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Top Work Injury Causes & What Companies Must Do

25 Sep

The annual Workplace Safety Index ranks the top 10 causes of disabling work-related injuries and we tell you how you can ensure you aren’t part of these statistics.  Liberty Mutual’s 2020 Workplace Safety Index finds that serious, nonfatal workplace injuries amounted to nearly $60 billion in direct U.S. workers compensation costs. This translates into more than a billion dollars per week spent by businesses on these injuries. In fact, the top 10 causes of workplace injuries account for more than $50 billion or 89% of the total cost.

  • OVEREXERTION INVOLVING OUTSIDE SOURCES Injuries from lifting, pushing, pulling, holding, carrying, or throwing objects accounts for 23% of the national burden when it comes to workplace injuries. TAKE ACTION: Train employees on the proper way to perform the physical tasks required on the job. Utilize equipment, instead of manual labor, when available. Ensure employees are provided breaks and rest when needed to prevent overexertion. 
  • FALLS ON SAME LEVEL Slips, trips and falls are one of the most common causes of workplace injuries indoors and outdoors. Employees are at risk for sprains, strains, lacerations or worse especially if they fall into surrounding debris that could cause further injury. TAKE ACTION: Ensure non-slip mats and rugs are in use, make good housekeeping a priority in the workplace, repair or clearly mark uneven walking surfaces and train employees on proper clean-up requirements.
  • STRUCK BY OBJECT OR EQUIPMENT When work is done at heights, large equipment is in use, or materials are stored vertically there can be a great risk for employees to be struck by falling objects or moving equipment. TAKE ACTION: All overhead materials should be stored in a secure manner. Caution signs should be used and proper PPE, like hard hats, should be in used when needed.
  • FALLS TO LOWER LEVEL Falls from heights can be from ladders, through floor holes or sky lights, from scaffolding, on stairways, from roofs or from large equipment. TAKE ACTION: Ensure all employees that work at heights have proper fall protection provided and they are trained on the use of the fall protection equipment including PFAS, guardrails or other engineered devices.
  • OTHER EXERTIONS OR BODILY REACTIONS These injuries are typically non-impact but occur when a body reacts or responds to something unexpected or has an injury due to a vigorous or strenuous effort. These injuries don’t fit into one of the other common categories. TAKE ACTION: Workplace risk assessments can help evaluate common hazards that employees may be exposed to and assist management with prevention and training opportunities.
  • ROADWAY INCIDENTS INVOLVING MOTOR VEHICLE Employees who drive for business purposes may have more opportunity to be injured in auto crashes and are also susceptible to distracted and drowsy driving. TAKE ACTION: Define safe driving policies with an emphasis on distracted, drowsy, and defensive driving. Provide employees with safe-driver training.
  • SLIP OR TRIP WITHOUT FALL Reaction injuries occur when an employee slips or trips but doesn’t fall down. The stress of the reaction to correct the body to upright can cause muscle strain, twisted ankles, or other trauma. TAKE ACTION: Place no-slip rugs near entrances/exits, make sure any uneven areas are labeled clearly (or repaired), keep all work spaces tidy and potential slippery areas around the building outside should be cleared.
  • REPETITIVE MOTIONS INVOLVING MICRO-TASKS Working on the computer or performing the same task on the assembly line day after day can strain muscles and tendons which may cause back pain, vision problems and carpal tunnel syndrome. TAKE ACTION: Employers should provide, and employees should advocate for proper ergonomic equipment and training. Employees should be encouraged to take breaks and a job rotation schedule along with cross-training could be considered.
  • TRUCK AGAINST OBJECT OR EQUIPMENT When employees unintentionally walk into equipment, walls, debris, or furniture in the workplace it is common to have head, knee, neck and foot bruising, sprains, and injuries. TAKE ACTION: Ensure good housekeeping is a priority in the workplace, walkways are designated, and potential hazards are clearly marked.
  • CAUGHT IN/COMPRESSED BY EQUIPMENT OR OBJECTS Caught-in injuries are one of the top 4 serious incidents that occur in construction and machine entanglement caught-in injuries occur most often in factory settings. TAKE ACTION: Provide protective barriers and train employees on how to recognize caught-in hazards.

CalWorkSafety & HR Is Here To Help:

NEED A FRESH IDEA FOR A SAFETY MEETING TOPIC? This Top 10 List is a great place to start. Review the entire list if you have more time and encourage discussion about the potential hazards found in your own workplace that might fall into each category.

SHORT ON TIME? Pick any one from the top 10 list that applies to your current work environment and focus on ways management and employees can prevent injuries and keep workers safe.

HERE’S THE SOLUTION: CalWorkSafety & HR greatly appreciates that our clients consistently take a “#Safety-First” approach.  

Contact your consultant or email: dondressler@calworksafetyhr.com

Achieve Business Profitability … Reduce Costs … Mitigate Risks Discover the extensive training courses we offer our clients.Contact us today – we are here to help!  

‘Game Changer’ in California Coronavirus Testing to Double Capacity and Speed Up Results

31 Aug

by Ana B. Ibarra August 26, 2020 CALMATTERS

A nursing student does patient check-in and hands out requisition forms allowing patients to get their COVID-19 test results online at Cal Expo in Sacramento. Photo by Anne Wernikoff for CalMatters

In summary

Gov. Gavin Newsom announced a new deal today with a diagnostics company that he says will add 150,000 more tests a day, with results back in 24 to 48 hours.

Gov. Gavin Newsom today announced that the state will soon more than double its coronavirus testing capacity, a move that at least one legislator described as a “game changer” in the state’s pandemic response.

The state will partner with the Massachusetts-based diagnostics company PerkinElmer, which will allow the state to conduct and process an additional 150,000 tests a day with expedited test results in 24 to 48 hours. 

“We have provisions in the contract to guarantee that turnaround time,” Newsom said. 

At 150,000 tests a day, the new contract would cut down the per-test cost from the current $150-$200 to $30.

Currently, the state is processing just slightly over 100,000 tests per day with an average turnaround time of five to seven days. By some estimates, like those by scientists at the Harvard Global Health Institute, California should currently be doing upward of 220,000 tests a day to truly mitigate spread of the virus— and significantly more to suppress it.

“Each and every day is a precious day in terms of test results,” Newsom said. The longer people wait, those test results are almost useless in terms of helping stop the spread, he said.  Newsom said the state will aim to get a new laboratory facility running by Nov. 1, just in time for the peak of flu season and a possible second wave of coronavirus, when more people are likely to seek out testing. 

Extra $300 weekly unemployment benefit approved for California, but timetable is uncertain

By David Lightman Sacramento Bee:  August 22, 2020

If you need a state unemployment expert to return your call, it’s going to take four to six weeks, the director of California’s Employment Development Department told an Assembly subcommittee July 30, 2020. By California State Assembly

California will be able to pay millions of jobless residents an extra $300 a week, the state’s unemployment agency said Saturday, but there’s no estimate of when people will see that money.

The state’s Employment Development Department said its application for funding the program has been approved by the federal government. When the $300 a week is added to state benefits, it will nearly double the average California claimant’s weekly unemployment check.

Larry Kudlow, a White House senior economic adviser, said this week that overall, the money should be in bank accounts “in the next week or two.”

The US Government’s Lost Wage Assistance Program, one of the recently approved Executive Actions taken by President Trump, is on top of regular unemployment benefits. EDD announced Friday Aug. 28 that the first payments in CA will be available the week of Sept. 7, 2020.

There will be two phases of the EDD rollout.  First will be claimants who previously provided information that they were unemployed due to COVID-19, and have already received regular UI benefits during the period of July 26 to Aug. 15. The payments mean that an person receiving the average UI benefit of $287 a week will receive $587.  Persons must receive a benefit of at least $100 a week to participate in the added payment. The second phase will be for applicants who did not indicate on their original application that they were out of work due to COVID-19. Approximately 1.13 million Californians applied for benefits. EDD is so backlogged by computer and staffing problems that it has only be able to process 239,000 claims by Aug. 28.

WCIRB Submits 2021 Rate Recommendation

The Workers’ Compensation Insurance Rating Bureau on Wednesday formally recommended that the California Department of Insurance increase the advisory pure premium rate by an average of 2.6% for policies incepting on or after Jan. 1.

If approved, it would be the first rate increase since November 2014, when the state adopted a rate of $2.74 per $100 of payroll. Since then, savings from the reforms in Senate Bill 863 and subsequent fraud-fighting efforts drove a series of annual and midyear rate filings that lowered the advisory rate by more than 44% to $1.52 for policies incepting in 2020.

Rates likely would have continued to fall but for the COVID-19 pandemic.

“Absent the impact of COVID-19 claims on 2021 policies, the filing reflects a modest decrease (1.3%) in advisory pure premium rates,” the WCIRB said in a statement. “In addition to projecting the cost of COVID-19 claims to be incurred on 2021 policies, the filing also reflects the impact of the pandemic-related economic slowdown on future wage growth, claim frequency and claim severity.”

Materials presented to the WCIRB’s Governing Committee during an Aug. 12 meeting show the indicated rate would have been $1.50 per $100 of payroll if projections for COVID-19 were excluded.

Although the indicated rate is higher than the last approved rate, it would still be 13.3% lower than the industry average charged rate of $1.80 per $100 of payroll as of July 1.

High Heat Warnings: How to Keep Outdoor Workers Safe

28 Aug

By Katie Culliton  August 18, 2020 33 Cal Chamber

As California experiences record-breaking temperatures — excessive heat warnings and watches have been issued throughout California, including Sacramento, the San Francisco Bay Area, Los Angeles and more — the California Division of Occupational Safety and Health (commonly known as Cal/OSHA) reminds all employers with outdoor workers to take steps to prevent heat illness.

Heat illness occurs when the body’s temperature control system is incapable of maintaining an acceptable temperature; very high body temperatures can damage the brain and other vital organs, and may eventually lead to death.

Remember, California’s heat illness prevention standard applies not only to all outdoor workers, but also to workers who spend a significant amount of time working outdoors, like security guards and groundkeepers, or in non-air-conditioned vehicles, like transportation and delivery drivers.

To prevent heat illness, all employers with outdoor workers must:

  • Develop and implement an effective written heat illness prevention plan that includes emergency response procedures;
  • Train all employees and supervisors on heat illness prevention, including the signs and symptoms of heat illness so they know when to take steps that can prevent a coworker from getting sick;
  • Provide fresh, pure, suitably cool and free drinking water to workers so that each worker can drink at least one quart per hour, and encourage workers to do so; and
  • Provide shade when workers request it and when temperatures exceed 80 degrees, encouraging workers to take a cool-down rest in the shade for at least five minutes.

Workers should not wait until they feel sick to cool down, and workers experiencing possible overheating should take a preventative cool-down rest in the shade until symptoms are gone. Employers should make sure their workers know their procedures for contacting emergency medical services, which includes directing them to the worksite if needed.

Heat Illness and COVID-19

Although employers must provide cloth face coverings or allow workers to use their own to help prevent the spread of COVID-19, it can be more difficult to breathe and harder for a worker to cool off if they’re wearing a face covering. Additional breaks may be needed to prevent overheating. In Cal/OSHA’s high-heat advisory, it recommends that workers have face coverings at all times, but the face coverings should be removed in outdoor high heat conditions to help prevent overheating as long as physical distancing can be maintained. More resources are available on Cal/OSHA’s Heat Illness Prevention webpage and the 99calor.org informational website.

COVID-19 Workers’ Comp Claims on the Rise in California

Oakland – The number of California workers’ compensation claims for COVID-19 continues to climb, as data from the Division of Workers’ Compensation (DWC) show that as of August 10, there were 9,515 claims reported for the month of July, bringing the total for the year to 31,612 claims, or 10.2% of all California job injury claims reported for accident year (AY) 2020. Those claims include 140 death claims, up from 66 reported as of July 6.

Updated figures for May and June show sharp increases in COVID-19 claims for each of those months, as the number of COVID-19 claims with June injury dates more than doubled from 4,438 claims as of July 6 to 10,528 claims as of August 10, while COVID-19 claims with May injury dates rose from 3,889 cases to 4,606 claims (+18.4%), indicating a time lag in the filing, reporting, and recording of many COVID-19 claims. Using claim development factors the California Workers’ Compensation Institute (CWCI) projects there could ultimately be 29,354 COVID-19 claims with July injury dates and 56,082 COVID-19 claims with January through July injury dates. Health care workers continue to account for the largest share of California’s COVID-19 claims, filing 38.7% of the claims recorded for the first 7 months of this year, followed by public safety/government workers who accounted for 15.8%. Rounding out the top 5 industries based on COVID-19 claim volume were retail trade (7.9%), manufacturing (7.0%), and transportation (4.7%).

The updated data is included in the latest iteration of CWCI’s COVID-19 and Non-COVID-19 Interactive Claim Application, an online data tool that integrates data from CWCI, the Bureau of Labor and Statistics and the DWC to provide detailed information on California workers’ comp claims from comparable periods of 2019 and 2020. The new version features data on 710,224 claims from the first 7 months of AY 2019 and AY 2020, including all 31,612 COVID-19 claims from AY 2020. The application allows users to explore and analyze:

· COVID-19 claim counts by month with the ability to segment and filter results by industry, region, injured worker demographics and injury characteristics;

· The volume of all reported workers’ compensation claims by industry and region; and Denial rates for COVID-19 and non-COVID-19 claims by month.

Keep Employees Safe: 7 Ergonomic Tips for Home

by Michele McGovern August 19, 2020

It’s great to work from the couch … except maybe for the aching back, tired eyes and sore neck. They’re nasty results of ergonomic sins we need to avoid.

And most brought home or picked up unsafe habits – ergonomically speaking – that have or will lead to unnecessary pain, discomfort and even injury.

More than 40% of employees work from home in some capacity since the onset of COVID-19, according to research from Stanford University.

The last thing you want is aching or injured workers who aren’t as effective or engaged.

“If you build the right culture, you can rely on what you already did well,” says Howard Spector, CEO of SimplePractice, an electronic health record and practice management software provider. “Start by taking good care of your employees and you can continue to do that under any circumstances.”

Whether work from home is temporary or long-term, employees need an ergonomically fit space. You’ll want to support healthy and safe work habits and practices at home, no matter how long they’ll be there.

Here are seven strategies to help keep employees working from home safe and healthy.

1. Make office benefits available

If employees already have ergonomically correct tools in their on-site workspace, let them get a hold of those for home.

To make sure everyone would be comfortable at home, SimplePractice gave employees time and space to go in the office and grab their chairs, keyboards and anything else that made their workspace comfortable.

You might set up a schedule so employees can be in the office alone and get items they can easily remove and adapt in their work-from-home space.

Ideally, everyone should try to replicate their workspace at home. If that means two screens, take them both home. If it’s an exercise ball for an office chair, grab it.

2. Set up computer, keyboard, mouse

If employees use a computer and keyboard primarily, it’s vital those are set up safely for comfort. If any piece – the keyboard, mouse and/or monitor – are out of whack, employees will likely end up with their necks or backs out of whack, too!

For the keyboard:

  • Position it at the edge of the desk, ideally using a palm rest for the wrists. Or get an adjustable keyboard tray to install below the desk surface.
  • Keep elbows at the side in about a 90-degree angle and shoulders relaxed while typing.

For the mouse:

  • Position it next to the end of the keyboard on the same level.
  • Add a wrist rest, if possible, so no one has to reach too far.

For the monitor:

  • Position it so the top third is eye level.
  • Stay centered directly in front of the monitor.

If employees use a laptop primarily you might want to invest in a few gadgets to make it more comfortable at a desk. You can get these for about $50 from Amazon and other retailers. Try a:

3. Set up the chair

Experts discourage people from working while sitting on a couch or easy chair … or anything other than a desk chair or one of its ergonomically correct alternatives.

Whether employees get their chairs from the office or they’re new, it’s important to make sure they’re set up well. Five keys:

  • Adjust it to a height where both feet rest firmly and evenly on the floor.
  • When seated, employees want two finger lengths between the back of their knee and edge of the seat.
  • Try to tilt your chair pan slightly forward for a comfortable slope. If the chair doesn’t have tilt capabilities, put a flat pillow across the back half of the chair for a natural tilt.
  • Adjust the seat back for a straight posture that mostly supports the space between the waist and the bottom of the shoulder blades. Or, if the seat doesn’t adjust, try a rolled-up towel to gain lumbar and back support.
  • Remove armrests if you primarily type to maintain good posture, experts suggest.

4. Light it up

Some people might say an upside of working from home is getting away from fluorescent office lighting. But home lighting has its own disadvantages: Too much natural light causes glares that lead to squinting and eye strain. Too little or ill-directed light causes strain, too.

The Occupational Safety and Health Administration suggests employees:

  • Position their desks and monitors so windows are in front of and beside their desk. If there’s only one window, employees want it positioned to their right.
  • Adjust blinds so there’s light in the room, but none directly on the monitor.
  • Use indirect or shielded lighting from lamps where possible to avoid intense lighting in the field of vision.

5. Follow the 20/20/20 Rule

Once the logistics are worked, employees need to beware of greater eye and neck fatigue. It happens because people aren’t distracted as often by colleagues and meetings. Instead, they stare at the computer for hours.

To avoid fatigue, practice the 20/20/20 Rule: For every 20 minutes of staring at the monitor, look away for 20 seconds at something 20 feet away.

6. Switch it up

Eyes aren’t the only thing that get fatigued while working for long periods at a home office computer. The body also needs a change to avoid burnout.

If possible, experts recommend changing actual work spots and positions throughout the day. For instance, employees can do a few hours at the desk. Then they might put their computers on a kitchen counter and stand for a while. Weather permitting, they can take it outside later.

7. Break away

Employees can enhance good ergonomic practices by transferring healthy elements from the office to home.

For instance, Spector of SimplePractice wanted to make sure his employees had access to physical wellness when they had to leave behind the company gym and office exercise classes.

He partnered with a fitness app to provide yoga, fitness and meditation classes to all employees. SimplePractice also hired a mindfulness coach to help employees at their convenience meditate and handle work from home stressors.

COVID-19 Workers’ Comp Claim Presumption Flowchart

15 Jun

Jessica Mulholland  June 9, 2020 6  HR Watchdog – Cal Chamber

Workers Comp

In early May, Governor Gavin Newsom signed an executive order extending workers’ compensation benefits to California employees who contract COVID-19 while working outside of their homes during the state’s stay-at-home order. This workers’ compensation benefits extension is causing some confusion, but a Sacramento-based law firm recently created a flowchart to help employers.

As previously reported, the order prompted many questions about its scope, criteria and implementation — and created a “rebuttable presumption” that workers meeting certain criteria who contract COVID-19 did so during employment (which means the law automatically assumes workers’ compensation covers their claims and shifts the burden to employers, who may then present evidence to rebut the presumption).

The California Department of Industrial Relations answered some questions in its Question and Answer page, but Sacramento-based law firm Mullen & Filippi went a step further, creating a COVID Claim Presumption Flowchart to further simplify how employers can determine whether a presumption applies.

Start at the top of the chart. If you answer yes to the first seven questions — which include whether the worker received a COVID-19 diagnosis or tested positive for the virus, whether the diagnosis was from a medical doctor holding a license from the California Medical Board and whether the diagnosis was confirmed with a positive virus or antibody test within 30 days, to name a few — COVID-19 is presumed as an industrial injury. This means that, unless you can rebut the presumption by providing evidence of an alternate cause, you must provide workers’ compensation benefits. If, however, you answer no to any of the questions, no presumption exists, and the normal evidentiary rules apply.

Assuming the claim is compensable, employers can use page two of the flow chart to help determine apportionment, compensable consequences, death benefits and temporary total disability benefits.

This executive order is retroactive to March 19, 2020, and extends through July 5, 2020.

Jessica Mulholland, Managing Editor, CalChamber

For more COVID-19-related federal, state and local resources, visit the CalChamber Coronavirus (COVID-19) webpage and access additional COVID-19-related HRWatchdog blogs.

Can an employee refuse to return to work?

HR CAlif. 6/11/2020

Yes. Although you can’t force a furloughed employee to return to work, their refusal to return may disqualify them from receiving unemployment benefits.

The California Employment Development Department (EDD) has released general guidance on COVID-19-related unemployment benefits.

For example, if a business has abided by local and state guidelines and is providing adequate employee protections, an employee who refuses to return to work out of a general fear of contracting COVID-19 wouldn’t qualify to receive unemployment benefits.

If, however, the business doesn’t have proper protective measures in place, an employee can use the lack of protective measures as a valid reason for not returning to work and will thus be able to claim unemployment benefits.

An employee who earns more money on unemployment cannot use the higher pay as a valid reason for refusing to return to work; their refusal would disqualify them from receiving unemployment benefits.

If an employee doesn’t have suitable childcare and cannot return work, it would likely be good cause for not returning to work and the employee would likely be able to keep their unemployment benefits.

Read more about Unemployment Insurance in the HR Library and HRCalifornia Extra’s Unemployment Insurance: A Guide for Employers with Newly Displaced Workers.

Q&As

OSHA Issues FAQ on Face Coverings

The new guidance outlines the differences between cloth face coverings, surgical masks and respirators.

JUN 10, 2020

WASHINGTON, DC – The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has published a series of frequently asked questions and answers regarding the use of masks in the workplace.

“As our economy reopens for business, millions of Americans will be wearing masks in their workplace for the first time,” said Principal Deputy Assistant Secretary for Occupational Safety and Health Loren Sweatt. “OSHA is ready to help workers and employers understand how to properly use masks so they can stay safe and healthy in the workplace.”

The new guidance outlines the differences between cloth face coverings, surgical masks and respirators. It further reminds employers not to use surgical masks or cloth face coverings when respirators are needed. In addition, the guidance notes the need for social distancing measures, even when workers are wearing cloth face coverings, and recommends following the Centers for Disease Control and Prevention’s guidance on washing face coverings.

These frequently asked questions and answers mark the latest guidance from OSHA addressing protective measures for workplaces during the coronavirus pandemic. Previously, OSHA published numerous guidance documents for workers and employers, available at https://www.osha.gov/SLTC/covid-19/, including five guidance documents aimed at expanding the availability of respirators.

For further information and resources about the coronavirus disease, please visit OSHA’s coronavirus webpage.

 

CALWORKSAFETY.COM ANNOUNCES COMPANY ACQUISITION OF ATENTO CONSULTING SERVICES

12 Jul

Atento Masthead Heading-7-1-19

IRVINE, CA — JULY 1, 2019 – Irvine, CA — Don Dressler, a national leader in human resources and risk management solutions, today announced the acquisition of Long Beach, CA-based ATENTO Consulting Services, Inc. by Irvine, CA-based CALWORKSAFETY, effective July 1, 2019.

Two ATENTO founding principles – Ron Paine, MS, ARM, and Laura Pensamiento – are seasoned experts in safety training for the construction industry. Combining the experiences with those of CalWorkSafety broadens the scope of Cal/OSHA compliance, citations defense services along with a wide variety of HR compliance solutions, specifically in Spanish and English: Safety, Risk Control & Human Resources including:

Safety Training Classes include: Hazard Communication (HazCom) Training, First Aid/CPR/AED training, Forklift Safety Training, Sexual Harassment Training (CA Compliant) and Defensive Driving Training.
Construction Specific Classes include: FED OSHA/CAL OSHA Construction 10-Hour Course & Certification, Excavation (including trenching & shoring), Fall Protection, Scaffold training, Qualify Flagger and safety traffic safety training, Construction Equipment Safety Certification, Rigging Safety and Confined Space training.

“Ron and Laura recognized employers with Spanish speaking workforces require hands on consideration developing safety programs that effectively address, overcome, and reconcile cultural difference,” said CalWorkSafety founder Don Dressler. “With 50+ years combined experience, they know what works and have collectively helped employers drastically reduce their losses through aggressive and persistent techniques that address the true causes of lost revenue,” Dressler said.

“We’ve focused on traditional approaches to establishing safety programs, such as engineering safety committees, safety incentive, and safety inspection programs for our clients. These programs aggressively motivate and educate managers on accident prevention,” Ron Paine said.

About Cal Work Safety 

Don Dressler is an experienced labor and employment law attorney and former workers’ compensation insurance company president. Nationally recognized expert on safety and workers’ comp programs and legal issues affecting business owners, Dressler is the architect of www.CalWorkSafety.com. For more than 25 years, CalWorkSafety has offered labor law/risk management consulting on: HR, Safety & Cal/OSHA, Labor Law/Discrimination/EOP and Workers’ Comp. CalWorkSafety’s customized Safety package designs significantly reduce worker’s compensation costs and protect employers from non-compliance issues affording effective employee training solutions to southern California companies. A virtual HR Department program offers effective hands-on management, discrimination and harassment claims. For more information on Cal/OSHA compliance related to illness and injury prevention, sexual harassment, discrimination contact Don Dressler at (949) 533-3742, or visit our website.

About That Loss Run Analysis

6 Nov
Loss Run Analysis-Cut Costs
The First Step: Cutting Worker’s Comp Costs. Loss Run Analysis Is the Second Step.

Online loss runs are the best method of cutting your Worker’s Comp (WC) costsfrom the claims perspective.  Even if you have a few accidents, online access usually results in immediate loss runs that can be printed or downloaded into a spreadsheet.

If your carrier offers a method to download information, it’s very helpful if everything possible is included in the download, because the more information on a spreadsheet, the potential to save WC dollars increases greatly.

Using the “red flag” terms when referring to loss runs is not suggested because there are no actual red flags as the loss runs may not have enough information to add this moniker on any of the claims listed. Paying attention to claim amountslooking ‘off’ is what you should analyze more specifically.

And, without looking at the loss runs, there is really no generic statements that can aid you in your loss run analysis.

For many employers the most confusing category is the term ‘Total Incurred’ which surprisingly, may not necessarily be a column on your loss runs. Below are common references used to define loss runs Total Incurred:

  • Total Reserves Incurred
  • Total
  • Total Reserves
  • Incurred
Loss Run Important Items:

  1. Injured worker’s name
  2. Date of loss
  3. Is it Open or Closed?
  4. Is the claim “litigated”, meaning injured worker has an attorney involved
  5. Claim amounts appear as “medical” and “indemnity”.  Other titles include: “medical/legal” and/or “allocated claims costs”.
  6. Cause of injury (not shown as such on all insurer loss runs).
  7. “Reserved” or “Unpaid” are claims where your action may help reduce costs or encourage insurer to close the case.

Attention getters arise when there is a significant amount of money in “reserved” or “unpaid” categories. Remember, since 2017 in California: there is a maximum dollar amount on each claim used to set your Experience Modification (Ex Mod). This amount is shown on the Workers’ Compensation Experience Rating Form issued each year by the WCIRB for your company.

Your broker has this form, so if you don’t have a copy, request it annually (prior to planning for your renewal of insurance for a new policy). The Experience Rating Form has a unique number: “Primary Threshold”. Remember, all costs of every workers’ compensation claim are charged to your Ex Mod, up to the maximum amount shown.

Beginning in 2019, every employee workers’ compensation claim will be listed on the form, and $250/claim will be deducted from the amount charged in your Ex Mod. This is done to offset the costs of “first aid” cases, which must now be reported to your insurer and the WCIRB.

CalWorkSafety offers detailed guidance on how I-9s are prepared and completed.  We assist with reviewing I-9 records and training employees on how to handle the I-9 process properly. To learn more send an email to: dondressler1@hotmail.com or call us at: 949-533-3742
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The Bottom Line:
Our Virtual HR Department offers effective hands-on Management and Staff training dealing with Mandated Regulations.  By simplifying the employee relations and compliance elements we help clients reduce workers’ compensation premiums, prevent discrimination and harassment claims, and settle/avoid employee claims. Email Us: dondressler1@hotmail.com
Visit our website: www.calworksafety.com or Call:  949-533-3742

$34.9 Million Awarded in Grants to Combat Worker’s Comp Fraud

17 Aug

Workers comp fraud is a large crime in America today. Tens of billions of dollars in false claims and unpaid premiums are stolen every year. Scams are forcing premiums higher — draining business profits and costing honest workers their pay and jobs.

Contrary to what most people believe, workers’ compensation fraud is more that just an employee exaggerating his medical condition or working for cash while supposedly disabled. While these things do occur, employers are also committing fraud by underreporting their payrolls to receive lower premiums and health care providers are billing for services they’ve never performed. Workers compensation fraud is costing the industry and citizens of our state billions of dollars each year.

Just recently, Insurance Commissioner Dave Jones awarded $34.9 million in grants to 37 district attorney offices representing 42 counties in California to combat workers’ compensation insurance fraud.

“These grants will assist district attorneys across the state in uncovering workers’ compensation fraud schemes and prosecuting those who take advantage of the system,” Jones said in a statement.

Do you have any questions about Insurance Fraud? Please don’t hesitate to contact us at CalWorkSafety.com or email us at dondressler1@hotmail.com.

Warning Signs for Employers Red Flags of Work Comp Fraud

6 Jun

There are several “red flags” that are common in workers’ compensation claim fraud. While none on its own is necessarily cause for alarm, the presence of two or more should raise suspicions and trigger an investigation.
1) Monday morning report of injury. The alleged injury occurs first thing on Monday morning, or the injury occurs late on Friday afternoon but is not reported until Monday.
2) Employment change. The reported accident occurs immediately before or after a strike, job termination, layoff, end of a big project, or the conclusion of seasonal work.
3) Suspicious providers. An employee’s medical providers or legal consultants have a history of handling suspicious claims, or the same doctors and lawyers are used by groups of claimants.
4) No witnesses. There are no witnesses to the accident and the employee’s own description does not logically support the cause of the injury.
5) Conflicting descriptions. The employee’s description of the accident conflicts with the medical history or injury report.
6) History of claims. The claimant has a history of a number of suspicious of litigated claims.
7) Treatment is refused. The claimant refuses a diagnostic procedure to confirm the nature or extent of an injury.
8) Late reporting. The employee delays reporting the claim without a reasonable explanation.
9) Claimant is hard to reach. The allegedly disabled claimant is hard to reach at home.
10) Changes. The claimant has a history of frequently changing physicians, addresses or jobs.
We believe that vigilant employers can nip most fraud in the bud with a tight workers comp management program that focuses on preventing injury, treating employers fairly and compassionately when injuries do occur and closely monitoring the recovery process until return-to-work on full or transitional duty. By actively demonstrating vigilance repeatedly, opportunistic fraudsters may think twice and sophisticated fraudsters may choose an easier target. Here are some best practices:
• Zero tolerance message. Educate employees about their rights and responsibilities under workers comp, and be clear that your intention is to care for anyone who is injured on the job, but that you aggressively prosecute fraud as a crime.
• Publicize your return-to-work program. Establish and reinforce a goal of recovery and return-to-work for any work-related injuries.
• Train supervisors. Your supervisors should understand workers comp and their role in the process. They should understand the employer/employee rights and responsibilities and what to do if an injury occurs. They should be alert for red flags.
• Aim for same-day injury reporting. Train employees to report injuries immediately when they occur.
• Conduct accident analyses. As soon as possible after a work injury or near miss, gather facts and witnesses while things are fresh. This will also set the stage for getting to the root cause and taking any remedial actions to prevent future occurrences.
• Set the tone at point of injury. Escort an injured worker to the treating physician in your network. Remind them of rights / responsibilities and that you will be monitoring their recovery.
• Keep in close touch with out-of-work injured employees. Let the employee know how important they are to the team. Have transitional work available that conforms with any restrictions and establish a return to work date.
• Work with your insurer. Be familiar with “red flags” and report any suspicious activity immediately.

State Fund Announces Work Comp Rate Increase for 4/1/15 – Some employers up to 17.5%

4 Feb

The State Compensation Insurance Fund in California is boosting its workers’ comp rates effective April 1st and it says insured employers will be paying based upon the overall average some 9% more under the modifications. Some employers however will be hit harder than others as State Fund is boosting tier A and B rates by 5%, dropping the 6% group discounts and increasing territorial surcharges in southern California 6.5% for Los Angeles and 4.8 for the rest of the area.
That means that effectively, a tier A or B account which is currently in a group and located in Los Angeles could see an increase of 17.5%. Accounts in Los Angeles not in a group will see increases of 11.5%.
State Fund, California’s market of last resort, is also increasing its requirements for schedule credits and debits to $25,000 and increasing minimum premiums by 25%.
All this is at a time when many employers are being hit hard by dramatic increases in their experience modifications, due to changes in the rating process in California.

Thanks to the Workers’ Compensation Executive for the news flash. http://www.wcexec.com

Workers’ Compensation Insurers Routinely Misclassify Payroll

22 May

The California Workers’ Compensation Insurance Rating Bureau (WCIRB) is finding that workers’ compensation insurers are often assigning the wrong payroll classification to their policies. In a recent WCIRB report about the large risk validation program, where the WCIRB is testing policies larger than those covered by the regular test audits of the Bureau, 13.3% of the time the largest premium policies have the wrong payroll classifications in use.
Up to now, these large policies (usually with premiums of over $1 million per year or higher) have been exempt from the regular audit program of the WCIRB because the assumption has been that larger policies were more accurate than smaller ones. That turns out to be false. In fact, in audits of 219 large policies, the WCIRB found $1.9 billion in premium had been reported in the wrong classifications. That means that approximately one in seven workers’ compensation policies, big or small, have the wrong payroll classifications being applied.
Employers need to take notice of this error rate. There is a good chance that your policy has the wrong class codes being applied, and that the premium auditor who is billing you is making a mistake as well. When in doubt, ask someone to review your classifications and your premium audits. The money you save could be your own.
Don Dressler Consulting assists employers with workers’ compensation classification issues and premium audit matters. Just contact us by email at DonDressler1@hotmail.com for information or help.