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COVID-19: Two Updates

Tuesday, May 19th, 2020

Who pays?

The last question asked in our question-filled Post of 13 May was the same as the first question asked, namely: Who’s the guy at the end of the line left holding the bill for COVID-19 workers’ compensation claim costs?

Right now, as we have written here, each state is addressing this in its own way; fifty different plans for one national crisis.Thus far, workers’ compensation is the pot out of which, in one way or another, claims are addressed. Employers do not like this.

Employers of essential workers haven’t wanted to scream too loudly about being the last in line guy, what with so many of their  workers falling ill, even dying, every day. That kind of crass insensitivity would be bad for business. But inwardly, they have to be nervous about getting stuck with the check, the cost of which, as we have documented here, could be enormous.

Employers have already taken a high hard one to the side of the head with the complete and utter devastation COVID-19 has done to their economic well being, and the requirement to pay the workers’ compensation claims which are going to avalanche over the top of them is something with which they strongly disagree. For what it’s worth, I think they have a point.

Back at the state capitals, I would venture, governors don’t really care where the money comes from, just as long as it’s not coming out of their state treasuries.

And throughout history, insurers have resisted paying for occupational disease claims. Witness the 20-year fight to avoid paying the costs of pneumoconiosis, which resulted in the Federal Coal Mine Health and Safety Act of 1969, amended four years later by the Black Lung benefits Act, which created the Black Lung Disability Trust Fund.

So, if the states don’t pay and if insurers don’t pay and if employers don’t pay, who is left?

Brothers and sisters, the federal government is left, which is another way of saying we are left. We will all share the risk and share the costs. If you cannot bring yourself to believe that, you haven’t been paying attention.

In fact, a model exists: The September 11th Victim Compensation Fund, which:

…provides compensation to individuals (or a personal representative of a deceased individual) who were present at the World Trade Center or the surrounding New York City exposure zone; the Pentagon crash site; and the Shanksville, Pennsylvania crash site, at some point between September 11, 2001, and May 30, 2002, and who have since been diagnosed with a 9/11-related illness.  The VCF is not limited to first responders.  Compensation is also available to those who worked or volunteered in construction, clean-up, and debris removal; as well as people who lived, worked, or went to school in the exposure zone.

The wheels are already in motion. Last week, a bipartisan group in the House unveiled the Pandemic Heroes Compensation Act, a plan to compensate essential workers who fall sick or die from COVID-19. The Act is modeled on the September 11th Victim Compensation Act.

Senate democrats are also proposing legislation. Like everything else in D.C. these days, the road from here to eventual victim compensation will be tortuous, but I cannot see any other way of paying for this national catastrophe other than with a national program. Can you?

The Moderna results

For a number of years, I chaired the Board of a BIOTECH pre-clinical Contract Research Organization (CRO). We took compounds, whose makers hoped would become the next blockbuster drugs, and tested them in mice, rats, guinea pigs, rabbits, pigs and non-human primates (that’s right, monkeys). In the biotech business, everyone knows everyone else, and we certainly knew a lot of scientists trying to develop vaccines.

Yesterday, the Boston pharmaceutical company Moderna reported a vaccine it was developing for COVID-19 produced antibodies in humans. In vaccine development, this is the beginning of a Phase One trial, and its purpose is to confirm the vaccine is not toxic. Moderna’s Phase One trial is composed of 45 participants, eight of whom  Moderna says produced the antibodies. We know nothing of the other 37.

While encouraging, you won’t find respected scientists getting too excited yet. They know what Moderna has done is to take the ball out of the end zone and reach the one yard line. Nintey-nine to go.

Two things are exciting, however. First, Moderna was able to get to this point at light speed. What Moderna did in about 70 days usually takes three to four years. That is over the moon fast, but the other ninety-nine yards are going to be increasingly more arduous. Second, there are more than 100 other groups around the world, both pharmaceutical and academic, who are also going hell bent for leather to develop the vaccine that will eradicate COVID-19. Although I have every confidence one of these groups, maybe Moderna,  will cross the goal line at the other end of the field, it will take a miracle on the order of the Raising of Lazarus for this to happen before mid to late 2021.

Until then: Constant vigilance. Complacency will kill you. Really. Please keep this in mind as all the beaches and parks open this coming Memorial Day weekend. It will be highly tempting to revert to former form.

 

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Important COVID-19 Workers’ Compensation Questions

Wednesday, May 13th, 2020

Economic chickens are coming home to roost all over America. Except for the one percenters, and I may be wrong about them, everyone is feeling it, the pain. Biomedical devastation is leading us to places we have never imagined, let alone seen. In the quiet little room called workers’ compensation where I have sat for some number of years, there are questions that are going to need answering. Let’s look at a few of them.

But first, a little background. A week ago we wrote about a recent National Council on Workers’ Compensation (NCCI) analysis of workers’ compensation cost projections due to COVID-19. NCCI’s analysis projected a best case scenario, in which loss costs increase $2 billion, and a worst case scenario, in which they increase $81.5 billion, or 250% more than current total loss costs. Willis Towers Watson also released a scenario-based analysis that suggested pretty much the same thing.

On 8 April, the California State Assembly Insurance Committee asked the the California Workers’ Compensation Insurance Rating Bureau (WCIRB) to project loss costs if conclusive (rebuttable) presumptions were provided to front line workers, something Governor Gavin Newsom actually did through Executive Order one month later, so the “if” became a “done.” Later in April, the WCIRB released the requested report and concluded:

…the cost estimates in this Research Brief are presented as a range of potential impacts based on varying assumptions of the number of COVID-19 claims filed. On this basis, the WCIRB estimates that the annual cost of COVID-19 claims on ECI (Essential Critical Infrastructure) workers under a conclusive presumption ranges from $2.2 billion to $33.6 billion with an approximate mid-range estimate of $11.2 billion, or 61% of the annual estimated cost of the total workers’ compensation system prior to the impact of the pandemic.

Note two things. First, for perspective, if California were a country, it would have the fifth largest GDP in the world. Second, regardless, the WCIRB’s best case scenario is $.2 billion more than NCCI’s best case scenario for all 38 states where it provides ratemaking services.

Clearly, whatever scenario happens, workers’ compensation losses are going to be cataclysmic.

So, about those questions:

  1. Who’s going to pay for all of this? In normal times, the answer is obvious: Employers and insurers (when losses exceed an employer’s liability). But if we know one thing for sure, these are not normal times. So, who takes the hit?
  2. What about secondary chronic conditions the virus has been shown to cause in some people? Many survivors of SARS (Severe Acute Respiratory Syndrome) suffered crippling ailments for more than a decade. We’re already seeing COVID-19 survivors come home from hospital with severe, possibly persistent, chronic conditions. Are these conditions covered by the initial claim? I can see the plaintiff’s attorney now. “Your Honor, but for the COVID-19 occupational disease, poor John here would never have immediately lost kidney function requiring dialysis three times per week, and would be the picture of health.”
  3. How will COVID-19 claims impact experience modification, which affects an employer’s premium for three years? It is only logical that if loss costs increase by billions in one year, an employer of essential workers, say a hospital, will see its experience modification factor take off like a SpaceX rocket. That is a recipe for economic doom and disaster beyond what we’re already seeing.
  4. What happens when an essential worker who has contracted COVID-19 and filed a claim infects other family members, or the neighbor next door, for that matter? Would they be covered by the claim, or by health insurance if they happen to have it? Keep in mind, job losses due to COVID-19 are now in excess of 20.6 million. Many have lost not only a job, they have also lost the health insurance the job provided. The Kaiser Family Foundation has said, “26.8M would become uninsured after losing job-based coverage during the coronavirus if they don’t enroll in other coverage.” Consequently, this question is very important, because workers’ compensation health care is totally free, unlike employer-based and nearly all other insurance options that all come with deductibles and co-pays.

Meanwhile, back at the California Workers’ Compensation Insurance Rating Bureau, the organization has submitted a proposed rule to deal with number 2, above. It wants to exclude COVID-19 loss costs from the calculation of experience modification. Specifically, the proposed rule says:

Claims directly arising from a diagnosis of Coronavirus disease 2019 (COVID-19), reported with a catastrophe Number 12 pursuant to the Uniform Statistical Reporting Plan, shall not be reflected in the computation of the experience modification.

The proposed rule would also reclassify workers now working remotely from home as clerical – 8810, which is the lowest premium rate possible.

Let’s suppose for just a moment that the WCIRB’s proposed rule is approved, and California’s employers are off the hook with respect to experience modification. This presents another question: Will other states do the same? All of them? Some of them? None? Whatever happens, it seems to me we need a nationally consistent approach. Wouldn’t you agree?

Finally, this all leads back to the first question: Who’s the guy at the end of the line left holding the bill for COVID-19 claim costs?

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How Are States Handling Workers’ Compensation During COVID-19?

Monday, May 11th, 2020

Last week we wrote about Governor Gavin Newsom’s Executive Order implementing a workers’ compensation rebuttable presumption for all essential workers who contract COVID-19 in California.

To review, a rebuttable presumption means an essential worker who contracts COVID-19 does not have to prove work-relatedness. The burden is on the employer to prove the disease was not caused by work.

Writing that other states have also taken action, I noted those actions varied widely across the country. But the monumentality of COVID-19 requires more on this topic. Just what are other states doing? Specifically.

Thirty-nine have either done nothing or have legislation pending. That is, they have taken no action via Executive Order, as Newsom did, or have yet to enact legislation. The District of Columbia is also in this group. Neither, have any of these states declared COVID-19 an occupational disease, although it obviously can be one.

The other 12 states have taken the following actions:

Akaska: On 9 April, Alaska Governor Mike Dunleavy signed legislation declaring a rebuttable presumption for first responders and other health care workers.

Arkansas: On 21 April Governor Asa Hutchinson issued an Executive Order creating a rebuttable presumption for first responders, other health care workers and National Guard personnel assigned to COVID-19 duties.

Florida: The state published a Memorandum saying first responders and health care workers “would be eligible for workers’ compensation benefits under Florida law.” Given the torment COVID-19 is causing throughout society, this is pretty wimpy, don’t you think?

Illinois: On 16 April, Governor J. B. Pritzker issued an Executive Order declaring a rebuttable presumption for first responders and other health care workers. Then, under intense pressure from the business and insurance communities, Pritzker, whose family owns the Hyatt hotel chain, rescinded the order. Obviously, a stand-up guy. So, I guess you could say Illinois now belongs in the camp of the other 38 states that have done nothing.

Kentucky: On 9 April, Governor Andy Beshear issued an Executive Order similar to Newsom’s, creating a rebuttable presumption for all essential workers who contract COVID-19. The business community isn’t happy, but, unlike Pritzker, Beshear has not changed his position.

Michigan: On 30 March, the Workers’ Disability Compensation Agency declared an Emergency Rule creating a rebuttable presumption for all First Response Employees, a term, as Michigan defines it, that includes just about everyone in health care.

Minnesota: On 7 April, Governor Tim Walz signed legislation establishing a rebuttable presumption for first responders, health care workers, correctional officers and child care workers.

Missouri: The Department of Labor and Industrial Relations issued an emergency rule, effective 22 April, declaring a rebuttable presumption for first responders, but, not, perplexingly, for other health care workers exposed to COVID-19. First responders are defined as “a law enforcement officer, firefighter or an emergency medical technician (EMT).”

New Mexico: On 23 April Governor Michelle Lujan Grisham issued an Executive Order creating a rebuttable presumption for state-employed first responders and volunteers to the health care system fighting the disease. Private sector employees are not covered.

North Dakota: On 25 March, Governor Doug Burgum issued an Executive Order creating a rebuttable presumption for all first responders and health care workers. On 16 April, he issued another one to cover funeral directors.

Utah: On 22 April, enacted legislation creating a rebuttable presumption for all first responders.

Washington: On 5 March, Governor Jay Inslee issued an Executive Order  creating a rebuttable presumption for first responders and other health care workers. The order also applies if the workers are merely quarantined.

The majority of states not listed here have some kind of legislation filed awaiting legislative action. But as anyone who has ever wandered the halls of a state capital watching the sausage being made knows, it doesn’t mean a thing until the Governor in the corner office signs it.

Time is wasting.

 

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More COVID-19 Quick Takes

Thursday, May 7th, 2020

Workers’ compensation and the disease

COVID-19 is presenting some interesting and perplexing issues for workers’ compensation. Among them are:

  1. Claims adjusters and Nurse Case Managers are far more familiar with injury claims than disease claims. Occupational disease claims are fuzzy, and work-relatedness is often difficult to determine. A broken arm on the shop floor is ever so much more cut and dried. Yesterday, Governor Gavin Newsom made this moot for California by signing an Executive Order that will make it easier for essential workers who contract COVID-19 to obtain workers’ compensations benefits. His order is in effect for 60 days and is retroactive to 19 March. Note Bene – his order establishes a rebuttable presumption and covers all workers deemed essential during the crisis; e.g., grocery workers, among others, as well as first responders and all health care workers. A rebuttable presumption means an essential worker who contracts COVID-19 does not have to prove work-relatedness. The burden is on the employer to prove the disease could not have been caused by work. California is one of a number of states that have taken action addressing workers’ compensation coverage for essential workers.
  2. But not all states have taken action in the same way. In fact, approaches vary considerably. Two issues treated differently among the states are: first, whether to establish a rebuttable presumption as described above; and, second, just who is essential. Some states say that while a number of occupations have been determined to be “essential” during COVID-19 (see Grocery Workers, above), only first responders and health care workers are essential enough to qualify for workers’ compensation if they come down with the disease. Labor unions say this is an issue of fairness, but since when has workers’ compensation been equally fair in all states? Consider loss of function awards, which vary tremendously across the nation.
  3. NCCI has jumped into the COVID 19 what if debate and projected various loss cost scenarios for the workers’ compensation insurance industry. All scenarios show increased losses, and some of the them are downright grim. In the worst case, 50% of all workers are infected and 60% of all claims are paid, in which case losses increase $81.5 billion, or 250% more than current total loss costs. Ouch! In the best case NCCI presents, there is no rebuttable presumption, only first responders and health care workers are eligible for workers’ compensation benefits, only 5% of them become infected, and only 60% of the claims are paid, which results in an increase in loss costs of $2 billion. The best case scenario is is not going to happen. See 1, above.
  4. And what about the poor employers and insurers who are going to foot the bill? Specifically, what about experience modification? One can almost say COVID-19 comes under the heading: An Act Of God. But the claims are going to be paid, so how does a confused insurer account for that in  the premium it’s going to drop on the head of John Q. Employer with a loud and painful thud?

Update on Long Term Care Facilities

I’ve addressed LTCFs here, here  and here, pointing out that there is no coordinated national reporting of LTCF COVID-19 cases or deaths. “One would think this cries out for federal data tracking conducted in a consistent manner across the nation.” Doesn’t seem to have happened yet.

The logical entity to track this is the Centers for Disease Control and Prevention (CDC), and maybe it is. But, then again, maybe it isn’t, because it won’t say. Yesterday, two Senate Democrats — Ron Wyden of Oregon and Bob Casey of Pennsylvania — called on the Trump administration to close this gap and commit to a timeline to release the information.

“There have been no signs that the Trump administration has an effective plan to address the tragedy that is taking place in America’s nursing homes,” they said in a joint statement.

It’s logical to assume that a disproportionate number of deaths would occur in LTCFs. The vulnerable elderly, many, perhaps most, with a number of comorbid underlying conditions, are packed together and present a breeding ground for the virus. Early on, this should have been apparent to the CDC. Why its talented scientists didn’t dive into this from Day 1 is beyond me.

We’ll continue to follow this.

Are We Learning From History, Or Repeating It?

Throughout history, infectious diseases have crippled societies. They have stymied progress and, in the best cases delayed, in the worst reversed, economic development and prosperity.

How have societies handled infectious disease pandemics throughout history, and are our actions in the midst of COVID-19 any better?

It’s true that our science puts us a quantum leap ahead of historical societies in terms of searching for therapies and a vaccine. Oh, the vaccine will happen, but between now and then are we dealing with our current infectious disease problem better than our ancestors?

Actually, no. Societies have long known that when a killing disease strikes on a grand scale the best thing to do is stay far away from other people. Quite literally, head for the hills. Trouble was, that wasn’t always possible due to urban densities and economic privation. Today, densely packed areas, especially cities, are the immediate hot spots, the poor and African Americans are disproportionately infected, and our mitigation efforts are the same as time immemorial.

Tomorrow, we’ll take a look at the history of pandemics, their societal effects and how we can learn from them as we move through and, we fervently hope, leave behind the scourge of COVID-19.

 

 

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CoVid 19 Upate

Tuesday, March 17th, 2020

Nuggets arriving over the transom.

Blood Supply

The American Red Cross is facing a serious blood shortage RIGHT NOW.

“We need people to start turning out in force to give blood,” Dr. Peter Marks, director of the FDA’s biologics evaluation and research, said in a statement. “We need people to prevent the blood supply from getting depleted. We need it not to get to the point that surgeries are having to get cancelled,” Marks said. “That’s something we absolutely do not want to have happen. To ensure an adequate blood supply we need people to come out and donate blood.”

Although hospitals around the country are cancelling elective surgeries, they cannot cancel emergency surgeries. A 2018 study concluded the Emergency-To-Elective Surgery Ratio to be 9.4 in the U.S., 5.5 in the E.U., but a whopping 62.6 in sub-Saharen Africa (not a lot of elective surgery going on there). Emergency surgeries still have to happen. So, what’s the beleaguered Red Cross to do? In this time of CoVid 19, it has quite the dillema. Federal and state governments tell us to stay home as much as possible, but the Red Cross, which faces an emergency every eight minutes, depends on people going to one of their centers to donate blood, which, given the virus scare, is something many are finding hard to do.

Information – Where To Get It

Everywhere you look (including this blog), people are passing on CoVid 19 updates. It can all be a bit of a mish-mash. So, at the risk of compounding the problem, I’d like to suggest looking at the website of the European Centre for Disease Prevention and Control (ECDC). It is superbly organized and helpful. Its staff publishes Situation Updates every day, both for Europe and the world. The main reason to spend some time with the ECDC is to get a better idea of what is likely heading our way. Europe is about two weeks ahead of us for CoVid 19 communal spreading, and the ECDC’s charts are well-done, enlightening and scary. Compare the Situation Updates in Europe to the CDC’s here and here in the U.S.

And In The World Of Workers’ Compensation

The state of Washington was the first U.S. CoVid 19 hot spot. We noted yesterday the plight of a 70-year-old Washington ER doctor who was in critical condition after contracting the disease. That certainly qualifies for workers’ compensation benefits. But what about clinicians, doctors and nurses who, although asymptomatic, are forced to quarantine themselves for two weeks following exposure? It’s one thing if their employers continue to pay them while quarantined, but what if they don’t? And what about the health care charges incurred during quarantine? Who pays?

In a move that could start a trend, Governor Jay Inslee yesterday said any Washington health care workers forced to quarantine themselves following exposure would qualify for workers’ compensation benefits. Will this propel health care institutions to discontinue paying clinicians under quarantine? Regardless, workers’ compensation covering all the health care charges is a big deal.

Like a red rope in the snow, we will follow this story to see whether other states follow Inslee’s lead.

And now to once more assume the position of the CoVid 19 shut-in and watch the Dow Jones bounce around like a bee bee in a boxcar.

Stay safe.

 

 

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Workers’ Compensation Performance Measurement: Keep The Bull’s Eye Simple

Wednesday, May 17th, 2017

For the last decade, injury frequency has been trending steadily lower. There are a number of reasons for this: automation, loss of manufacturing jobs, better safety engineering, etc. Injury severity, however, has not followed suit despite technological gains in claim administration and medical management and an ever so slow move to the use of predictive analytics.

This creates challenges for employers, especially of the small and middle market variety, and, to a certain degree, even for a few national, enterprise accounts who find themselves pretty much where they were ten years ago in terms of style and policy with respect to workers’ compensation. One reason for this is the deep rooted legacy mentality and resistance to change of many insurers and Third Party Administrators. In many ways, these organizations remind me of flies circling around a light in a lampshade, mistaking movement for progress.

However, employers still foot the bill and are still in command. Keeping in mind that the workplace is the best place to control workers’ compensation costs, employers still need to build and maintain solid programs to prevent and contain loss. Case in point is Bob Oberosler, Vice President of Loss Prevention for Rite Aid, a national pharmacy chain. At the New Jersey Self Insurers Association’s Annual Meeting a couple of weeks ago, he described his company’s work to craft a forward thinking loss prevention and workers’ compensation management program and communicate it to employees who are far and wide, indeed. But before that could happen, Mr. Oberosler said, he faced an even more daunting task – getting management’s commitment and buy-in to the effort. The good news is this happened and Rite Aid has been enjoying some spectacular results because of it.

This got me thinking. In order to sustain C-Suite commitment, a risk manager, or Loss Prevention VP, such as Bob Oberosler, needs to provide the Leadership team a steady, easily understandable Performance Measurement Results Dashboard. So, what should be the characteristics of such a Dashboard?

Performance measurement should have four characteristics: It should be simple, it should be meaningful, it should be consistent and it should be continuous.

By simple, I mean easily and quickly understood by senior management. Meaningful means that it should sit in senior management’s sweet spot; it should be something that is anticipated and valued by leaders. It should be consistent, because those leaders, once trained to view performance in one way, do not appreciate abrupt course changes. And to be effective over the long term, it has to be a continuous and routine process. The mantra should be: What is consistently well-measured is highly valued.

With this framework in mind, I usually recommend that monthly or quarterly reports to senior management measure two things religiously: Incurred losses per full time equivalent employee (and this should be done by department, division and company) and incurred losses per every hundred dollars of payroll (again, split out by department, division and company). Before any measurement occurs, however, management should settle on targets, which should be a bit of a stretch, but attainable. And target selections should be set against actual performance in the prior three or four years. For instance, if costs per FTE have been in the $200 to $300 range in the last few years, a good target would be a reduction of 30% to 40% in the current year.

Senior managers have finite attention spans. Therefore, workers’ compensation performance measurement should fit on one page, a Scorecard that senior management can assimilate in no more than a few minutes. If the information is pithy enough, that’s as long as it should take, but it should also lead to fruitful discussion about management actions to enhance performance, discussion that comes out of knowledge.

There are many other solid and valuable workers’ compensation metrics, but, in Lynch Ryan’s experience, these two are the ones that senior managers appreciate the most.

All of this assumes, of course, that, as at Rite Aid,  a serious and ongoing safety, workers’ compensation and injury management program is humming along and that all parts of the organization have been trained in how to keep it that way.

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WCRI: Day One, Part Two: The 1st Opt-Out Session

Thursday, March 10th, 2016

The afternoon of WCRI’s 2016 Annual Conference was devoted to Opt-Out. The first of two sessions was a Point-Counterpoint exercise. Trey Gillespie of the Property & Casualty Association of America led off. To Mr. Gillespie, with Opt-Out it’s 1910 all over again. He described Opt-Out in Texas and Oklahoma as allowing employers to deliver sub-standard care to injured workers without government oversight. Showing stark contrasts between what is allowed in Opt-Out and required in workers’ compensation, he suggested that employees were at the mercy of employers, which could sometimes be good and sometimes be bad. Opt-Out’s a kind of Employer Personal Responsibility Plan.

Bill Minick, of PartnerSource, followed with a presentation in favor of “Options to Workers’ Compensation.” Minick has been the loudest proponent and most significant advocate for Opt-Out. He and Opt-Out were the subject of a Propublica investigative journalism story late last year. He described Opt-out as a substantial improvement on a failed system and painted a picture of employers being able to provide better care for injured workers at less cost, because regulatory and bureaucratic requirements have been stripped out. Essentially, Minick claims that the workers’ compensation system makes employers go from Massachusetts to Rhode Island by way of Alex Swedlow’s California. He’d rather just drive the 30 miles down Route 95.

My basic problem with Opt-Out, wherever it is, is that some employers with resources and good intentions welcome the chance to design their own injury benefit plans that will provide benefits at least as good as traditional workers’ compensation at significantly less cost. This, in itself, is a good thing. Some large employers in Texas, such as Costco, seem to have done that. Trouble is, not every employer is Costco. As I wrote when I evaluated Opt-Out in 2014, I’m concerned about Kenny’s Citgo, down the street and around the corner, where Kenny and his five hourly workers labor without the benefits of a mandated workers’ compensation plan, because Kenny has Opted-Out. There are more Kenny’s than Costcos.

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Workers Comp Insider: 5 years and counting!

Tuesday, September 9th, 2008

Yay us! This month is our 5th year blogging anniversary so we were pleased to be named to Lexus-Nexus Top 25 Blogs for Workers Compensation — and to see a few of our esteemed colleagues on the list, too. We have to laugh because when we started, we weren’t sure we would find enough to post about to make it to year 2, let alone year 5. And back then, the business blogging landscape was pretty thin indeed, so we’d never have foreseen such a robust community emerging for such a niche topic.
You are reading post #934. In the 1680 days we’ve been keeping track, we’ve had 900,000 visits from 600,000 unique visitors. We generally have about 18 to 20 thousand visitors a month, and as would be expected, about 85% of our visitors come from the U.S., but Canada, the UK, and Australia also make a good showing. We’ve had visitors from about 200 countries, including some that challenged our geographic awareness: Kiribati? Burkina Faso? (sidetrack: how many countries can you name in 5 minutes?)
In honor of the event, we thought we’d dish up our top 15 all-time greatest hits. These posts reflect the most searched for topics, as well as the ones that you, our readers, have clicked on the most:

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NCCI 2005 Issues Report – a look back, a look ahead

Wednesday, April 6th, 2005

Every spring, NCCI publishes a series of reports that paint a portrait of the workers compensation industry’s health. These include an annual “Issues Report,” followed later by a “State of the Line” report. For those of us who work in the industry, these reports offer a quick look of where we’ve been and provide a cookie trail for where we are likely headed. They are mandatory reading for industry insiders, but they are not just for insurance wonks. If there’s one drum we continually like to beat here at Workers Comp Insider, it’s that the more employers understand about the insurance industry, the better prepared they can be to weather any market vagaries.
The 2005 Issues Report has been released, and in his Annual Snapshot (PDF), executive director Stephen Klingel paints a good news/bad news scenario of a market in transition. Some of his observations include:
Insurer reserve deficiencies were reduced by approximately $5 billion dollars. Although improved, reserve deficiencies are still a problem. In workers comp, losses have the famous “long tail” – that is, they play out over years. Insurers set aside reserves for the estimated cost of the claim. If they don’t set aside adequate reserves, when it’s time to pay the piper, insurer insolvencies occur and havoc ensues. Insurer insolvencies still loom as a potential problem.
Medical costs – particularly prescription drug costs – are still galloping away. Wage replacement was always the largest share of lost time claim cost, but now medical costs represent 55% of the cost, on average. In some states – AL, AZ, IN, KY, TX, and WI – the cost approaches 70%.
Frequency continues to decline. That’s good news. It means that employers are doing a better job in the area of safety. NCCI reports “significant declines occurred in fatal, permanent total, and permanent partial claim frequency.” But on the flip side of the coin, severity is increasing. That means that the medical costs and/or the duration of claims are rising. Not so good.
Terrorism Risk Insurance Act (TRIA) uncertainty looms. The uncertainty about whether Congress will extend TRIA casts a pall over the industry. The clock is ticking, it is due to expire at the end of the year. TRIA provides a federal backstop or safety net for insurers in the event of any catastrophic events. Because workers comp is mandatory coverage, it is a line of insurance that is particularly exposed – insurers can’t exclude terrorism coverage when issuing policies.
The residual market is stabilizing. The residual market is sometimes called the assigned risk pool, or more familiarly, “the pool” or “the market of last resort,” while the rest of the market is known as the voluntary market. If you are an employer, you might get thrown in the pool for any of a number of reasons: your loss experience may be terrible or you may simply be in a high-risk industry. For one reason or another, no one wants to write your policy. NCCI reports that the residual market now represents about 13% of the total premiums, up from about 10.7% in 2003. However, the rate of growth for the residual market appears to be appears to be slowing.
NCCI

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Airport baggage screening: a high hazard job

Thursday, March 10th, 2005

USA Today recently ran a feature on airport baggage screeners and the extraordinarily high rate of injuries that they suffer in the course of their work. Approximately one out of every four workers reports an injury and one out of 8 workers has an injury that requires lost time. Yikes – this makes bag screening one of the nation’s most hazardous jobs.
Injured workers at the Transportation Security Administration (TSA), more than two-thirds of whom are screeners, missed nearly a quarter-million days of work last year. The lost job time has contributed to a staffing shortage that has strained checkpoint security and lengthened lines at airports.
TSA employees injured on the job missed work in 2004 at five times the rate of the rest of the federal workforce. They were injured four times as often as construction-industry workers and seven times as often as miners.
Most of the injuries are soft tissue strains and sprains resulting from lifting and carrying heavy bags. Since most of the screening machines and checkpoints were added after 9/11 and squeezed in wherever they would fit, few screening stations were designed with an eye to ergonomics. OSHA has issued numerous hazard citations to airports across the country.
Adding to these problems, the TSA staffed up quickly and in most instances, strength tests were not part of the application process, and training – at least from a safety standpoint – was minimal. In a snowballing problem, the more staff injuries and absences there are, the more overworked remaining employees are. According to the article, the staff attrition rate last year was 22%.
This is distressing both for the workers involved and also for airline travelers. Although authorities say that security is not being compromised, it is hard to see how injured, overworked, and poorly trained workers can deliver the best results.
Related:
OSHA Ergonomics eTool on Baggage Handling
Safe Lifting
Safe lifting tecchniques
Lifting Safety: Tips to Help Prevent Back Injuries

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