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Recent Workers Comp Fraud

Bookmark and Share Fraud is a part of life, regardless of how much we wish it wasn't. People will always try to get as much as possible without expending too much effort. For those who see workers comp as just an unlimited paycheck, it's necessary to keep up with the news to see if there are new trends within the industry. Opportunity crime is everywhere, so if people see a loophole you can bet there will be more exploitation of it. The creativity used can be truly amazing, so learn to recognize signs now so you can prevent fraud later.

Several Schemes


If a worker starts collecting workers compensation for a legitimate injury, the temptation to continue collecting after healing seems to be strong. Two cases, one in Ohio of a married couple and one in Canada, recently show that people continue working (generally when they're self-employed or the principal employee in the business) while still collecting checks.

It's impossible to know if their original claims were thoroughly investigated before being approved, it seems clear that the money outweighed the potential negative consequences for the people committing the crimes. In this case, they had a dual income for quite some time. If you have an employee that you know can do his or her job at home, then you may want to take some extra precautions in these cases.

Also, another man in Ohio was charged with fraud soon after his sister was charged with the same crime. The couple and the siblings are good indicators of what a ripple effect can look like when one person receives clear benefits by taking advantage of the system. Keep everyone involved informed and be as honest as possible. If you suspect that an employee is not telling the full truth, as with a yet unsettled case from a cop who may have injured his knee while off the job, then sometimes asking questions is your best line of defense. People can be tripped up in lies fairly easily, so keep details straight and if something doesn't add up then you'll need to speak up to the proper people.

Both Sides Now

Unfortunately it's not just employees who commit fraud. Employers have been in the news lately because they haven't had enough coverage or have failed to provide adequate restitution to their employees. This may not have even been intentional fraud, so ensure that you're not skipping any steps or taking any shortcuts when it comes to your business. You never know when a legitimate problem will arise and you'll need to have all of your ducks in a row in order to have a sustainable outcome so you're not hurt by legal fees or worse - jail time.
 

Keeping Up in Safety

Bookmark and Share There are lots of studies being completed to try to determine where worker injury might occur. Student engineers may run workers through repetitive tasks over and over again to see where potential dangers lie so they can write up their proposed solutions. You can't keep up on every new medical or scientific document that may come out but you can develop some tactics to find the right information. Seek it out, and you may be surprised at how helpful it can be.

Start Local

Those in education ask and answer questions for a living, so this may be your best bet. Try setting up a meeting at the nearest college. If you work in a hazardous environment, speak to the experts. Come prepared with a list of specific concerns, and let the person know your expertise in the matter.

Even if you feel like you've already learned everything there is to know from simply being on the job day in and day out, you might be surprised at the insights you can glean from those who have looked at the situation from different angles. Those in the academic world are able to do this while you may not have time because you have so many other responsibilities in your day-to-day life.

They may be able to tell you about new technology advances that come out or statistics that can teach you of the most common threats. Whether you manage construction workers or welders, don't assume that you have all the information.

Talk to Your Competition

If you have a relationship with your competitors, then exchanging information can be beneficial. Ultimately, worker safety needs to be promoted for everyone, so this is a neutral issue. If you don't know your competitors, then this could be a good way to develop a mutual respect for one another.

The person you speak with will have different experiences and knowledge, and may have noticed something that you haven't. You could both provide information that the other one may not have considered which saves both of your companies money in potential claims. Employees can be careless, but the more efforts you make to avoid a potentially life-threatening disaster, the better everyone will be.

The key here is to utilize all your resources so you have a full understanding of what safety means today.

General Trends


For those who work in more conventional office environments, you'll need to stay on top of what's happening with American workers. Obesity and back pain is rampant, and they cause everyone's insurance premiums to rise while increasing the risk you'll be charged with workers comp. consider raising more awareness throughout the office with a fitness plan or a healthier lunches program.
 

2016 Changes in Health Care Insurance

Bookmark and Share If you're familiar with the Affordable Care Act (aka ACA or Obamacare) at all, then you may know just how difficult it was to come to fruition. There was untold amounts of opposition, and then when it finally did roll out, it frustrated and upset a lot of people with a clogged website that failed to keep up with the growing demand, complicated rules and extremely resistant doctors.

Here's what you need to keep in mind for the new year in health insurance for this controversial bill and beyond:

The ACA is still in effect right now, but Republicans recently pushed a bill through Congress to the president for approval. Obviously, the bill wasn't approved by Obama, but Republicans did all of this to prove a point. Their goal was to show that they had the ability to get this petition up through the Senate and to the president. Should the president change this year to a Republican candidate, then the outcome would likely be very different. While it will undoubtedly make a lot of people angry to have the ACA repealed, as an employer, you must accept it as a potential reality.

Other potential changes for this year include the introduction of more virtual visits to the doctor. Health insurance works to provide options, convenience and overall cost savings to their program participants. While that may save a little money, the rising costs of health care could cause your premiums to go up.

There may also be more restrictions on higher priced drugs. There are ways for name brand drug companies to skirt around patients ordering generics, which are almost always just as effective. This pushes everyone's costs up, so there are more steps that doctors will need to go through to justify ordering the expensive drugs. Lipitor, for example, does have a generic version, but there is a small portion of the population that will only respond to Lipitor. If your workers happen to be in a similar situation, then that's something for them to be aware of.

Depending on your costs this year, you may have wondered if you should use higher deductible plans. This may increase your budget for this year to be put toward additional measures in the business; however, you'll need to be careful. If you're planning to do this, you may want to consider discussing this with your employees, as they might feel blind-sided by the change. This is expected to be a major trend for this year, but there will undoubtedly be unseen costs with this type of change.

Regardless of what you choose, knowing what other companies are doing (both your direct competitors and the insurance companies) can help you understand everything in the context of your own business.
 

Chronic Back Pain and Workers Comp

Bookmark and Share According to the Institute of Medicine of The National Academies, there are 100 million people in the US suffering from chronic back pain. This should be a frightening figure for anyone who works with workers compensation because many jobs require long hours of sitting in chairs that may or may not be providing the right ergonomic support. While the odds aren't great, there are things you can do to improve the overall safety in the workplace. Here are some ways to combat the chances of having unnecessary claims filed for chronic back pain.
  1. Start Making Exercise a Part of Your Day

    Wal-Mart famously did this by having workers do calisthenics before their shift started. Maybe it seemed too little silly for more professional organizations to adopt the practice, but you certainly won't find it in most offices. However, just incorporating it into the morning routine could do wonders for productivity and overall worker satisfaction. Basic stretching or even a few lunges will suffice for increasing worker awareness about their back when sitting as well as strengthen the muscles. It also could encourage otherwise sedentary employees to be more active throughout the day.

  2. Post Signs and Send Out Memos

    It doesn't take very long to do, and again, gets workers to remember that their bodies need to be taken care of are as they work through their daily list of tasks. Let them know the proper posture (back and neck straight and taut) that's best for warding off this dreaded condition. When people are cognizant of what they're doing throughout the day, it can encourage better habits that then become second nature. For those who work in a more active environment, caution against workers taking shortcuts such as lifting items with their back.

  3. Offer Choices In Their Environment

    Investing in the proper chairs is far cheaper than potentially paying out for a workers comp claim or having your insurance premiums raised. Quality chairs can last for years when treated properly, and are smarter choices than their cheaper counterparts. Chair backs should have an angle of 10 degrees while providing support for the small of the back and hips. Feet should be flat on the floor and elbows should be at a 90 degree angle to the desk. You may also want to offer ergonomics balls or stand-up keyboards. These can be morale savers in an office environment for people who want options. Many companies are offering cash incentives too for employees who manage to stay active which is an important part of avoiding chronic back pain. Overweight people are far more susceptible to developing back pain, so encouraging overall wellness in your employees is imperative.