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New WCRI Study: Lump Sums Assist Rather than Discourage Return to Work

Author DavidMalloy , 7/16/2012

Cambridge, MA -(PRWeb)- An ongoing question for many policymakers is whether lump-sum settlements in workers’ compensation cases help or hurt return to work for injured workers. Although some believe that settlements discourage return to work, the Workers Compensation Research Institute’s (WCRI) new study, Return to Work after a Lump-Sum Settlement, shows the opposite.

“This is an important study because we need to find out whether settlements discourage return to work for injured workers who want to return to work or assist them in closing this chapter of their life and moving on with their career,” says Bogdan Savych, author and public policy analyst at WCRI. “My hope is this research will help policymakers and other stakeholders understand how workers respond to receiving a lump-sum settlement.”

The study follows the experience of 2,138 workers who were injured in Michigan in 2004 and later received a lump-sum settlement. WCRI followed the employment experience of these workers up through 2008. Although the study focuses on injured workers in Michigan, policymakers from across the country can learn from these findings and better understand a worker’s decision to return to work after a lump-sum settlement.

Among the study’s many findings are:
  • Three quarters [78 percent] of the injured workers in the study who received a lump-sum settlement didn’t change their employment status, which means that many of those who were employed at the time of the lump sum stayed employed and those who were not employed remained unemployed.
  • Of those injured workers that did change their employment status, nearly a third [30 percent] who were employed at the time of the lump-sump settlement left work and nearly a fifth [19 percent] of those who were not employed at the time of the lump sum attained employment.
  • On average, more injured workers returned to work after receiving a lump-sum settlement than exited. Average employment in the sample increased from 25 percent of workers at the time of the lump sum to 32 percent of workers 1 year after a settlement. The exception is older workers who experienced a decline in employment after a settlement.

Joke of the week

Author DavidMalloy , 6/15/2012

A man at the airline counter tells the rep. “I’d like this bag to go to Berlin, this one to California, and this one to London.

The rep says, “I’m sorry sir. We can’t do that.”

The man replied: Nonsense. That is what you did last time I flew with you.

Paul Binsfeld: Nurse Hotlines & Injury Triage: 9 Things You Should Know

Author DavidMalloy , 5/31/2012
From Company Nurse

Due to continued escalation of medical and indemnity costs, many organizations may soon experience a rise in workers’ compensation premiums. A recent report, “Workers’ Compensation: A Bumpy Road from Recession to Recovery,” released in April 2012 by Conning Research & Consulting outlines the key drivers that have led to inadequate rates and the industry not reaping a profit since 2006.

Whether organizations utilize commercial coverage or self-insurance, the industry has been hard hit with losses for the last few years. Although frequency of injuries had dipped for a short time, injuries are now on the rise, particularly those severe in nature and which require more time away from work. This challenging environment has called for innovative solutions that unite the claims community in a collaborative effort toward controlling costs over the long term and to support a happier, more productive workforce.

To do this, many organizations—whether insurance companies, third-party administrators, risk pools, employers or public entities—have successfully deployed nurse hotlines at the front-end of their claims process. This one strategy has helped to enhance injury management for the benefit and advantage of all stakeholders.

In fact, there are nine things you might not have known about nurse hotlines and how they help the overall workers’ compensation process:

1. Telephonic Demand Management.
In workers’ compensation, nurse hotlines have become an effective way to telephonically manage and direct the demand for care. This strategy, also known as injury triage, ensures the most effective use of medical resources; controls medical costs; and matches the severity of an injury to an appropriate disposition for care. For example, when an injured employee presents at the ER with a minor injury, they often have to wait two hours or longer to be seen, as the more critically ill or injured patients require treatment immediately and typically ahead of them. With a nurse hotline, telephonic demand management channels injured employees to a more appropriate level of service, which improves—not only costs—but also convenience and satisfaction for injured employees.

2. Prompt Reporting of Injuries.
The traditional injury reporting process has been plagued with challenges—primarily timeliness and compliance. Injuries are often reported late—sometimes as much as five to 10 days after an injury occurred. By that time, injured employees may have already visited an ER, taken time off from work, and entered a temporary disability status. In essence, the organization has missed its opportunity to manage care and influence return-to-work (RTW) results. In this way, an initial lag in reporting can result in multiple setbacks in coordinating the best-possible outcome. By using a nurse hotline, the injury reporting process is streamlined and immediate. The employee or supervisor can simply call the toll-free number to report the injury 24 hours a day. Triage nurses are trained to perform thorough questioning to gather comprehensive injury information. They also handle paperwork, which greatly reduces the burden on supervisors and injured employees to fill out and submit forms. With such an easy process, organizations often achieve a high rate of same-day reporting.

3. The “Day of Injury” Advantage.
The “day of injury” is the most critical point in the workers’ compensation process, as it is the time when organizations can exert the greatest influence over medical care and RTW results. Nurse hotlines provide a major advantage in injury management, as employees are able to speak with a nurse within minutes of an injury occurring. The triage nurse makes immediate, critical medical decisions that set claims on the right course from the start, and positively impact patient care, as well as claims’ costs and outcomes.

4. A Coordinated Approach.
After triaging an injury, the nurse hotline will send an immediate injury report to all designated contacts, including the worksite supervisor, claims adjuster, HR liaison, and RTW coordinator. Prompt distribution enables all stakeholders to initiate their respective roles in the workers’ compensation process, enabling each person to optimally affect the claim’s outcome. The nurse hotline also sends an alert to the medical provider office. Staff and physicians then know an injured employee is being sent to their facility for care. The report includes the employee’s personal and injury information, as well as employer details and workers’ compensation insurance. With this information, provider offices are able to handle workers’ compensation cases much more efficiently, and the physician is able to stay focused on providing the best-possible care and getting employees back to work quickly and safely.

5. Triage Algorithms & Nurse Expertise.
Nurse hotlines have been around for a while, but the sophistication of the model has grown and evolved significantly over time—from structured protocols to clinical algorithms that lead to a more reliable and systematic process in triaging injuries. Algorithms are decision trees that enable nurses to make an in-depth evaluation of an injury and the patient’s medical background. The result is a sound triage decision based on clinical knowledge and supplemented by a nurse’s compassionate, personalized attention to each and every injured employee.

6. Right Level of Care.
Worksite supervisors are often involved in making treatment decisions on where to send injured employees for care. However, these managers are not trained medical professionals. Many decide it is best to err on the side of caution, sending every employee for treatment with a medical provider. The result is unnecessary medical costs for minor and non-emergency injuries. With a nurse hotline and triage process, every injury is assessed by a medical professional and is referred to a level of care appropriate to the injury’s acuity. In an analysis performed by Company Nurse, it was shown that many employers reduce “unnecessary” ER visits by as much as 300 percent.

7. First Aid.
With approximately 20 to 40 percent of incoming calls, a nurse hotline may recommend first aid or self-care guidelines. After speaking with a nurse, many of these employees do not require or request additional medical services. Others may utilize first aid advice to address injuries prior to seeing a physician, which often improves treatment results. Many calls, however, result in “report only” or “first aid” injuries, which do not enter the workers’ compensation system and do not become compensable claims. This can often lead to a 10 to 30 percent reduction in claims.

8. Improved Utilization of Preferred Providers.
Many organizations invest time and effort in establishing a list or network of preferred providers, who are most qualified to treat occupational injuries and understand workers’ compensation objectives. However, the rate of referrals to these providers is often less than optimal. If this type of list does not exist, organizations will encourage their worksites to identify providers on their own and to establish a consistent referral process. However, this is very difficult to do without proper knowledge and a structured system. A nurse hotline has the expertise to help organizations identify and pre-designate quality providers within a reasonable radius of worksites. This list of providers or an existing network can be integrated into the hotline’s triage process. In this way, organizations have a mechanism to consistently utilize the best, most cost-effective facilities in their area.

9. Compassion Reduces Litigation.
Injured employees usually experience a higher level of recovery and satisfaction if they’re able to speak to someone about their injuries. A nurse hotline serves this purpose, so it’s the injured workers who benefit most. By speaking with a triage nurse, employees receive a compassionate response to what is often an upsetting workplace accident. Nurses listen closely to the details of each injury and focus on the individual’s unique medical needs. As a result, employees have an overall positive experience with the triage process and walk away with greater peace of mind. With nurse triage in place, one Florida-based employer reduced its rate of litigation by almost 40 percent.
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Author DavidMalloy , 5/11/2012
According to recent data collected by the Bureau of Labor Statistics, approximately 15 million people in the United States work on a rotating shift, night shift, or evening shift schedule. In addition, the total number of hours worked by employees in the United States is higher than most of Western Europe and Japan. Both working irregular shifts and working long hours have been shown to contribute to safety risks and health problems.

Shift workers tend to be more tired than the general population, which can lead to difficulty concentrating and slower reflexes. As a result, shift workers are more likely to make errors on the job or be involved in accidents. The stress of shiftwork might also cause such employees to acquire certain health conditions.

When an individual works at night, he or she is unable to get enough restorative sleep. Sleep following a night shift is usually shorter and less regenerative than sleep during the night would have been. During nighttime hours, body functions and brain activity slow down. Because the individual is already lacking sleep, he or she is likely to exhibit performance problems. Individuals who work rotating schedules will experience additional problems each time they must switch between day and night shifts.

In addition to fatigue and concentration problems, shiftwork can also lead to serious health problems. Research has shown that employees who work rotating shift schedules are more likely to experience digestive problems, such as nausea, constipation, and stomach ulcers. Heart conditions are also more common among shift workers than in the general population.

Because shiftwork is often unavoidable, it is important to design the work schedule so that it minimizes the stress of shiftwork as much as possible. A properly designed work schedule can prevent accidents, improve worker morale, and decrease the likelihood of employee health problems.

All workers have a natural circadian rhythm that tells their bodies when to sleep and be awake. For this reason, employees who must be at work during late night and early morning hours are likely to have more trouble focusing. Certain shift times might also prevent workers from seeing family and friends. To prevent problems that might result from unusual shift times, many employers avoid scheduling the same worker for late night or early morning shifts during all work periods.

Though it might seem like it would be easier for workers to adapt to an unusual shift if it were a permanent assignment, most workers readjust to a normal schedule on their days off. For this reason, the majority of employers assign shiftwork on a rotating schedule. Rotating schedules prevent a worker from constantly experiencing the stress associated with the night shift. However, rotating schedules require workers to make changes to readjust to new sleep patterns regularly. To prevent serious health problems, it is advisable to rotate a worker's shift every few weeks, rather than weekly or after only a few days.

Another important factor to consider in shiftwork is the amount of time an employee has to rest. Employees who work eight-hour shifts have more hours in the day remaining for rest than employees who work 12-hour shifts. Unfortunately, the other tasks employees must perform after their shift will not decrease when they work overtime, so employees who work long shifts must often sacrifice sleep in order to make ends meet. To prevent a buildup of fatigue, employers of employees who must work long hours should avoid scheduling too many consecutive workdays for the same employee.

Employers who require workers to perform shiftwork should also teach employees effective coping skills to deal with the stress of the schedule. Employees working rotating shifts can improve their situations by getting as much sleep as possible during their time off. They should also make an effort to spend time with family and friends, exercise, and eat a balanced diet.

Do your clients understanding the implications of shift work? PMC can help find you the best Policies for your clients to protect their liability.

Operating in the Continental US!
Phone: 1-877-PMC-COMP| (781)-449-7744  
Email PMC | Visit our website

Thank you PMC Insurance Group!

Author DavidMalloy , 4/25/2012
PMC Insurance Group“In the past David has provided me quotes from several insurance companies though his company. He has always been very friendly, professional, and able to answer any coverage questions that I may have. Thank you David for your great service!" 
April 20, 201 Kimberley Bryon

  “David is a great person to work with when obtaining quotes. He is responsible and responds in a timely manner. I would recommend sending and working with David.” 
April 13, 2012 Melissa Arnold, CRIS, AIS, MLIS, Account Manager, Assurance

 “David has helped me place workers compensation business on several occasions. He is very thorough and everything is back on time. Thanks David.” 
April 13, 2012 Mike Christensen

  “I have worked with David on behalf of several clients in search of solutions for their business insurance needs. He has been very professional and I would highly recommend his services to those in need of insurance solutions.” 
April 13, 2012 Jason Bishop, Risk Manager, Corporate Risk Solutions  

Operating in the Continental US!

           Phone: 1-877-PMC-COMP| (781)-449-7744

Email PMC | Visit our website

See What Our Satisfied Customers Had To Say About PMC Insurance Group

Author DavidMalloy , 3/26/2012

PMC Insurance Group

We pride ourselves on what our satisfied clients have to say

“I called PMC to see if they had a market for a large contractor and if they could turn it around in a couple of days. I had previously sent the account to one of my other markets and they kept putting me off. Then, at the last minute told me they didn’t have enough time to offer a quote. This seemed to be an excuse they were using not to write the account or assist our agency. Totally frustrated, I sent a submission to PMC. Because of their knowledge and relationship with the same carrier, they were able to get me a quote in 2 days and I closed the deal. They have a history with our agency of getting the job done when we really need it.” -Mary A. Arola, 

Alper Services LLC, Chicago, IL


“I am very impressed with the level of service PMC provides my staff here at Charles River Insurance Brokerage, Inc. Their expediting of accounts has been noticed by me and my staff, but most importantly our clients! I hope they keep up the good work and we look forward to working with them more.” - Gerry Kennedy, Charles River Insurance Brokerage, Framingham, MA  

Call us today and put our expertise to work for you!

PMC Insurance Group (P) 877-PMC-COMP (P) 781-449-7744 (F) 781-449-7889


To contact us, and for more information, please visit our CompleteMarkets storefront.

Interesting Facts About Insurance

Author DavidMalloy , 3/21/2012

 Did You Know???

  • PMC Insurance Group

    ING Life Insurance Romania is officially a brand new Guinness World Records holder after issuing not only the Largest insurance policy in history but also the largest legal document ever made!
    • The legal document stands at an impressive 9 meters height and 6 meters width. The record was certified by the Guinness World Records Adjudicators on 15 March 2008.
  • The world’s first skyscraper was the Home Insurance Building in Chicago, erected in 1884-1885. The so-called “Father of the Skyscraper” towered all of 10 stories with its peak at 138 feet, miniature by today’s standards but gargantuan at that time.
  • Some public celebrities sometimes buy insurance for their body parts. They don’t take chances on getting any part of their body changed or disfigured.
    • Singer Mariah Carey seems to think her legs are far more valuable than any footballer’s — she’s insured them for $1 billion!
    • The James Bond actor’s body was reportedly insured for 5 million pounds back in 2008, when he was shooting for Quantum of Solace. It is believed that Craig insisted on doing his own stunts and suffered several injuries, so producers decided to keep their star covered — in a blanket of money!
    • After Dostana catapulted his rear in tiny swimming trunks to fame in 2008, John Abraham decided to have it covered with a policy worth an alleged Rs 10 core.
    •  Musician Bruce Springsteen  insured his husky voice for 3.5 million pounds with Lloyd’s of London.
    • David Beckham’s legs are insured at $35 million each.
    • The Rolling Stones guitarist Keith Richards has insured just the middle finger on his left hand covered for $1.6 million dollars. May be he feared that some one would break it considering he used to stick it out so often!
    • Now the Superstar Rajni is said to be insured and copyrighted his voice. So don’t roam around mimicking Rajni’s voice if you don’t want to get sued!
    • Now the weirdest Insurance! – Rocker David Lee Roth had his sperm insured for a million dollars! If any paternity suits were filed against him because of ROCK ‘n’ ROLL life style, the insurance company would pay the charges!
    • Singer Dolly Parton, who had her breasts insured for $600,000.

Call us today and put our expertise to work for you!

PMC Insurance Group (P) 877-PMC-COMP (P) 781-449-7744 (F) 781-449-7889


To contact us, and for more information, please visit our CompleteMarkets storefront.

Formulating, Implementing Return to Work Programs

Author DavidMalloy , 3/7/2012

Ask the Workers' Comp Expert: Formulating, Implementing  Return-to-Work Programs
by Robert G. Jones , Vice President, PMC Insurance Group

PMC Insurance GroupLast month, we commented on cost containment and morale as they relate to effective, multi-faceted return-to-work programs. Today, our focus is on formulating and implementing. At the outset, business owners and employees need a clear understanding of the benefits of transitional duties that allow injured workers to return to the job.

Prior to program implementation, the business owner should meet with supervisors and employee representatives to identify duties and functions that are available and appropriate for transitional assignments. Written job descriptions are then developed and shared internally with employees and externally with appropriate medical providers.

These descriptions can be modified and combined to accommodate a returning injured worker. There is also a significant opportunity for the business owner to engage medical providers in constructive and cooperative communication. A collaborative approach with medical providers will go a long way to achieving good results in terms of returning injured workers to the job. Dr. Richard Pimentel, a national expert on disability management, notes that 20 percent of lost time from work injuries could be eliminated if the physician was given sufficient information about the transitional job possibilities. Remember to consider the provisions of the Family and Medical Leave and Americans with Disabilities Acts as part of this process.

Employee training is a key to successful program implementation. The organization’s philosophy, program benefits along with a copy of the return-to-work program and job descriptions, are part of this orientation. New employees should receive this information at the time of hire. As the program undergoes a process of continued improvement and evolution, it becomes embedded into the culture of the organization.

PMC Insurance Group’s only business is workers’ compensation. Our insurance professionals have extensive experience helping IIABNY members expand their marketing capabilities by providing workers’ compensation solutions for their clients including offering guidelines for formulating and implementing return-to-work programs.    

PMC Insurance Group
50 Cabot Street 
PO Box 920179 
Needham, MA 02492-0002 
Phone: 1-877-PMC-COMP, (781)-449-7744 Fax: (781)-449-7889