Archive for June, 2014

Women of Steel

Friday, June 27th, 2014

Are there many women in construction? They represent about 9% of the industry. Dorothée Moisan offers an excellent feature on New York’s Women of Steel, illustrated beautifully with photos by Jonathan Alpeyrie. Early pioneers talk about what it was like to break into the field. One little vignette from days gone by:

“I remember a young woman very well,” Janis says while smoking a cigarillo in her New York office. “This was really early in the game, in the late 1970s. The boss sent her into the field in order to do the kind of job that a superintendent would do. But the men yelled and threw rocks at her. The boss came and said, ‘Guys, what’s the matter with you? I want to train her.’ And their response was, ‘We don’t want her here because now we can’t pee on the steel!'”

Things have changed considerably since those days, as women in the article relate. You can also get a current feel for the profession in these associations:
The National Association of Women in Construction was founded in 1953 by 16 women working in the construction industry. Today its an an international association of women employed in construction, which promotes that industry and supports the advancement of women within it. In addition to its national charter, NAWIC has International Affiliation Agreements with the Canadian Association of Women in Construction, NAWIC-Australia, NAWIC-New Zealand, NAWIC-United Kingdom and South African Women in Construction. They offer women in construction stats in the chart below (or click here for the original Fact Sheet (PDF))
Another key organization is the Professional Women in Construction, with 6 chapters and over 1,000 members. PWC serves a constituency of close to 15,000, representing a broad spectrum of the industry. As its mission, PWC encourages and advances the goals and interests of woman and minority owned businesses.

Cavalcade of Risk #211: Lightning Round

Wednesday, June 25th, 2014

We’re pleased to be hosting the 211th edition of Cavalcade of Risk and we give you the Lightning Round edition in honor of Lightning Safety Awareness Week. If you are struck by lightning, your odds are apparently pretty good of surviving the encounter – see the story of the Georgia man who was recently jolted out of his boots but lived to tell the amazing tale. Take a few minutes this week to learn how to lower your risk of a similar encounter because even tho survival rates are high, most lightning strike survivors suffer lifelong maladies from the experience.

OK, on to our other risk-related issues – here are our blog submissions of the week:
First up, a good news entry from Hank Stern of InsureBlog: A report on
a medical breakthrough for folks with diabetes which promises to reduce the risk of insulin crises. See: Hi-Tech Diabetes news
Bob Wilson of From Bob’s Cluttered Desk fame brings us another good news item about how loving parents and an excellent support network can make the difference between living a life of disability and a life well lived. See: Rachel Mast’s Second Coolest Program of the Day
At Health Business Blog, David Williams looks at the Veterans’ Administration medical mess, noting that the data that the organization collects and uses for internal benchmarking and quality improvement is ironically part of what got them in trouble. While the numbers look pretty bad, he notes that we have no idea how private sector facilities would compare, since they don’t collect or report such information. See: Are we picking on VA hospitals too much?
Jason Shafrin of Healthcare Economist says that after Obamacare passed, the rate of uninsured in Minnesota fell by almost half. What is responsible for this decline in uninsurance rates? He takes a look: Health Reform in Minnesota.
We have a pair of posts that talk about risk mitigation through insurance, describing some specialized needs. At Insurance Thought Leadership, Nancy Germond looks at the insurance coverages a consulting firm needs . And at Workers Comp Roundup, Michael Stack notes that volunteering can be mutually beneficial to employer and employee alike, but he offers this caveat: Don’t Overlook Workers Comp Needs for Volunteers.
Newcomer to Cavalcade Alan Whitton – aka “Big Cajun Man” talks about Atrociously Dangerious Investment Advice at the Canadian Personal Finance Site.
And here at Worker’s Comp Insider, we point you to a pair of posts on the theme of this issue: Lightning Stike Survior Stories and The one in a million club you don’t want to join.
That’s it for this issue. The next host – two weeks from today – is RJ Weiss. Just in time for your poolside reading!

Health Wonk Review: The “Undeterred by World Cup Fever” Issue

Thursday, June 19th, 2014

While people all over the globe are gripped by World Cup fever, here in health-wonk-istan, our bloggers take a more philosophical approach to football. They are not distracted from their important mission of bringing you the best in the health policy arena. Without further hooplah, we give you our bloggers’ best posts from the prior two weeks. Because our entries are all winners, we dish them up in the order in which they were received.
We begin with a steamy post from Henry Stern at InsureBlog, who reports on a (now former) anesthesiologist’s – say THAT 10 times fast – unique (and disturbing) multi-tasking abilities in his submission More Red Hot Lover/Physician Tricks.
David Harlow of HealthBlawg interviews Roy Schoenberg, CEO of American Well about the model policy recently adopted by the Federation of State Medical Boards to get state medical boards up to speed quickly and to access standards of care that are both protective of patients’ interests and offer baselines against which physician behavior may be judged by an individual board. (After this post went up, the AMA issued a halfhearted endorsement of the whole enterprise.)
David Williams has launched a Health Business TV YouTube channel as an adjunct to his respected Health Business Blog. You can see his debut edition, in which he discusses Castlight Health, the Affordable Care Act, and more.
At Health Care Renewal, Roy Poses continues watchdogging bad behavior by corporate health entities. He reports on two recent health settlements involving companies that are no strangers to legal misadventures in his post Fool Me Twice? – Boehringer Ingelheim, Medtronic Settle Lawsuits Alleging Deceptive Marketing. One settlement involved allegations that the company hid data about the adverse effects of a popular and heavily promoted drug; the other involved allegations of paying off doctors to promote use of expensive medical devices. The settlements provide a cloak of deniability so kudos to Dr. Poses for shedding light on perverse incentives.
Jason Shafrin says that numbers do not lie: health insurers with the largest market share have the largest increases in health insurance premiums. Check out his post on Healthcare Economist to find out why the numbers may not tell the whole story: Are market leaders raising health insurance premiums?
For Father’s Day, Maggie Mahar dished up the scoop on the great cholesterol con at her Health Beat Blog. Despite a lack of medical evidence that statins helps anyone who hasn’t already had a heart attack, the perpetuation of the idea that “bad cholesterol” causes heart attacks successfully demonized eggs – a perfectly good source of nutrients = while bolstering the bottom line for statin manufacturers.
Brad Wright talks about the Geographic Divide: How Federalism Has Formalized Health Disparities at Wright on Health. He looks at the Medicaid expansion (and non-expansion) and how this affects border communities that straddle sate lines. The issue of whether or not people have health insurance and access to care is a sometimes matter of which part of town they live in.
At the NCPA’s Health Policy Blog, NCPA Senior Fellow Devon Herrick talks about how so-called specialty drugs are displacing traditional drugs as the primary component of drug spending, noting that there are a number of regulation challenges that will impact how patients will get access to these drugs and how much they will pay. See his post, At a Pharmacy Near You: The Specialty Drug Turf War
While mountains of commentary appeared about the problems with the so-called “roll out” of the computer system for the federal Affordable Care Act, there were also similar problems in several states that had decided to run their own public exchanges. At Healthcare Talent Transformation, Patrick Pine looks at some of the reasons why the feds and several states had so many problems setting up computer programs for the public exchanges.
At Health Affairs Blog, Joel Kupersmith, former head of research at the Veterans Health Administration, CEO of Kupersmith Associates, and an adjunct professor at Georgetown offers his thoughts on the VA scandal and the future. He outlines the VA’s scope and assets, its problems, and strategies for moving forward in both the short and long terms.
On the front lines of the Affordable Care Act roll out, Louise Norris of Colorado Health Insurance Insider reports that health insurance enrollment continues to climb, even in this “off-season.” She reports hard numbers on on enrollment growth and offers predictions for how tie enrollment period will likely look when it wraps up in the next five months, and the prospects for 2015.
At Managed Care Matters Joe Paduda looks at the “collateral damage” that occurred in layoffs related to a recent spate of workers compensation mergers & acquisition activity. He notes that strong non-compete agreements executed under duress needlessly and unfairly tie the hands of experienced professionals in his post The Good, the Bad, and the Ugly.
Here at Workers’ Comp Insider we point you to Tom Lynch’s excellent tribute to industry thought leader Dr. Jennifer Christian. He chronicles her past achievements as well as some of her current initiatives in occupational health.
That concludes this issue off Health Wonk Review – we’re kicking the ball to Jennifer Salopek at Wing of Zock, who will host the July 17 edition.

Tom Lynch interviewed by Steve Schmutz at Claimwire

Wednesday, June 18th, 2014

Pardon us while we self promote for a minute… but many thanks to Steve Schmutz at Claimwire for featuring Tom Lynch in his interview series. For those of you who don’t know Tom and would like to learn a little more about him, you can read the interview here: Industry Spotlight: 20 Questions with Tom Lynch, CEO at Lynch, Ryan & Associates…and when you’ve read that, here is an archive of all Steve’s prior interviews with insurance leaders. They are interesting reading because they dig below the professional surface with some questions designed to reveal what makes these well-known insurance professionals tick – who influenced them, what their career paths have been like, who they admire and other interesting questions that give insight. Thanks, Steve, for including Tom in your series.
Since this is blog post with Tom Lynch as a topic, it gives me a podium to add my personal perspective. As someone who has known and worked with and for Tom for more than 20 years, I would add that he is remarkable visionary and has been a key influencer in our industry — as well as on the lives and careers of his many employees over the years.
Today. many of the day-to-day employer best practices in managing workers’ comp claims that we take for granted were nurtured in the Lynch Ryan “labs” in the early days of the company. In those bad old days, Tom brought the true entrepreneurial spirit to addressing a broken system. “Changing the paradigm” is a shopworn cliche that rarely plays out beyond press releases, but Lynch Ryan truly shifted the approach by focusing on managing the human event rather than the financial transaction, a change in focus that enabled better and healthier outcomes for worker and employer alike. Tom & team identified many of the flaws and friction points in a malfunctioning system: a system in which most employers had better plans in place to address their copy machine breakdowns than they did for their injured workers; a system that was essentially geared to treating the “bad apple” on the bell curve, but not the preponderance of honest and legitimately injured workers; a system in which employers took a hands-off stance at point-of-injury, a critical management/human juncture; a system in which employers were paying large sums of money for a service it knew little to nothing about. Tom applied common sense management principles and a human-focused approach to fixing these problems saving employers a bundle in the process. Treating people well and fairly was actually more cost effective than treating people suspiciously and punitively — who knew!
Tom hired a remarkable team in those early days (if I do say so myself, heh), inspired them with passion and gave them wide latitude to enact their ideas – effecting some out-sized industry-wide practices that continue to this day. I can say that it has been a true privilege to work with Tom.

Undocumented Immigrants In The Workers Comp Bullseye?

Monday, June 16th, 2014

This morning, Work Comp Central’s Mike Whiteley published a well-researched 2,500+ word article focusing on the plight of undocumented immigrant workers who get hurt on the job. His article, Immigration Reform Expected to Impact Comp Systems, highlights the attempt of the National Employment Law Project to push for passage of immigration reform legislation adopted by the U. S. Senate last year. The legislation would make it much easier for undocumented workers to collect workers comp benefits following injury on the job. It is unfortunate that, given recent political machinations (see Eric Cantor, John Boehner, et al), the Senate’s legislation has as much chance of being passed anytime soon as a thrown strawberry has of putting a hole in a battleship.

As of 2013, twenty-eight U. S. state Supreme Courts have ruled that undocumented immigrants are entitled to workers comp benefits. Only one, Wyoming, has ruled otherwise.
We’ve been writing about this since 2004 – ten years. In 2005 we wrote:

It’s one of our nation’s dirty little secrets: immigrant workers are doing some of the nation’s most dangerous jobs, are being injured and dying disproportionately in those jobs, and denied benefits when injuries and deaths occur. In a political climate where the rhetoric and emotions are high and seemingly getting higher by the day, a “blame the victim” mentality is pervasive.

Unfortunately, the only thing that seems to have changed in ten years are those court rulings. But just because a worker is entitled to benefits doesn’t mean the worker is going to get them. And that, I think, is the primary thrust of Mr. Whiteley’s article.

In addition to the quite understandable fear of undocumented workers that if they report an injury they’ll likely face aggressive retaliation, there is the little problem of a social security number (SSN), which, by definition, undocumented workers don’t have. At least, not legal ones. In any event, an SSN seems to be required on the First Report of Injury (FROI). And that’s where the trouble begins, because as soon as an injured undocumented worker gives a fraudulently obtained SSN, ICE, Immigration and Custom Enforcement, comes calling.

I say, “seems to be required,” because, although the FROI does have a block for the SSN, more and more states are allowing workers to choose to have a random number assigned to them, rather than the SSN. Trouble is, many workers don’t know this. It will take time for this to catch on.

Meanwhile, as Mr. Whiteley reports, many workers get caught in the Catch 22 of the “seemingly required” SSN. Moreover, it is not unusual for ethically compromised employers to do everything in their power to prevent benefits being awarded to undocumented workers they have hired. I call these employers American Predators, because they hire workers they know to be in the country illegally and then kick them smartly to the curb when they get hurt on the job. This is probably why experts think that only a small percentage of undocumented worker injuries ever get reported into the workers comp system.

There’s an interesting twist to this story. In addition to Mike Whiteley’s article, Peter Rousmaniere, working independently, published his own column in Work Comp Central this morning on the same subject. Peter has long advocated for better treatment of undocumented workers, even going so far as to create a blog in 2006 on the subject – Working Immigrants.

Immigration reform seems to be a bridge too far right now. I fear that undocumented workers will continue to be workers compensation’s bastard stepchildren. And that is shameful.

Cavalcade of Risk

Friday, June 13th, 2014

Jeff Root has posted this week’s risk roundup at Rooftin blog – check out Cavalcade of Risk #210.

Forklift safety – Infographic

Friday, June 13th, 2014

Forklift-related fatalities are not uncommon. On average, one to two people are killed per week – we read of a fatality in NY just this week. Plus, there are thousands of forklift-related injuries. AisleCop has put together a handy infographic (below) and we’ve compiled a few safety resources.
Preventing Injuries and Deaths of Workers Who Operate or Work Near Forklifts
OSHA – Powered Industrial Trucks – Forklifts
AisleCop’s library of Forklift & Pedestrian Safety articles
How Much Do You Know About Forklift Safety?
What should you do if you’re driving a forklift and it starts to tip over? Is it safer to stay in the vehicle, or to jump out quickly?
When Forklifts Attack (with Forklift Disaster Videos)
10 Things You Need to Know About Your Forklift
Prevent forklift accidents with these safety tips

Health Wonk Review Week & a Tribute to D-Day Heroes

Friday, June 6th, 2014

Joe Paduda has posted an excellent edition of Health Wonk Review over at Managed Care Matters – check it out!
And on this, the 70th anniversary of D-Day, we take a minute to honor the nation’s heroes.

Original Associated Press Report On D-Day Landing Re-Issued
D-Day on

Jennifer Christian, MD: A Big Idea Person If There Ever Was One

Tuesday, June 3rd, 2014

The workers comp buzzword of the era seems to be “Opioids.” Whether it’s big Pharma creating ever stronger varieties and then using money and muscle to co-opt doctors, or physicians dispensing from a kind of pharmacy in their offices and over-prescribing on a grand scale, Opiates rule the day. Everyone talks about them and many try to do something to counter what is turning, or, in some areas has turned, into a bona fide epidemic.

The Opioid problem is relatively easy to understand. Greed throws a Fancy Dress Ball, and everyone shows up. And there are villains. Joe Paduda has been shining an arc light on many at his highly influential Managed Care Matters blog. He deserves great credit for making it just about impossible for people to ignore this issue. Joe does outrage well.
We’ve also written about it often, for example, recently focusing on my home state of Massachusetts and the Zohydro ER wars.

Which brings me to Dr. Jennifer Christian, a heroine of mine of considerable distinction.

Jennifer, or Dr. J, as she’s sometimes known to friends, does not go after the easy answers. Smart and articulate, she never settles for a quick fix when something more profound is needed. Unfortunately, quick fixes seem to be what everyone clamors for these days. In any event, before I get to the main point of this screed, I want to take just a moment of your time to sing Dr. Christian’s praises.

I’ve known Jennifer since Managed Comp, which many readers (I hope) recall as the nation’s largest managing general underwriter and which I co-founded with Tufts Associated Health Plan in 1987. Jennifer became Managed Comp’s Chief Medical Officer in the mid 1990s and thus began to have an impact on how injured workers were treated on a large scale. Earlier in her career she had tremendous success reducing frequency and severity (by 68%) at Maine’s Bath Iron Works, where 8,000 iron workers were breaking records in their workers comp race to the bottom.
After Managed Comp, she founded Webility, her consulting company, and, in 2001, the Work Fitness & Disability Roundtable, still going strong with more than 1,300 worldwide members from all areas of workers comp and disability management. The Roundtable just published issue number 3,206.
In 2006, Jennifer, a woman of big ideas, created the 60 Summit Project, whose mission was to “Propagate the work disability prevention paradigm across North America.” From 2006 to 2012, she fashioned 60 Summit groups in all 50 states and 10 Canadian Provinces.

As Chair of the Work Fitness & Disability Section of the American College of Occupational & Environmental Medicine (ACOEM), Jennifer was instrumental in creating the ACOEM Guidelines, which emphasize a systems and evidence-based treatment of the whole person.

So, why am I heralding this remarkable physician? Here’s why: Over time, Jennifer came to realize more and more that, as we say at Commonwealth Care Alliance, “Healthy is harder for some.” And the ACE Study proved that. Haven’t heard of the ACE Study? It’s a 17,000 person study and collaboration between the Centers for Disease Control and Kaiser Permanente. ACE stands for Adverse Childhood Experiences, and the the study produced a 10-question tool that can predict injuries that will more than likely have difficult outcomes unless systemic and personal intervention is applied. I say “personal,” because Jennifer believes that what’s required in those kinds of cases is not the traditional approach to working with injured and disabled people. She realizes that returning those unfortunates to good health requires the assistance of a guide or coach, trained, experienced and good at helping people see what is in their best interest, who will lead them to find the tools and resources they need to make themselves better.

Sounds touchy-feely, doesn’t it? A little soft? So what? Jennifer is proving that it works.

She’s created a program she calls Maze-Masters, and is piloting it with a couple of insurers (confidential, at the moment). She’s hoping that as she builds success after success, insurers will see the benefits to this one-on-one, personal approach. I think insurers and employers will always do what is in their economic best interests, so I’m hoping she trumpets the cost savings above all else, because that’s the way the world works.
I’m also hoping that at least one insurer, a super-regional perhaps, dives into Maze-Masters with both feet. Better yet, SSDI, Social Security’s Disability Insurance program, is fertile ground for this kind of effort.

Lately, I’ve been writing about people, Quixotes all, charging great big windmills. Some will say this is another windmill charge. Not me, though. That is small mind thinking. Disability in all its forms with all its problems (think about those opioids) requires great big minds thinking great big ideas. That’s Jennifer Christian in a nutshell.
Oh, one last thing, just in case you’re wondering: I have absolutely no connection or involvement, economic or otherwise, in anything Jennifer is doing. I just admire the woman.