It Takes Twice as Long to Close California Workers’ Comp Claims Compared to Other States
File this under the “I’m not surprised” file, it takes seven years to close most workers’ compensation claims in California, more than double the time in the median state.
The Workers’ Compensation Insurance Rating Bureau of California (WCIRB) released a report detailing duration drivers for California workers’ compensation claims.
The report, Drivers of California Claim Duration, describes duration drivers for California workers’ comp claims, including how claim duration differs regionally across the state.
Here’s the report:
Highlights of the report include:
- It takes seven years to close 90% of claims in California compared to three years for the median state.
- Longer California claim duration is driven by four “duration drivers,” including a higher share of permanent partial disability and cumulative trauma claims in California, greater utilization of medical-legal services in California and regional differences within the state.
- Claim closing rates rose steadily following the reforms of Senate Bill 863, particularly for PPD claims of lower-wage workers.
- Claim closing rates declined during the pandemic in 2020 and were relatively flat in 2021.
California, why do you have to make everything so complicated? [banging head on desk]
Source: Insurance Journal
-JK
OSHA’s Updated COVID-19 Guidelines: What Businesses Should Do Now to Avoid Penalties and Legal Pitfalls
As businesses wait to see whether OSHA will issue emergency temporary standards and OSHA State Plans renew and consider their own standards, find out what your business can do now to get ready.
Hear from an OSHA 30 Certified legal specialist on the highlights of OSHA’s January 29, 2021 Guidance on Mitigating and Preventing of COVID-19 in the Workplace, how both management and employees play a role in developing and implementing the revised safety requirements, and how to minimize related legal risks.
In this pre-recorded webinar, AmTrust’s Kelley Barnett, VP Corporate Counsel – Labor and Employment and OSHA 30 Certified and Jeff Corder, VP of Loss Control shared:
- Why should businesses care about the updates, and what are the consequences of NOT caring?
- What do businesses need to know to implement OSHA’s guidelines?
- What changes should businesses implement to avoid compliance landmines and legal pitfalls and get ready for increased OSHA enforcement?
OSHA 300A Summary Posting Reminder
It’s that time of year when employers are required to tally the number of entries on their “Log of Work-related Injuries and Illnesses” (OSHA Form 300), and post the “Summary of Work-related Injuries and Illnesses” (OSHA Form 300A) in a prominent location.
The OSHA Summary Form 300A is required to be posted in the workplace beginning Feb. 1, 2018, and must remain posted for the entire three months of February, March, and April. It should be in an easily visible location so that employees are aware of the injuries and illnesses occurring in their workplace.
Employers that had 11 or more employees the previous year — except those in certain low-hazard establishments in the retail, professional services, finance and real estate sectors — are required to maintain records of all work-related injuries and illnesses, and post the summary of their records for the 2017 calendar year.
Many employers under Federal OSHA are required to electronically submit the summary of injuries and illnesses to OSHA. To ensure your entire management team is aware of these changes, I suggest making OSHA’s Recordkeeping Rule one of your first training sessions of the new year.
Workers’ Compensation Fraud Billboard in San Diego
During a quick day trip down to San Diego last weekend, I caught this billboard from the San Diego County District Attorney which kind of took me by surprise. Picturing a handcuffed jail inmate it reads “Commit Workers’ Comp Fraud, Get A New Outfit.” In addition, “don’t do it, don’t tolerate it, report it” with a phone number to call right there. As a commercial insurance professional who sees’s businesses affected by this often, it was kind of refreshing to see actually. Here’s the sign:
Taken straight from the California Department of Insurance:
In California, workers’ compensation insurance is a no-fault system. Injured employees need not prove an injury was someone else’s fault in order to receive workers’ compensation benefits for an on-the-job injury. In addition to medical expenses being covered for injured employees, some injured workers are entitled to recover a portion of lost wages resulting from an injury. Fraudulent workers’ compensation claims can be an enticing target for criminals.
Workers’ compensation insurance fraud occurs in simple and complex schemes that often require difficult and lengthy investigations. Employees may exaggerate or even fabricate injuries. At the other end of the spectrum, white-collar criminals, including doctors and lawyers, entice, pay, and conspire with others to defraud the system by creating false or exaggerated claims, overtreating, and over prescribing harmful and addictive drugs. Insurance companies “pick up the tab,” passing the cost onto policyholders, taxpayers, and the general public.
The Workers’ Compensation Fraud Program was established in 1991. The legislature made workers’ compensation fraud a felony, required insurers to report suspected fraud, and established a mechanism for funding enforcement and prosecution activities. The legislation established the Fraud Assessment Commission to determine the level of assessments to fund investigation and prosecution of workers’ compensation insurance fraud.
Funding for the program comes from California employers who are legally required to be insured or self-insured. The total aggregate assessment for the fiscal year 2015-16 was $58,862,000.
During the fiscal year 2015-16, the Fraud Division identified and reported 5,380 suspected fraud cases; (SFCs) assigned 502 new cases, made 249 arrests and referred 167 cases to prosecuting authorities. Potential loss amounted to $193,354,616.
Workers’ Compensation Fraud Convictions
-JK
3 Key Elements of A Safety Culture
According to OSHA, “Safety cultures consist of shared beliefs, practices, and attitudes that exist at an establishment. Culture is the atmosphere created by those beliefs, attitudes, etc., which shape our behavior.”
Safety culture is the overall organizational attitude, belief, and values associated with safety in the workplace.
See the three key elements of a safety culture from Employers Compensation Insurance Company:
Many small and medium-sized businesses fail to invest in safety, when they’re the ones that can benefit the most from it. They have the most to lose in the face of a costly workplace accident. Creating a climate of safety doesn’t have to break the bank and it doesn’t require a large investment of time or a committed safety officer. Contact me today if you need help for your business.
Research is showing that, for every dollar a business invests in preventative measures, they’re seeing a four dollar return on that investment.
-JK
Los Angeles Has Highest Workers’ Comp Claim Costs in California
File this under the No Surprise folder but a new study by the Workers’ Compensation Insurance Rating Bureau show that Los Angeles has the highest workers’ comp claim costs in California.
Among other key findings, “The Los Angeles/Long Beach Area is the most litigious region in California. Medical legal costs are over 2.8 percent of total incurred costs on indemnity claims in the Los Angeles/Long Beach area compared with 2.0 percent statewide.”
“Indemnity claim frequencies in the Los Angeles/Long Beach area were 24.0 percent higher” than the rest of the state of California.
Read more here from the Insurance Journal:
As frustrating as this is, none of it surprises me. Not a week goes by where I don’t see a workers’ comp claim come across my desk for “cumulative trauma” or “repetitive motion” from an attorney after termination of an employee. And as I always say, nobody hurts more from this than the honest business owner trying to get by everyday running an honest business. They’re the ones paying the costs of these claims.
Here’s a map showing the regional differences of indemnity claims as a share of the total claims counts in California:
-JK
Top 5 Workers’ Compensation Injury Types
Data recently collected from the Bureau of Labor Statistics and the National Academy of Social Insurance shows that 65% of workers’ compensation costs can be traced to five common workplace injury types. By knowing the top five Workers’ Compensation injury types, employers can target those injuries and take action to prevent them.
According to the data, the following are the top five injury types:
- Overexertion injuries which are caused by pushing, pulling, carrying, holding or throwing.
- Falls on the same level that may happen for a variety of reasons, such as a wet floor or a tripping hazard.
- Being struck by equipment or an object, or even a vehicle. These injuries are common in the construction industry.
- Falls to a lower level, which can be prevented by using proper fall protection, ladder safety or scaffolding.
- Other exertions or bodily reactions, which can cause strains and sprains.
A safe workplace and injury prevention are vital to keeping your workers’ compensation costs down. If your company has an increased number of claims compared to previous years, this can directly affect your experience modification factor (also known as your mod factor) and increase your workers’ compensation premium. On the other hand, decreasing your number of claims can lower your mod factor and your premium.
For more information on workplace safety, including implementing or updating a safety program in your workplace, contact me at (310) 373-6441. We have the tools to help you take control of your workers’ compensation costs.
-JK
2014 Most Frequently Cited OSHA Standards
The Occupational Safety and Health Administration (OSHA) recently unveiled its top 10 most frequently cited violations at the annual National Safety Council Congress and Expo. The agency reports the leading causes of workplace injuries during its fiscal year (October through September).
The 2014 top 10 list of most frequently cited standards did not change significantly from 2013, with fall protection violations remaining at the top of the list. In fact, the top four most cited violations remained the same. The 2014 top 10 most frequently cited standards are as follows:
- Fall Protection (29 CFR 1926.501)
- Hazard Communication (29 CFR 1910.1200)
- Scaffolding (29 CFR 1926.501)
- Respiratory Protection (29 CFR 1910.134)
- Lockout/Tag out (29 CFR 1910.147)
- Powered Industrial Trucks (29 CFR 1910.178)
- Electrical – Wiring Methods (29 CFR 1910.305)
- Ladders (29 CFR 1926.1053)
- Machine Guarding (29 CFR 1910.212)
- Electrical – General Requirements (29 CFR1910.303)
This is kind of the abbreviated version. If you’re interested in seeing the definitions/explanations of these violations, you can contact me direct and I’ll send.
-JK
Bank Robbery Conspirator/ Deadbeat Charged With Workers’ Comp Fraud
One of the various reasons we see Workers Compensation Insurance rates on the rise are due in part to deadbeats like this. Not only in aiding of the robbery of her on bank branch of $565,500, Aurora Barrera, 33, later filed a claim for post-traumatic stress disorder. “The bank’s insurance company subsequently paid her more than $35,000 in disability benefits and covered more than $9,000 in medical bills associated with the alleged workplace injury.”
See the full story from the Los Angeles Times. More than happy to see her locked up for 9 years. Honest employers pay the price for frauds like Aurora Barrera.
-JK
Is Sitting The New Smoking?
Some doctors are saying that sitting is the new smoking. According to the Mayo Clinic, sitting, like smoking, is a pervasive problem that harms your health. Approximately 80% of Americans work a non-active job, making all-day sitting a common occurrence.
Lengthy, uninterrupted periods of sitting cause poor circulation and low calorie burn and are linked to various health problems, including obesity, hypertension, diabetes and cardiovascular disease, as well as stiffness, headaches and sluggishness.
Your job may require you to spend a considerable amount of time at a desk, or maybe you’re fond of all-day movie marathons. Try these tips to sit less, move more and improve your health:
- Stand while talking on the phone or watching television.
- Have a walking or standing meeting at work.
- Stand up and stretch at least every hour.
- Wear a pedometer and find ways to add steps into your daily routine.
- Take the stairs when possible.
- Consider walking or biking when commuting to work or running errands.
Source: Zywave, Inc.
JK
About Me
I grew up in Fullerton, CA and graduated from Servite High School in Anaheim. I have my Bachelors degree from Loyola Marymount University in Los Angeles. I currently live in Tustin, CA.
Please contact me if you need help with any of the following lines of insurance for your business:
-Businessowners
-Property
-Commercial General Liability
-Product Liability
-Workers Compensation
-Group Medical
-Commercial Auto
-Umbrella/Excess Liability
-Errors & Omissions/ Professional Liability
-Employment Practices Liability
-Directors & Officers
-Life & Disability Insurance
Jimmy Kinmartin, CPCU 