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The new Government Accountability Office report on OHSA's lackluster efforts for tracking worker injuries makes an interesting observation about the effectiveness of employer safety incentive programs.
The programs that reward employees with prizes when their worksites reduce injuries also discourage workers from reporting injuries, according to the GAO report. Employees are not reporting injuries because they do not want to forego potential prizes for themselves and coworkers.
That is not good because as savvy employers know, early reporting of injuries and prompt medical attention reduce costs over the long term. So now the question is, do short-term savings from reducing accidents with safety incentive programs encourage long-term health care expenses?
Safety incentive programs are just one subject the GAO report is sure to generate discussions about.
For instance, Adam Dombchik, president of the California Applicant's Attorneys Assn. says in this California Progress Report posting that work comp claims frequency has declined since 1990 because “workers despair over getting needed medical care and fair disability compensation for their injuries.”
Comp Time disagrees. Claims frequency has declined because over the years employers have implemented good safety programs.
But Mr. Dombchik and the GAO report do raise important issues, however. There is no shortage of employers that will neglect their workers and do anything to lower their comp costs including hide injuries. Employees who fear for their jobs are also discouraged from reporting if they don't understand the system.
That is why OSHA needs to be pushed to do a better job of collecting worker injury data. According to an OSHA press release, the agency will implement GAO recommendations for improving its gathering of workplace injury data.
Recently liquidated Southeastern U.S. Insurance Inc. has left unsuspecting employers, including many of Georgia's public entities, scrambling to find new coverage.
Some critically ill workers whose ongoing medical care depended on the Atlanta-based comp insurer may also be wondering who is going to pay for that care, according to a Georgia Public Broadcasting story.
Georgia Insurance Commissioner John W. Oxendine obtained a Superior Court liquidation order for Southeastern on Oct. 27. The liquidation followed regulator review of Southeastern's financial records after its CEO, Clark Fain, received a loan of more than $10 million from the insurer, according to another Georgia Public Broadcasting story.
A Georgia insolvency pool may not pick up some policyholder claims because the pool only covers employers with a net worth of $25 million or less, according to a Jacksonville.com story.
Reports vary on the number of policyholders impacted, but they indicate that at least 50 public entities including schools, cities, and counties along with 200 private employers purchased coverage from Southereastern.
Some of those insureds may have lost premiums they paid Southeastern, which is also known as SEUS and originally formed as a captive insurer. SEUS insureds could also be on the hook for worker injuries that won't be covered by the insolvency pool or any new insurer they contract with.
Policyholders always need to be careful who they purchase coverage from. Meanwhile, some Georgia policyholders may be wondering why regulators didn't act before they purchased insurance from Southeastern.
An $89 hand-held massager could eliminate the big bucks employers spend on various workers comp consultants, claims managers, and paying comp benefits.
That's what a recent press release touting a Chi Massager is claiming.
Lots of press releases cross my desk, but this one for Chi Massagers contains particularly interesting comments. It says comp claims have increased significantly during the past 10 years.
Comp Time has been under the impression that claims frequency has steadily dropped over the past decade or so. Could all that insurance industry data be wrong? Or maybe the Chi Massager people are talking about claim costs?
“The NIOSH” report, says mental stress claims in California have increased 700% over 8 years and 90% of those claims were successful, according to the Chi Massager press release.
But the release doesn't say what NIOSH report it is referring to and Comp Time finds it peculiar that NIOSH would be a source for California comp claims. Also, California made it much harder during the early 1990s to file stress-related comp claims and Comp Time hasn't seen any other source report a dramatic increase in California stress-related losses.
Comp Time tried to clear up this confusion, but a telephone number attached with the Chi Massager press release is not working. Chi Massager has an active website for ordering its products, including a cute, hand-held massager that looks like a dolphin.
But the telephone number for ordering Chi Massagers continually produced a busy signal.
The press release suggests that several massages throughout the work day could reduce stress problems tied to increased work loads and job insecurity driven by the current recession.
No doubt, less work and more massages would reduce workplace injuries. If only those of us currently working to keep our jobs had time for several massages a day.
On another subject, The New York Times reports that a study to be published in The American Journal of Industrial Medicine found female hotel workers are 50% are more likely to be injured than their male counterparts.
The injury rate for Hispanic women working in U.S. hotels is two-thirds higher than for their white female counterparts, the study found.
According to an ABC News story, a study of 550 factory workers in China found that men exposed to bisphenol-A, or BPA, were four times more likely than men not working with the product to report sexual dysfunction.
BPA has come under question for its use in baby bottles and other plastic products.
Also, Comp Time expresses kudos to Julie Ferguson at Lynch Ryan's Workers' Comp Insider blog for a nice Veterans Day piece providing information and resources on post traumatic stress disorder.
Finally, the the Los Angeles Times reports that the American Medical Assn. has softened its long-held stance that marijuana's should remain classified as a highly restricted drug.
The AMA position change will allow more testing on whether their really is a medical use for the drug. This should matter to employers because as more states adopt medical marijuana laws worker safety is likely to be increasingly impacted.
Are any employers currently experiencing an impact from medical marijuana laws?
In these tough economic times it might pay for workers and employers to scrutinize companies they work for or contract with to make sure they have mandatory workers comp coverage.
As I report in the current issue of Business Insurance, fraud investigators believe the economy is driving more employers to skip buying work comp insurance, which is mandatory to provide benefits for injured employees.
Investigators also say they have seen an increase in fraudulent insurance certificates. Legitimate employers usually request the certificates from companies they contract with to verify the contracted company has insurance for its employees.
Many, but not all state workers comp regulators maintain data bases allowing the public to check whether specific employer’s have insurance.
Interesting to note that a law just adopted in California requires the Workers’ Compensation Insurance Rating Bureau to establish such a site within a year. California also increased employer penalties for not purchasing coverage to the greater of two times what their premium would have been or $1,500 per employee.
All states should crack down on employers that skirt the law requiring them to arrange work comp coverage. They make it harder for employees to get proper medical care and indemnity benefits while taxing other employers to make up for their flaunting of the law.
I’m not sure, though, if $1,500 per employee meets my definition of cracking down.
One thing Comp Time is curious about is whether anyone in the industry is hearing of their comp insurer’s special investigations unit being cut back because of budget constraints. Please let me know.
Courts are looking for “competent evidence” of a solid link between mold in the workplace and injuries allegedly caused by spores.
A few years ago coverage for injuries allegedly caused by mold attracted the attention of attorneys and the media.
The issue first arose in homeowner claims with much speculation mold could become the next asbestos. Litigation and insurance observers then wondered whether workers comp systems would see an abundance of mold claims.
As a pair of recent cases show, courts are demanding solid evidence of a link between mold and occupational disease or illness, just as they do in other types of cases.
Last week, in Steve R. Jones v. Steve Jones Auto Group and Universal Underwriters, the North Carolina Appeals court affirmed a 2008 Industrial Commission ruling that an auto dealership's general manager is entitled to benefits because of exposure to workplace mold over a three-year period.
According to the appeals court decision, there seemed to be no ambiguity that black mold found on the back of sheetrock and chairs in the plaintiff's office led to excessive and uncontrolled coughing, wheezing, a burning sensation in his nose and mouth, headaches, dizziness, and a lack of energy.
Testing by a certified industrial hygienist failed to find black mold just outside the plaintiff's office, but high levels of it were present inside the office, court records show. A couple of clinical professors of medicine at Duke University found a lack of evidence the plaintiff suffered from cognitive defects before exposure to the mold and they opined a relationship to his workplace.
Another physician, board certified in internal, pulmonary, critical care, and sleep medicine, also found that the plaintiff's exposure to workplace mold was “the factor” causing his lung inflammation.
The appeals court concluded that all the evidence “is competent” to support the “Commission's finding that the plaintiff's work placed him at an increased risk for contracting pulmonary airway disease.”
In contrast, a Special Workers' Compensation Appeals Panel of the Supreme Court of Tennessee last year reversed a trial court finding that a teacher was entitled to a 35% permanent partial disability rating because of workplace mold tied to respiratory allergies.
Court records in Deborah R. Wagner v. Washington Department of Education show the evidence in this claim was more conflicting than in the North Carolina case.
Here, an allergist/immunologist doctor found that a skin test showed the teacher suffered from allergies related house dust mites, cat hair, dog dander and pollen while test results for mold allergy were negative.
Another doctor, however, did diagnose the teacher to be suffering from "occupational asthma” as well as mold allergy. But tests found her home contained mold.
The evidence appeared to conflict.
The Tennessee appeals panel found that the teacher did not produce “sufficient evidence” to prove her allergies followed from a workplace exposure or that her problems did not originate outside the workplace.
The court reversed the lower court and dismissed the case.
Whether courts in other states will rule similarly remains to be seen. But so far it appears that claimants filing work-related mold cases will need solid evidence of a link between their place of employment and their symptoms.
While chronic health problems already present when an employee suffers a work accident can increase the care necessary to treat the work injury, the good news is that more employers are taking time to learn about their workers' total health.
More employers are asking, when a work-injury is first reported, about other health problems the employee may suffer from, Teresa Bartlett told Comp Time.
Ms. Bartlett is an M.D., senior vp and medical director for Sedgwick Claims Management Services Inc. Those employers that are asking about other health issues are also investing in wellness programs to address their workers' chronic health problems, Ms. Bartlett said.
That is important because as Comp Time reported yesterday, a survey of 27,000 employees conducted by the Integrated Benefits Institute found that nine in ten said they suffer from more than one chronic health problem.
The survey relied on the employees to self report their health conditions and Comp Time does not know whether a different group of employees, say younger workers, may have provided different responses.
Nonetheless, it's safe to say plenty of American workers suffer from multiple chronic illnesses such as depression, diabetes, heart disease and asthma.
“Strategically, many of our clients have formalized approaches to comorbid conditions,” Ms. Bartlett said. When “we become aware at the moment of intake (for a workplace injury) that the employee has diabetes or cardiovascular disease, there is an automatic transfer” to an employer's wellness program.
That can include a referral to an employer-sponsored smoking cessation or healthy back program.
Employers are not likely to stop offering such programs because their data is showing that the efforts reduce healthcare costs and other expenses, such as the need to hire replacement workers.
So an increasing number of employees may be getting better health care attention after reporting a comp injury.
But that may be happening mostly for employees working for large, sophisticated employers. Comp Time suspects smaller employers are less likely to offer such services.
How do we bring them aboard?
New research from the Integrated Benefits Institute indicates U.S. workers are chronically ill.
They are in “dire straits” with nine in ten reporting one or more chronic health problems, according to IBI research findings released Oct. 28. The research results are based on 27,000 employee self-reported surveys collected by IBI.
Many are suffering from multiple conditions such as depression, diabetes asthma, and heart disease.
“The diversity of those multiple conditions dramatically complicates treatment and management across those conditions and leads to additional lost work time – and this is a survey of workers healthy enough to be employed,” according to IBI, which provides employers and their vendors with health and productivity research and benchmarking data.
Comp Time suspects these findings mean that work comp medical treatments and return-to-work programs are also impacted and could benefit by taking IBI's survey results into consideration.
An IBI press release on the topic is available here and more information is available upon request from IBI.
OSHA is boosting its monitoring of states that administer their own OSHA programs, according to a press release from the federal agency.
The press release says that as a result of “safety concerns” federal OSHA discovered when it evaluated the Nevada Occupational Safety and Health Administration it will strengthen its oversight of other states.
The Pump Handle blog recently provided a good discussion on a Congressional hearing on the severity of problems in Nevada and OHSA’s plans to expand its state oversight.
The National hearing Conservation Assn. , meanwhile, is asking OSHA to reduce the permissible exposure limit for noise in the workplace. It says nearly 22 million U.S. workers are exposed to hazardous noise daily and that much hearing loss is preventable.
A letter NHCA sent to OSHA is available here.
Over at Managed Care Matters, blogger Joe Paduda has taken on the North Dakota work comp fund for hiring a former state trooper to head up the state’s work comp agency.
Evidently, the former state trooper knows nothing about the complexities of work comp. But he plans on using his leadership acumen and experience in dealing with people to run the agency.
As Joe points out, the trooper who plans to learn as he goes is facing an incredibly complex business.
Joe also raises questions about the prosecution of Sandy Blunt, the former head of the North Dakota fund who was convicted of felony charges. The deeper he dug into this situation, Joe says, “the stinkier it got.”
The North Dakota Workforce Safety & Insurance website is available here.
Also, please notice that Comp Time now has an RSS feed you can subscribe to.
A study by University of California, Berkeley researcher Frank Neuhauser is drawing great interest for concluding that integrating comp medical care into group health could save up to $560 billion nationwide over 10 years.
Blog postings have taken up the 24-hour care subject and Mr. Neuhauser tells Comp Time he has received a lot of requests for his study. It is available here, and a Business Insurance summary of it is available here.
The study is provocative, and an accompanying report states that the savings could pay for 26% to 78% of the incremental cost of universal coverage. Savings would result from the greater efficiency with which health insurance delivers care compared to workers' compensation insurance, according to the study.
Mr. Neuhauser is a respected researcher who has conducted past studies on California's comp system.
He always has an interesting perspective, Bill Zachry, vp of risk management for Pleasanton, Calif.-based Safeway Inc. tells Comp Time. But much of the work comp system's overhead is driven by regulations promulgated to assure timely and adequate care, Mr. Zachry says.
There are other cost differences in the two systems, Mr. Zachry points out. The focus of comp treatment, unlike in group health, is returning employees to work and the group health system has co-payments.
“The devil is in the details,” Mr. Zachry says.
Other insurance industry professionals commenting on a Linkedin work comp forum say the 24-hour integration idea won't work and they pointed out problems they see with the study.
Accessing those postings requires a Linkedin registration that is available here.
Comp Time agrees a federal 24-hour care system is not likely to get serious consideration at this point.
But it's an important issue to research, so kudos to Mr. Neuhauser and his funding providers for looking at the issue.
Also, Comp Time notices that much of the discussion has focused on costs and dollar amounts used in Mr. Neuhauser's study. Costs are immensely important. But what about the potential to improve care?
Detractors are likely to point out such a system wouldn't help care delivery, but Comp Time finds it interesting the care of injured workers hasn't surfaced in this debate. Meanwhile, Mr. Zachry agrees the comp system could do better in reducing administration costs. But, he says, “it will take significant changes in thought and philosophy on the part of all parties, as well as significant legislation.” Changes in thought and philosophy, that seems to be what Mr. Neuhauser's study lays the groundwork for.
LexisNexis Workers' Compensation Law Center has selected Comp Time among its 2009 top 25 work comp blogs.
Comp Time is honored and happy for the recognition and kind words from LexisNexis. Comp Time is also thankful to be included among other blogs that I find extremely helpful and regularly link to.
LexisNexis said its 25 honorees provide “a wealth of information for the workers' compensation community with timely news items, practical information, expert analysis, practice tips, frequent postings, and helpful links.”
Other blogs selected as 2009 honorees include Workers' Comp Insider, published by Lynch Ryan. LexisNexis recognized it for Best Ongoing Achievement. Comp Time couldn't agree more. Julie Ferguson first launched the site in 2003, when comp weblogs were still in their infancy.
Josehph Paduda's Managed Care Matters also received recognition in the Best Ongoing Achievement category, having published about health policy, comp, and medical news since 2004. You get a real expert with this blog.
Comp Time was honored as Best News Industry Blog. You can see the rest of the honorees here. While on the LexisNexis site you may want to cast a vote for your favorite comp blog as LexisNexis will chose the Top Blog of the Year from among its 25 honorees.
As a personal note, LexisNexis' notice that Comp Time made its top 25 list caused excitement around my household with my wife forwarding it to all the in-laws.
Here is what it said about my postings: “You can rely on Comp Time, written by Roberto Ceniceros, one of the best business journalists in the country, to cut to the chase when it comes to recent developments in the world of workers' compensation.”
My head was in the clouds, being called “one of the best business journalists.” Unfortunately, when I went to alert my wife of this it was early in the morning and still dark out. I realized as I was telling her that LexisNexis called me one of the best that I was standing in doodoo my dog Cooper had left behind.
Life has a way of keeping you humble.
