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Psychosocial factors weigh on comp claims

Psychosocial factors weigh on comp claims

Trecia Sigle, Columbus, Ohio-based associate vice president of worker comp claims for Nationwide Insurance, said the industry is ripe for change.
“I don’t think that they saw the value in it … We as an industry didn’t understand the impact of the bio-psychosocial problem when we were looking at a claim.” Ms. Sigle and others credit recent studies that point to psychosocial issues such as depression and anxiety that arise with an injury as a major driver when it comes to an insurer’s inability to close a claim.
1 barrier to successful claim outcomes, according to Chicago-based managed care solutions provider Rising Medical Solutions’ 2016 Workers Compensation Benchmarking Study.
According to the Rising report, the “greatest roadblock to timely work injury recovery and controlling claim costs … is the negative impact of personal expectations, behaviors and predicaments that can come with the injured worker or can grow out of a work injury.” The report also highlights how many claims professionals surveyed have skills in customer service and communications, and possess traits such as empathy.
The Rising study follows other recent studies such as one conducted by Hartford Financial Services Group Inc., which in 2016 analyzed its workers comp claim data from 2002 to 2015 to find that 10% of them featured at least one psychosocial issue and that those claims accounted for 60% of claims costs.
“I think that studies are better and medical literature is better,” said Ms. Sigle, whose company is now exploring what it can do to better serve injured workers to avoid problems later on.
“(It’s) a program that we are working on to revise claim-handling philosophy to a more advocacy-based approach,” she said.
Nationwide isn’t the only company honing in on the psychosocial aspect of a claim.
In the Rising study, Albertsons revealed that since 2013, roughly 9% of workers injured in the company’s stores who were voluntarily screened for mental complications were found to have psychosocial issues embedded in their workers comp claim.
“Through this examination, one can see how adversarial, compliance and task-driven claim styles are ill-suited for addressing the fears, beliefs and perceptions of this distressed population.” In 2013, Albertsons launched a pilot program in several of its 40 markets that provided injured workers the opportunity to consult with a third-party “health coach” whose primary job was to gauge the worker’s mental state in light of the injury, according to Ms. Algire, who called the program a success and a major driver for improved return-to-work figures.

Integrated disability makes a comeback

Integrated disability makes a comeback

Integrated disability makes a comeback.
Reprints A recent increase in the number of state and municipal leave regulations, along with an expansion of paid family leave laws, is prompting employers to take a fresh look at integrating their workers compensation, disability and benefit programs, either internally or through third-party vendors, and creating a new wave of momentum around the concept of integrated disability management.
Having inconsistent leave policies and practices opens employers to audits and fines, said Terri Rhodes, CEO of the San Diego-based Disability Management Employer Coalition.
“The idea isn’t necessarily new, but the amount of cooperation and partnership is reaching a new level,” said Jeff Smith, a disability and productivity consultant with the Workplace Possibilities program, an absence and disability management program operated by Portland, Oregon-based disability insurer Standard Insurance Co. Decades ago, employers considered ways to create synergies between occupational medical claims and nonoccupational health claims to save on overhead costs.
“Some progressive organizations have managed to work through those silos.
In addition, depending on past administrative practices, employers that implemented integrated disability managed programs saw a 10% to 25% decrease in days away from work, Sedgwick said in a 2014 white paper.
Administrative cost savings are a primary benefit of integrating workers compensation and disability management, said Mr. Sears.
Employers have an opportunity, he said, to incorporate wellness initiatives, such as smoking cessation programs, with workers comp programs to help improve medical outcomes and reduce comp costs.
Workers comp and disability programs can work together and share resources in a mutual effort to get workers back to work quickly and prevent future claims, said Mr. Smith.
“Preventing a short-term disability claim might be preventing a workers comp claim as well,” he said.

Court rulings, big rate increases concentrate reform efforts in Florida

Court rulings, big rate increases concentrate reform efforts in Florida

The National Council on Compensation Insurance Inc. initially sought a 19.6% increase in state workers comp rates in response to these court decisions last year, but the Florida Office of Insurance Regulation approved only a 14.5% rate increase that took effect last December.
The vast majority of the higher rate filing was “due directly to the Florida Supreme Court’s Castellanos decision striking down the statutory attorney fee schedule, and that highlights why it’s so critical that the legislature act to address the attorneys fee cost drivers effectively and as soon as possible,” said Ronald Jackson, Atlanta-based vice president for state affairs, Southeast region at the American Insurance Association.
“The portion attributable to the cost impact of Castellanos is controversial and is expected to continue to develop in subsequent years, which would lead to additional rate increases.
It “seems like a drug formulary is on the horizon in Florida,” said Desiree Tolbert-Render, Orlando, Florida-based assistant vice president, national tech compliance for workers comp at Sedgwick Claims Management Services Inc. Last December, Jacksonville Beach, Florida, state Rep. Cord Byrd, also proposed a bill that would allow companies in Florida to opt-out of purchasing workers comp insurance, but the bill was never formally introduced and experts say that Florida adopting opt-out for workers comp is unlikely.
“All the other states that have tried to put it through have failed.
Other workers comp reform legislation in Florida includes H.B.
The bill has been amended since its introduction and has received support from the business community and organizations such as AIA.
1582 remain because while it provides for a transition to loss-cost ratings, it will not address the primary drivers of workers comp costs: excessive litigation and attorney fees, Mr. Jackson said.
Rob Bradley, would codify Westphal, increasing the time limit on temporary partial disability and temporary total disability benefits from 104 weeks to 260 weeks and change workers comp attorney fees to address Castellanos, which ruled that a cap on workers comp claimant attorney fees was unconstitutional.
“We have to be cognizant in the way we go about handling claims in Florida and doing everything we can to avoid litigating claims that don’t need to be litigated.”

Medical marijuana may hold promise, but federal law curtails research

Medical marijuana may hold promise, but federal law curtails research

Can medical marijuana replace opioids?
That is the question on the minds of those who deal with pain in workers compensation.
Anecdotally, some say yes.
Several states such as New Mexico have seen decreases in opioid use with the widespread availability of medical marijuana for pain management.
Meanwhile, given the lack of research into medical marijuana — including for side effects, effectiveness and dosage — others say the workers compensation industry is more cautious.
So far, 29 states and the District of Columbia have legalized marijuana for medicinal use.
And several other states are considering adoption of regulations that would pave the way.
But the federal government’s stance that medical marijuana remains an illegal substance — along with that of the new presidential administration, which has voiced skepticism — has stalled further research on medical marijuana, which has forced insurers to tread lightly as the industry adopts an evidence-based approach to health care.
And then there is the accessibility issue, she added.
“It very well could reduce the amount of narcotics prescribed,” she said.

Trump’s Tax Plan Is An Assault On Working Families
Social Security Disability

Trump’s Tax Plan Is An Assault On Working Families

Trump’s Tax Plan Is An Assault On Working Families.
Working American families need relief, American small businesses need help to compete in an increasingly global economy, and many of our nation’s wealthiest individuals use loopholes to avoid paying their fair share.
Congress needs to find bipartisan, workable solutions for genuine tax reform that help all Americans make ends meet, and I am ready to work with lawmakers on both sides of the aisle to make that happen.
Out of the trillions of dollars in tax cuts that Trump proposed this week, nearly all of that money would end up in the pockets of America’s highest income households and corporations, like Trump and his family.
By any measure, the President’s tax plan proposes massive giveaways to high-income individuals.
The average income in my district for a family of four is just $34,000 annually, and only one percent of the families in my congressional district make over $200,000.
The Trump tax plan calls for reducing the corporate tax rate and “pass-through” tax rate to 15 percent, a proposal that helps wealthy corporations far more than the mom-and-pop businesses in Alabama’s 7th District.
But the elimination of programs like these does not even come close to paying for the $7 trillion in tax cuts proposed in Trump’s tax plan.
This tax plan isn’t just a missed opportunity, it actively works against reform by raising the deficit and laying the groundwork for damaging budget cuts.
Regardless of party, I believe that every lawmaker wants the best for their constituents and for the future of our country, because that is what brought me to Congress.

Some pre-European debt crisis signs are popping up again

Some pre-European debt crisis signs are popping up again

And this goes directly to how to think about credit risk in Europe.
Both sets of arguments quickly progress from the economic to the political.
Goodhart believes that had policymakers examined how Emu was set up, they would have discovered that the declining transaction costs of a common currency simply couldn’t make up for the economic losses from a loss of sovereignty – unemployment, economic crisis, and — most importantly here — default risk.
Here’s how Goodhart puts it, with an example using Belgium – then a problem child in Europe because of its high government debt load: But what happens after Emu when there is a drop in the demand for the bonds of a particular national government?
What if, for example, bond investors start to see Belgium as a worsening credit risk: it has an ageing population, a declining tax base, and a government which lacks the political will to trim its spending programme.
But these bond market crises could be much worse than their foreign exchange market forebears if the contagion threatened to spread from the debt of governments to that of the banks, and the financial system itself was thereby undermined.
And everything Goodhart said about an ageing and economically sclerotic Belgium in 1997 is true in spades for Italy in 2017.
And to get that growth, it needs change politically.
And when it does fall, Italian sovereign and bank credit risk will skyrocket.
More: Credit Writedowns Credit Writedowns Pro European Union Italy Euro Crisis

We’ve seen this movie before: Economy set for spring surge after first-quarter slumber

We’ve seen this movie before: Economy set for spring surge after first-quarter slumber

We’ve seen this movie before: Economy set for spring surge after first-quarter slumber.
The same script is being followed in early 2017.
Over the past several years, the economy has usually started out slowly in the first quarter, only to see a frantic burst of growth in the spring.
The government last week reported that gross domestic product rose just 0.7% from January to March, marking the worst quarterly performance in three years.
Yet economists predict the U.S. will speed up to 3% in the second quarter than runs from April to June.
The highlight will be the April employment report on Friday that’s expected to show almost 200,000 jobs were created in the month — double the disappointing 98,000 rate in March.
Although the labor market is tight with an unemployment rate at 4.5%, U.S. job openings are near a record high.
“You don’t get 0.7% GDP growth when employers are furiously trying to fill 5.74 million job openings,” said Bernard Baumohl, chief global economist of The Economic Outlook Group.
That’s helped to drum up sales for energy producers and large, export-heavy American firms.
Although the Fed is expected to hold off raising interest rates for now, central bankers believe the economy is strong enough to warrant more increases later this year.

Le Pen’s ‘outsider’ politics move to center stage in France

Le Pen’s ‘outsider’ politics move to center stage in France

The National Front has gone mainstream.
It was also the second time her far-right National Front party, or Front National (FN), has come this close to the Elysee. ‘Part of the political landscape’ Even if a 2017 Le Pen presidency is a long shot, the far-right agenda has firmly taken root in mainstream French politics.
Especially since many young people vote for them,” said Jean-Yves Camus, a French political analyst who writes about extreme right movements in Europe.
Europe’s nationalist factions have been around since the end of World War II.
Camus says what’s new is these parties now take between 14 and 45 percent of votes.
She even went as far as kicking her father out of the party. “The difference is that she does not use those divisive topics simply because there is no interest for those between 18 and 24,” Camus said. ‘Last chance for France’ Christophe Barbier, a political journalist at French newspaper L’Express says Macron is France’s last chance at a moderate government. “If Macron fails, the next president will be Marine Le Pen or Marion Marechal Le Pen (her niece),” Barbier said.

Robots are going to take a lot of jobs — here’s what we could do about it

Robots are going to take a lot of jobs — here’s what we could do about it

Robots are going to take a lot of jobs — here’s what we could do about it.
WASHINGTON — For all the talk of robots replacing humans on the job, in schools and even in bed, students at Everett Community College in Washington State are preparing for a robot future.
Some of their employers even went bankrupt, he says.
Here’s another sticking point for universal basic income: Why not give money to everyone, even the wealthy, and not just to those who need it?
Advocates argue, not without reason given widespread support for universal programs like Medicare and Social Security, that targeted programs are easy targets for future elimination, exactly because they lack a broad-based backing.
The negative income tax The notion of a guaranteed minimum income, which sounds pretty liberal by today’s political metrics, is actually closely related to the idea of a very conservative economist, University of Chicago professor and Nobel laureate Milton Friedman: a negative income tax. “The idea of a negative income tax is to treat people who are poor in the same way we treat people who are rich.
The concept is basically the same, of creating a social safety net of wages below which no worker shall fall.
The robot tax A more recent idea that’s popped into the radar screen of automation-watchers is that of a tax on robots.
More: Jobs automation Robots Basic Income

U.S. Jobless Claims Rise for First Time in 4 Weeks

U.S. Jobless Claims Rise for First Time in 4 Weeks

WASHINGTON – The number of Americans applying for new unemployment benefits rose last week, but remained at a low level suggesting steady job growth.
Initial jobless claims, a proxy for layoffs across the U.S., increased by 10,000 to a seasonally adjusted 244,000 in the week ended April 15, the Labor Department said Thursday.
Economists surveyed by The Wall Street Journal had expected 240,000 new claims last week.
Claims increased last week for the first time since the week ended March 18.
Data on unemployment applications can be volatile from week to week.
Jobless claims have remained below 300,000 for 111 consecutive weeks, the longest such streak since 1970–when the U.S. workforce and population were much smaller than they are today.
A low level of layoffs typically indicates steady employment growth.
Nonfarm payrolls increased by a seasonally adjusted 98,000 in March from the prior month, the Labor Department said, a slowdown from earlier in the year.
The Labor Department on Thursday also said continuing unemployment claims, reflecting benefits drawn by workers for longer than a week, decreased by 49,000 to 1.98 million in the week ended April 8.
Data on continuing claims are released with a one-week lag.