Category Archives: Workers Comp

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The Cost of Workplace Bias

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There are many costs associated with workplace harassment and discrimination—monetary, reputational and the morale of employees to name a few. In 2012, the U.S. Equal Employment Opportunity Commission (EEOC) reported filing 122 lawsuits including 86 individual suits, 26 multiple-victim suits (with fewer than 20 victims) and 10 systemic suits. The EEOC’s legal staff resolved 254 lawsuits for total monetary recovery of $44.2 million.

The agency added that it secured monetary and non-monetary benefits for more than 23,446 people through administrative enforcement. These methods include mediation, settlements, conciliation and withdrawals with benefits. The number of charges resolved through successful conciliation, the last step in the EEOC administrative process before litigation, increased by 18% over 2011.

Harassment & Discrimination: Do You Know the REAL Impact?
By The Network Inc., the leader in providing integrated ethics, risk and compliance solutions

Read more: http://www.tnwinc.com/solutions/discrimination-and-harassment/infographic-workplace-harassment-training/#ixzz2jDmSPiiH

California Seeks to Limit Pro Athlete Workers Comp Claims

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Over the past few years, several former NFL players including Deion Sanders, Marshall Faulk and Michael Irvin have filed workers compensation claims in the state of California despite playing their careers outside of California. On September 9 the California legislature passed a bill intended to prevent these types of claims.

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The bill, AB 1309, would prevent professional athletes who have played less than 20% of their career in California, or have played seven or more seasons outside of California, from filing workers compensation claims in the state of California. Under current law anyone who pays state taxes in California are eligible for workers compensation benefits. This includes professional athletes who play for teams outside of California, but do pay state tax when they play away games in California.

Supporters of the legislation, including the National Football League and the Los Angeles Chamber of Commerce, claim that the legislation closes a loophole that is costing taxpayers money. “The state has a guarantee corporation, funded by taxpayers, that assumes responsibility for claims made and approved in the state, so out-of-state claims cause rates to be driven up for employers and taxpayers in the long run,” said Gary Toebben, Los Angeles Area Chamber of Commerce president and CEO.

The NFL Players Association (NFLPA) and AFL-CIO feel that athletes who play games in California, regardless of whether they play for a California team, should be entitled to benefits because they pay California taxes for the games they do play. The NFLPA claims that professional athletes pay $300 million per year in California income tax. Former NFL player Mel Owens, a county attorney for NBO Law who represents at least 1,000 retired football players suing for workers compensation in the state, claims that professional athlete claims in the state cost “one-tenth of one percent” of total losses to the California comp system. “Calling the California workers compensation law a ‘loophole’ is a fallacy—anyone that has played in California and got hurt in California pays state taxes and is entitled to benefits here,” said Owens.

According to state workers compensation records, there have been more than 4,400 claims filed by professional athletes in the state of California.

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Many of these are for head and neck injuries, with nearly 80% of them coming from former football players. By some estimates these claims could cost professional leagues as much as $1 billion to resolve. More than 2,300 of these claimants were also plaintiffs in the federal concussion lawsuit which the NFL recently settled for $765 million.

AB 1309 was passed by huge margins in both the California Assembly and Senate and is now on the desk of Governor Jerry Brown. The governor has until October 13 to sign or veto the bill.

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California Town Must Improve Risk Management or Lose Insurance Coverage

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Insured City

One southern California town has officially been warned that their insurance will be cut off if city officials do not adopt risk management policies.

Irwindale’s insurer, the California Joint Powers Insurance Authority, issued a performance improvement plan on August 28 and said city liability and workers compensation insurance will be terminated if it does not adopt the measures. Allegations of corruption have cast a pall over the police department and local government, and the city has been forced into almost $2 million in settlement payouts over the past five years, according to the Pasadena Star News.

“They’re on notice that they need to improve their risk management practices within the city’s operations, specifically in the police department, to maintain their insurance coverage with our agency,” JPIA’s risk management program manager Bob May told the paper.

Irwindale has been mired in controversy over the past few years.

Of 24 police officers, three are on paid administrative leave and the department is conducting 14 internal affairs investigations. A local woman recently filed a $20 million lawsuit against the city, alleging that an officer sexually assaulted her during a traffic stop. Police Lt. Mario Camacho has been accused of retaliation by an officer under his command and of sexual harassment by a female cadet. Four city officials are charged with of misappropriation of public funds, embezzlement and conflict of interest resulting from a series of lavish trips to New York City that utilized over $200,000 of public funds.

Under the guidelines from JPIA, the city must hire a permanent human resources manager and council members must complete training on council relations and cooperation. If they do not complete the improvement plan, they risk losing coverage and will have to go to the open market or self-insure.

In September 2011, the JPIA issued a similar warning to the city of La Puente, Calif. As part of the “healthy members program” criteria, which outlines what members should do to stay within risk management guidelines, Insurance Journal reported that the town’s performance improvement plan required that La Puente “hire a permanent city manager, give notice of any harassment and retaliation complaints, and send council members to etiquette classes to learn how to get along.” The city recently completed the program and remains insured.

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So far, the only town to be officially cut off by the California Joint Powers Insurance Authority is Maywood. The city was dropped in 2010 and the lack of insurance forced the local government to lay off almost all of its employees and disband the police department.

Regional Conflicts in Workers Compensation

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This week I attended the 21st Annual National Workers Compensation and Disability Management Conference & Expo in Las Vegas. Among many of the sessions offered was one addressing the regional conflicts in workers comp. I sat in on the session addressing workers comp issues in the Northeast. Along with the moderator, there were three individuals representing the TPA, the carrier and the employer.

  • Steve Gidwitz, COO, NCA Comp, Buffalo, New York (TPA)
  • John Leonard, president and CEO, Maine Employers’ Mutual Insurance Company, Portland, Maine (carrier)
  • Richard Graham, corporate director, insurance and risk control, Crozer-Keystone Health System, Chester, Pennsylvania (employer)
  • Maureen McCarthy, senior vice president, Liberty Mutual, Boston, Massachusetts (moderator)

McCarthy began by addressing the economy and how it’s affecting workers comp in the Northeast and, more specifically, how it has impacted getting people back to work.

“In the health care system since 2007 we’ve had several layoffs,” said Graham. “The focus on impatient to outpatient care is the next big thing. We’ve actually had to shrink the workforce inside the hospitals.”

“In New York, before comp reform in 2007, the average weekly indemnity claim was $400, now it’s $702,” said Gidwitz. “Light duty or return to work programs are more important than ever.”

“The Northeast is the old rust belt — old union labor,” added Graham. “The economy has changed in terms of what drives it — meaning less manufacturing. We’re going through a transformative process in which we’re trying to interrupt the whole culture of the organization. Getting back to owning one’s job is important.”

McCarthy then questioned the panel about the consequences of recession in terms of fewer jobs and, maybe more importantly, an aging workforce in those positions that have weathered the storm. She referenced a study by Reuters, which states that during the peak of the recession, job loss in the private sector was 5-7% and 3-10% in the public sector. Another statistic stated that in 2000, 34% of workforce were 45 or older. Today that same statistic is 42%. The workforce is older than it was 10 years ago and continuing to get older. How has that changed workers comp, she asked.

“It has caused a shift in thinking at [the National Council on Compensation Insurance] in regards to younger workers getting injured more frequently than older workers,” said Leonard. “We see that it’s not related so much to age, but time on the job at that position. There is a dynamic shift underway that’s taking away the concept of age and focusing on time at work. New hires are more likely to be injured. Also, the nature and severity of injuries are increasing because as the workforce ages, the time it take to heal increases.”

McCarthy noted that a more mature workforce isn’t necessarily a bad workforce. “They tend to be more trained and well-versed,” she said. “However, when they are injured, it will take longer for them to return to work.”

Gidwitz and Graham said the focus should be on training. “When you get new employees, regardless of age, you must spend the time to train them properly,” Gidwitz said. “If they’re not trained properly, they develop bad habits and keep those bad habits.”

Graham took a tougher stance. “Do the employee a favor — sometimes you do them a favor by walking them out the door in the first 90 days,” he said. “On day 91, you’re stuck with them [if they are not following the training properly].”

In terms of obesity, Graham said it’s a national problem, not just an issue within the workers comp sector.

“We’ve got some transformative issues to go through as a country,” he said. “If your knee injury is because you’ve been morbidly obese your entire life, then is comp supposed to pick up half?”

“By 2020 or 2030, the percentage of people overweight or obese will be 80-85%,” noted Leonard. “As you look down the road, you have an older worker with physical problems due to lifestyle and you have the development of a crisis.”

Graham followed with his view on the obesity epidemic and its impact on workers comp. “The number of knee replacements that I’m paying for boggles my mind,” he said. “This person has been morbidly obese for 20 years and you’re telling me the knee replacement is work-related? There’s a storm coming — look at our workforce, look at the age, the health. We actually had a medic who had a heart attack while performing CPR.”