Author Archive

9th Annual ASSE Kids’ Safety-on-the-Job Poster Contest

Tuesday, May 3rd, 2011

In honor of NAOSH week, we thought it might be nice to feature a sampling of safety tips from the next crop of safety engineers. It’s nice to see these kids are learning such important lessons early. Good job, kids!
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Camille D. Soto, 6, FL: Make sure you wear safety glasses…
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Tamaya Olivia Bush, 8, SC; Come Join the Crew
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Da’moreon Travis, 10, KY, Make Safety First or You Won’t Last
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Sai Pravallika Velicheti, 12, Kuwait; Confined Spaces Can Kill
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Robin Newman, 14, AL; Don’t be the sender to cause a fender bender

Cavalcade of Risk & briefs from the Blogosphere

Thursday, April 7th, 2011

Russell Chatwood, our riskmeister from New Zealand (… or as some have put it “down under the Down Under”) is our host for this week’s edition of the 128th Cavalcade of Risk. It’s a substantive issue — and don’t miss the oddball features.
System spillover – In a recent column in Risk & Insurance, Peter Rousmaniere takes a look at workers’ comp and finds leaks in the system. He talks about how many nonoccupational disability and health problems find their way into the comp system, while many work injuries leave the work comp system to roost elsewhere.
Federal shutdown? – If tomorrow brings a government shutdown, the Federal Times reports that some 800,000 federal employees will be furloughed, and discusses the likely impact. Federal Times is a news and information service for Federal Managers, so might be a good source to follow along if worse comes to worst. Related: CNN also has a government shutdown FAQ.
One year laterEHS Today takes a look back at the Big Branch mining disaster on the one year anniversary. Reporter Ken Ward of the WV Gazette raises the questions that linger about Massey’s mine disaster on his Coal Tattoo blog, and points us to a tribute to the miners composed by one of his colleagues. Also see Faces of the Mine, a moving community-driven, interactive memorial for those affected by the Upper Big Branch mine disaster.
Rhabdomyolysis & athletes – If athletes are among your employees, you may want to note that the recent post about rhabdomyolysis that ran in the L.A. Times health blog, Booster Shots. This is a type of overexertion illness in which muscle tissue is so overworked it breaks down and floods the bloodstream with a protein that can impair kidney function.
Medicare: FAQs on ACOs – the folks at HealthLawProf Blog have compiled some good resources on Accountable Care Organizations: Your ACO Primer Links and Getting up to speed on ACOs.
Lights, camera, action… – Bet you thought our item about a sitcom called Workers Comp was an early April Fool’s joke … nope, here is a news update: ‘Sopranos’ actor added to cast of Bradenton-shot TV show. The show is described as a “comedy about zany employees dealing with weird insurance claims.” Get your popcorn ready.
Briefs from the Blogosphere

Cool work safety tool from WorkSafeBC – “What’s wrong with this photo?”

Tuesday, April 5th, 2011

Remember playing those “what’s wrong with this picture” games in activity books when you were a kid? Well WorkSafe BC has adapted the concept as a safety tool. Every issue of WorkSafe Magazine includes a photo that has been staged to show at least six hazards or dangerous work habits – you can interact with the photo to position pushpins on identified hazards, describe the hazards, and then submit your response to WorkSafeBC for a possible prize (although it’s likely that only B.C. residents are eligible). In each issue, they include the winning entry from the last issue, along with responses from other readers. Neat.
One of the really cool and useful things is that they keep an archive of all past photos online – you can either take the challenge online and then check the answer key, or you can print the photos and the answer keys and use them in safety meetings or toolbox talks.
Here’s one example: Can you spot the safety hazards in this commercial kitchen? Note: the image below is only a sample pic – the online interactive version is accessible at Kitchen Safety and here’s the commercial kitchen answer key to check your responses.
WorkSafeBC
Archived “What’s wrong with this photo” tools
There’s a pretty good array of work scenarios representing a variety of industries. Here are direct links to each:

Single Payer in Vermont: Occ Doc or Not?

Monday, March 21st, 2011

In a move stunning for its contrariness, Vermont is moving toward a single payer health care system. In the course of the debate, the inevitable issue of whether to include workers comp has come up. At this point, a committee will make recommendations on whether to “integrate or align” workers comp with the state’s radical reconfiguration of the health care system. (Further details are available at WorkCompCentral – subscription required.)
The Vermont approach would completely separate indemnity from medical benefits. Employers would continue to pay for the indemnity portion, but are unlikely to have any input into treatment plans. The Insider has pointed out – ad nauseum, some might say – that the relatively miniscule comp system is quite different from the behemoth health delivery system. In the interests of saving the Vermont committee a little time, here are a few of the conundrums confronting anyone trying to merge the two systems:

: Comp is paid solely by employers. Injured workers pay nothing (no co-pays, not deductibles, ever).
: Consumers pay quite a bit for conventional health coverage: a portion of premiums along with co-pays and deductibles for treatment and for medications
: Comp has very narrowly defined eligibility requirements, while conventional health has virtually none
: The goal of comp is to provide medical treatment for injured workers and, if possible, return them to work; if return to work is not possible, comp pays lost wage benefits and injury-related medical bills virtually forever.
: The goal of the conventional health system is to take care of people, regardless of the employment implications
: Comp provides indemnity, temporary or permanent, for those unable to work. No such wage replacements exist in the conventional health system
: Perhaps most important, medical services under comp have an occupational focus, with the explicit goal of returning people to their jobs. In the conventional health system, any occupational focus would be subordinate to the goals of the consumer.

Should Vermont achieve its ambitious goal of universal coverage, the presumption is that everyone would have a primary care physician, who would serve as gatekeeper for all medical services. (Let’s set aside, for a moment, where the Green Mountain state will be able to find these primary care doctors.) In a unified system, injured workers would go to their primary care physicians for work-related injuries. These primary care docs may or may not focus on returning their patients to work. Many people hate their jobs and might welcome a few weeks or months of indemnity-supported leave. The primary care physician might be quite sympathetic to their cause.
This brings us to the great divide between conventional health care and workers comp: conventional health care may or may not embrace the need for return to work. Indeed, if the work is hazardous – as much work is – the doctor may want to discourage his patient from returning to it. The doctor’s goal is to “do no harm” – so why send someone back into harm’s way? If the patient suffers from lower back problems and has a job involving material handling, what is the right thing for the doctor to do?
Who Pays?
In the current system, workers comp pays doctors for eligible medical services. Whether or not they like the comp fee schedules, doctors are acutely aware that comp is paying for the services of a particular individual. Often, treatment is provided by occupational specialists, who bring a unique “return-to-work” focus to the treatment plan. These occ docs are often in communication with employers seeking to return injured workers to productive employment. The occ docs specify the restrictions so that employers can design appropriate modified duty jobs. The employers have a sense of urgency, as they are losing the productivity of the individual who is out of work – and of course, they are paying all of the costs associated with the injury.
Under the proposed Vermont system, all bills will be paid the same way. Comp disappears from the doctor’s view. Employers may have little input into the choice of doctors or specific treatment plans. The role of occupational doctors is unclear, to say the least. Given that primary care physicians generally lack an occupational focus, return to work may become secondary to the comfort and personal inclinations of the patient. As a result, there is a risk of substantial increases in indemnity costs.
When contemplating change on the scale of Vermont’s single payer system, it is tempting to brush aside the implications for something as small as the workers comp system. That would be a big mistake. The system might be small, but the costs to the state’s employers are already substantial and have the potential for going much higher. The comp system plays an unique and long-established role in protecting both workers and employers. As they take steps to transform healthcare in Vermont, lawmakers need to remember that workers comp itself is worthy of their protection.

Swine Flu Meets Workers Comp

Monday, April 27th, 2009

It’s only Monday morning and many of us are just refocusing after a weekend of gardening, football drafts, NBA playoffs, baseball (Ellsbury steals home!), so we are probably not quite ready to think about the unthinkable: a potential swine flu pandemic, originating in Mexico and already active in several major American cities.
Here is the official government announcement (which appears to circumvent potential panic by burying the bad news in gov-speak):

As a consequence of confirmed cases of Swine Influenza A (swH1N1) in California, Texas, Kansas, and New York, on this date and after consultation with public health officials as necessary, I, Charles E. Johnson, Acting Secretary of the U.S. Department of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, 42 U.S.C. § 247d, do hereby determine that a public health emergency exists nationwide involving Swine Influenza A that affects or has significant potential to affect national security.

[Where, oh where, do they learn to write like that?]
As is our custom, we focus on the implications for workers comp. Back in 2005 we blogged the ramifications of smallpox exposure from the comp perspective. The smallpox exposure – a result of the terrorism scare – proved to be a false alarm. The swine flu, unfortunately, appears to be all too real.
The Comp Dimension
It’s not difficult to isolate the kinds of activities that might expose an individual to the Swine flu. Many of these exposures are prevalent in the world of work:
: travel
: frequenting congested areas (travel terminals, public transportation, classrooms, etc.)
: touching anything handled by strangers
: eating out
: meeting business colleagues from around the country and around the world
In order for the flu to be a compensable event under comp, certain requirements must be met:
: the individual must be “in the course and scope of employment” when exposed to the virus
: the exposure must arise out of work (as opposed to being a totally random event)
: work itself must put the individual in harm’s way
An individual commuting to work via public transportation might have high risk exposure, but flu caught on a subway or bus would not normally be covered by comp. But if the exposure stems from company-provided transportation (for example, a van), the subsequent illness might well be compensable.
If one worker in a closed environment brings the flu to work, co-workers who succomb to the virus can make a good case that the illness is work related. The initiator, however, would not have a compensable claim, unless he/she could demonstrate a definitive work-related exposure.
Health workers are on the front lines of any pandemic. Even though it might be impossible to prove that they actually caught the virus at work, any and all cases of Swine Flu are likely be compensable.
If you fly on an airplane on company business and the person next to you is sneezing and coughing, your exposure is work-related and the subsequent illness is likely to be compensable. If you are flying to visit Aunt Martha, you are on your own.
The comp system is not well equipt to deal with illness. It’s usually very difficult, if not impossible, to determine exactly when an individual actually caught the virus. With state laws varying in their assumptions of compensability, with a multitude of insurance carriers and third party administrators making compensability determinations, we will see a crazy quilt of decisions regarding the compensability of swine flu.
There is a lot of money at stake in these compensability decisions. For mild cases, the issue is moot. It’s the more severe cases – prolonged illness and even death – that raise the greatest concerns. While thus far the fatalities have been limited to residents of Mexico, if the feared pandemic occurs, there will be prolonged illness and even fatalities in the states. Then the crucial decisions regarding compensability will directly impact the future cost of workers comp insurance.
What is to be Done?
So how should employers handle flu exposures? For a start, educate employees on prevention. The above government website has some helpful hints – and they are actually written in plain English; unfortunately, they are only written in English.
Any employee showing up at work with flu symptoms should be sent home immediately. And if any employee appears to come down with the flu while “in the course and scope” of employment, employers should report the illness to the insurer/TPA, so that a proper compensability determination can be made. As in all things comp, it is usually a mistake for the employer to make assumptions about compensability. When in doubt, report the illness and let the experts determine what to do.
As the world lurches from one crisis (economic) to another (pandemic), it is all too clear that we have fulfilled the Chinese (?) curse: “May you live in interesting times.” We do, indeed.

Rocky Mountain Two Step: Destabilize and Deprivitize?

Thursday, April 9th, 2009

Colorado, like most states, is facing a serious budget deficit. They are scrambling to balance the budget. So the legislature came up with the brilliant idea of tapping the reserves set aside by Pinnacol, the state’s largest provider of workers comp coverage, with 70 percent of businesses in the fold. Pinnacol began as a state operation and was subsequently spun off. It now operates – very profitably – as a mutual insurance company.
The state, facing a budget deficit of $1.4 billion, has its eye on $500 million that Pinnacol has set aside to cover the future costs of current claims. They have proposed a Rocky Mountain two step: first, make Pinnacol a state agency, as it once was, thereby assuming control of the company’s assets. Then, draw $500 million from the reserves and use them to cover a chunk of the current budget deficit.
As is so often the case, Pinnacol is being punished for being successful. Despite having reduced comp premiums by 42 percent over the past four years, and despite having set aside the funds needed to cover future obligations on current claims, Pinnacol is now the proverbial sitting duck. Blinded by cash in the coffers, legislators are poised to make two big mistakes: deprivatize a successful privatization and destabilize a financially stable operation. What are they smoking in the thin mountain air?
Mediocre Alternatives
A consortium of Colorado businesses has lined up against the ill-advised measure. As an alternative, they suggest three steps to close the budget gap:
: “tobacco securitization” – selling bonds against future tobacco settlements [after the economic debacle of the past 8 months, you might label this proposed process insecuritization.]
: sell state buildings [in a depressed market???]
: Reduce the pay of all state employees across the board [easy for the private sector folks to say]
At this point, I’m not convinced that either plan is worth pursuing. As a general rule, it is a bad idea to solve big,short-term problems by making bigger, long-term mistakes. Here’s hoping that cooler heads in the clear, mountain air of Colorado kick back with a Coors and figure out a better path toward solvency .