Interested 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. 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.
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.
The 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]
Interested stakeholders in the workers’ compensation process are constantly seeking ways to reduce program costs.
One area includes the discontinuance of workers’ compensation benefits for school employees and teachers suffering from the effects of a work injury during the summer break period. While statues and case law interpretations vary in each jurisdiction, employers and insurers are generally limited in their ability to discontinue or suspend various workers’ compensation benefits for school employees during this time of year – even if they have no plans of looking for work while under restrictions on their activity.
Schools Out – Time to Discontinue Work Comp Benefits?
While the school year typically runs from late August through late May, employees of school districts around the country sustain work-related injuries every day. The ongoing effects of those work injuries do not magically disappear for summer break. Sadly, those hot summer days a teacher, paraprofessional or administrative staff employee would like to spend at a beach, can be spent at home convalescing. Proactive members of the claims management team might view this as an opportunity to discontinue ongoing wage loss and vocational rehabilitation benefits. Unfortunately, this is often not consistent with many state workers’ compensation laws via case law interpretation.
One case on point comes from Minnesota, where a school district sought to discontinue ongoing wage loss benefits at the conclusion of a school year. The rationale for the discontinuance was based on the premise the employee did not intend to work during the summer months, and the result was no loss in wages. A compensation judge rejected this argument and affirmed by the Minnesota Workers’ Compensation Court of Appeals.
You have implemented a corporate return-to-work program, but your projected workers’ compensation savings haven’t yet materialized. Supervisors are telling you they can’t get employees back to work, and even if they could they don’t WANT them to return to work. We’ve all heard it.
It may be time to examine the impact of collateral resources, often resulting in employees out on workers compensation receiving more income and benefits than they would have if they were working.
Common Disincentives to Returning to Work:
Salary and Wage Continuation: Some companies pay 100% of salary in lieu of having an employee collect workers compensation for injuries of short duration.
Occupational Injury Pay Supplements: Many firms pay supplemental benefits to make up the difference between workers compensation benefits and regular earnings.
Open-Ended Job Return: Instead of holding jobs open indefinitely, employers should hold jobs open for a specific time period, such as six or nine months.
Vacation and Sick Time: Companies frequently allow vacation and sick time to accrue for employees on workers compensation. Some even allow employees to “borrow” more sick time if they need to stay out of work longer.
Short-Term Disability: In some companies, disabled employees receive STD benefits in lieu of salary after six weeks. But the standard definition for disability may differ from workers comp, allowing an employee to collect both.
Perk Continuation: Employers often maintain ancillary benefits and privileges such as car allowances, club and professional dues, company store privileges and periodical subscriptions for employees on disability.
Loan Protection Policies: Individual insurance policies are available to pay mortgages and consumer loans such as car loans and credit card debts in the case of a disability.
Unemployment Compensation: In a few states, an employee receiving workers comp also can qualify for state unemployment benefits.
“We find extensive opioid prescribing leads to longer duration of temporary disability. When we compare the effect of longer-term opioid prescriptions with no opioid prescriptions, the effect is to triple the duration of temporary disability benefits.”
That finding from the Workers Compensation Research Institute highlights the latest trends in the opioid epidemic as it relates to the workers’ compensation industry. It represents the first evidence of a causal relationship between long-term opioid use and disability duration. The authors will be on hand to delve into the research and the topic during WCRI’s Annual Issues and Research Conference in Boston this month.
The WCRI researchers looked at data from 28 states for low back pain injuries between 2008 and 2013 where workers had more than 7 days of lost work time. Additional findings were:
Local prescribing patterns play a significant role in whether injured workers receive opioid prescriptions. In certain states and particular areas within states, injured workers are more likely to receive opioid prescriptions than in other areas. When they compared injured workers with the same injuries in different areas, they found that a 10 percentage point increase in the local rate of longer-term opioid prescribing was associated with a 2.6 percentage point higher likelihood that a similarly injured worker would receive longer-term opioid prescriptions.
Opioid prescriptions persist, despite recommendations against them. While most medical guidelines do not typically recommend prescribing of long-term opioids for low back pain, about 12 percent of WCRI’s sample had them prescribed, and about 39 percent of workers had at least three opioid prescriptions.
Orlando, FL (WorkersCompensation.com) – Several national workers’ compensation experts will lead 1.5 hour sessions during the National Rx Drug Abuse Summit April 10-12 at the Walt Disney World Swan Resort in Orlando, Fla.
· Joseph Paduda, principal of Health Strategy Associates and president ofCompPharma, LLC, and Dr. Richard Victor, Executive Director of the Workers’ Compensation Research Institute, discuss factors leading to opioid abuse in workers’ compensation, regional variations of narcotics use and strategies employers are using to help addicted employees regain control of their lives and return to work. The session starts at 1:30 p.m. on Wed., April 11.
· Showcasing Washington State’s guidelines, Dr. Gary M. Franklin, MD, MPH, Medical Director, Washington State Department of Labor & Industries and Dr. Alex Cahana, MD, MAS, DAAPM, FIPP, Endowed Professor with University of Washington Medical Center explore ways to curb the use of narcotics through physician education, treatment guidelines and community-wide integration of care. This also starts at 1:30 p.m. on April 11 in a different track.