This week in comp, July 29, 2016

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

Safety

OSHA penalties to rise nearly 80% beginning August 1

OSHA is increasing its fines for the first time since 1990 to adjust for inflation.

OSHA is increasing its fines for the first time since 1990 to adjust for inflation.

Beginning Aug. 1, 2016, OSHA will increase the maximum penalty a company must pay per violation from $7,000 to $12,471 . If a company fails to correct a violation, it will face a maximum penalty of $12,471 per day, also up from $7,000…MORE

Vermont police say drunken driver who crashed was playing Pokemon Go
Alcohol and distraction contributed to a car crash in Vermont this week. Police say the driver had a blood-alcohol content of .205, more than twice the legal limit of .08. The man also admitted he was distracted because he was playing Pokémon Go on his cellphone…MORE

Studies on traffic near work zones produce a new way to merge
A new driving method, called the zipper merge, has been shown to decrease the overall length of traffic backup by up to 40 percent and lower the chance of fender benders near work zones. Minnesota, Washington, Kansas and Missouri are promoting the zipper merge, in which drivers wait until they approach the closed lane before merging rather than moving over as soon as they see signs…MORE

Things are safer in a connected world
Every day, billions of wearables, cellphones and other devices exchange information with each other. It’s called The Internet of Things (IOT), and it is poised to revolutionize workplace safety. This weeks Texas Mutual blog post put the abstract IOT into concrete language we can all understand…MORE

Claims

pill bottle with money

Congress recently approved
$180 billion in grants to fight opioid abuse, a major driver behind pharmacy costs.

Work comp drug spend going down
On average, payers’ drug spend dropped 6.5 percent from 2014 to 2015, according to CompPharma’s annual Prescription Benefit Management in Workers’ Compensation Survey. Joe Paduda of Managed Care Matters says the biggest driver behind the reduction is the depth and breadth of pharmacy clinical management programs…MORE

New FAA rules open door for increased use of drones in insurance
The recent release of Federal Aviation Administration (FAA) rules for drones weighing less than 55 pounds will allow drones to be used in more commercial applications, including claim investigations. The FAA says the new rules, which go into effect August 29, are designed to minimize risks to other aircraft, people and property…MORE

Fraud

8 ways social networks can help identify fraud
Claim adjusters and investigators often examine a claimant’s social media activity for inconsistencies and misrepresentations. But insurers should also leverage the wealth of information provided by social network analysis (SNA). SNA helps insurers identify relationships between claimants and other individuals/entities, defend themselves against organized fraud, and build a real-world, real-time picture of claim activity…MORE

Florida staffing agency steals more than $1 million in scheme

One in five employers feel unsure how to identify workers’ compensation scams, according to the Coalition Against Insurance Fraud.

A Florida staffing agency owner allegedly provided fictitious workers’ compensation policies and pocketed his clients’ payments. The man is being held responsible for the theft of more than $1,000,000…MORE

Underwriting

NCCI tool provides state-specific workers’ comp data
The National Council on Compensation Insurance (NCCI) recently announced the launch of its redesigned State Insight tool for carriers and regulators. The intuitive, interactive tool provides state-specific workers’ compensation results at a glance and offers additional details with just a few extra mouse clicks…MORE

 

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Things are safer in a connected world

iotIn a previous post, we looked at how virtual reality and other technology-driven tools are revolutionizing the way we protect people on the job. These tools work by collecting data about us and our environment, and then using that data to nudge us into healthier, safer choices.

It’s traditionally been a private conversation between us and our devices. But here’s the thing: Our devices aren’t just talking to us anymore; they’re talking to each other.

It’s called The Internet of Things (IOT), and it operates on a simple premise: Any device that is connected to the Internet can share data with other connected devices.

Cisco estimates the number of connected devices worldwide will grow from 15 billion today to 50 billion by 2020. That makes for a ton of cyber chatter, much of which humans will be blissfully unaware of.

The IoT can be a bit abstract, so let’s consider a concrete application.

Have you ever put together what you thought was a comprehensive shopping list, spent two hours battling crowds at the store, gotten home and unloaded your groceries, only to find you forget the apples?

A new product from Samsung eliminates those fruitless shopping trips by connecting your smart phone and your refrigerator. It’s called the “Family Hub,” and Samsung equipped it with interior cameras that capture an image every time the door closes. If you’re second-guessing your shopping list, simply access the most recent photos and see what’s inside.

That’s great news for shoppers, but how does the IoT work on the jobsite, where one wrong move can cost someone their life?

Since traffic accidents are consistently the leading causes of workplace fatalities, let’s let the automotive industry put the IoT in perspective.

In January, the U.S. Department of Transportation (DOT) announced an initiative that would require auto manufacturers to start phasing in vehicle-to-vehicle (V2V) technology. V2V technology allows vehicles to collect information from other vehicles, as well as from their surroundings, and then warn drivers about hazards.

For example, a “connected” vehicle will alert you if a car ahead is braking or travelling in your blind spot. Similarly, the system will caution you if it’s unsafe to enter an intersection due to a high probability of colliding with another vehicle.

Now, any time vehicles that weigh tons meet at high speeds, the results can be fatal. But everyone has a fighting chance if they’re wearing their seat belts. That’s often not often the case when vehicles get too close for comfort with pedestrians and bicyclists.

The National Highway Traffic Safety Administration reports motor vehicles killed 4,735 pedestrians in 2013. That same year, 743 bicyclists died in vehicle crashes.

In a DOT-funded pilot project, Tampa, Florida equipped smartphones with V2V technology that alerted drivers to the presence of bicylists and pedestrians. The DOT estimated the V2V technology used in the project could reduce the unimpaired vehicle crash rate by 80 percent. With that type of promise, it’s no surprise the White House bought in – to the tune of $4 billion. That’s how much the president requested for the development of V2V technology over the next decade.

Stay tuned
Technology is revolutionizing safety at a dizzying pace. Today’s trendy tools could be tomorrow’s relics. Follow our blog and stay up-to-date on the latest developments.

This week in comp, July 22, 2016

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

Texas Mutual news

It’s dividend season at Texas Mutual
Dollar Bills
Texas Mutual will distribute a company-record $240 million in dividends more than 45,000 safety-conscious policyholder owners in 2016. This weeks blog post explained the dividend program components and showed how policyholders can improve their chances of earning future dividends…MORE

Texas Mutual pays $176,118 dividend to Cattle Feeders safety group
Texas Mutual recently awarded a $176,118 dividend to the Texas Cattle Feeders Association workers’ compensation safety group. The dividend was based on group members’ commitment to preventing workplace accidents and minimizing their costs when they do occur…MORE

Safety

How the construction app boom is changing the job site
apps
Technology is changing the way we work, and the construction industry is no exception. In 2014, one-third of construction firms used more than five mobile business apps…MORE

ROI and VOI: A strong wellness program measures both
The return on investment in employee wellness programs is well-documented and easy to calculate. Studies show employers can see a $1.50 to $3 return – largely in the form of health care savings – for every dollar they invest in employee wellness. The business case for wellness is even stronger when you consider the value on investment, such as improved work satisfaction and decreased absenteeism…MORE

New Zika case throws investigators a curve ball
mosquito
The case of a Utah man who contracted Zika after caring for his infected father has raised questions for health experts about how the mosquito-borne virus spreads. When he passed away, the man’s father had more than 100,000 times the amount of Zika in his blood than typical victims. That could mean high levels were also present in his saliva and urine…MORE

Underwriting

Construction market keeps building: Brokers’ outlook on current & future opportunities
Construction workerConstruction is picking up across the country, and more carriers are competing for business. Time-tested laws of economics dictate that with increased competition comes decreased rates. But experts also attribute this buyers’ market to the industry’s improved safety record…MORE

Machine learning for UBI: An optimal path to insurance ratemaking?
Traditional insurance ratemaking approaches consider numerous rating variables to estimate risk, but they often take a more circuitous path than necessary. Usage-based insurance (UBI) programs offer an alternative approach. UBI programs use sophisticated decision-making tools to discern the variables that most closely “map” to each policyholder’s estimated loss propensity…MORE

Fraud

Fraud concerns emerge as compounding drug sales skyrocket
pill bottle with moneyThe federal government’s workers’ compensation program saw spending on compounded medications grow from $2.35 million in fiscal 2011 to $214 million in fiscal 2015. Some of those prescriptions may not have been medically necessary. Others may not have been dispensed at all…MORE

Pharmaceutical worker admits role in compound medication scheme
A New Jersey pharmaceutical employee admitted filling his own medically unnecessary prescriptions and recruiting others to do the same as part of a scheme to fraudulently obtain reimbursements for compound medication prescriptions. The scheme resulted in $3.69 million in losses…MORE

Claims

Commercial lines insurers investing in tech for claims, underwriting data
Drones, the Internet of Things, robots and autonomous vehicles are poised to transform the insurance industry. These technologies promise to reduce the need for on-site adjusters and investigators, while improving underwriting and pricing…MORE

Congress approves $180 million in funding to combat opioid abuse
Congress passed a bill authorizing the Department of Justice to distribute $180 million to help state and local governments combat the opioid crisis…MORE

Health care costs

Companies leverage wellness programs to control health care spending
Fitness shoesHealth care costs in America are no longer inflated; they’re “hyperinflated.” In 2015, companies spent close to $10,000 on health care benefits for each employee. Employers can reduce those costs by investing in a wellness program. Texas Mutual reports that 97 percent of its employees participate in its wellness program, helping the company save nearly $4,000 per employee on health care costs…MORE

New WCRI studies examine impact of reforms on physician dispensing
The Workers’ Compensation Research Institute (WCRI) releasedeight studies that exam the impact of state reforms to the rules for drugs dispensed by doctors to injured workers. The studies focus on three primary outcomes:  1. Did the reforms lead to price reductions for physician-dispensed drugs? 2. Did physicians continue to dispense after the reforms? 3. Are there emerging issues that suggest unintended consequences of the reforms?…MORE

It’s dividend season at Texas Mutual!

Earlier this summer Texas Mutual announced that we’ll be distributing a company-record $240 million in dividends in late July. These dividends make a big difference for the thousands of policyholders across the state who receive them. This year, more than 45,000 business owners will open their mailbox to find a dividend check that they can use to help offset workers’ comp costs, re-invest into safety equipment and training, or just give a boost to their bottom line. But how exactly do policyholders earn a Texas Mutual dividend or maximize their return? Take a look at the dividend video below to see how the dividend process works, then read on for ways to make the most of Texas Mutual’s dividend program.

 

As the video shows, there are two components of a Texas Mutual dividend: safety and loyalty. The area you have the greatest opportunity to make an impact in is safety. Workplace safety isn’t just good for company morale and productivity. It also has a significant impact on your bottom line. Fewer workplace accidents can potentially mean less lost work time, lower claims costs and even a greater dividend. Because dividends are determined largely based on loss ratio, you have the power to increase your chances of qualifying for one by making safety a priority.

Workplace safety can seem daunting, so we have thousands of free resources available to help you launch safety programs, educate employees and maintain safe environments. The safety resource center at texasmutual.com gives policyholders exclusive access, and worksafetexas.com keeps you in the know about trending safety issues. Our safety services support center is also available at 844-WORKSAFE Monday through Friday from 8 a.m. to 5 p.m. to help you identify the best resources for your business or connect you with a safety services consultant.

Another way to improve your loss ratio is to have a solid return-to-work program in place so that when accidents do occur, you have a plan for minimizing losses and getting workers back on the job. Texas Mutual has a number of resources to help with this, and our recent post about return-to-work is a great place to start.

These resources and plans may seem like small steps, but they could add up to a dividend for your business. Find out more about Texas Mutual’s dividend program by clicking here.

This Week in Comp, July 15, 2016

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

Safety

OSHA delays deadline for anti-retaliation provisions in recordkeeping rule
deadline
OSHA pushed back the deadline for employers to comply with anti-retaliation provisions in its new recordkeeping rule from August 10 to November 1, 2016. OSHA will use the extra time to lead outreach efforts and offer additional guidance to employers who have questions about the rule…MORE

Texas records first Zika-related birth defect
Texas received laboratory confirmation of a past Zika virus infection in a baby recently born with microcephaly in Harris County. The mother traveled from Latin America, where she was likely infected, and the baby acquired the infection in the womb. Neither baby nor mother is infectious, and there is no additional risk in Texas…MORE

Pokémon Go fantasy game creates real-life vulnerabilities
Pokémon Go descended on the U.S. gaming scene last week and mesmerized player of all ages. The game allows players to straddle the line between fantasy and reality in search of creatures with names such as Diglett, Ponyta and Doduo. Gamers should remember that although Pokémon Go offers a fantasy experience, it presents real-world risks, such as sharing personal information online, driving or walking while distracted, and being lured into dangerous places…MORE

Work can be a stressful, dangerous place: NPR study
American workers are stressed out and exposed to safety hazards on the job, according to a new National Public Radio study. Overall, 43 percent of working adults say their jobs negatively affect their stress levels. And despite increased awareness of the importance of workplace safety, 45 percent of low-wage workers report they face on-the-job hazards…MORE

Underwriting

NCCI announces new chief regulatory services officer
Susan Donegan will serve as chief regulatory services officer of the National Council on Compensation Insurance effective September 19, 2016.  Donegan’s career includes leadership positions, including counsel to the commissioner of insurance in Massachusetts and executive director at an international non-governmental organization, as well as a private law and consulting practice…MORE

Fitch: U.S. workers’ comp insurance swung to profit in 2015
MoneytrendAfter years of underwriting losses, underwriting performance for the U.S. property/casualty (P/C) industry’s workers’ compensation line generated a significant profit in 2015, according to a new report from Fitch Ratings. Fitch attributes the turnaround to  past premium rate increases, stable loss cost trends and improved loss reserve experience…MORE

Summit identifies top 3 system issues
Benefit adequacy, regulatory complexity and treatment delays are the top three issues facing the workers’ compensation system, according stakeholders who participated in the Dallas workers’ compensation summit…MORE

Survey reveals what agents value in their lead carriers
Agents value commercial line carriers’ claims service, competitive pricing and customer service more than they did five years ago, according to the ninth annual Channel Harvest survey. This years survey also indicated agents value their carrier’s underwriting responsiveness. Five years ago, agents gave the highest marks for underwriting expertise…MORE

Combined Agents of America names Cross as CEO
Combined Agents of America LLC (CAA) has hired Peter Cross as its new chief executive officer. Before joining CAA, Cross served as managing director at ARM Risk Solutions…MORE

Claims

Wearable tech gives claim investigators another tool
wearableFitness trackers, smart watches, heart-rate monitors, blood-sugar monitors, GPS trackers and other wearable devices collect and store huge amounts of information. A claimant’s personal data from one of these devices may produce critical evidence in a claim investigation…MORE

Study: 43% of insurers’ prescription payments going to specialty drugs
pill bottle with moneySpending on expensive “specialty” drugs by commercial insurance plans jumped from 11 percent of spending on all prescriptions filled in 2003 to
43 percent in 2014. Meanwhile, patients’ out-of-pocket costs for pricey drugs climbed
46 percent over that period. The rise is driven by annual double-digit price hikes for many drugs, drugs for cancer and rare diseases that command prices of $100,000 or more per year, and millions of recently insured patients gaining prescription coverage…MORE

Dispense as written
When an insurance company nurse put on her detective hat and started digging, she discovered how a claimant inappropriately received brand-name opioids instead of generic. The nurse’s investigative skills helped lower the patient’s morphine equivalent dose, restore their life and save the policyholder money…MORE

Fraud

Ohio health care worker convicted of workers’ comp fraud
A Cleveland woman caught holding a regular job while receiving injured worker’s benefits must pay the Ohio Bureau of Workers’ Compensation $16,000 and serve five years’ probation. Investigators call this type of fraud double-dipping because the claimant collects benefits for being too injured to work when he or she is, in fact, gainfully employed…MORE

Group introduces app to help fight insurance fraud
apps
The Coalition Against Insurance Fraud has rolled out an app that gives investigators instant access to critical information from anywhere in the field. FraudWire makes it easy for users to tap into fraud news, weekly blogs, podcasts, videos, fraud trends and other information from the coalition’s website. The coalition notes that 40 percent of users access its website on mobile devices…MORE

Cop/strongman contestant faces fraud charges
A California police officer reported a work-related injury and began collecting workers’ compensation benefits. Meanwhile, an investigation uncovered evidence the man, a former college football player, competed in “strongman” contests while collecting benefits…MORE

Return-to-Work: Job descriptions are your ace in the hole

You work hard to prevent on-the-job injuries, but accidents happen. When they do, the goal is to get the employee well and back to work. One of the first questions your insurance carrier will ask is, “Can the employee still do their normal job?”

That question is tough to answer if we don’t know what the employee’s normal job duties are.

Watch this short video to see how a near-fatal accident sent Lonnie Williams down a new career path.

Thorough job descriptions for every position at your company are critical to the return-to-work process. They are important pieces of the disability puzzle that help vocational case managers put on their creative return-to-work thinking caps.

A vocational case manager’s job is to evaluate the injured worker’s normal job duties. Then, they coordinate with doctors to get a work release based on agreed upon modifications to the original job.

Thorough job descriptions pay close attention to the physical demands of each task. In developing job descriptions, ask yourself these types of questions:

  • How much does the employee have to lift? How high? How often and how long?
  • What kind of tools and equipment does the employee use?
  • What are the environmental conditions (heat, cold, noise)?
  • How long does the employee sit, stand or bend?
  • Does the job comply with the employee’s new work restrictions?

That last question can be tough to tackle, but remember that you don’t have to answer it alone. The physician can help if you provide a good job description.

The Texas Department of Insurance created form DWC-74 as a template for communicating injured workers’ job duties to physicians. A thorough DWC-74 tells the physician exactly what the employee does on the job every day. From there, the doctor determines whether the employee can still do those tasks.

If not, the doctor will use form DWC-74 to explain the injured worker’s restrictions. Your vocational case manager can use that information to identify alternative productive work the employee can do while they recover.

Your insurance carrier might be able to help you develop job descriptions. For example, Texas Mutual employs the state’s largest team of workplace safety professionals. They help our policyholders analyze jobs and develop written job descriptions for the return-to-work process.

For more information about writing job descriptions, see page 17 of Texas Mutual’s Return-to-Work Kit for a Physical Demands Task Assessment checklist. For more information on return-to-work, visit our website.

 

Regulatory Roundup, July 8, 2016

Regulatory Roundup is a weekly digest of wellness, safety and other workers’ compensation news.

Safety

Employers grapple with OSHA’s stance on blanket post-injury drug testing
In its improved injury tracking rule, OSHA suggests blanket post-injury drug-testing policies deter proper reporting of injuries to the agency. Many employers plan to respond to the new rule by eliminating post-accident testing entirely, but OSHA stresses that is not the rule’s intent…MORE

OSHA to increase maximum penalties by 78 percent
IncreaseEffective Aug. 1, 2016, OSHA will increase the maximum penalty for serious violations from $7,000 to $12,471. The maximum penalty for willful or repeated violations will increase from $70,000 to $124,709. The increase reflects inflation since OSHA last increased fines in 1990…MORE

BLS data sheds light on injury, illness trends
During most times of the day or night, overexertion involving outside sources is the most common cause of workplace injuries or illnesses for which people miss work to recuperate, according to new BLS data. Between 4:01 a.m. and 8 a.m., falls to the same level are a leading cause of workplace injuries or illnesses…MORE

Texas strengthens Zika efforts as threat persists
Texas health officials don’t expect widespread Zika transmission this summer, but they want to be ready just in case. This week, the DSHS hosted a Zika summit in McAllen. Health and local leaders participated in two tabletop exercises, walking through how they would handle the first confirmed local Zika transmission, as well as sustained transmission. Visit the DSHS website for the latest information on Zika…MORE

Laws, regulations

NM Supreme Court rules ag workers entitled to workers’ comp protection
legislationThe New Mexico Supreme Court ruled that a nearly 100-year-old provision in state law that allows agricultural employers to opt out of the workers’ compensation system is unconstitutional. The provision allowed employers with more than three employees to opt out of coverage for farm and ranch laborers but not other agricultural workers…MORE

NCCI releases quarterly economics briefing
Payroll increased for most states and industry groups last year, but some states experienced declines, particularly in manufacturing and contracting, according to the National Council on Compensation Insurance Quarterly Economics Briefing. The briefing examines the state of the economy and the implications for workers’ compensation insurance…MORE

Fraud

Investigators foil 15-year, $429K workers’ comp fraud scheme
Handcuff FraudA New York woman who fraudulently collected $429,000 in workers’ compensation benefits between 2001 and 2016 is facing 20 years in prison and a $250,000 fine. The woman claimed an on-the-job injury rendered her housebound. Video surveillance showed her raking leaves, mowing the lawn, carrying large pails of yard waste and bending over repeatedly…MORE

Claims

Workers’ comp disability guidelines withdrawn from guidelines.gov
The Work Loss Data Institute (WLDI) has withdrawn its Official Disability Guidelines from the National Guideline Clearinghouse (NGC). The WLDI said the NGC review team found it too difficult to keep up with continuous updates to a large number of topics and recommendations to the ODG…MORE

New rules ease restrictions on doctors who treat opioid addiction
Narcotics with Prescription Warning LabelThe Health and Human Services department issued new rules that increase the number of opioid-addicted patients doctors can treat with buprenorphine, a medication that eases withdrawal symptoms, from 100 to 275 per year…MORE

Maine delivers a quiet blow in battle against opioid epidemic
States across the Northeast recently made noise by adopting 7-day initial opioid script laws. A measure taken by Maine isn’t making headlines, but it might prove far more significant in the battle against opioid abuse. Effective Jan. 1, 2017, doctors cannot prescribe any combination of opioid medication in an aggregate amount in excess of 100 morphine milligram equivalents of opioid medication per day…MORE

State fund news

Texas Mutual thinks outside the box to save lives
Imagine experiencing four of the construction industry’s deadliest hazards and living to tell about it. Texas Mutual recently rolled out a virtual reality app, aptly named Safety in a Box, that empowers users to learn lifesaving lessons without putting themselves in harm’s way…MORE

SFM Mutual Insurance acquires Minnesota’s Barrier Free Access
State Fund Minnesota has acquired Barrier Free Access, a Byron, Minn.-based provider of safe patient handling products, design consultation and training to medical facilities across the Upper Midwest…MORE

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