Regulatory Roundup, December 2, 2016

This week in comp is a weekly digest of workers’ compensation news from across the country.


Construction firm underbids competitors by cheating workers’ comp system
auto-insurance-fraudA New York construction firm allegedly altered workers’ compensation forms to make it appear as if it was exempt from workers’ compensation coverage. The scheme allowed the company to underbid the next-highest competitor on a project by about one-third. Companies that commit premium fraud gain an unfair advantage over honest competitors…MORE

Fraud by any other name
An Ohio man used aliases to continue working while collecting workers’ compensation benefits. Investigators calls this type of scam double-dipping…MORE


What you need to know about OSHA’s new electronic reporting rule
The retaliation and drug testing components of OSHA’s electronic injury reporting rule went into effect on Dec. 1, 2016. Texas Mutual’s blog explains what employers need to know about the new rule…MORE

Oklahoma airport shooting likely case of workplace revenge
violenceA man who gunned down a Southwest Airlines employee outside of Oklahoma City’s airport likely did so in retaliation for having lost his own job with the airline last year. The tragedy underscores the importance of recognizing and responding to the signs of workplace violence…MORE

Texas logs first case of locally-acquired Zika
A Brownsville resident became the first person to contract the Zika virus from an infected mosquito in Texas. Until now, all of the state’s 250-plus cases of Zika have involved travel to areas that have experienced local Zika transmissionMORE


IDC predicts health care ransomware attacks to double by 2018

The average data breach costs $665,000.

Health care is a soft target when it comes to cyberattacks because the industry hasn’t invested in security technology to the extent that other industries have. Additionally, the increase in internet of things technology results in the convergence of mobile, social and sensors. The result could be a doubling of ransomware attacks against health care institutions by 2018, according to IDC Futurescape…MORE


Free tool gives context to medical costs
The Workers’ Compensation Research Institute has rolled out a new tool that helps stakeholders understand increasing costs for treating injured workers. The tool details medical prices in 31 states, allowing stakeholders to compare pricing, see how policy choices affect pricing, and determine whether fluctuations are local or consistent with national trends… MORE



Zika 101

This week, Texas recorded its first locally-acquired case of the mosquito-borne Zika virus. Pregnant women are especially vulnerable because Zika can cause a birth defect known as microcephaly in unborn children.

In this short presentation, you will learn how the Zika virus spreads and get tips for protecting yourself and your employees.

For the full, recorded version of this Texas Mutual webinar, we encourage you to visit our website.

Heart-healthy Thanksgiving tips for the dining room and the job site

A balanced diet includes sensible portions of the five primary food groups.

A balanced diet includes sensible portions of the five primary food groups.

Loyal readers of this blog know it as a forum for our workers’ compensation pros to share tips on fighting fraud, managing claims and preventing workplace accidents. So what’s with the turkey day tips?

It turns out there is a symbiotic relationship between worker wellness and safety. Healthy workers suffer fewer injuries. When they do get injured, they recover and return to work sooner.

With that in mind, we’re sharing this list of heart-healthy tips from our partners at the American Heart Association (AHA). If you follow the AHA’s advice, you just might emerge from the holiday season heart-healthy and guilt-free. As a bonus, you’ll also be better prepared to navigate on-the-job hazards. (This is a workers’ comp blog, after all.)

Try healthy substitutes
Safety professionals often lean on a strategy called substitution to control workplace hazards. In simple terms, you substitute a hazardous chemical, process or piece of equipment for a safer alternative. For example, you might substitute lead-based paint for acrylic-based paint.

You can apply the same principle, sans paint, to your holiday recipes.

Consider satisfying your sweet tooth by swapping chocolate chips with dried fruit. Instead of whole milk or heavy cream, substitute low-fat or fat-free/skim milk.

Prepare vegetables, eat a balanced meal
Any well-planned building project starts with a firm foundation. In the safety world, we recommend five core elements for building a solid safety program. When it comes to heart health, the experts at the AHA recommend you build your Thanksgiving plate on a solid bed of vegetables. You’ll get the nutrients you need, and you’ll be less likely to overload on the foods your body needs less of.

Increase physical activity
In a previous post, we explained how functional fitness prepares industrial athletes for the rigors of a long work day. A little physical activity can go also a long way toward keeping your heart strong. Instead of plopping down in a lounge chair after a heavy holiday meal, take a walk or spearhead an old-fashioned game of touch football.*

Keep stress to a minimum
Stress compromises your concentration, a lack of concentration can get you injured on the job. Whether you’re working on top of a skyscraper or taking the stairs at the office, one misstep can have serious consequences. Stress also increases your heart rate, constricts your blood vessels and raises your blood pressure. You can manage your holiday stress by planning your schedule to use your time efficiently, focusing on one thing at a time and taking time to relax.

Get enough sleep
Tired workers are more likely to make mistakes that can result in serious or fatal injuries. In fact, traffic accidents are the leading cause of workplace fatalities, and fatigue is too often to blame. Poor sleep quality is also linked to high blood pressure, according to the AHA. It can be difficult to get the recommended six to eight hours of sleep each night during the holidays, so get to bed early and give yourself time to wind down.

Free download
Eating heart-healthy, especially during the holidays, can be difficult. The AHA makes it a little easier with this free Holiday Health Eating Guide. Download it now for healthy versions of your favorite holiday fare.

*Remember to consult your physician before you launch an exercise program.

This week in comp, November 18, 2016

This week in comp is a weekly digest of workers’ compensation news.


OSHA issues final rule on walking/working surfaces, fall protection

OSHA estimates its new walking/working surfaces rule will prevent 29 fatalities and more than 5,842 lost-workday injuries each year.

OSHA estimates its new walking/working surfaces rule will prevent 29 fatalities and more than 5,842 lost-workday injuries each year.

In 1990, OSHA issued a notice of proposed rulemaking for its walking/working surfaces standard. This week, the agency issued the final version of the rule. The new rule goes into effect Jan. 17, 2017…MORE

What you need to know about OSHA’s electronic reporting rule
On Dec. 1, 2016, the anti-retaliation component of OSHA’s electronic reporting rule goes into effect. This week’s blog post explained what the rule means to employers…MORE

The proof is in the post
If posts on Facebook, Twitter and other social media channels are any indication, the public recognizes the potential life-saving benefits of driver-assist technology. An analysis of 50,000 social media posts showed a 21 percent increase in posts about advanced driver assistance systems and vehicle safety technologies. The analysis also showed a 27 percent increase in positive conversations since the launch of the MyCarDoesWhat? website…MORE

West Texas companies earn Texas Mutual’s top safety honor

Click on the image for a full-sized photo of our West Texas safety award winners.

Approximately 200 of Texas Mutual’s 65,000 policyholders earned the company’s top safety award in 2016.

The downturn in the oil and gas market has forced companies to make tough budget decisions. For the 22 West Texas winners of Texas Mutual’s annual safety award, preventing workplace accidents is a priority. Texas Mutual recognized these companies at a special event this week…MORE


Monster classification mistake puts puppeteers on brink of bankruptcy
A New York puppet manufacturer’s workers’ comp premium skyrocketed from $3,500 to $50,000, thanks to a classification code error. The puppeteers, who deal mostly in fur and fuzz, were stamped rubber goods manufacturers and put in the same risky category as tire manufacturers, which melt molten rubber…MORE


Woman who stole from mother guilty of workers’ comp fraud
A woman who stole her disabled mother’s workers’ compensation benefits to support her drug habit must pay $26,170 in restitution to her mother and the insurance carrier…MORE

Texas pharmacist pleads guilty to fraud

A Texas pharmacist faces up to five years in federal prison for his role in a fraud scheme.

A Texas pharmacist faces up to five years in federal prison for his role in a fraud scheme.

A Houston pharmacy owner pleaded guilty in a health care fraud and kickback scheme. The pharmacist admitted to paying about $5.3 million in illegal kickbacks to a Killeen chiropractor in exchange for patient referrals for prescriptions and influencing physicians to prescribe compounded medications supplied by her pharmacy…MORE


NCCI releases latest report on impacts of ACA on workers’ compensation
A reduction in the U.S. obesity rate from 35 to 25 percent, in accordance with the goals of the Affordable Care Act (ACA) wellness initiative, could reduce workers’ compensation medical costs by 3 to 4 percent, according to a study by the National Council on Compensation Insurance. The study also showed the ACA has not discernibly infringed on workers’ compensation claimants’ access to primary care…MORE

What you need to know about OSHA’s new electronic reporting, retaliation and post-accident drug testing rule

This summer, the Occupational Safety and Health Administration (OSHA) increased its citation structure by 80 percent. The increase gives safety- and budget-conscious employers more incentive to fulfill their regulatory obligations. But with OSHA standards covering everything from jobsite drinking water to fall protection, keeping up can be difficult.

Texas Mutual is here to help. Our safety services staff has been fielding questions from employers about one of OSHA’s newest rules: improved tracking of workplace injuries and illnesses. Let’s take a closer look at the rule and clear up some common misconceptions.

The rule includes two components:

  1. Electronic injury and illness reporting: This component requires certain employers to electronically submit the injury and illness information they are already required to keep under OSHA regulations. OSHA designed this component to increase accountability and prevent injuries. The electronic submission requirements take effect Jan. 1, 2017, but OSHA will phase them in. We will dig deeper into this component in a future blog post, so stay tuned for more information.
  2. Anti-retaliation: OSHA reasons that the data it collects under the electronic reporting component will only be accurate if employees feel free to report injuries and illnesses without fear of retaliation. The rule’s anti-retaliation component goes into effect Dec. 1, 2016.

The anti-retaliation component includes three provisions:

  • Employers must inform employees of their right to report work-related injuries and illnesses, free from retaliation. Employers can fulfill this obligation by posting the Job Safety and Health — It’s The Law poster. OSHA also recommends employers make it clear in their employee handbooks and new employee orientation materials that employees have the right to report workplace injuries.
  • An employer’s procedure for reporting work-related injuries and illnesses must be reasonable and must not deter or discourage employees from reporting. For example, procedures that do not allow a reasonable amount of time for an employee to realize they have suffered a work-related injury or illness could violate this provision.
  • An employer may not retaliate against employees for reporting work-related injuries or illnesses. OSHA cites three types of polices that could be considered retaliatory under this provision: disciplinary policies, drug-testing polices and incentive policies.

Question: Am I allowed to discipline employees for violating safety rules?

Answer: The rule does not prohibit an employer from disciplining employees for violating legitimate safety rules, even if that employee was injured as a result of the violation. The rule does prohibit retaliatory, adverse action against an employee simply because they reported a work-related injury or illness. Examples include suspension, harassment, reassignment and termination.

Question: Does the rule prohibit employee safety incentive policies?

Answer: No, but it does prohibit incentive programs that deter or discourage an employee from reporting an injury or illness. Incentive programs should encourage safe work practices and promote worker participation in safety-related activities.

Question: Does the rule prohibit post-accident drug testing?

Answer: Employees who abuse drugs or alcohol compromise their own safety and their co-workers’ safety. The new rule does not prohibit post-accident drug testing. But it does stipulate that if an injury or illness is very unlikely to have been caused by employee drug use, or if the method of drug testing doesn’t identify impairment but only use at some point in the recent past, a drug test might inappropriately deter reporting.

For example, it would likely not be reasonable to drug test an employee who reports a bee sting, a repetitive strain injury or an injury caused by a falling object.

Question: What if U.S Department of Transportation regulations require me to conduct post-incident drug tests?

Answer: If an employer conducts drug testing to comply with the requirements of a state or federal law or regulation, the employer’s motive would not be retaliatory, and testing would not be prohibited.

More information

For more information about the improved tracking of workplace injuries and illnesses rule, see OSHA’s fact sheet and list of frequently asked questions. If you still have questions about the rule, contact your local OSHA office or the Occupational Safety and Health Consultation program.




This week in comp, November 11, 2016

This week in comp is a weekly digest of workers’ compensation news from around the country.


Injuries requiring days away from work drop

Carpal tunnel syndrome and tendonitis accounted for the fewest cases involving days away from work.

Carpal tunnel syndrome and tendonitis accounted for the fewest cases involving days away from work.

The number of Texas workplace injuries involving days away from work fell from 52,970 in 2014 to 46,440 in 2015, according to a TDI report. Injured employees in the information industry recorded the highest number of median days away from work at 22…MORE

Get in rhythm with the time change
Last Sunday, Americans set their clocks back one hour in an annual ritual known as fall back. The extra hour of sleep that night was a nice perk, but the time change also increases the risk of a pervasive, chronic safety issue: traffic accidents…MORE

4 reasons employers should have a driver safety program
Traffic accidents costs employers $60 billion and three million work days each year. Considering the human and monetary costs of accidents, employers cannot afford to pass on the National Safety Council’s free driver safety program resources…MORE


Ready your workplace for the flu
The flu costs employers 111 million work days and $7 billion in sick days and lost productivity each year. OSHA offers free resources to help employers reduce the flu’s impact on their employees and their bottom line…MORE


A workplace wellness program can help reduce heart disease and other chronic health issues.

Wake-up call leads CEO to American Heart Association
Sometimes, a major health issue hits close to home and motivates us to make changes in our lives. That’s what happened to Texas Mutual President and CEO Rich Gergasko when he found out a co-worker died from a heart attack…MORE


Injured TX employees have ready access to medical care, study shows
In 2015, 84 percent of injured workers in Texas received initial care in seven days or less, compared to 76 percent in 2000. That is significant because studies show injured workers who aren’t treated within seven days accumulate an average of 40 percent more in medical costs over the first six months of an injury, according to a new study by the Workers’ Compensation Research and Evaluation Group…MORE

Social media: Good and bad for insurers, claims
Sometimes, claimants have a positive experience with an insurer and tell their friends about it on Facebook. That’s valuable word-of-mouth advertising money can’t buy. But social media can also hinder claim and lawsuit settlements…MORE


Workers’ compensation rates in Texas among nation’s lowest
Thanks largely to lower injury rates, better return-to-work outcomes and reduced medical costs, Texas employers pay the 10th-lowest workers’ compensation rates in the country, according to a study by the Oregon Department of Consumer and Business Services…MORE

NCCI releases 2016 workers’ comp issues report

Agents can bookmark Texas Mutual's website for the latest NCCI developments.

Agents can bookmark Texas Mutual’s website for the latest NCCI developments.

For every $100 of medical services paid on claims older than 10 years, approximately $45 to $50 will be for prescription drugs, according to the National Council on Compensation Insurance Workers’ Compensation 2016 Issues Report…MORE


New York rolls out administrative option for curbing opioid epidemic
In New York, payers can now request a hearing before the Workers’ Compensation Board to determine whether continuing opioid usage is necessary or weaning from opioids is recommended…MORE


Employer gets six months in jail for fraud scheme
An Ohio court sentenced the owner of a tree-trimming service to six months in jail for bilking his workers’ comp insurer out of $22,000 in premiums…MORE

Get in rhythm with the time change

On Sunday, Americans set their clocks back one hour in an annual ritual known as fall back, not to be confused with its spring counterpart, spring forward. If you forgot about the time change and arrived one hour early to work on Monday, you’re probably not alone.

Unfortunately, it would take an act of Congress – literally – to change the system.

The Uniform Time Act of 1966 dictates that Americans move the clocks forward one hour on the second Sunday in March (Daylight Saving Time) and one hour back on the first Sunday in November (Standard Time).

Besides messing with our morning commute, the return to Standard Time increases the risk of traffic accidents. That’s because the sun rises and sets earlier, which affects the body’s natural sleep cycle, known in scientific circles as the circadian rhythm. It also means more light on the way to work and less light on the drive home.

Maybe Congress will eventually see the light and legislate out all this falling back and springing forward. In the meantime, follow these tips to stay safe behind the wheel and on foot.

Sleep well: Our bodies need several days to adjust after the time change. Don’t exacerbate the problem by building a sleep deficit. Get seven to nine hours of qualify sleep each night.

Maintain your vehicle: Adequate, quality sleep prepares your body to fall back one hour. You should prepare your vehicle for the time change, as well. Make sure all your lights work properly, check your mirrors for cracks, and clean streaks from your windshield to offset glare. Don’t forget to make sure your headlights are aimed correctly by shining them on a wall about 25 feet away. If one light is higher than the other, adjust the aim.

Control glare: Counter the effects of daytime glare by wearing anti-reflective sunglasses, but remember to remove them at dusk. You can reduce nighttime glare from headlights by using the night setting on your rearview mirror.

Scan the road: Scanning the road at night helps your eyes adjust to the dark. It also keeps you more alert and ready to respond to unforeseen incidents, such as people and animals crossing the road. The Insurance Council of Texas (ICT) notes that Texas leads the nation in deaths from deer collisions. The ICT advises motorists to use extra caution in November, when deer-related crashes traditionally spike.

Walk this way: Pedestrians are nearly three times more likely to be killed by cars in the days following the end of Daylight Saving Time, according to a Carnegie Mellon University study. If you’re walking around at dawn or dusk, wear brightly colored or reflective gear. Always use crosswalks, look both ways before crossing, face oncoming traffic and use sidewalks when possible.

Keep a close eye on children: More children are hit by cars near schools than at any other location, according to the National Safe Routes to School program. Drivers should protect kids by slowing down and avoiding distractions in school zones, as well as near buses and playgrounds. Parents should make sure children use the curbside door away from traffic when entering or exiting a vehicle.

Get more information

Visit the National Safety Council for more information about how the time change compromises driver safety. For other fall back safety tips, visit the American Society of Safety Engineers.