Tag: Workers Comp

Walmart Inc. has agreed to a $500,000 settlement with Massachusetts for allegedly violating the state’s prescription pricing procedures designed to keep workers compensation costs down, Massachusetts Attorney General Maura Healey announced Tuesday.

The retailer did not admit any wrongdoing in connection with the settlement.

The state’s workers compensation system sets limits on the costs of medications prescribed to injured workers and mandates that companies validate prices against specific regulatory benchmarks before processing charges. Walmart pharmacies were accused of failing to follow those regulations when applying prices for injured workers’ prescriptions, dating back to 2016.

“Having a workers compensation system that is transparent, functional and affordable is essential for employers and workers across Massachusetts,” Ms. Healey said in a statement.

As part of the settlement, Walmart agreed to work with Ms. Healey’s office to develop a protocol to prevent similar violations.

Massachusetts has reached similar settlements totaling more than $16 million with Express Scripts Inc., Optum Rx Inc. Walgreens Co., Stop & Shop Supermarket Co. LLC and United Pharmacy Services LLC.

A U.S. Department of Labor proposal that could put more independent contractors in the employee category has the potential to shake up business models, workers compensation experts say.

“This can be a really big deal, especially in the gig, shared economy,” said Ben Powers, Atlanta-based executive vice president and head of large & complex casualty for the Southeast region at Willis Towers Watson PLC.

“Overall, the employee/employer relationship versus that principal/independent contractor relationship impacts our clients in a lot of big ways,” as workers compensation coverage would be among the largest mandated insurance requirements for companies forced to reclassify workers, he said.

The DOL’s proposed rule, introduced Oct. 13 and open for public comments until Dec. 13, would apply a narrow “economic realities test” to determine whether a worker is an independent contractor. It would assess six conditions to determine whether the worker is economically dependent on the employer or is in business for themself.

The DOL has stated its intention to rein in companies that rely heavily on independent contractors, who lack access to such protections as workers compensation and wage and hour laws.

Comp experts say that, depending on the type of company, a move to reclassify independent contractors as employees would force many businesses to rebalance their risk profile.

If regulation “forces employers to reclassify independent contractors as employees, there is a significant effect on workers comp and on the overall economics of their business model,” said Will Brauer, Marsh LLC’s sharing economy and mobility casualty leader in Chicago.

“There is a fine and sometimes difficult-to-discern line between employee status and independent contractor,” he said. “Each state, and in some cases municipality, define these requirements differently, but most have some common elements.”

While many companies that rely on independent contractors have general liability policies to protect assets in the event of a contractor getting injured — if the worker alleges and can prove negligence on behalf of the company — workers compensation is a wider net, a guarantee of benefits in most cases, and would increase insurance costs drastically, said Paul Primavera, Washington-based executive vice president and practice leader, national risk control group, at Lockton Cos. LLC.

Conversely, the risk could be greater under general liability, as workers comp is the exclusive remedy and is safeguarded by regulations, Mr. Primavera said. “Certainly one could argue that a third-party claim could result in more exposure to an organization than a workers compensation claim simply because there are no limits on wages and pain and suffering,” he said.

With potential federal changes looming, experts say companies also need to ensure they are classifying their workers in line with current state regulations, which have shifted in some cases.

California has tightened rules on who is considered an employee and Vermont and Rhode Island considered measures this year that would have changed the definition. More states could continue to push for clarification on the issue, the National Council on Compensation Insurance reported, naming the issue a major legislative trend.

According to NCCI, three states passed laws this year addressing gig workers, such as those working for transportation network companies including Uber and Lyft, and other marketplace contractors.

S.B. 150 in Alabama excluded certain contractors working for marketplace platforms, such as Uber and the food delivery platform Grubhub, from the definition of employee and considers them independent contractors. H.B. 118 in South Dakota clarified when a worker is an independent contractor of a delivery facilitation platform; and H.B. 2076 in Washington addressed workers compensation coverage for transportation network company drivers under certain conditions.

Hanging over the issue is the DOL’s proposal, experts say.

“This is a key issue to continue to watch,” said Greg McKenna, Rolling Meadows, Illinois-based national practice leader for the public sector at Gallagher Bassett Services Inc. “It would be good advice for employers to continue to see how the federal government is going to take action on this.”

A salt mine operated by Morton Salt Inc. last week was hit with a U.S. Department of Labor notice for a pattern of violations of mandatory health and safety standards under the federal Mine Safety and Health Act.

The POV notice is the first issued to a U.S. mine operator since 2014.

The Mine Safety and Health Administration issued the notice after finding that Morton Salt’s Weeks Island Mine and Mill in New Iberia, Louisiana, had a high number of “significant and substantial” violations, and other health and safety compliance problems, a DOL statement said.

A significant and substantial violation is one that is reasonably likely to result in serious injury or illness, and a POV notice is considered one of the agency’s strictest enforcement actions, the statement said.

Regulators said the mine received 82 significant and substantial violations from Sept. 1, 2021, to Aug. 31, 2022, of which 32 were issued for the operator’s high negligence or reckless disregard.

Federal law allows the mining safety regulator to remove miners from sites that receive a POV notice.  

 

 

 

 

The Occupational Safety and Health Administration has fined a Utah company $304,556 in connection with the deaths of two coal workers in Colorado in June.

The agency said Monday that inspectors determined Utah-based Savage Services Corp., a provider of industry infrastructure and supply chain services, failed to follow national safety standards and did not properly train workers on safety protocols.

The two workers were fatally buried beneath a pile of shifting coal at an industrial loading facility in Pueblo, Colorado. They had climbed onto the pile to determine if the feeder below was receiving the coal, according to OSHA.

The agency cited Savage for one serious violation and two willful violations.

The company has 15 days to contest the findings.

 

Lawmakers in South Carolina have filed three bills in the last week that would make post-traumatic stress disorder a compensable illness for first responders.

S.B. 81 and S.B. 82, now with the Senate Judiciary Committee, would amend the state’s workers compensation code to include an injury “rising from the first responder’s involvement in a significant traumatic experience or situation in the course and scope of his employment, without regard to whether the experience or situation was extraordinary or unusual in comparison to the normal working conditions of a first responder’s employment.”

While the two bills are mostly identical, S.B. 81 lists 14 circumstances that would qualify, such as witnessing the death of a child or transporting a gravely injured minor to a hospital. 

S.B. 251 similarly lists incidents that a first responder would have to experience in order to qualify for PTSD benefits and treatment; however, instead of adding a definition to the state’s description of a workplace injury, it states that first responders medically diagnosed with PTSD would qualify for benefits.

The Occupational Safety and Health Administration said Friday it has cited Dollar Tree Stores Inc., which operates Family Dollar and Dollar Tree stores, for safety hazards found at a store in Georgia.

OSHA said safety inspectors found improperly secured compressed gas cylinders and unsafely stacked boxes of merchandise at the Family Dollar store in Richmond Hill and proposed a fine of $364,645.

The company has 15 business days to contest the findings.  

A federal appeals court on Friday reinstated a retaliation lawsuit filed by a cook at a Popeyes Louisiana Chicken restaurant in Riverview, Florida, who was beaten by coworkers.

Thurman Goodman reported in March 2016 to Florida Pop LLC, which owned the franchise, that another cook had been drinking on the job. Later that night that cook, a shift supervisor, and two other individuals assaulted Mr. Goodman at a 7-Eleven store across the street from the restaurant, saying he had “snitch(ed) … to corporate,” according to Goodman v. Florida Pop LLC, filed in the 11th U.S. Circuit Court of Appeals in Atlanta.

Mr. Goodman, who lost consciousness during the attack, recognized one of his attackers but did not recognize that the shift supervisor had participated in the attack until he viewed 7-Eleven surveillance footage a year later.

The day after the attack, Mr. Goodman reported the incident to Florida Pop, which fired the attacker Mr. Goodman recognized. The attackers who worked at Popeyes continued to threaten Mr. Goodman, who spoke with the store manager about seeking workers compensation for the injuries he had suffered during the attack, according to the ruling. The manager told Mr. Goodman that Florida Pop “wasn’t going to do anything, so (he) might as well retain an attorney,” which he did, according to the ruling.

The attorney helped Mr. Goodman obtain workers compensation after he left his job at Popeyes in July 2016 following more threats, including one of gun violence, claiming he did “not feel safe returning to work,” according to the ruling.

Mr. Goodman sued Florida Pop in February 2020, alleging workers comp retaliation, stating that the employer had “intimidated, coerced, and constructively discharged him by permitting its employees … to violently attack him outside of their workplace.”

The suit also stated that Florida Pop “then acted recklessly and maliciously by exposing (him) to (the former employees) after it knew, at minimum, that (one) had significantly harmed him, and it exhibited callous behavior toward (him) after the attack,” according to the ruling.

The district court dismissed the lawsuit, concluding that Mr. Goodman’s attempt to premise his retaliation claim, in part, on a threatening phone call from a shift supervisor failed because there was no evidence that the offending caller knew of his efforts to seek workers comp, the ruling said.

“Without evidence that (the supervisor) was aware of the protected conduct,” the lower court stated, “no reasonable jury could find that (he) retaliated against Goodman because of Goodman’s attempts to seek workers compensation.”

The appellate court said the lower court’s decision was erroneously based “on grounds not raised by the parties without affording notice and an opportunity to respond,” and it remanded the case for further proceedings.

 

 

A Florida appellate court said a police officer who filed a claim for post-traumatic stress disorder after responding to a school shooting was eligible for benefits because while the incident happened before a change in state law, his disability didn’t begin until he was placed on administrative leave.

The claimant was a police officer for the City of Hallandale Beach who was among the officers who responded to the school shooting at Marjory Stoneman Douglas High School in February 2018, according to No. 1D21-2138, filed Nov. 30 in the Court of Appeal for the 1st District of Florida.

While helping to clear students and secure the building, the officer saw the bodies of the victims, including teenagers. He was placed on administrative leave in November 2018 after he started suffering symptoms of post-traumatic stress disorder.

He was eventually placed on light duty and subsequently terminated around January 2022. The officer filed multiple claims for indemnity and medical benefits pursuant to Florida law, which went into effect eight months after the shooting — on Oct. 1, 2018 — and which now allows first responders to receive benefits for mental stress injuries that are not accompanied by a physical injury.

The employer claimed the accident date for his claim happened on the day of the shooting, which was before the law changed. The officer argued that the date of disability controls, and that the date of disability should be the day he was placed on leave, which was after the law changed.

A judge of compensation claims agreed with the officer and found the date of the accident was in November 2018 when he went on administrative leave.

The Court of Appeal for the 1st District of Florida affirmed, rejecting the city’s argument that the controlling date of the accident ought to have been the date of the exposure to the event causing the PTSD.

“The ‘P’ in PTSD stands for ‘post,’” the court wrote. “By its very name, PTSD cannot occur until sometime after a traumatic event occurs.”

WorkCompCentral is a sister publication of Business Insurance. More stories here.

 

 

NEW YORK — Progress has been made, but organizations still have work to do to build inclusive cultures where more women can advance into leadership roles in the insurance industry, according to a panel of speakers Thursday at the 2022 Business Insurance Women to Watch Awards & Leadership Conference.  

Diversity, equity and inclusion is something that the industry has lacked historically, said Michael Chang, head of corporate risk and broking North America at WTW.

“There’s a lot of talent and diversity of thought, and diversity of people is what organizations need in this industry to be successful,” Mr. Chang said.

When he joined WTW 60 days ago, Mr. Chang said he saw that WTW’s senior executive leadership team in North America was not as diverse as he thought it should be and that it needed to change in order to execute its goals.

“I saw there were not that many women. I don’t think there were any people of color, and there may have been one person of the LGBTQ+ community. That’s pretty synonymous with a number of other companies across the U.S. in the financial services industry,” he said.

The team, made up of 40 senior executives in North America, now comprises 50% people of color, women and the LGBTQ+ community, Mr. Chang said. “They are all super talented; they were just overlooked,” he said.

In 2021, women held 21% of board seats, 19% of C-suite and 5% of CEO roles in the financial services sector, based on Deloitte LLP data, said Cynthia Beveridge, president of Aon Broking.

McKinsey & Co. data shows that 64% of financial services C-suite executives are white men and 23% are white women, while 9% are men of color and 4% are women of color, Ms. Beveridge said.

“Those are shocking because we’ve been at this for quite some time. We’re on a journey,” she said.

Women of color comprise about 52% of entry-level positions in the financial services sector, and 57% in the insurance industry, but after that the representation falls off in every corporate position by 80%, Ms. Beveridge said.

While the insurance industry is making progress, “we should be thinking about what our firms look like and how we respond to our client base,” she said.

Lynn Oldfield, president and CEO of AIG Canada, said some 58% of her executive team are women. “There is diversity; 25% of my board are women and 48% of my managers are women simply through intention, investment and walking inclusion,” Ms. Oldfield said.

Building an inclusive workforce is “mission critical” to an organization’s financial health, she said. “Controlling the top and bottom line within an organization is, I believe, the future state and the ability to rise to the C-suite level,” she said.

AIG has 11 women running countries and regions around the world, Ms. Oldfield said. “Here in North America, our head of casualty, our head of financial lines and our global leader of multinational are all women,” she said.

The session “Breaking glass ceilings – and walls” was moderated by Bonnie Boone, an executive broker and underwriting professional.

Ms. Boone was a 2008 Business Insurance Women To Watch honoree and in 2015 was one of three past honorees to be recognized with Business Insurance Impact Awards for their exceptional contributions to diversity and inclusion in their industries.