April 2010 Archives

Earlier this month the New Orleans Saints pushed House Bill 1097 proposed by Rep. Cameron Henry in an attempt to lessen their burden of workers' compensation expenses for injured players. The bill, as it was initially drafted, would require professional athletes for Louisiana teams to be subject to workers' compensation benefits under Louisiana laws should they be injured in a game or during practice. The bill addresses a recent surge of injury claims, some of them decades old, filed in California by former Saints players that would not be allowed under Louisiana workers' comp laws. However, with legal concerns about a carve out specialty for athletes, Rep. Henry broadened the language of the bill to apply to all workers in Louisiana. The bill is causing major hearburn for some.

The bill was approved and sent to the House floor for debate, even though the NFL, lawmakers and workers' compensation attorneys have all expressed major concern over the impact the bill may have in terms of "unintended consequences."

The debate involves NFL football and a dispute between the team owners and former players over injury claims. The NFL, and the Saints in particular, have seen a rise in the number of trauma claims filed in California. Apparently, the laws there are more lenient and allow players to file a claim if their team ever played a game in California, or if they had a California agent. The NFL Players Association asserts that these issues should be addressed through the collective barganing agreements between players and team owners and warned that if the bill is passed, it may very well end up in court.

Read "Bill Targeting Workers' Comp Issues Expanded," as it appeared in the Insurance Journal earlier this month.

Where to start? Here's a quick tour of "who" is saying "what" in workers' comp...

Get Ready for More Change

As Joe Paduda writes on his blog today, we don't really know what's coming. But we better be prepared for change. His post, Where the work comp world is heading - Part 1 is an interesting read. Drawing from years of experience in the insurance industry, Joe has a very seasoned and unique perspective on how things work in the world of workers' comp. It will be hard to wait for Part 2.

Fallen Workers Remembered

Kudos to Julie Ferguson from Workers' Comp Insider for her post yesterday about Workers' Memorial Day. We've written about work fatalities in the past and how many of these accidents could be prevented if proper safety precautions are taken. She also does a stellar job of summarizing recent highly publicized disasters in which workers have been killed. It's a very sobering but good read.

Positive Trends on The Horizon?

Roberto Ceniceros writes on Comp Time of discussions he had at RIMS with underwriting executives who think they are seeing positive trends. Read his post titled State Budget Woes Impacting Claims Duration. Positive trends may be on the rise.

Kids Chance

Lexis Nexis Workers' Compensation Law Blog posts about a national nonprofit organization called Kids' Chance. The organization helps children of workers who are seriously injured or killed while on the job by providing scholarships for education. Learn more about this organization in the blog post titled About Kids' Chance: Helping Children of Workers Seriously Injured or Killed on the job.

NCCI Publishes New Study on Cost Drivers in Loss Development

For all you actuaries out there, NCCI has just published a new study titled, get ready because it is very long, Identifying and Quantifying the Cost Drivers of Loss Development: A Bridge Between the Chain Ladder and Statistical Modeling Methods of Loss Development. The study, according to NCCI, addresses their recent work on enhancing the modeling of loss development.

Health Wonk Review

And last but not least, Health Wonk Review: NBA Playoffs Edition has just been posted by Healthcare Economist. While I must admit, I'm still trying to get up to speed on what exactly the Health Wonk Review is, I have noticed that it is highly anticipated and perhaps revered in the complex world of workers' comp.

Whew! My brain is tired after that tour. Next time, I think I'll use my bike.

Our Freaky Comp Friday post is not so freaky, just a bit odd. A state appeals court has decided that a Wendy's Restaurant employee is in fact entitled to workers' compensation benefits previously denied. She was injured during a fall at the end of her work shift after she hugged a co-worker in January 2008.

According to an article posted on Chicago Workers' Compensation Lawyer Blog, Wendy's Restaurant Employee Who Hugged Worker Before Getting Hurt...the employee,  who underwent knee surgery and physical therapy, was originally denied benefits. The original ruling cited that the hug was a deviation from her normal work activities and therefore not a required activity in order to perform her job.

A three judge panel found that even if the hug in question was a deviation from her normal work duties, the fall happened after the hug, not during it, so the employee was in the process of performing her normal work duties and should receive benefits.

So, there you have it. If you are going to hug people at work, make sure you don't get injured in the process of the hug, otherwise, it may not be a compensable injury.

Total Medical Solutions' Zack Craft, vice president of rehabilitation technology and complex care, has written an excellent article on the importance of managing permanant disability claims with special attention. Permanent disability claims, also known as complex claims, are defined as involving more than one body system and separate diagnoses, Zack points out that while these kinds of claims make up only 1.1 percent of the total claims, they account for nearly 12% of the medical costs in workers' comp.

Read his article, titled "The Calculus of Permanence," recently published by Risk and Insurance.

If you manage complex care claims, make a commitment this Earth Day to manage your claims the GREEN way. Consult with a company such as Total Medical Solutions who specializes in complex care claims. You can save money by avoiding unnecessary claim costs, avoid wasted supplies and materials, provide more appropriate care and make your claimants happier by doing it.

Nothing fancy about today's post. Just the retelling of a story I heard from Cara Barde, President of Total Medical Solutions last week. She says this kind of thing happens frequently. It is unbelievable, but true. The nature of the claimant's injury here is really not relevant, so I'm not going to go into those details. Just straight to the point...

Claimant Requests Room Add On

A client called on TMS to review a case where the claimant needed to remodel their home. Basically, the claimant was asking for a room addition. So, naturally, TMS sent a rehab technician to the claimant's home to assess the situation. When the technician asked the claimant why they needed the extra space, the claimant said, "I need it to store all of my medical supplies." So, the TMS technician asked to see the supplies.

Too Many Medical Supplies

The technician was quite surprised to find that the claimant was storing several rooms full of medical supplies. Rows and rows of boxes that were apparently being auto-shipped to the claimant. The supplies were, in fact, all relevant supplies based on the claimant's injury and condition. However, upon further investigation, the TMS technician discovered that the claimant had recently come home from an extended stay in the hospital. He had been in the hospital for over three months, due to some complications. The supplies continued to be shipped, even though the claimant was in the hospital and didn't need them at home.

How Much Are YOU Spending on Wasted Medical Supplies?

Seems like a simple mistake, right? This one case amounted to several thousand dollars worth of unnecessary supplies being shipped to a claimant. Had TMS not been called into action, it could have been a mistake worth over $100,000. And for what? For a room addition to store medical supplies that weren't needed in the first place. I wonder how many mistakes like this happen on an annual basis....you do the math.

A judge in Louisiana has ordered an oil refinery company to pay $250,000 to five former workers in a hearing loss case. Murphy Oil Company must pay each worker $50,000 for noise-induced hearing loss. Read the full story Hearing Loss Case Costs Company $250,000.

The company may be facing more charges...the court is yet to rule on 35 additional claims by former employees. Based on the rulings of this case, the company could be facing fines up to $2 million, if each employee is awarded $50K.

The story also highlights a small point of interest: during a $35 million plant expansion in the late 1970s, Murphy Oil decided against spending $110K on noise control equipment. Say what?

Thanks to SafetyNewsAlert.com for sharing this story.

In an effort to discourage misuse and abuse of the drug OxyContin, the FDA has approved a new formulation of the medication. The drug is prescribed for the management of moderate to severe pain when a continuous analgesic is needed for an extended period of time. Read the FDA's news release FDA Approves New Formulation for OxyContin.

In its new form, the drug is harder to crush, cut, chew, ground, or dissolve in liquid. While it is not expected to be the "end all" for OxyContin addiction and abuse, experts agree that it is a step in the right direction. The new formulation is really aimed at cutting down on the number of accidental overdoses related to the drug that occur each year. According to the FDA, about half a million people people used OxyContin for the first time for non-medical reasons in 2008, citing statistics from the U.S. Substance Abuse and Mental Health Services Administration.

Other recent news on OxyContin...

Los Angeles Times Article - OxyContin Gets a Safety Makeover 

New York Times Article - Harder-To-Break OxyContin Pill Wins Approval

NPR - Prescription Drug Overdoses Send More People to Hospitals

This is not the first time I've read about a case like this, but it still makes the cut and is my pick for Freaky Comp Friday...

An employee working for the City of Detroit filed a lawsuit under the Americans with Disabilities Act, claiming that her co-workers perfume made it difficult for her to breathe. According to the story titled "Employee wins $100K over allergy to co-workers perfume" on SafetyNewsAlert.com, the city did not think her perfume allergy qualified as a "major life activity." The judge on the case disagreed with the city, citing that breathing is, in fact, a major life activity. Under the settlement, the city will now have to enact a new policy on personal scents, including posting notices in building where the employee works advising other city employees not to wear scents at work.

One company turned the situation into an opportunity to promote their product - an uncented deodorant called Crystal. They recently distributed free samples to City of Detroit workers.

A little personal history...being an allergy sufferer myself, I endured years of misery dealing with co-workers various scent habits. I used to work with a woman who was a chain smoker. After going out for a smoke, she covered herself in heavy perfume that made me dizzy, nauseated and typically resulted in a pounding headache. I was never sure if it was the smoke, the perfume or the toxic mixture of the two "scents" that made me sick. I just know for the duration of the time that I worked with this woman, which was over two years, I did not feel well most of the time. Then there was the boss who used to rub scented lotion on her legs right through her pantyhose in the middle of staff meetings. Rubbing lotion through one's pantyhose in front of co-workers is a topic for another day. But the "lotioning" always triggered an immediate sneezing fit for me, that typically resulted in a pounding headache. I never filed a lawsuit. Like most people, I just suffered through it. The topic of personal scents poses a real dilemma, though, both for employees and for employers. 

The topic of "scent management" at work or "fragrance free work zones" may seem frivolous, but cases like these are on the rise. See another case of an employee who filed a lawsuit in South Carolina recently in the article titled "Customer's perfume made her sick...".

The lesson learned with the City of Detroit example is to at least take employees complaints seriously. If it is important enough for an employee to complain in the first place, employers may save themselves much time and money by considering what can be done to accommodate the complaint BEFORE it is taken to the courts.

If you are an allergy or asthma sufferer, talk to your employer about implementing a fragrance-free work zone.

Employers, the American with Disabilities Act was amended as of Sept 28, 2008. The law makes it clear that employers and courts should use a broader interpretation of the term "disability." As this is the case, you may consider adding Fragrance Sensitivity to your safety policy manuals, and/or provide updated training to your managers to avoid discrimination law suits. Here are some resources for you:

ADA Amendments Act of 2008: Frequently Asked Questions, a compilation of frequently asked questions about the ADAAA of 2008.

Employees with Fragrance Sensitivity, a handbook published by the Job Accommodation Network, a service of US Dept of Labor, Office of Disability Employment Policy.

Avoid the Courtroom: Employee Disability Awareness and Sensitivity Training, an article posted on www.HRtools.com

Other articles of interest:

Living Without Magazine recently published this article: Scent Sensitive - Fragrance Free

Allergic Living Magazine published this article: Allergies: Plants That Clean Your Home Air