Tag: Workers Comp

Agriculture is one of the few industries where relatives of workers suffer high rates of injuries due to the nature of working farms existing on private lands, and researchers say farmers need to ensure children are kept safe from workplace incidents.

The National Institute for Occupational Safety & Health, in a Wednesday blog post, said while agriculture ranks among the most hazardous industries for workers, it is unique in that family members are also at risk of suffering fatal and nonfatal injuries.

Researchers said 33 children a day are seriously injured in agriculture-related incidents, and a child dies on a working farm every three days, although more than 60% of children involved in farming incidents were not working at the time an injury occurred.

While many farmers know about the risks of bringing children onto active worksites, a lack of childcare options is one reason why kids remain on farms during working hours, researchers wrote.

Other reasons include a lack of financial support to help pay for safe play areas, a lack of paid family leave and not enough childcare tax credits.

Researchers said living and working in the same location presents unique challenges, and stakeholders must address ways to improve safety for children of working farmers.  

 

 

The family of a grocery store employee killed after being struck by a vehicle during a work break cannot sue the company for wrongful death because the injury and death were covered under workers compensation, a California appeals court ruled Tuesday.

Timoteo Alejandro Martinez Ildefonso died soon after being struck by a pickup truck while walking in a crosswalk near the Whole Foods market where he worked. He was on a 15-minute work break at the time.

His family filed a wrongful death lawsuit against several parties, including Mrs. Gooch’s Natural Food Markets Inc., the store’s parent company.

A judge ruled the death was employment-related, and the California Workers’ Compensation Appeals Board agreed.

The family argued there is an exception to comp exclusivity when employers serve a dual capacity. They argued the company acted as both employer and emergency first aid responder.

The plaintiffs said the fraudulent concealment exception also applied, since employees knew Mr. Ildefonso was injured but didn’t tell him it was covered by comp.

In its ruling, the California Second Appellate District Court of Appeal said the injuries and death were comp exclusive.  

The dual capacity comp exception only applies when work injuries are aggravated by an employer that steps into a non-employer role, such as when a doctor treats a hospital employee’s injuries, the court wrote.

The fraudulent concealment exception also didn’t apply in the case, the court ruled.     

 

 

The Washington State Department of Labor & Industries is proposing a 4.9% increase in the average hourly rate employers and workers will pay for workers compensation insurance next year.

In a statement, L&I Director Joel Sacks attributed the increase to “economic uncertainty and lingering impacts of the pandemic” and “finding a balance between charging enough to cover costs and keeping rates steady and predictable.” 

L&I also said the increase is necessary because of “higher-than-normal” increases in the state’s average wage in recent years, according to the statement.

The proposed increase is below what L&I expects to pay for 2024 claims, so the agency will augment the premiums with funds from the workers compensation contingency reserve.

A series of public hearings has been scheduled for this fall and a final decision is expected by Nov. 30. 

 

CHICAGO — While rival sports organizations compete fiercely on the field, they can work together effectively to battle risk management concerns they have in common, including workers comp issues, three baseball risk managers said.

And the data-heavy analysis that clubs use to optimize players’ performance extends into other areas of their operations and is used to help reduce workers compensation claims and other potential liabilities, they said Thursday during a session of Chicagoland Risk Forum, sponsored by the Chicago chapter of the Risk & Insurance Management Society Inc.

“On the field everyone’s super competitive in the league, but off the field there are things you can learn from each other and share,” said Anthony Avitabile, New York-based director of industry risk management for Major League Baseball.

MLB has a group insurance program in place covering all the clubs and their affiliates for most lines of coverage, including workers comp, general liability and property. In addition, the program includes a Vermont-based captive, Mr. Avitabile said.

One initiative that MLB put together was the league’s Workers Compensation Quality Council, where best practices are shared, he said.

Clubs also collaborate and hold conference calls on safety, said Darius Anderson, manager-risk management for the Milwaukee Brewers.

In recent years one of the main issues of concern has been heat awareness for ballpark employees and fans, he said.

“Those calls are really, really helpful to share best practices and stay ahead of the curve,” Mr. Anderson said.

Information is also shared informally between risk managers in the sector, he said.

“Sometimes you’re like an island right within your organization, so I need to pick up the phone and call another club,” Mr. Anderson said. Discussions often center around particular workers comp claims or mitigation strategies.

Similar to their on-field strategies, clubs access significant amounts of data for risk management purposes.

“Data has been very important to the Milwaukee Brewers in terms of assessing our potential claims or near misses,” Mr. Anderson said.

However, other factors also should be considered, he said.

“You can get lost in data real fast and kind of lose touch with some of the personal side of things — especially the workers comp side. I always tell our club trainers, ‘Take care of the player first, figure out the rest later,’” said Dino Stiris, manager of risk management for the Chicago Cubs.

Focusing on overall workers comp results can sometimes lead to decisions that are not in the interests of injured individuals, he said.

“If you get into the data, you can really just steer in a direction that is not a positive for the associate because you’re just so focused on ‘we need to get here,’” he said.

Medical science that the clubs use can also be useful for risk mitigation, Mr. Stiris said.

For example, identifying a player with a weak shoulder can help trainers mitigate the issue by building up the player’s muscle before an injury occurs, he said.

“It’s helped us in many situations, especially with pitchers,” Mr. Stiris said.

MedRisk LLC, a workers compensation managed care organization, announced Tuesday the appointment of its new CEO, Sri Sridharan.

Mr. Sridharan replaces Danielle Lisenbey, who retired in May.

The King of Prussia, Pennsylvania-based company said Mr. Sridharan, who joined MedRisk as chief client officer in 2022 and was appointed president this year, will continue to guide MedRisk toward its “mission of restoring movement, empowering recovery, and driving progress in workers compensation.”

During his time with MedRisk, Mr. Sridharan has helped advance client management, analytics and provider relations, and was behind a new technology designed to better streamline processes to enhance provider satisfaction and scalable patient engagement, according to MedRisk.

Mr. Sridharan has more than 20 years of insurance industry executive leadership experience.  

It was not yet clear who would replace Mr. Sridharan as president.

 

 

A former Hertz Corp. employee who claims he experienced workplace retaliation and harassment after complaining about discrimination is not entitled to workers compensation benefits for a claimed mental injury, a Tennessee workers comp court ruled Monday.

The employee sought benefits for psychological injuries, claiming he suffered a mental breakdown in February after a yearlong period of co-worker altercations.

The Tennessee Court of Workers’ Compensation Claims determined the worker wasn’t entitled to benefits because he failed to offer evidence showing the mental harm was specifically connected to the workplace.  

In order for a mental injury claim to be compensable in Tennessee, an employee has to prove the psychological injury was caused by a specific work incident, and that the worker in this case failed to identify an unusually stressful work-related event that would have caused his mental injury, the court wrote.

The court wrote that a gradual or cumulative mental injury claim has not been recognized as compensable in Tennessee.  

 

 

Lawmakers in Washington, D.C., have introduced legislation designed to create parity in workers compensation in cases involving injured workers who receive out-of-state benefits.

The Parity in Workers’ Compensation Recovery Act of 2023, filed Tuesday, states that workers who receive comp awards in any state are not barred from seeking compensation under D.C. workers comp law for the same injury or death.

While workers injured in D.C. could seek comp benefits under the measure, the bill states that any such award would be reduced by the amount received in comp benefits awarded in other jurisdictions.

The act would take effect following approval from D.C.’s mayor and after a 30-day congressional review period. 

 

 

The West Virginia Supreme Court on Thursday upheld the denial of opioids and related medication to treat an injury in a workers compensation claim filed by a laborer who was hurt on the job in 2014.

The high court ruled that the West Virginia Workers’ Compensation Board of Review correctly determined that opioids and drugs used to reverse an opioid overdose were not warranted in a claim by Terri Becca.

Ms. Becca, who worked for Eagle Manufacturing, was injured when a block of material fell and caused her to hyperextend her left wrist.

In October 2020, a physician requested authorization for the drugs relating to diagnoses of chronic low back pain and chronic pain syndrome, but a claims administrator denied the request, a decision upheld by the Workers’ Compensation Office of Judges, and later affirmed by the board.

The judges found the treatment inappropriate because Ms. Becca failed to submit evidence showing she met state requirements relating to opioid use.

The Supreme Court agreed with the lower determinations that Ms. Becca failed to prove the course of treatment was related to her compensable injury.

The court said that the authorization of such medication requires “extensive documentation” including a treatment plan, a weaning plan, regular drug screenings and physician statements, and that Ms. Becca provided no such documentation before seeking the opioids and related drugs.

 

Identifying and addressing behavioral health and mental health issues and providing staff training on empathy and other soft skills are among the performance differentiators for top workers compensation claims management companies, according to survey results released Monday by Chicago-based Rising Medical Solutions.

Rising’s annual benchmarking survey, now in its 10th year, gathered the input of 388 claims leaders in 2022, identifying how high-performing claims organizations distinguish themselves across 30-plus data variables.

In addition to better management of mental health and more empathy among claims staff, companies with better metrics in claims management — which include good claims closure rates — the survey identified measuring injured worker satisfaction as “a key metric of claims management effectiveness.” The results also found that “harnessing performance-based strategies with staff and vendor partners” and “employing workflow automation and predictive and prescriptive analytics” helped top-performing claims organizations.

The survey also found that applying data and technology in claims management — found to be adequately deployed by only 42% of organizations surveyed in 2019 — is now a mainstay for 78% of organizations applying technology to improve claims efficiency.