California’s Non-Fatal Worker Injuries, Illnesses Stable In 2015

By WorkersCompensation.com – October 28, 2016

Fabulous California sign in the Las Vegas styleOakland, CA – The Department of Industrial Relations (DIR) has posted California’s 2015 occupational injury and illness summary data on employer-reported injuries.

According to the estimates provided by the U.S. Bureau of Labor Statistics’ Survey of Occupational Injuries and Illnesses (SOII), California’s overall incidence rate of nonfatal occupational injuries and illnesses remains unchanged at 3.8 cases per 100 workers for full time employees, the lowest rate in over a decade. Detailed case and demographic data for 2015 will be published on November 10.

“In California we review statistics to assist in focusing our regulatory and enforcement efforts,” said DIR Director Christine Baker.  “This preliminary data along with the case and demographic statistics to be published next month will help us refine and strengthen workplace safety and health regulations, training materials, and outreach and education efforts for employers and workers.”

The estimates show there were approximately 470,600 nonfatal reportable job related injuries and illnesses in 2015, with 77% occurring in private industry and 23% in state and local government sectors.

The total numbers of injuries and illnesses increased slightly year to year, which correlates to an uptick in the state’s employed labor force from 17.4 million in 2014 to 17.8 million in 2015.

The statewide all-industry rate of “lost time” cases, (referred to in the survey as “days away from work, job transfer, or restriction” (DART) cases) remained constant at 2.2 cases per 100 full time workers over the last three years surveyed, while the rate of days away from work cases (DAFW) has remained unchanged for the last seven years.

 Continue reading California’s Non-Fatal Worker Injuries, Illnesses Stable In 2015

Cast Sunlight At Work, Not Shade

My kids went back to school last month, and my preteen daughter has been regaling us at dinner with tales of middle school.

photo of sunlight streaming through a forestAs is often the case in seventh grade, some of her stories center on classmates “throwing shade” at one another. That’s teen speak for talking trash about someone. We’ve had important conversations at the dinner table about the effects that this type of “shade” has on people. My husband I and reinforce with our kids that no matter how witty or clever the comment, if it cuts someone down, it’s damaging.

If throwing shade harms people, sunlight (metaphorically speaking) has the ability to reverse that damage. Think back to high-school biology class and the term “heliotropic,” which refers to a plant’s ability to move or grow toward the direction of sunlight.

Social scientists have drawn from this aspect of nature the phrase “heliotropic effect.” Kim Cameron is a professor of management and organizations at the University of Michigan’s Ross School of Business.

In his paper that explores how leaders can mimic this positive element of nature, Cameron writes that there is a “tendency in all living systems toward that which gives life and away from that which depletes life — toward positive energy and away from negative energy.” Continue reading Cast Sunlight At Work, Not Shade

Driving Drugged

By Mark Pew  – October 19, 2016

The “D” in DUI is not just for Drinking.
Should the person driving next to you at 70 mph be on the road?

Whether it’s distracted driving (texting, calling, eating, playing with your infotainment system), drugged driving (alcohol, prescription drugs, marijuana, illicit drugs) or otherwise cognitive impairment (due to disease or age), defensive driving is always required (this Business Insider article offers seven helpful hints).

Per the National Institute on Drug Abuse (NIDA):

•  10 million people aged 12 or older reported driving under the
influence of illicit drugs during the year prior to being surveyed
•  18 percent of drivers killed in a crash tested positive for at least
one drug
•  11 percent of deadly crashes involved a drugged driver

RoadwixRx site from AAA Foundation for Traffic Safety
RoadwiseRx, built by the AAA Foundation for Traffic Safety

So what about those polypharmacy regimens dealing with pain? They’re prescription drugs … sanctioned by the Federal Government (i.e. FDA, DEA) … prescribed by a clinician who has been trained on their use … dispensed by a pharmacist who has been trained on their use … and there’s an educational package insert in each bottle. Should the patient / user be driving? Ummmm … Maybe not. Continue reading Driving Drugged

Return To Work Not As Hard With Work Hardening

October 6, 2016 by Michael B. Stack

Work hardening exercises
Work Hardening or Hardly Working?

The majority of the employees who are injured will need only standard medical care to return to work.  Most of the employees who need rehabilitation will recover completely with physical therapy or occupational therapy.

However, some employees do not recover enough of their physical capabilities to return to work even though they have recovered from their injury. This is a result of the muscles becoming atrophic and the employee deconditioned due to lack of physical activities during the injury recovery time.  Work hardening is a comprehensive and systematic therapy plan created specifically for an injured employee to return him to the physical condition he was in prior to the injury.

Objective to Bring Skills Back to Prior Levels

The objective of work hardening is to return not only the employee’s physical ability but also to bring the employee’s functional, behavioral and vocational skills back to the skill level present prior to the injury. The therapist administering the work hardening program should be provided a detailed job description in order to tailor the work hardening program to the specific job requirements of the injured employee.  Occasionally, the employee who needs work hardening has attitude issues or chronic pain that has caused the employee to become severely deconditioned.

Program Involves Physician, Nurse Case Manager, and Therapists

For an injured employee to be in a work hardening program, the treating physician will make the request, normally a written prescription.  The nurse case manager should arrange the work hardening program with a physical therapy or occupational therapy facility that conducts work hardening programs on a regular basis.  The nurse case manager should stay actively involved with the treatment until it has been totally completed.
Continue reading Return To Work Not As Hard With Work Hardening

Outcomes-Based Approaches in Workers’ Compensation Are Reducing Costs, Litigation and Improving MPN Performance

By WorkersCompensation.com 10/12/2016

cartoon for outcome based healthcareNewport Beach, CA  – Outcomes-based network management can improve MPN performance and reduce costs and litigation, according to findings presented by Harbor Health Systems  and the California Workers’ Compensation Institute at the CAJPA 2016 Conference.

During their session, “Starting at the Finish Line: Applying an Outcomes-Based Approach to Workers’ Compensation Physician Networks,” speakers Kent Spafford, Board of Directors, One Call Care Management (“One Call”), and Advisor to Harbor Health Systems, and Alex Swedlow, President of CWCI, explained the type of data that can be analyzed in order to identify high-performing networks and providers, and the results that can be achieved by utilizing top networks.

“Identifying best doctors requires an analysis of multiple variables, including cost, duration, recidivism, and total disability of claims,” noted Spafford. “With these objective measures and the ability to get more injured workers treated by the top twenty percent of scored physicians, results in MPNs are improving in terms of lower costs, less litigation, and shorter claims duration.” Continue reading Outcomes-Based Approaches in Workers’ Compensation Are Reducing Costs, Litigation and Improving MPN Performance

Occupational Fatigue—New Insights on Causes and Consequences

Elk Grove Village, IL (WorkersCompensation.com) – matthew.hallowell@colorado.edu

inforgraphci for Occupational FatigueSleep loss and poor working conditions are the most important causes of occupational fatigue—which can impair mental and physical performance with the potential for serious errors and injuries, reports a review and update in the October Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).

Matthew Hallowell, PhD, and colleagues of University of Colorado at Boulder analyzed previous research to develop a “comprehensive systems model” of the interrelated causes and consequences of occupational fatigue. Fatigue, which may be acute or chronic, is defined as “a decreased ability to perform activities at the desired level due to lassitude or exhaustion of mental and/or physical strength.”

Based on available data, the “major drivers” of fatigue were sleep deprivation and factors in the work environment—such as noise, vibration, and temperature. These causes could all interact with other factors, such as increased work load and long work hours.

The most significant consequences of fatigue were short-term degradation in cognitive (thinking) and physical functioning. Illnesses, human error, and injuries also occurred to a lesser extent. Evidence suggested that some consequences of fatigue can make other outcomes worse, reinforcing fatigue and leading to a “downward cycle.”

Occupational fatigue affects more than 20 percent of the US working population, resulting in more than $136 billion in lost productivity and health care costs each year. Unfortunately, the problem of fatigue may draw attention only after major accidents—the researchers cite the Three Mile Island, Chernobyl, and Exxon Valdez disasters.

[READ FULL STORY HERE]

Workers’ Compensation Bloggers Debate Industry Trends

By 10/07/2016

graphic for Safety National Chronicles and bloggersTop industry bloggers debated the hottest issues facing workers’ compensation and risk management at the 2016 California Workers’ Compensation and Risk Conference.

Speakers included:
• Bob Wilson, President & CEO, WorkersCompensation.com, LLC
• Julius Young, Attorney, Boxer & Gerson, LLP
• Jennifer Jordan, Chief Legal Officer, Medval
• Michael Gavin, President, Prium
• Mark Walls, Vice President Communications & Strategic
Analysis, Safety National (moderator)

Yesterday the Department of Labor (DOL) released a report around state workers’ comp commissions outlining areas of inadequacy and oversight. What are your initial thoughts about this?

Jordan: I thought the report was unfair, was dated and the didn’t use updated data. It was full of threats with no ability to help. It reminded me of what we saw with CMS and that fixed nothing. I do agree that the Social Security system does need reform, however, because people are being put into the system from frivolous injuries just to get the claim off the adjuster’s desk.

Gavin: I was disappointed because the report was based on the assumption that injured employees also become disabled. There’s an assumption that our system needs to be reformed related to disability, with no medical focus on the very definition of disability. You can tell that the DOL doesn’t know much about workers’ compensation, but the fact that they brought this to the forefront should be a wake-up call. We need to be proactive as an industry in addressing some of the allegations.
Continue reading Workers’ Compensation Bloggers Debate Industry Trends

Impact of Mental Health at the Workplace

By Safety National 10/06/2016

name tags: Hello My Name is StressThis session at the 2016 California Workers’ Compensation & Risk Conference addressed some of the latest thinking and research related to the impact of mental well being and behavioral health in the workplace.
Speakers included:
•  Denise Zoe Algire, National Director, Managed Care & Disability, Corporate Risk Management, Albertsons/Safeway

•  Dr. Teresa Bartlett, Senior Vice President Medical Quality, Sedgwick Claims Management Services, Inc.

Mental health is a key component of wellness. It is a state of well-being in which an individual can cope and become a contributor. It includes how someone feels, thinks and acts and helps to determine how we handle stress, relate to others and make choices. Ultimately, mental health is about balance, resiliency and the ability to return to normal when something goes wrong. Mental health is also directly associated with performance in the workplace.

Studies show:

•  16% of people in the workplace are depressed and 57% of those
are untreated.
•  14% have chronic fatigue, with 83% untreated.
•  15% suffer from anxiety, with 66% untreated.
•  6% have chronic sleeping problems, with 61% untreated.
Continue reading Impact of Mental Health at the Workplace

California Aims To Limit Surprise Medical Bills

September 11, 2016
Heard on Weekend Edition Sunday 
Stephanie O’Neill

Cassie Ray and husband Gerry  got a surprise bill from an out-of-network anesthesiologist
Cassie Ray (seen with her husband, Gerry) got a surprise bill from an out-of-network anesthesiologist after an operation. – Courtesy of Cassie Ray

When it comes to navigating the intricacies of health insurance, Cassie Ray considers herself a pro. She actually reads her policy, including the fine print.

So when the 57-year-old from Fairfield, Calif., needed routine follow-up surgery after a mastectomy, she did her homework.
“I looked up on my insurer’s network and made sure the outpatient facility that I was being referred to was in my network,” Ray says.

A month later, she received an unwelcome surprise: a $580 bill for an out-of-network anesthesiologist.

“I called the facility back, and at first, I felt like, this has to be a mistake. They’ll fix it,” Ray says.

Instead, the clinic said her only option was to negotiate the bill directly with the doctor. Ray’s experience illustrates the surprise of balance billing.
Continue reading California Aims To Limit Surprise Medical Bills

New Workers’ Compensation Laws Will Reduce Treatment Delays and Fraud

By WorkersCompensation.com  

wc-fraudSacramento, CA  – Two newly signed laws will build upon California’s workers’ compensation reforms by addressing two critical issues—reducing treatment delays for injured workers and rooting out provider fraud and illegitimate liens.

Governor Brown signed SB 1160 (Mendoza) and AB 1244 (Gray and Daly), which build on the 2012 workers’ compensation reforms designed to increase benefits and improve medical care for injured workers, and to control costs for employers.

“Expedited and appropriate treatment in the critical first month of injury encourages the best outcome for injured workers and employers,” said Christine Baker, Director of the Department of Industrial Relations (DIR). “In reforming the utilization review process used to contest care to injured workers and tightening controls on fraud, these new laws further the treatment and savings goals initiated by the Governor and the Legislature in 2012.”

SB 1160 reduces most utilization review in the first 30 days following a work-related injury. It also mandates electronic reporting of utilization review data by claims administrators to the Division of Workers’ Compensation, which will enable the division to monitor claim processes and address problems.
Continue reading New Workers’ Compensation Laws Will Reduce Treatment Delays and Fraud