Topic: Fraudulent Worker's Compensation Prosecution

In August 1999, Debra Rodriguez reported to her insurance carrier that she injured her right shoulder, wrist and neck, as well as aggravated her left shoulder. According to investigators, she claimed the alleged injuries occurred after sitting at a desk that was not properly modified for her. Investigators say one treating physician believed Rodriguez was exaggerating her pain based on his testing and examination. Rodriguez was also seen by a Qualified Medical Examiner (QME). The QME physician examined Rodriguez and also believed her symptoms were not credible. According to investigators, both doctors found inconsistencies and no physiological aspects to the injuries.

As a result of this fraudulent claim, Travelers Property Casualty Insurance paid out $34,710.

If convicted, Rodriguez could face up to five years in state prison and/or a maximum fine up to $50,000.

Source: State of California

Topic: Florida Workers' Compensation Claim Costs Continue Upward Path

TALLAHASSEE, Fla.--(BUSINESS WIRE)--Aug. 29, 2001--Workers' compensation claim costs continue their significant growth in Florida, according to a new study by the Workers Compensation Research Institute (WCRI).

The study reported that claim costs rose nearly 9.5 percent in 1998, following several years of double-digit increases. The 11.7 percent average yearly increase in Florida from 1996 to 1998 was the highest of the eight large states in the WCRI study.

WCRI reported that a 13 percent jump in indemnity benefit costs - payments to injured workers for lost-time - was a major factor behind the overall increase. Medical payments per claim also rose, but at a slower pace, increasing 4.7 percent from 1997 to 1998. The study cited other factors behind the continued increase in claim costs, including a high and growing percentage of claims with lump-sum settlements and permanent partial disabilities. These claims represent 28 percent of 1998 claims with more than seven days of lost time, up eight percentage points since 1994.

Source: Insurancenewsnet.com

Topic: Insurance Fraud

Springfield, IL - Governor George H. Ryan signed legislation on August 2, 2001, to enhance the state's efforts to stem organized insurance fraud. Senate Bill 879 establishes a whistleblower provision and expands fraud reporting requirements to the Department of Insurance. The new law implements recommendations made by the Insurance Fraud Task Force statutorily created last year to investigate the issue of organized insurance fraud and methods to combat it.

Source: State of Illinois

Topic: Fraud Fighting Regulation

Superintendent of Insurance Gregory V. Serio announced that the Department has submitted to the Department of State its comprehensive insurance fraud-fighting regulation for final promulgation. Regulation 68 will be effective as of September 1, 2001.

"Regulation 68 will provide important weapons to fight fraud and abuse in our continuing effort to control automobile insurance costs," said Serio. "Regulation 68 provides better safeguards for the consumer and returns the no-fault automobile insurance system to its roots as a system that provides for the prompt and fair adjudication of automobile insurance claims."

Regulation 68 institutes new timeframes for accident victims to report a claim and medical providers to submit claims for payment--eliminating existing loopholes that have been exploited as opportunities for fraud and abuse. It reduces the time medical providers have from each treatment to submit claims for payment from 180 days to 45 days while it maintains the amount of time the carrier has to pay on claims.

Source: State of New York

Topic: Fact Sheet - Mold

Mold damage has been on the rise in the last several years in the Northwest and across the country. In addition to the property damage that may ensue there has been a growing concern with the health implications that may derive from mold.

There are more than 100,000 species of mold of which at least 1,000 are common in the United States. According to the Center for Disease Control (CDC), there is always a little mold everywhere - in the air and on many surfaces. The CDC suggests people should take routine measures to prevent mold growth in the home, usually by stopping the accumulation of moisture and immediately cleaning up any mold that does develop.

Consumers should be aware that most standard homeowner policies typically do not cover losses caused by rust, rot, mold or other fungi. Insurers generally consider mold a "home maintenance" issue. However, there may be cases where water/moisture has been deposited by a covered peril in a short period of time (i.e. burst water pipe in a wall).

Mold can be found almost anywhere moisture is present and can grow on wood, carpet, paper and food.

Source: State of Washington

Topic: Many U.S. Passenger Vehicles Are Driven on Under-inflated Tires

Prompted by the Administration's emphasis on transportation safety and a new survey showing that many tires on passenger vehicles are under-inflated, U.S. Transportation Secretary Norman Y. Mineta today urged motorists to check their tire pressure and inflate them properly before setting out on trips for the Labor Day weekend.

"It is vitally important to safety to carefully monitor tire pressure on a regular basis, and I urge motorists to check their tires before setting out on Labor Day trips," Secretary Mineta said. "Driving with substantially under-inflated tires can lead to crashes and tragedy, in addition to reducing fuel efficiency and shortening tire life."

Safety is the Bush administration's highest priority for transportation.

Fully 27 percent of passenger cars on U.S. roadways are driven with one or more substantially under-inflated tires, according to a major survey conducted by the U.S. Department of Transportation's National Highway Traffic Safety Administration (NHTSA).

Moreover, 32 percent of light trucks (including sport utility vehicles, vans and pickup trucks) are driven with one or more substantially under-inflated tires, according to the first study of its kind to be conducted by the government in two decades.

Source: Department of Transportation

Topic: Air Bag Cutoff Switches Not Being Used Properly

A study of vehicles equipped by the manufacturer with air bag cutoff switches has revealed widespread misuse endangering nearly half the front seat child passengers under 13, the U.S. Department of Transportation's National Highway Traffic Safety Administration (NHTSA) reported today.

Even though passenger side air bags have saved more than a thousand lives, there are some people who should not be exposed to an air bag deployment. As of April 1, 2001, NHTSA is aware of 104 deaths of children attributed to the force of a deploying air bag. In 1995 NHTSA issued a rule allowing manufacturers to install an on-off switch for the passenger air bag in vehicles that cannot accommodate a rear-facing child seat anywhere except in the front seat, such as pickup trucks and cars either with no rear seats or with small rear seats.

The survey released today showed that 48 percent of the air bags were left on for child passengers 1-12 years old, potentially exposing these children to serious injury or death from the force of deployment. In most of these cases, the drivers erroneously told interviewers air bags needed to be turned off only for babies, or for children younger than their passenger - or they left the switch on all the time, thinking air bags were safe for all of their passengers.

Source: Department of Transportation

Topic: Confirmation of Assistant Secretary of Labor for OSHA

WASHINGTON -- Secretary of Labor Elaine L. Chao announced today that the United States Senate has confirmed John Henshaw as the new Assistant Secretary of Labor for Occupational Safety and Health on Friday.

"American workers win with John Henshaw," Chao said. "John is the perfect person to lead an effort to create the safest and healthiest environment for American workers."

Prior to his nomination, Henshaw served as director for environment, safety and health at Astaris LLC in St. Louis, a joint venture between Solutia Inc. and FMC. From 1997 to 2000 he served in a similar position with Solutia Inc. Henshaw has over 26 years experience in the safety and health profession in small to medium sized businesses. He has also served in the Air National Guard, working as a bioenvironmental engineer.

Source: Occupational Safety and Health Administration

Topic: Recordkeeping and Musculoskeletal Disorders

One Week Left to Comment on MSD Record Keeping August 27, 2001 September 4, 2001 is the final date for comments to be filed with the OSHA Docket office in regards to new record keeping rules that may eliminate the recording of musculoskeletal disorders (MSDs).

The Department has proposed to delay for one year the record keeping rule's definition of "MSD" and the requirement that employers check the MSD column on the OSHA Log. The Department has announced its intention to develop a comprehensive plan to address ergonomic hazards and has scheduled a series on ergonomics. The issues to be decided as a result of these forums include the appropriate definitions of the terms "ergonomic injury" and MSD. Labor Secretary Chao has said, "Until a definition is agreed upon, the data collected will not help us target the injuries that need to be eliminated."

Previous data recorded on MSDs concluded that over 580,000 such disorders were sustained in 1999.

Source: Ergoweb.com

ANA Calls for a New Ergonomics Standard

August 1, 2001

Washington, DC -- At a hearing on ergonomics safety in the workplace, American Nurses Association (ANA) representatives Maggie Flanagan, RN, Ann Converso, RN, and Roslyn Muhammad, RN, today called for immediate action by the Department of Labor to issue a new ergonomics standard. The forum took place in Chicago and is one of three national forums scheduled by the Department of Labor.

The Occupational Safety and Health Administration (OSHA) has estimated that nearly half of all workers in the health services industry, which includes RNs, will experience at least one work-related musculoskeletal disorder (MSD) during their working lives. Studies of back-related worker's compensation claims reveal that nursing personnel have one of the highest claim rates of any occupation or industry.

Speaking on behalf of the ANA and her constituent member association, the Alaska Nurses Association, Flanagan told how she experienced serious back, neck and shoulder injuries that prohibited her from working for eight months. "Work shouldn't hurt," stated Flanagan during the forum. "American workers deserve workplaces where people are considered more 'valuable' than profits."

Liberty Mutual Releases Workplace Injury and Cost Data August 17, 2001 Liberty Mutual Group announced findings from their first-annual Liberty Mutual Workplace Safety Index, listing the 10 leading causes of injuries and illness that account for 86 percent of the $38.7 billion in wage and medical payments employers paid in 1998, the last year for which data is available.

The Safety Index highlights these leading causes and also provides guidelines to help reduce the human and economic costs generated by the top causes of job-site accidents. Liberty Mutual identified the leading causes of workplace injuries and illness and associated direct cost using its own claims data and findings from the Bureau of Labor Statistics and the National Academy of Social Insurance.

According to the Safety Index, overexertion, or injuries caused by excessive lifting, pulling, pushing, holding, carrying, or throwing an object resulted in $9.8 billion in direct costs. Repetitive motion injuries accounted for $2.3 billion.

Accident Drivers  
 

Accident causes:	Percent of workers compensation direct cost paid in 1998:	Estimated workers compensation direct cost nationwide:
Overexertion - injuries caused by excessive lifting, pushing, pulling, holding, carrying or throwing of an object	25.57%	$9.8 billion
Falls on same level	11.46%	$4.4 billion
Bodily reaction - injuries resulting from bending, climbing, loss of balance and slipping without falling	9.35%	$3.6 billion
Falls to lower level, such as falling from a ladder or over a railing	9.33%	$3.6 billion
Being struck by an object, such as a tool falling on a worker from above	8.94%	$3.4 billion
Repetitive motion	6.10%	$2.3 billion
Highway accidents	5.46%	$2.1 billion
Being struck against an object, such as a carpenter walking into a door frame	4.92%	$1.9 billion
Becoming caught in or compressed by equipment	4.176%	$1.6 billion
Contact with temperature extremes that result in such injuries as heat exhaustion, frost bite or burns	.92%	$.3 billion
All accident causes	100.00%	$38.7 billion

Source: Ergoweb.com

Topic: US Businesses Report Workplace Safety Delivers a Return on Investment

BOSTON - Ninety-five percent of business executives report that workplace safety has a positive impact on a company's financial performance, according to the findings of The Executive Survey of Workplace Safety announced today by the Liberty Mutual Group, the nation's leading provider of workers compensation insurance. Of these executives, 61 percent believe their companies receive a return on investment of $3 or more for each $1 they invest in improving workplace safety.

Source: Liberty Mutual Insurance