Tag: Workers Comp

The Occupational Safety and Health Administration announced Wednesday that it has launched a local emphasis program aiming to reduce the higher rates of injuries among the more than 90,000 food production workers in Illinois and Ohio.

The program, which began Oct. 3, started with an initial outreach focused on more than 1,400 manufacturing facilities in Illinois and Ohio where year-round and seasonal workers manufacture and process confectionery, animal, fruit and vegetable-based products.

Between 2016 and 2020, OSHA says it investigated multiple fatalities, along with dozens of workers suffering amputations, fractures and crushed hands or fingers. Investigators often determined that the employers commonly failed to control hazardous energy or allowed workers to operate machines without adequate guarding.

In 2019, OSHA found that food production workers in Ohio had a nearly 57% higher rate of amputations and 16% higher rate of fractures compared with the overall rates for manufacturers in the private sector. In Illinois, these workers experienced a nearly 29% higher rate of amputations and 14% percent higher rate of fractures when compared to rates for private-sector manufacturing jobs.

Once OSHA completes the three-month outreach effort, the program empowers the agency to schedule and inspect select food industry employers in Illinois and Ohio whose injury rates exceed the state average among all manufacturers. In April 2022, OSHA established a similar program in Wisconsin, according to the announcement.

 

 

 

 

An annual study conducted by the National Academy of Social Insurance revealed workers compensation cost and benefits took a sharp downturn during the first year of the COVID-19 pandemic, while reporting at the state level uncovered a stark contrast in results. 

Data compiled by the academy ran over a five-year period from 2016 to 2020 and highlighted trends and outcomes in workers compensation benefits, costs and coverage.  

In a statement issued by NASI, Jennifer Wolf, chair of the study panel on workers compensation data and president of the Minnesota Workers’ Compensation Insurers Association, said the publication provides unique insights for policymakers and researchers within compensation programs.

Not only did COVID-19 impact employment and social insurance systems, “[T]he pandemic placed pressure on workers compensation and other disability benefit programs to keep households afloat,” she added.

Over the first three years of the study, total benefits paid went up 0.5% but backpedaled 6.5% during the first year of the pandemic, resulting in a cumulative drop of 6% over the study period.

Throughout the five years covered by the study, total benefits paid slipped from $62.7 billion in 2016 to $58.9 billion in 2020. Over the same time, cash benefits remained stable while medical benefits fell an overall 12%, including an 11.4% nosedive in the first year of the pandemic.

Standardized indemnity and medical benefits — benefits paid per $100 of covered wages — were also on the decline during the study, tumbling 14.5% and 24.8%, respectively, to create a 19.6% drop in total standardized benefits.

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

 

Pharmacy benefits manager Express Scripts Inc. has agreed to pay $3.2 million after allegedly failing to follow prescription pricing procedures that prevent overcharges in the workers compensation insurance system, Massachusetts Attorney General Maura Healey announced Monday.

Court documents say that in some circumstances Express Scripts failed to apply various regulatory benchmarks — such as the Federal Upper Limit for Medicare and the Massachusetts Maximum Allowable Cost — to its pricing determinations, according to a statement from the attorney general.

The terms of the settlement require Express Scripts to implement procedures to prevent overcharges in the workers compensation insurance system and ensures that Express Scripts will cooperate with monitoring of the company’s future regulatory compliance.  

This case is part of an ongoing review by the attorney general’s office into prescription pricing procedures in the workers compensation system. The office says it has so far reached settlements with several pharmacy benefits managers over comp drug pricing violations totaling approximately $16 million.

Officials at Express Scripts did not respond to a request for comment.

 

 

 

 

 

Changes to Oregon’s workers compensation law on who qualifies for death benefits are set to go into effect in 2023, according to an announcement issued Monday by the state Workers’ Compensation Division.

In accordance with H.B. 4086, which was signed into law this year, the changes broadened the definition of a surviving relative to include a parent, a parent’s spouse or domestic partner; a grandparent, a grandparent’s spouse or domestic partner; a grandchild, a grandchild’s spouse or domestic partner; siblings and stepsiblings; sibling’s or stepsibling’s spouse or domestic partner; and “any individual related by blood or affinity whose close association with a worker is the equivalent of a family relationship.”

The bill also removed two exceptions to who qualifies as a beneficiary: dependents who are noncitizens that reside outside of the United States and spouses who are “living in a state of abandonment.”

Current state law narrows those who qualify to as dependents, including a parent, grandparent, or stepparent, a grandson or granddaughter, a brother, sister, half-brother, or half-sister, or a niece or nephew. Cohabitating partners who lived with the deceased for more than a year also qualified — the new law does not include the one-year stipulation but states that a cohabitating partner qualifies if they meet other state laws for what constitutes such an arrangement.

 

 

The Oregon Workers’ Compensation Division on Tuesday announced that premium assessment rates will remain unchanged in 2023.

The WCD said its parent agency, the Department of Consumer and Business Services, determined that an assessment rate of 9.8% on earned premium is necessary for 2023.

The annual assessment funds operations of the WCD, the Workers’ Compensation Board, most of Oregon’s Division of Occupational Safety and Health, a portion of the Division of Financial Regulation and other parts of DCBS.

An additional assessment of 0.1% will be levied on self-insured employers and public-sector self-insured employer groups, while a 0.5% surcharge will be assessed for private-sector self-insured employer groups to fund the Self-Insured Employer Adjustment Reserve and the Self-Insured Employer Group Adjustment Reserve.

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

The New Jersey Compensation Rating and Inspection Bureau on Saturday announced a 6.1% decrease in workers compensation insurance rates effective in 2023.

The rating bureau filed for a decrease of 4.7% in rates and rating values, however, the state insurance commissioner revised the reductions based on “the latest financial and statistical data reported to the Rating Bureau, which includes losses resulting from the COVID-19 pandemic.”

Also effective Jan. 1, 2023, the maximum weekly benefit for all types of workplace injuries, except permanent partial disabilities, will be raised to $1,099 from $1,065. The minimum weekly benefit will increase to $293 from $284. In cases involving permanent partial disabilities, the present maximum weekly benefits ranging from $284 to $1,065, based on duration of disability, will be changed to $293 to $1,099.

 

A Florida appellate court overturned a denial of benefits for a paramedic suffering from post-traumatic stress disorder, saying the trial judge erroneously concluded she was not exposed to a qualifying event on her last day of work and was not entitled to benefits pursuant to statutory changes enacted in October 2018.

The appeals court said the paramedic correctly asserted that her injury date was on her last day of employment in November 2018, at which point the statutory changes allowing first responders to seek indemnity benefits for PTSD had already gone into effect, according to Nos. 1D19-4601 and 1D20-2383, filed in the First District Court of Appeal on Nov. 2.

“Because the employee’s right to compensation by statute does not accrue until the occupational disease causes a loss, the date or dates an employee suffers exposure or contracts the disease would not be at all relevant to determine the date of the accident in this context,” the court said. “The JCC’s ‘last injurious exposure’ approach, then, was not commensurate with what the statute requires.”

The paramedic started working as an emergency medical technician and paramedic for Polk County Fire Rescue in August 2015. In the three years that followed she responded several serious accidents and incidents, including deadly acts of domestic violence, and that which included injuries and death of children.

She began experiencing signs of possible post-traumatic stress disorder in 2016. She sought assistance with her symptoms from a critical incident stress management team, which was available to first responders. She also began seeing a therapist in 2017, but her trauma continued to worsen. She stopped working in November 2018.

She filed a comp claim citing a 2017 change in state law that allowed first responders to receive medical benefits for a mental or nervous injury that was unaccompanied by a physical injury.

Polk County conceded that the woman suffers from PTSD that developed because of her exposure to the on-the-job traumatic events, but it denied her claim because all of the qualifying events that led to her PTSD occurred before the effective date of the 2018 amendment. A judge of compensation denied her claim for medical benefits and wage benefits.

The appeals court reversed, stating the paramedic suffered PTSD as a result of being exposed to various traumas between 2016 and June 2018, but she did not experience a compensable loss of wages until her PTSD led to an “incapacity” to work in November 2018, making it the date of her accident.

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

 

 

Florida Insurance Commissioner David Altmaier on Monday approved an 8.4% decrease in workers compensation rates for 2023, in accordance with the National Council on Compensation Insurance’s filing.

This is the sixth year of comp rate reductions for employers in the state, according to the Office of Insurance Regulation.

Florida’s chief financial officer Jimmy Patronis said in a statement that the latest reduction will help business owners combat the impact of rising inflation.

 

 

Oklahoma Insurance Commissioner Glen Mulready on Friday announced an 8.2% decrease in workers compensation loss costs for 2023.

Loss costs are the average cost of lost wages and medical payments of workers injured per $100 of payroll or as a percentage of payroll. The new loss costs will go into effect for new and renewing policies, effective Jan. 1.

“This marks the 12th consecutive year that the department has approved loss cost decreases for workers compensation insurance,” the commissioner’s office said in a statement. “Oklahoma’s loss cost has decreased significantly from 2016 to 2021, averaging a 9.5% decrease per year.”

Declining frequency is a key factor in falling loss costs. The commissioner said lost-time claim frequency has fallen by almost 50% over the last 15 years and is projected to fall again in 2023.

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

 

 

 

The U.S. Centers for Disease Control on Friday released its revised guidelines for opioid prescribing with new recommendations for providers that emphasize greater communication with patients and that opioids should not be on the front line for managing pain.

The last time the CDC released opioid guidelines was in 2016, of which triggered what many considered harsh reductions in pain medication prescribing and a host of laws and other regulations that left pain undertreated and unmanaged, according to the experts. The CDC document said some of the 2016 recommendations resulted in “misapplication” of strategies for limiting opioid prescribing and in some cases, abrupt discontinuation of opioids that jeopardized patients’ health.

The CDC said the new recommendations “aim to improve communication between clinicians and patients about the benefits and risks of prescription opioids and other pain treatment strategies; improve the safety and effectiveness of pain treatment; improve pain, function and quality of life for persons with pain; and reduce the risks associated with opioid pain treatment (including opioid use disorder, overdose and death) and with other pain treatment.”

The recommendations address tapering for patients who have been on long-term opioid therapy, urging physicians to utilize a slow approach to lowering medication strength and dosages: “If benefits outweigh risks of continued opioid therapy, clinicians should work closely with patients to optimize nonopioid therapies while continuing opioid therapy. If the benefits do not outweigh the risks of continued opioid therapy, clinicians should optimize other therapies and work closely with patients to gradually taper to lower dosages or, if warranted based on the individual circumstances of the patient, appropriately taper and discontinue opioids. Unless there are indications of a life-threatening issue such as warning signs of impending overdose (e.g., confusion, sedation, or slurred speech), opioid therapy should not be discontinued abruptly, and clinicians should not rapidly reduce opioid dosages from higher dosages.”

Among the recommendations, the CDC said nonopioid therapies “are at least as effective as opioids for many common types of acute pain” and that doctors “should maximize use of nonpharmacologic and nonopioid pharmacologic therapies.”

For chronic pain, the CDC says that nonopioid therapies “are preferred” and that before starting opioid therapy for subacute or chronic pain, “clinicians should discuss with patients the realistic benefits and known risks of opioid therapy, should work with patients to establish treatment goals for pain and function, and should consider how opioid therapy will be discontinued if benefits do not outweigh risks.”