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Author: Sheena Harrison

Posted on October 25, 2012August 6, 2018

Internal Surveillance Cameras can Reduce Workers’ Compensation Fraud

Security cameras can help employers stave off fraudulent workers’ compensation claims, but experts say companies should consider the risks of conducting internal surveillance throughout their facilities.

Cameras have been part of an overall effort to reduce workers’ comp and liability costs for Irving, Texas-based CEC Entertainment Inc., which operates Chuck E. Cheese’s restaurants and has more than 17,000 employees nationwide. Jeff Strege, the company’s director of risk management, described the company’s strategy during the California Workers’ Compensation & Risk Conference in Dana Point, California, last month.

Chuck E. Cheese’s has reduced claims costs by about $600,000 during the past four years by implementing several claims management procedures, such as billing claims to individual stores to increase accountability. From 2009 to 2010, the company also installed security cameras throughout each of its 510 company-owned stores.

During last month’s conference, Strege said the camera footage has been effective at reducing fraudulent comp and liability claims against Chuck E. Cheese’s.

“We’ve made a number of claims literally vanish once we produce the video footage to show that what the claimant says, whether it’s an employee or a guest … didn’t really happen,” Strege said.

Workers’ comp experts say cameras can be effective in preventing fraud. Rebecca Shafer, president of Amaxx Risk Solutions Inc. in Hartford, Connecticut, said major retailers such as the Great Atlantic & Pacific Tea Co. Inc. have used security footage to help investigate comp and liability claims.

“I think it just makes everybody a lot more aware that the actual nature of the injury can be substantiated,” said Shafer, who has noticed companies starting to use cameras outside of the retail sector.

Marsh Inc. recommends cameras for certain industries to monitor workplace safety, said Christopher Flatt, New York-based leader of Marsh’s Workers’ Compensation Center of Excellence. Those include retail, manufacturing, transportation and financial institutions.

Video footage is an added safeguard for employers that are trying to keep comp costs down, Flatt said. “The added benefit is of having tape of potential injuries or claimed injuries and being able to validate them,” he said.

Cameras are part of several technologies used by employers to monitor claims activity and potential insurance fraud, said Paul Braun, managing director of casualty claims for Aon Global Risk Consulting in Los Angeles.

“The privacy issue is a little different than it was years ago,” Braun said. “So if somebody is in a situation where they’re claiming an injury that really didn’t occur or wouldn’t have occurred, there’s usually some way that technology has either recorded it (or) helps identify the result of it.”

Employees who know they’re being filmed also can be less likely to file bogus claims, Braun said. “Rarely is it ever something, in my opinion, that the employee doesn’t know is going on,” he said of companies that use video surveillance.

Thomas Martin, CEO of Martin Investigations & Security Services in Lima, Ohio, has seen more requests for security camera installation among small businesses and large employers in his area.

Companies that install such systems have to be mindful of privacy laws that affect where employees and patrons can be filmed, Martin said. For instance, cameras aren’t allowed to film inside of restrooms, and companies can be required to post signs informing employees and patrons that they are under video surveillance.

“Where your eyes are allowed to see, the cameras are allowed to see,” Martin said.

Although cameras can’t film all areas of a company, Martin said employers could choose to look closely at workers’ comp or liability claims that happen outside of the cameras’ view.

“If you have pretty much 75 percent coverage, and they happen to fall and claim an injury in the other 25 percent, it becomes very suspicious that (the injury) wasn’t recorded,” Martin said.

While cameras can be used to fight fraud, sources note that video footage also can prove an employer’s culpability in legitimate workers’ comp claims. Strege said Chuck E. Cheese would consider settling any case in which camera footage showed the company was liable for an injury. The company also provides additional safety training at facilities where accidents occur.

“What’s really important with cameras … is to make sure that you don’t just cherry-pick the cases that you pull camera footage on,” Strege said

Despite the potential for video footage to work against a company, experts agree the cost of such systems can be worth it to prevent the payment of illegitimate claims.

“In the long run, especially if a company has a lot of employees, I think it would pay for itself,” Martin said.

Sheena Harrison writes for Business Insurance, a sister publication of Workforce Management. Comment below or email editors@workforce.com.

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Posted on July 30, 2012August 7, 2018

NFL Creates Wellness Program for Current, Former Players

The National Football League has created a wellness initiative that it says will provide mental health support and other assistance for current and former NFL players—thousands of whom are suing the league over concussion-related injuries.

In a statement July 26, the league said that the NFL Total Wellness program “will help empower players to make positive health decisions; promote support-seeking behaviors in connection with behavioral and mental health issues; and provide health and safety education for players and all members of their support network. … “

The program includes NFL Life Line, a 24/7 service that allows players to connect with mental health professionals by phone or online.

“There is no higher priority for the National Football League than the health and wellness of our players,” NFL Commissioner Roger Goodell said Thursday in a statement to 11,000 current and former NFL players.

The NFL is being sued by thousands of former professional football players who say the league misled them about the dangers of concussions. The athletes say they suffer from various neurological and cognitive problems related to head injuries they received while playing football for the league.

Defendants in the suit include the NFL, football helmet manufacturer Riddell Inc. and affiliated entities of those two businesses.

The multidistrict litigation, being heard in U.S. District Court in Philadelphia, has grown to include complaints from more than 2,400 former players, according to recent media reports.

Former Atlanta Falcons player Ray Easterling, a lead plaintiff in one of the numerous lawsuits consolidated into the Philadelphia case, committed suicide in April.

The NFL is expected to use a workers’ compensation exclusive remedy defense in the liability lawsuits. The league contends that it did not mislead players about the risks associated with playing football.

Sheena Harrison writes for Business Insurance, a sister publication of Workforce Management. To comment, email editors@workforce.com.

Stay informed and connected. Get human resources news and HR features via Workforce Management’s Twitter feed or RSS feeds for mobile devices and news readers.

Posted on June 29, 2012August 7, 2018

Officer Hit By Car While Walking to Get Coffee Due Workers’ Comp

An Oregon police officer who was hit by a car while walking to get coffee is entitled to workers’ compensation benefits because the accident happened in the course of her employment, the Oregon Court of Appeals has ruled.

Carolyn McDermed was a police lieutenant for the city of Eugene, Oregon, court records show. She worked for the department’s internal affairs office, and most of her duties included office work.

In April 2008, McDermed was struck by a car while she was walking to get a cup of coffee across the street from her office. She suffered multiple injuries to her head, right foot and chest.

The police department denied McDermed’s workers’ comp claim, arguing that she was injured during a “solely personal mission.” But the Oregon Workers’ Compensation Board awarded benefits to her after finding that McDermed’s injuries arose from her employment.

On June 27, the Oregon Court of Appeals unanimously upheld the board’s ruling. In its decision, the appellate court said that McDermed was still at work during her coffee run, since she was expected to perform community policing duties while not in her office.

“When claimant was on duty and on the street, the street was her ‘work environment’—and any injury she suffered either as a result of distinctly work-related risks, or of neutral risks associated with that environment to which the conditions of employment exposed her, compensably ‘arose out of’ her work,” the appellate court ruled in upholding the benefits award.

Sheena Harrison writes for Business Insurance, a sister publication of Workforce Management. To comment, email editors@workforce.com.

Stay informed and connected. Get human resources news and HR features via Workforce Management’s Twitter feed or RSS feeds for mobile devices and news readers.

Posted on May 30, 2012August 7, 2018

After Workplace Violence Incident, Mental Health Resources a Must

Physical attacks on employees are rare but when they happen, employers should be ready to provide psychiatric resources for victims as they work to cope with trauma.

Violent incidents involving customers, co-workers or outside aggressors can leave workers who have experienced or witnessed attacks with depression, anxiety, or post-traumatic stress disorder.

As they seek to help traumatized employees, companies can turn to specialty insurance coverages to pay for counselling.

Whether they have coverage or not, experts advise employers to be ready to provide the resources employees need.

“If it does happen, it is so emotionally, financially and psychologically devastating to the employees and the organization that we do strongly counsel people to make sure that you’re prepared,” said Gregory Bangs, vice president and product manager for crime and kidnap and ransom insurance at Chubb Corp. in Warren, New Jersey.

Michael Mantell, a clinical psychologist and corporate workplace violence consultant based in San Diego, said people tend to experience a range of emotions after being victimized or witnessing an attack.

Healthy individuals often feel shock, disbelief or denial in the days or weeks after an attack, followed by a “cataclysm of emotion” that stems from traumatic anxiety and can involve a “roller-coaster” of reactions related to the office violence, Mantell said.

A third stage of coping occurs weeks or months after a violent incident, Mantell said, when people start to confront and deal with their reactions.

While most people reach emotional equilibrium in the third stage, some individuals go on to develop PTSD or other long-term mental effects that could hinder them from moving forward, Mantell said.

Larry Poague, senior loss control and prevention specialist with Lockton Cos. L.L.C. in Kansas City, Missouri, said the range of reactions can be based on how an employee learned to cope with traumatic events as a child, or whether that person has positive relationships at work and home that can serve as a support system.

Employees who experience difficult reactions to workplace violence often can become less productive or experience absenteeism compared with coworkers who are more effective at processing such traumatic events, Poague said.

“Some people are going to be back (to work), and work is what’s going to carry them through,” he said. “But there will also be a six-month or eight-month lag for some folks before they start to experience what happened.”

While rare, workplace violence can be costly when it occurs, according to NCCI Holdings Inc. Sources agree that companies that have had an incident of workplace violence need to make sure they provide mental health resources to help employees move forward in a healthy fashion.

Jay Supnick, a clinical psychologist and owner of Law Enforcement Psychological Associates in Rochester, New York, said it can be necessary for companies to offer multiple group counseling sessions or “debriefings” for employees that allow them to discuss trauma and process their emotions.

“One person may need a number of sessions, another person may not need anything,” Supnick said.

Experts say employers that hold debriefings should make sure that such discussions are helping employees rather than harming them. For instance, Mantell said, a counseling session may be ineffective if it talks only generally about the stages of grief but doesn’t give employees a chance to discuss their own feelings about recent violence.

“If debriefing sessions turn into complaints about the company, it really fosters a lot of negativity, and that attaches itself to anxiety,” he said.

Supnick said companies should try to schedule debriefing sessions when employees seem ready to discuss the situation, rather than forcing workers to talk immediately after workplace violence. He encourages companies to seek professional help in striking the right balance.

“I think you need to have some skilled clinicians that do this kind of work, and it probably should not just be one session that happens,” Supnick said. “It should be tailored to people’s needs.”

Chubb’s Bangs said most individuals can benefit from intensive counseling for a 10-day period after workplace violence. But he said some workers could need additional counseling to process traumatic events.

Insurance coverage can help pay for the cost of such assistance. For instance, Chubb offers workplace violence insurance that will pay for such benefits as crisis mental health counseling and a consultant to help ensure that a facility is “hardened” to prevent future attacks, Bangs said.

Chartis Inc. also offers a product as part of its employment practices liability coverage that helps pay for costs that result from workplace violence. That includes employee counseling, security counseling or public relations consulting that can help companies allay reputational damage, said Joni Mason, senior vice president and employment practices liability product manager for Chartis in New York.

Companies that experience workplace violence should evaluate whether they missed signs or did not provide effective procedures to help prevent attacks in the first place, experts say. Such introspection can lead companies to make security improvements that allow employees to feel safe at work again after violence occurs, said Kim Brown, senior workers’ compensation consultant for Lockton.

Employers also should work to make sure employees are trained in techniques that can help them prevent or escape violent scenarios, Chubb’s Bangs said. That information can help employees feel empowered if they face an unlikely event of workplace violence, he said.

“If you do that up front, you’re going to help things down the road,” Bangs said.

Sheena Harrison writes for Business Insurance, a sister publication of Workforce Management. To comment, email editors@workforce.com.

Stay informed and connected. Get human resources news and HR features via Workforce Management’s Twitter feed or RSS feeds for mobile devices and news readers.

Posted on May 15, 2012August 7, 2018

Workers’ Compensation Audit Reviews Can Reveal Costly Errors

With workers’ compensation rates firming, some employers are pressing for reviews of their workers comp audits with an eye to lowering their premiums.

Some of the those reviews are turning up clerical errors and misclassifications that can cost employers as much as hundreds of thousands of dollars in overpaid premiums and adversely affect their financial profile.

By checking industry classifications and experience modification calculations, companies can ensure that their comp premiums are in line with their employment numbers and loss experience, said Lisa D. Costello, senior risk consultant at Willis North America Inc.’s strategic outcome practice in Overland Park, Kansas.

“I think more clients will request this service as the (workers’ comp) rates increase and those increases get traction in the marketplace,” Costello said. “I think the better question is: How many employers or insureds know that there’s even an issue?”

Costello said about one out of five audits that Willis reviews for clients have clerical errors, while about one in three ex-mods includes a mistake. About 10 percent of Willis’ clients that go through the audit review process receive a partial premium refund, she said.

Aside from the total cost of workers’ comp coverage, Costello said such errors can affect a company’s lending profile and even its ability to win contracts.

“This is a significant problem for contractors, because if their (ex-mod) is incorrect because of a clerical error, they’re prevented from bidding jobs and they may not secure the bid because their mod is too high,” she said.

Simon Feuer, president of Apex Services Ltd., said he’s seen more companies requesting workers’ comp premium recovery services as the economy has improved. The Cedarhurst, New York-based company seeks refunds for employers that have overpaid their workers’ comp premiums.

“They see their premiums going up and they’re looking for solutions to get their premium down to what it was,” Feuer said.

Most of Apex’s clients include employers with annual premiums in excess of $100,000. Errors in their policies typically stem from miscalculated ex-mods, Feuer said.

Audit reviews can help companies looking to contain their workers comp costs, he said.

“We go and knock (the premium) down, and they have a better underwriting profile in the marketplace,” Feuer said.

Chicago-based AuditRate Inc., also a premium recovery service, found a classification error that resulted in more than $606,000 in overpaid workers’ comp premiums between 1996 and 2000 for a small Illinois manufacturer.

Howard Alper, chairman and CEO of Alper Services L.L.C., which owns AuditRate, said the error resulted in Byron, Illinois-based Quality Metal Finishing Co. being classified incorrectly as a foundry rather than a plumbing goods manufacturer. While the client has a foundry division, the rest of the business consists of lower-risk operations, Alper said.

The Illinois Department of Insurance ordered the company’s insurer, Liberty Mutual Insurance Co., to repay the excess premiums in 2010. Liberty Mutual is appealing the decision and declined to discuss the case.

Alper said classification errors in workers’ comp policies occur regularly, particularly for industrial firms with various job functions. He said such companies usually need help to correct workers comp premium mistakes.

“The businessperson may have the judgment that it’s wrong, but they don’t have the tools to fix it,” Alper said.

Not all errors result in premium refunds for employers, said Judy Leo, New York-based area senior vice president at Arthur J. Gallagher & Co.’s casualty risk management practice.

The broker reviews workers’ comp audits annually for its clients and finds clerical errors about 10 percent of the time, she said. In some cases, the review showed that companies underpaid their premiums and need to pay the difference, Leo said. Still, she said the process is beneficial because it helps employers catch mistakes before they turn into significant problems.

Willis’ Costello said recovery audits are just a small part of risk management practices that can help employers manage their workers’ comp costs.

“The bigger piece of this is … the claims management or claims prevention,” Costello said.

Sheena Harrison writes for Business Insurance, a sister publication of Workforce Management. To comment, email editors@workforce.com.

Stay informed and connected. Get human resources news and HR features via Workforce Management’s Twitter feed or RSS feeds for mobile devices and news readers.

Posted on December 1, 2011August 8, 2018

Ailing Economy Hurts Return-to-Work Efforts for Injured Employees: Analysis

The economic downturn has made it more difficult for injured employees to return to work, according to a study by the Workers Compensation Research Institute.

In a report released Nov. 29, Cambridge, Massachusetts-based WCRI studied workers’ compensation procedures and outcomes in Pennsylvania and Wisconsin, which were deemed to have faster and higher return-to-work rates than other states.

In the study, WCRI said the economy has reduced the impact of certain workers comp practices in those states.

“Against a backdrop of high unemployment, some injured workers may face even greater challenges in returning to work, potentially leading to increases in the duration of disability,” WCRI said in the report.

It said the Great Recession made it more difficult for employers to offer modified work duties for injured workers that would allow those employees to re-enter the workplace during their recovery.

“Employers are leaner and less inclined to offer light, transitional or modified duty in the economic downturn, particularly employers who do not want to have to lay off another employee in order to bring an injured worker back to light duty during the healing period,” according to the study.

The institute also said there are fewer jobs for unemployed injured workers to seek, and that some employers are reluctant to hire workers with permanent work restrictions.

Despite increased challenges, the down economy has created a financial incentive for employees to return to work as soon as possible—particularly when they stand to lose temporary disability benefits, the study said.

Sheena Harrison writes for Business Insurance, a sister publication of Workforce Management. To comment, email editors@workforce.com.

Stay informed and connected. Get human resources news and HR features via Workforce Management’s Twitter feed or RSS feeds for mobile devices and news readers.

Posted on October 26, 2011August 8, 2018

Appeals Court Finds Retaliation Claim Against UPS Valid, but Judgment ‘Excessive’

The United Parcel Service likely retaliated against an injured worker when it blocked him from returning to work with lifting restrictions, according to the 10th U.S. Circuit Court of Appeals.

However, the court said a $2 million judgment against UPS in the case was “excessive,” because the company’s actions only caused monetary harm to Keith Jones, a former UPS package car driver and plaintiff in Jones vs. United Parcel Service Inc.

Jones of Kansas City, Kansas, claimed that UPS violated the Americans with Disabilities Act when the company said a lifting restriction, caused by a 2003 shoulder injury, prevented him from working any job within UPS, court filings show. A company-appointed doctor restricted him from lifting more than 20 pounds overhead after his injury, though UPS carriers are routinely required to lift packages weighing up to 70 pounds overhead.

Two doctors who evaluated Jones in 2004 said he was later able to lift 70 pounds. But they testified that discussions with Monica Sloan, a UPS occupational health manager, prevented them from removing his lifting restrictions.

Subsequently, Jones was unable to return to UPS. He argued that the company retaliated against him for filing a workers’ compensation claim for his shoulder injury.

In a 2-1 ruling on Oct. 24, the appeals court said Jones’ retaliation claim is valid because Sloan, “on multiple occasions, intentionally interfered with the doctors’ medical evaluations in an attempt to prevent Jones from returning to work.” The court also ruled that punitive damages were appropriate in light of Sloan’s actions.

However, it said a $2 million jury award is excessive because Sloan “did not act with disregard for the health and safety of others,” and that her “conduct was not so reprehensible” to warrant such a large award. A $630,300 jury award to Jones for actual damages in the UPS case was affirmed by the appeals court.

Jones can choose to pursue a new jury trial in order to determine punitive damages in the case, the appeal court said.

Sheena Harrison writes for Business Insurance, a sister publication of Workforce Management. To comment, email editors@workforce.com.

Stay informed and connected. Get human resources news and HR features via Workforce Management’s Twitter feed or RSS feeds for mobile devices and news readers.


 

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