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One Last Look At “The Demolition Of Workers’ Comp”

Monday, March 16th, 2015

This year’s WCRI conference is now a week in the past. It was an informative event with session presenters waxing eloquent with their charts and graphs and the general nitty gritty of workers’ compensation. There was a touching tribute to departing Executive Director Rick Victor and an equally touching and humble valedictory by him. An uplifting moment, that.

But in the week since then nobody’s talking about the charts and graphs and uplifting moments. No, what has filled the workers’ comp blogosphere is a continuing discussion about the ProPublica/NPR series, The Demolition of Workers’ Comp, the result of a year-long investigation by ProPublica’s Michael Grabell and NPR’s Howard Berkes.

On the date of publication, we wrote about the Grabell/Berkes piece, as well as another investigative report coincidentally released on the same day, this one by OSHA, entitled Adding Inequality to Injury: The Costs Of Failing To Protect Workers On The Job.

Both reports were highly critical, arguing that over the last decade more than 30 states have reduced benefits to injured workers. The ProPublica/ NPR series illustrated its thesis by focusing on individual workers who had suffered horrific injuries with poverty-inducing benefits. During the WCRI conference, as well as in the intervening week, the series has been roundly damned by workers comp professionals as biased in the extreme.

While explicitly saying he was not judging The Demolition of Workers’ Comp, Dr. Victor said, “It is hard to write a balanced report based on anecdotes.” Others in the business have not been so kind.
Most of our colleagues who have commented on the series have focused on what they perceived to be wrong with it. Lost in the weeds has been what is right with it. So, let me suggest what I think are two of the serious messages we should take from The Demolition of Workers’ Comp.

First, it is indisputable that there is wide variance and, in many cases, profound inequality with respect to workers’ comp benefits provided by the states. Grabell and Berkes pound this point home with the heaviest sledgehammer they can find. Workers’ comp pros may not like that, but it doesn’t make the point any less valid. Sure, they illustrate the issue with the most glaring examples, but so what? The inequality of scheduled benefits is absolutely true. It is true as Grabell and Berkes write that “The maximum compensation for the loss of an eye is $27,280 in Alabama, but $261,525 in Pennsylvania.” It is true that “The loss of an arm…is worth up to $48,840 in Alabama, $193,950 in Ohio and $439,858 in Illinois.

It is also true that maximum total temporary disability benefits differ among the states, sometimes markedly so. For example, if a worker living in West Stockbridge, Massachusetts, is injured on the job, maximum TTD weekly benefits are equal to the Massachusetts state average weekly wage, which is currently $1,214.99. However, if another worker, living 3 miles to the west – in New York – suffers the same injury, his or her maximum weekly benefit is $808.65. Is that fair? Why the difference?

The answer is that, although the average weekly wages in both states are roughly equal ($2.01 separate them) and although Massachusetts’ maximum benefit is equal to the state average weekly wage ($1,214.99), in New York the maximum benefit, at $808.65, is only two-thirds of the the Empire State’s average weekly wage. So, the Massachusetts maximum benefit is 50% higher. Both workers may shop at the same Big Y supermarket, but I can guarantee the Big Y doesn’t have one price for the New Yorker and another for the Bay Stater.

To me, this glaring disparity in state benefits, especially scheduled benefits due to the loss of bodily function, cries out for profound reform. Trouble is, I don’t see any Galahad coming over the crest of the hill to right this wrong. Do you?

The second message concerns employers and it is this: Regardless of what you may think of benefits paid to injured workers, and despite the perceived high medical loss costs and physician dispensing issues we spent nearly two days last week discussing in Boston, it is true that, nationwide, workers’ comp premium rates are at a level not seen since the very early 1980s, and, in some states, the 1970s. It is true that, in terms of workers’ comp premiums, today’s employers have never had it so good.

That’s great, and I plead guilty to having worked very hard over the last 30 years helping employers make that happen. But perhaps it’s time to take some of those premium savings and invest them in better scheduled benefits in the states that lag far behind in the fairness race. Perhaps it’s time for all states to take another look at the 1972 National Commission’s recommendations and consider re-examining how they stand with respect to recommendation adoption. Finally, perhaps it’s time we workers’ comp professionals unload the gatling gun and stop shooting the messengers.

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WCRI: Day One

Thursday, March 5th, 2015

Two major issues were discussed this morning on the first day of WCRI’s annual conference: cost shifting from group health to workers’ comp and physician dispensing.
Dr. Richard Victor, the 31-year WCRI CEO who’ll be retiring in 2015, hung the cost shifting issue firmly around the neck of capitated group health insurance plans. His reasoning went this way:

    • Capitated plans have been steadily decreasing in number since the turn of the century.
    • A capitated plan pays doctors a set amount for each patient in the plan assigned to them.
    • Workers’ comp is fee for service and pays more than capitated plans.
    • A major goal of the ACA is to establish Accountable Care Oranizations, which pay by capitation.
    • Therefore, there will be a reversal in the decline of capitated plans and they will steadily increase in the future.
    • Consequently, there will be a heightened incentive for doctors and patients to shift some claims from group health to workers’ comp, especially soft tissue injuries, which are harder to attribute to a specific cause.

The second presentation, one that was a bit more dense, looked at physician dispensing, specifically in the 18 states that have changed their rules governing reimbursement.
The physician dispensing panel was moderated by WCRI’s Dr. Vennela Thumula, and consisted of her, Alex Swedlow, President of the California Workers’ Compensation Institute, Dongchun Wang, of WCRI, and myMatrixx’s Artemis Emslie.
With the exception of Dr. Swedlow’s presentation, I have the following takeaways from this panel:

      • The state reforms lowered costs.
      • But physicians continued to dispense, because, even with the lower reimbursements to them, they were still getting paid significantly more than pharmacies were paid for the same drugs.
      • The lower costs may not be sustainable, because Pharma has figured out that it can retake the low ground by changing the strength of drugs. Vicodin is an example.

Regarding Alex Swedlow’s presentation – I felt like I was drinking from a firehose. Try as I might, I couldn’t keep up with all of the data he was dishing out. I know it was really good, but I felt like the Ed Sullivan Plate Spinner trying to keep all the plates on their sticks while being handed yet more sticks and plates. What my feeble brin came away with was this: California workers’ comp is a many headed hydra, and Alex and his colleagues can’t keep up with all the heads. They’re fighting the good fight, and the research produced by the CWRI is awesome, indeed, but there are forces at work in the Golden State that are formidable and relentless.

Gary Orren, Ph.D., of Harvard’s Kennedy School of Government, gave the last session of the morning. It was titled, Persuasion: The Science and Art of Effective Influence. Dr. Orren built his talk around Joshua Chamberlain’s heroic contribution at the Battle of Gettysburg. Chamberlain’s actions at the battle of Little Round Top were critical to the Union winning the battle of Gettysburg and, ultimately, the war. One could argue that if his Maine troops didn’t succeed at Little Round Top there would be no United States today.

As a history buff, I found this to be great stuff, but I have no idea what it had to do with workers’ compensation.

In the afternoon sessions, NCCI’s Barry Lipton presented data on the Price Impact of WC Fee Schedules and WCRI’s Dr. Rebecca Yang on the Perverse Effects of Low Fee Schedules. For Liptpon’s preasentation, I had returned to the firehose. He offered yet more data showing that workers comp costs routinely exceed those of group health and Medicare.

I take a bit of an issue with Yang’s presentation, which suggested that low fee schedules lead to problems with access to care – what doctor wants to treat someone if payment is really low?

Well, I suggest that WCRI take a hard look at Massachusetts, the state with the lowest fee schedule in the nation, where medical loss costs are 36% of total loss costs and where there is no problem with access to care. Just a suggestion.

I look forward to tomorrow’s sessions. Now, it’s on to a good dinner, followed by the Boston Symphony Orchestra’s performance of Szymanowski’s opera, King Roger.
Couldn’t be better.

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Two New Major Reports on Workers’ Comp

Wednesday, March 4th, 2015

In what can be nothing other than a coordinated move, both OSHA and ProPublica today released major reports targeting similar workers’ comp issues. ProPublica’s report was co-produced with National Public Radio.
The Demolition of Workers’ Comp
ProPublica’s Michael Grabell and NPR’s Howard Berkes wrote this report, which sledgehammers the workers’ comp industry, specifically insurers, state regulators and the business community. No matter how you feel about it, if you’re a workers’ comp professional, you should read this report.
In their skewering of the industry, Grabell and Berkes point to the gross differences in benefits provided by the states. They ask, “How much is an eye worth?” Then go on to show that it’s worth ten times more in Pennsylvania than it is in Alabama (around $261 thousand compared to $27 thousand – if you’re going to lose an eye, Pennsylvania’s the place to do it).
They note that workers’ comp premiums around the nation have been falling since the early 1990s, something we’ve written about often, and are now at the level of the late 1970s. Moreover, they note that:

Since 2003, legislators in 33 states have passed workers’ comp laws that reduce benefits or make it more difficult for those with certain injuries and diseases to qualify for them. Florida has cut benefits to its most severely disabled workers by 65 percent since 1994.

Despite this, Grabell and Berkes write that business owners clamor for still lower rates and more restrictive benefits in order to keep and attract business.

“That was always the No. 1 issue,” said state Sen. Brian Bingman, the Republican president pro tem of the Oklahoma Senate. “Your workers’ comp rates are way too high.”


Well, in thirty years of working for employers I have yet to meet one who did not think workers’ comp rates were too high – no matter how high or low they were.
Inequality of state workers’ comp benefits is a serious issue, yet one which I don’t see being addressed by anybody anytime soon. Do you?
This piece is thought-provoking and intelligently written. And Grabell and Berkes have heavy-hitter John Burton agreeing with them. Of course, that might have something to do with Dr. Burton’s Quixote-to-the-windmill quest for another workers’ comp national commission.

The recent changes are “unprecedented in the history of workers’ comp,” Burton said in an interview. “I think we’re in a pretty vicious period right now of racing to the bottom.”

I urge all workers’ comp professionals to read this informative piece of investigative journalism.
The OSHA Report
In today’s tag team match, OSHA released Adding Inequality To Injury: The Costs of Failing To Protect Workers Injured On The Job. This is a seriously impressive work.
In a 20 page, well-researched, well-sourced paper, complete with 37 endnotes, the agency takes the baton pass and sounds its own ringing indictment, taking aim at employers who evade workers’ comp responsibilities by misclassifying employees, labeling workers as independent contractors when they’re really employees, outsourcing high-hazard jobs and making heavy use of temp agencies. In this regard, OSHA cites research indicating that workers’ comp covers only 21% of the costs of injuries for these employees, while 50% is borne by them out-of-pocket (Leigh JP, Marcin JP. Workers’ compensation benefits and shifting costs for occupational injury and illness. Journal of Occupational and Environmental Medicine 2012;54:445-450).
One of the report’s more serious charges, among many, is found in this paragraph:

Moreover, only a fraction of injured workers receive any workers’ compensation benefits through state workers’ compensation programs. Several studies have found that fewer than 40 percent of eligible workers apply for any workers’ compensation benefits at all. Indeed, recent BLS-supported analyses that match cases reported to workers’ compensation carriers with those cases recorded by their employer on OSHA logs, treated in emergency rooms or admitted to hospitals, found a sizable proportion of injured workers receive no benefits through the workers’ compensation system. For example, a review of all recordable work-related amputations in Massachusetts found that less than 50 percent of the cases received any workers’ compensation benefits.


Just for a moment, suppose that Grabell and Berkes and whoever wrote the OSHA paper (it’s uncredited except for all those endnotes) are right. Would that mean that all of us, the professionals who labor in the workers’ comp vineyard, have had our collective heads in the sand for lo these many years? Is that possible? Perhaps it is. What would that mean for the future?
Well, here’s a suggestion for all of us. Read the ProPublic/NPR report. Then read the OSHA paper, paying particular attention to those 37 endnotes. Then, perhaps we could begin a conversation about how, while we’re all helping employers and insurers to reduce costs, we could actually deliver the lawful benefits to which all of America’s injured workers are entitled.
There’s an idea.
Hope to see you tomorrow in Boston where we might begin the conversation.

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WCRI, Inside Baseball in California, Patient Records in New Jersey and Who’s Managing What Care

Thursday, February 26th, 2015

The WCRI Annual Issues and Research Conference gets underway a week from today in Boston. The conference and Lynch Ryan are each in their 31st year, but, truth to tell, the first WCRI conference could have been held in a telephone booth (not The Tardis).

We wrote about this conference a couple of weeks ago, so no need to cover old ground. However, it is worthwhile to mention how valuable the conference has become. It’s a serious event attended by serious professionals. Sorry- not much partying. Las Vegas it aint. And this year its style is even more cramped what with more than eight feet of snow hanging around. But the walkway around the Charles is cleared, so you can bring your running shoes. I, on the other hand, coffee in hand, will be happy to wave goodbye to you as you head out the hotel door for that morning run. The older I get the more I subscribe to Winston Churhill’s view of exercise: he said he got enough of it carrying the coffins of his athletic friends.

Unfortunately, we just learned that the WCRI has “reluctantly” decided to cancel its Opt Out session, because “at least one of the presenters felt that the time allotted for the session was too short for the objectives to be well-met.” This is truly unfortunate given the momentum the Opt Out movement is gaining nationally. You would have thought the presenters could have raised this issue a lot earlier. Nonetheless, I’m sure there will be much opt out discussion among attendees outside of the sessions. WCRI is offering to refund registration money for those who choose to “opt out” of Boston due to the cancellation. Regardless, I hope to see you in Boston.

Inside Baseball In California
When looking for something a bit out of the ordinary, California workers’ comp never disappoints. Work Comp Central’s Greg Jones reports this morning that:

A Southern California applicants’ law firm claims in court filings that Knox Ricksen “hacked” the computer network of a vendor it uses to sign up new clients to gain access to an estimated 2,000 confidential and privileged documents.

In the suit, the plainiffs’ law firm, Reyes & Barsoum, says it has a vendor, HQ Sign-up Services Inc., whose job it is to “sign up” customers for the firm. The suit alleges that the defense law firm Knox Ricksen hacked HQ Sign-up, gaining access to claimant information which HQ Sign-up would forward to lawyers at Reyes & Barsoum. This would give Knox Ricksenan unfair and illegal advantage in the legal proceedings. People, I did not title this Inside Baseball for nothing!

This little dust-up shines a light on the dog-eat-dog adjuducative business that is California workers’ comp. It’s not pretty and it never has been. I wonder what opt out legislation would do for California?

Patient Records In New Jersey
Now we balance the cesspool into which California’s workers’ comp courtroom wars sometimes descend with workers’ comp law as it should be practiced. John Geaney, a man for whom I have great respect, is an executive committee member and shareholder with New Jersey’s Capehart Scatchard. John began publishing a client newsletter in 2001. A few years ago it morphed into a blog, which Lexis Nexus awards as one the nation’s Top 25 workers’ comp blogs. John’s blog should be required reading for all workers’ comp professionals in New Jersey. For that matter, it’s instructive wherever you are.
Today’s blog post concerns the right of injured workers to have access to their medical files. In my experience, there are some claims adjusters that resist this. However, doing so can worsen the situation and alienate the injured worker. Transparency is good for everyone. This blog post is well worth reading.

Who’s Managing What Care
In his Quick Tips blog post of today, Barry Thompson takes no prisoners as he derides what has become of “Managed Care,” which Barry has renamed “Manipulated Cost.” His is a tale told in anger, and he asks, “Where’s the outrage?” Good question. In the early 1990s, I gave a presentation at NCCI’s Annual Issues Conference and titled the presentation Managed Care: Who Manages, Who Cares? ‘Twas ever thus. It seems that the question is still begging for an answer.

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Peter Rousmaniere’s Seismic Shifts in Workers’ Comp: A Thought-Provoking Call To Arms

Monday, February 23rd, 2015

In the mid-1980s, workers’ compensation underwent a management revolution. Until then, employers bought insurance policies, and when injuries occurred passed the baton to their carriers. Then they went back to making widgets trusting that the carriers would take care of everything.

That didn’t work out so well, and costs took a rocket ride to the moon. Across America, employers looked for help. Why would injured workers remain out of work long after it was medically necessary for them to do so. The answer, as we all know, was found in the mirror. Employers, themselves, were the key to getting injured workers back into the bosom of the workplace, but they’d never been taught how to do that. Didn’t know it was their job.

Thus was the workers’ comp management consulting industry born. My company, Lynch Ryan, was first out of the gate. We were the Pathfinders, and Peter Rousmaniere was Employee Number 3 in what was to become a 55 person firm. Peter – Groton School, Harvard BA, Harvard MBA – wanted to join us because he was looking for a challenge. I wanted Peter to join us because he was really smart, and his brain worked like nobody’s I’d ever met. Peter thought “outside the box” before there was an outside the box.

Peter still thinks like nobody else, and today Work Comp Central has published his Seismic Shifts: An Essential Guide for Practitioners and CEOs in Workers’ Comp, subtitled, How Technology and Demographics Will Impact Workers’ Comp From Today Through 2022. This self-funded, year-long venture looks out into the future and envisions another revolution, one that we ignore at our peril.

In Seismic Shifts, Rousmaniere catalogues the nearly unnoticed, but drumbeatingly steady, changes in workers’ compensation since the early 1990s. He shows that since 1991 lost time injuries have declined by 60% and projects that by 2022 there will be a further decline of at least another 35%. He is perplexed about how the insurance industry has missed this decline in injuries and claims, what he calls ‘the elephant in the room,” and suggests that it has done so because for more than a decade it has been obsessively fixated on medical costs, an observation with which I agree. Rousmaniere contends that the insurance industry does not understand how this has happened or why.

His thesis is that this sea change, this seismic shift, is the result of employer improvements in safety engineering, information technology, telematics, robotic design, predictive modelling analytics and the continuous yearning for enhanced productivity. And most important, this natural gravitational movement will continue inexorably. Further, he believes that the workers’ compensation insurance industry has not considered where all of this will lead, how it can be part of and optimize this transformational movement and what kind of workforce it will need to take advantage of this new paradigm.

In Rousmaniere’s view, workers’ compensation practitioners, as well as occupants of the C-Suite, would be well-advised to understand what’s happening and embrace, rather than resist, these evolutionary developments. In his mind, the embracers will succeed and control the future; the resisters will be swept away. It’s as simple as that. He describes, as example, the profound employer movement toward total absence management, rather than merely occupational absence. The move toward total absence management is gathering steam at larger employers, and workers’ comp insurers don’t know what to do about that. Neither do they have a plan for coping with the “opt out” phenomenon. First Texas, then Oklahoma, and just last Friday legislators in Tennessee filed opt-out legislation built on the Oklahoma model. This is becoming a trend.

But the workers’ compensation industry has never distinguished itself in the race to the future. It will be interesting, indeed, to see if Rousmaniere’s clarion call is even acknowledged by today’s potentates. To help it along Work Comp Central is hosting a 4-part webinar series during which Peter will lay out his thesis and try to persuade others in the workers’ comp community to join him in his effort to drag the industry kicking and screaming into the future. Check with Work Comp Central for dates of the Webinars.

Seismic Shifts is an important work, one deserving of your attention and consideration.

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The WCRI Annual Conference: May The Weather Gods Cooperate

Thursday, February 12th, 2015

As Bostonians try to dig out from the most snow ever recorded in a 30-day period in Boston, we look forward to the WCRI’s upcoming Annual Conference at the Westin Copley Place Hotel on Thursday and Friday, March 5th and 6th.

More about the snow a little later, but first the conference.

This year, the conference theme’s title is Resilience or Renovation. However, we won’t get the resilience and renovation until Friday, Day Two. Day One is devoted to updates on all things medical, starting with Dr. Richard Victor, the Institute’s Executive Director, discussing the impact of the ACA on case shifting, which promises to be interesting, indeed. From there we move on to physician dispensing and the perverse effects of low fee schedules.

When the boat docks at Resilience and Renovation on Day Two, we begin with a session titled Resilience: Lessons From Two Decades of Reforms. The panel will discuss reforms in Texas, Pennsylvania, Oregon and Florida. While I am sure this discussion will be stimulating, as well as engaging, I find it curious that conference planners skipped over the greatest reform in the history of workers compensation. It happened in 1992 right where conference attendees will be sitting – the Commonwealth of Massachusetts.

“Renovation” is a good way to describe a couple of late morning sessions on Day Two, one on Opt Out and the other on challenges to the constitutionality of workers comp. You might think that a bit wonky, but I think attendees will find it thought provoking. It’s interesting that the Opt Out session will focus on the Texas perspective, not the Oklahoman. You may recall that the Texas Opt Out provision has what I consider to be flaws of the first order. Those flaws were corrected when Oklahoma adopted its version of Opt out.

All in all, the conference is an excellent opportunity for workers comp professionals to stay in front of the research curve and to connect with some of the leading lights in the field. I hope to see you there.
Now, the weather. Here’s a Fenway Park snow sellout. Seats full of snow fans.


Speaking for all Bostonians, I think we’ve had enough. Really. Monday night, during our third major snowstorm within a week and a half, Boston Mayor Marty Walsh announced there would be no public transportation the following day. None. A gazillion people ride what we affectionately refer to as “The T” to get to work every day in and around Boston. Not Tuesday. Shortly after that, standing in front of the TV cameras, Governor 5-weeks-in-office Charley Baker said the 100-year-old MBTA’s performance is “not acceptable.” I guess the bloom is off his rose. We have entered the “find a scapegoat” phase.

Yesterday, the first head rolled – Dr. Beverly Scott, the T’s General Manager. She won’t be the only one.
The rest of us will be fine, but, my God, I’m looking at more than five feet of snow outside my door, and it’s not a drift! And Boston has nothing on Worcester, just 35 miles to the west where nearly 100 inches, that’s more than eight feet, have already fallen at about the halfway point of the snow season. Mother Nature has now gifted Worcester with more snow than any other city in America. Take that, Fargo! You,too, Buffalo! When this stuff melts (please, God, make it melt) we’ll probably have a new lake to rival Michigan in Central Massachusetts. Oh, and our friendly local meteorologists, never happier than when they’re forecasting impending doom, now predict that beginning tonight we’ll descend into the coldest weather of the year. High temps will be in the single digits. Human digits will freeze and fall off. And Saturday night through Sunday there’s a foot more of the fluffy white stuff headed our way just in time for Valentine’s Day. The Lord just keeps showering us with his tender mercies.

But here’s the good news: Spring training is right around the corner. Pitchers and catchers report in three days. By the time the WCRI Conference rolls around Fenway South will be in full bloom. And here in Boston the sun will be shining, the snow will be gone, temperatures will be balmy and the T will be running on time.

And pigs will be seen flying in formation outside the windows of the Westin Copley Place Hotel.

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LexisNexis: Furthering the Workers Comp Community

Monday, December 22nd, 2014

I am not a lawyer, thank you very much, but I am married to one. So, you may imagine that I am familiar with more than a few members of the breed. I’ve heard every lawyer joke there is (but if you want to send me a couple of your favorites, that would be OK).

In the mid-1980s, the early days of Lynch Ryan, I often heard my attorney friends saying they had to search “Lexis” for one thing or another. Since they were occasionally charging me for doing that, I wanted to know a bit about “that Lexis thing.” Over lunch one day I was educated about this remarkable innovation for the legal community, an innovation that was actually saving me money.

The whole thing began as a searchable database experiment of the Ohio State Bar in 1967. In 1970, the Mead Corporation’s Mead Data Central took it over and named it Lexis. In 1973, Mead made Lexis’s full text search available for all cases in Ohio and New York. In 1980, after a 7-year key punch effort (you read that right), Lexis went nationwide for all federal and state cases. That same year, Mead launched the Lexis sister, Nexis, which allowed journalists to search news stories related to law.

In 1994, Mead sold LexisNexis to Reed Elsevier for $1.5 billion. Not a bad return on investment from those Ohio State Bar days.

Starting in 2000, LexisNexis began to get into the risk solution business, primarily by acquisition: Riskwise in 2000 and ChoicePoint, a data aggregator, in 2008. By the time of the ChoicePoint buy, LexisNexis had become profoundly involved in risk, especially workers compensation. It became a leading publisher of workers compensation material, including Larson’s Workers Compensation Law.
The LexisNexis Senior Editor for all things workers compensation is Robin Kobayashi, a ridiculously smart and talented person (Phi Beta Kappa from UCLA — by contrast, the closest I ever got to Phi Beta Kappa was admiring Gary Anderberg’s pin).

Robin is the visionary who decided to recognize workers compensation bloggers, beginning in 2009. That year there was only one winner, and I’m proud to say we were it. However, beginning in 2010, Robin expanded the award to the top 25 blogs, realizing that there was a wealth of insightful Web commentary that cried out for recognition.

Recently, LexisNexis announced the top 25 workers compensation blogs for 2014, a most distinguished list, and we congratulate everyone on it. However, during this time of recognition, I thought it might be a good idea to shine the Workers Comp Insider arc light on the far-sighted professional who made this award possible, thus deepening and expanding the workers compensation community in a meaningful and long-lasting manner.

For her vision and dedication, we salute Robin Kobayashi.

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A Friday Eulogy

Thursday, December 11th, 2014

Sitting here in Massachusetts on this dreary, dour and dank day, looking out the window and watching all manner of birds at the feeders (they’re really fond of the suet), I was planning on writing something about Roberto Ceniceros’s excellent article, “Taking the Psych Out of Psychosocial,” published this week in Risk & Insurance’s Workers Comp Forum.
Roberto suggests that the prefix “psych” in “psychosocial” causes confusion in the payer community, because it is difficult to distinguish between social co-morbidities and true psychological ailments. He also quotes our friend and colleague Jennifer Christian,M.D., who recently started a LinkedIn thread that gained immediate traction on the same subject.
Whatever you want to call them (how about co-morbid issues?), what we now know as psychosocial issues as well as the predictive analytics for identifying them early form the basis for an interesting and necessary discussion.
But we’re not going to do that today. No, today we’re going to sing the praises of someone most of you have never heard of – Ted Coughlin.
Over the years, the Insider has written about the shortage of skilled workers in the US, especially in manufacturing, which has become highly technical. The country’s educational systems were not keeping up with the speed-of-light technological advancements that bombard us continuously. This was especially true in Worcester, Massachusetts, where Worcester VoTech had become a city embarrassment. For twenty years, Worcester businessman Ted Coughlin devoted his considerable energy and local power to changing that. A one man force of nature, Ted was the person most responsible for the creation of Worcester Technical High School, a state of the art, nationally envied educational institution.
Early this year, the school won the US Department of Education’s National Blue Ribbon School Award, an award won by only 0.2% of the nation’s public and private high schools. Secretary of Education Arne Duncan toured the school in March. In April, the school’s Robotics and Automation Technology Team, the Commandos, one of 420 teams from 23 countries, won the VEX Robotics World Championship. In June, President Obama came to deliver the Commencement Address and acknowledged the extraordinary commitment of the city to lead the way to education’s future. But he saved his greatest praise for Ted, without whom the school would never have happened.
We lost Ted last night. He took a fall at home and died. He was a big-hearted, charismatic Prince of a guy who was loved and admired. In the years to come, graduates of Worcester Technical High School, as well as those from the other schools that Worcester inspires, tomorrow’s leaders, will owe a debt of gratitude to this wonderful man.
And so, that’s why, with apologies to Roberto and Jennifer, we’re postponing the column on psychosocial issues.
Rest in peace, Ted.

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And The Winner Is…..

Friday, October 10th, 2014

California! Again!
Early this week, Oregon’s Department of Consumer and Business Services published its biannual rankings of state workers’ comp costs (by the way, did you know that “biannual” means both twice a year and once every two years? English is a funny language). Kudos to Jay Dotter and Mike Manley for once again separating the wheat from the chaff.
Since 2006, we’ve written about Oregon’s rankings, as well as those of the actuarial consulting firm, Actuarial & Technical Solutions (ATS) and the National Foundation for Unemployment Compensation and Workers’ Compensation (UWC) headquartered in Washington, DC. If you’re so inclined, see our in depth 2006 report, our 2009 report highlighting Massachusetts and our 2010 report.
Following the Oregon release the blogosphere was quick to note that California, leapfrogging Connecticut and Alaska, had won the 2014 gold medal for most costly state in the nation. People, this was not a surprise.
We have been watching the Golden State’s periodic workers’ comp train wrecks since the late 1980s. Here’s how things usually go.
1. Costs go through the roof
2. Vested interests run around with their hair on fire
3. Legislature enacts reforms
4. Costs drop precipitously (everyone takes credit)
5. Lawyers figure out how to outflank the reforms
5. Costs go through the roof
6. Repeat the process
This has happened at least three times in the last 20 years, most notably during the administration of the Terminator, Arnold Schwarzenegger, when annual costs exceeded $29 billion dollars (you read that right). After reform, costs dropped to around $14 billion. Everyone declared victory and left the field until the sky fell again.
Alex Swedlow and the California Workers’ Compensation Institute have done a marvelous job tracking costs and, through solid research, shining a light on possible ways to lower costs going forward. Nonetheless, to say that California’s workers’ compensation costs are continually volatile seems indisputable.
A couple of other notes on the Oregon rankings:
1. Although lagging far behind California, Connecticut retains its place of honor at Number Two in the ranking. It’s costs are 155% of the median costs for all states and the District of Columbia;
2. In addition to Connecticut, it’s worth noting that four of the other six New England states, Vermont, Maine, New Hampshire and Rhode Island rank in the top 20;
3. And, you might ask, what about the sixth New England state, the Commonwealth of Massachusetts, the home of the bean and the cod. Well, it may be the proverbial broken record, but I’m proud to note that Massachusetts, our home state, at 48th most costly, holds the distinction (again) of being the least costly of any major manufacturing state. This has been the case for the last 15 years. Why other New England states, for that matter all other high cost states, don ‘t take a leaf from the Massachusetts book is beyond me.
I’m betting that California, the state, which, if it were a country would have the fifth highest GDP in the world, will continue its up and down roller coaster ride as time marches on. It’s just too big with too many highly entrenched vested interests to do otherwise.

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9/11 Remembrance

Thursday, September 11th, 2014

If you’re looking for something about workers’ compensation, might as well stop reading now, because this isn’t about workers’ compensation, although we know that 9/11 produced a slew of claims .
No, this is a brief post to share my 9/11 tribute song recorded on 28 September 2011 at one of the three greatest small concert halls in American – Mechanics Hall in Worcester, MA. Peter Clemnte is on guitar. As the song says:
We must be strong
For friends who’ve gone.
I hope the song brings comfort on this sad anniversary.

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