our changing climate, the fluctuations under the new system will be greater than in the past.

Given the trend toward very large (catastrophic) claims, it would not be surprising to see the state rating points also increase: for example, instead of capping individual claims at $200,000, the limit might be closer to $300,000. (To date, NCCI has been silent on this matter.)

Winners and Losers
NCCI actuaries are working under the requirement that total premiums within a state remain the same under the new system. In other words, when they apply the new rules, experience mods will go up or down for individual employers, but the total premium in the state will stay the same.

On an individual insured level, there will be winners and losers. Here is our advice to any employers with debit mods (above 1.0) in states managed by NCCI: follow these new NCCI developments carefully. [The easiest way to do this, of course, is to keep reading the Insider.] Primary losses remain the biggest cost driver in the workers comp system and primary losses within individual claims are about to double and soon triple. The strategies for experience mod management that were effective with the primary loss ceiling at $5,000 may no longer apply. As the rules of the game change, savvy managers will change with them.

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September 16, 2011

 

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Reminder: September 22

If you haven't signed up yet, head on over to Business Insurance and register for Virtual Advantage 2011 - Workers Comp Trends & Cost Control Strategies. We're very pleased that our own Tom Lynch will be participating on a blogger panel with three other blog luminaries: Roberto Ceniceros, Joe Paduda, and Mark Walls. There will also be a keynote by NCCI's Harry Shuford, an expert panel on pharmaceutical cost controls for worker's comp - and more. It's a one-day virtual conference - and best of all - there is no charge to attend.
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August 23, 2011

 

In this summer of weather extremes, workers comp is celebrating its 100th birthday in America. The weather forecast - along with the prognosis for workers comp - probably sound familiar: periodic storms, heavy rain, damaging winds. The National Council on Compensation Insurance (NCCI) has issued its "state of the line" report for workers comp: 2010 was a tough year and the outlook for 2011 carries a severe weather warning.

The key indicator for insurance health is the combined ratio: add up the accumulated losses and the expenses, subtract investment income and hope you end up somewhere around 1.0. The combined ratio for 2010 went up to 1.15, five points above the previous year. Despite improved returns on investment (otherwise known as the "jobless" recovery), pretax losses for the industry averaged one percent - the first such loss since 2001.

Insurers are suffering from a convergence of negative factors: poor underwriting results, a drop in premiums (due to reduced payrolls), and an increase in claims frequency, which is perhaps the most alarming trend of all. For a number of years the increase in severity (the average size of claims) has been balanced by a decrease in frequency. If frequency continues to trend upward, the warning flags for severe trouble will be flapping in a very stiff breeze.

Politics as Usual
Further complicating matters for insurers, state level politicians are single minded in their effort to keep the costs of comp insurance as low as possible. As part of their relentless struggle to stay competitive, state regulators are reluctant to increase rates. NCCI has applied for rate increases in 14 of the states which they directly manage, up from eight in the previous cycle. Any move toward higher rates may signal at least the beginning of the long-awaited end of the soft market that has endured for over a decade.

Finally, there has been a lot of turnover among the state officials who regulate workers comp: there are 24 new insurance commissioners across the country. As NCCI puts it:

The number of newly elected and appointed officials means that the industry will face a challenge in terms of education and information for next few months at least.

Time to polish up the Gucci's? The insurance industry hardly needs to crank up the lobbying apparatus - it's always operating full tilt.

Candles in the Wind
As workers comp turns 100, we note that longevity itself is not cause for celebration. Just as it's no fun to grow old, it's not much fun trying to make money in workers comp these days. Despite a decade of tightened eligibility requirements and cuts (some draconian) in benefits, we have seen a continued deterioration in the financial health of comp carriers. Perhaps it's my imagination, but I seem to detect a tone of anxiety as stakeholders gather to sing "Happy Birthday" to Workers Comp in America. The flames of the candles falter in the midst of a raging storm.

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May 23, 2011

 

With yesterday's catastrophic tornadoes in Joplin, Missouri, the most recent in a long line of 2011 disasters, the cost of re-insurance is going up. Prior to yesterday, the reinsurance bill for 2011 stood in the vicinity of $50 billion, leaving virtually no room for additional losses through the end of the year. Alas, we now have Missouri, and the year is not even half over, with hurricane season yet to begin.

Risk & Insurance magazine highlights the problems facing reinsurers:

Yvette Essen, an analyst for A.M. Best, said that the catastrophic first quarter means that many reinsurers will struggle to record any full-year underwriting profit for 2011.

"The industry faces further challenges in achieving profitability as the hurricane season approaches and investment yields remain low," she commented.

"While reinsurers continue to maintain sound capital positions, the excess capacity that existed at the prior year-end has clearly been diminished," he said.

Richard Ward, CEO Of Lloyd's of London, warns that the relatively inexpensive cost of insurance is really an illusion: "Prices are dangerously low at present," he told an industry conference. "Clients may think they are getting a bargain. But the fact is that they are buying security. The insurers who write unprofitable business are inevitably the first to collapse when disaster strikes."

Beyond Risk Transfer
It appears we are entering a period of steadily increasing instability in nature. Ferocious storms and floods in the US, the Japan earthquake and tsunami, the volcano in Iceland, the fires in Australia - all flitter across our computer screens and raise the specter of inconceivable loss. Insurance - where it's available - merely provides capital for rebuilding. Much of what is lost cannot be insured and even where there is insurance, what is lost on a personal, family-to-family level cannot be replaced. Yet we see selfless efforts to help survivors, most of whom will demonstrate a remarkable ability to endure. So much of what is precious to these people has been lost, but they will move on. That's human nature at its best.

Meanwhile, the reinsurance market, long in the soft-market doldrums, will finally begin to harden. We will all pay a little more for insurance - and we will complain about it. That, too, is human nature, not at its best, perhaps, but a reflection of these tumultuous times.

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May 19, 2011

 

Last year 29 coal miners died in an explosion at Massey Energy's Upper Big Branch Mine in West Virginia. Don Blankenship, Massey CEO, blamed the explosion on federal interference and a gigantic methane bubble that percolated up from below the mine shafts. The bubble has burst, but not in the way Blankenship would have you believe.

An independent team appointed by the former West Virginia governor, Joe Manchin, and led by the former federal mine safety chief Davitt McAteer, has issued its findings, which are both unambiguous and scathing. There was no methane bubble. There was, instead, a pattern of negligence by management that led directly to the deaths of the miners.

As summarized in the New York Times, the report is a searing indictment of Massey's management style:

"The story of Upper Big Branch is a cautionary tale of hubris," the report concluded. "A company that was a towering presence in the Appalachian coalfields operated its mines in a profoundly reckless manner, and 29 coal miners paid with their lives for the corporate risk-taking."
The report goes on to say that a "perfect storm" was brewing inside the mine, combining poor ventilation, equipment whose safety mechanisms were not functioning and coal dust, which, contrary to industry rules, had been allowed to accumulate, "behaving like a line of gunpowder carrying the blast forward in multiple directions."

Given the uncompromising language of the report, Massey management may not enjoy the "exclusive remedy" protections of the workers comp statute. They are now vulnerable to charges of criminal negligence. I suspect that attorneys for the widows and children of the miners will look rather closely at the assets of Massey's (now former) CEO.

Farewell, My Ugly
Don Blankenship resigned from his CEO post in December of last year. Don't bother putting up a collection to buy this ethically-challenged titan of business a gold watch. In 2009 he earned $17.8 million, which does not include deferred compensation of an additional $27.2 million. There is no question that Blankenship's leadership created profits for the company. Unfortunately, these profits came at the expense of the environment and of the men who extracted the coal from the West Virginia mountains.

The anecdote that tells you a lot about Blankenship involves his personal water supply. When Massey Energy activity poisoned the water reaching his own home, Blankenship ran a private pipeline to the next town, where clean water was readily available. His neighbors, lacking Blankenship's resources, have to make do with the local, polluted water.

It will be interesting to see what happens next. In a just world, Blankenship would be held accountable for his actions as Massey's CEO. But we do not live in a world where justice prevails very often. Blankenship will likely continue to enjoy his retirement years, drinking clean mountain waters, railing about government interference, buying a few politicians and generally living the good life. We can only hope that each and every night his dreams are haunted by visions of the 29 miners and their struggling families. That would be one form of justice indeed.

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May 9, 2011

 

NCCI has released two reports that are essential reading for risk managers and anyone else who enjoys the Big - albeit somewhat gloomy - Picture.

The first report is a summary of workers comp performance through 2010: while many indicators are positive or at least neutral, the major concern is overall performance. The combined ratio for insurers (losses plus expense) is creeping steadily upward: 101 percent in 2008, 110 percent in 2009, 115 percent in 2010. In other words, in 2010 carriers spent 15 percent more than they earned through premiums. Even with improved returns on investments, insurers are caught in the zone where many are losing money, especially those whose combined ratios have drifted above the average.

The troubled economy has complicated matters: as payrolls go down, premiums go down with them. Comp premium peaked in 2005 at $47.8B; in 2010, premium totaled $33.8B. To be sure, fewer people are working, but that often results in increased stresses - and risks - for those who still have jobs.

Finally, there is the highly politicized issue of rates for comp insurance. No state wants to be the first raise the rates, as this increases the cost of doing business and makes the state less competitive in attracting new business. So states hold the line or even force reductions, making all businesses - except insurance related - happy.

The Really Big Picture
For those of you who seek perspectives beyond comp, into the broadest possible, world-wide view of risk transfer, Robert Hartwig of the Insurance Information Institute offers slides that are compelling viewing. He examines the dual specters of terrorism and natural catastrophe. Bin Laden's unlamented death may increase the risk of attack in the coming months, resulting in open-ended exposures for workers comp and property insurance. As for natural disasters, with the spate of earthquakes, tsunamis, and tornadoes, any actuary who is paying attention is having trouble sleeping these days.

Japan's earthquake, tsunami and nuclear plant meltdown appears to be the most expensive natural disaster in history. The total losses are expected to run between $100-300B, of which only a relatively small portion ($45B) is insured. (Government will bear the brunt.)

Tornadoes tearing through mid-America thus far have avoided major population areas, but the recent event at the St. Louis airport raises the specter of urban disaster.

Who Pays?
When calamity strikes, the impact is greatest on reinsurance, which kicks in when limits are reached in-front line policies. With the unprecedented scale of recent events, the cost of reinsurance must go up, and as it does, the cost of insurance for the consumer (business and personal) goes up with it. We live in risky times and the increasing costs of risk transfer reflect our darkening world.

One final note: Hartwig reveals that the 9/11 attacks added 1.9 percent to the combined ratio for 2001, which totaled a robust 121.7 percent. That's a sobering thought for this beautiful spring morning. My advice? Slap on some sunscreen and get out for a stroll. There's no better cure for gloomy data than a walk in the sunshine.

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May 3, 2011

 

In honor of NAOSH week, we thought it might be nice to feature a sampling of safety tips from the next crop of safety engineers. It's nice to see these kids are learning such important lessons early. Good job, kids!

Camille-D-Soto.jpg

Camille D. Soto, 6, FL: Make sure you wear safety glasses...

Tamaya-Olivia-Bush.jpg

Tamaya Olivia Bush, 8, SC; Come Join the Crew

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Da'moreon Travis, 10, KY, Make Safety First or You Won't Last

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Sai Pravallika Velicheti, 12, Kuwait; Confined Spaces Can Kill

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Robin Newman, 14, AL; Don't be the sender to cause a fender bender

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April 28, 2011

 

Today is the annual day devoted to memorializing all those who died at work and honoring their memory by committing to work for safer conditions for the living. April 28 was chosen because it is the anniversary of the Occupational Safety and Health Administration and the day of a similar remembrance in Canada.

Each year, to coincide with this day, the AFL-CIO issues
Death on the Job - The Toll of Neglect (PDF) - A National and State-By-State Profile of Worker Safety And Health In the United States. This is the 20th Edition. It offers a detailed breakdown - here is a brief into:

In 2009 (the latest figures available), 4,340 workers were killed on the job--an average of 12 workers a day--and an estimated 50,000 died of occupational diseases. More than 4.1 million workplace injuries and illnesses were reported in private and state and local workplaces. But the report says the 4.1 million "understates the problem," and the actual number is more likely 8 million to 12 million.

The safety report estimates that since the OSH Act become law 40 years ago tomorrow, it has saved an estimated 431,000 lives. The nation's two mining laws, the 42-year-old Coal Mine Health and Safety Act and the 34-year-old Mine Safety and Health Act, have saved thousands more.

Last year's string of major workplace tragedies, however, shows the desperate need for stronger safety and health rules coupled with tougher enforcement. Those disasters included the Upper Big Branch (W.Va.) coal mine explosion that killed 29 miners, an explosion at the Kleen Energy plant in Middletown, Conn., that killed six workers, another at the Tesoro Refinery in Washington State that killed seven workers and the BP/Deepwater Horizon Gulf Coast oil rig explosion that killed 11 and caused a massive environmental and economic disaster. Says the report:

The nation must renew the commitment to protect workers from injury, disease and death and make this a high priority. Employers must meet their responsibilities to protect workers and be held accountable if they put workers in danger. Only then can the promise of safe jobs for all of America's workers be fulfilled.

The number of workers killed on the job fell in 2009 and the rate of on-the-job deaths dropped, 3.3 per 100,000 workers, down from 3.7 per 100,000 workers in 2008. But the U.S. Bureau of Labor Statistics says the economy was a major factor as the recession resulted in declines in hours worked, particularly in construction and other industries that historically have experienced large numbers of fatalities.

A state-by-state breakdown of job deaths and injuries in "Death on the Job" finds that Montana led the country with the highest rate of worker fatalities in 2009, with Louisiana, North Dakota, Wyoming and Nebraska following close behind. The report also finds that Latino workers continue to be at increased risk of dying on the job, with a fatality rate of 3.7 per 100,000 workers in fiscal year (FY) 2009.
(More at AFL-CIO)

For more on Worker Memorial day events:
AFL-CIO - about and 2011 events & resources
Weekly Toll
Statement By John Howard, M.D., Director, National Institute For Occupational Safety And Health (NIOSH)
Workers' Memorial Day * 28 April on Facebook

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April 26, 2011

 

Kudos to the American Society of Safety Engineers (ASSE), whose 32,000 members will be celebrating the organization's 100 year mark during the annual North American Occupational Health & safety Week (or NAOSH week, for short), which runs from May 1 to May 7. Annually, ASSE teams up with the Canadian Society of Safety Engineering (CSSE) in the first week of May to raise public awareness about safety.

Here's a few of the resources that are available

NAOSH Week Toolkit
Safety Through the Decades chart
May 4 - Occupational Health and Safety Professional Day

ASSE's 100th Anniversary

ASSE's 100th Anniversary from jon schwerman on Vimeo.


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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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January 29, 2008

 

New Hampshire has come up with their own 12 step program to determine whether contractors are truly independent or just employees. Meanwhile, the IRS has come down hard on FedEx, hitting the company with a $319 million fine for misclassifying drivers as independent contractors.

Let's start in New Hampshire. The state has come up with 12 criteria for determining independence, all of which must be met or the system defaults toward an employer-employee relationship. The criteria include the usual focus on control of the work, but there are a few new wrinkles:

A. The person possesses or has applied for a federal employer identification number of social security number or in the alternative, has agreed in writing to carry out the responsibilities imposed on employers under this chapter.

[This appears to imply that undocumented workers - who cannot have federal id numbers or social security numbers - are automatically employees.]
...
F. The person has continuing or recurring business liabilities or obligations.
G. The success or failure of the person's business depends on the relationship of business receipts to expenditures.

Like Massachusetts, New Hampshire is looking for objective evidence that the independent contractor runs a legitimate business. Both states accept the presence of employees with the IC as compelling evidence - but that will not help the typical sole proprietor without employees. Whereas Massachusetts has stipulated that a subcontractor in the same trade as the contractor is by definition an employee, New Hampshire does not focus at all on the sub's specific trade.

Having issued all this clarification, the states now sit back and let someone else figure out the details. That someone else, alas, is the poor insurance auditor, who has been given the unenviable task of determining the status of each and every subcontractor. You don't suppose that this detective work is contemplated in the current fee structure, do you?

In MA, auditors have some latitude. If the independent contractor/sole proprietor does not have any employees, they are likely to be added to the general contractor's payroll for workers comp. In New Hampshire, auditors are held to a higher standard. They must inspect records and operations of every GC and sub to determine whether the subcontractor meets all 12 criteria for independence. They do this at their own risk: If they make a wrong determination, they are in violation of state law.

Closing in on FedEx
The IRS in December determined that FedEx drivers were misclassified as independent contractors. They slammed the company with a $319 million fine and penalties. Since the fine only covers 2002, FedEx could face additional penalties totaling over a billion dollars after the IRS completes its investigation. FedEx has already lost the argument in a number of states, including California. Now they've lost at the federal level as well. They are going to sit down with the IRS this spring to hash out the implications of their latest losing argument. (For our numerous postings on this important case, just enter "FedEx" in the search box.)

FedEx managers are apparently hanging their hopes on a 1995 agreement between FedEx Ground's predecessor company (Roadway Package System) and the IRS, which reads in part: "The Service agrees that it will not reclassify the RPS owner-operators as employees, except upon a determination after audit, that RPS has exercised control over the RPS Owner-Operators in a manner that conflicts with the 1994 Operating Agreement, Letter of Assurance and Exhibits." Unfortunately for FedEx, there is a growing body of evidence that the company exercises rigid control over every aspect of the relationship with their "independent" drivers, from uniforms and length of hair to schedule of pick up and delivery.

Much has been made of the liability facing FedEx in the area of employee benefits, but little attention has been paid to workers comp. We can safely assume that hundreds of current and former drivers have been injured on the job. When they come up with a total cost for violating fair labor standards, the comp costs will have to be added in. This long-profitable enterprise appears on the verge of accepting retroactive responsibility for as many as 17,000 employees. That's a lot of drivers and a truckload of liability.


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July 25, 2007

 

A federal appeals court on Tuesday struck down the Bush administration's rules that increased the number of hours a trucker can spend behind the wheel. In an article by Stephen Labaton in the New York Times, we read that the Bush approach increased weekly hours to 77 from 60 over 7 consecutive days, and to 88 hours from 70 over 8 days. The rules also permitted up to 11 hours of driving per day. (At one point, legislation was proposed to increase the allowable hours of driving to 14 per day - see our posting here.)

The court found that the Federal Motor Carrier Safety Administration had ignored the results of its own study, which reviewed more than 50,000 truck accidents from 1991 to 2002. Using the data, the study extrapolated a substantially higher risk of fatigue-related accidents in the extra hours of service allowed by the new rules.

The court's ruling does not take effect until September. In the meantime: data, shmata. Let's haul our aching bodies into the cab and keep on truckin'!

Twelve Gear Reaction
The American Trucking Associations have already challenged the ruling. Their press release states:

The current rules limit driving time to 11 hours and mandate a 10-hour rest time. ATA supports the current regulation, which promotes a regular work-rest cycle for truck drivers and a schedule that is closer to a 24-hour circadian rhythm. The 11th hour of driving time safely provides flexibility for trucking operations without increasing driver fatigue. The 34- hour restart gives drivers much greater flexibility to manage their time, relieving stress and allowing more time at home.

I find the references to circadian rhythms and an enhanced home life a bit disingenuous. As my colleague Julie Ferguson reminded us in a recent post, truck drivers in general are notoriously unhealthy. They're overweight, they smoke and they have trouble sleeping. Their health problems contribute substantially to the high rate of fatalities among drivers and the increased dangers to other drivers on the road. But heck, if they can't sleep anyway, why not just let them keep on driving?

Flexibility versus Regulation
Industry supporters of the loosened standards say they have made it faster and cheaper to move goods across the country. (There is a similar argument, of course, justifying the widespread use of undocumented workers in many labor-intensive, low-paying jobs.) The trucking industry says that the revised rules promoted safety (that sounds a bit dubious) and that shorter hours would force the industry to put more drivers with little experience behind the wheel.

Is that really the choice: limit the hours of skilled drivers and suffer the consequences of inexperienced truckers - or increase the hours of skilled drivers and risk their making fatigue-fueled mistakes? Allow flexibility and personal choice, or set strict safety limits and enforce them?

The freedom versus regulation arguments raise some interesting issues about our collective ability to manage risk. Is it worth the savings in dollars and time to over-extend truckers, especially in light of the compromised personal health that seems to accompany their choice of occupation? How do truckers (as opposed to their associations) feel about the regulations?

I know how I feel. When I'm driving 70 miles per hour down an interstate, sandwiched between two rigs, I'm just hoping the other guys are sipping strong java and are tenaciously awake.

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May 2, 2007

 

The Risk and Insurance Management Society's annual meeting - the insurance industry's equivalent of Woodstock - is currently in progress in New Orleans. For those of you who are sidelining things this year, our colleague Joe Paduda is blogging the event, so you might tune in to Managed Care Matters this week to get his perspective on things. And if you have a subscription to Business Insurance, you can follow along with daily video coverage of RIMS. You can keep up with some related headlines that hit the media by running a Google news search on RIMS, although this will also return some unrelated news on non-related "rims" matters, like things pertaining to tires.

You can also follow any media releases that RIMS issues. One of the more interesting releases to date is the 2006 Annual Benchmark Survey which notes that "the commercial insurance industry continued to experience an overall decline in total cost of risk in 2006." According to the 1200 survey participants, although there was significant variation by industry segments, the average total cost of risk fell by 9.2 percent for all survey participants.

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March 6, 2007

 

Workers Compensation in Delaware is expensive. According to the Oregon rankings, Delaware has moved from the seventh highest cost state in 2005 to number three in 2006. With reforms well under way in the second highest cost state of California, the only obstacle between Delaware and a (dubious) number one ranking is Alaska. Oh well, they're almost # 1! You won't find the state's chamber of commerce touting this particular distinction.

A glance at the rates for some basic occupations underlines the state's problem: Carpentry - shop only (class # 2892) runs $17.44 per $100 of payroll, the highest rate in the nation. Machine shop (3632) is $9.11, compared to $3.67 in neighboring Maryland. (Where would you choose to operate your machine shop?) Even the penny ante class of office and clerical (8810) runs $0.89, nearly the triple the rate in Maryland and over five times the Massachusett's rate of $0.16. These costs add up, minute by minute, day by day, as employers struggle to do business in Delaware.

Courting Disaster?
Before we analyze the macro conditions that have led to this crisis in Delaware, let's take a quick look at a recent state supreme court case that illustrates one of the problems, the absence of managed care. Shirley Smith worked in the shipping department of James Thompson & Co. She injured her back in August of 2002. Suffering from a herniated disc, she declined surgery and treated conservatively while collecting temporary total benefits.

In September of 2004, she told her doctor that she needed money, so he released her for light duty. She worked for one month at a new employer and was then laid off. In January of 2005, she asked her doctor for support in applying for Medicaid and food stamps, so the doctor totally disabled her for six to twelve months (even though there was no change in her medical condition). At the same time, Smith petitioned for resumption of her indemnity benefits under workers comp. She lost at the hearing level and at the appeals court. The Delaware Supreme Court, however, found in her favor.

In other words: in January of 2005 Smith was capable of light duty. Nonethless, her doctor totally disabled her (apparently to help her secure benefits of one kind or another). There were no objective medical findings to back up the doctor's recommendations. Here is how the doctor explained his actions:

I believe she is capable of modified duty work. But since we were approaching the case in a different way all together that we wanted to get a surgical opinion, I wanted her to be off of work so she could address her scenario. If surgery is not an option, I would have her go back to work.

If you can figure out what this grammatically challenged doctor is trying to say, good for you. (Every once in a while I like to address my own scenario, but it's usually at my own expense.) The state supreme court ruled that despite the absence of objective medical findings, the simple fact that the doctor put her out of work - and did so in what the court calls "good faith" - is in itself grounds for reinstating the comp benefits.

Which brings us back to the place we began: Delaware is a very expensive state for workers compensation.

Needed Reforms
Delaware needs to revise its workers comp statute. And no, we do not recommend the Missouri model, which simply clobbers injured workers at every turn. Prudent reform is balanced and fair, exacting some price from all the parties involved and relentlessly focused on the goal of keeping people productive.

In abbreviated form, here is what Delaware needs to do:
1. Implement a managed care program, with some modest control of the treatment path in the hands of insurers and employers.
2. Implement rate setting, so that health providers are reimbursed at reasonable (as opposed to "usual and customary") rates.
3. Open the door to independent medical exams (which would have been extremely useful in the Smith case). Currently, for reasons I could not determine, you can be fined $500 every time you refer to an "independent medical exam" in a medical document.(Section 2343 of the comp statute)
4. Incentivize return-to-work programs. Set the expectation for all employers that they work with injured workers and their doctors to return employees to productive employment as soon as possible.
5. Revise the time table for compensability. Currently, injuries are compensable after the third lost day (a quick trigger, but acceptable). However, the benefits are retroactive to the first lost day once day seven is reached. This is the quickest compensability trigger of its kind in the country and inevitably fosters a "disability" culture. Retroactivity should occur only after two or even three full weeks of disability.

Delaware's Low Point
As Delaware approaches the top of the list for workers comp costs, the pressure for reform will build. Let's hope they do it the right way. Delaware is no ordinary state. According to Wikipedia, they used to be noted for having the nation's lowest high point: that is, their highest elevation was lower than that of any other state. Alas, they have fallen to number two in this regard, to Florida, which claimed the number one spot when its highest point fell into a sinkhole below the 442 feet elevation.

Well, number one is not necessarily where you want to be, especially when it comes to the absence of elevations - and the cost of workers compensation.

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November 29, 2006

 

Judge Stanwood R. Duval Jr of the Federal District Court in New Orleans has opened the door to payments for homeowners whose homes were destroyed by Katrina. Or has he? We read in the New York Times that some insurers must pay for damage because the flooding in New Orleans was due to human error - specifically, the failure of man-made levees to hold back the water. Because most insurance policies do not specifically exclude "man-made" flood disasters, the judge has determined that the insurers must pay. On the other hand, he says that State Farm and the Hartford are off the hook because their policies do not provide coverage for flooding "regardless of cause."

While lawyers for the homeowners are calling this a major breakthrough, defense lawyers see it as a temporary set back. They are confident that the judge's parsing of the policy language will be overturned at the appeals court level.

"The judge reached the wrong conclusion," said Robert Hartwig, chief economist at the Insurance Information Institute. "The policies clearly exclude flood-related damage under any and all circumstances. We do not believe the decision will be upheld."

With over 200,000 homes and thousands of businesses damaged or destroyed by the flooding in New Orleans, there are billions at stake. Beyond that, the future of the city itself is uncertain, as billions in promised federal aid has failed to reach the people who need it.

Comp is Really Different
All of this litigation, the months and years of uncertainty for all parties involved, stand in stark contrast to the workers comp system. For those of us who deal with comp every day, we are reminded that comp is a no fault system that operates with generous parameters of compensability. If you are "in the course and scope of employment," if you are in fact someone's employee, your injury is likely to be compensable. Once a claim is reported to the carrier, the insurer usually has just a couple of weeks to determine compensability and start making payments. This standard can be difficult to meet and creates headaches for claims adjusters. But the great benefit is that it takes uncertainty off the table for injured workers and their families. They don't have to scrounge for food and shelter while their case wends its way through the courts.

We will follow the fate of New Orleans property owners with great interest. It will be fascinating to see if Judge Duval's ruling opens the floodgates to significant payments to home owners or just ends up being another judicial "distinction without a difference." The future of a city - and possibly that of the insurance industry - may well hang in the balance.

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October 9, 2006

 

Workers comp is about workplace injuries and injuries almost always involve pain. So it's no surprise to see painkillers at the top of the leader board for medicines prescribed in the comp system. The Hartford has published the latest rankings, which is still dominated by powerful and exotic drugs. Oxycontin is still number one, for reasons that defy logic but give rise to serious partying among the talented sales team at Purdue Pharma. (This particular drug comes with plenty of warnings.) The Cox-2 inhibitors (Vioxx and Bextra) have disappeared (for obvious reasons). Here's the entire top seven:
1 Oxycontin
2 Gabapentin (generic neurontin, an anti-seizure med useful in reptitive motion pain)
3 Hydrocodone (generic Oxycontin)
4 Lidoderm (for burns)
5 Celebrex (usually for arthritis pain)
6 Actiq (see below)
7 Oxycodone (another generic version of Oxycontin)

Our colleague Joe Paduda blogged this important issue back on September 27. He questions whether doctors are managing pain or just passing out pills. He is particularly interested in a newcomer to the top 7, Actiq, a powerful new pain reliever developed specifically for cancer patients with severe pain that breaks through their regular narcotic therapy. (As I recall, Oxycontin also began as a drug for terminal cancer patients.) Actiq is an opioid narcotic more powerful than morphine. The medicine comes in the form of a flavored sugar lozenge that dissolves in the mouth while held by an attached handle. Gee, it not only kills the pain, it tastes like candy. Yum! This new favorite comes with a hefty price tag ($1,200 a month), but that's hardly a problem in the comp system, as injured workers are not troubled with a co-pay.

The FDA has some warnings that accompany this latest designer drug. Actiq may be fatal to children. Because Actiq is designed to be dissolved slowly in the mouth, it's not hard to imagine kids trying it out. FDA approved Actiq under special regulations that restrict distribution as defined in a comprehensive risk management plan. Pardon my cynicism, but I wonder just how many injured workers are provided with detailed risk management plans when they receive a script for this drug.

Living with Pain
It's beyond the scope of this blog to tackle the issue of pain medications and why doctors prescribe one drug over another. But the big picture is pretty clear. Doctors treating workplace injuries routinely write scripts for the most powerful drugs available. They appear to move rather quickly toward drugs that were originally designed for the chronic, intense and long-term pain of a terminal illness. Most workplace injuries resolve themselves relatively quickly, so while the initial pain may well be acute, it usually does not - and should not - become chronic. When pain does become chronic in the workers comp system, it is almost always an indication that the employee has not returned to work.

All of this leads us to speculate on the relationship of pain to time: if all the key players (employer, doctor, insurer) focus relentlessly on returning injured employees to work, if we give these employees the opportunity to work through the pain while continuing to function in the workplace, we would probably see a greater reliance on pain drugs at the lower end of the spectrum. In other words, a comp system functioning at optimal levels would have a radically different list of top seven drugs. Needless to say, despite a leveling off of pharma costs, the workers comp system from state to state is not functioning anywhere near these optimal levels.

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February 28, 2006

 

Today the Insider looks at seemingly divergent issues which converge in a striking manner: federal involvement in mine safety (MSHA enforcement), federal prosecution for workers comp fraud, and the ongoing saga of work in the mines. It's a complex picture, but one which resolves into a single focus: the exploitation of the people who work in mines.

MSHA and the Phantom Miners
We begin with an article by Frank Thomas in USA Today. The recent disaster at the Sago mines killed 12 miners. We were all momentarily saddened by their hastily penned farewell notes to their families, but that was then, and this is now. It turns out that MSHA had found numerous violations in the Sago mine prior to this disaster. But to determine fines, MSHA uses a bizarre math: they multiply the violation by the number of miners exposed to the specific danger. In 90% of Sago's violations in 2004 and 2005, inspectors said one person was endangered. You send a crew into a mine, but MSHA comes up with a count of one! As a result of this peculiar math, the fines prior to the disaster were minimal.

Here are some specific examples cited by Thomas in the article, quoting federal inspectors:

• On Aug. 16, 2005, an inspector found a main escape path "obstructed by concrete blocks." On Nov. 8, 2005, an escapeway was "not being maintained in a safe condition to assure passage of anyone." Sago got six citations for blocking escapeways miners use to flee a fire or explosion. Each citation said one miner was endangered. The mine paid $60 fines for two violations. The amounts of the four other fines are being decided.

• On Aug. 16, 2005, an inspector found "chemical smoke" being blown toward areas where two mining teams were working. A team typically has eight to 10 miners. The citation said one miner was endangered. A fine is being determined.

• Sago was cited for 22 violations from July 2004 to December 2005 for "accumulation of combustible materials" — coal dust and coal chunks that can spread fires and explosions. All 22 violations said one miner was endangered. MSHA fined the mine a total of $1,768 for 17 violations and is deciding fines for the five others.

Thus, on the prevention side, MSHA's enforcement efforts were seriously undercut by an unwillingness to accurately count the miners. MSHA blew an opportunity to put real leverage into enforcement before the disaster occurred.

More Phantom Miners
Now the second story. Meg Fletcher has an interesting article in Business Insurance about a case of workers comp fraud in Tennessee. Once again, undercounting of miners is a key to the situation. Gary Slater ran several leasing companies that provided workers for the mines. He operated companies with deceptively similar names: for example, Carol Dale Contracting Inc and Carol-Dale Inc. He would secure workers comp for one of the entities, but not for the other. He employed over 100 miners, but only about 15 were formally covered by a workers comp policy.

When a worker was injured, Slater would either buy them off or, in the case of a more serious injury, he would move the employee from the payroll of his uninsured company to that of his similarly named insured entity. Then he would file a claim. As a result of his gross understatement of payrolls, he was able to defraud two insurance companies of over $6 million in premiums.

Unfortunately for Slater, his scheme had one fatal flaw: by absorbing the losses for over 100 people, the premium for his insured entity (with a payroll of only 15 people) was vastly understated. So his rate of injury was extremely high (even in the high risk world of mining), and his experience rating went through the roof. As a result, the insurers began to investigate.

Federal Charges
Slater was done in by his own success. As a result of avoiding comp premiums, he generated huge profits that had to be hidden. So he set up an elaborate money laundering scheme involving phony invoices for trucking services. Because his criminal activity involved both the mails (mailing key documents including fraudulant application forms for insurance) and money laundering, the investigation was able to benefit from robust federal resources. After his partners in crime pled guilty and agreed to cooperate, Slater's conviction was a slam dunk. He has been sentenced to nine years in prison and ordered to pay more than $5 million in restitution.

Ghosts of Living Workers
These two story lines converge in the hard-scrabble lives of the miners. The common theme seems to be that miners literally do not count. MSHA cannot see them, so mine owners, instead of being financially motivated to fix safety problems, avoid heavy fines. The owners in some cases don't even hire the workers - they lease them from the likes of Mr. Slater, who in turn hides the workers off the payroll and avoids paying taxes and benefits.

Every day thousands of people put on their gear and go where none of us would go. They live in constant fear. They never see the sun at work. Even if they survive from shift to shift, they face long-term health hazards. These "ghost workers" move among us, as we turn on the lights, crank up the heat, and log onto the internet. We cannot function without them, but we, in turn, are doing a very poor job of making their work safe and of rewarding them for their sacrifices.

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February 2, 2006

 

Business Insurance has a free access "open house" at their site from now through February 28th. The open house allows full access to current issues as well as access to archived material since 1996. For those who aren't familiar with the publication, it's a well-respected and established industry trade issued weekly by Crain Communications. In its own words:

"Business Insurance serves business executives who are responsible for the purchase and administration of corporate insurance/self-insurance programs, encompassing both property and liability insurance and employee benefit programs, including life, health and pensions. Each week, the printed publication includes news and feature articles related to these key functions. From its Website, BI also delivers current news and information on a daily basis."

The open house is a good way to explore the site if you aren't familiar with the publication, and if you have any topics you've been meaning to research, now's the time. They are also offering a significant discount on first-time or renewal subscriptions during this time.

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November 10, 2005

 

Do any of you folks plan to be at the Workers Compensation & Disability Conference in Chicago next week? I'll be there for a few days, and I understand that our colleague and fellow-blogger Joe Paduda will be there, too. If you plan to attend, let me know - I'd love to meet some readers! Drop a line to communicationsATlynchryan.com (substitute the AT with @ so we know you aren't a spamming robot).

Among other things, I am looking forward to hearing Dr. Jennifer Christian's presentation on The Real Truth About Disability Management. I worked with Dr. Christian for several years, so I developed a great respect for her expertise. Shes a noted expert in occupational medicine and a prolific author and lecturer. You can read some of her writings at her website, Webility.md. She writes a monthly column called "Ask Dr. J" for the Disability Management Employer Coalition and also hosts the Work Fitness and Disability Roundtable, an e-group comprised of more than 500 professionals dedicated to " ... preventing and minimizing the disruptive impact of injury and illness on peoples' daily lives, especially regarding their work, and in promoting the health and productivity of the American workforce."

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October 6, 2005

 

This week is Fallen Firefighter Memorial Weekend, a time to salute the brave people who sacrificed their lives to make the world a safer place for you and me. Firefighters are out there on the front lines every day, risking injury and death. According to the Centers for Disease Control, more than 100 firefighters die at work each year. At this time of year, my thoughts turn to six hometown firefighters who died in the line of duty some half-dozen years ago.

So given that this weekend is a time set aside to recognize these fallen heroes, it seemed fitting when I got a note in my mailbox from the Public Entity Risk Institute (PERI) about a free online symposium entitled Fire Department Integrated Risk Analysis and Management that is scheduled for November 7 to 11. The program brings together authors and experts from the U.S. and U.K. to discuss an integrated risk management approach to injury prevention. According to PERI: "Each day during the program, PERI will email participants specially commissioned "Issues and Ideas Papers" that discuss aspects of the integrated risk management approach. Participants can read the papers at their convenience, and also make copies to distribute to colleagues. All enrollees can participate in an online discussion in the Symposium Center, exchanging ideas, posting comments, and asking questions about the issues and solutions presented in the papers.

What better tribute could be offered to those who previously gave their lives than to learn more about how to make work safer for all the men and women who are at risk on the job every day? Learn more, or enroll for the seminar: Fire Department Integrated Risk Analysis and Management.

September 26, 2005

 

The Hill is reporting that insurance lobbyists have been working overtime since Katrina to extend passage of the Terrorism Risk & Insurance Act (TRIA), the federal backstop for insurers that is scheduled to expire on December 31. Many lawmakers think that the voluntary market should be developing alternatives to cover any terrorism risk, but the hard hit that the reinsurance industry is taking post-Katrina may reinvigorate the debate. Renewal is thought to be a particularly significant issue for workers compensation since it is mandatory business insurance. See Doug Simpson's May blog on why TRIA renewal is thought to be vital to the workers comp market.

Free webinar about TRIA renewal
Business Insurance is sponsoring a free hour-long panel - A World Without TRIA: Why A Terrorism Insurance Backstop is Vital - a discussion about what this might mean for your business and for the insurance industry. 1:30 p.m. EDT Oct. 12. You can register here.

The panelists for this event are: Ramani Ayer, chairman and chief executive officer of The Hartford Financial Services Group Inc.; Bradley Wood, senior vp-risk management of Marriott International Inc.; and Joel Wood, senior-vp of government affairs for the Council of Insurance Agents & Brokers. The discussion will be moderated by Business Insurance Senior Editor Mark A. Hofmann.

Prior postings on TRIA:
Terror and risk transfer
Congress considering Terrorism Risk Insurance Act (TRIA) renewal
TRIA set to expire

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April 28, 2005

 

According to the BLS, there were 5,559 workplace deaths due to traumatic injuries in 2003, a slight increase from the number of deaths in 2002, when 5,534 workplace deaths were reported. The AFL-CIO released its 14th annual death on the job report. Access the full 154-page report -- Death on the Job, The Toll of Neglect (PDF) -- or read Jordan Barab's excellent summary of report "highlights". Also, visit rawblogXport for some links to various labor sites commemorating Worker Memorial Day 2005.

It would be good to see a larger focus on this topic in the media, but in doing a Google search we were disappointed to find little on the topic. We found an article noting that Wyoming has the dubious distinction of the most work fatalities, with a rate of 13.9 deaths per 100,000 workers vs. the national average of 4 deaths per 100,000 workers, and one other article about the death rate for Hispanics on job climbing in Colorado. I guess everyone is busy with the Michael Jackson trial. I wonder how many deaths the media could help prevent if only a small fraction of the attention that was devoted to the Terry Schiavo case could be devoted to this important issue?

It's also disappointing that little progress had been made in legislation to prosecute serial killers - those employers that willingly and knowingly flout basic OSHA safety standards resulting in repeated worker fatalities. Immigrant workers are particularly at risk of losing their lives on the job.

The best thing we can all do to commemorate the 5,559 people who died on the job is to redouble our commitment to work safety and injury prevention. I've worked with conscientious employers who have experienced a work death - the horror of such an event and the lasting trauma on the families, on other workers, and on managers and supervisors can't be adequately conveyed. Employers, this is a truly terrible lesson you do not want to learn the hard way - don't let a preventable work death happen on your watch.

Here are related posts that we've made since last year's event.
Hispanic Fatalities on the job: the Tip of the Iceberg
Three construction workers die every day in the U.S.
Workplace deaths increased in 2003
Felony for willful safety violations - legislation gaining traction?
Florida shuts down uninsured employer after two worker deaths
Workplace "freak accidents" as a media myth
Dyang at Work, Part 1 and Part 2
Wrongful Death Accountability Act.

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April 25, 2005

 

I spent last week at the annual Risk & Insurance Management Society annual meeting in Philadelphia last week. This is one of the single largest events in the property and casualty industry, attracting thousands of attendees and exhibitors. A quick snapshot of the show reflects an industry in turmoil. When I reflect the first RIMS I attended in Orlando more than a decade ago, the changes are boggling. Industry giants from those days have disappeared, victims of consolidations or outright insolvencies; new, less-familiar players have emerged. It's a challenging environment for risk managers. This year, in the wake of the Spitzer investigations shaking the broker world, the buzzword at the show was transparency and all the talk was about ethics and open customer communications. RIMS leadership called for members to take responsibility in the issue of disclosure.

The Terrorism Risk and Insurance Act was also of some concern. TRIA renewal was much on the minds of attendees and the subject of several sessions.

Rising workers comp severity trends and high medical costs were another issue of great concern. While frequency is down, the cost of claims keep increasing, largely driven by skyrocketing medical expenses. This concern was in evidence by the plethora of medical specialty services that dominated the exhibitor hall. Our friend and fellow blogger Joe Paduda reports on the trend to medical risk management, with particular observations on Pharmacy Benefit Managers (PBMs).

The annual benchmark survey of risk managers produced for the Risk and Insurance Management Society by Advisen was just released, and shows that the property casualty market softened in 2004, although the high cost of WC and professional liability kept overall risk cost 3% higher than the prior year. For more information, read Michael Bradford's report of the survey in Business Insurance.

Congratulations are in order. We were very pleased to open our mailbox last week to see that James D. Hinton of HCA, Inc. was gracing the front cover of the pre-RIMS Business Insurance issue. Jim was named 2005 risk manager of the year in the publication's annual award. Some of us at Lynch Ryan remember working with Jim in the early 90s when he was implementing workers comp programs at Humana - he was very progressive and ahead of the curve back then, so we are pleased to see him getting some well-deserved recognition.

And more kudos - Susan Meltzer, assistant vice president, risk management for Sun Life Financial in Toronto won the Goodell Award, the highest award that RIMS bestows. Congratulations are also in order for Ellen Vinck, vice president of risk management, benefits and safety for CA-based U.S. Marine Repair Inc. who begins her tenure as new President of RIMS. On a personal note, it was nice to see so many prominent women rising in the ranks of an industry that has been largely male-dominated until the last decade go, women in insurance!

People are looking to next years show in Hawaii with mixed reactions. While most people love the location in theory, some larger exhibitors are concerned about both the travel expense and the increased travel time that the event will require. Its anyones guess whether the allure of the location or tight purse strings will rule. You can get a 10 percent discount over and above the earlybird discount by registering before May 1, 2005.

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April 18, 2005

 

Every year health and safety activists and unions around the globe set aside a day to remember the thousands of workers who are killed an injured on the job each year. Jordan Barab, a fellow blogger and a tireless and impassioned advocate of worker safety, suggests that the day should a time to "recharge our batteries" and rededicate our commitment to worker safety. He points us to some resources for April 28. If you have any doubt about the importance of such a day, just read through one of his chilling reports of the weekly toll.

We suggest that it might be a good day for risk managers and employers everywhere to conduct an audit of their own record and practices. Safety should be an ongoing concern every day in every work place - but perhaps this would be a fitting day for employers to take an inventory - what better way to remember to those who died on the job?

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March 30, 2005

 

We recently blogged the increasing reliance on older workers among some of the nation's largest retail chains. While we welcome the inclusion of older workers into the workforce, we caution employers about the potential impact on workers compensation. The older you get, the more likely it is that you have pre-existing conditions that may impact your ability to do the job safely.

I don't have exact numbers, but I would guess that in 1967, when the Age Discrimination in Employment Act (ADEA) was passed by Congress, older workers comprised a minority of the workforce. Today, nearly 40 years later, the 75 million workers over 40 make up about 53% of the total workforce. Protections for older workers, in other words, are now protections for the majority. (Which of course does not mean the protection is not needed!)

"Disparate Impact"
In the years since the ADEA was passed, the Supreme Court had never decided whether it authorizes cases involving unintentional discrimination, known as "disparate impact" suits. Federal appeals courts have issued contradictory rulings on the issue.

Today the Supreme Court found in Smith v. City of Jackson, Mississippi, that discrimination need not be intentional. In other words, you don't have to prove that the employer intentionally discriminated against workers above the age of 40. You only need to prove that the actions had a disproportionate impact on older workers. Nonetheless, the standard of proof remains high. Indeed, in this particular case, the Court found in favor of the employer.

Occupational Geriatrics?
As the workforce ages, and as people prolong their careers into their late 60s and 70s, we will be facing unprecedented issues for the workers compensation system. Keep in mind that the system was created when people trained for a single job, generally worked for a single employer, and retired right at 65. Today, people change jobs (and even careers) numerous times, they work for many different employers, and they might not retire until they reach their 70s. State legislatures across the country are faced with obsolete notions of work and retirement. In addition, the medical profession is about to be confronted with older and older people trying to overcome injuries and get back to active employment. Will medical schools soon offer a new specialty in occupational geriatrics?

Hiring is Always Risky
Any act of hiring, regardless of the age of the applicant, is full of risk. Indeed, hiring a stranger may be the riskiest action an employer makes. So we recommend that you make the hiring process as thorough and rigorous as possible. Don't just require a written job application: read it carefully! Talk directly to applicants, preferably in a variety of settings, using different members of your team. And check references. Even if prior employers will only verify dates of employment, push hard for full disclosure. (There is such as thing as a "negligent reference"!) If your jobs are physically demanding, explore the feasibility of pre-employment physicals. Once you hire someone, you've made a commitment with profound ramifications for your organization. There is no such thing as a "casual" hire!

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March 7, 2005

 

This year marks the first time that the World Congress of Safety & Health at Work will convene in the U.S. The event is scheduled for Sept. 18-22 in Orlando with a theme of "Prevention in a Globalized World - Success through Partnerships." This is a triennial event - the last Congress met in Vienna in 2002. Dupont has been named the key sponsor. Organizers include the United Nations International Labor Organization, the International Social Security Association, and the National Safety Council, the U.S. host for the event. The event is expected to attract more than 3,000 leaders from around the world in government, labor, industry and academia.

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February 8, 2005

 

The American Academy of Ophthalmology (AAO) has declared February as Workplace Eye Safety Month and theyve compiled some resources to help drive home the point that 90 percent of all work-related eye injuries are preventable.

We didn't bring you the news sooner because last year this observance occurred in March. We were alerted of the change in months by several queries to our search engine. Sorry for any confusion.

What's not confusing, however, is how an important an issue eye safety is, and it would be just as well if heightened awareness was practiced in the workplace every month. Revisit last year's post for work eye safety resources and we've compiled some additional resources for 2005:

NIOSH - Eye Protection for Infection Control
NIOSH - Eye Safety Tool Box Talk - Instructors Guide
OSHA - Eye and Face protection e-tool
NASD - Eye Protection Training for Employees (in English, French or Spanish)
NASD - Eye Protection for Farmers
Madison Area Technical College - Eye Safety Bulletin (PDF)
Occupational Hazards - Don't Lose Sight of Eye Safety
Ohio State University Medical Center - Eye Safety at the Computer
Industrial Safety & Hygiene News - Eye Safety In Construction
Industrial Safety & Hygiene News - Focused on eye safety
Vietnamese - Eye Protection brochure (PDF)
Spanish - Seguridad De Los Ojos En El Sitio De Trabajo
Spanish - Proteccin Para Los Ojos

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October 5, 2004

 

Are you a researcher with an interest in workers compensation? If so, you may want to submit an application to the John Jones Scholar in Workers Compensation Research by February 1, 2005 for a $10,000 research grant. This award was created by the Workers' Compensation Research Institutes (WCRI) Board of Directors to recognize the many contributions of John Jones, one of the founders of WCRI. The objective of the grant is to stimulate interest in workers compensation research and facilitate creation of important, new, publishable research. Topic areas of interest for potential research include medical treatment guidelines, return to work, benefit adequacy and equity, reducing litigation, and evaluating the design of PPD systems. For more information, contact: Linda Carrubba at 617-661-9274, ext. 245 or lcarrubba@wcrinet.org

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May 23, 2004

 

To commemorate labor history month, take a tour of Labor Arts, a virtual museum that gathers, identifies, and displays historic images of working people and their organizations. The site states that its mission is "to present powerful images that help us understand the past and present lives of working people."

Some of the many fascinating exhibits and collections include:

Labor Sings - songs from the 20s and 30s, including Old Paint, Beltiline Girl, and the Soup Song.

Ordinary People, Extraordinary Lives - a collection of photos, stories, and songs from pre-World War I to the present.

Buttons and Badges, cartoon art, leaflets and pamphlets and a vast collection of photos and artifacts from the early 20th century to the present.

Thanks to rawblogXport for pointing us to this great site.

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March 5, 2004

 

"In observance of March as Workplace Eye Safety Month, the American Academy of Ophthalmology, the Eye M.D. Association, and Eye M.D.s across the nation want to alert Americans to the possibility of eye injuries in the workplace.

According to Prevent Blindness America, each working day in the United States more than 2,000 employees sustain job-related eye injuries, making workplace injury a leading cause of ocular trauma, visual loss and blindness. Of these, 10 to 20 percent will be disabling because of temporary or permanent vision loss."

The following are resources for employers and employees on regulations, personal protection equipment and eye injury prevention.

OSHA - eye and face protection
Employers - protect your workers' vision
Toolbox talk - eye safety
10 Ways to Prevent Eye Injuries at Work
Eye injuries in construction
Computer screens and your eyes
Workplace eye safety quiz
Seguridad De Los Ojos En El Sitio De Trabajo

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February 19, 2004

 

If you are planning to attend the RIMS 2004 Annual Conference & Exhibition in San Diego from April 18-22, 2004, get your reservations in now. The deadline for early bird registrations looms. Take advantage of the $100 savings by getting your reservations in by tomorrow, February 20, 2004. Here's the RIMS Conference overview if you'd like a quick preview. Drop us a note if you are planning to attend.

Are you a risk manager? If so, while you're at the site, you may want to take the 2004 Risk Management Compensation Survey or the RIMS Benchmark Survey to learn how you and your company stack up against others in the industry.

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September 17, 2003

 

October is a big conference season, and there are two back-to-back meetings in Boston that you may want to put on your calendar. The Annual Business Insurance Workers Compensation Conference is scheduled for Oct. 20-22 at the Fairmont's Copley Plaza. When it wraps up, hop in a cab and head for the WCRI Annual Issues and Research Conference which starts on October 22 and runs through the 23rd. The event will be at The Westin Copley Place. Drop us a line and let us know if you are attending.


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