Workers Compensation Training Synergy Coverage Solutions

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Workers CompensationTraining
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Overview

• History of Workers Compensation
• Claims
• Claims Reporting
• Accident Analysis
• Accident Investigation
• Early Return to Work
• Post Accident Drug Testing
• Hiring Practices
• Slips Falls
• Back Safety
• Personal Protective Equipment
• Ergonomics
• Defensive Driving
• OSHA Regulations

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History of Workers Compensation

• Workers' Compensation in the U.S. began in 1911
  during the Progressive Era when Wisconsin passed
  the first statutory system. Other U.S.
  jurisdictions followed suit. In general,
  statutory Workers' Compensation systems strike a
  compromise, guaranteeing workers medical care and
  payment for lost time on a no-fault basis. Prior
  to the enactment of Workers' Compensation laws,
  injured workers had to file suit against
  employers (usually for the tort of negligence),
  and such legal actions had significant drawbacks
  for workers. At the same time, a successful suit
  could impose very large and unpredictable costs
  on an employer. Statutory Workers' Compensation
  systems provide for prompt payment of medical,
  rehabilitation, and lost time costs to injured
  workers, while placing limits on the cost of the
  system for employers. This trade-off became known
  as the "workers' compensation bargain" that is,
  the worker traded his/her right to bring a tort
  suit against their employer in exchange for
  prompt medical care and disability payments
  (indemnity payments). Thus workers compensation
  is the original "Tort Reform."

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History of Workers Compensation

• Workers' compensation provides insurance to cover
  medical care and Indemnity payments. While plans
  differ between jurisdictions, weekly payments in
  place of wages (functioning in this case as a
  form of disability insurance), compensation for
  economic loss (PPD, TPD and PTD), reimbursement
  or payment of medical and like expenses
  (functioning in this case as a form of health
  insurance), and benefits payable to the
  dependents of workers killed during employment
  (functioning in this case as a form of life
  insurance). General damages for pain and
  suffering, and punitive damages for employer
  negligence, are generally not available in worker
  compensation plans.

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Claims

• Injury by Accident there must be an accident
• Specific Traumatic Incident Back
  injuries/Hernias
• Occupational Disease Asbestosis, Carpal Tunnel
• Claim Accepted or Denied
• Denied Claim Form 33 Request for Hearing
• Mediation
• NCIC Hearing

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Reporting Claims

• The Employer should file a NC Industrial
  Commission Form 19 with the workers compensation
  insurance company within 24 hours following the
  accident.
• The Employee can file a NC Industrial Commission
  Form 18.

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NC Form 19 First Report of Injury
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NC Form 18 Employees Claim
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Claims Reporting

• According to an article published in April 1995
  issue of NATIONAL UNDERWRITER, prompt claim
  reporting significantly reduces the cost of a
  claim and likeliness of attorney involvement.
• Timely reporting allows for better coordination
  of medical treatment and rehabilitation efforts
  to get the injured employee back to work.
  Indemnity costs make up more than 50 of the
  total claims cost.

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Prompt Claims Reporting NATIONAL UNDERWRITER
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Why Investigate Accidents?

• To Prevent Future Accidents

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The Cost of an Accident

• Direct Costs
• Medical Indemnity costs associated with the
  injury.
• Indirect Costs
• Can be at least 4 times greater than direct costs
• Loss of productivity
• Employee morale
• Lack of experienced employee replacing injured
• Time taken away to investigate accident
• Time taken away to deal with claims issues
• Cost of broken equipment
• Higher Workers Comp. premiums due to higher
  experience mod.

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Conducting an Accident Investigation

• Respond immediately.
• Investigate to find the facts.
• Analyze the facts to determine the root cause.
• Develop specific corrective actions.
• Review findings with employees (Lessons Learned
  from Losses).

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Early Return to Work Program

• A formal written Plan designed to return
  injured employees back to work in some limited or
  modified duty capacity as quickly as medically
  feasible.

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Benefits of ERTW

• Reduce workers compensation costs
• Brings the injured employee back to wage earning
  capacity sooner
• Shortens length of medical treatment
• Lowers cost of claim (TTD)
• Prevents malingering and symptom magnification
• Gives injured worker an opportunity to contribute
  to the company
• Injured worker remains active and productive

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The objectives of a modified duty program

• Familiarize/educate each employee with the
  modified duty programs prior to an injury.
• To provide each employee with support during
  recuperation due to an on-the-job injury.
• To provide employees with a means to maintain a
  productive lifestyle.
• To control claim cost.
• To help reduce experience modification factor

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Early Return to Work

• Commitment to the program by management and
  supervisors
• Written policy in place
• Determine restricted duty jobs
• Follow Doctors restrictions
• Work closely with your W. C. claims dept.

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ERTW Process

• Prepare in advance written modified duty job
  descriptions
• Have these job descriptions given to the initial
  medical care provider selected by the employer.
• The adjuster or employer should have the medical
  doctor sign off on the modified duty job
  description
• Have these job descriptions ready to give to the
  claims adjuster.
• Offer the modified duty job to the injured
  employee in writing and we recommend via
  certified letter.

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Post Accident Drug Test

• NCGS 97-12
• Law changed 2005
• Burden of Proof
• 2005 law changed from the Employer having to
  prove the drug was a proximate cause to the
  Employee having to prove it was not a proximate
  cause
• What did this change?

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Hiring Practices and Workers Compensation Claims

• Typically a bad hiring decision results in a
  Bad workers compensation claim

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Hiring

• Application
• Interview
• Background checks
• Reference checks
• Motor Vehicle Record evaluations
• Criminal background checks
• Pre-employment drug screening
• Post Offer Medical Questionnaire

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Loss Prevention

• Slips, Trips, and Falls
• Back Safety
• Personal Protective Equipment
• Ergonomics
• Defensive Driving
• OSHA Regulations

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Significance of Slips and Falls

• Over 540,000 slips and falls each year requiring
  hospitalization
• Slips and falls account for over 300,000
  disabling injuries each year
• One in three serious bone breaks for seniors
  result in death, within one year of the accident.
• It is the second leading cause of accidental
  death and disability after automobile accidents.
• Slip and fall accidents account for 30 of all
  reported injuries.

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Slips Falls

• Periodic safety evaluations of each business
  location.
• Improve employee awareness to slips falls at
  office and their clients locations.
• Conduct initial and periodic employee safety
  training on slip fall prevention.
• Require proper shoe wear.

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Back Safety - Patient Handling

• Health Care is the only profession that thinks
  100 pounds is light.
• Employee Safety Training - Review proper lifting
  techniques with all employees on a regular basis.
• Employee Safety Training - Periodic review on how
  to handle patients within the home and work
  environment.
• Use mechanical lifts whenever possible.

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Back Safety - General

• Techniques bend at the knees
• Keep load close to the body
• Plan the lift synchronize
• Stay healthy diet/regular exercise
• Stretching exercises

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Personal Protective Equipment

• Engineering Controls
• Protect employees from chemical and physical
  hazards
• Safety glasses, face shields, steel-toed shoes,
  gloves, respirators, etc.
• Policy development and enforcement

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Ergonomics

• Musculoskeletal Repetitive Motion
• Engineering Controls task redesign fitting the
  task to the employee, ergonomic tools
• Administrative Controls employee rotation,
  exercise programs
• Workstation evaluation

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Vehicle Accidents are Expensive

• Motor Vehicle Accidents are the No. 1 cause of
  workplace fatalities.
• According to the National Highway Traffic Safety
  Administration, motor vehicle crashes cost
  employers more than 50 billion every year in
  medical care, legal expenses, property damage,
  and lost productivity.
• When a worker has an on-the-job crash that
  results in injuries, the cost to the employer is
  more than 24,000.
• In one year, employer medical care spending on
  crash injuries was nearly 9 billion. Another 9
  billion was spent on sick leave and life and
  disability insurance for crash victims.

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Vehicle Accident Prevention

• MVR review upon hire and annually thereafter.
• Periodic employee training on Defensive Driving
  is critical.
• Training can take 30 minutes to 1 hour in length.
• Defensive Driving training presentation (video or
  PowerPoint), and short test to validate transfer
  of knowledge.
• Do hands-on training for preventative
  maintenance.
• Written test remains in training file

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Defensive DrivingTopics Reviewed

• Defensive Driving Techniques
• Cell phone policy and usage
• Preventative Maintenance
• Daily, Weekly, Monthly Vehicle inspection
• 2 and 3 second rules Following Distance
• Adverse driving conditions
• Speed kills
• Seat belts

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OSHA Regulations

• 29 CFR Part 1910
• Hazard Communication
• Means of Egress
• Powered Industrial Trucks (Forklifts)
• Hearing Conservation
• Machine Guarding
• Electrical

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Safety Resources

• Your Insurance Carrier (workers compensation,
  auto, property, liability, etc.)
• Federal OSHA website..www.osha.gov
• Centers for Disease Control and
  Preventionwww.cdc.gov
• National Safety Councilwww.nsc.org
• NC Occupational Safety and Health
  Divisionwww.dol.state.nc.us/osha/osh.htm
• North Carolina Industrial Commissionhttp//www.co
  mp.state.nc.us/ncic/pages/safety.htm
• NC Dept. of Labor Video Library
  www.nclabor.com/lib/libaud.htm

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Summary

• Safety begins with upper management.
• To be a successful company, safety is everyones
  responsibility.
• Designate a person responsible for Safety.
• Ask for assistance.
• Do NOT quit on your Safety Program.
• Comply with OSHA (www.osha.gov).