Posts Tagged ‘Massachusetts’

Managing Chronic Pain

Monday, June 20th, 2011

In the world of workers comp, chronic pain is a major cost driver. When pain persists beyond expected healing times, the prognosis is grim: injured workers suffering from prolonged pain often drift into anxiety and depression and may even become addicted to powerful pain medications. In the downward spiral of relentless pain, it becomes increasingly difficult to separate physical and psychological issues. The prospect of return to work disappears, the injured worker’s life disintegrates and the cost of the claim goes through the roof.
The claims adjusters who are responsible for managing chronic pain injuries usually resist any recommendations for psychological counseling; they avoid such interventions because treatment – whether individual or group therapy – cannot and should not be limited to what is “work related.” Pain subsumes the worker’s entire life. Yet counseling is often an essential part of what is needed: injured workers talking through their many difficulties and sharing their experience with others.
So is it possible to develop a chronic pain program that limits financial exposures, narrows the treatment options and sets reasonable time frames for completing the treatment cycle? And can pain management encompass at least some focused counseling?
A Guide for the Perplexed?
Massachusetts has taken a shot. The state’s Department of Industrial Accidents(DIA) Health Care Services Board has issued draft guidelines (PDF) for managing chronic pain. Under the leadership of Dean Hashimoto, who holds both medical and legal degrees, the draft protocol tiptoes through a minefield populated with poppy plants, doctors with prescription pads and long needles, chiropractors, acupuncturists, counselors and biofeed back practitioners – not to mention the ever-present drug salespeople. The draft guidelines could well serve as a Guide for the Perplexed.
Beginning with the caveat that 10 percent of all chronic pain cases will fall outside of the protocol, Hashimoto’s task force tries to set parameters for all types of treatment: the number and type of diagnostic and therapeutic injections permissible; the goal-oriented use of mental health counseling, with specified durations (6 to 12 months); “very limited” use of opioid analgesics, with referral to pain specialists, if needed, and including a detailed list of specific actions designed to avoid addiction.
A Work in Progress
The DIA is soliciting comments on these guidelines. Alas, they are unlikely to hear from the relatively small portion of stakeholders who are profiting from the current chaos: the pill-happy doctors, the attorneys who discourage injured workers from returning to work, the physical therapists and chiropractors who believe that treatment, once begun, should go on forever, and the pharma sales folk who encourage use of the most powerful opiates for what is usually short-term pain.
The draft guidelines are comprehensive and reasonable. As the final guidelines will not and cannot have the force of law, they will not eliminate the abuse that currently exists. But if they help motivated treatment practitioners to offer more effective services, and if they open the door to at least some counseling for injured workers, the guidelines will surely save both lives and careers. That in itself will validate the admirable and essential work of Hashimoto’s board.

GCs in MA: Comp’s Not-So-Exclusive Remedy

Wednesday, May 25th, 2011

Henry C. Becker Custom Building Limited was doing some construction work in Newburyport MA. They hired the Great Green Barrier Company to do some waterproofing. They apparently did not ask for a certificate of insurance; Great Green Barrier did not carry workers comp for their employees. There was an explosion on the jobsite. Timothy Wentworth, an employee of Great Green Barrier, was killed; his son, Ezekiel, was severely injured. As the employees of an uninsured subcontractor, the Wentworths collected workers comp through Becker’s insurance company, which paid out substantial lump sum settlements to each.
Then the Wentworths sued Becker as a third party. Becker objected: comp, after all, is an exclusive remedy. Once the Wentworths collected comp benefits, they should be precluded from any other remedies. Becker sought and won a summary judgment dismissing the lawsuit.
The case wended its way to the MA Supreme Judicial Court, where the justices determined that the summary judgment was improper: the exclusive remedy provision of the comp statute applies only to employees. The Wentworths were not employees of Becker, but of Great Green Barrier. Becker, in other words, was a third party and thus, despite the payment of comp benefits, was not immune from lawsuit.
Compounded Liabilties
Becker is going to pay and pay again: first, under their workers comp policy, the payroll for Great Green Barrier employees will have been added to the Becker payroll in the premium audit; that’s the chump change. Then, the substantial losses for the Wentworths – each likely exceeding the state rating point limit of $175,000 – will be added to the experience modification calculation for Becker over a three year period. That’s serious bucks (but nowhere near the financial hit taken by Becker’s comp carrier).
Then, given this ruling, the Becker company is vulnerable to a lawsuit, which is likely to result in additional payments to the Wentworth family. The MA Supreme Court has made it crystal clear: general contractors are liable for the comp costs of uninsured subs, but the acceptance of comp benefits does not preclude a third party lawsuit.
The lesson for GCs should be clear: proper risk transfer must be a fundamental part of the operation. Make sure subcontractors carry workers comp: require that any and all subs produce a certificate of insurance, with the GC named as an additional insured. Track the expiration dates on the certificates and do not allow subs on the job site unless they have shown that comp (and liability) policies are in place.
Henry C. Becker Custom Building has learned about risk transfer the hard way, an expensive lesson indeed. May a word to the wise be sufficient.

Health Wonk Review & other noteworthy news of the week

Friday, April 15th, 2011

Health Wonkery – At Health Business Blog, David Williams hosts a concise compendium of assorted health policy news at this week’s Health Wonk Review. He notes that judging by the quality and quantity of entries received for this edition, it’s a wonderful time to be a wonk. These bi-weekly digests are a good way to keep current on healthcare trends – important, given that the medical portion of comp is now accounting for more than half of every claim dollar.
OSHA’s residential fall protection upheld in court challenge – the U.S. Court of Appeals for the Seventh Circuit backed OSHA in a court challenge to its directive to require fall protection measures for residential construction. The directive faced a challenge by the National Roofing Contractors Association’s (NRCA), which sought to maintain an option for residential construction to use alternative protection measures that bypassed some fall protection requirements. Falls are the number one cause of fatalities in construction. BLS shows that about 40 workers are killed each year as a result of falls from residential roofs. “One-third of those deaths represent Latino workers, who often lack sufficient access to safety information and protections. Latino workers comprise more than one-third of all construction employees.”
Trucking & misclassification – The National Conference of Insurance Legislators adopted the Trucking and Messenger Courier Industries Workers’ Compensation Insurance Model Act to address employee misclassification. It would establish six standards, and employees that do not meet the standards would be considered employees. There was wide participation in formulating the standards. Parties offering input to the model law included state insurance and workers’ comp regulators, American Insurance Association (AIA), American Trucking Associations (ATA), Dart Transit Company, FedEx, International Brotherhood of Teamsters, Leadership Conference on Civil and Human Rights, Messenger Courier Association of America (MCAA), National Council on Compensation Insurance (NCCI), National Employment Law Project (NELP), Property Casualty Insurers Association of America (PCI), and United Parcel Service (UPS).
Social media – at Legal Talk Network, two respected & knowledgeable workers comp attorneys – Alan Pierce and Jon Gelman – join forces in a half hour podcast on Privacy, Clients and Social Media. Even if you aren’t an attorney, this is worth a listen. See Gelman’s related article: Facebook Becomes a Questionable Friend of Workers’ Compensation.
WC rate relief? – MarketScout reports that the commercial market is hardening, with workers comp rates either flat or rising. That is borne out in Massachusetts, where a deal was struck to keep rates flat until 2012. This puts a halt to the long-term trend of rate decreases in MA.
More transparency for OSHA rules process – Celeste Monforton at The Pump Handle calls the Obama administration on the carpet for a lack of transparency in safety rulemaking when it comes to meetings with industry representatives. “The President’s own Office of Information and Regulatory Affairs (OIRA) has hosted two meetings with industry representatives who are opposed to an OSHA regulation on crystalline silica, but OIRA fails to disclose these meetings on its website (screenshot 4/11/11.) This is the second time in as many occasions that this OMB office has failed the transparency test when it comes to extra-curricular meetings on OSHA rules. OIRA did the same thing last summer on OSHA’s proposed minor change to its injury recording log. Others have identified even more serious infractions by OIRA, but have yet to receive a response from the White House.
Reality TV – While we’ve been joshing about upcoming fictional portrayals of workers comp on TV, Roberto Ceniceros at Comp Time points us to an interesting case of reality TV catching mining safety violations in action. A spike TV program about West Virginia coal mining – created by the same folks who do the “dangerous jobs” series – revealed violations that prompted citations from Mine Safety and Health Administration inspectors. It’s an interesting story – Roberto offers the full scoop complete with links.
Legal matters – At LexisNexis Larson’s Spotlight offers another round of Five Recent Cases You Should Know About, with cases spanning the Going and Coming Rule, heat-related illness, a COPD claim, and more.
Disability redefinedComplex Care Blog keeps us updated on bionic legs and other miracles that demonstrate the power of the human spirit and technology to overcome the odds.
Kudos to NAIC – National Association of Insurance Commissioners (NAIC) 2010 Annual Report Pillars of Strength offers “a testimony to the fundamental strength of our national system of state-based insurance regulation.” NAIC has been actively involved in the Patient Protection and Affordable Care Act, including the creation of Medical Loss Ratios, a rate review process, and working with federal and state authorities to establish health care exchanges. The organization has also been active in financial regulatory reform, including a Solvency Modernization Initiative to update US insurance solvency framework, market regulation, and more. NAIC is also noted for its excellent consumer information and fraud awareness initiatives. This includes a great insurance primer for for owners of small companies and home-based businesses: Insure U for Small Business.
Of noteHR Daily Advisor features a great article on six ways attorneys will attack your investigation – not workers comp specific, but a good backgrounder of any potentially litigious employment situation.

FedEx in MA: Buying Time

Monday, September 13th, 2010

Five years ago we blogged the problem FedEx would inevitably run into in Massachusetts, where the definition of “employee” is so inclusive, it’s almost impossible to find a truly “independent contractor.” Well, the proverbial chickens have come home to roost.
Attorney General Martha Coakley has announced a settlement with FedEx, wherein the delivery giant has agreed to pay a little more than $3 million relating to the status of 13 “misclassified” delivery drivers. Without admitting liability or wrongdoing, FedEx has agreed to refrain from using the “independent contractor” strategy in response to claims for benefit coverage, including payroll taxes, unemployment insurance, and workers comp. In exchange, Massachusetts will refrain from any further legal action for one year. In other words, for the modest sum of $3 million, FedEx has bought itself a year to clarify its business strategy. Therein lies a tale of attorneys, well worth the telling.
FedEx maintains a steadfast commitment to a business model for its ground delivery system where the work is performed by independent contractors. With a healthy scepticism in our hearts, we have frequently blogged the barriers to independence: the drivers wear FedEx uniforms, drive FedEx trucks, adhere to FedEx dress codes and schedules, etc. FedEx ground does not exist without these drivers and that makes them, in effect, employees. The response to the fundamental query “who controls the work?” has been unambiguously, FedEx.
ISP to the Rescue?
As part of its agreement with the Commonwealth, FedEx has outlined its rationale for the independent contractor model. They propose entering into an Independent Service Agreement (ISP) with driver/managers in each service area. Appended to the MA settlement in draft form, the ISP agreement tries diligently to carve out a middle ground where the work is performed independently, but to FedEx standards.
Here are a few of the details:

  • The local driver/manager must operate under a corporate entity recognized by the state(s) in which he or she operates.
  • The driver/manager can hire and fire employees and must provide all mandated benefits to employees, including workers comp
  • Theoretically at least, the driver/manager can be a sole proprietor without employees; in this case, the issue of workers comp coverage is governed by the state statute on sole proprietors (who usually can opt out)
  • The agreement states that FedEx Ground has no authority to “direct as to methods, manner or means” the provision of services.
  • The ISP manager has “exclusive rights” in a specific geographic area
  • While the ISP has the right to decline service, in such cases this triggers the right of FedEx to ensure services
  • Drivers are not compelled to wear FedEx uniforms or drive FedEx vehicles, but they are paid a weekly incentive to do so.
  • As you can see, FedEx is trying to establish independence while still maintaining its identity and its standards. The Attorney General has not made any judgment about the validity of this strategy; she has simply cashed a nice check, in exchange for which she has given FedEx a year to work out the kinks. After the year is up, the FedEx model will likely be challenged once again.

    Not Quite Independent?
    You have to credit the presumably well-paid FedEx team: they have tackled head on the thorny issue of “free from control and direction.” On the surface at least, the ISP approach offers a credible if not totally convincing appearance of independence.
    Unfortunately for FedEx, the MA standards have two additional components, neither of which appear to be addressed in the draft ISP agreement: independent contractors must provide a service outside of the general contractor’s usual course of business (no way FedEx can do this) and their independence is reflected in their marketing of services beyond a single customer (what would this look like?).
    It will be interesting to see how FedEx responds when local driver/managers stretch the rules and standards in an attempt to assert some real independence. That’s where the rubber will meet the road in this seemingly endless saga: a company with a ferocious need to control, giving up control in order to preserve their idiosyncratic business model.
    And some folks say employment law is boring….Stay tuned.

    Massachusetts Comp: The Power of “Any 3 Persons”

    Thursday, August 26th, 2010

    Massachusetts has been in the forefront of the independent contractor issue. The state has narrowed the definition of “independent contractor” to the point where almost anybody can be defined as an employee. But how do you enforce this? Where is the leverage to confront employers who are avoiding comp premiums by misclassifying their employees as independent contractors?
    Under the direct influence of labor unions, the Commonwealth has empowered “any 3 persons” to take action against suspected comp fraud. Governor Deval Patrick recently signed a law that allows any 3 people to file suit against an employer who fails to comply with the workers comp statute. If that sounds pretty broad, well, it is. Here is first section of the new law:

    Whenever facts exist showing that an employer has failed to comply with this chapter, then any 3 persons may bring a civil action and that civil action shall be deemed a private attorneys general action….Plaintiffs shall prove a violation of this chapter by a preponderance of the evidence.

    I do wonder what those “facts” and the supporting evidence might look like. Beyond that, this language invites lawsuits for any violation of the workers comp statute, a very wide parameter of possibilities, indeed. The focus, however, will be on premium fraud: deliberate misclassification of employees; paying people under the table; and failing to carry workers comp insurance altogether. The plaintiffs can collect up to $25,000 in unpaid premiums and an additional $25,000 in damages, plus “costs and reasonable attorneys fees.”
    These suits must be filed no sooner than 90 days after a policy ends (how would the “3 persons” know this date?). Then the process will take an additional 90 days. So six months after the policy ends, all hell breaks loose.
    Bitter Remedy
    Where are the “3 persons” likely to come from? I’m guessing that disappointed bidders on (increasingly rare) construction projects are likely to team up with disgruntled (former) employees of the successful bidder to form a merry band of 3. You might find three laid off employees/independent contractors jumping in to get back at their former bosses. Heck, the standard of “3 persons” is so low, this game is not much more difficult than playing the state lottery.
    It will be fascinating to watch this new statute roll out. Simmering rivalries are going to boil over. The frictional cost of doing business in the Bay State is about to go up. The ultimate question, of course, is how effective this new weapon against premium fraud will be. To the extent it exposes unfair business practices, it will help level the playing field for all Massachusetts employers. But given the broad and ultimately vague language of the enabling statute, there is plenty of opportunity for abuse in this cure for abuse. From a blogger’s perspective, of course, it’s just about perfect.

    Tewksbury (Finally) Opts In

    Tuesday, June 15th, 2010

    There are five towns in Massachusetts that do not carry workers comp insurance for their employees. Four of them – Dana, Prescott, Enfield and Greenwich – are under 412 billion gallons of water: they were submerged during the 1930s in the making of the Quabbin Reservoir, which supplies drinking water to Boston and a number of suburban cities and towns. The fifth, Tewksbury, voted to join the workers comp system way back in 1914, but a clerical error recorded the positive vote as negative, resulting in nearly 100 years of a go-it-alone, pay-as-you-go, hope-for-the-best approach to comp among the residents of the town, now nearing 30,000 people.
    To date, Tewksbury has been pretty lucky. The town has paid out between $100,000 and $189,000 per year for claims in recent years. That’s not bad, considering that one failed back can run upwards of $500,000. But just because Tewksbury has been lucky does not mean they are going to stay lucky. The liability to the town’s tax payers is precariously open-ended. In these challenging times of reduced budgets for all municipal services, the specter of an unanticipated claim could put Tewksbury on the verge of bankruptcy. Because the town did not participate in the comp system, injured workers had the option of suing for damages unavailable in the comp system.
    As we read in Insurance News Net, last month the town meeting voted to adopt workers comp coverage. (Presumably, the vote was properly recorded this time.) It will take a few years to develop an experience rating, based upon actual losses and statutory benefits. Overall the cost of insurance will run a bit higher than an average loss year, but that’s price you pay for transferring the risk to a third party.Comp will finally become a set cost in the town budget. A workers comp policy comes with a comfort factor that cannot be measured simply in premium dollars: any claims, large or small, any catastrophic losses involving multiple town employees, will now be covered by insurance. That should help town residents and officials sleep a little better at night.
    As for the surviving citizens of Dana, Prescott, Enfield and Greenwich, displaced long ago by the state’s appetite for water, comp is not a likely component in their dreams. I imagine they welcome a nocturnal glimpse of the communities where they once lived and waken with sense of sadness and of loss.

    The Politics of Workers Comp Rates

    Wednesday, May 12th, 2010

    Massachusetts has the lowest workers comp rates among the major industrial states and just about the lowest rates in the nation. The cost of comp in the other New England states is roughly double that in the Bay state. So you would think that the rates in MA would at best stay the same from year to year, or increase slightly. Well, think again. Martha Coakley (yes, that Martha Coakley), the current and future Attorney General, has brokered a deal for yet another rate reduction: an average of 2.4 percent across all classifications. The insurance industry had argued for an increase of 4.5 percent. I guess they did not exactly convince Martha.
    The AG thinks that the insurers are overstating future losses. In my experience with carriers operating in MA, they are actually understating losses, but that’s a matter for the actuaries. If, as the AG argues, rates are too high in MA, what can you possibly make of rates in the other New England states and across the country? Are MA employers really that much better at preventing injuries and at getting injured workers back to their jobs? If you buy that argument, I have a nice bridge spanning the Mystic River that you might be interested in owning.
    The trends in MA are no different from those across the country: while frequency is down, severity is rising at an alarming rate. In MA, severity is spiraling out of control. The state’s generous wage benefit structure, combined with a first rate (and pricy) medical system and a judiciary that tilts strongly toward the injured worker, are making six figure reserves all too common. It’s truly puzzling that the AG can look at the performance numbers for the insurance industry and conclude that rates are too high. They are way too low.
    Politics: Local and Loco
    It’s not hard to fathom why an elected official chooses to drive deflated rates even lower. It’s politically popular; any rate increase – even the marginal bump proposed by the industry – would be met with howls of outrage from small businesses, who are already under seige in a struggling economy. Strange to say, the depressed cost of comp is subsidizing the otherwise high cost of doing business in MA.
    The AG is not finished with her rate scalpel: she thinks a few more points can be carved out next year. It will be fascinating to see how the carriers respond. Not too many folks think there is much money to be made in MA comp. And that rapidly dwindling club is about to get a lot smaller.

    MA Supremes: teacher chaperoning ski trip due workers comp

    Tuesday, December 15th, 2009

    In a recent decision that shouldn’t be too surprising to those who follow workers’ comp compensability issues, the Massachusetts Supreme Court recently upheld a decision by the Department of Industrial Accidents to grant workers compensation benefits to Karen Sikorksi, a Peabody teacher injured while chaperoning high school kids on a 2004 ski trip. The City of Peabody had contested the award on the basis that she was a volunteer engaged in a recreational activity.
    We’ve seen many of these cases and the decision often hinges on the voluntary nature of the activity. In this case, the city of Peabody probably thought they were well within the law in denying benefits. According to Insurance Journal, the Massachusetts legislature added a little twist to the workers’ comp statue in 1985, when it excluded “… any injury resulting from an employee’s purely voluntary participation in any recreational activity, including but not limited to athletic events, parties, and picnics, even though the employer pays some or all of the cost thereof.”
    Note the adjective “purely.”
    When is a volunteer really not a volunteer? Usually, when an employer encourages the employees to participate in said activity. (Everybody who has ever been an employee is likely familiar with the concept of so-called voluntary recreational activities – non-participation can be a career-limiting option.) According to reports, the Peabody school administration has historically expected teachers to become involved with the school’s extracurricular activities and, in this particular case, the school principal and the ski club adviser solicited teachers to serve as chaperones. In Sikorski’s case, the Supreme Court justices unanimously found that she was “acting in the course of her employment” and not in a recreational activity as described in the law. The court found that her responsibilities as chaperone were “…essentially the same ones teachers must exercise while working in the school building during school hours.” Chaperones were expected to supervise students both in the lodge and on the slopes.
    Another common criteria that courts use is in determining whether an activity is “voluntary” is how beneficial it is to the employer and whether it furthers the employer’s interests. In this case, the court found that it did: “…the ski club’s trips benefited the city by furthering the school’s educational mission.”
    Of course, nothing is ever simple with workers’ comp – there are 50 different flavors, so every state law may have its own particular nooks and crannies related to these issues. Andrew G. Simpson has an excellent article on ‘Forced Fun’ and related workers’ compensation problems, in which he discusses variations in state laws.
    Other posts related to the issue of “mandatory fun”:

    Ten Years After: the Worcester Cold Storage Fire

    Friday, December 4th, 2009

    Most Massachusetts residents will recall how their heart sank 10 years ago upon hearing TV and radio reports of the on-the-job deaths of six firefighters in the Worcester Cold Storage fire. While firefighting is a dangerous job, this was the first time that six firefighters fatalities occurred in a building where neither a collapse nor explosion had occurred. The first two firefighters became lost in the labyrinth building and the next four were lost in trying to rescue them. Firehouse.com has a Worcester 10th Anniversary Tribute and the Telegram & Gazette have devoted a special section to the remembrance: Worcester Cold Storage and Warehouse Fire: 10 Years Later.
    Worcester is a community that several of us at Lynch Ryan know well – we’ve lived there and worked there. Given the nature of our work, we are no strangers to on-the-job fatalities – we’ve heard many heartbreaking stories about work-related deaths that never should have happened. But rarely does an event hit so close to home and with such force as on that day. Many locals will remember the shock of hearing about two lost firefighters – shortly followed by the almost unbelievable word that the tally was now up to six. Many locals who knew firefighters as friends, family, or neighbors waited the long, tense vigil until names of the deceased were released, and then again waited mournfully until fellow firefighters were able to pull the bodies of their colleagues from the rubble a few days later. We all became familiar with the faces of bereaved spouses, children, parents, and siblings. We all saw and hurt for the heavy burden of grief that the fellow firefighters labored under.
    There was an amazing tribute for the fallen firefighters: fifteen-thousand firefighters from around the globe came for the memorial service. President Clinton and Vice President Gore spoke at the service, along with local Senators Kennedy and Kerry. Senator Ted Kennedy, a man who was no stranger to tragedy, encapsulated things by saying that “Sometimes life breaks your heart.” It was fitting that Kennedy was at the ceremony for the fallen firefighters, he fought for worker safety throughout his career.
    In the aftermath of the tragedy, Two major reports were issued: the U.S, Fire Administration’s Abandoned Cold Storage Warehouse Multi-Firefighter Fatality Fire and a report from NIOSH.
    Firefighter safety still has a long way to go. Tragically, two and a half years ago, nine firefighters lost their lives in Charleston SC. The fire was in a furniture showroom and warehouse – and again, a labyrinth building where firefighters became disoriented.
    Firefighters continue to study and learn from the hard lessons of these warehouse fires. In 2001, Firefighters in Jersey City battled a warehouse fire with similar conditions to the Worcester blaze. Fire authorities credit a seminar that they took with members of the Worcester Fire Department for guiding their strategy in fighting this fire and preventing loss of life. In addition, many communities have been more vigilant about monitoring large vacant properties, and firefighter communication technologies have been improved.
    The matter of firefighter disorientation is still an issue of concern and one that is under study. (See: U.S. Firefighter Disorientation Study). This has given impetus to other safety initiatives, such as advances in First Responder Locator Systems. These include a system developed at a local university, Worcester Polytechnic Institute, where engineers are nearing completion of a First Responder Locator System.

    Massachusetts Premium Rates Redux

    Monday, November 23rd, 2009

    My blog post of last Thursday (19 November 2009) addressing why workers’ compensation costs in Massachusetts are the lowest in the nation, while benefits are among the highest drew a mild pushback from Mark Walls, who manages the excellent LinkedIn Workers’ Compensation Forum. Mark wrote:
    “Working for an excess carrier, I would never have expected Massachusetts to be considered a “low cost” state. In Massachusetts you cannot settle medical, and there are COLA’s on the lifetime benefits. In my world, it’s a high cost state.
    I guess it’s all about your perspective.”
    And he’s right- it is all about perspective. Mark also wrote, “I’m a claims guy,” and the blog post in question was all about premium rates. Sometimes, what appears logical when looking at claims can appear illogical when viewed through the prism of premium rates.
    I can certainly understand why claims professionals in Massachusetts might be a bit frustrated, because not being able to settle the medical portion of a claim, along with having to contend with annual Cost of Living Adjustments, tends to obliterate predictability.
    The perspective Mark mentions changes, however, when one considers a workers’ compensation program unique to the Massachusetts voluntary market, a program that substantially increases premium collected in the state while not driving up premium rates: the All Risk Adjustment Program, or, as it’s better known, the ARAP Surcharge.
    In all 38 NCCI states, the ARAP, a sort of second experience modification that penalizes severity more than frequency, exists as the Assigned Risk Adjustment Program and is found in the Residual, but not in the Voluntary, market. This is supposed to provide even more of an incentive for employers in the Pool to do the right things to get themselves into the voluntary market. It’s a debit mod only. In Massachusetts, however, the ARAP can be found in both the Residual and Voluntary markets. If an employer in the Voluntary market has a high experience modification, it will also most likely find itself with an ARAP surcharge, anywhere from 1% to 25%, which is applied to the standard modified premium.
    For example, say a company in the Voluntary market has a manual premium of $100,000, an experience modification of 1.5 and an ARAP of 1.2. The resultant total premium will be $180,000. Think of the $30,000 ARAP charge as compound interest. This means that Massachusetts premiums are more sensitive to losses than premiums in other states, even “loss cost” states.
    And why shouldn’t an employer with high claim severity pay more for workers’ compensation? Why should employers with low claim severity subsidize those with high claim severity? Although many in industry abhor the idea of the Voluntary market ARAP, it seems to me that Massachusetts is doing the fair and reasonable thing.
    In 2007, ARAP surcharges in Massachusetts brought in additional premium of $60 million, or about 7% of total premium in the state. However, this should decline fairly significantly in 2008 and going forward for two reasons:
    • First, until 2008, the maximum ARAP surcharge was 49%; in 2008, the maximum was lowered to 25%;
    • Second, Massachusetts has been hard hit by the recession, causing payrolls to decrease substantially; lower payrolls result in lower premiums.
    The Massachusetts Workers’ Compensation Rating and Inspection Bureau is now engaged in the monumental task of putting together a rate filing to be submitted in 2010. It will be interesting, indeed, to see to what extent lowering the maximum ARAP surcharge from 49% to 25% impacts the filing.