Gulfshore Insurance > Gulfshore Blog > Workers' Compensation

Commercial Lines Surge in LitigationA wave of increased litigation will likely emerge as workers who have been laid off see their savings run low and start to look for alternative sources of income. The key to addressing this phase will be how organizations conduct layoffs. Companies that initiate layoffs with little forethought and guidance may see a rise in workers compensation claims and experience numerous other unintended consequences. Companies that develop thoughtful reduction-in-force strategies are likely to see fewer workers compensation claims and lower overall expenses.

To avoid this, consider making settlements on open cases despite the lack of hearings or IMEs. Parties may need cash. Negotiations may resolve informally. Some carriers have seen claims moving to settlement early, sometimes at or below reserve estimates. Therefore, the current economic climate may be creating a prime opportunity to resolve stubborn cases.

Additional Disruptions:
The rise of COVID-19 and the ensuing economic recession are crashing at once and creating profound shifts in the workers’ compensation system. Together these waves will drive changes to the workers compensation system for years to come, reshuffle the insurance industry, and could potentially alter health care in the US.

A decrease in traditional workers’ compensation claims, due to fewer workers and fewer work hours will be at least somewhat offset by an increase in new types of claims, including:

  • COVID-19 claims.
  • Post-termination claims. As waves of workers get furloughed, we can expect a wave of new claims, especially from deeply affected industries such as hospitality and retail. This is driven, in part, by situations where an employee has an injury and may not have filed a claim in a healthy economy but decides to do so in a downturn after seeing his or her bank account run low.
  • Work-at-home claims. These may be related to mental stress, sleep deprivation and other conditions related to extended social distancing. Claims for repetitive strain injuries may also increase.

The “onslaught of pent up demand” for medical treatment among injured workers whose care has been delayed will put stress on the system. Some organizations are expanding care networks and establishing new channels of care. A rise in fraud can be expected in the next few months among attorneys and providers known to engage in workers’ compensation fraud. We should see more claims that are challenging to define as legitimate or fraudulent because they occurred in a distributed work environment where there are no witnesses to corroborate the injury.

The following strategies can help organizations prepare for short- and long-term challenges:

  • Prepare teams to handle an influx of COVID-19 claims. Also, checking and adjusting reserving estimates should be done more frequently.
  • Onboard new tools to increase productivity. New platforms, for example, should be evaluated to help companies prepare for a resurgence when the economy recovers.
  • Augment in-house analytics with artificial intelligence. Smart carriers and TPAs are looking for partners that can augment their in-house expertise with AI-as-a-service. This new approach enables them to unlock unstructured insights buried in scans, images, handwritten notes, combine them with structured data from a cross-industry data lake, and generate predictions based on a range of AI techniques. The result is more accurate forecasts overall, and the ability to generate predictions on unique emerging cases, such as COVID-19.
  • Expand provider networks. Along with preparing for recovery, incorporating new specialists is also advised; such as pulmonologists and immunologists who can treat conditions such as COVID-19.
  • Optimize legal panels.
  • Consider settling potentially expensive claims.

If you have any questions, please do not hesitate to reach out. We are here to help.

Dave Wissel is a Client Advisor and Partner at Gulfshore Insurance who specializes in construction, landscaping, and the oil and petroleum industries. Comments and questions are welcome at dwissel@gulfshoreinsurance.com

Please note: The content of this article was taken from workerscompensation.com

COVID-19: OSHA and Workers' CompensationAs a business owner and employer, COVID-19 has likely caused major changes in the way you are operating your business. As we now look to reopening the economy and other segments of business, you should be prepared for when an employee falls ill or tests positive for COVID-19.

OSHA has provided Guidance on Preparing Workplaces for COVID-19. In addition, you should consider how Workers’ Compensation may apply and if there is any necessary OSHA reporting if you have an employee test positive.

Workers’ Compensation Benefits:

Historically, it has been difficult for an employee who is not working “on the front lines” (i.e. healthcare industry, emergency response, fire, law enforcement) to receive Workers’ Compensation benefits due to a communicable disease or an “ordinary disease of life” as it is often referred. An ill employee not working in the job descriptions listed above has a heightened burden of proof to show that the illness arose out of or was caused by conditions peculiar to the work, and that he/she had a greater risk of contracting the disease in a different manner than the general public. That being said, as more employees fall ill, there is sure to be many workers who will try to prove that case.

OSHA 300 Reporting:

OSHA has released a memorandum specifically addressing COVID-19 reporting. For occupations other than healthcare, emergency response (fire and law enforcement) and correctional institutions, COVID-19 must be reported on the OSHA 300 if the following is true:

  1. It is a confirmed case of COVID-19, as defined by the CDC
  2. The case is believed to be work-related (i.e. several cases developing among workers)
  3. The evidence being work-related was reasonably available to the employer (i.e. information given to the employer by employees, or information an employer learns regarding employees’ health and safety in the ordinary course of managing its business and employees).

Needless to say, if you have knowledge that an employee has been exposed to COVID-19, keep them away from the rest of your workforce, at home, and look to pay them their normal wages during that time.

For more information regarding COVID-19 OSHA requirements and employers’ responsibilities, visit the OSHA COVID-19 Information Page.

Jeffrey Sanders, TRIP is Client Advisor at Gulfshore Insurance. Jeff works with a wide range of business clients to deliver strategic risk analysis, guidance, and insurance. Comments and questions are welcome at jsanders@gulfshoreinsurance.com

The Occupational Safety and Health Administration released guidance to help employers prepare their workplaces for an outbreak of COVID-19 — along with a reminder that any incidents of employees contracting the novel coronavirus at work are recordable illnesses, subject to the same rules and failure-to-record fines as other workplace injuries and illnesses.

While OSHA specifically exempts employers from recording incidents of employees contracting common colds and the flu in the workplace, COVID-19 is not exempt, the agency noted on a newly added website providing OSHA guidance for preventing occupational exposure to the rapidly spreading virus.

The guidance, while not a standard or regulation, outlines safety standards that employers whose workers are at high risk of contracting COVID-19 should implement to remain in compliance with the Occupational Safety and Health Act’s general duty clause.

The report also advises employers to develop an infectious disease preparedness and response plan, implement basic infection prevention measures and develop policies for the identification and isolation of ill individuals.

OSHA recently unveiled the top 10 violations of 2019. It was no surprise that familiar violations from the past few years crowded the list. Fall protection led the list with more than 6,000 violations, followed by more than 3,500 violations of the hazard communication standard.

  1. Fall Protection – General Requirements – 6,010 violations. This is the ninth year in a row this Construction standard has had the most OSHA violations. Among those most cited: roofing contractors, masonry contractors, and commercial and home builders.
  2. Hazard communication – 3,671 violations. Problems that come up the most: no hazcom program, no worker training on hazcom, and lack of safety data sheets (SDSs). Employers most cited: masonry contractors, painting and wall covering contractors, machine shops, and general contractors.
  3. Scaffolding – 2,813 violations. Where companies are going wrong: Using cross-braces as scaffold access, not fully planking, scaffolds not on firm foundations, and no guardrails. Employers most cited: masonry contractors, roofing contractors and commercial builders.
  4. Lockout/tagout – 2,606 violations. Companies cited don’t have LO/TO rules for specific machines, employees aren’t trained, there’s no periodic evaluation of the program, and LO/TO devices aren’t affixed. Among industries most cited: product manufacturing and sawmills.
  5. Respiratory protection – 2,450 violations. Companies aren’t providing employees with a medical evaluation before they use respirators, they don’t have a respiratory protection program, and employees don’t receive a fit test. Most cited: Auto maintenance, masonry contractors, cut stone contractors and painting and wall covering contractors.
  6. Ladders – 2,345 violations. Problems inspectors find most: ladders not extending at least three feet above a landing, using the wrong type of ladder, employees using the top step, and ladder structural defects. Most cited: Roofing, framing, siding and painting contractors.
  7. Powered Industrial Trucks – 2,093 violations. Problems inspectors find most: trucks not operating in a safe manner, operators not re-evaluated every three years, no certificate of training, and trucks in unsafe condition. Most cited: warehouses, framing contractors and machine shops.
  8. Fall protection – Training requirements – 1,773 violations. Inspectors find employees weren’t provided training, there’s no written certification, training is inadequate, and employees don’t retain training. Most cited: roofing, framing, siding, commercial and residential contractors.
  9. Machine guarding – 1,743 violations. Employers aren’t guarding points of operation; equipment isn’t anchored properly and fan blades aren’t guarded. Most cited: machine shops and metal shops.
  10. Personal protective equipment – eye and face protection – 1,411 violations. Workers aren’t protected from flying parts, liquid chemicals and radiant energy (welding), and there’s no side protection for eyes. Most cited: roofing, framing, masonry and siding contractors.

 

truckingWe know that workplace injuries are costing your business money in a many ways; increased insurance premiums, cost of hiring and replacement, lost efficiency, additional training, increased paperwork and administrative costs, and more.

According to the Bureau of Labor Statistics, professional truck drivers suffer more injuries than any other industry.

Why are these injuries happening?
A recent 10 year study out of Washington state gives us the statistics behind the leading Truck Driver injuries…

  • 40% are due to Musculoskeletal Injury (strains, sprains, pulls, overexertion, etc.)
  • 19% are due to Falls from Elevation or Same Level (mostly getting in or out of the vehicle)
  • 12% are due to being Struck By or Against an Object (falling object, swinging door, etc.)
  • 9% are due to Vehicle Crashes

 

Most of these injuries are preventable with the proper training, planning and awareness.  Keep your employees safe and your premiums and other injury costs down by taking a proactive approach.

Musculoskeletal
Scenario: Moving containers or equipment (boxes, crates, bins etc.)
Solution: Provide proper lift training and “strategy”.  Employees should first evaluate, then lift.  Use mechanical aids when necessary.

Falls from Elevation or Same Level
Scenario: Falling while entering/exiting the vehicle and trailer/loading area.
Solution:  Use the “3-Point Contact” rule when entering or exiting – no jumping.  Provide proper step conditions (step ladder to cab/trailer).  Provide training and reminders that employees cannot jump from trailer or cab.

Struck by or Against an Object
Scenario: Struck by container or loose cargo.
Solution:  Provide ample equipment to secure/store cargo properly.  Replace binders/straps if they are worn.  Train employees on proper stacking and loading techniques.

Crashes
Scenario: 29% of all crashes are Rear-End Collisions.  Most of these are due to following too closely.
Solution:  Use a “4-second rule” when following another vehicle.  Reduce speed increase following distance in poor/wet conditions.  Constantly discuss and remind drivers of the importance of keeping proper following distance.  Provide trainings and information about proper following techniques.

Investing in safety and training for your employees will pay dividends by keeping insurance premiums and injury related costs down over the long haul.

At Gulfshore Insurance, we specialize in insurance and risk management in the trucking and transportation industry. We work with more than 10,000 clients throughout Florida and we are happy to assist you with training materials, safety programs, and insurance for your business.

Jeffrey Sanders, TRIP is Client Advisor at Gulfshore Insurance. Jeff works with a wide range of business clients to deliver strategic risk analysis, guidance, and insurance. Comments and questions are welcome at jsanders@gulfshoreinsurance.com