Archives for November 2015

Workers Comp Innovators At NWCDC – One Astounding Company

November 19, 2015 By JL Risk Management Consultants

Workers Comp Innovators At The NWCDC

Almost all of the workers comp innovators at the NWCDC (National Workers Comp and Disability Conference) in Las Vegas were the exhibitors. Three years ago, I visited every booth, and found basically zero innovation. Exogen had the most innovative product. Yes, a bone stimulator was the most innovative product or service.

clip art with bulb workers comp innovators black back ground

Last year, as this year, the innovators seemed to recognize that WC can be a major market for their products. The innovation was not from the WC industry itself. The innovative vendors were actually from outside of the insurance world.

The companies that were seen as innovative last year were Proove Pharmaceuticals and Thermazone.

The sessions this year were very good overall. I could not find one that actually covered an innovative product or service. The sessions on Oklahoma’s opt out program would have been the closest for my search.

The vendor area access times were quite different than in years past. I was able to visit some of the displays/booths to find any workers comp innovators.

The gentleman at the Thermazone booth was quite informative. See the above link for more information.

There was also a vendor that provided a mousepad keyboard for injured employees. However, they were supposed to ship me one to test- which I would have sent back – that did not arrive last year. I left my card with the booth this year.

Advanced Arm Dynamics was amazing.

From the company’s website –

clipart of four bulb workers comp innovators Big Idea

Advances in technology, materials and design are the momentum behind the newest generation of upper extremity prostheses. We work with manufacturers all over the world to help design, test and improve new products. Recent tech trends include: multi-articulating hands with specialized grasp patterns; custom electric digits for finger amputees; custom fabricated silicone interfaces that accelerate comfort; and innovative surgical techniques that may significantly improve a person’s ability to use a prosthesis. New technologies present an increasingly brighter future for people who rely on upper extremity prosthetics.

I will add in more cutting edge companies from the conference later this week or next week.

The WC industry has always lagged behind in technology. I must admit that I am also behind in certain tech areas. I actually tried Uber for the first time in Vegas. Now, that is an innovative service. OK, stop laughing.

The official charity from the 2015 NWCDC was Kids Chance. It is a worthy cause. Someone gave me a Kids Chance pin that I had worn during the entire conference.

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Workers Comps Future – Recruiting/Retaining Next Generation

November 17, 2015 By JL Risk Management Consultants

Workers Comps Future – Recruiting & Retaining the Next Generation of Claims Talent

The Workers Comps future rests on the next generation of claims talent.

Picture Of Three Woman Workers Comps Future Looking Up

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Jennifer Burkhart | National Workers’ Comp Claims Leader, Westfield Insurance

Dan Holden | Manager of Corporate Risk & Insurance, Daimler Trucks North America

Rick Thompson | VP of Talent Management & Administration, Rising Medical Solutions

November 12, 2015 2:00pm – 3:15pm

*The title may seem incorrect. The WordPress system does not like apostrophes. Please excuse the odd-sounding phrase.

This NWCDC Session was PM5 from the Program Management track. I decided to attend this one as this subject was one of the major concerns at the Rising Medical Think-Tank from earlier this year.

One of the better slides during this session pointed out how offices were 10 years ago.

No cell phones while at work.
Business formal dress code.
Very little schedule flexibility or work from home.
123RF
Employee handbook over 100 pages.<<<Actually a conservative figure
Annual reviews (quarterly today, with daily huddles and weekly touch-bases).
Less than 10% of workers were Millennials (today it’s over 50%).
One computer desktop/screen. Few laptops. No smartphones or tablets.
Virtually no online collaboration (email document-based).

The session centered very heavily on appealing to Millennial generation workers. One statistic that was shocking to me was the workforce now being 50% Millenials.

Millennial Challenges

They don’t know/care about insurance/risk management (not “sexy” or fun). That is actually a given.
Loyalty/commitment (high turnover). This was occurring in the industry long before Millennials were on the scene.
Talent shortage of 85,000 commercial claims professionals in 2015 (Deloitte). Expected to grow to 400,000 in five years (Insurance Journal).
WSJ – Insurance on “least desirable industries” list.

Until this session, I did not realize the insurance industry is and will be experiencing such a heavy shortage of workers. The shortage reaching almost 1/2 million workers total is astounding.

The rest of the session covered how each respective company is recruiting, training, and retaining the millennial generation. This was a great session that “looked outside the box” so to speak.

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How Nurse Case Managers Add Value to WC Claims

November 13, 2015 By JL Risk Management Consultants

CM3: How Nurse Case Managers Add Value to Workers’ Compensation Claims

Workers Comp claims a nurse case managers and add value. Mary O’Donoghue, Vice President, Medical Services Helmsman Management Services

Picture of Nurse Case Managers Medical & Health Management

Wikipedia – Rosie.Andre

Stephanie Perilli, Senior Director, Medical & Health Management The Home Depot

November 12, 2015 8:30 a.m. – 9:45 a.m

Nurse Case Managers (NCM) have long been a recommended WC claims management technique as recommended by J&L often. The right case managers can reduce the cost of claims greatly.

This is a chart that shows the value of a nurse case manager as a claim lengthens by comparing the claim costs with and without a nurse case manager.

There are instances where a NCM may not provide value such as an injured employee with no comorbidities and a great relationship with the employee<<I thought that was a great point of emphasis.

An employer-based study compared shoulder surgery claims with nurses to similar claims from 31 other companies that did not have a nurse assigned. Claims with a nurse assigned had 57% fewer disability days. From my experience, this is a valid %.

Home Depot uses nurses in these instances:

Unique intervention based on assessed needs of our population
Targeted case management strategy beyond catastrophic cases
Clear and concise integration of all medical resources

That was a nice summary list.

Home Depot calculated they are experiencing a 12% reduction in claim payouts when an NCM is on the file.

This was a good presentation on Nurse Case Managers. I have even seen larger reductions in claim values when a nurse is involved on the file. The key is to know when and whether or not to assign a NCM.

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Rising Medical Solutions Comprehensive Think Tank Report

November 10, 2015 By JL Risk Management Consultants

Rising Medical Solutions Invited James Moore To Think Tank

A very forward-thinking company – Rising Medical Solutions- and Peter Rousmaniere invited me to a think tank type meeting earlier this year in Chicago.

Picture Of Doctor Rising Medical Solutions Holding Stethoscope

Wikimedia Commons – Alex Proimos

There is no article on the J&L Risk Management website that covers the meeting as I decided to hold off until the final report was finished earlier this month. The all-day fly-in meeting was hosted by Rising Medical Solutions out of Chicago. From what I gather, the meetings had started in 2009 and continued through 2015.

Rising Medical Solutions were great hosts including their Head of Marketing Rachel Fikes. I very quickly felt at home. The summary report link is here. Yes, you do have to provide very little information to receive a copy of the report. It is worth it.

The report is 36 pages long. You can request the report here. Rising Medical Solutions is not a spammy company so your inbox will not be packed with emails from them if you happen to sign up. They have sent me two emails since June- not spammy.

Doctor Rising Medical Solutions With Files

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One very important area covered was improving the recruiting, hiring, training, and retention of claims adjusters. Check this older post by me with my concerns on the brain-drain and lack of a younger crowd in adjusting and Risk Management.

This is an area where there will be a large amount of future discussion. Claims and Risk Management are not the glamorous smart-phone based positions that appeal to the current crop of college graduates or young workers.

Even though I did “end up with the skunk” by the end of the meeting, it was time well spent. That is an inside joke.

Denise Zoe Algire – Safeway’s Risk Management guru also deserves a shout-out as she is the lead researcher on this much-needed study.

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Trans-Pacific Partnership Obamatrade Agreement Full Access

November 6, 2015 By JL Risk Management Consultants

Trans-Pacific Partnership Obamatrade Agreement Access

Wikimedia Commons – The White House

The full Trans-Pacific Partnership Obama trade agreement was a rare find.

I have received any inquires as to the link in the last article on the TPP Obamatrade agreement. It seems the Feds have split it into hundreds of documents. I do not necessarly understand why the Feds decided to split the document into so many subsections that make it almost impossible to follow.

I downloaded a full copy yesterday from the website before the split. The complete PDF is here. This is coming off our server, so please be patient as the document is large for a PDF file. At the time of the publication of this post, this site is the only place to find the complete document. It was just blind luck to obtain a complete copy before the TPP was divided up into so many parts.

It is massive, but you may want to at least skim it. You will likely need a PDF plugin besides having the updated Adobe PDF Reader. Your computer will let you know if you need the plugin.

Smartphone users – the document is 23.4 MB.

Document Storage – TPP Obamatrade – No copyright.

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Trans-Pacific Partnership Agreement Contains Workers Comp Provision

November 6, 2015 By JL Risk Management Consultants

Trans-Pacific Partnership Agreement Page 4343

How is Workers Comp Affected?

The Trans-Pacific Partnership Agreement (TPP) is now the new buzzword in the political arenas. The controversial agreement was just released yesterday. How many times does it appear in the TPP? Will it affect WC?

two person shaking hand pacific partnership agreement descriptive

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Actually the TPP only mentions WC once. It is on page 4343. The complete section that begins on page 4341 is contained below.

The exact text is highlighted below in red.

Actually the TPP defines WC as social protection. If you want to see a copy of the massive text, you may find it here.

Article 19.10: Cooperation

1. The Parties recognise the importance of cooperation as a mechanism for effective
implementation of this Chapter, to enhance opportunities to improve labour standards and to
further advance common commitments regarding labour matters, including workers’
wellbeing and quality of life and the principles and rights stated in the ILO Declaration.

2. In undertaking cooperative activities, the Parties shall be guided by the following
principles:
(a) consideration of each Party’s priorities, level of development and available
resources;
(b) broad involvement of, and mutual benefit to, the Parties;
(c) relevance of capacity and capability-building activities, including technical
assistance between the Parties to address labour protection issues and activities
to promote innovative workplace practices;
(d) generation of measurable, positive and meaningful labour outcomes;
(e) resource efficiency, including through the use of technology, as appropriate, to
optimise resources used in cooperative activities;
(f) complementarity with existing regional and multilateral initiatives to address
labour issues; and
(g) transparency and public participation.

Wikimedia Commons – Antichik

3. Each Party shall invite the views and, as appropriate, participation of its stakeholders,
including worker and employer representatives, in identifying potential areas for cooperation
and undertaking cooperative activities. Subject to the agreement of the Parties involved, cooperative activities may occur through bilateral or plurilateral engagement and may involve
relevant regional or international organisations, such as the ILO, and non-Parties.
4. The funding of cooperative activities undertaken within the framework of this Chapter
shall be decided by the Parties involved on a case-by-case basis.
5. In addition to the cooperative activities outlined in this Article, the Parties shall, as
appropriate, caucus and leverage their respective membership in regional and multilateral
fora to further their common interests in addressing labour issues.
6. Areas of cooperation may include:
(a) job creation and the promotion of productive, quality employment, including
policies to generate job-rich growth and promote sustainable enterprises and
entrepreneurship;
(b) creation of productive, quality employment linked to sustainable growth and
skills development for jobs in emerging industries, including environmental
industries;
(c) innovative workplace practices to enhance workers’ well-being and business
and economic competitiveness;
(d) human capital development and the enhancement of employability, including
through lifelong learning, continuous education, training and the development
and upgrading of skills;
(e) work-life balance;
(f) promotion of improvements in business and labour productivity, particularly
in respect of SMEs;
(g) remuneration systems;

Trans-Pacific Partnership Agreement Leader Member Picture

Wikimedia Commons – Gobierno de Chile

(h) promotion of the awareness of and respect for the principles and rights as
stated in the ILO Declaration and for the concept of Decent Work as defined
by the ILO;
(i) labour laws and practices, including the effective implementation of the
principles and rights as stated in the ILO Declaration;
(j) occupational safety and health;
(k) labour administration and adjudication, for example, strengthening capacity,
efficiency and effectiveness;
(l) collection and use of labour statistics;
(m) labour inspection, for example, improving compliance and enforcement
mechanisms;
(n) addressing the challenges and opportunities of a diverse, multigenerational
workforce, including:
(i) promotion of equality and elimination of discrimination in respect of
employment and occupation for migrant workers, or in the areas of
age, disability and other characteristics not related to merit or the
requirements of employment;
(ii) promotion of equality of, elimination of discrimination against, and the
employment interests of women; and
(iii) protection of vulnerable workers, including migrant workers, and lowwaged,
casual or contingent workers;
(o) addressing the labour and employment challenges of economic crises, such as
through areas of common interest in the ILO Global Jobs Pact;
(p) social protection issues, including workers’ compensation in case of
occupational injury or illness, pension systems and employment assistance
schemes;
(q) best practice for labour relations, for example, improved labour relations,

Businessman Hand Shaking Pacific Partnership Agreement Building Background

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including promotion of best practice in alternative dispute resolution;
(r) social dialogue, including tripartite consultation and partnership;
(s) with respect to labour relations in multi-national enterprises, promoting
information sharing and dialogue related to conditions of employment by
enterprises operating in two or more Parties with representative worker
organisations in each Party;
(t) corporate social responsibility; and
(u) other areas as the Parties may decide.
7. Parties may undertake activities in the areas of cooperation in paragraph 6 through:
(a) workshops, seminars, dialogues and other fora to share knowledge,
experiences and best practices, including online fora and other knowledgesharing
platforms;
(b) study trips, visits and research studies to document and study policies and
practices;
(c) collaborative research and development related to best practices in subjects of
mutual interest;
(d) specific exchanges of technical expertise and assistance, as appropriate; and
(e) other forms as the Parties may decide.

Is New Virginia Rule 14 Work Comp Fee Schedule?

November 4, 2015 By JL Risk Management Consultants

The New Virginia Rule 14 – Fee Schedule Soon?

The new State of Virginia Rule 14 is now closed for comments. A copy of the Proposed Rule 14 can be found here. (PDF File).

Wikimedia Commons – Adobe

According to the Virginia Workers Compensation Commission, a public hearing on Virginia Rule 14 was held on October 13, 2015. The slides from the Rule 14 presentation can be found here. Unfortunately, the deadline for comments was October 15, 2015.

I have always been a proponent of full state fee schedules. Virginia has community rates, but not a true statewide fee schedule. A 10 community rate basis is part of the new rule. Check out the new regions in Virginia map below – (c) MC Innovations

As a side note, the Virginia Workers Compensation Commission’s webpage on medical charges is as follows:

Outside view of Virginia rule 14 capitol

Wikimedia Commons – Analogue Kid

The Act also provides the standard that is to be used in calculating reimbursement.Va. Code §65.2-605 states that the employer’s liability for medical charges is limited to “such charges as prevail in the same community for similar treatment[.]” The term “community” is defined by reference to Commission Rule 14. There is no fee schedule in Virginia. Charge schedules agreed to by the carrier and provider will be enforced.

If a dispute arises as to reimbursement for a medical charge, the health care provider may invoke one or more of the following remedies:

Adjudication Requirements

Appropriate where there has been no payment or where provider is dissatisfied with level of reimbursement
Initial decision issued by a deputy commissioner after reviewing evidence
Right of review by the Commission
Appeals to Virginia Court of Appeals and Supreme Court of Virginia
Initiated by filing a request along with supporting evidence to the Commission

The result of no fee schedule will be further analyzed tomorrow along with a study from WCRI. Rarely do all the planets align in the WC world. This is one instance. Check back in tomorrow.

Few Work Comp Premium Written Surprises for 2014

November 3, 2015 By JL Risk Management Consultants

Work Comp Premium Written Surprises for 2014

The total work comp premium written for 2014 increased 5.6% over 2013 to $46.8 billion according to AM Best. These figures were part of the Top 25 Workers Comp carriers for 2014 report issued annually.

picture of factory work comp premium written emblem from web

Wikimedia

Two carriers doubled their net premiums written (NPW):

Great American increased its NPW by approximately 103%.
AmTrust came in at 95.5% over 2014

I am not sure why the two carriers decided to increase their NPW so dramatically. Could this have resulted from picking up insureds from Liberty and other carriers which wrote less premium than in 2013?

As expected with an announcement earlier this year Liberty Mutual decreased its NPW by over 27%. This may be due to a more selective renewal process.

Two state funds that only write domestically (in their own state) ranked in the top 10.

The State Compensation Insurance Fund (SCIF) now ranks 7th. SCIF increased its NPW by 37.3%. One has to wonder does this mean a start to another WC insurance crisis in California. The crisis situation is not likely to reoccur soon. In the 1990’s SCIF was the #1 ranked carrier in size.
Texas Mutual came in 8th with a steady but not significant increase in premiums.

Colorado’s Pinnacol increased its NPW by over 18%. The trend of state-based domestic carriers significantly increasing NPW will be have to be monitored closely.