Obesity drives up workers’ comp claims

Originally posted November 21, 2013 by Dan Cook on http://www.benefitspro.com

Obese employees make more workers’ comp claims, and they make costlier ones than non-obese employees.

That conclusion was drawn by Lockton Companies based on its review of several independent studies on employees with high health risks (including obesity, smoking, high blood pressure and limited physical activity) and workers’ comp claims.

The Kansas City, Mo., provider of risk management, insurance, and employee benefits consulting services cites three studies that, when taken together, paint a troubling picture, especially of the impact overweight workers can have on workers’ comp claims.

Lockton says that wellness programs, properly designed and implemented, can address this situation by helping obese workers lose weight. But Lockton doesn’t offer any stats on how effective wellness programs are overall in combating obesity.

Still, the studies cited offer food for thought.

The University of Michigan Health Management Research Center studied Xerox Corp. employees and confirmed that “employees with high health risks tended to have the highest workers’ compensation costs.”

Xerox was an early proponent of wellness plans. The UM followed employees for four years and reported that “workers’ compensation costs increased for those employees whose health risks were increasing or high already (e.g., smoking, physical inactivity, hypertension, high cholesterol, and life/job dissatisfaction).”

Lockton also refers to a 2010 study by the National Council on Compensation Insurance which more closely correlated obesity with workers’ comp claims.

The data “showed that workers’ compensation claims that included the obesity comorbidity diagnosis incurred significantly higher medical costs than comparable claims without the high health risk. NCCI also discovered that claims for employees identified

as “obese” almost tripled from 2000 to 2009 from 2.4 percent to 6.6 percent,” Lockton said.

Lockton then cites a more recent NCCI study testing whether “the lost-time duration of obese claimants is a multiple of non-obese claimants.”

It was.

“According to their findings, obese claimants incurred medical costs 6.8 times higher than non-obese (as defined by body mass index), were twice as likely to file a claim and an indemnity duration that averaged about 13 times higher,” Lockton summarized.

What Lockton suggests is that companies take the following steps to empower their wellness plans to really help employees address chronic health issues:

  • Proactively engage HR and employee benefits to better understand the scope and breadth of existing corporate wellness initiatives, as well as how the organization is tracking the effectiveness of those programs.
  • Determine how your insurer and/or third party administrator is capturing data on comorbid factors in workers’ compensation claim files and how that information can be incorporated into effective analytics.
  • Collaborate with internal safety, health, and environment professionals (if applicable) to discover how best to integrate employee wellness with workplace safety.

“Effective corporate wellness initiatives have shown to be successful in not only reducing the duration of lost-time workers' compensation claims,” said Lockton's Michal Gnatek, author of the report, “but also in promoting healthy behaviors that potentially inhibit unsafe or inattentive workplace behavior.

“Risk managers and claims professionals should be adding employee wellness to the available arsenal of weapons to combat increasing claims.”


Thousands of California injury claims made by professional athletes

Originally posted Ken Bensinger on September 25, 2013 on http://www.latimes.com

The National Football League’s increasingly visible injury legacy has become a topic of national debate, one that threatens to cast a lasting shadow over the country’s most popular, and profitable, sport.

Far less attention has been paid to the physical woes of other athletes, but a review of injury filings in California suggests that professional athletes of all stripes walk away from their sports with nagging and often permanent injuries.

Over the past two decades, more than 2,500 claims have been filed by former baseball, basketball, hockey and soccer players against their former teams in California’s workers’ compensation system.

In the past six years, more than 940 of them -- among them stars such as two-time baseball most valuable player Juan Gonzalez and basketball legend Kareem Abdul-Jabbar -- have made filings alleging serious brain and head injuries.

The claims were isolated as part of a Los Angeles Times analysis of more than 3 million filings made to the California Division of Workers’ Compensation. Last month, The Times published a searchable database of claims by football players, and now it's being updated will all other major team sports.

Database: workers' comp claims by baseball players

Database: workers' comp claims by basketball players

Database: workers' comp claims by hockey players

Database: workers' comp claims by soccer players

Database: workers' comp claims by women's basketball players

Although the total number of claims from all other sports combined is significantly smaller than those made by football players, which number nearly 5,000, the data are a clear indication of the lasting toll professional sports leave on all athletes.

They also help explain why Major League Baseball, the National Hockey League, the National Basketball Assn., the Women’s National Basketball Assn. and Major League Soccer joined the NFL in a push to pass legislation in California that would seriously restrict such claims in the future.

That bill, AB 1309, easily passed the Legislature this month and is now on Gov. Jerry Brown’s desk. If he signs it into law, it would preclude all athletes who played for non-California teams, as well as many California athletes, from making claims for the most serious types of injuries, incurred over time and known as cumulative trauma.

The leagues, as well as their insurers, say the claims should not be filed in California. However, the players unions in each sport retort that such claims are generally not permitted in other states due to narrow definitions of cumulative trauma or expired statutes of limitations.

Organized labor worries that the measure potentially opens the door for future legislation that could deprive workers in other industries of their ability to file here. Because teams and their insurers pay the entirety of costs of successful claims without a dime of taxpayer money, unions argue that the bill would amount to a huge handout to billionaire owners of professional teams.

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Unlike civil lawsuits, which workers cannot file against their employers for workplace injuries, workers’ compensation awards are strictly limited in size and scope and may include lifetime medical care. Still, spread across thousands of injured players, the costs can mount quickly.

For example, former baseball all-star Cliff Floyd received a $102,500 settlement from the San Diego Padres for injuries to the brain, face, neck, shoulders and numerous other body parts this past April, documents reviewed by The Times show. Floyd, who retired after the 2009 season, now works as a television and radio analyst.

Overall, more than 900 baseball players, including many minor-leaguers, have made claims in California since 1990, The Times’ data show. Of them, at least 460 allege cumulative head or brain trauma, which has been linked to conditions including dementiachronic traumatic encephalopathyand Alzheimer’s disease.

Since 2006, WNBA players have made 87 filings in the state, while professional soccer players have made 51 claims in that period. Although it’s not known for its jarring physical collisions, an increasing number of soccer players are alleging head trauma.

Among them is former U.S. national soccer team star Eric Wynalda, who filed in 2009 claiming cumulative injuries to a host of body parts including his head. In 2011, he won a $127,500 settlement paid by the Chicago Fire of the MLS and the Charleston Battery of the United Soccer Leagues. Settlement figures do not include attorney fees.

Claims by former stars garner the most attention and tend to be held up by the sports leagues as evidence that California’s system has been too generous to people paid millions of dollars to play sports.

But a substantial majority of the claims come from athletes who never made anyone’s all-star list, enjoying relatively short careers and frequently earning the league minimum. Hundreds more were filed by people who never made it to the big leagues, earning little better than the minimum wage in the minor leagues, including Arena Football, the XFL as well as minor-league baseball and hockey, data show.

Even in professional sports’ lowest levels, however, the contact is hard and the physical toll apparently very real. During his career, defenseman David Cousineau skated for teams such as the Las Vegas Wranglers, Phoenix Roadrunners and Long Beach Ice Dogs, earning just $650 a week toward the end of his five-year career.

The rangy Canadian never saw a minute of NHL ice, but his workers’ compensation filing in California details a string of traumas to his head, shoulders, back and legs. In 2010, Cousineau won a $68,000 settlement from his last two teams, agreeing to permanently forsake all future claims and to cover his own medical expenses in exchange.



How to Keep Unneeded Lawyers Out of Workers’ Comp

How to Keep Unneeded Lawyers Out of Workers’ Comp (via CFO.com)

Risk Management | November 27, 2012 | CFO.com | US It's no secret that workers’ compensation cases involving attorneys are generally more expensive. In fact, workers’ compensation, started a century ago to remove workers and their employers from the tort system, remains highly litigious. It does…

Read more

How to Determine if Your Company Picnic Could Create a Workers Comp Claim

By Rebecca Shafer-ReduceYourWorkersComp
Source: workerscompensation.com

Many Factors to Consider if Injury is Covered

Summer picnics, softball games, corporate retreats and golf outings all sound like fun.  When all the attendees are employees and an injury occurs, is it covered by workers’ compensation?  “It depends” is the answer the claims adjuster or corporate counsel will give you.

In order to determine if workers’ compensation is applicable, the adjuster will have to ask a lot of questions.  While the criteria may vary from state to state, the following are general guidelines to separate a workers’ compensation injury from a personal injury that is not covered by workers’ compensation.

  • Is the event employer sponsored or employee sponsored?
  • Is the event primarily financed by the employer?
  • Does the employer benefit from the event by providing training or presentations, or by making morale speeches or passing out special achievement awards?
  • Does the employer mandate attendance or is attendance voluntary?
  • Does the employer encourage attendance by making a record of attendance?
  • Were the employees paid for the time in attendance?
  • Were employees who chose not to attend required to work their regular job if not in attendance?
  • Do the employees regard the event as a fringe benefit they are entitled to?
  • Does the social event occur during normal work hours?

If the answer is “yes” to most of the above questions, the injury most likely will be covered by workers’ compensation.

Activity of Employee at Time of Injury Big Factor

However, the activity of the employee at the time of the injury is also a factor in whether or not the injury is workers’ compensation related.  For example – the corporate retreat is to be held Friday, Saturday and Sunday at a five star resort.  The sales manager arrives on Thursday night to enjoy the amenities of the resort.  While walking down the grand staircase in the hotel lobby, he trips and falls, and fractures both arms.  Even though the sales manager was required to be at the resort as a part of his job, the injury occurred while the employee was there on his own time.  The employer received no benefit from the sales manager arriving early to enjoy the amenities of the resort prior to the official start of the corporate retreat.

In the above example, if the same fall and injury had occurred during the course of the meeting on Saturday, while the sales manager went from one presentation to another, it would be covered by workers’ compensation.

When the benefit of the social event to the employer is hard to measure, any injury occurring is normally not workers’ compensation.  This is often true with sporting events such as the company softball team, bowling team, volley ball team, etc.  When the company allows the team to use the corporate name in the sports league but does not schedule the sports events, does not provide financial support and keeps no records of participation, any injury will not be covered by workers’ compensation.  When all participation is totally voluntary and the sporting event is after normal business hours, any injury that occurs is not workers’ compensation.  For example – the first basemen for the company sponsored softball team breaks his ankle sliding into home plate with the winning run in the bottom of the ninth inning.  [WCx]

If Social Event Being Paid in Lieu of Work, Injuries Covered

When the social event is company sponsored and the company encourages participation, even if attendance is voluntary, if an injury occurs during the event, it is workers’ compensation.  For example – the office Summer Picnic at the major amusement park is a huge event, and is considered a fringe benefit paid for by the employer.  It is held on a week day when the employees would otherwise be working and the employees are being paid their regular earnings while attending the Summer Picnic.  While doing the Limbo dance, the secretary injures her lower back.  The injury would be covered by workers’ compensation due to the event being paid for by the employer, the employee being encouraged to attend and the employee being paid while participating in the event.

Social events can result in workers’ compensation claims.  The facts surrounding the social event and the facts surrounding what the employee was doing at the time of the social event will be the determining factor in whether or not an injury is a workers’ compensation claim.

OSHA launches heat safety phone app

Source: http://www.wave3.com
By Joey Brown

LOUISVILLE, KY (WAVE) – The extreme heat can be a work hazard for some people, and for that reason, the Occupational Safety and Health Administration (OSHA) has created a mobile phone app to help keep workers safe.

The OSHA Heat Safety tool provides vital safety information whenever and wherever it is needed on workers' mobile phones.

The app allows workers and their supervisors to calculate the heat index for their work site and displays a risk level to outdoor workers. It also issues reminders about protective measures that should be taken at that risk level to protect against heat-related illnesses.

Under the Occupational Safety and Health Act, employers are responsible for the safety and health of their workers, including conditions that could lead to heat-related illness.

To get the free smart phone app, search for "OSHA Heat Safety Tool" at the App Store.


How can company policies prevent injury?

Source: http://www.riskandinsurance.com

Implementing, enforcing policies can improve bottom line, study suggests

Prescription drug abuse, texting, and falls by older adults are among the emerging injury threats cited in a new study. It suggests policymakers and others implement and enforce policies to reduce preventable injuries.

More than $400 billion is spent annually in lifetime costs for medical care and lost productivity resulting from injuries. While the report focuses on steps states can take to prevent injuries, the recommendations are also appropriate for employers trying to reduce workers' comp costs and improve their bottom lines.

Injuries are the third-leading cause of deaths nationally, according to the researchers. Among the most common types are:

  • Falls. "More than eight million Americans suffer falls that require medical attention each year," it says. One in three people age 65 and older experiences a fall annually, and falls are the leading cause of injury deaths in adults over 65 years of age. Falls can be reduced "by as much as half" among participants involved in exercise programs.
  • Violence. Injuries caused by intimate partners alone cause more than 2,000 deaths a year. Nearly three in 10 women and one in 10 men have experienced physical violence, rape, or stalking by a partner.
  • Misuse and abuse of prescription drugs. The report notes the dramatic increase in the past decade, saying prescription painkillers are responsible for approximately 15,000 deaths and 475,000 emergency room visits a year.

For employers, injuries mean lost productivity as well as increased workers' comp and health care costs. Adults between the ages of 25 and 44 comprise 30 percent of the U.S. population but account for 44 percent of injury-related productivity losses.

Overall, businesses lose $326 billion in productivity annually due to injuries. Motor vehicle and other road-related accidents are responsible for $75 billion of the total while falls account for $54 billion, and struck by or against costs $37 billion.

"Many injuries are predictable, preventable and controllable," according to the study. "For instance, researchers found that seat belts can greatly reduce the harm caused to individuals in motor vehicle crashes."

The study, The Facts Hurt: A State-by-State Injury Prevention Policy Report, cites research showing seat belts saved an estimated 69,000 lives between 2006 and 2010. However, 18 states do not have primary seat belt laws.

Thirty-one states do not require helmets for all motorcycle riders, although research says they saved an estimated 8,000 lives from 2005 to 2009.

The researchers ranked the states in terms of their injury prevention efforts based on 10 key indicators. They included whether the state has enacted a prescription drug monitoring program, whether it has a primary seat belt law, and whether it requires a helmet for all motorcycle riders.

California and New York received the highest score while Montana and Ohio netted the lowest.

"Millions of injuries could be prevented each year if more states adopted additional research-based prevention policies and if programs were fully implemented and enforced," the report says.

"We could dramatically bring down rates of injuries from motor vehicles, assaults, falls, fires and a range of other risks even more if more states adopted, enforced and implemented proven policies," said Amber Williams, executive director of the Safe States Alliance. Hers was one of several groups that teamed up with the Trust for America's Health and the Robert Wood Johnson Foundation for the study.