1 wc issues & injury prevention presented to radisson paper valley hotel appleton, wi 9/12/08...

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WC ISSUES & INJURY PREVENTIONWC ISSUES & INJURY PREVENTIONPRESENTED TO PRESENTED TO

RADISSON PAPERRADISSON PAPERVALLEY HOTELVALLEY HOTELAPPLETON, WIAPPLETON, WI9/12/089/12/08

FITZGERALD CLAYTON JAMES & KASTENFITZGERALD CLAYTON JAMES & KASTENJEFF THIEL, CPCU – EXECUTIVE VICE PRESIDENTJEFF THIEL, CPCU – EXECUTIVE VICE PRESIDENT

DARREN CHEREK - LOSS PREVENTION CONSULTANTDARREN CHEREK - LOSS PREVENTION CONSULTANT

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AGENDAAGENDA

•INTRODUCTIONSINTRODUCTIONS•HOW IS YOUR RATE DETERMINEDHOW IS YOUR RATE DETERMINED•HOW IS YOUR EXPERIENCE MOD DETERMINEDHOW IS YOUR EXPERIENCE MOD DETERMINED•INJURY TRENDSINJURY TRENDS•SAFETY COMMITTEESAFETY COMMITTEE

•IDENTIFYING LOSS TRENDSIDENTIFYING LOSS TRENDS•FLEETFLEET•MAINTENANCEMAINTENANCE•DRIVERDRIVER

•REVIEW LOSS RUNSREVIEW LOSS RUNS•IDENTIFY REPEATERSIDENTIFY REPEATERS•CONDUCT INJURY REVIEWSCONDUCT INJURY REVIEWS

•QUESTIONS & ANSWERSQUESTIONS & ANSWERS

CREATION OF CODE 7705The following amendments to the Wisconsin Basic Manual have been approved effective October 1, 2007, applicable to new and renewal business:

1. Ambulance and Emergency Medical Services Wisconsin background: Wisconsin currently classifies for-profit ambulance service providers under code 7380 and volunteer ambulance service providers under code 7710. Thus, Wisconsin already is an exception to NCCI’s classification of ambulances under code 7370. Approved action: Adopt code 7705 for paid, for-profit ambulance providers while retaining code 7710 for volunteer ambulance services. The rate for code 7705 will be the same as code 7380 until such time that the class develops sufficient experience to determine its own rate. NCCI’s description of code 7705 will also be adopted with the exception of striking any language indicating that volunteers are to be included under the code. Finally, in time, if the rates for codes 7705 and 7710 do not indicate large differentials, consideration will be given to combining the two ambulance codes, paid for-profit and volunteer, just as NCCI proposes in this filing.

Wisconsin Compensation Rating Bureau

Code 7380• 10/1/2008 $5.20• 10/1/2007 $5.26• 10/1/2006 $6.05 • 10/1/2005 $6.33• 10/1/2004 $6.14• 10/1/2003 $6.63• 07/1/2002 $6.33

Code 7705• 10/1/2008 $5.20• 10/1/2007 $5.26


7705 for paid, for-profit ambulance providers7705 for paid, for-profit ambulance providers

Code 7710• 10/1/2008

$11.15• 10/1/2007 $9.13• 10/1/2006 $7.47 • 10/1/2005 $5.86• 10/1/2004 $4.69• 10/1/2003 $4.16• 07/1/2002 $4.02


7710 for volunteer ambulance services7710 for volunteer ambulance services

Description: CIVIL DEFENSE WORKERS AND VOLUNTEER RESCUE SQUADS - INCLUDING MEMBERS SERVING AS AUXILIARY POLICE OFFICERS AT EMERGENCIES (Actual payroll shall be taken, but in no event less than $1,560 per individual per annum in calculating premium.)

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WHAT IS AN EXPERIENCE MODIFICATION FACTOR?

THE EXPERIENCE MOD IS AN INDICATOR OF HOW SAFELY OR UNSAFELY THE BUSINESS HAS OPERATED.

THE STATE OBTAINS INFORMATION ON THE NUMBER OF ACCIDENTS, AND THE COSTS OF THE ACCIDENTS, FOR EACH OCCUPATION, STATEWIDE.

THE STATE THEN CALCULATES WHAT THE AVERAGE NUMBER OF ACCIDENTS AND THE AVERAGE COST OF THOSE ACCIDENTS FOR EACH OCCUPATION. THIS IS CALLED AN “EXPECTED LOSS RATE”

THESE AVERAGES ARE BASED ON THREE (3) YEARS OF LOSSES.

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EXPERIENCE MODIFICATION EXPLANATIONEXPERIENCE MODIFICATION EXPLANATION

FITZGERALD CLAYTON JAMES & KASTENFITZGERALD CLAYTON JAMES & KASTEN

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WHAT IS AN EXPERIENCE MODIFICATION FACTOR?

THE EXPERIENCE MOD IS AN INDICATOR OF HOW SAFELY OR UNSAFELY THE BUSINESS HAS OPERATED.

THE STATE OBTAINS INFORMATION ON THE NUMBER OF ACCIDENTS, AND THE COSTS OF THE ACCIDENTS, FOR EACH OCCUPATION, STATEWIDE.

THE STATE THEN CALCULATES WHAT THE AVERAGE NUMBER OF ACCIDENTS AND THE AVERAGE COST OF THOSE ACCIDENTS FOR EACH OCCUPATION. THIS IS CALLED AN “EXPECTED LOSS RATE”

THESE AVERAGES ARE BASED ON THREE (3) YEARS OF LOSSES.

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HOW IS AN EXPERIENCE MODIFICATION FACTOR CALCULATED?

3 YEARS OF LOSSES, 3 YEARS OF PAYROLL INFORMATION ARE USED FROM THE LAST 4 YEARS, EXCLUDING THE MOST RECENT.

EXAMPLE: 10/1/08 - 09 MOD – 4/30 UNIT STAT DATE – CLAIMS SHOULD BE REVIEWED PRIOR TO 4/30 FOR MOST ACCURATE MOD

10/1/07 – 08 10/1/06 – 07 10/1/05 – 06 10/1/04 – 05

PAYROLL PAYROLL PAYROLL PAYROLL

LOSSES LOSSES LOSSES LOSSES

YOUR PAYROLL IS MULTIPLIED BY AN EXPECTED LOSS RATE FACTOR THAT IS DETERMINED BY THE WORKERS’ COMPENSATION BUREAU. THIS DETERMINES THE AMOUNT OF LOSSES EXPECTED FOR THE AMOUNT OF PAYROLL YOU HAVE IN THE CLASS CODES USED BY YOUR BUSINESS.

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LOSSES ARE VALUED 18 MONTHS AFTER THE INCEPTION DATE OF THE POLICY, AND YEARLY THEREAFTER FOR A TOTAL OF 3 TIMES. THEREFORE, LOSSES AFFECT THE MOD FOR 3 YEARS.

THE ACTUAL LOSSES ARE COMPARED TO THE EXPECTED LOSSES TO DETERMINE THE EXPERIENCE MOD FACTOR.

IF THE ACTUAL LOSSES ARE HIGHER THAN EXPECTED LOSSES A DEBIT MOD RESULTS.

> 1.00 (COSTS ABOVE EXPECTED)

IF THE ACTUAL LOSSES ARE LOWER THAN EXPECTED A CREDIT MOD RESULTS.

< 1.00 (COSTS BELOW EXPECTED)

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LOSSES ARE IN 3 CATEGORIES:

MEDICAL ONLY - NO WAGES WERE PAID BY THE INSURANCE CARRIER. (MEDICAL ONLY CLAIMS GO IN AT 30% OF THEIR VALUE. I.E. A $100 CLAIM WILL ONLY COST YOU $30 ON THE MOD CALCULATION.)

FREQUENCY (INDEMNITY CLAIMS UNDER $5,000) - WAGES WERE PAID TO THE INJURED WORKER BY THE INSURANCE CARRIER.

SEVERITY (INDEMNITY CLAIMS OVER $5,000) - WAGES WERE PAID TO THE INJURED WORKER BY THE INSURANCE CARRIER.

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WHAT IS YOUR CURRENT MOD?

1.29

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# Claim Type Comparison on Mod

5

01

20

27

32

1

5

2

2004-05 2005-06 2006-07

Ind > 5000 Ind < 5000 Medical Only

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$156,857

$4,518

$220,651

$20,937

$6,726

$20,628 $25,224$24,882

2004-05 2005-06 2006-07

Ind >5000 Ind < 5000 Medical Only

$ Claim Type Comparison on Mod

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2008 MOD BREAKDOWN BETWEEN

FREQUENCY, MEDICAL ONLY AND SEVERITY CLAIMS

0.5

93

7

0.5

73

60

0.0

41

00

0.0

81

70

Min Mod Ind > 5000 Ind < 5000 Medical Only

2008 mod = 1.292008 mod = 1.29

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COST EFFECTS OF MOD$110,750

$86,257

$69,365

1.29 MOD 1.00 MOD .80 MOD

$16,892$16,892

SAVINGSSAVINGS

$24,493$24,493

SAVINGSSAVINGS

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CONTUSION TO HAND

Manual Premium: Indemnity Medical

$284,793 Claim Claim

Medical Cost: $3,927 $3,927

Indemnity Cost: $591 $0

Total Claim Cost: $4,518 $3,927

Value on Mod: $4,518 $1,178

(30% x $3,927 )

Mod Points: 0.017 0.0046

3 year Premium Cost: $14,524 $3,930

Salary Continuance: $0 $887 *

Net Cost to You: $14,524 $4,817

Savings: $9,708

*WC payments are approximately 2/3 of hourly wage and are tax exempt so the employee would have to have a larger payment to overcome the tax liability.

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CLAIM AMOUNT: $40,641MOD POINTS: 5.68COST FOR 3 YEARS ON PREMIUM: $48,529

4 TO 10 TIMES THE VALUE OF THE CLAIM$48,529 x 4 = $194,115

$194,115 / 5% = $3,882,298

LOSS / PROFIT MARGIN = UNINSURABLE COST

TIME TO INVESTIGATE, REPORT, LOSS IN PRODUCTIVITY, DECREASE IN QUALITY, PROPERTY DAMAGE, ETC.

INDIRECT COSTS OF A CLAIM

SALES PROFITS VS INDIRECT COSTS

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Where do we go from here?Where do we go from here?

Lower Payrolls?Lower Payrolls?

Lower Rates?Lower Rates?

Lower Losses?Lower Losses?

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SALES PROFITS VS INCIDENT COSTS

YEARLYINCIDENT PROFIT MARGIN

COSTS 1% 2% 3% 4% 5%

$1,000 100,000 50,000 33,000 25,000 20,000$5,000 500,000 250,000 167,000 125,000 100,000

$10,000 1,000,000 500,000 333,000 250,000 200,000$25,000 2,500,000 1,250,000 833,000 625,000 500,000$50,000 5,000,000 2,500,000 1,667,000 1,250,000 1,000,000

$100,000 10,000,000 5,000,000 3,333,000 2,500,000 2,000,000$150,000 15,000,000 7,500,000 5,000,000 3,750,000 3,000,000$200,000 20,000,000 10,000,000 6,666,000 5,000,000 4,000,000

SALES REQUIRED TO COVER LOSSES

It is necessary for the salespeople of a business to sell an additional $1,667,000 in products to pay the costs of $50,000 in annual losses from injury, illness, damage or theft, assuming an average profit on sales of 3%. The amount of sales required to

This table shows the dollars of sales required to pay for different amounts of claim costs. I.e. if an organization's proift margin is 5%, it would be required to make sales of $500,000 to pay for $25,000 in claims costs.

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MANAGER’S ROLEMANAGER’S ROLE

1.1. RETURN TO WORK PROGRAMRETURN TO WORK PROGRAM

• PRE-IDENTIFIED TASKSPRE-IDENTIFIED TASKS

• DO NOT SEND PEOPLE HOMEDO NOT SEND PEOPLE HOME

2.2. ACCIDENT INVESTIGATIONACCIDENT INVESTIGATION

• 11STST DAY REPORTING DAY REPORTING

• IDENTIFY ROOT CAUSEIDENTIFY ROOT CAUSE

• I.D. CORRECTIVE ACTIONI.D. CORRECTIVE ACTION

• ADVERTISE POSITIVE CHANGES TO STAFFADVERTISE POSITIVE CHANGES TO STAFF

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MANAGER’S ROLEMANAGER’S ROLE

3.3. UP HOLD SAFETY POLICIES OF YOUR UP HOLD SAFETY POLICIES OF YOUR DEPARTMENT / ORGANIZATIONDEPARTMENT / ORGANIZATION

• FOLLOW YOUR PROGRESSIVE DISCIPLINARY FOLLOW YOUR PROGRESSIVE DISCIPLINARY PROGRAMPROGRAM

4.4. MAKE SAFETY PART OF EACH EMPLOYEE MEETINGMAKE SAFETY PART OF EACH EMPLOYEE MEETING

• FORUM TO DISCUSS CONCERNSFORUM TO DISCUSS CONCERNS

• SAFETY TOPIC OF THE MONTHSAFETY TOPIC OF THE MONTH

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POINTS TO PONDER

Statistical Data:

Ambulance crashes account for the bulk of EMS workplace mortality. According to the National Institute for Occupational Safety and Health, EMS workers have an estimated fatality rate of 12.7 per 100,000. For non-EMS workers, the estimated fatality rate is 5.0 per 100,000.

Getting struck by another vehicle at the scene is the second most prevalent event that kills EMS personnel. Isn’t it ironic that those whose primary purpose is to save lives have a risk of work-related death more than twice that of the general population? How can one apply Risk Management Principles to guarantee that all Medical Transportation personnel “Arrive Alive and Do No Harm”?

VITALS A Weekly Safety Newsletter for Medical Transport Professionals

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POINTS TO PONDER

In the May, 2003, issue of JEMS, Les R. Becker, Ph.D., NREMT-P, used two large national databases to show that between 1988 and 1997 there were 305 fatal ambulance crashes, 71 ambulance occupant fatalities and 9,465 injuries. Similar numbers were observed between 1991 and 2000.At the time of the publication of the JEMS article, Dr. Becker had another publication in press which showed a detailed statistical analysis that indicated the following:

The fatality risk for restrained ambulance occupants involved in a crash was nearly four times lower than for unrestrained ambulance occupants.

The risk of suffering an incapacitating injury for restrained ambulance occupants involved in a crash was nearly 6.5 times lower than for unrestrained occupants.

The risk of fatality vs. no injury for rear occupants of an ambulance involved in a crash was more than five times greater than for front-seat occupants.


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POINTS TO PONDER

Ambulance occupants traveling non-emergency were nearly 2.7 times more likely to be killed than occupants traveling emergency if involved in a crash.

Ambulance occupants traveling non-emergency were nearly 1.7 times more likely to suffer an incapacitating injury than occupants traveling emergency if involved in a crash.

52% of ambulance fatalities occurred among “unrestrained occupants riding in positions other than the front seat” and restrained occupants riding in the back accounted for another 20% of fatalities


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POINTS TO PONDER

Key Concepts:

1) Risk Identification2) Risk Evaluation3) Prioritize Risk4) Determine and Implement Controls5) Evaluate and Revise.

Dr. Becker clearly identified the risk, evaluated it, and showed that the reduction of risk is indeed a priority. Everybody and everything in the vehicle needs to be secured. There has been a recent spate of claims regarding patients who were not “tied down” properly. Remember that even if immobilization is not required for potential spinal or orthopedic injuries, patients must be safely secured at all times. Also, passengers who are not essential for patient care should be avoided. Evaluations which lead to the development of safer ambulance interiors and personal protective equipment specific to in transit needs also provides a scientific basis for the revision of transport standards. It is also estimated that emergency units cause 60,000 “wake effect” crashes annually. VITALS A Weekly Safety Newsletter for Medical Transport Professionals

30

60

8090

98

110120

140

165

180

194

0

50

100

150

200

Whisper

Normal ConversationPhone

Hair Dryer/Lawn MowerHand Drill

Chain Saw

Ambulance SirenJet Engine

Shotgun

Rocket Launch

Loudest Possible Tone

NIOSH Sound Meter www.cdc.gov/niosh/topics/noise

Exposures > 85 dB may cause hearing loss

85 dB

Possible solution – move siren to front grill vs top of ambulance.

18.03%

48.28%

25.11%

6.65%

1.93%

20 to 24 25 to 34 35 to 44 45 to 54 55 to 64

BLS DAYS AWAY FROM WORK 2006 OSHA REPORTABLE INCIDENTS 4,730 DAYS

DAYS AWAY FROM WORK FOR DAYS AWAY FROM WORK FOR AMBULANCE COMPANY PERSONNEL AMBULANCE COMPANY PERSONNEL

2006 DATA USA2006 DATA USA

BY AGEBY AGE

11.81%

22.57%

37.34%

28.27%

Less than 3 months 3 months to 11 months 1 year to 5 years More than 5 years


BY LENGTH OF SERVICEBY LENGTH OF SERVICE



14.16%

19.03%

24.10%

11.63%

13.53%

4.86%

12.68%

Cases involving1 day

Cases involving2 days

Cases involving3-5 days




Cases involving31 or more days


DAYS AWAY FROM WORK (MEDIAN 5) DAYS AWAY FROM WORK (MEDIAN 5) PER BLSPER BLS



73.72%

14.74%

5.34%2.99% 1.50% 1.07% 0.64%

Sprains, strains Soreness, Pain Back pain Bruises,contusions

Cuts,lacerations,punctures

Multiple injuries Fractures


NATURE OF INJURYNATURE OF INJURY



37.42%

22.83%

13.53% 13.32%

7.82%

1.69% 1.48% 1.06% 0.85%

Health carepatient

All other Vehicles Floor,ground

surfaces

Workermotion orposition

Furniture,f ixtures

Machinery Parts andmaterials

Containers


SOURCE OF INJURYSOURCE OF INJURY



46.67%

14.93%13.87%

10.13%7.47%

2.93% 2.13% 1.87%

Overexertionin lif ting

Transportationaccidents

Fall on samelevel

All other Contact w ithobject,

equipment

Fall to low erlevel

Assault,violent act by

person

Slips, trips


EVENT OR EXPOSUREEVENT OR EXPOSURE



8.03%

19.87%

12.90%

15.64% 15.22%

20.72%

7.61%

Sunday Monday Tuesday Wednesday Thursday Friday Saturday


DAY OF WEEKDAY OF WEEK



10.15%

4.44%

22.41%

19.45%

12.05%

7.40%

24.10%

12:01 AM - 4:00AM

4:01 AM - 8:00AM

8:01 AM - 12:00PM

12:01 PM - 4:00PM

4:01 PM - 8:00PM

8:01 PM - 12:00AM

Not reported


TIME OF DAYTIME OF DAY



4.65%

7.40%

11.42%12.68%

8.46%

19.66%

4.65% 4.23%

1.90%

24.95%

Less than1 hour

1 - 2hours

2 - 4hours

4 - 6hours

6 - 8hours

8 - 10hours

10 - 12hours

12 - 16hours

More than16 hours

Notreported


HOURS WORKEDHOURS WORKED





WHAT ALL OF THIS MEANS…..WHAT ALL OF THIS MEANS…..

WHO IS MOST LIKELY TO BE INJURED?WHO IS MOST LIKELY TO BE INJURED?

SOMEONE WHO IS 25 TO 34 YEARS OLD AND HAS BEEN SOMEONE WHO IS 25 TO 34 YEARS OLD AND HAS BEEN WORKING WITH YOU FOR 1 TO 5 YEARS. WORKING WITH YOU FOR 1 TO 5 YEARS.

WHEN ARE THEY MOST LIKELY TO BE INJURED?WHEN ARE THEY MOST LIKELY TO BE INJURED?

ON A FRIDAY BETWEEN 8:01 AM & 12:00 PM.ON A FRIDAY BETWEEN 8:01 AM & 12:00 PM.

WHAT WILL THEY BE DOING?WHAT WILL THEY BE DOING?

LIFTING A PERSON IN NEED OF TRANSPORT LIFTING A PERSON IN NEED OF TRANSPORT

WHAT WILL BE THE RESULT?WHAT WILL BE THE RESULT?

A STRAINED BACK RESULTING IN 3 – 5 DAYS AWAY FROM WORK.A STRAINED BACK RESULTING IN 3 – 5 DAYS AWAY FROM WORK.



SOLUTION……SOLUTION……

GIVE THESE PEOPLE FRIDAY MORNINGS OFF?GIVE THESE PEOPLE FRIDAY MORNINGS OFF?

SOURCE: THE INTERNET

AMBULANCES AROUND THE WORLDAMBULANCES AROUND THE WORLD

CANADACANADA



INDIAINDIA



RUSSIARUSSIA



FRANCEFRANCE



BULGARIABULGARIA

1 wc issues & injury prevention presented to radisson paper valley hotel appleton, wi 9/12/08...

Documents

creation of code

nccis description of

forprofit ambulance

ambulance codes

experience mod determinedhow

sufficient experience

experience modification

expected loss rate