Archive for September, 2011

10 Years After 9/11 – insurance reflections and more

Monday, September 12th, 2011

First responders and oral histories
We are mindful that the 9-11 story was one that largely affected ordinary people who were going about their workdays. When the planes hit, thousands of first responders jumped into action and their courage and quick actions helped to save untold thousands. Among the many remembrances and stories in the10-year commemorative events, we found the 60 Minutes story on the experiences of first responders to be particularly powerful. It focused on 911 Responders Remember, an oral history project initiated by Dr. Benjamin Luft, director of the Long Island World Trade Center Program (the SUNY-Stony Brook arm of the WTC Medical Monitoring and Treatment Program consortium). This Center of Excellence provides service and monitoring to approximately 5,000 WTC responders across Long Island. These men and women are law enforcement officers, construction workers, electricians, emergency medical personnel, firefighters, iron workers, plumbers, dog handlers, doctors, and many others.
In addition to cancer, respiratory and pulmonary disorders and other physical problems, many workers still suffer from varying levels of emotional or psychological distress, including PTSD. This project is a national historical record, a public health document, and for many participants, a therapeutic exercise which allows them to open up to tell about events or things that they witnessed that they may not previously been able to talked about.

See more testimonies.
Related: A decade later, the list of Sept. 11 victims continues to grow
Related: Fight Over Compensation for 9/11 Responders Shifts to Cancer Victims.
Hitting close to home
September 11 took an extremely heavy toll on the insurance industry. The terrible events claimed the lives of 295 employees of Marsh & McLennan and 176 employees at Aon Corporation. Dave Lenckus of Business Insurance offers recollections from insurance executives who were connected with or escaped from the WTC in his article Terror of September 11 lives in memory. Also see the company tribute pages: Remember: September 11, 2001 – a site to remember and celebrate the lives of those Aon employees lost on September 11, 2001, and Marsh & McLennan 9/11 Memorial – both a website and a physical memorial.
Tribute song & Firefighter Foundation
After 9/11, our own Tom Lynch recorded a 9/11 Tribute Song with Peter Clemente at Mechanics Hall in Worcester, MA. Actor and comedian Denis Leary used the song to raise money for the New York fallen firefighters. Leary is very devoted to firefighters and runs the Leary Firefighters Foundation. The Foundation was established in 2000 in response to a tragic fire in Worcester, Massachusetts that claimed the lives of Leary’s cousin, a childhood friend, and four other firefighters. The Leary Firefighters Foundation’s mission is to provide funding and resources for Fire Departments to obtain the best available equipment, technology and training. Inadequate equipment – particularly faulty tracking and radio equipment – contributed to deaths in both events.
Insurance media coverage
PropertyCasualty360: 9/11: 10 Years Later, Execs & Risk Managers Weigh In on How Industry Has Changed
Insurance Journal: 9/11 and Terrorism Risk 10 Years Later and Why 9-11 Changed Everything
Risk & Insurance: Selling Carriers on Rebuilding Ground Zero
Risk Management Monitor: Ten Years After
Occupational Health & Safety: NFPA Cites Safety Improvements Rising from 9/11
CNNTech: How 9/11 inspired a new era of robotics
workerscompensation.com: 9/11 Tribute
Other resources
Understanding 9-11: A Television News Archive – a library of news coverage of the events of 9/11/2001 and their aftermath as presented by U.S. and international broadcasters. A resource for scholars, journalists, and the public, it presents one week of news broadcasts for study, research and analysis.
The Encyclopedia of 9/11 – from New York Magazine
The September 11 Digital Archive

Friday sing-along: Songs for the Working Man & Woman

Friday, September 9th, 2011

For Labor Day Weekend, Peter Rotheberg took “a stab at the impossible task of naming the best songs ever written about working people.” He compiled a noteworthy list of the Top Ten Labor Day Songs – a great list with more than a passing nod to some of the labor classics. (Thanks to Jeffrey Hirsch
at the Workplace Prof Blog for pointing us to the enjoyable post).
Here’s a few more workings songs we like:

Florida is getting tough on the pill mills

Thursday, September 8th, 2011

Florida doctors bought 89% of all the Oxycodone sold to practitioners nationwide last year and thousands of outside visitors flocked to the state to buy drugs at the 1,000+ pain clinics. But armed with new legislation, the state is cracking down hard by shutting down pill mills and suspending the licenses of about 80 physicians who were high-volume prescribers. And physicians are now generally barred from dispensing narcotics from their offices. In October, things will get even tougher as a new prescription drug monitoring system will be implemented.
Lizette Alvarez reports on on the Florida pill mill crackdown in The New York Times, stating that “As a result, doctors’ purchases of Oxycodone, which reached 32.2 million doses in the first six months of 2010, fell by 97 percent in the same period this year.” This article has some eye-opening observations about the scope of the prescription drug problem: “Last year, seven people died in Florida each day from prescription drug overdoses, a nearly 8 percent increase from 2009. This is far more than the number who died from illegal drugs, and the figure is not expected to drop much this year.”
You can read more about how authorities are going after medical licenses of over-prescribers in a Miami Herald article by Audra Burch. This article discusses some egregious abuses, including a physician who dispenses from the back of a car and an office with long lines waiting outside and many cars with out-of-state license plates in the parking lot.
Related Resources
The issue of physician dispensing is one that our colleague Joe Paduda has covered extensively. See:
Physician dispensing – Exactly how much more does it cost?
Why Florida’s work comp costs are heading up
Florida’s dispensing legislation clarified
The issue of transparency related to a physician’s relationship with pharmaceutical companies is one that ProPublica has been taking on in their Dollars for Doctors campaign. See:
Patients Deserve to Know What Drug Companies Pay Their Doctor
Piercing the Veil, More Drug Companies Reveal Payments to Doctors
For more about Prescription Monitoring Programs, see:
Alliance of States with Prescription Monitoring Programs – The Alliance was formed in 1990 to provide a forum for the exchange of information and ideas among state and federal agencies on prescription monitoring programs. Since then, it has grown to be a valuable resource to all those concerned with combating the increase in prescription drug abuse, misuse and diversion. Currently, 48 states and one territory either have operating Prescription Monitoring Programs, or have passed legislation to implement them.

Risk roundup, substance abuse, changing workforce, cool tool, & more

Wednesday, September 7th, 2011

Cavalcade of Risk – Emily Holbrook hosts this week’s Cavalcade of Risk at Risk Management Monitor – go check it out. If you are interested in risk and insurance – and presumably so if you are reading this blog — then RMM should be on your must-read blog list. If you aren’t familiar with it yet, take a few minutes to poke around the archives Emily and Jared consistently do a terrific job on an array of risk related matters. It covers everything from bedbugs to earthquake hotspots.
Substance abuse & WC – Roberto Ceniceros posts about a controversy over stats citing the prevalence of drug and alcohol use in workers comp accidents and claims. Merchants Information Solutions says they are a factor in 65% of all accidents and 50% of all claims. Peter Rousmaniere disputes this and puts his money where his mouth is. “And here is why Rousmaniere thinks potentially exaggerated claims about the prevalence of alcohol and drugs in workers comp claims is dangerous: he says it “perpetuates an unhealthy tendency to shift attention away from safe worksite policies and towards blaming the worker.”
Prescription drugs – Joe Paduda talks about the recent WCRI benchmark report on prescription drugs in Washington and explains why what works in Washington likely won’t work elsewhere.
Spinal Cord Injuries – Kelly Scott posts about spinal cord injuries, noting that September is spinal cord injury awareness month.
Changing workforce – Lots of good reading in The Atlantic recently. Well, more than recently, but a few caught our eye over Labor Day. Sara Horowitz makes the case that the freelance surge is the industrial revolution of our time, with a follow-on article about a jobs plan for the post-cubicle economy. And, also of note, a slide show on 7 Jobs that are making thousands of workers sick
Illinois – Ameet Sachdev of The Chicago Tribune charts changes to the workers compensation law.
Cool Tool – We just discovered OSHA’s $afety Pays Cost Estimator, an interactive expert system to assist employers in estimating the costs of occupational injuries and illnesses and the impact on a company’s profitability. Hat tip to the post at Safety Daily Advisor, which talks more about the tool.
bi-conference.JPGReminder: September 22 – If you haven’t signed up yet, head on over to Business Insurance and register for Virtual Advantage 2011 – Workers Comp Trends & Cost Control Strategies. We’re very pleased that our own Tom Lynch will be participating on a blogger panel with three other blog luminaries: Roberto Ceniceros, Joe Paduda, and Mark Walls. There will also be a keynote by NCCI’s Harry Shuford, an expert panel on pharmaceutical cost controls for worker’s comp – and more. It’s a one-day virtual conference – and best of all – there is no charge to attend.

Franchisees: Independent Contractors or Employees?

Tuesday, September 6th, 2011

We have been tracking the fate of the FedEx business model in state courts as it collides with increasingly stringent definitions of “employee.” FedEx operates under a sophisticated and ingenious contract designed to transform their drivers into “independent contractors.” It’s been a tough haul. For the most part, FedEx has been losing the argument in courts, state by state, and then delaying any ultimate resolution by filing appeals. Today we examine a similar business model: cleaning operations that are classified as franchises.
Coverall North America is one of the largest franchise cleaning operations in the world, with 9,000 franchise owners, 50 support centers and 50,000 customers. Franchise owners are trained by Coverall, wear Coverall uniforms, use Coverall mandated supplies and receive payment for their work through Coverall. Coverall bills customers and then pays the franchise owners, after deducting management and royalty fees plus any other incurred expenses.
The Massachusetts Standard
Unfortunately for Coverall, they have the burden of demonstrating franchisee “independence” in Massachusetts, which has a very tough, three-pronged standard for independent contracting [Ch. 149, Sec 148B]:
1. The contractor operates free from control or direction
2. The work of the contractor is fundamentally different from the work of the general contractor/owner
3. The contractor operates an independent business and is free to offer services to anyone
Under the MA requirements, independent contractors must meet all three criteria. Coverall first encountered the problem when out-of-work franchisees filed for unemployment benefits. The MA Division of Employment & Training focused on the third prong, determining that franchisees were indeed employees of Coverall, as their work was limited to that secured through Coverall.
In a case brought in Federal Court, franchise owners sought summary judgment against Coverall for the deceptive and unfair labor practice of calling them “independent contractors.” U.S. District Court Judge William Young got the case. He focused on the second prong: Coverall had to demonstrate that they were in a fundamentally different business than their franchisees.
Coverall fashioned a clever but ultimately unsuccessful defense: Coverall corporate is not in the cleaning business, but in the franchising business. Coverall corporate trains people who clean offices and Coverall manages the finances of franchisees, but no one in Coverall actually cleans. Judge Young did not buy that argument. He determined that Coverall provides the administration for the franchisees, who provide the cleaning services. One cannot exist without the other. He granted summary judgment to the plaintiffs.
Who Works for Whom?
We are by no means at the end of this seemingly endless attempt to separate independent contractors from employees. What is at stake is pretty obvious: work performed by employees is a lot more expensive than that performed by independent contractors. The lives of most people working as “independent contractors” are difficult; the hours are long, the pay is marginal, the benefits non-existent. And if injured, these folks are usually on their own.
Listen to the names of some of the plaintiffs in this particular case: Aldivar Brandao, Denisse Peneda, Jai Prem, Pius Awuah, Benecira Cavalcante, Nilton Dos Santos. Can you hear exotic music in the names of people born in other lands? And can you hear something more ominous: the dissonence and dislocation of immigration, the struggle to survive in a new land that seemed full of promise from afar, but which has proven to be harsh, stingy and relentlessly demanding?
Welcome to America, employees of Coverall!

Health Wonk Review: Hurricane Irene Edition

Thursday, September 1st, 2011

Health Wonk Review is launching its back to school season with The Hurricane Irene Edition posted by Avik Roy at the Apothecary. If you’ve been missing your biweekly dose of health wonkery during the abbreviated summer schedule, now is your chance to catch up!