Joe West Company

Workers Comp

Workers Comp

Contacts:
Tim Driskill
Bob Turner
Barry Tims
Bill Johnson
Harold Craig
Guy Griggs
Mike Robinson
Jeff Cleveland
918-660-0090

Regardless of what industry you're in, workers comp insurance coverage is required by state statute if you have employees or uninsured contracted labor. This requirement can place a heavy financial burden on your business.

We are pleased to share with you a new product called "pay as you go" workers comp. It's a cutting edge product that allows you to pay each pay period for your workers comp coverage. You pay for the coverage without the burden of large lump-sum down payment or annual audit.

If you would like one of our experts to review your current coverages with you to assess your current risk level and to see if we can offer a more comprehensive and cost effective policy, contact us here.

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Workers Compensation and General Liability Insurance on a per payroll billed basis

Is your business stretching dollars as far as they will go?
Is your business trying to find ways to conserve cash flow?

We now can review your business coverage with an insurance carrier that offers an innovative
payment plan.

Our Workers Compensation rates are substantially less than Compsource Oklahoma or most
major carriers.

  • Premium is paid on a per payroll basis using electronic funds transfer.
  • There is no premium deposit or down payment.
  • Premium is billed using actual wages instead of estimated wages.
  • Payroll audit exposure is minimized as premium is paid using actual payroll.
  • There are no finance charges or fees.
  • Coverage is available for many types of business.

For a no obligation quote, contact one of our Construction contacts today.

Helpful Links:

Affidavit of Exempt Status Under the Workers Compensation Act Form

Work Comp Claim Forms


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Four Tests for Employee Recreational Injuries

By: Christopher Boggs

Employees injured while participating in recreational activities may qualify for workers compensation coverage. Typically, four tests are applied to the facts surrounding the injury to decide compensability:

    1. Did the accident occur on the employer's premises? An affirmative response does not guarantee compensability. An employee injured while engaged in a pick-up basketball game on the employer's premises may not be eligible for workers compensation because the employer is not directly benefiting from the activity and the employer is not directing the activity. Making recreational facilities available does not make the employer liable. Nor is it required that the injury occur on the employer's premises to be compensable.
    2. Was the event or team organized by the employer? Company-organized softball teams competing in "industrial leagues" may qualify under this provision. However, several employees deciding to form a team is wholly different from a team organized by the employer, encouraging "good" ball players to participate.
    3. Did the employer pay for the activity? It is unclear if this refers to the total cost or a subsidy on behalf of the team. For example, the league charges 450 from every player, but the company pays $40 on          behalf of each player. While the activity is not fully paid for by the employer, it could be viewed as employer-paid or sponsored (and participation encouraged).
    4. Did the employer benefit? Advertising in the community (team shirts), improved employee morale or better team work. An employer can "benefit" from these activities in more ways than tangible output.

From, "The Insurance Professional's Practical Guide to Worker's Compensation: From History through Audit."

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Is the H1N1 Virus Compensable Under Workers’ Compensation?
By Christopher J. Boggs, CPCU, ARM, ALCM

Illnesses and diseases must first arise out of and be in the course and scope of employment before being considered “occupational.” Further, to be compensable, the illness or disease must arise out of or be caused by conditions peculiar to the work.

Black lung disease, for example, results from prolonged exposure to higher-than-normal concentrations of coal dust, making it peculiar to the coal mining industry. Another example of this “peculiar” exposure is a healthcare worker contracting an infectious disease such as HIV or hepatitis as a result of contact with infected blood.

Qualifying an illness or disease first as occupational and secondly compensable may ultimately require industrial commission or court intervention to sort medical opinion from legal facts. There is no singular test that can be applied to every case to declare an illness or disease as compensable or non-compensable, thus each case is judged on its own merits and encompassing circumstances.

Medical opinion leading to the conclusion that an illness is occupational is not necessarily based on the disease but on the facts surrounding the patient’s sickness. Physicians will investigate:

·        The timing of the symptoms relational to work: Do symptoms worsen at work and improve following prolonged absence from work (in the evening and on weekends);

·        Co-workers showing similar symptoms: Do co-workers show some of the same symptoms currently or in the past (may not be to the same degree as the patient as each individual has varying tolerances);

·        If such illness is common to employees in that particular industry;

·        If the employee has a predisposition that may lend itself to the illness such as an allergy

·        Personal habits and medical history of the patient: Patients in poor medical condition (overweight, smokers, unrelated heart disease, etc.) and poor family medical histories may be more likely to contract a disease or illness than others in similar circumstances would not, clouding the relationship between the occupation and the illness. For example, smokers may be ill-equipped to fight off the effects of chemical concentrations to which others may have no problem being exposed.

Industrial commissions and courts: 1) compile the opinion of the treating physician and the opinions of other expert medical witnesses; 2) couple the medical evidence with the facts surrounding the case; and 3) compare the subject case with precedent to render a compensability ruling based on the facts. This process can sometimes take years.

But What About the Swine Flu (H1N1)

Judged against the qualifying factors presented, is the swine flu a true workers’ compensation exposure for most employers? The short answer is, “no, not likely.” Other than the fact that this illness has an attention-getting name, it is no more occupational in nature than the “no-name” flu.

Unless it can be proven that the employee has an increased risk because of a peculiarity of his job, this illness is not occupational. Employees working in the healthcare industry may be able to prove such increased risk as they have little choice but expose themselves to the bacteria as a regular part of their job duties. Beyond healthcare workers, not many employments will qualify for workers’ compensation protection.

Which Policy Responds to Qualifying Occupation Illnesses and Diseases?

Occupational illnesses and diseases generally have long “gestation” periods. Employees may be exposed to the harmful condition for many years before the illness manifests. It is also possible that the employee doesn’t contract the disease until years after the exposure ends.

The workers’ compensation policy specifically states that the policy in effect at the employee’s last exposure responds to the illness - even if the employee is working for another employer at the time the disease manifests itself.

Conclusion

Occupational illness or disease resulting in injury tends to lend itself to litigation. Since there is rarely a definable place or time of the injury, industrial commissions and courts will likely continue to play a large role in these claims. Employees’ personal habits and medical histories will, likewise, continue to find their way into the piles of evidence as workers’ compensation carriers look for legitimate ways to deny coverage.

Contracting swine flu (H1N1) is a humankind exposure rather than one that is peculiar to most employments. It is unlikely that the “occupational” and “compensable” thresholds will be crossed by the vast majority of individuals succumbing to the virus. The key question remains, is the illness peculiar to the job? If not, the illness is not occupational nor compensable.
 

Information for this article is taken from “The Insurance Professional’s Practical Guide to Workers’ Compensation: From History through Audit.”

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OKLAHOMA REFORM PLAN WOULD PHASE OUT WORKERS' COMP COURT

Oklahoma State Rep. Mark McCullough said in mid-November he plans to file legislation to overhaul the state's workers' compensation system. While the proposed legislation would keep the current Workers' Compensation Court for existing claims, it would phase out the court as cases are resolved. The number of judges would be reduced from 10 to four and the court would only handle cases filed before the effective date of the proposed law. All judges would be gubernatorial appointees subject to Senate confirmation and all would be required to have at least five years of experience in worker's comp issues in Oklahoma.

McCullough, a Sapulpa Republican, said many people devoted hundreds of man-hours to developing the proposal, including state Rep. Lewis Moore and Mike Seney, senior vice president of Operations for The State Chamber.

The bill creates a three-member "Workers' Compensation Commission" to run Oklahoma's Workers' Comp system for all claims filed after the bill's effecitve date, according to information released by the Oklahoma House of Representatives. The three members would include one attorney, one physician and one industry professional. Each must have five years
experience in Oklahoma workers' compensation issues.

The three-member commission would oversee an administrative law judge (ALJ) system. Each ALJ would be assigned to handle cases in specific counties (one each in four regional quadrants and two each in Oklahoma City and Tulsa). The bill would also establish a chief medical officer under the oversight of the commission who would be charged with medical evaluation of worker injuries.

Under the bill, all hearings would be recorded and made public. The bill also enacts a value added clause for attorney fees. If a settlement offer is rejected and a claim taken to trial, the attorney's fees would be taken from the amount won in excess of the initial rejected settlement offer.

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Fear of Reporting Injuries Creates Even Greater Risk for Employers

According to the Government Accountability Office (GAO), the auditing arm of Congress, the workplace safety data of the Occupational Safety and Health Administration (OSHA) does not provide an accurate picture of workplace safety. The GAO examined OSHA’s 2005-2007 audits and found that both employers and employees were underreporting work-related injuries and illnesses. Steven Greenhouse, “Work-Related Injuries Underreported,” www.nytimes.com (Nov. 17, 2009).

The GAO study suggests that employers underreport out of fear of increasing their workers’ compensation costs or of hurting their chances of winning contracts.

Employees cite other concerns. Some are afraid that reporting might lead to discipline or even termination. Some worry that an accurate report might cause their co-workers to lose rewards in safety-based incentive programs. Other employees have expressed concern the employer will require them to undergo drug testing after incidents resulting in reported injuries.

For 2007, OSHA reported 4 million injuries, including 5,600 fatalities. The GAO study suggests the real number is much higher. In fact, one-third of the health practitioners surveyed by the GAO stated that employers or workers had pressured them to provide insufficient medical treatment to hide or play down work-related injuries or illnesses.

The GAO report noted that OSHA’s “sole reliance on employer-reported injury and illness data” for one of its major surveys results in inaccurate data. In response to the GAO audit, OSHA will adopt the GAO’s recommendations, including requiring inspectors to interview employees during all audits to verify the accuracy of employer-provided data.

Commentary and Checklist

OSHA requires employers with more than 10 workers to record every work-related injury or illness that results in lost work time or medical treatment other than first aid.

OSHA statistics reveal that the rate of workplace injuries has declined fairly steadily since 1992. While this is good news, it appears the actual numbers are higher than those reported to OSHA. The GAO report cited several academic studies that found that OSHA data did not include up to two-thirds of all workplace injuries and illnesses.

Truly disconcerting is that some employees believe that reporting will lead to retaliation. State laws prohibit employers from retaliating against an employee for filing a workers’ compensation claim, and the law encourages employees to report their injuries.

While employers may fear the cost of workers’ compensation claims, the cost and risk of defending retaliation claims far exceed the risks associated with workers’ compensation. Consequently, employers should take every precaution to prevent retaliation from reporting injuries.

One of the best means for preventing retaliation claims is to provide employees the name and phone number of an officer in your organization who will accept their calls and intervene on the employees’ behalf. This officer acts as an ombudsman and helps employers and employees resolve the issue internally.

Here are some other suggestions:
  • Train your managers and supervisors on preventing wrongful termination.
  • Instruct your managers and supervisors to watch closely how employees interact with those employees that have filed a workers’ compensation claim.
  • Consider an outside reporting line where employees can report retaliation to a party outside the organization, if necessary.
  • Counsel managers and supervisors on the risk of retaliation when employees are reintegrated back into the workforce after filing a workers’ compensation claim.
  • Orientate returning employees on whom to call should they experience retaliation.
This informational piece is part of “The Loss Prevention Journal” published on November 23, 2009.


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