Category Archives: Workers Compensation

12 Frequent Hard Hat Questions

If the hard hat has sustained an impact, dispose of it immediately, even if the damage is not visible.

workers with hardhats for article, Twelve Frequent Hard Hat Questions

Protecting employees from potential head injuries is a key element of a safety program in virtually all industries. The primary reasons for an organization to require hard hats in the work environment is to help protect employees from head trauma from objects falling from above; bumping into fixed objects, such as pipes or beams; or contact with electrical hazards. Head protection also can serve to help protect employees from splashes, rain, high heat, and exposure to ultraviolet light.

In this article, we will discuss many of the frequently asked questions related to hard hats.

When Is a Hard Hat Required?
OSHA requires, in 29 CFR 1910.135, that if the following hazardous conditions are present, then head protection is required:

  • Objects might fall from above and strike employees on the head
  • There is potential for employees to bump their heads against fixed objects, such as exposed pipes or beams
  • There is a possibility of accidental head contact with electrical hazards

Other countries or organizations may have additional requirements, but most regulations are hazard based and start with a thorough workplace hazard assessment.

What Industry Standard or Approval Do Hard Hats Need?
This can vary by country or global region because there are various standards in place. In North America, the current standards are the American National Standards Institute (ANSI) Standard for Head Protection, Z89.1 (current version is 2009) and the Canadian Standards Association (CSA) Industrial Protective Headwear, Z94.1 (current version is 2005). These two standards share the “Type” and “Class” descriptors, which makes it easier to ensure that the right hard hats are selected for your application. However, as you will see below, the tests are slightly different, so a hard hat manufacturer must test to all standards that it chooses to meet, based upon the markets in which it wants to sell.

[SEE REST OF THE STORY HERE]

How to Use HIPAA to Obtain Timely Medical Records

Are you hip to HIPAA?

August 27, 2018 by 

Members of the claims management team obtain medical records on a frequent basis when investigating workers’ compensation claims. It is important they do this promptly given the many constraints of workers’ compensation laws. Given the nature of these requests, state and federal privacy laws come into play. Failure to understand these laws and their requirements can lead to delay and problems down the road. Now is the time to better understand these laws and how to incorporate them into your team’s best practices.

It All Starts with HIPAA

HIPAA logo for article, How to Use HIPAA to Obtain Timely Medical RecordsThe Health Insurance Portability and Accountability Act of 1996 (HIPAA) serves as the basis for healthcare privacy and the dissemination of medical records in the United States. The law was enacted in 1996 to address the many issues medical providers were facing and to protect the privacy of all individuals. In essence, it serves as the baseline for standards enacted at the state level for all covered entities.

Understanding the Basics of HIPAA

To understand the law, it is important to understand when it applies and whom it protects. HIPAA applies to all “covered entities,” which are defined under 45 C.F.R. §160.103, as:

Health care providers who transmit “protected health information;”

Entities that process personal health information (healthcare clearinghouses);

Health plans such as Group Health Plans; and

Any business partner of a “covered entity.”

It is also important to note that the federal law applies to “protected health information,” otherwise known as PHI. This is information defined under 45 C.F.R. §164.501, which is individually identifiable health information maintained or transmitted in any form, whether electronically, on paper or orally.

Exceptions to HIPAA in Work Comp

Employees at healthcare providers are required to know and understand HIPAA and have a duty to protect a patient’s PHI. Continue reading How to Use HIPAA to Obtain Timely Medical Records

SmokerStop App Review: A Motivational Tool for Your Patients

Douglas Maurer, DO/MPH/FAAFP | August 2, 2018

Tobacco use remains the #1 preventable cause of morbidity and mortality in the United States and worldwide. Overall, cigarette smoking among U.S. adults (aged ≥18 years) declined from 20.9 percent in 2005 to 15.5 percent in 2016. Still nearly 38 million

smoking cessation info graphic for article, SmokerStop App Review: A Motivational Tool for Your PatientsAmerican adults smoked cigarettes in 2016, according to the Centers for Disease Control and Prevention (CDC). Smoking remains the leading cause of cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD). National efforts have included tobacco taxes and smoking bans which have both proven effective.

More recently, the prescribing of apps for cessation has been utilized and shown to be effective. We recently reviewed and praised the outstanding QuitMedKit from the University of Texas MD Anderson Cancer Center. The app includes nearly everything the primary provider would want to have to aid patients in tobacco cessation: the 5A’s approach, information on medications for cessation, tips on motivational interviewing, graphics to assist in cessation, and links to online resources.

The QuitMedKit app does not include much information tailored to patients regarding personal health and financial goals. The SmokerStop app by Dr Titus Brinker in Germany uses personal motivation as its primary smoking cessation technique. The app uses data input by the patient to calculate health information such as reduction in blood pressure, lung cancer risk, as well as financial goals such as when an ex-smoker will have enough cash for movie tickets, an iPhone, etc. The app also allows patients to put in their own goals. All of this information is tracked by the app and reminders are periodically sent to to the patient to help keep them motivated.

[SEE FULL STORY HERE]

Expanding the Paradigm of Occupational Safety and Health: A New Framework for Worker Well-Being

An article recently published in the Journal of Occupational and Environmental Medicine titled Expanding theWorker Well Being Logo Paradigm of Occupational Safety and Health: A New Framework for Worker Well-Being describes NIOSH’s newly developed conceptual framework for worker well-being. Historically, worker well-being has been measured through job satisfaction, employee engagement, positive emotions, and good mental and physical health.

This framework seeks to define and operationalize the concept of worker well-being through the following domains:

info graphic for article, Expanding the Paradigm of Occupational Safety and Health: A New Framework for Worker Well-Being

  • work evaluation and experience,

  • workplace physical environment and safety climate,

  • workplace policies and culture,

  • health status, and

  • home, community, & society.

This framework can make a valuable contribution to the efforts of researchers, policymakers, employers, workers, and communities as they take steps to better investigate, understand, and improve the well-being of workers. To learn more about the framework and what it means for applications in occupational safety and health, please see the full article HERE.

6 Effective Claim Handling Tips For Undocumented Employees

July 24, 2018 by Michael B. Stack

farm workers for article, 6 Effective Claim Handling Tips For Undocumented EmployeesInterested stakeholders in workers’ compensation need to pay attention to the changing workforce as immigration continues to change the composition of the American workforce.  This includes being mindful of immigration laws and making good faith efforts to comply with the Immigration Reform and Control Act and the employment of individuals authorized to work within the United States.  Notwithstanding these efforts, people without such proper documentation enter the workforce and become injured.  This creates problems for employers and insurers that can add costs to a claim.

Understanding the Basics

The Immigration Reform and Control Act controls employment practices in the United States.  Under this law, only American citizens or non-citizens with the proper work permits are allowed to perform work legally.  However, employers continue to employ people without proper authorization – in some instances knowingly engaging in this type of employment practice.

A state’s workers’ compensation law defines eligibility for benefits.  In many instances, one’s legal employment status does not serve as a bar to benefits after following a work injury.[1]  The issue of hiring someone not legally allowed to work in the United States is not going away.  The only true way to deal with such issues is to make good faith efforts when verifying someone’s work status.  The reality is even if an employer undertakes these efforts, people not legally allowed to work will continue to seek employment.

[SEE FULL STORY HERE]

6 Opportunities to Improve Your Return to Work Program

July 23, 2018 by 

Lost time from work is a significant driver in workers’ compensation claims.  Consider some of the following statistics:

  • On any given workday, up to 5% of the total US workforce is off work;
  • Lost wages and productivity account for $267 billion per year – with roughly $88 billion of that amount attributed to work injuries; and
  • Time off from work due to injury accounts for additional stressors on employees, employers and the claims management team. This includes increased workplace dissatisfaction, loss of workplace morale, increased overtime (including mandatory overtime costs) and a reduction in the quality of work one performs.

Return to Work icon for article, 6 Opportunities to Improve Your Return to Work ProgramThe bottom line is nobody wins when an employee is off work due to an injury.  Based on these factors, interested stakeholder seeking to improve their workers’ compensation programs and improve efficiency should seek to return injured workers to work – and do so as soon as possible.

 

Opportunities to Return Employees to Work

Quick and effective return to work benefits all interested stakeholders.  There are countless ways to return an employee to work following an injury.  It takes time and energy, but it has many benefits to the program’s bottom line.  This requires a plan that needs to be in writing and strictly followed to drive program efficiency.

  • Prepare a written RTW policy: This policy should encourage all employees regardless of their age, tenure with the employer or position to return to work following a work injury.  It should require contact between all interested stakeholders.  One key consideration is the number of weeks an employee can perform light duty work with the date of injury employer.  Doing so tends to motivate employee’s to return to return quickly to work.
  • Prepare a written job description: When it comes to job descriptions, the devil is the details.  Important information should conform to the state’s workers’ compensation act and what is considered “suitable gainful” employment.  Items that need to be defined include both the essential and marginal functions the employee will perform.  The wages and hours and employee will work are also important;[SEE FULL STORY HERE]

Overcome 3 Common Return to Work Barriers

info graphic on factors that can be barriers to returning to work, for article: Michael B. StackMembers of the claims management team and other interested stakeholders in a workers’ compensation program need to be proactive when it comes returning an injured employee back to work. This includes being ethical and hardworking when it comes to vocational rehabilitation matters. This is especially the case when it comes to overcoming common barriers in the RTW and rehabilitation process. Failure to do so can result in increased workers’ compensation costs and other added expenses.

Who is Responsible

The employer is the most important and impactful party in return to work. The best practice is for the employer to develop the position of a “RTW Coordinator.” This should be a person who is knowledgeable in human resource matters, state and federal disability and discrimination laws, and accessible to the entire workforce. The RTW Coordinator should also be responsible for all interactions with the injured worker on behalf of the employer and maintain documentation related to a workers’ compensation claim.

Responsibilities of the Employer: This party is responsible for reporting the work injury and helping with the investigation. The employer should take action in letting the employee know their rights, which is often required under a state workers’ compensation law. They are also responsible for identifying available light-duty work opportunities and monitor the employee’s recovery.

Responsibilities of the Insurer: Coordinate with the employer on all work injury matters and pay for all workers’ compensation benefits the injured employee is entitled to under the law. The insurer can also make recommendations on light duty job opportunities and provide education to their insured.

[SEE FULL STORY HERE]

Navigating the ADA Minefield in Work Comp

July 16, 2018 by 

icon graphic for article, Navigating the ADA Minefield in Work CompInterested stakeholders in any workers’ compensation program need to be aware of the many issues when it comes to running an effective program.  One of those includes being aware of how the American with Disabilities Act (ADA) impacts their program and post-injury efforts to return an employee to work.  Failure to do so can result in fines, penalties and lack of good will.  Now is the time to pay attention and prepare.

What is the American with Disabilities Act?

The ADA was passed was signed into law in 1990 as an amendment to the Civil Rights Act of 1964.  The law prohibits certain discriminatory practices based on an individual’s disability.  The law was amended one most recently in 2008, when President George W. Bush signed amendments to the law that expanded the scope of the ADA to include additional areas of coverage.

Important matters to consider in the context of workers’ compensation claims include the following:

  • Disability: This is defined by the statute to include “a physical or mental impairment that substantially limits one or more of the major life activities;” and
  • Qualified Individual with a Disability: The ADA only applies to an “individual with a disability who, with or without reasonable accommodation, can perform the essential functions of the employment position.”

    [SEE FULL STORY HERE]

What Is A Workers’ Comp Vocational Consultant?

July 12, 2018 by 

Vocational consultants are not needed on most of your worker’s compensation claims; just the severe claims. When an employee has a level of permanent partial disability, to the point that the impairment from the injury will prevent the employee from returning to work, a vocational consultant is required.

Vocational Consultant Evaluates Ability of Injured Employee to Work

vocational rehabilitation consultant tee shirt for article, What Is A Workers’ Comp Vocational Consultant? A vocational consultant evaluates the ability of the injured employee to work and then assist the employee in finding employment within the physical limitations of the employee. The typical course of the vocational process is for the vocational consultant to perform a vocational assessment including vocational testing, perform a labor market analysis, a transferable skills analysis and assistance with job placement.

To access the injured employee’s ability to perform a different occupation, vocational testing is used. Testing to measure the employee’s educational achievement, aptitude, interests, and level of intelligence may be used to gauge what the employee’s skills are. These tests are the first steps in a vocational assessment for the employee.

The vocational assessment for each employee is done on an individualized basis. To make a complete evaluation of the injured employee’s abilities, the vocational consultant will:

  • Complete a detailed interview to obtain the employee’s background information on formal education, trade schools, prior work experiences, interests and hobbies
  • Based on the results of the detailed interview of the employee, a
    transferable skills analysis will be completed
  • Vocational testing to verify the level of the transferable skills the employee has will be completed

    [SEE FULL STORY HERE]

Practical Tips for Implementing Urine Drug Testing

July 2, 2018 by 

urine testing kit for article, Practical Tips for Implementing Urine Drug TestingIdentifying and intervening with at-risk injured workers can save payers a bundle in workers compensation costs. These are the so-called “creeping catastrophic’ claims; the seemingly minor injuries expected to resolve within weeks that go south and before you know it, have been on the books for months or longer. They typically involve a variety of expensive medical procedures and medications, all of which are unsuccessful in alleviating the person’s pain.

This small fraction of workers’ compensation claims encompasses a majority of costs for payers. In recent years, the industry has done a better job of red-flagging these claimants earlier in the process. But an oft-overlooked tool to help is urine drug testing.

Urine Drug Testing helps physicians whether the patient is compliant with prescribed medications and/or using non-prescriber or illicit drugs.

But UDT has been ignored in many cases or overused in others. Using UDT judiciously can be a tremendous help.

The Stats

Recent research shows fewer than half the injured workers prescribed opioids received UDT – 17 percent to 50 percent. However, it also showed that of the top 5 percent of claims, UDT was conducted in 7 out of 10 physician visits.

Guidelines from the American College of Occupational and Environmental Medicine, the Official Disability Guidelines and the Washington State Interagency vary regarding UDT frequency recommendation. But they all call for UDT at baseline when opioids are initially prescribed, then at various times throughout the year based on the injured worker’s risk stratification. Those at low risk may only need UDT every six months to annually; while high-risk claimants might need to be tested monthly.

The testing provides objective information to support improved clinical decision making, and helps medical providers:

[SEE FULL STORY HERE]