This week in comp, September 23, 2016

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

Texas Mutual news

Rich Gergasko has served as Texas Mutual president and CEO since 2013.

2016 Best CEOs: Rich Gergasko, Texas Mutual
Texas Mutual President and CEO Rich Gergasko was named among the best CEOs of 2016 by the Austin Business Journal…MORE

10 tips for surviving an OSHA inspection
OSHA increased its fee structure by 80 percent in August. This week’s blog post featured 10 tips employers can follow to stay off OSHA’s radar and survive an audit if an inspector comes knocking…MORE

VR safety tool earns innovation award

Texas Muutal’s Jeremiah Bentley accepts an innovation award for the company’s virtual reality safety training tool, Safety in a Box.

Texas Mutual earned an SMA Innovation in Action Award for its Safety in a Box virtual reality training tool. The award spotlights insurers and solution providers who completed transformational projects or initiatives in the past year…MORE
Safety

Zika update
As of Friday, September 23, Texas has recorded 201 cases of Zika virus, with Harris County accounting for 56 of those cases. All cases were associated with travel to an area where Zika is being spread…MORE

Top 5 ergonomic trends redefining the workplace
Everyone wants to be Google. The trendy tech company is redefining corporate culture with its free gourmet meals, massages and nap pods. It’s also redefining workspaces by making them fit their employees’ bodies…MORE

Opioid epidemic

Opioid epidemic costs U.S. $78.5 billion annually: CDC
Abuse of powerful prescription painkillers called opioids costs the U.S. economy $78.5 billion a year in lost productivity, direct health care costs and costs to the criminal justice system, according to a new study from the Centers for Disease Control and Prevention. Medicaid, Medicare and other public programs shoulder nearly 25 percent of the costs…MORE

Jury convicts pill mill doctor

The opioid epidemic claims 78 American lives every day.

A California doctor faces 13 years in prison for unlawfully prescribing controlled substances without a legitimate medical need to undercover operatives working with the Drug Enforcement Administration…MORE

Technology

Why insurers must pick up their technology pace
Nowadays, insureds are just as likely to compare a carrier’s service responsiveness to that of companies such as Amazon as they are to compare them to another carrier’s responsiveness. That means insurers must adopt technology to streamline their operations…MORE

Claims

Workplace wellness programs can help reduce operating costs and improve productivity.

Overweight and obesity linked to high workers’ comp costs for major injuries
In a new study of major-injury claims, costs for obese workers averaged about $470,000, and costs for overweight workers averaged $270,000. That compares with average costs of $180,000 for normal-weight workers. The study underscores the importance of workplace wellness programs…MORE

State fund news

Beacon Mutual automates medical-only claim process
Information technology and claims professionals at Beacon Mutual put their heads together to streamline the medical-only claims process. The organization’s new medical-only auto-adjudication tool files medical-only claims and issues payments without human intervention…MORE

New Mexico Mutual empowers underwriters with predictive technology
New Mexico Mutual has partnered with Valen Analytics to give underwriters increased visibility into risks and set consistent prices with a new predictive analytics tool…

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10 tips for surviving an OSHA audit

From Billboard’s Hot 100 to the Ten Most Dangerous Hackers, people love lists. Some lists are an honor to be part of. Case in point, Texas Mutual was thrilled to be named a 2016 Wards 50 Top-Performing P&C Carrier. And then there are lists you want no part of. Case in point, OSHA’s list of top 10 violations.

This summer, OSHA increased its fee structure by 80 percent. That means if an inspector catches you violating standards, it could cost you up to $124,709 per violation.

OSHA’s new fee structure
Type of violation	Previous maximum penalty	New maximum penalty
Serious Other-Than-Serious Posting Requirements	$7,000 per violation	$12,471 per violation
Failure to Abate	$7,000 per day beyond the abatement date	$12,471 per day beyond the abatement date
Willful or Repeated	$70,000 per violation	$124,709 per violation

Now, most employers will never cross OSHA’s radar. The agency only employs one inspector for every 59,000 job sites. But what if OSHA does come knocking?

In the spirit of our affinity for lists, here are 10 tips for surviving an OSHA inspection.

Report injuries and illnesses

OSHA requires employers to record and report all fatalities, as well as certain injuries and illness. Starting in 2017, OSHA will require many employers to submit injury and illness records electronically. You can avoid costly fines by complying with recording and recordkeeping requirements.

Know what triggers an inspection

OSHA conducts programmed and unprogrammed inspections. Programmed inspections are planned. They focus on high-hazard companies and industries. Unplanned factors, including fatalities, severe injuries and employee complaints, trigger unprogrammed inspections.

Understand the inspection process

OSHA inspections follow a strict process, starting with the inspector presenting his or her credentials. From there, the inspector explains the purpose of the visit during the opening conference. The inspector will then walk the job site looking for hazards. The process wraps up with the closing conference, where you learn about any violations the inspector found.

Create an I2P2

A written injury and illness prevention program, known in OSHA-speak as an I2P2, provides a road map for sending employees home injury-free. The plan identifies the hazards employees are exposed to, explains how the company will protect employees and assigns accountability within the program.

Keep accurate records

Accurate records are a critical component of any successful safety program. They’re also a key part of OSHA inspections. During the opening conference, you will present your written I2P2, safety training records, medical surveillance records and OSHA logs. The inspector will also ask for applicable OSHA-required programs, such as hazard communication, hearing conservation, forklift safety and confined spaces. For sample programs, visit OSHA and the Texas Department of Insurance (TDI) online.

Don’t fall victim to scams

OSHA requires its inspectors to present their credentials before entering any workplace. There have been reports of people posing as inspectors and issuing fake citations or coercing employers into buying products or services to avoid violations. An OSHA inspector will never ask for immediate payment for a citation. You can verify an inspector’s credentials by calling the nearest OSHA area office.

Don’t interfere with the inspection

Sometimes, an employer allows the inspector to enter but interferes with or limits an important aspect of the inspection, such as the walk-through or employee interviews. Remember that interference could result in legal action.

Apply for variances

You might qualify for a compliance exception, or variance, to an OSHA standard. For example, some employers may not be able to comply fully and on time with a new safety or health standard because of a shortage of personnel, materials or equipment.

Get compliance assistance

If you’ve tried to navigate OSHA’s standards, you know it’s easy to get overwhelmed. Fortunately, you’re not on your own. Take advantage of these free OSHO-sponsored compliance assistance programs:

• OSHCON – OSHA partners with TDI to offer the Occupational Safety and Health Consultation (OSHCON) program. The program is a non-regulatory service that helps employers identify and correct violations without getting fined.
• VPP – Qualifying employers can enroll in OSHA’s voluntary protection program (VPP). Participating employers are exempt from programmed inspections while they maintain their VPP status.

Visit Work Safe, Texas

Maintaining a safe workplace is the best way to stay off OSHA’s radar, and Texas Mutual is here to help. We refresh worksafetexas.com each month with relevant, free resources. We encourage every employer to leverage the resources and make safety a value in their organization.

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This week in comp, September 16, 2016

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

Safety

OSHA issues two new temporary worker guidance documents

OSHA recommends staffing agencies and host employers  share responsibility for keeping temporary workers safe.

OSHA has issued new guidance documents that provide tips for protecting temporary workers from bloodborne pathogens and powered industrial truck hazards. The documents are part of OSHA’s initiative to reverse injury trends among temporary workers…MORE

Worker burned by hot grease when restaurant floor collapses
A worker at a fast-food chicken restaurant near Houston suffered burns over 65 percent of her body when a damaged floor collapsed and caused dozens of gallons of boiling grease from nearby fryers to spill. The incident underscores the importance of keeping workplaces in good condition and repairing damage as soon as possible…MORE

Fraud

Berkshire accused of stealing workers’ comp premiums
A complaint filed in New York accuses Berkshire Hathaway of executing a reverse Ponzi scheme on consumers. The complaint states victims of the scheme are led to believe their capital is being paid into protected cells and will eventually be returned to them. Instead, it is siphoned off through an unregistered Hawaiian entity, leaving New York employers and injured workers without the funds required by New York State to cover losses related to worker injuries…MORE

Man accused of stealing dead person’s worker’s compensation checks
A Florida man is facing a charge of organized fraud in connection with the alleged theft of $20,000 in workers’ compensation checks for a Melbourne man who died in January 2015…MORE

Opioid epidemic

Texas closed formulary reduces costs, opioid use

Texas’ closed formulary requires prior approval before a doctor can prescribe certain drugs, also known as N drugs.

Texas’ closed formulary has contributed to a 15 percent drop in total drug costs, an 80 percent drop in N-drug costs and an 81 percent drop in prescriptions for N-drug opioids, according to a Texas Department of Insurance report…MORE

Cost of opioid misuse treatment services grew 1,000% over four years
Between 2011 and 2015, professional charges for services provided to opioid abusive or dependent patients grew from $71.66 million to 721.80 million, a 1,000 percent increase. The two most expensive groups of billable codes researchers found for those diagnosed with opioid abuse were for emergency department services…MORE

Drugs in U.S. workplaces hit highest level in decade
Following years of decline, the percentage of employees in the combined U.S. workforce testing positive for drugs has steadily increased over the last three years to a 10-year high, according to a new report. The report did show a decline in positive tests for certain prescription opiates but an increase in positive tests for heroin…MORE

Underwriting

A.M. Best special report: Workers’ comp has likely entered soft market

In a soft market, competition among carriers increases, and pricing decreases.

Rate declines that began in the first quarter of 2015 persisted through the second quarter of 2016 and ushered the workers’ compensation market into the soft phase of its cycle, according to a new report by A.M. Best. The report also notes that in 2015, seven of the 18 state funds had market shares of at least 50 percent in their respective states, and each ranked first in its state based on direct premiums written…MORE

Claims

Uber-like video service lets adjusters assess damage from their desks
Uber’s ride-sharing model has infiltrated the insurance industry. A new service allows insurance adjusters to get videos of losses without leaving their desks. The videos are supplied by an Uber-like network of 64,000 contracted smartphone users called Droperators…MORE

Regulatory roundup

Oklahoma Supreme Court declares opt out unconstitutional
Oklahoma’s opt out law is an unconstitutional “special law” that creates impermissible, unequal, disparate treatment for injured workers, according to a ruling by the state’s Supreme Court. The ruling leaves Texas as the only state that allows employers to opt out of the workers’ compensation system…MORE

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This week in comp, September 9, 2016

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

Texas Mutual news

Make safety a universal language
In 2015, there were 26.3 million foreign-born people in the U.S. labor force, comprising 16.7 percent of the total. This week’s blog post explained how to break down communication barriers and make safety a universal language…MORE

Safety

Study examines how financing constraints affect workplace safety
A new study by researchers at the University of Texas found that injury rates increase with negative cash flow, suggesting some companies cut safety from the budget when business gets lean…MORE

OSHA now offers its entire website in Spanish
OSHA recently announced that users can instantly translate any page on its website into Spanish by clicking a button in the upper-right corner of the page…MORE

Fraud

New TDI fraud unit tool cuts intake processing time in half
The Texas Department of Insurance’s fraud unit has a new case management system that cuts the time it takes to get fraud reports into investigators’ hands by half. Among the system’s high-profile benefits is the automatic download of data from the National Insurance Crime Bureau and the National Association of Insurance Commissioners…MORE

Fraud alert: Thieves are trying to steal your medical identity
There were an estimated 2.3 million cases of medical identify theft in 2014, according to Consumer Reports. Experts say the biggest risk is medical, not financial, because the thief’s medical information can get mixed up with the victim’s…MORE

Claims

6 trends that will change insurance claims

With more devices linked to the Internet of Things, closer and more effective monitoring of businesses and individual behavior has become a reality.  Technology is one of six trends poised to change every link in the claims process.…MORE

Opioid epidemic

The opioid paradox: Prescription opioid use declines as heroin use increases
Addiction to prescription opioids makes an individual 40 times more likely to become addicted to heroin, according to the Centers for Disease Control and Prevention. The first step in combating heroin addiction is to decrease the overprescribing of opioids…MORE

What workers’ comp payers need to know about Naloxone
Health care providers are increasingly prescribing Naloxone to counter the ill effects of opioid analgesics. Experts attribute the trend to regulatory reforms that have improved Naloxone access and elevated awareness of how opioid analgesics affect the major body systems…MORE

 

Underwriting

Ratings agencies expect reinsurance premiums to continue dropping in 2017
Reinsurance pricing could drop 5 percent in 2017, according to ratings agencies. Experts attribute the decrease to competition driven by high returns and low interest rates…MORE

State fund news

BWC awards funding to Ohio universities for workplace safety research
The Ohio Bureau of Workers’ Compensation has awarded grants totaling more than $900,000 to two Ohio universities to conduct research in occupational health and safety. One study at Ohio State University will explore solutions to patient-handling injuries among firefighters…MORE

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Make safety a universal language

Imagine it’s your first day on the job with a construction crew, and you’re laying a foundation for a fancy office building. High above, another worker is walking along a scaffold. He accidentally kicks a hammer off the scaffold, and you are directly below it.

Common Safety Messages
English	Spanish
Clean up spills	Limpiar derramamientos
Emergency exit	Salída de emergencia
Entrance	Entrada
Exit	Salída
Hot	Caliente
Report accidents	Reportar accídentes
Report hazards	Reportar pelígros
No smoking	No fumar
Wear seat belts	Usar sinturon de seguridad
Wet floor	Piso mojado

Fortunately, your company has a total safety culture in which everyone is accountable for their own safety and their co-workers’ safety.

With that in mind, someone yells, “¡Cuidado, el martillo se puede cáer sobre ti!”

Your co-worker just warned you to get out of the way. If you don’t speak Spanish, you probably missed the message.

That’s a predicament non-English speaking workers face every day.

Who are America’s foreign-born workers?

In 2015, there were 26.3 million foreign-born people in the U.S. labor force, comprising 16.7 percent of the total. So who are they, and how do they make their livings? To help you paint a picture, here are a few 2015 statistics, courtesy of the Bureau of Labor Statistics:

Ethnicity: Hispanics accounted for 48.8 percent of the foreign-born labor force, followed by Asians at 24.1 percent.

Gender: Men accounted for 58.3 percent of foreign-born workers.

Occupations: The top three occupations for foreign-born workers were management, professional and related occupations at 30.8 percent; service occupations at 23.4 percent; and sales and office occupations at 16.6 percent.

Age: Workers between the ages of 25 and 54 made up 73.7 percent of the foreign-born labor force, compared with 62.5 percent for native-born workers.

Region: The foreign-born made up a larger share of the labor force in the West and Northeast at 24 and 19.5 percent, respectively. Foreign-born workers comprised 15.5 percent of the labor force in the South and 8.7 percent in the Midwest.

From minority to majority

Now that we have a picture of America’s foreign-born labor force, what about the Lone Star State? In 2005, minorities became the majority in Texas, representing 50.2 percent of our population. Hispanics make up Texas’ largest minority group, and that won’t change anytime soon.

In fact, demographers expect the state’s population to double by 2050, with Hispanics accounting for 60 percent of our population. And if the data analysis experts at IHS are correct, 55.4 million Hispanics will speak Spanish in their homes by 2034, a 50 percent increase over 2014.

So what does that mean for employers who care about their employees’ safety and want to send them home injury-free?

Message received

You know that fizzy, sweet drink Texans call a Coke, regardless of what brand we’re talking about? It’s also called pop and soda in other parts of the country.

Language can be a barrier to communication, even among people who speak the same language. Imagine how hard it is for Hispanic workers who speak little or no English.

Fortunately, you can make safety a universal language in your workplace if you follow a few simple tips:

• Remember that the Occupational Safety and Health Administration (OSHA) requires you to train workers in a language they understand. Consider hiring a translation company to put safety training material into Spanish. Make sure the translator is fluent in the Spanish dialects your employees speak.
• Use more pictures and fewer words to point out hazards and teach safety procedures.
• Provide hands-on demonstrations of the safe way to do each task.
• Remember that most communication is nonverbal. Watch workers’ eyes, body language and expressions to see whether they understand instructions.
• Train supervisors in basic, conversational Spanish. Send non-English speaking Hispanic workers to a conversational English class that includes commonly used words in your industry.
• Hire Spanish-speaking supervisors who have experience in your industry.
• Keep safety training basic, and ask bilingual employees to translate messages.
• Offer safety training away from the workplace. If the trainer is someone other than a manager, employees may be less intimidated and more likely to ask questions.

Get free resources

Texas Mutual policyholders have free access to Spanish-language training materials in the safety resource center at texasmutual.com. Anyone can take advantage of OSHA and Texas Department of Insurance (TDI) training materials for Spanish-speaking workers. OSHA recently announced that users can translate every page on its website into Spanish with the click of a button. And TDI’s free services include Spanish-language OSHA 10-hour construction training.

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This week in comp, September 2, 2016

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

Safety

Temporary worker safety: A shared responsibility

OSHA’s temporary worker initiative includes free resources for preventing workplace accidents.

Employers increasingly hire temporary workers to cut costs, lower liability and fill needed slots when permanent help isn’t unavailable. Unfortunately, temporary workers are more likely to get injured, according to an expert who spoke at a national safety conference this week. OSHA expects host employers and staffing agencies to share responsibility for keeping temporary workers safe…MORE

Prevent hot car deaths
Of the 755 children who have died in hot cars since 1990, 55 percent were unknowingly left behind. Manufacturers are introducing technology that can help reduce these tragedies, but there are also low-tech option parents can use…MORE

Fraud

Charges target 16 in ‘massive’ $175M insurance fraud scheme
A federal court has charged 16 conspirators involved in a massive compound medication scheme that generated more than $175,000,000 in criminal proceeds. The conspirators face from five to 25 years in prison, along with fines ranging from $250,000 to 500,000…MORE

Former claims examiner sentenced to 15 months in federal prison for taking bribes

Statistics show insurance fraud is not a victimless crime.

Perry Rowell, a former senior claims examiner at the Department of Labor’s Office of Worker’s Compensation Program (DOL/OWCP), was sentenced to 15 months in federal prison after pleading guilty to one count of bribery received by a public official. A former DOL/OWCP claims supervisor who now represents claimants before the OWCP paid Rowell $24,000 in brides over a two-year period. In exchange, Rowell expedited claim payments and decisions…MORE

Claims

Nonprofits provide a helping hand for return-to-work
Employers who bring injured workers back to the team under modified duty can increase productivity and reduce costs. But what happens if modified duty isn’t an option? Some employers allow injured workers to contribute their time to nonprofits until they can return to work…MORE

WCRI study shows variations in hospital outpatient care costs across states

Texas was one of 33 states included in a WCRI study of outpatient care costs.

Hospital outpatient payments per surgical episode varied significantly across states in 2014, ranging from 69 percent below the study-state median in New York to 142 percent above the study-state median in Alabama, according to a new study by the Workers’ Compensation Research Institute…MORE

Opioid epidemic

FDA issues new labeling requirements for opioids, benzodiazepine
The Food and Drug Administration has issued new labeling requirements that warn consumers about the dangers of mixing opioids and benzodiazepine. The new requirements, part of the FDA’s Opioids Action Plan, will affect approximately 400 products. Between 2004 and 2011, overdose deaths involving both classes of drugs nearly tripled…MORE

Houston Doctor accused of running illegal pain clinic

Synthetic drugs such as K2 are chemically made versions of legal drugs that are slightly altered to avoid being classified as illegal.

Houston doctor Melanie Mencer-Parks is accused of running an illegal pain management clinic. When patients arrived at Parks’ Synergy Medical and Wellness Group office, a staff member met them in the parking lot to collect cash payments before ushering them inside, according to court documents…MORE

Synthetic drugs evade detection
Standard drug tests typically detect marijuana, heroin and other traditional drugs. But there is a new class of drugs, called synthetic drugs, that does not show up in traditional tests. That’s why employers should learn to recognize the signs of abuse…MORE

Technology

In claims, all roads lead to innovation
Virtual reality and the Internet of Things are just two examples of how claims departments are leveraging technology to improve efficiency, effectiveness and customer experience…MORE

Cybersecurity ‘has to be everyone’s problem,’ says former NYPD commissioner
There are four primary catastrophic events that can impact business, according to Ray Kelly, the New York Police Department’s longest-serving commissioner. Kelly says all four involve cyber security…MORE

The best of the rest

Opposing sides file briefs in challenge to Oklahoma’s work comp opt-out
In 2013, Oklahoma legislators passed a law allowing employers to opt out of the workers’ comp system. The law requires opt-out employers to provide alternative benefit plans equal to or better than comp. An employee whose work-related injury was denied as a pre-existing condition by an alternative plan is now challenging the law…MORE

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Reasonable accommodations: Lessons from the gridiron

Jason Pierre-Paul is among the mere 1.6 percent of college football players gifted enough to make it to the National Football League. Pierre-Paul, better known as JPP, is a pass-rushing defensive lineman for the New York Giants. In layman’s terms, he makes a living – a darn good one – making life difficult for the opposing team’s quarterback.

Sample reasonable accommodations
Injury	Accommodation
A warehouse worker with a shoulder injury had trouble reaching material overhead.	Storage areas were rearranged so heavy and frequently used materials were accessed at waist level.
A forklift driver with rheumatoid arthritis had difficulty grasping the steering wheel.	The forklift was fitted with a spinner ball to eliminate the need for grasping.
A data entry clerk was having difficulty sitting for long periods due to his back impairment.	He was accommodated with a sit/stand workstation, an ergonomic chair and a copy holder.
A medical technician who was deaf could not hear the buzz of a timer, which was necessary for specific laboratory tests.	An indicator light was attached to the equipment.
A police dispatcher with heart disease had fatigue, which worsened when he did not keep a regular sleep schedule.	He was accommodated with a dayshift instead of having to rotate shifts.
Credit: Job Accommodation Network

Like anyone how ascends to the game’s highest level, JPP has worked hard all his life, and he can spend his money on whatever he sees fit. And that’s exactly what he did last summer, when he purchased a U-Haul van full of fireworks for a Fourth of July party at his home.

Despite sage advice from the Occupational Safety and Health Administration, JPP orchestrated the show himself rather than hiring a professional. And that was just fine until a bottle rocket exploded in his hand. Witnesses say a green and white light instantly swallowed JPP’s 6′ 5″, 278-pound frame.

If you follow the game even marginally, you know JPP survived the ordeal relatively intact, with one notable exception. Doctors had to amputate his right index finger, as well as part of his thumb and middle finger.

When you spend the better part of your life learning to use your hands to move opposing players out of your path, losing even one digit is devastating. So it’s no surprise JPP panicked in the aftermath of the accident.

It’s not that he can’t do his job anymore. He just has to learn how to do it differently. And that is the perfect jumping off spot for two key points in today’s post:

1. Your employees’ personal lives inevitably carry over into their work lives.
2. Injured employees might not be able to return to their normal duties immediately, but that doesn’t mean that can’t contribute to productivity. You might be able to work with the treating doctor to come up with reasonable accommodations.

Reasonable accommodations are modifications or adjustments to a job, the work environment or processes that enable a person to work. For JPP, that means a wrist strap fitted with hooks to help him lift weights and a glove custom-fitted for his right hand.

The adaptive devices industry grows every day, so it’s easier than ever to identify and implement reasonable accommodations. Some are simple, and some require creative thinking.

Basic solutions include one-handed keyboards to accommodate hand injuries, chairs that allow workers with spinal conditions to alter sitting positions, software that increases text size for people with visual impairments, and adjustable-height work surfaces.

Advanced solutions include re-engineering packaging machines, modifying cutting devices and switching to lightweight, plastic dumpster lids. The only limits on adaptive devices are our own imagination and the laws of physics. It’s all about finding what works for your employee. And that’s where they can help.

Texas Mutual return-to-work specialists recommend employers collaborate with their employees to identify reasonable accommodations. Employees know their jobs better than anyone, and they are in the best position to tell you what will work for them.

Reasonable accommodations can be costly in the beginning, but they ultimately pay off for employees and the bottom line. If return-to-work sounds like a worthy investment for your business, take advantage of the free resources you have access to.

Texas Mutual’s website includes webinars, state-mandated forms and a comprehensive guide to implementing all aspects of a return-to-work program. The Texas Department of Insurance also offers a range of free material on its website.

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