Control the Variables: Keeping Workers Comp Costs In Line

Workers Compensation sounds pretty cut-and-dried, right?  Your rate – determined by the state where your company is located and the type of business – gets multiplied by your total payroll and then divided by 100.

But then modifiers enter the picture, which can raise or lower your costs, based on your loss history, or the record of measurably reducing the risk of injury to employees.  Naturally, you want a modifier that drives your workers comp costs down.  Here are some ideas on how to do just that.

  1. Save Money on Workers' Comp Insurance – The same as selecting car or health insurance, it’s important to shop around for the best workers’ compensation insurance policies.
  2. Ensure You're Following Workers' Comp Claims Management Best Practices – By making sure your claims adjuster always follows best practices associated with claims management, payouts can be reduced by up to 50%.
  3. Focus on Safety – Create and embed a true safety culture, continually providing information on safe processes and procedures, instituting regular safety checks, and characterizing safety less in terms of statistics and more by how injuries impact people and their families.
  4. Have an injury procedure in place – It is essential to manage any injuries quickly and effectively before they become worse, and for managers and employees to know their roles and responsibilities when someone is hurt at work.
  5. Start an Incentive Program for New Hires – Employees, especially new hires, often benefit from incentive programs that reward them for learning the safety protocol. Older employees can also be encouraged to help the newer hires learn about the culture of safety through group incentives.
  6. Implement a Return-to-Work Program – Maintaining ongoing communication with injured employees leads to them returning to the job faster, which means returning to a regular paycheck for them and lower overall costs to the company.
  7. Check With Your State – Some states offer discounts if a company implements a program that promotes safety, so it’s worth checking on your state’s policies.
  8. Review Your Employee Classifications – The simple act of ensuring that each employee is classified correctly regarding his or her current job can represent substantial savings.

When you understand and control the variables surrounding workers comp coverage, you can achieve the modifier level that leads to better control of those costs.  Plus, in virtually every example cited here, it’s the proper, practical, and ethical thing to do, as well.  Contact the workers comp professionals at The Reschini Group today to learn more.


Copyright 2022 The Reschini GroupThe Reschini Group provides these updates for information only, and does not provide legal advice.  To make decisions regarding insurance matters, please consult directly with a licensed insurance professional or firm.Source: https://news.briotix.com/9-workers-compensation-cost-reduction-strategies

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The Reschini Blog: Workers’ Comp and the Pandemic

Believe it or not, 2020 may not have been such a bad year for workers’ compensation insurers and insureds after all.

The National Council on Compensation Insurance (NCCI) looked at results through the third quarter of 2020 and extended those through the end of the year, using data from private carriers and state funds in 41 jurisdictions. The NCCI figures are calendar year and do not reflect the full costs of treating COVID-19 or other health conditions with long-term effects.

Overall for 2020, NCCI found:

  • Worker claims due to COVID-19 have ranged from no symptoms to critical care, hospitalizations and, unfortunately, fatalities in some cases.
  • The overall COVID-19 claims picture is by no means dire, with the majority of cases only requiring the injured worker to miss work and quarantine or recover at home.
  • About 80% of the COVID claimants received very limited treatment, with 20% admitted to the hospital, representing the costliest and most complicated cases.
  • The typical COVID inpatient stay lasts on average about seven to eight days.
  • The majority of workers filing COVID workers’ compensation claims were women, at nearly 70%. These claimants are also generally older than the typical injured worker, with a large share age 55 years and older.
  • Also, injured workers who contracted COVID-19 and required medical treatment were more likely to have comorbidities such as hypertension and chronic pulmonary disorder.
  • COVID-19 claims were predominantly among frontline workers, first responders, healthcare and other essential workers, and teachers.

As the Delta variant surges across the U.S., it will be important to see how trends impacting workers’ compensation claims mirror or diverge from those seen from the initial round of COVID-19.For more information, contact the workers’ compensation experts at The Reschini Group.Download our resources about Workers Comp and COVID:

 


Copyright 2021 The Reschini GroupThe Reschini Group provides these updates for information only, and does not provide legal advice.  To make decisions regarding insurance matters, please consult directly with a licensed insurance professional or firm.

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The Reschini Blog: Preparing for COVID-19 Lawsuits and Claims

According to national human resources and legal experts, employers can expect to face many lawsuits and claims related to COVID-19 from infected or laid-off employees and families of deceased workers in the coming months.  Claims for gross negligence, wage and hour oversights, discrimination, and layoff-notice discrepancies are possible.

Workers Compensation claims are being submitted to insurers and tracked by rate-making or -reporting bodies at the state level.  WC laws vary by state, as they relate to communicable diseases, with some state legislatures enacting laws to expand statutes related to COVID-19 claims.Uncertainty about whether workers' compensation will apply to COVID-19-related illnesses remains at the federal and state levels.  For that reason, employers would be wise to do all they can to limit potential liability, legal experts advise.  The best way for employers to do this is by following all guidance from the U.S. Centers for Disease Control and Prevention (CDC), state and local health departments, and the Occupational Safety and Health Administration.Exposure to lawsuits and claims could take a number of specific paths:

  • Employers should expect a wave of workers' compensation claims from employees who have contracted COVID-19, claiming that they contracted the virus while at work. Causation should be easier to prove with someone who worked at a facility that continued operating after multiple employees tested positive for COVID-19 than with an individual who worked at a site with one previously confirmed case in a location far from that person.
  • In states that exclude flu-like illnesses from workers' compensation coverage, employees might still bring negligence claims, or their families could still allege wrongful death, since workers' compensation laws' exclusive remedy provisions wouldn't apply.
  • Laid-off workers may claim discrimination. Reduction-in-force decisions can impact older workers disproportionately because they tend to be the most highly compensated.
  • The Americans with Disabilities Act may come into play, as well, if an employer denies a COVID-19 related accommodation.
  • There also could be Occupational Safety and Health Act retaliation claims from workers who contend that they were let go after refusing to return to an unsafe workplace.

The best advice to policyholders is to submit all claims promptly to get an initial coverage determination.  Waiting makes it harder to gather critical information to manage costs and losses later.  The professionals at The Reschini Group can expertly advise any public or private company on crafting the proper coverage, or anticipating how current coverage terms will be able to handle COVID-19 related claims as they are presented.  Contact us today to learn more.Related Resources from The Reschini Group:Read an update from OSHA about COVID-related preparedness in the workplace.  OSHA Issues Prevention Guidance on COVID-19 in the Workplace 2.1.21 Read a primer about gathering information related to Workers Compensation Claims.  WCI- The First 24 Hours After an Injury Watch a video regarding latest trends in litigation related to COVID-19 and the resulting economic impact. (LINK: https://www.reschini.com/litigation-trends-regarding-covid-19/ )


Copyright 2021 The Reschini GroupThe Reschini Group provides these updates for information only, and does not provide legal advice.  To make decisions regarding insurance matters, please consult directly with a licensed insurance professional or firm.Source: https://www.shrm.org/resourcesandtools/legal-and-compliance/employment-law/pages/coronavirus-wide-range-of-lawsuits.aspx

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The Reschini Blog: Preparing for Covid Claims

Covid-19 has placed a spotlight on insurers, who have been preparing for the waves of inquiries and claims across multiple categories of coverage.

Many insurers, following the 2003 SARS outbreak, introduced exclusion clauses for communicable diseases and epidemics/pandemics into most non-life products such as business interruption and travel insurance.

Because business interruption policies usually pay out only if physical damage occurs to an organization's assets or operations, coronavirus-related claims may not be covered.  Claims and related litigation have already begun and the marketplace is reacting.Travel insurance may offer cover if a customer is diagnosed with the virus before or during a trip, but not for travel cancelled because of the pandemic.  The lone exception would be if the policyholder has taken out premium “any cause” cover, but very few do.  The pandemic may actually spur increased interest in such premium policies.Two major areas to watch are trade credit insurance and workers compensation.Trade credit insurance covers businesses against debts that can’t be paid by customers or suppliers.  Small-to-medium sized businesses could be hit hard due to supply chain disruption and a crunch in business levels. The cost may hinge on the extent of the pandemic and government restrictions on non-essential businesses.  Claim activity in this sector could spiral quickly.Regarding workers' compensation, claims could rise from employees asserting they were not adequately protected by their employers against exposure to the virus brought about by their normal working duties.  Insurers offering this type of coverage to employers should prepare for this level of increased activity.The professionals at The Reschini Group can guide you in determining how best to safeguard your organization against exposure in the wake of Covid-19.Source: https://home.kpmg/xx/en/home/insights/2020/03/do-insurers-have-covid-19-covered.html


Copyright 2021 The Reschini GroupThe Reschini Group provides these updates for information only, and does not provide legal advice.  To make decisions regarding insurance matters, please consult directly with a licensed insurance professional or firm.

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Showing Your Cards: Insisting on Pre-Employment Physicals

Poker has always been a game more reliant on intent and projection than on the actual collection of cards in a given player’s hand.  That’s what makes it a gamble.

But if a player would show his or her hand before the betting and calls began, all of the excitement and tension would immediately disappear. The gamble would be over.  The outcome would be immediately known.  Safe and predictable.To apply this example to the operation of a business, unlike a poker game, no one wants to gamble with outcomes.  The idea of a safe, predictable set of facts and conditions sounds perfect.  So let’s not hide the cards we hold.  Let’s show them all, right up front.One of the best ways any business can pursue this strategy comes in the form of conducting pre-employment physicals, performed by a licensed physician, to determine a candidate’s physical fitness for the job an employer wants to fill.Sounds so obvious and logical, right?  But not every employer insists on this simple process – or they bring candidates on before the process has been completed – and in either case, the consequences can be costly, embarrassing, and damaging to short- and long-term profitability.For example, say a company hires and places a group of new employees into its field operations before receiving the results of their physicals.  One of the new recruits suffers an injury almost immediately.  The physical may have given the employer enough information to keep this person from a job with conditions that he was not capable of safely executing.It’s imperative to remember that you as the employer are responsible for whatever physical conditions are present among your employees.  That means in the example that the employer was on the hook for medical costs and recovery programs for the injured employee – all of which might have been easily avoided by not rushing the person into an inappropriate role.A pre-employment physical examination helps to guarantee the employer of a lower rate of absenteeism due to sickness, injuries, or occupational hazard.  It also helps avoid workers compensation issues, lost production, and higher operational costs.In short, the benefits far outweigh the costs.  Show all your cards right up front and take the gamble out of operating your business by conducting and abiding by pre-employment physicals for all new hires.  Contact the professionals at The Reschini Group to learn more.


Copyright 2020 The Reschini GroupThe Reschini Group provides these updates for information only, and does not provide legal advice.  To make decisions regarding insurance matters, please consult directly with a licensed insurance professional or firm.

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Candid Camera: The Use of Surveillance in Workers Compensation Claims

Ask anyone over the age of 40, and they can complete this old TV theme song:  “When you least expect it, you’re elected, you’re the star today!  Smile, you’re on…”

“Candid Camera!”  The program secretly filmed ordinary people put in intentionally silly or embarrassing situations, all for laughs.  It remained one of the most popular TV shows of the ‘60s and ‘70s, thanks largely to the hook of catching people in the act of being their real selves.

In the world of workers compensation insurance, catching people in the act of being their real selves happens too.  But it’s rarely, if ever, for laughs.  The use of surveillance has been and remains a central tool in identifying and minimizing insurance fraud.Workers comp providers press for surveillance when a claim warrants additional proof of injury or disability pertaining to a claimant.  Obtaining proof of what an individual does in his or her off-hours can have direct implications on whether their claim is valid, and if so, to what degree.The employer paying for workers comp coverage has or wants this additional, objective information on a claimant, and approaches the insurance carrier, who typically makes the decision on whether to pursue surveillance.  Third-party private investigators may be used.  Social media, thanks to its ubiquitous presence and its ability to share information and images immediately, also comes into play.A workers comp claimant looking for a large settlement because of an inability to work due to a back injury should not be photographed or videotaped participating in a bowling league, or lifting large heavy packages into a friend’s pickup truck, for instance.  Capturing evidence like this, which contradicts a claim’s baseline argument, can frame mediation or a settlement in short order.Surveillance can shorten the life of a claim, leading to settlements of lower, many times fairer, value.  Of course, if no evidence of fraud is discovered via surveillance, the settlement will be every bit as fair, based on the proven and justified accuracy of the claim.It’s worth always keeping in mind, though, that the workers comp provider’s “candid camera” is ever at the ready, and that it is up to the claimant to file claims accordingly.Contact the team of professionals at the Reschini Group for more information on surveillance and other tools to safeguard your organization’s workers comp coverage.


Copyright 2020 The Reschini GroupThe Reschini Group provides these updates for information only, and does not provide legal advice.  To make decisions regarding insurance matters, please consult directly with a licensed insurance professional or firm.

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The State of Things: The Web of Workers’ Compensation Requirements

Work Injury Claim FormBy The Reschini Group

“Workers' compensation is a mandatory type of business insurance that provides employees who become injured or ill while on the job with medical coverage and income replacement. It also protects companies from being sued by employees for the workplace conditions that caused such an injury or illness. 

Businesses are required by law in all fifty states to pay for the medical treatment and lost wages of employees who suffer job-related injuries or illnesses. In order to avoid crippling expenses in this regard, companies purchase workers' compensation insurance policies of one kind or another.

Each state determines its own system's payment schedules, employee eligibility requirements, and rehabilitation procedures. Although provisions of each state's laws differ greatly, the underlying principle is the same—that employers should assume the costs of injuries, illnesses, and deaths that occur on the job, without regard to fault, and partially replace wage income lost.”

This definition of workers’ compensation, as cited on www.uslegal.com, states the facts of the matter clearly. All employers must provide for workers’ compensation, but the rules, procedures, and guidelines differ by state.  Employers based in Pennsylvania, for example, need to know that contiguous states like Ohio, West Virginia, Maryland, and New York each have distinct approaches and requirements regarding workers’ compensation.A sampling of specific workers’ compensation requirements in neighboring states include:

  • OHIO – This is one of four “monopolistic” states in the union, meaning that coverage can only be purchased from the Ohio Bureau of Workers’ Compensation. In some cases, Pennsylvania-domiciled clients that have employees that travel into Ohio for a period that equates to less than 90 days must still purchase an administrative policy in Ohio, and add the Stop Gap endorsement to either the Worker’s Compensation or General Liability policies, but still must also sign a waiver saying that they choose Pennsylvania benefits as their method of remedy.
  • NEW YORK – This state requires short-term disability coverage for workers there. New York State must be listed on the workers’ compensation policy purchased by the employer.
  • WEST VIRGINIA – A worker can sue his or her employer for “deliberate intent” to cause illness or injury, while still collecting workers’ compensation payments in this state. Five criteria must be met for a claim to be awarded, including: that a specific unsafe working condition existed; that the employer had actual knowledge of the condition; that one or more safety standards, whether regulations or commonly accepted, were violated; that the employer intentionally exposed the employee to the unsafe condition; and the employee suffered serious compensable injury or death.

The professionals at The Reschini Group can help make sure you have the right level of workers’ compensation for your specific situation.  Contact us at 724-349-1300 to set up a time to talk.


Copyright 2017 The Reschini Group The Reschini Group provides these updates for information only, and does not provide legal advice.  To make decisions regarding insurance matters, please consult directly with a licensed insurance professional or firm.

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Reprise: Context is King: The Effect of Lagging Indicators on Coverage

As summer winds down, here is an encore of an essay regarding the importance of lagging indicators in successfully securing the proper insurance coverage.

By Mike Drew, The Reschini Group

  • Is the quarterback resourceful – or reckless?

    Understanding the context in workers' compensation issues can make all the difference.

  • Is the candidate truthful – or tactless?

  • Is the businessperson poised – or preening?

  • It all depends on the context.

The same can be said for the effect of safety-related lagging indicators, two in particular – Experience Modification Rate (EMR) and Total Recordable Incident Rate (TRIR) – that can have significant effects on insurance rates, and even on the ability of contractors to secure work, primarily in the oil and gas industry.EMR helps to determine workers' compensation premiums for businesses. A mathematical formula calculates an annual rate, and premiums can go up or down depending on the company's claims experience. By learning how to monitor company processes, some additional control may be gained over those workers' compensation expenses.  TRIR is a measurement used by the federal Occupational Safety and Health Administration (OSHA) to record safety-related incidents across an organization.While these measurements represent responsible accountability metrics, with safety remaining a top priority for companies and their employees, occasionally the impact on premiums can outpace the actual significance of safety-related events.  A single incident in a TRIR calculation, for example, can knock a company out of the running for contract bid submittals for years.Say an employee suffers a minor accident while on the job.  After receiving prompt treatment at a hospital, he is medically cleared to return to work that same day and does so.  But because this event technically qualifies as a recordable incident, his company experiences some very real and negative financial ramifications.In other words, the episode gets taken out of context.  The “punishment” can easily exceed the “crime.”Yet here’s the hard truth of the matter.  The rules are the rules.  EMR and TRIR rates cannot be changed.  Safety incidents can and should be explained within the proper context, so that future work engagements can still be sought without penalty and so that premiums can remain reasonable.At The Reschini Group, our in-house safety consultants bring a fuller understanding and context to safety documentation.  Our expertise in safety practices, covering both pre- and post-accident conditions, can explain and detail the proper context, so that a minor occurrence doesn’t need to turn into a major problem.Contact us to learn more or discuss your situation.


Copyright 2016 The Reschini GroupThe Reschini Group provides these updates for information only.  To make decisions regarding insurance matters, please consult directly with a licensed insurance professional or firm. 

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Chicken or Egg:

Assessing Pre-Existing Conditions Aggravated On-The-Job

By Mike Drew, The Reschini GroupPre-existing conditions and workers compensation can become a “which came first” scenario. Let us help clarify the situation.

It’s one of the oldest riddles in history: Which came first, the chicken or the egg?  And while it may be amusing to ponder that pesky and unsolvable mental puzzle, it can become infinitely more troublesome and costly when the question gets applied to an on-the-job injury.

Say, for example, that an employee has a pre-existing hernia.  That same employee suffers severe discomfort from the hernia becoming aggravated while at work, but he says nothing and does not report the event to his supervisor.  Over the next day or two, the discomfort becomes acute enough to inhibit the employee’s ability to perform his expected tasks and he ends up staying home to recover.Does the incident fall under workers compensation or not?Well, that depends.  If what the employee was actually doing while at work contributed to the hernia flaring up, then most likely it would fall under workers comp.  But if an investigation – to include information from a medical professional – concludes that on-the-job activity did not affect the hernia, then the answer could change.It also becomes important to establish that the injury occurring at work is, in fact, the same as any pre-existing condition and can be connected to that condition.  Good job descriptions and a careful, thorough post-event investigation become critical in making all of these determinations.  Hiring decisions should be made carefully, because workers comp expenses can be daunting, carrying long-term implications if lost time becomes a factor.Let the experts at The Reschini Group help to ensure that you have the proper programs and coverages in place to handle pre-existing medical conditions that may become aggravated on-the-job.  Because, unlike between the chicken and the egg, in this case it matters quite a bit which came first.


Copyright 2016 The Reschini Group The Reschini Group provides these updates for information only.  To make decisions regarding insurance matters, please consult directly with a licensed insurance professional or firm.

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Easy Money

Establishing A Workplace Safety Committee

By Mike Drew, The Reschini Group

“Click here for a free vase,” the florist’s website declares.

“Refer a friend and get a free month’s rental,” advertises the storage shed provider.

“Buy one-get one free,” the supermarket tells its customers.

Found money.  Available money.  Easy money, in all instances.

The same holds true for oil and gas companies – any company, actually – that establish aeasy moneyworkplace safety committee.  When this simple step gets taken, it yields a 5% discount on Workers Compensation coverage.For such a straightforward decision, the savings can be significant.  Few businesses today can afford to pass on any available savings.  A 5% discount means dollars saved that can be used elsewhere, as needs determine.Establishing a new workplace safety committee can be done quickly and easily.  The same can be said for companies who had once had a committee in place, and who want to reinstitute and reconstitute one now.These committees are a proven and effective way to promote safe practices in the workplace.  They can increase awareness, boost enthusiasm, and provide employee ownership of safety and health while reducing accidents. The creation of a workplace safety committee, and its ongoing performance, represents a win-win for both employers and employees.The Pennsylvania Department of Labor and Industry, in its Workplace Safety Committee Technical Assistance Manual, validated this when it stated, “Effective workplace safety committees are a proven tool in reducing workplace injuries and illnesses, as well as producing significant savings for employees.”The Reschini Group and its Safety Consultants, trained at the Safety Sciences Department at Indiana University of Pennsylvania, stands apart from other insurance brokers and providers by offering advice and counsel to all clients on establishing workplace safety committees.  Contact us to learn more.The 5% discount on Workers Compensation coverage would be reason enough.  Easy money, yours for the taking.  But the greater – and much more meaningful – savings can be realized in ensuring a higher standard of safety and health for all employees.


Copyright 2016 The Reschini GroupThe Reschini Group provides these updates for information only. To make decisions regarding insurance matters, please consult directly with a licensed insurance professional or firm.

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Context is King

The Effect of Lagging Indicators on Coverage

By Mike Drew, The Reschini Group

Understanding the context in workers' compensation issues can make all the difference.

Is the quarterback resourceful – or reckless?

Is the candidate truthful – or tactless?

Is the businessperson poised – or preening?

It all depends on the context.

The same can be said for the effect of safety-related lagging indicators, two in particular – Experience Modification Rate (EMR) and Total Recordable Incident Rate (TRIR) – that can have significant effects on insurance rates, and even on the ability of contractors to secure work, primarily in the oil and gas industry.EMR helps to determine workers' compensation premiums for businesses. A mathematical formula calculates an annual rate, and premiums can go up or down depending on the company's claims experience. By learning how to monitor company processes, some additional control may be gained over those workers' compensation expenses.  TRIR is a measurement used by the federal Occupational Safety and Health Administration (OSHA) to record safety-related incidents across an organization.While these measurements represent responsible accountability metrics, with safety remaining a top priority for companies and their employees, occasionally the impact on premiums can outpace the actual significance of safety-related events.  A single incident in a TRIR calculation, for example, can knock a company out of the running for contract bid submittals for years.Say an employee suffers a minor accident while on the job.  After receiving prompt treatment at a hospital, he is medically cleared to return to work that same day and does so.  But because this event technically qualifies as a recordable incident, his company experiences some very real and negative financial ramifications.In other words, the episode gets taken out of context.  The “punishment” can easily exceed the “crime.”Yet here’s the hard truth of the matter.  The rules are the rules.  EMR and TRIR rates cannot be changed.  Safety incidents can and should be explained within the proper context, so that future work engagements can still be sought without penalty and so that premiums can remain reasonable.At The Reschini Group, our in-house safety consultants bring a fuller understanding and context to safety documentation.  Our expertise in safety practices, covering both pre- and post-accident conditions, can explain and detail the proper context, so that a minor occurrence doesn’t need to turn into a major problem.Contact us today to learn how The Reschini Group helps keep minor occurrences from becoming major problems.


Copyright 2016 The Reschini GroupThe Reschini Group provides these updates for information only. To make decisions regarding insurance matters, please consult directly with a licensed insurance professional or firm.

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