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June 2010

YOUR HEARING IS A VALUABLE ASSET: PROTECT IT ON THE JOB SITE

By Workplace Safety

Although we might not often think about it, our ability to hear is a valuable asset. We hear soft, pleasant sounds such as whispers and music, and we hear loud noises such as those made by heavy equipment. With our ears, we register sounds and pass this information along to our brain. Regrettably, our ears cannot regulate sound levels, and excessive exposure to loud noise can damage the ability to hear irreversibly. One in 10 Americans has a hearing loss that affects his or her ability to understand normal speech.

People vary in their sensitivity to noise. However, as a rule, noise might be damaging to your hearing if you have to shout over background noise to make yourself heard, the noise hurts your ears or makes them ring, or you have difficulty hearing for several hours after exposure to the noise.

Loudness (or sound intensity) is measured in decibels. A whisper measures about 20 decibels, while an average speaking voice is usually around 60 decibels. A shop saw measures at about 100 decibels, and a jet engine is a loud 140 decibels! It is considered hazardous to your hearing to expose your ears to 85 decibels or greater for lengthy periods of time.

More than 16 million American workers are exposed to noise on the job that can result in hearing loss. The best way to prevent this loss is to wear hearing protection on the job site. There are two main types of protection available.

Earplugs fit in the outer ear canal and should be fit properly in order to ensure a proper seal. They come in a variety of sizes and shapes and offer the best protection against low frequency noise.

Earmuffs are a second option. Earmuffs fit over the entire outer ear with an adjustable headband. They offer the best protection against high frequency noise. Either type of protection reduces noise levels by 15 to 30 decibels. If both types are worn together, you can add another 10 to 15 decibels of protection.

Your protective equipment is only effective when you wear it consistently, and when you make sure it fits properly. Studies reveal that about half of the workers wearing hearing protectors receive one-half or less of the noise reduction potential of their protectors because these devices are not worn continuously while in noise or because they do not fit properly. Deciding to remove your earmuffs or earplugs for just an hour over an eight hour work day and exposing your ears to loud noise can reduce your 30 decibel protection to only nine decibels.

Remember that hearing loss is irreversible, but fortunately, it is also preventable. It is well worth extra effort to protect your hearing in the workplace.

UNDERSTAND THE UNDERLYING CAUSES OF INJURY TO IMPROVE RISK MANAGEMENT

By Workplace Safety

According to the U.S. Occupational Safety and Health Administration, 969 construction workers suffered fatal injuries while on the job in 2008, almost one-fifth of all U.S. workplace fatalities that year. Another 314,000 workers suffered non-fatal injuries. When four construction workers die every weekday, it is clear that the industry needs to improve its safety practices. Too often, however, companies take measures that treat the symptoms of the problem but not the problem itself.

Suppose a particular company is having frequent job site injuries. Management decides that workers need additional training on safe work practices. After the training, their loss experience improves, causing management to shift its attention elsewhere. Gradually, though, the losses begin to mount again. This time, management decides to invest in better tools. Loss frequency declines again, and again management focuses on other things, but eventually the injury rate climbs back up.

Management is baffled, so they decide that the problem is sloppy, inattentive work, and they lay down the law. Managers will make unannounced spot checks on job sites and discipline employees caught performing work unsafely. This puts the fear of God in the workforce, but it produces results: Injury rates dip again, though a few skilled workers pay for transgressions with their jobs. Satisfied that a firm hand has fixed the problem, management moves on. Sure enough, the injury rate bumps back up.

Managers are livid. “Maybe, they snarl, we should do away with your bonuses so we can pay for the higher Workers Compensation bills we’re getting.” Management instituted these bonuses to encourage workers to increase profits by doing more jobs in less time and spending less on each individual job. Now the workers are angry because they’ve busted their tails to finish as many jobs as possible but have failed to satisfy management. Management is angry because training, equipment, and threats did not solve the problem. What none of them see is that the bonuses are the problem.

The bonuses give workers a financial incentive to work as quickly as possible. If they finish early and move onto the next job, they get nice checks every quarter. However, speed, power tools, ladders, and a group of human beings are often not a combination conducive to safe work. When workers rush, they cut corners, lose focus on the task at hand, and get careless. The guy working on the roof who will get an extra $1,000 in the fall if the company finishes two jobs in July will knock himself out (sometimes literally) to finish the roof on Wednesday instead of Friday. This can lead to him hammering his fingers instead of the roofing nails. Management can buy him a nicer hammer and give him weeks of safety training, but if that extra $1,000 will cover the college tuition bill, none of those things will stop him from rushing through a job.

When confronted with risk management problems, construction firms need to look beyond the symptoms — banged up hands, sprained ankles — and look for the underlying cause driving the behavior that leads to these injuries. When they treat the problem (perhaps by creating new financial incentives for loss prevention), they will see lasting improvement.

CAUTION ON THE ROAD: HOW TO DEAL WITH AN AGGRESSIVE DRIVER

By Workplace Safety

Every driver needs to adhere to the rules of the road, and when driving is part of your job, there is added importance to the task. Driving for a living increases the amount of time you spend on the road each day which increases your likelihood of having to handle aggressive drivers.

What defines an aggressive driver?

Aggressive drivers are some of the most dangerous and reckless drivers on the road. They don’t just drive fast; they make aggressive maneuvers in their vehicles that put all other drivers and pedestrians at risk. Below are some examples of aggressive driving behavior:

  • Attempting to bully the person in front of them by tailgating and trying to get them to change lanes.
  • Passing that results in cutting other people off, as well as passing on the right or on the shoulder of the road.
  • Showing a blatant disregard for red lights, stop signs, yield signs, and crossing zones.
  • Displaying a general disregard and contempt for the safety and personal space of other cars and drivers.

When you observe an aggressive driver, the sharp and abusive way they operate their vehicle suggests that an angry person is behind the wheel. To further enhance this notion, most aggressive drivers yell, flash their lights excessively, make volatile and aggressive hand gestures and honk their horns at other drivers. Make no mistake that an aggressive driver is a dangerous driver whose behavior is completely unpredictable.

How do you handle aggressive drivers effectively?

The first thing to remember when facing an aggressive driver is not to turn into an aggressive driver in response. Never attempt to teach the aggressive driver a lesson or punish them by thwarting their efforts to pass you or by increasing your speed. Similarly, do not try to keep them penned in behind you or beside you. Instead, make safety your first priority and let them pass you by. You are better off behind an aggressive driver than you are in front of one.

As an aggressive driver passes you by, they might make certain offensive hand gestures or yell things to which you feel compelled to respond. Resist the temptation to respond. Always act in a professional manner and treat all other drivers, even the aggressive ones, as you would any company customer. Remember that aggressive drivers are irrational (at least, while they are aggressive) and responding to them, even politely, can escalate the situation. Simply ignore what they are doing, and refuse to make eye contact.

Be sure to take note of the make and model of an aggressive driver’s car, as well as their license plate number, if you are able. When you are in a safe location and no longer driving, call your local authorities and report the driver. If the driver is acting especially dangerous and erratic, you might want to pull over into a safe, public area and call the authorities immediately.

Remember, vigilante justice does not pay. Your primary goal should be on your safety, and the safety of other cars around you. Let the local authorities deal with the aggressive driver and keep your focus on remaining safe and productive.

WE ALL NEED TO BE VIGILANT TO BEAT THE EPIDEMIC OF HEALTH CARE FRAUD

By Employment Resources

In 2007, health care expenditures in the United States hit approximately $2.6 trillion, according to the Centers for Medicare and Medicaid Services. Estimates put the portion of this outlay that is attributable to health care fraud — payment for nonexistent, exaggerated, or ineligible services — at anywhere from 3% to 10%, according to the National Health Care Anti-Fraud Association (NHCAA). Health care fraud comes in many different shapes and sizes. Perpetrators include patients, providers, as well as individuals or groups with no connection to the health care system. Organizations such as the NHCAA emphasize that, although the vast majority of doctors, hospitals, therapists, etc., are honest and submit valid billings, most cases of health care fraud do originate with providers. The types of health care fraud seen from providers include:

  • Billing for services that were never actually provided to the patient.
  • Falsifying a diagnosis.
  • Upcoding, or billing for a more expensive service, treatment, or procedure than the one that was actually performed.
  • Recoding, or billing for a different treatment or procedure than the one actually provided (for example, the service actually provided is a nose job, which is considered a cosmetic procedure and not covered under the plan; but the provider codes it as a repair to the septum, which would be covered).
  • Performing unnecessary tests and/or procedures (e.g., diagnostic tests).
  • Unbundling services that are part of one procedure and billing for each separately.
  • Billing for the entire cost of a service when partial payment (such as a copayment) has been collected from the patient.

Patients commit health care fraud by listing and filing claims for ineligible dependents; sharing health plan identification cards; filing claims for services they never received; altering or forging bills and receipts; and buying and re-selling prescription medications. Health care fraud can also be perpetrated by individuals or groups posing as providers who, using stolen or purchased patient insurance information and provider billing numbers, submit bills for services from a fictional clinic. Or, they might pose as providers in order to obtain other individuals’ legitimate health insurance information, and then use the information for themselves, or even sell it.

Although health care fraud adds to costs, it also carries a price tag that is not financial. Patients undergoing unnecessary procedures, testing, or drug therapies face risks to their health. Phony or inflated diagnoses result in inaccurate patient medical records, which can complicate later treatment. Amounts paid on fraudulent claims might result in an insured reaching a dollar-amount or number-of-visits maximum under a policy when seeking coverage for later, legitimate claims.

Industry groups, insurance companies, and state and federal governments have become increasingly proactive in their efforts to prevent, detect, and punish instances of health care fraud. The Health Insurance Portability and Accountability Act (HIPAA) established health care fraud as a federal criminal offense. HIPAA provides for financial penalties as well as imprisonment for up to 10 years for health care fraud convictions, with longer sentences if the fraud results in patient injury or death. Many state insurance departments require anti-fraud efforts by the insurers or HMOs that operate in their states. Insurers and HMOs staff dedicated investigative units that use computer technology, patient education, and solid communications with other insurers and law enforcement to battle health care fraud. The NHCAA offers a professional certification — the Accredited Health Care Fraud Investigator — to those that complete a training course.

It is in the best interest of every business and individual to do what it can to prevent health care fraud. Not only does fraud contribute to the overall rate of health care cost increases, it affects your rates at renewal. Talk one of our health insurance professionals about anti-fraud efforts, and help your employees become attuned to what they can do to avoid becoming an unwitting participant in a health care fraud scheme (e.g., safeguarding their health insurance ID cards and insurance information; being wary of offers for “free”� services; examining explanation of benefits (EOB) statements for accuracy). These efforts, at a grassroots level, do make a difference.

HOW WILL HEALTHCARE REFORM IMPACT EMPLOYERS?

By Employment Resources

On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act. Along with the Health Care and Education Reconciliation Act of 2010, this legislation will make significant changes to our current health care system.

The Act adds new responsibilities for employers and insurance carriers. Although most of the provisions will start in 2014 or later, some provisions are effective right away or within a short period of time after enactment.

Effective 2010

  • Small-Business Tax Credit. A tax credit of up to 35% of the employer’s health care contribution is available for qualified small employers (any employer with no more than 25 full-time employees and average wages of less than $50,000). This tax credit will increase to 50% starting in 2014 once exchanges are operational.
  • Early Retirees. A temporary reinsurance program is provided to employers that offer coverage to early retirees between the ages of 55 and 64.
  • Health Plan Changes. 1) Plans must offer unlimited lifetime benefits and annual benefit limits will be restricted. 2) Pre-ex conditions will be prohibited for children under 19. 3) Recissions are prohibited except in the case of fraud. 4) Plans must cover certain preventive health services at no cost to the insured. 5) Dependent coverage age limit extended to 26.
  • Federal High Risk Pool. Temporary establishment of a high risk Health insurance pool for individuals unable to find insurance elsewhere.

Effective 2011

  • W-2 Reporting. Employers must report value of health care benefits provided on employee w-2s, but not as taxable income.
  • Higher Penalty Tax on Non-Qualified Health Savings Account (HSA) Withdrawals. Non-qualified withdrawals will be taxed at 20% versus the current 10% penalty.
  • Cafeteria Plans. A new Simple Cafeteria Plan is created through which small employers (fewer than 100 employees) can easily provide tax-free benefits to their employees without the administrative burden of sponsoring a cafeteria plan.
  • Standardized Definition of Qualified Medical Expenses. Costs for over-the-counter medications obtained without a prescription will no longer be considered a qualified medical expense.

Effective 2013

  • Flexible Spending Account Limits. Annual contribution limits are reduced to $2,500 per year, with CPI increases available in future years.
  • Itemized Deduction for Medical Expenses. The Act increases the income threshold for claiming the itemized deduction for medical expenses from 7.5% to 10%. Individuals over age 65 would be able to claim the itemized deduction for medical expenses at 7.5% of adjusted gross income through 2016.
  • Higher Payroll Taxes for High Income Earners. The hospital insurance tax rate will be increased 0.9 percentage points for wages over $200,000 for individuals and $250,000 for those filing jointly.

Effective 2014

  • Employer Coverage Mandates. Employers with 50 or more employees who do not offer employee health coverage will pay $2,000 annually for each full-time employee, excluding the first 30 full-time employees. The penalty is increased to $3,000 for any full-time employee receiving a federal tax credit for coverage, because his or her employer health coverage is considered “unaffordable.” Coverage is considered “unaffordable” where the employee contributes more than 9.8% of his or her income, or the employer contributes less than 60% of the actuarial value of the plan.
  • Insurance Exchanges. Exchanges are created at the state level starting in 2014, where individuals and small employers can shop for health coverage. Initially, the exchanges would be available to individuals and small groups (less than 100 employees), unless the state opts to cover only groups with up to 50 employees. Starting in 2017, states could open the exchanges to larger groups.
  • Wellness Programs. Employers can offer larger rewards, up to 30% of the cost of coverage, to employees for participation in a wellness program or for meeting certain health-related goals.
  • Individual Tax Credits. Credits are available for people with incomes up to 400% of the poverty level for insurance purchased through an exchange.
  • Health Plan Changes. 1) Insurers cannot refuse to issue coverage on any individual due to pre-existing conditions. 2) Higher rates cannot be charged to any individual based on health status, gender or other demographic factors. 3) Coverage cannot be non-renewed or dropped because an individual participates in a clinical trial.

Effective 2018

  • High Value Plan Excise Tax. A nondeductible excise tax of 40% is imposed on any health insurance plan with combined annual employer/employee premiums exceeding $10,200 for individual coverage and $27,500 for family coverage. The tax would only apply to premiums in excess of the threshold.

USE INCENTIVES AND CLEAR COMMUNICATIONS TO BOOST PARTICIPATION IN WELLNESS PROGRAMS

By Employment Resources

More than half (58%) of employers that offer health benefits also offer wellness programs, according to Kaiser Family Foundation’s 2009 Employer Health Benefits Survey. Many of these say their primary reason for doing so is to help improve employees’ health, reduce absenteeism, and lower health care costs. These goals, if achieved, can represent significant cost savings for a company — but this can happen only if employees participate. Frequently, participation in wellness initiatives falls short of expectations. Creative and consistent marketing, together with a careful use of incentives, can positively impact wellness program participation and help these programs bring cost-savings results.

Wellness initiatives run the gamut from simple workplace walking clubs to onsite fitness centers. The most common include health risk assessments; screenings for high blood pressure, cholesterol and diabetes; exercise incentives, such as discounts to local gyms; weight management and nutrition programs; smoking cessation programs; and disease management programs. According to a survey from Health2 Resources, a health care and e-health public relations and communications firm, 73% of employers measured the return on investment from their wellness programs, and 83% of these employers saw a return of better than dollar for dollar on their investment.

With such a return on investment being possible, increasing employee participation in wellness programs becomes a priority. Here are some ideas to engage employees in wellness initiatives:

Offer the types of programs in which your employees would be interested. A key element of successful marketing is to offer consumers the products they want. Bring this perspective to your wellness initiatives, and survey employees or talk with them informally about various wellness activities that your company would be willing to bring into the workplace, to see where employee interest lies.

Build interest in the program by using a variety of media, beginning several weeks before the program launch date. Remember that individuals learn in many different ways, so employ all means of communication at your disposal: articles in the company newsletter; paycheck stuffers; lunchroom posters and table toppers; e-mails; a letter from top management; employee meetings; DVDs/videos with program highlights; presentations by the wellness program vendor. Furthermore, build excitement for a program launch by dispensing communications strategically and structuring them in a way that enables employees to personalize the experience.

Make it as easy as possible for employees to participate. For example, if your company’s wellness initiatives include onsite screenings, make it easy to sign up for them, schedule them throughout the day, and let employees know they are permitted to take a work break to have the screening done. To encourage spouse participation, include early morning and evening times. If your company’s wellness initiatives include a health risk assessment, offer paper and electronic ways of completing it, and keep it as short and simple as possible.

Make participation fun. Incorporate contests, party-atmosphere health fairs, and club/team based activities that get employees moving (like lunchtime walking clubs, or a softball or bowling team).

Since some employees hesitate to provide health information through a wellness initiative, suspecting that the employer will be privy to it, take steps to overcome this barrier. Clearly communicate the company’s confidentiality policy and the confidentiality guaranteed by HIPAA, as well as the steps taken to ensure that participant confidentiality indeed is maintained.

Offer financial incentives, which are thought by many to be the most effective motivator toward wellness program participation. Common financial incentives include a health plan discount or premium differential, contributions to a health savings account, cash or payroll credits, or copay reductions. The Health2 Resources survey found that two-thirds of surveyed firms that offered wellness programs used incentives to motivate participation. The value of incentives in 2009 averaged $329 and ranged from $1 per pound of weight lost to annual premium reductions valued at more than $1,500.

Most important of all, make sure employees know the value of improving their health, both in terms of disease prevention/longevity and dollars and cents. On some basic level everyone knows it is better to be healthy than not, but drive this point home with accurate data on, for example, the impact being overweight has on all aspects of a person’s health, and how this can translate to an individual’s personal health care spending. The bottom line of well-used wellness programs is significant potential savings for both the employer and program participants.

THE ABCS OF EVIDENTIAL BREATH TESTING (EBT)

By Risk Management Bulletin

Every business needs an effective drug and alcohol testing program to meet compliance requirements, reduce its legal liability for accidents due to substance abuse, keep costs under control, and maintain effective employee relations. Evidential breath testing (EBT) plays an essential role in these programs. You can use your own certified employees, contract out for these services, or join a consortium of employers.

An in-house specimen-collection and testing program will cost time and money for buying and maintaining EBT devices, training employees, and keeping records. Because alcohol testing renders immediate results and in-house operations tend to risk disclosure, you risk violating your employees’ right to privacy. On the other hand, using third-party testers also has its drawbacks; you need to consider the reliability, quality, experiences, and resources of the organization.

Only a trained breath alcohol technician who passes a proficiency exam by the Department of Transportation can calibrate and maintain the EBT machine.

In addition, the machine must:

  • Meet National Highway Transportation Safety Agency standards
  • Print the results in triplicate, sequentially numbered, with the manufacturer’s name, device name, and serial number, and time and date of the test
  • Test “air blanks” before each screening;
  • Perform external calibration checks. It also needs recalibration after each positive confirmation test and at least once a month.

The EBT program must use labs approved by the Mental Health Services Administration, and testers must carry adequate insurance.

Random drug testing is mandatory for 50% of employees each year. Random alcohol testing must be performed on 25% of employees each year (depending on the rate of violations).

You need to remove drivers with a 0.02% breath alcohol concentration from their safety-sensitive position immediately. Drivers with a 0.04 % concentration can’t return to duty without evaluation by a substance abuse professional and treatment for alcohol misuse.

HANDY TIPS FOR PREVENTING HAND-RELATED INJURIES

By Risk Management Bulletin

Hand-related musculoskeletal disorders (MSDs) are painful, sometimes crippling, injuries that generally affect nerves, tendons, tendon sheaths, and muscles in the hands, fingers, and wrists. A worker with a severe hand-related MSD might require surgery, be out of work for weeks, and have to remain on restricted duty for a while after returning to work. All of that can add up to a lot of pain and suffering for the worker and lost productivity and increased costs for your organization.

Hand-related injuries develop from frequent repetitive motions on a machine or keyboard, packing, cutting, etc.; forceful exertion; or from the use of vibrating or impact tools. Carpal tunnel syndrome, for example, is a common MSD that occurs when the nerve that runs through the wrist’s carpal tunnel is pinched. Initial symptoms are numbness, tingling, and weakness. Carpal tunnel syndrome can reduce strength and mobility in wrist and hands and may cause permanent damage.

The best way to handle hand-related MSDs is to prevent them. It’s essential for employees to choose the right tool for the job to reduce strain and awkward positions. To prevent injury when using tools, employees should:

  • Grip tools so the thumb and index finger overlap slightly
  • Avoid bending wrists while holding tools
  • Use clamps, jigs, etc., to help avoid awkward positions and bent wrists
  • Carry materials using a palm-down grip
  • Reduce vibration-related injuries by operating tools at the lowest efficient speed possible
  • Hold tools as loosely as possible without losing grip
  • Use mechanical aids, not hands, to grasp and hold materials while working on them
  • Keep hands warm. Cold hands make workers grip tools and materials too tightly. When their hands are cold, workers are also more likely to develop problems from vibration.

Whatever their job, make sure that your workers:

  • Avoid repetitive movements whenever possible
  • Alternate tasks to reduce time spent performing tasks that put a lot of stress on hands
  • Take frequent mini-breaks to relax tense muscles and give hands a rest.

Finally, encourage employees to report MSDs affecting the hands, fingers, and wrists immediately. Symptoms include pain or aching; numbness, tingling, and stiffness; a burning sensation; swelling; and weakness.

FOUR STEPS TO BUILD SAFETY AWARENESS

By Risk Management Bulletin

If you’re like many safety professionals, you spend your days (and probably nights, too) working on and thinking about ways to make your workplace safer. Unfortunately, this can all come to naught without one thing your workers need to develop: A sense of safety awareness — building safety into the way your workers think about things.

Without it, workers won’t wear their PPE, or won’t wear it properly. They won’t make full use of the safety features built into their equipment; and they won’t observe basic rules, such as those of good housekeeping, that can prevent accidents. Without safety awareness, workers might think about production, their compensation, or tonight’s softball game but not safety.

To get them to do so, follow these guidelines.

  1. Develop a Safety Manual. This book, given to new workers on day one, should pool safety information from department managers, equipment and tool manufacturers, and workplace safety experts. It should include startup and lockdown procedures, types of activity to avoid at work, and proper attire for operating equipment.
  2. Name a Safety Champion. Choose one employee in each work area to research and report on safety at regular safety or department meetings. It’s amazing how often workers take to this responsibility. In one organization, the safety coordinator subscribes to safety magazines and continually contacts safety organizations to bring his co-workers the best and latest information. The gratitude of his colleagues is his only payment
  3. Hold a Safety Event. Let employees plan and carry out safety demonstrations or create exhibits for these events, which can be either freestanding or part of larger company gatherings. This is an ideal time to hold contests or distribute safety awards. You can also invite guest speakers from vendors or safety or trade associations.
  4. Build Safety into Employee Communications. Every employee contact from daily e-mails to paycheck stuffers to newsletters should stress workplace safety. The more you focus on safety, the more it will become a core value for your organization. Don’t forget posters and how to display them properly. This means locating safety messages so they won’t drown in a sea of EEOC and Wage and Hour announcements. Make sure that these messages get priority placement in work areas and aren’t covered by other postings as time passes.