By Donna Motley, Vice President of Claims

I recently attended a conference where one of the speakers was John Flood, D.O. from Michigan Orthopedic Center in Lansing, Michigan. Dr. Flood is a physician we have utilized for Independent Medical Evaluations in the past. Dr. Flood presented some interesting facts concerning low back pain.

One fact is that 80% of the population will experience low back pain during their lifetime. Of that 80%, 15% will experience the pain for 2 weeks or more. Interestingly enough, experiencing low back pain “decreases” after age 65. The annual incidence of back pain has been unchanged over the past 30 years.

The good news is that 85% of this population will improve at 6 weeks; 90% improve at 12 weeks; 10% will have ongoing pain. However, the recurrence rate at one year is 25-80%. Permanent work disability affects about 5% of those treating for low back pain.

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By Travis Halsted, Loss Control Consultant

Accident investigation and analysis is a means used to prevent accidents. As such, the investigation or analysis must produce information leading to corrective actions to prevent or reduce the number of accidents in the workplace. In 2014 the state of Michigan had 37 workplace fatalities. The investigations from these events are essential as they provide the possible root cause of the accident as well as assist in developing long term remedies. Injuries result in loss of productivity and efficiency, increased workloads on supervisors and co-workers, possible damaged equipment costs, economic hardship to the injured workers’ family, and a cost of the time spent on the accident investigation, return to work programs, and workers’ compensation claims management. By conducting accident investigations a company could possibly implement a remedy that could prevent future occurrences.

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By Donna Motley, Vice President of Claims

We are all aware of how and where potential “serious” injuries can occur in the workplace and hopefully actions are taken to avoid those situations. Things like weight limits on lifting, guarding on machinery, wearing safety glasses and other personal protection equipment. But what about those seemingly innocent actions and movements, that are almost second nature to a person? The following are actual claims handled by our office.

An employee stopped to get the mail and slipped on black ice and snow resulting in an ankle fracture in three places and a shattered heel. Surgery was performed with plates and screws; and the employee remains disabled from work.

An employee jumped off the bed of a truck resulting in a heel and foot fracture. The employee has been referred to a specialist to see if surgery is necessary. The foot fracture was not noticed on the initial diagnostic testing. The employee remains disabled from work.

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By Donna Motley, Director of Claims

Medical expenses always seem to be on the rise. The Workers’ Compensation weekly benefit (the amount paid to the injured worker) usually increases annually even though it is based on the State Average Weekly Wage. Workers’ Compensation coverage is mandatory in the State of Michigan – part of the cost of doing business!

Once a Workers’ Compensation claim is turned in to our office, we take the reins and take control, attempting to minimize all the costs involved, the length of disability, and to assure a successful return of the injured worker to productivity. Everyone benefits. But, as an employer, there are things that you can do to help mitigate the expenses or costs on the claim.

Obviously, one of the most important things an employer can do, is report the claim As Soon As Possible! That way, we are controlling treatment (and costs) from the onset. As an employer, NEVER tell an injured worker to seek treatment with their primary care physician or a physician of their choosing. Any treatment outside the Occupational Clinic results in a delay in obtaining medical records that are required before authorization to treat can be rendered. If an employee is off work during this period – the cost of the claim has just increased significantly. If the injury is questionable and/or you are unsure of the direction that should be taken, PLEASE call our office for advice.

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By Chris Demeter, Senior Loss Control Consultant

OSHA has expanded the list of severe injuries & illnesses that employers must report and updated the list of industries who are partially exempt from routinely keeping OSHA records.

“OSHA will now receive crucial reports of fatalities and severe work-related injuries and illnesses that will significantly enhance the agency’s ability to target our resources to save lives and prevent further injury and illness. This new data will enable the agency to identify the workplaces where workers are at the greatest risk and target our compliance assistance and enforcement resources accordingly.”
— Assistant Secretary of Labor for Occupational Safety and Health, Dr. David Michaels

For workplaces under Federal OSHA jurisdiction

• Final rule becomes effective January 1, 2015 For workplaces in State Plan States (MIOSHA)
• States encouraged to implement new coverage provisions on January 1, 2015, or as soon after as possible.

The rule expands the list of severe work-related injuries and illnesses that all covered employers must report.

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By Donna Motley, Director of Claims

While scanning some publications, I came across an article that itemized “8 CHARACTERISTICS OF A SUCCESSFUL W/C PROGRAM”. The original source of the article was Zurich American Insurance Company. Below we have modified the article to explain these characteristics and include ways MTMIC can help you with your programs. The characteristics were listed as follows:

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By Travis Halsted, Loss Control Consultant

Each year, millions of workers suffer workplace lacerations that could be prevented. From the use of improper tools, moving material unsafely, and inadequate personal protective equipment, employees suffer a great deal of avoidable injuries.

Through a review of the lacerations within MTMIC’s loss run history, the issue of laceration injuries is very apparent. Since 2009, 2,091, or 25% of the total 8,536 injury claims reported have been lacerations. Of those 2,091 laceration claims, 1,508, or 72%, were reported to have taken place on the hand (fingers, thumbs) of the injured employee.

Monetarily speaking, lacerations account for $4,401,735, or 10%, of the total $42,654,333 spent on workplace injuries by MTMIC since 2009. This percentage is only surpassed by fractures (12%) and strains (46%). As the numbers point to the fact that lacerations are not only one of the most reported workplace injuries, but also one of the most costly, it is vital to identify some measures to reduce the likelihood of continued lacerations.

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By Ruth Kiefer, ARM Loss Control Manager

Just this year, safety professionals from all over the country were asked by EHS Today “In what area would you most like to see an improvement in your safety program?” Listed below are the top ten answers professionals gave to this question. I’ve added a loss control view after each identified issue.

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By Glenda Moyle
Premium Accounting Manager

Every year after the final audits are completed we have a few companies who have a significant audit balance due. As much as you hate paying these surprise audits we dislike collecting on them.

One way to avoid this would be to take a look at your estimated payrolls and compare it to your actual payrolls. You can find your estimated payrolls on your current declaration page broken down by class code.

If you find that your actual payrolls are above your estimated payrolls and you wish to revise them please contact me at glenda.moyle@mtmic.com/blog or you can call me at (800) 274-5606 X1315 with any questions you might have.

ByRuth Kiefer, ARM
Loss Control Manager

I’d like to take a moment to explain the reason why my staff and I take safety very seriously when we survey your facilities. Our time doing this job has taught us one thing, that when things go wrong, they are quick and unforgiving. During our safety walkthroughs of your facilities, we try to encourage you to address certain hazards, we may sound like broken records at times, and there is a clear and fateful reason why we do. Injuries and deaths occur all the time in our industry. It is real. We see it first hand, we investigate it, we analyze the data, and we crunch the numbers. It may be just a story that you read, a highlight on the nightly news, but these are real people, that could have been your own employee. Or perhaps have been one of your employees.

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By Travis Halstead, Loss Control Consultant

As the warmer months are quickly approaching, many of your facilities will be directly affected by the increasing temperatures. As you do not have the ability to close your facility for the summer, it is essential that we try to identify the symptoms of heat related illnesses and ways to prevent them. Through proper training and some other proactive steps, there will be a better chance of reducing the possibility of your employees being exposed to heat stress.

By employees being exposed to extreme heat they are more apt to heat stress. While workers that are 65 years of age or older are at a greater risk of having heat stress, other individuals that are overweight, have heart disease or high blood pressure, or take medications may also be easily affected by extreme heat.

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Experience Modifications have been used for decades as a method to adjust employer’s workers’ compensation premiums based on their own loss experience. Good experience would earn a credit experience modification, an experience modification below 1.00. Loss experience higher than anticipated in the rate results in an experience modification greater than 1.00. This is all old news. So what is new? Three inquires in the last 6 months from our policyholders about their experience modifications. That by itself is not usual. What was unusual is that all three had a significant panic in their call. In each case, the insured’s largest customer was letting them know that future work was being discontinued because their experience modification was above 1.00. (more…)

By Donna Motley, Director of Claims

Late reporting of employee injuries can be costly in multiple ways.

We received a claim on August 16, 2013 for a July 3, 2013 injury date – approximately 6 weeks after the injury allegedly occurred. The employee said they “bumped” their elbow on a part. The diagnosis was “post traumatic olecranon bursitis”. The employee did not lose time from work. The employee treated for the condition on July 3, 2013 (the day of injury), July 8, 11, 22, 29, and October 8, 2013 when they were discharged from care.

Notice there were five visits with the medical provider before we even received the injury report. Per the Workers’ Compensation Act, the W/C provider/insurance carrier exclusively directs all medical treatment for the first 28 days! In this particular case, we lost that opportunity. Could we have shortened the length of this claim and thereby the amount spent – very likely!

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By Cindy Boyce, Senior Claims Adjustor

In the majority of Workers’ Compensation cases employees who are injured at work recover and return to work. In some cases employees do not return to work claiming that they are still disabled from the work injury. A small percentage will end up in court and enter into litigation by filing an Application for Hearing. Shortly after the Application is filed, it is processed by the Workers’ Compensation Agency and the employer will be served with an Acknowledgement and Notice of Hearing. Below are a few recommendations that will assist you in understanding the litigation procedure.

1. Once a claim is disputed, the employee may resort to filing an Application for Hearing.

When you are served with the Acknowledgement and Notice of Hearing, you will note the Magistrate assigned to hear the case, the hearing site and the date of the initial pretrial hearing. In most cases, the adjuster will also be served. However, it is recommended that you contact MTMIC upon receipt of the Application to confirm that we have been served.

Once we receive the Application for Hearing, we will retain an attorney to represent your company’s legal interests.

In most cases you will not be required to attend the pretrial or subsequent hearings unless we have notified you otherwise.

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