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The City of Columbia, Mo.’s money-saving efforts include increasingly concentrated attempts to keep Workers’ Compensation costs down, says Sarah Perry, the city’s risk manager for more than 15 years and a member of NU’s Risk Managers Advisory Board.

Measures undertaken to that end include increased focus on work-zone safety measures for any public employee working on a roadway: police, firefighters, road crews, mowing crews from the parks and recreation department, and utilities workers. “Work-zone safety is [getting] a big push right now,” Perry says.

Columbia also is putting more emphasis on driver-safety measures among its public employees in order to prevent employee injuries and save lost work hours.

Perry also notes an increase in law-enforcement liability suits. It’s a trend she has come to recognize by the sheer number of claims that come across her desk and “how much time I have to spend with attorneys.”

Perry attributes the increase to both the slow economy—“people are looking for money from somewhere”—and changing public attitudes about law enforcement.

“There’s not that automatic level of respect anymore,” she says, “and because of that, we are seeing a lot more police cases filed.”

WC & THE ECONOMY

The economy has affected Workers’ Comp in two ways, according to Cindy Mallett, human-resources and risk manager for the city of Gainesville, Ga., who also currently serves as president of the Public Risk Management Association.

First, higher health-insurance premiums, deductibles and co-pays may encourage some employees who are “financially strapped and negatively motivated” to resort to filing frivolous claims, Mallet says.

And second, some city employees don’t want to draw attention or take sick leave for fear of jeopardizing their jobs, so they’re not reporting justifiable claims. “They’re fearful,” she notes. “Some of that might be easing a little bit, but it’s been a tough few years.”

On the pricing front in Workers’ Comp, Mallett says: “The market is starting to harden back up just a little bit. Pricing seems to be increasing, though I haven’t seen it in large percentages.”

The Workers’ Compensation Board announced that it intends to adopt new fee schedules for physicians, chiropractors, podiatrists, psychologists, and other medical professionals who treat injured workers.

The new fee schedules went into effect on June 1 and will incorporate the latest current procedural terminology codes from the American Medical Association. The fee schedules also incorporate technical changes to some ground rules.

Read more at the WorkersComp Forum homepage.

Injured who take opioids slower to return to work

NEW YORK – Workplace insurers are accustomed to making billions of dollars in payments each year, with the biggest sums going to employees hurt in major accidents, such as those mangled by machines or crushed in building collapses.

Now they are dealing with another big and fast-growing cost – payouts to workers with routine injuries who have been treated with strong painkillers, including many who do not return to work for months, if ever.

Workplace insurers spend an estimated $1.4 billion annually on narcotic painkillers, or opioids. But they are also finding that the medications, if used too early in treatment, too frequently, or for too long, can drive up associated disability payouts and medical expenses by delaying an employee’s return to work.

Workers who received high doses of opioid painkillers to treat injuries such as back strain stayed off the job three times longer than those with similar injuries who took lower doses, a 2008 study of claims by the California Workers Compensation Institute found.

When medical care and disability payments are combined, the cost of a workplace injury is nine times higher when a strong narcotic such as OxyContin is used than when a narcotic is not used, according to a 2010 analysis by Accident Fund Holdings, an insurer operating in 18 states.

“What we see is an association between the greater use of opioids and delayed recovery from workplace injuries,’’ said Alex Swedlow, the head of research at the California Workers Compensation Institute.

The use of narcotics to treat occupational injuries is part of a broader problem involving what many experts say is the excessive use of drugs such as OxyContin, Percocet, and Duragesic. But workplace injuries are drawing particular interest because the drugs are widely prescribed to treat common problems such as back pain, even though there is little evidence that they provide long-term benefits.

Along with causing drowsiness and lethargy, high doses of opioids can lead to addiction and have other serious side effects, including fatal overdoses.

Between 2001 and 2008, narcotics prescriptions as a share of all drugs used to treat workplace injuries jumped 63 percent, according to insurance industry data. Costs have also soared.

In California, for example, workplace insurers spent $252 million on opioids in 2010, a figure that represented about 30 percent of all prescription costs; in 2002, opioids accounted for 15 percent of drug expenditures.

As a result, states are struggling to find ways to reverse the trend, and some of them have issued new pain treatment guidelines, or are expected to do so soon. These states include New York, Colorado, Texas, and Washington.

Doctors in four states – Louisiana, Massachusetts, New York, and Pennsylvania – appear to be the biggest prescribers of drugs for workers’ injuries, according to a review of data from 17 states by the Workers Compensation Research Institute, a group in Cambridge, Mass.

Painkiller-related costs are also hitting taxpayers, who underwrite coverage for public employees such as police officers and firefighters, experts say.

There is little question that strong pain medications can help some patients return to work and remain productive. But injured workers on high doses of the drugs can develop chronic pain and face years of treatments.

In a sense, insurers are experiencing the consequences of their own policies. During the last decade, they readily reimbursed doctors for prescribing painkillers while eliminating payments for treatments that did not rely on drugs, such as therapy.

Those policies may “have created a monster,’’ said Dr. Bernyce M. Peplowski, the medical director of the State Compensation Insurance Fund of California, a quasi-public agency.

The National Football League and the Atlanta Falcons are suing nine former Falcons players to force them to litigate workers’ compensation cases in Georgia rather than in California, where dozens of current and former NFL players have sought compensation for injuries sustained from playing football.

The eight-page suit, filed by King & Spalding attorneys Darrick L. McDuffie and S. Stewart Haskins II on behalf of the Falcons and the NFL Management Council, asks U.S. District Judge Thomas W. Thrash Jr. to enforce what the suit called a binding arbitration ruling issued last month in New York.

That ruling by arbitrator Michael Beck ordered the nine former Falcons to halt their efforts to collect workers’ compensation benefits in California for injuries stemming from their careers with the Falcons.

When the suit was filed March 5, the players’ claims were pending before the workers’ compensation board in California, the complaint alleges.

The suit appears to be part of a broader fight between the league and the players over how and whether current and former players should be compensated for injuries incurred on the playing field.

The former Falcons players include Roderick Coleman, Wilrey Fontenot, Tony Gilbert, Kindal Moorehead, Stanley Pritchett, Karon Riley, Brett Romberg, Jason Webster and Dez White.

Professional football players injured while playing are generally entitled to workers’ compensation benefits while they are out of work; the benefits include pay for medical expenses arising from that injury, according to the NFL Players Association website.

“This is important since NFL clubs will not pay medical expenses after a player leaves the game unless the player files a workers’ compensation claim,” the website states.

The Atlanta suit is one of a number of federal suits the NFL and professional football teams are filing against hundreds of former football players who have lodged workers’ compensation claims in California, even when the teams for which they played are based elsewhere.

According to a 2010 New York Times investigation, California is the only state where professional athletes who have played as little as a single game in the state may file workers’ compensation claims for long-term injuries they may have sustained years earlier.

According the Times report, California law also bars employees from signing away certain workers’ rights and their unions from bargaining them away. Those policies have prompted the players association to argue that player contracts requiring them to file workers’ compensation claims in their teams’ home states may be unenforceable.

Football players from the Cincinnati Bengals, the Denver Broncos, the Tennessee Titans, the Miami Dolphins, the Kansas City Chiefs, the Chicago Bears, the New Orleans Saints and the Atlanta Falcons have filed workers’ compensation claims in California, according to national news reports.

California’s liberally construed workers’ compensation laws have been bolstered by the NFL’s current collective bargaining agreement with the players association. That agreement—which ended last year’s lockout—included a provision that allows players to file workers’ compensation claims in states where their teams aren’t based, according to the website Business Insurance.

The prices paid for medical professional services for injured workers were higher and rising faster in states without fee schedules compared with states that have them in place, according to a new study from the Workers Compensation Research Institute (WCRI), Medical Price Index for Workers’ Compensation, Fourth Edition (MPI-WC).

Cambridge, MA (PRWEB) March 29, 2012

The prices paid for medical professional services for injured workers were higher and rising faster in states without fee schedules compared with states that have them in place, according to a new study from the Workers Compensation Research Institute (WCRI), Medical Price Index for Workers’ Compensation, Fourth Edition (MPI-WC).

The WCRI study is designed to help public policymakers and system stakeholders understand how prices paid for medical professional services for injured workers in their states compare with other states and know if prices in their state are rising rapidly or relatively slowly. They can also learn if the reason for price growth in their state is part of a national phenomenon or whether the causes are unique to their state and hence, subject to local management or reform.

“In documenting the growing prices paid for the medical care received by injured workers, this unique study also shows the effectiveness of medical fee schedules in controlling those costs,” said Dr. Richard Victor, executive director of WCRI.

For example, six states in the 25-state study-Indiana, Iowa, Missouri, New Jersey, Virginia, and Wisconsin-had no medical fee schedules as of 2011. The prices paid for professional services in Virginia, Missouri, New Jersey, Iowa, and Indiana were 27 to 51 percent higher than the median of the study states with fee schedules and the prices in Wisconsin were more than twice the median of the study states with fee schedules, the highest of all the study states.

States without fee schedules also saw more rapid price growth over the 2002 – 2011 study period, with prices in Missouri, Indiana, Iowa, Virginia, and New Jersey rising 32 to 38 percent, compared with the median growth rate of 14 percent for the study states with fee schedules. The prices in Wisconsin experienced the most rapid growth among the 25 study states, rising 50 percent.

The study also found that changes in fee schedules were an important factor driving changes in actual prices paid for professional services.

In addition, the study reported that in states with certain services not covered by their fee schedules, the prices paid for those services often grew more rapidly than those for the services covered by the fee schedules.

Unlike the consumer price index for medical care (CPI-M), which measures general prices paid for medical goods and services, the MPI-WC focuses only on the prices paid for the medical care that injured workers receive under their state’s workers’ compensation system.

The MPI-WC tracks medical prices paid in 25 large states from calendar year 2002 through June 2011 for nonhospital, nonfacility services billed by physicians, physical therapists, and chiropractors. The medical services fall into eight major groups: evaluation and management, physical medicine, surgery, major radiology, minor radiology, neurological and neuromuscular testing, pain management injections, and emergency care.

The 25 states included in the MPI-WC, which represent nearly 80 percent of the workers’ compensation benefits paid in the United States, are Arizona, Arkansas, California, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

Click here to download a free copy of this report.