Category Archives: Workplace

Workers Compensation Issues to Watch in 2014

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With 2013 behind us, here are my thoughts on some workers compensation issues to watch for in 2014:

Rates Continue to Climb

In most of the U.S., rates for workers compensation insurance continue to rise. Rates are being driven by rising medical costs, the low interest rate environment, and the general unprofitability of the line of business.

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Potential Expiration of TRIPRA

Unless Congress takes action, the Terrorism Risk Insurance Program Reauthorization Act (TRIPRA) will expire on Dec. 31, 2014. Companies with high employee concentrations in certain cities are already seeing fewer options, with some carriers scaling back their writings to reduce their exposure to a potential terrorism event.

Impact of the Affordable Health Care Act (AHCA)

There has been much speculation about the potential impact the AHCA will have on workers compensation. With a finite number of medical providers available to handle the increased utilization, it is imperative that workers compensation payers identify the providers who deliver the best clinical outcomes for injured workers.

Integrated Disability Management

More employers are realizing that the impact of federal employment laws, like the Americans with Disabilities Act and the Family and Medical Leave Act, must be considered on workers compensation claims. Companies are also recognizing the value of managing non-occupational disability so that valued employees can get back to the workplace and be productive. Integrated disability management programs are the next generation of claims-handling and will expand in the future.

State Legislative Issues

Several states that passed significant reform legislation in the last two years are working to implement those reforms. Passing a law is only the first step, as the rules, regulations, and implementation of those laws determine if they will achieve their intended purpose. The most significant states to watch are in California, New York, and Oklahoma.

When California passed SB 863 in 2012, the expectation from the state’s legislature was that it would increase benefits to injured workers, while lowering costs for employers in the state. Litigation and unanticipated consequences of the bill have resulted in increased complexity and continually rising insurance rates. There is currently talk of potential clean-up legislation to go along with continued efforts at implementation. We will know by the end of the year whether SB 863 will be able to produce the promised cost savings.

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New York streamlined its assessment process, resulting in a significant reduction of the assessment rate for most employers. Since these rates are adjusted annually, it remains to be seen if these assessment savings will continue into the future.

The big news in Oklahoma is the bill that allowed employers to opt-out of workers compensation starting in February 2014. There have been delays in developing the rules and regulations supporting the opt-out plans, and this has in turn delayed carriers’ development of policies to cover new benefit plans. It appears unlikely that everything will be in place in time for employers to opt out beginning in February.

Vendor consolidation

In the last few years, there has been significant vendor consolidation in the workers compensation industry. First on the third-party administrator side and most recently in medical management. All this consolidation is making buyers of these services uneasy.

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They question how this will impact the quality of the services they receive and wonder how their goals of reducing costs align with the vendors’ goals of increasing revenues.

Analytics

Despite the huge amount of premium, exposure and claims data produced by the workers compensation industry, many complain about the lack of actionable information. As an industry, we will see a continued focus on the use of more meaningful analytics that can assist in identifying savings opportunities, formulating action plans, and measuring the impact of change.

Assessing ROI for Medical Cost Management Efforts

Programs including bill review, utilization review, and nurse case-management are all necessary components of any successful workers compensation program. It is important, however, that these programs are constantly monitored to ensure they are being used appropriately.

Please join me Jan. 15, for a webinar discussing these issues and other potential legislative developments to watch in 2014.  Click here to register

New Year, New Natural Disaster Emergency Plans

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Along with January renewals and analyzing whether existing policies offer sufficient coverage, the new year is a perfect reminder to review company-wide emergency plans. While 2013 may have been a relatively light year for catastrophe losses, there’s no reason to assume 2014 will be, too.

Check out this infographic from Boston University’s Masters in Specialty Management program for a jump-start on identifying the risks of natural disaster and updating plans for how to handle any emergency:

Survive a Natural Disaster

 

Plan Ahead for Holiday Party Risks

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Holiday office parties are a good opportunity to bring employees together, but they present potential risks for organizations. With social media added to the mix, even slight misconducts can be amplified if they go viral. What might have been an embarrassment handled quietly by a company can quickly become a reputation issue.

According to an article by Lloyd’s, the addition of social media “can seriously impair a company’s ability to manage a crisis,” said Eric Alter, Risk Consultant at Marsh Ltd.

“Social media and business entertainment can be a challenging mix—whether it is a sales conference, awards dinner or a Christmas party—the use of social media in the work environment has to be carefully considered,” he said, adding that websites like Twitter, Facebook and Instagram enable almost instant sharing of information, but even email can cause problems. An employee intending to send a funny email to a coworker, for example, could accidentally send it to clients.

Steve Adcock, Underwriting Manager at QBE Europe observed that alcohol can lead to a heightened risk of inappropriate comments, behavior or even assault. “People can lose their inhibitions and may not think about what they say or do,” he said. “Employees will not always get along at the Christmas party. Disagreements can lead to hurt feelings through to a potential assault.”

Paul Griffin, Head of Employment and Labor at international law firm, Norton Fulbright cautioned that an employer is liable for the wrong doings or injuries of their employees, unless they can show they have taken all reasonable steps to prevent them.

To protect themselves and their employees, organizations need to advise staff attending a party that the usual company rules still apply, Alter advised. “A company policy should make it clear that any event that is associated with work should be treated as work, and that the social media policy continues to apply.”

OneBeacon Professional Insurance noted in “A Guide to Minimizing Risk at Company Holiday Parties,” that because of the infrequency of company-sponsored holiday events, liability risks are often overlooked. Concerns such as liquor consumption, premises safety and security, discrimination and food borne illness are just a few of the issues that need to be addressed to help prevent injuries or even harassment.

According to the report, any accidents or injuries occurring at company events may be considered work-related and could possibly be subject to workers compensation.

To help avoid safety mishaps OneBeacon advises:

• When using a venue away from the office, inspect it to ensure it meets safety standards. Note exits, emergency lighting and whether there is flooring to prevent slips and falls, particularly if there is a chance of bad weather.

• Consider the effects that weather may have on safe travel to and from the party. Special considerations may be needed to keep sidewalks and parking lots clear if the event is outside of normal business hours.

• Think about potential security needs, especially if the event is in an unfamiliar neighborhood or of the venue is closed to the general public.

• Keep an eye on party-goers to ensure that no one wanders off or goes to a car or parking garage alone after dark.

• Have an emergency plan in place in case someone is injured or needs medical assistance. Find out the location of the closest hospital and whether anyone can perform CPR or use a defibrillator.

• Review situations for employees with disabilities who may require special attention. For example, if a disabled employee must use a wheelchair, check that there is a safe entrance, navigate the event and know how to deal with a possible emergency.

Minimizing the Dangers for Hospital Nurses

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Nurses in Emergency Room

In “Bad Medicine,” from the December issue of Risk Management magazine, Alan H. Rosenstein wrote about managing the risk of disruptive behaviors in health care settings, which he defined as “any inappropriate behavior, confrontation or conflict, ranging from verbal abuse to physical or sexual harassment, that can negatively impact patient care.
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” More than half of respondents in one survey felt these events led to medical errors and compromises in patient safety and quality of care, Rosenstein reported.

But the risks nurses face do not just come from within the staff—simply doing their jobs presents a minefield of potential danger to physical and mental health. According to the Occupational Safety and Health Administration, those who work in nursing are the most likely to face violence on the job. Over 54% of emergency room nurses report experiencing physical violence or or verbal abuse on the job, of whom 41% report they have been punched or slapped at work and almost 28% report being pushed, shoved or thrown.

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Nearly 98% of physically violent incidents against nurses are perpetrated by patients, who are also responsible for 92.

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3% of verbal abuse in the health care setting.

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Check out the infographic below for more details on the risks nurses face, and some preventative best practices to minimize risk for hospital workers:
The Dark Side of Nursing
Source: TopRNtoBSN.com