Horseplay – The Four Step Checklist For Workers Compensation Compensability

When is horseplay a workers compensation compensable injury? Court and legislative attitudes have shifted in this area. As stressed in previous blogs, once again this reinforces the need for a thorough accident investigation. Here is why.

Historically courts held that horseplay was such a deviation from the course and scope of employment that it was considered an abandonment of duty. Injury suffered outside the "course and scope" is not eligible for workers' compensation protection. Therefore, using this test injured employees were routinely denied coverage. This now has changed.

The Kansas' Supreme Court overturned decades of prior case law regarding compensability of injury resulting from horseplay. The Court's opinion in Coleman v. Armour Swift-Eckrich mirrors the prevailing attitude surrounding a workers compensation injury arising out of horseplay. In this rule the court stated:  "We are clearly convinced here that our old rule should be abandoned. Although appropriate for the time in which it arose, we are persuaded by the overwhelming weight of contrary authority in our sister states and current legal commentary."

Now the prevailing opinion now centers on and applies a set of rules known as "Larson's Workers Compensation Law.” This law applies a four-part test of the facts surrounding the horseplay and is used as a guide to determine compensability. The four tests of fact are:

• The extent and seriousness of the deviation. Here it must be determined if the horseplay was "reasonable" or did the parties go so far out of the way as to constitute unreasonable deviation. In one case, three men wrapped another employee from his ankles to his shoulders in duct tape. The injured employee was allowed to forego the sole remedy offered by workers compensation and sue the participants in tort as the activities were considered too far outside "normal."
• The completeness of the deviation. Here is must be determined if the horseplay comingled with the regular performance of duties or did it involve (and require) an abandonment of duty? As a general rule, the most closely the horseplay is associated with the job duties of the individuals involved the most likely it will be ruled compensable.

On-Site Recreation And Claim Compensability

Suppose your employees like to play basketball during their lunch break so you set-up an area of the back parking lot for them. But one day an employee is seriously hurt why playing a pick-up game. Is this injury compensable under workers compensation law? The proper answer to this question depends on the facts involved and this, in turn, depends on the thoroughness of your accident investigation procedures.

The determination of compensability will hinge in large measure on the “course and scope of employment doctrine.” Extending the "course and scope of employment" doctrine to the pick-up basketball game combines questions of fact decided by juries (gathered through accident investigation, etc.) and questions of law decided by the court. In order to apply these two principles to the facts surrounding the injury sustained during the pick-up basketball game the courts routinely apply four tests:

Did the accident occur on the employer's premises? The fact that the pick-up basketball game took place on the employer’s premises does not automatically make the employer liable.

Was the event or team organized by the employer? As a general rule company-organized softball teams competing in "industrial leagues" may qualify under this provision. However, several employees deciding to form a team is wholly different from a team organized by the employer, encouraging "good" ball players to participate. As it applies to the pick-up basketball game the determination of compensability will hinge on the fact the employee did set-up the area in the back parking lot. Doing to, it can be argued, implies organization of the pick-up game. The fact that the pick-up game is not supervised by the employer often is of no consequence in applying this test.

Did the employer pay for the activity? Interestingly it does not matter if the employer paid for the entire activity. For example, let’s assume the employer paid for the basketball hoop and the employees paid for the basketball. While the activity is not fully paid for by the employer, it could be viewed as employer-paid or sponsored (and participation encouraged).

Did the employer benefit? An employer can "benefit" from these activities in more ways than tangible output or tangible economic value. In the case of the pick-up basketball game it can possibly be argued that making this game available will employee morale and, as a result, their productivity.

As you can see, our pick-up basketball game can be a great area. Determining workers compensation compensability, and avoiding the payment of workers compensation claims that are not compensable, requires a throughout accident investigation process. The documented facts gathered through your accident investigation will go a long way towards refuting the injured employee's assertions that the pick-up game was in the “course and scope of employment.”

CompEraser comes with on-line, on-demand resources needed to CONTROL the initial stages of a workers compensation claim and establish initial compensability. Resources also include the formalization of your safety team, injury prevention, OSHA compliance, safety training, prompt injury response, workers compensation disability management, plus more. These resources are available 24/7 and used irrespective of which workers compensation carrier you select. Its patent-pending technology also provides unique financial reports for monitoring the effectiveness of your safety and health program on an on-going basis. For more information visit our website at www.CompEraser.com.

Your Workers Compensation Safety Plan Is The Critical Roadmap To Success

Recent studies have demonstrated that only 75% of organizations have formal written safety plans and just over half (52%) hold management accountable for their safety program's success. Also, four out of every five employers do not publish their safety goals throughout the organization. This is inspite of recommendations from OSHA.

A successful safety program requires management commitment and this commitment deserves serious and thorough planning in order to accomplish the ultimate goal of maintaining “zero injuries.” Otherwise, the organization’s collective safety and health efforts will fall short of expectations and will waste valuable time and resources. To make matters worse, employees will view the organization’s efforts as “just another management fad,” and the overall effort will not be taken seriously.

If properly developed the annual injury prevention plan will provide the following benefits to the organization in its effort to minimize work-related injuries:

Your Workers Compensation Safety Inspections Are Only As Good As The People Who Do Them

Often the problems experienced by organizations with respect to the timeliness and thoroughness of their workers compensation safety inspections can be traced directly to how well the inspectors have been trained.

Consider two opposing situations. In company A the inspectors were merely given the inspection forms and told that they are expected to fill out the form once a month and return it to the “person in charge.” There was no further explanation or training.

On the other hand, in company B the inspectors were fully informed of what was expected of them. They were also exposed to initial and on-going training (as needed) in how to conduct the inspection, what to look out for, how to identify the “root causes” of the problem, how to fill out the form, and what the procedures were for rectifying the problems found.

In company A you probably would find the safety and health inspections were being performed inconsistently and irregularly. Also, assuming the inspection reports are returned to the “person in charge” promptly (which is probably not the case), they are merely filed away and little action is taken to rectify the situation. Would it be a surprise to find that both the inspectors and the employees viewed the safety and health inspection program as a “waste of time” and “just another management fad”?

In company B you probably would find just the opposite situation. The inspections are performed in a consistent and regular manner. The inspectors view this task as an important part of their job. The inspection reports are completed and returned on a timely basis. The Safety Director, along with the inspector and the Safety Committee, take the time to review the results. The appropriate action is taken as soon as possible, often immediately. Most importantly, the “safety culture,” as perceived by the inspectors and the employees, is based on the routine identification and correction of unsafe hazards and conditions.

CompEraser offers a fast, down and dirty checklist to quickly size up your workers compensation safety inspection program. An assessment of the training needs of your safety inspectors is also included. To get this FREE checklist please email us at bill@CompEraser.com today.

Also, you can now benchmark the effectiveness of your safety training program using CompEraser’s Safety And Health Benchmark Survey. If you agree that the critical first step in making quantum improvements in your safety and health program, and reducing your total worker injury costs, is to evaluate what you have in place and measure its effectiveness then this FREE, no obligation, on-line safety assessment is for you. Nowhere else can you get such a fast, easy to use elf-evaluation that will immediately analyze the twelve major components that drive your worker injury costs, including the formalization of your safety team. Go to www.CompEraser.com today.

The True Financial Impact Of Worker Injuries To Your Organization

A worker injury not only creates a workers compensation insurance claim. It immediately creates financial waste throughout your organization. As an example, according to OSHA, for every $1 of medical only claims your organization sustains $4.5 in indirect, uninsured costs. At first blush you would think that this is a small number. In fact, it is like bleeding a slow death.

Let’s assume that your organization averages 20 medical only claims a year and that every medical only claim pays workers compensation benefits of $550. This means that your workers compensation adjuster is paying $11,000 a year. However, using the OSHA estimate of indirect costs, your organization also incurs $49,500. This reflects the financial waste and inefficiency throughout your organization. As a result, these 20 medical only claims actually cost your organization $60,500. Assuming a 5% pre-tax profit, this also means that your organization must sell $1,210,000 each year to pay the total cost of these 20 medical only claims. How many employees must you hire to produce goods and services to generate these sales?

Workers compensation disability claims produce more amazing results. According to OSHA, for every $1 of workers compensation disability payments the organization insures between $2 and $10 of uninsured, indirect costs. To be conservative let’s assume that the ration is 2:1. Also, let’s assume that your organization has 10 workers compensation disability claims and each averages $12,500. Your workers compensation adjuster would pay $125,000 for these workers compensation claims. Also, using the conservative OSHA ration of 2:1 your organization would also sustain $250,000 in indirect, uninsured costs. This additional cost reflects the waste and inefficiency throughout your organization. Again assuming a 5% pre-tax profit, the total cost of these disability injuries ($375,000) requires your organization to generate $9,375,000 in sales to pay for these 10 workers compensation disability injuries. Again, how many employees must you hire to produce goods and services to generate these sales?

I invite you to take five minutes to estimate your TOTAL COST of worker injuries using OSHA estimates in the privacy of your office. It is on-line and available 24-7. To find out more go to www.comperaser.com. These resources also include injury prevention, OSHA compliance, safety training, prompt injury response, workers compensation disability management, plus more. These resources are available 24/7 and used irrespective of which workers compensation carrier you select. Its patent-pending technology also provides unique financial reports for monitoring the effectiveness of your safety and health program on an on-going basis.

Workers Compensation Injures Impact Product/Service Quality

In yesterday’s blog I addressed the value of workers compensation safety from a productivity perspective. While employee safety is just one component of a successful strategy here, there is no longer any doubt that it impacts these issues every day. The equation is simple:

Reduced workers compensation claims equals increased productivity

The flip side of this equation is that, when a workers compensation claim occurs, product/service quality will suffer. An example, one the CompEraser customers experienced a workers compensation claim recently. The employee was working in a department that assembles the final product and incurred a serious back injury. This particular customer, in order to minimize inventory and reduce operational costs, was operating very lean. Their raw product and in-process inventories were maintained at low levels. Also, their finished product inventory was maintained based upon customer demand. Man-hours were managed very carefully so that labor costs were also maintained based upon consumer demand. Everything was running fine until the workers compensation claim occurred. But here is what happened after the injury. First, the assembly department immediately fell behind in meeting its orders. In this case the employee was off work for 2 ½ months. At first the department attempted to make up the shortfall in production by paying overtime but once it because clear that the employee would be off work for an extended period of time they had to bring in a temporary worker. According to the customer this temporary worker was working, at best, at ½ the rate of the injured employee. Quickly seeing this, they then brought on an additional temporary worker. So now you have overtime payroll and two temporary workers to pay for.

Second, the organization’s ability to ship products to waiting customers became a problem. Because finished good inventories were kept low, there was no buffer here. As a result, customers began to complain and some even went to competing companies to fulfill their needs.

Third, product quality itself began to slip. The customer reported an 18% increase in product return rate over the next three months. No only did this add to the strain already placed on the organization, it drove up manufacturing costs.

Finally, according to the customer, once the injured employee came back to work it took that employee approximately 60-days to get back to full capacity and for the department to get back to its pre-injury production/product quality levels.

All of these costs eventually found their way to the customer’s bottom line – and none were paid for by workers compensation insurance. The ripple effect of a worker workers compensation claim can be quite significant. In this case it was calculated using CompEraser’s patent-pending system that the workers compensation claim itself was $22,225 and the indirect, uninsured costs were 4.1 times this figure, or $91,125. In short, the total cost of this injury to the customer was $113,350. This customer operates in to today’s competitive economic environment at a 4% pre-tax profit. Therefore, they must produce $2,833,750 in sales to pay for this workers compensation claim.

I invite you to take five minutes to estimate your TOTAL COST of worker injuries using OSHA estimates in the privacy of your office. It is on-line and available 24-7. To find out more go to www.comperaser.com. These resources also include injury prevention, OSHA compliance, safety training, prompt injury response, workers compensation disability management, plus more. These resources are available 24/7 and used irrespective of which workers compensation carrier you select. Its patent-pending technology also provides unique financial reports for monitoring the effectiveness of your safety and health program on an on-going basis.

Successful Workers Compensation Safety Equals Increased Productivity

As I talk to owners and managers of companies in virtually all industry sectors there are two consistent themes that become crystal clear. First, companies are under enormous strain to compete and grow profitably in the face of rising operational costs. The cost of energy in all forms has skyrocketed and has touched virtually every aspect of their operations. While TQM, Six Sigma and Lean Thinking concepts are valuable processes to improve operational efficiency these new financial challenges have placed an even greater burden on managers to find ways to improve operational efficiency.

Second, more and more organizations are taking a fresh look at the concept of productivity throughout their organization. If this were only a matter of investing in new technology this challenge would be relatively straightforward, although not always easy. But what makes this productivity evaluation so difficult is that it involves PEOPLE, and this imposes strain and complexities on the employment relationship. As I talk to owners and managers I get a real sense that they are struggling with this issue every day and it often keeps them up at night. As one manager said to me recently - “It is more than just displaying leadership and expecting employees to follow your lead. I must convince all of my employees that we have a common interest in operational efficiency, open up channels of communication, and earn their trust that we will truly listen to them and make the right decisions.”

While employee safety is just one component of a successful strategy here, there is no longer any doubt that it impacts these issues every day. The equation is simple:

Reduced workers compensation claims equals increased productivity

Every day that an injured employee is off work has two devastating effects on the organization. First is the impact on the bottom line. For every $1 of insured workers compensation claim costs the organization incurs between $2 and $10 of uninsured costs. In fact, CompEraser’s clients are averaging $3.80 of indirect, uninsured costs. These uninsured costs result primarily from the reduced productivity of the injured worker and fellow employees. Second, a workers compensation injury is a test of the employment relationship. Not only has a valued employee gotten hurt. It is a breakdown in the organization’s efforts to prevent injuries. Unless the organization has Prompt Injury Response and Temporary Duty Programs which are embraced by all employees and implemented consistently with compassion the trust that management is seeking to earn will quickly evaporate.

Safety is no longer a standalone “silo” within the organization. It truly must be an integral part of its effort to compete profitably in the world marketplace. It touches the hearts and minds of your employees every day. If successful your organizational productivity will increase. If unsuccessful the opposite will occur.

I invite you to take five minutes to estimate your TOTAL COST of worker injuries using OSHA estimates in the privacy of your office. It is on-line and available 24-7. To find out more go to www.comperaser.com. These resources also include injury prevention, OSHA compliance, safety training, prompt injury response, workers compensation disability management, plus more. These resources are available 24/7 and used irrespective of which workers compensation carrier you select. Its patent-pending technology also provides unique financial reports for monitoring the effectiveness of your safety and health program on an on-going basis.

Warning: The Treating Physician’s HIPPA Policy Can Derail Your Workers’ Compensation Claim Management Efforts

The Standards for Privacy of Individually Identifiable Health Information (“Privacy Rule”) establishes a set of national standards for the protection of certain health information.  The U.S. Department of Health and Human Services (“HHS”) issued the Privacy Rule to implement the requirement of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).   The Privacy Rule standards address the use and disclosure of individuals’ health information (called “protected health information”) by organizations subject to the Privacy Rule (called “covered entities”), as well as standards for individuals' privacy rights to understand and control how their health information is used.  Within HHS, the Office for Civil Rights (“OCR”) has responsibility for implementing and enforcing the Privacy Rule with respect to voluntary compliance activities and civil money penalties. 

A major goal of the Privacy Rule is to assure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high quality health care and to protect the public's health and well being.  The Privacy Rule strikes a balance that permits important uses of information, while protecting the privacy of people who seek care and healing.  Given that the health care marketplace is diverse, the Rule is designed to be flexible and comprehensive to cover the variety of uses and disclosures that need to be addressed.

Healthcare providers vary as to their privacy procedures in order to comply with HIPPA. These regulations require covered entities to establish privacy policies but provide no standard guidelines. As a result, there can be as many different privacy policies as there are doctors, hospitals and health plans. There is no guarantee of uniformity. Therefore, employers must increasingly make an effort to understand the privacy standards the health care provider will use in treating their injured employees and make a determination as to whether their privacy standards pose insurmountable problems. In fact, this evaluation may lead to the employer limiting or avoiding the use of their medical services.

CompEraser comes with on-line, on-demand resources needed to evaluate the treating physician’s HIPPA policy and its potential impact on claim management strategy. These resources also include injury prevention, OSHA compliance, safety training, prompt injury response, workers compensation disability management, plus more. These resources are available 24/7 and used irrespective of which workers compensation carrier you select. Its patent-pending technology also provides unique financial reports for monitoring the effectiveness of your safety and health program on an on-going basis. For more information visit our website at www.CompEraser.com.

Warning: Rely Totally Upon Your Workers Compensation Carrier For Safety Support At Your Own Peril

Every year, when you purchase and receive your workers compensation policy, you eventually receive a workers compensation policy. Like most organizations you focus on safety and workers compensation claims and put the policy in the file. In talking with many organizations I find that they expect a lot of safety support from their workers compensation carrier. After all, the workers compensation carrier has promised a high level of service to get your business.

But Read Your Workers Compensation Policy. The Fine Print May Surprise You

Did you know that the services actually provided are not guaranteed and are mainly for the benefit of the workers compensation carrier? Don’t take my word for it. The workers compensation policy says it all. A standard clause in the policy reads:

“We have the right, but are not obligated to inspect your workplace at any time. Our inspections are not safety inspections. They relate only to the insurability of the workplace and the premiums to be charged. We may give you reports on the conditions we find. We may also recommend changes. While they may help reduce losses, we do not undertake to perform the duty of any person to provide for the health or safety of your employees or the public. We do not warrant that your workplaces are safe or healthful or that they comply with laws, regulations, codes or standards. Insurance rate organizations have the same rights we have under this provision.” (Source: Workers Compensation and Employers Liability Insurance Policy, WC 00 00 00 A, page 7 of 8, produced by the NCCI effective April, 1992)

Actually your workers compensation carrier has the right, but is not obligated, to inspect your workplace at anytime. However, many employers take this to mean that such inspections are formal safety inspections and even rely on these inspections to prevent worker injuries. In fact, your workers compensation policy indicates just the opposite. If an insurance company conducts an inspection the following stipulations actually are made:

Your workers compensation is NOT obligated that they will make safety inspections at all.

The inspections provided by your workers compensation carrier are NOT safety inspections. In fact they are only used to determine the insurability of the workplace and the premiums they will charge you (how self-serving it that!);

The insurance company “may” but is not obligated to give you a copy of their report on the conditions they find;

The insurance company “may” share recommendations with you but is not obligated to do so;

The insurance company is clearly indicating they are not performing a duty or service to provide for the safety and health of your employees.

The insurance company in no way warrants that your workplace is in compliance with state or federal laws (i.e., OSHA).

The Dirty Little Secret Is That Workers Compensation Services Are For Their Benefit, Not Yours

It is a mistake to totally rely on your workers compensation carrier to prevent worker injuries. This is further compounded if you change carriers. In the final analysis you will get less than you expect and your total cost of worker injuries will continue to reduce your bottom line profits.

CompEraser comes with on-line, on-demand resources needed to develop and implement an effective safety and health program. These resources include injury prevention, OSHA compliance, safety training, prompt injury response, workers compensation disability management, plus more. These resources are available 24/7 and used irrespective of which workers compensation carrier you select. Its patent-pending technology also provides unique financial reports for monitoring the effectiveness of your safety and health program on an on-going basis. For more information visit our website at www.CompEraser.com.

OSHA’S New Personal Protective Equipment (PPE) Rule -  Are You In Compliance?

The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) announced last Fall its final ruling on employer-paid personal protective equipment (PPE). This new regulation addresses employer payment for personal protective equipment (PPE), which is any safety equipment or device that must be worn in the workplace to prevent worker injury. Common examples of PPE include goggles, gloves, protective footwear, back belts, and ear plugs.

The rule became effective on February 13, 2008. The employer compliance deadline for OSHA’s final rule on payment for personal protective equipment (PPE) expired May 15th, 2008. In short, your organization must now be in compliance with the new ruling.

As a brief overview, many OSHA’s health, safety, maritime, and construction standards require employers to provide their employees with protective equipment, including personal protective equipment (PPE), when such equipment is necessary to protect employees from job-related injuries, illnesses, and fatalities. These requirements address PPE of many kinds: hard hats, gloves, goggles, safety shoes, safety glasses, welding helmets, face shields, chemical protective equipment, fall protection equipment, and so forth. The provisions in OSHA standards that require PPE generally state that the employer is to provide appropriate PPE. However, up until this ruling the OSHA provisions did not specify that the employer is to provide such PPE at no cost to the employee, although the vast majority of organizations did. Under this new ruling OSHA is requiring employers to pay for the PPE provided. The rule does not require employers to provide PPE where none has been required before. Instead, the rule merely stipulates that the employer must pay for required PPE, except in the limited cases specified in the standard.

To comply with PPE regulations, it is recommended that you survey your worksite to determine what type of PPE is needed, communicate those decisions to your workers, and provide the necessary equipment at no cost to the employee where required. Failure to comply with OSHA regulations, including the new PPE rule, can result in fines up to $7,000 per violation, so there is significant bite to this ruling.

CompEraser provides a number of on-line, on-demand resources to help you reduce the total cost of worker injuries. Resources include the formalization of your safety team, injury prevention, OSHA compliance, safety training, workers compensation disability management, plus more. These resources are available 24/7 and used irrespective of which workers compensation carrier you select. Its patent-pending technology also provides unique financial reports for monitoring the effectiveness of your safety and health program on an on-going basis. For more information visit our website at www.CompEraser.com.

New Employee Safety Indoctrination Reduces Workers Compensation Costs

Getting new employees off on the right foot relative to the established safety program is absolutely critical. New employees are at times uneasy and lack a sense of belonging when they are initially hired and brought into the workplace. They are eager to learn and want to succeed. This setting produces an opportunity for the organization’s safety and health team to develop a positive working relationship with new employee in addition to general safety awareness. It also creates significant safety hazards if not addressed early in the employment relationship.

Once a new employee has been assigned to a department, the Supervisor should be responsible for taking following steps. First, immediately after the new employee is introduced to the department the Supervisor should give a copy of the employee safety handbook to the new employee and take the necessary time to review the applicable safety rules and regulations. In this way the new employee is made aware of his or her responsibility to follow all safety rules that apply to their job.

Second, the Supervisor should introduce the Safety Mentor to the new employee. The Safety Mentor should be someone who displays a high level of safety awareness and would be a good example to the new employee in the areas of safety awareness, follows the organization’s safety rules, and exemplifies quality work habits. Ideally, the Safety Mentor should be someone who is familiar with the equipment, tools and process that the new employee will be working with as well.

Third, as part of the new employee indoctrination process, the Supervisor should be required to completely fill out the “New Employee Safety Checklist.” A sample of this form can be obtained by emailing me at info@CompEraser.com. This form must be filled out and returned to the Safety Director at the end of the first day of employment. It must be signed by the Supervisor, Safety Mentor, and the new employee.

Fourth, the Supervisor and Safety Mentor should be expected to observe and monitor the new employee daily and to make sure that safety rules are being obeyed. It is also important that the Supervisor touch base with the Safety Mentor regularly to get his or her feedback as well. Here is a tip that may prove effective. While the new employee is on “safety probation” give them a different colored hard hat. Some companies use a yellow or green hard hat for this purpose. That way everyone knows that the employee is new and under safety probation.

Fifth, once they are satisfied with the progress of the new employee (or at the end of the probationary period), the Supervisor and Safety Mentor will make a recommendation to the Safety Director that the new employee be recognized in some way for his or her accomplishment.

Finally, the new employee should be recognized by the Safety Director and, where possible, receive a certificate of accomplishment.

CompEraser provides a number of on-line, on-demand resources to help you implement a New Employee Safety Indoctrination Program. Resources also include the formalization of your safety team, injury prevention, OSHA compliance, safety training, workers compensation disability management, plus more. These resources are available 24/7 and used irrespective of which workers compensation carrier you select. Its patent-pending technology also provides unique financial reports for monitoring the effectiveness of your safety and health program on an on-going basis. For more information visit our website at www.CompEraser.com.

The General Duty Clause And OSHA Compliance

The General Duty Clause has become increasingly important to employers in the last few years as OSHA has begun to utilize the clause in its penalty and enforcement actions.

The General Duty Clause states:

“Each employer shall furnish to each of his employees employment and a place of employment which is free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees.”

In simple terms, this statement means that an employer may be obligated to protect employees from recognized hazards in the workplace even if there is not an OSHA standard which applies to the situation or if hazards still exist after compliance with a standard. In effect, the General Duty Clause obligates employers to take additional steps toward safety if the well-being of employees is in jeopardy.

The General Duty Clause extends OSHA's authority beyond the specific requirements of the OSHA standards when a recognized workplace hazard exists or potentially exists. The General Duty Clause is often used by OSHA when there is no specific standard which applies to a recognized hazard in the workplace. OSHA may also use the General Duty Clause when a standard exists, but it is clear that the hazards involved warrant additional precautions beyond what the current safety standards require.

OSHA's action on ergonomic hazards in the workplace is a good example of the application of the General Duty Clause in situations where a standard does not currently exist. There are no standards governing job or work station design to reduce or prevent cumulative trauma disorders or other injuries. However, OSHA has widely applied the General Duty Clause to address ergonomic hazards in the workplace. Typically in these situations, OSHA will discover ergonomic-related problems while reviewing a company's accident and injury records. For example, the highly publicized citations issued to several meatpacking plants for cumulative trauma disorders are an example of the use of the General Duty Clause to correct ergonomic hazards. The action in this area eventually led to the issuance of ergonomic guidelines for the meatpacking industry and consideration of a standard for the general industry.

OSHA has also issued General Duty Clause citations on other issues where no apparent safety standard exists. Citations have been issued for lack of training, failure to have additional safety or alarm equipment to detect or warn of chemical leaks, and failure to provide safe locations or safe access to valves or other instruments necessary to an employee's job.  

CompEraser provides a number of on-line, on-demand resources to help you comply with OSHA standards. Resources also include the formalization of your safety team, injury prevention, OSHA compliance, safety training, workers compensation disability management, plus more. These resources are available 24/7 and used irrespective of which workers compensation carrier you select. Its patent-pending technology also provides unique financial reports for monitoring the effectiveness of your safety and health program on an on-going basis. For more information visit our website at www.CompEraser.com.

Accelerate Workers Compensation Cost Reduction By Integrating Safety Into Quality Control Meetings

While using a standard “Safety Suggestion Form” may be used effectively to get feedback from employees and identify unsafe hazards, a potential drawback to this approach is that it requires the employee, through his or her own initiative, to complete it. It also requires a separate response process by the safety and health team. There is another way to get safety suggestions and, at the same time, put safety awareness on overdrive throughout your organization. Have you considered taking your Safety Suggestion Program into the inner workings of your quality control or productivity meetings? The diagram below shows how this process can work:

During the course of your quality control or productivity meeting the participating employees will discuss on-going production or service issues of all kinds, including safety hazards. The team leader will ask for and encourage comments of all kinds. It does not matter what the suggestion is. It could be minor or major. The key is to encourage employee safety suggestions that will improve their productivity. The only requirement is that the team work together to clearly identify the problem and work together to develop a recommended solution for management’s consideration. This process should also be “risk free.”

Once completed the quality control team will submit its recommendations to management for review and action. Management will then review the recommendation, makes its decision on a course of action, and assigns the task to someone to complete in a timely manner. That individual will then develop a budget and implement the action. It is critical that management notify the quality control team within five business days of its decision and also will notify them once the recommendation has been fully implemented. Otherwise the employees will quickly realize that this is just a “management fad” and “they are only interested in production.” By responding promptly management is clearly expressing genuine interest and concern for their safety and backing it up with action.

CompEraser provides a number of on-line, on-demand resources to help you quickly implement this process. Resources also include the formalization of your safety team, injury prevention, OSHA compliance, safety training, workers compensation disability management, plus more. These resources are available 24/7 and used irrespective of which workers compensation carrier you select. Its patent-pending technology also provides unique financial reports for monitoring the effectiveness of your safety and health program on an on-going basis. For more information visit our website at www.CompEraser.com.

A Fast, Down And Dirty Way To Detect Fraud To Reduce Workers Compensation Costs

Workers compensation fraud costs the insurance industry approximately $5 billion each year, according to the National Insurance Crime Bureau, and it is partly blamed for a rise in insurance premiums for businesses across the board. Whether caused by workers, employers, or medical networks, workers’ compensation fraud is a rampant problem that has been worsened by a weakened economy. Unfortunately for companies around the country, workers’ compensation fraud is just one more consideration when conducting business in the current economic climate.

Fraudulent claims are filed by employees who are seeking workers compensation benefits for non-existent conditions or for conditions that are not work-related. Employees seldom stage work-related injuries. That being said, it is more common to find employees who were actually injured off the job and who claim that their injuries occurred at work. As an example, an employee may injure his back while doing yard work over the weekend and wait until the next workday to file the claim as work-related. Fraudulent claim reporting may also occur during plant shutdowns or layoffs, or situations that may create a high degree of employee discontent. The good news is that by identifying the fraudulent claims early you have a good chance of successfully defending them.

One of the key indicators of potential employee fraud is when the employee reports the injury late. This should be a “red flag” and should always service careful review. While in most cases there may be a plausible story behind the delay, it is the employee’s responsibility to report the injury promptly and the employer deserves the right to know why it was reported late.

Another way to quickly detect employee fraud is to compare the facts presented in the following documents: (1) the accident investigation report, (2) the employee’s written or verbal statement, (3) the statement of witnesses to the injury, and (4) the written report from the treating physician. Each of these documents should ideally be obtained in the first 48-hours. If there is a major variance between the facts presented in these documents this should also be a “red flag” and deserve careful review.

It has been my experience that the vast number of fraudulent worker injury claims can be identified using basic, tried and true principles. The patent-pending CompEraser system provides, on-line 24/7, the tools and processes to help your organization respond promptly to a worker injury and, in the process, systematically identify potential fraudulent claims. Resources also include the formalization of your safety team, injury prevention, OSHA compliance, safety training, workers compensation disability management, plus more. These resources are available 24/7 and used irrespective of which workers compensation carrier you select. Its patent-pending technology also provides unique financial reports for monitoring the effectiveness of your safety and health program on an on-going basis. For more information visit our website at www.CompEraser.com.

Attorney Involvement Equals Increased Workers Compensation Costs

When you stand back and think about it, attorneys not only create friction in the worker injury claim process. They often eliminate the win-win option for both the employer and employee. All you have to do is watch TV commercials or read ads in the local newspaper to find how aggressive attorneys are at soliciting workers compensation business. They work hard at giving employees the impression that, by retaining them, their insurance award will be higher. What the employee fails to realize is that many situations they actually get less that they otherwise would. Yet in the process attorneys often exaggerate the system and prolong claim settlement for a percentage of the workers compensation award.

The strategy of the injured employee’s attorney hinges on their involvement early in the claim process. Once the attorney sends a letter of representation to the employer, or files a formal claim on behalf of the injured employee, the employer can no longer discuss the claim with the injured employee. This gives the attorney strategic advantage as they will totally control the information provided to the injured employee.

Once this is established they often try to gain control over the medical care provided to the injured employee. For example, they may send the employee to a healthcare provider who is more likely to provide an evaluation of the employee’s health and work capacity status that suits their legal initiative. Unfortunately, this alternative medical analysis is often in conflict with the information supplied by the initial treating physician. To make matters worse the attorney may send the injured employee to a physician who will provide the more aggressive and invasive care. This not only raises the value of the claim itself, it may not be in the injured employee’s interest.

It has been my experience that the vast number of litigated worker injury claims could have been avoided using basic, tried and true principles. The patent-pending CompEraser system provides, on-line 24/7, the tools and processes to help your organization minimize the involvement of workers compensation attorneys.

Resources also include the formalization of your safety team, injury prevention, OSHA compliance, safety training, workers compensation disability management, plus more. These resources are available 24/7 and used irrespective of which workers compensation carrier you select. Its patent-pending technology also provides unique financial reports for monitoring the effectiveness of your safety and health program on an on-going basis. For more information visit our website at www.CompEraser.com.

Managing Healthcare Practitioners To Reduce Workers Compensation Costs

The workers compensation system is the last bastion of medical cost shifting in the United States An employee benefit program typically contains one or more aggressive cost containment techniques designed to curb rising group medical costs. So how does the healthcare industry recoup this income? You guessed it – through the workers compensation system. As a result, worker injury medical costs are catching the full weight of increases in healthcare costs – and there is no end in sight.

To make matters worse, in many state jurisdictions employees can go to any physician they want, making it very difficult to direct the employee to the most cost effective medical service. As a result, your organization will often lose a high degree of control over the quality and delivery of healthcare to the injured employee. In addition, without proper communication between your organization’s Claim Coordinator and the claim adjuster vital information will not be shared with during the first 48-hours of an injury and the organization’s temporary duty program will not be implemented properly. This lack of communication can drive workers compensation costs through the roof.

Finally, many healthcare practitioners do not understand the workers compensation system. They are well trained in diagnosing an employee’s injury and prescribing the appropriate medical care. However, they often struggle with such things as:

• Working with the employer to develop an ADA-compliant accommodation strategy that will get the injured employee back to work as soon as possible;

• Understanding the “essential functions” of the job the employee performs and putting this in the context of return-to-work strategy;

• The impact that “balance billing” has on the employee’s attitude towards their employer;

• The need to communicate frequently with the Claim Coordinator and claim adjuster throughout the process of employee healing;

• Understanding the different classes of disability and what they mean to effective claim management.

• Understanding the regulatory process associated with workers compensation claims and where they fit into it.

It is recommended that your claim management team develop and use a checklist to evaluate medical providers situated in its local area.  It is also highly recommended that members of the claim management team tour the health provider’s facilities as they complete this survey.

The claim management team should take its time in discussions with medical providers. There should be no mystification as to how medical services will be delivered. Remember that poor communication with medical providers can directly short-circuit the organization’s claim management process.

For a free copy of CompEraser’s checklist titled “Occupational Medical Facilities and Services Checklist” please email us at info@comperaser.com.

CompEraser comes with on-line, on-demand resources needed to design and implement an effective PROMPT INJURY RESPONSE system, including this important step in the process. Resources also include the formalization of your safety team, injury prevention, OSHA compliance, safety training, workers compensation disability management, plus more. These resources are available 24/7 and used irrespective of which workers compensation carrier you select. Its patent-pending technology also provides unique financial reports for monitoring the effectiveness of your safety and health program on an on-going basis. For more information visit our website at www.CompEraser.com.

Further Proof That Prompt Injury Response Reduces Workers Compensation Costs

In previous blogs I had talked about the importance of promptly responding to and reporting worker injuries. What it is intuitively obvious that this will reduce workers compensation costs, Hartford Insurance has recently published its own findings that are quite interesting. There study covered workers compensation medical only and lost-tiime claims from 2003 – 2007.

If the claim is reporting within 48-hours there is no material increase in workers compensation claim cost. However, if the claim is reported a week after the date of injury the cost goes up approximately 5%. If there is a two week delay the cost goes up 19%. If claim is reported 2-3 weeks after the date of injury the cost goes up 23%; after one month the cost goes up 36%. These are amazing numbers and reinforce the necessity for having a structured prompt response program.

Prompt reporting of the worker compensation claim by the injured employee is the first step in providing prompt, quality and compassionate medical care. Your organization should have a written and communicated policy that clearly states that the injured employee must report any and all injuries or illnesses to his or her Supervisor immediately. By the organization’s prompt and fair handling of the situation it is demonstrating its genuine concern for the safety and welfare of the employees. In this way departmental employees will look up to their Supervisors and claim management team as people who take decisive action that is in their best interest and whose first concern is their health and safety. Departmental employees will take to take pride in working for someone who shows genuine concern for them.

You can now benchmark the effectiveness of your PROMPT INJURY RESPONSE program using CompEraser’s Safety And Health Benchmark Survey. If you agree that the critical first step in making quantum improvements in your safety and health program, and reducing your total worker injury costs, is to evaluate what you have in place and measure its effectiveness then this FREE, no obligation, on-line safety assessment is for you. Nowhere else can