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NOTE: In preparation for the Holiday Season, when donated blood is most needed Pro Group has scheduled a blood drive with United Blood Services on October 15, 2008 from 9:00 a.m. - 1:00 p.m. If you or a family member can give blood, we encourage you to come to the Pro Group office located at 575 S. Saliman Carson City, NV 89701 on October 15th. This is a good cause and welcome your participation.

For more information contact Kathy Pinochi at (800) 859-3177.

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Claim Acceptance: The Coming and Going Rule

When are employees covered under workers’ compensation and when are they not?  This is a question often asked when it comes to the employee travelling to and from work and when completing a work related task outside of the office. The simple answer is that if the Employer is aware of the travel plans, commissioned the travel plans and the travel is work related then it will more than likely be covered through your workers’ compensation coverage.

But let’s look at this a little more. Last month in the SIG Alert we reviewed Claims denied due to AOE/COE issues. These same rules apply to the “coming and going rule” when addressing away from primary location injuries. Last month we discussed an employee whose claim would be denied when the travel included stops other than those that are work related. For example: If your employee is going to drop off a package and stops for an ice cream, slipping on their way out of the store would not be covered. Should they fall on their way out of the mail center, that would be covered. You must be able to show a relation to work duties.

It is also important to understand when paid time begins and when it ends. For example, if you are a company with field technicians or crews that travel from jobsite to jobsite the important determination factor is point of origin. If your employee comes to the office or construction yard, checks in and then travels to the job site, his travel from the office to the job site would be covered should there be a mishap. But, if the employee travels from his home to the jobsite, then the jobsite is considered his workplace and a workers’ compensation claim made related to travel would not be accepted.

As you can see there are many questions that need to be addressed when a claim is made involving travel to and from job sites and when completing work related errands. Help our third party administrator by documenting the following information:

  • Was the Employer aware of and commissioned the work related travel?

  • Was the travel required to complete the job task?

  • Where did the claim occur in relation to the required travel?

  • What task was being performed when the claim occurred?

  • Was there a third party involved? (Obtain information)

  • Are there witnesses to the claim? (If so obtain witness statements)

By gathering the above information you will be able to add it to your accident investigation helping to avoid future travel related claims. For more information on addressing claims that involve the “coming and going” rule, contact your third party administrator,  Associated Risk Management, Inc. at (800) 935-0640.

In This Issue

CLAIMS
SAFETY

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Dear Adjuster,

I am a member of a SIG and I have some concerns regarding an alleged injury by one of my employees. This employee finished work on a Friday and happily said goodbye that evening, with no complaints of any injury. She was seen over the weekend by other employees at social events acting completely normal and active. She came to work on Monday morning saying that she had twisted her knee at work on Friday and she feels like it is going to require medical treatment. I have serious doubts that this occurred on Friday. In fact, I believe she was injured over the weekend and is just looking for this to fall under workers' compensation. What can I do?

Signed, Doubtful

Dear Doubtful,

While you can’t deny this individual the right to file a worker’s compensation claim, I have many helpful tools you can use in the future to prevent this from happening again.  I highly recommend that at the time of hire of all employees, you implement in your policies and procedures an acknowledgement form that all work related incidents and/or accidents involving injury or possible injury must be reported to the supervisor immediately.  Have all employees sign this at the time of hire informing them what is expected if they have an accident.  By Nevada Revised Statue, the employee has seven days to report an injury, but there are other steps you can take to help ensure you avoid the above situation. 

The next thing that I would advise you implement immediately is a paycheck statement.  This can be done in several different formats and we would be happy to help you design a form that would work best with your situation.  This is a statement that you have your employees sign at the end of every week confirming whether or not they were injured during this week.  If they indicate they were, you would proceed with having them fill out a C1 form.  If they indicate they were not injured, it makes it hard for them to come back after a weekend and say that they were injured the prior week when they have already signed off that they were not.  With this documentation, we have been very successful in upholding a denial.

 In your particular case, you need to fill out the proper paper work and send your employee for treatment.  When you have completed the C3, the Employer’s Report of Industrial Injury, please make sure that you indicate your doubts regarding the validity of this injury and Associated Risk Management, Inc. will thoroughly investigate the claim before they render a determination. 


Dear Adjuster,

One of my employee’s came to work and said she wasn’t feeling good.  I told her to feel free to go home at anytime.  As the day progressed, she continued to feel worse and her symptoms progressed into fever, vomiting and dizziness.  We sent her home and advised her to seek medical treatment.  She returned a couple days later after going to the emergency room stating she had been diagnosed with West Nile Virus.  She claims she was bitten by a mosquito while at work.  Will this claim be accepted?

Signed, Concerned

Dear Concerned,

This is a very touchy situation and would fall under the Nevada Revised Statute for occupational diseases.  In order to qualify for an occupational disease claim under NRS 617.440, your injured employee would have to prove that the mosquito that bit her could be fairly traced to her employment as the proximate cause for the disease.  She would also need to prove that she was not equally exposed to this disease outside of her employment.  In other words, she would have to prove that she had absolutely no possible exposure to obtain a mosquito bite outside of work. Something else to consider is that she would also need to prove that she was in the course and scope of her employment while bitten. More than likely the claim would be denied.

Submit Claims questions to Kelly Woodward at
Pro Group Tel: (800) 859-3177,
Fax (866) 439-9701 or email: kellywoodward@pgmnv.com


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NANSIG NEWS  
 

NANSIG NEW MEMBERS

Henderson Nissan


For those of you who are new members, have new employees handling claims, or just missed the previous workshops...

Pro Group Management, Inc. has scheduled Claims Workshops via Video Conferencing to take place on the following days in our Carson City and Las Vegas offices unless otherwise noted.

Seating is limited.

REGISTRATION - To reserve your seat for the training, please call Jackie Vogel at 1-800-859-3177
Register online, View Live Reservation Form (PDF) or fax this form back to Pro Group Management, Inc.

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PGM SAFETY SERVICES, LLC WILL DISCUSS THESE TOPICS AT THE September 2008 SAFETY SEMINAR

Hazard Recognition (CARSON CITY, CRYSTAL BAY, RENO, & LAS VEGAS ONLY): This Nevada and Federal statute is the starting point for all safety and health programs. We will discuss, with photos, the types of hazards that your employees are subjected to and what can be done to protect your employees.  Attend and learn how to recognize workplace hazards.  Members are expected to be in attendance at this important seminar. 

Accident Investigation for Supervisors (CARSON CITY, CRYSTAL BAY, RENO, & LAS VEGAS ONLY): Under NEVADA ADMINISTRATIVE CODE 618.540(d) the employer must include in the written program, the procedures that must be followed to investigate an accident that has occurred and the corrective actions that are to be initiated.  All members will benefit from this seminar where we provide the information and instruction on compliance.

RENO & LAS VEGAS ONLY
Emission Controls (Now and in the Future) for Transporters (NMTA)
Nevada & USDOT Regulatory Updates for Transportation Industry (NHP)

Click on your location below to see specific class locations & times on the schedule.

Carson City 9/17/08 - Crystal Bay 9/17/08
Reno 9/18/08 – Las Vegas 9/24/08

Site Specific Safety Training

Site specific training is available for group members planning to provide training to 5 or more employees, (excluding CPR First Aid Certification which requires a guaranteed Minimum of 10 employees & a Materials Fee per Attendee).  Contact PGM Safety Services at 800-859-3177 to discuss your specific training needs.

“If you think training is expensive,
try ignorance!”

PGM SAFETY SERVICES, LLC WILL DISCUSS THESE TOPICS AT THE
Upcoming October 2008 SAFETY SEMINARS

Special Safety Training Classes offered in Ely, Elko & Winnemucca
Electrical Safety ~ Hand and Power Tool Safety ~ Accident Investigation for Supervisors ~ Personal Protective Equipment Compliance Mandates

Click on your location below to see specific class locations & times on the schedule

Ely 10/7/08 - Elko 10/8/08 - Winnemucca 10/9/08

______________________________________

CARSON CITY, CRYSTAL BAY, RENO, & LAS VEGAS

Electrical Safety:  Come to understand the complexities of the current regulations on Electrical Safety, both in a facility and on jobsites.  Behavior normally considered acceptable at home can cause major injuries and large fines in the workplace.  National Electric Code and OSHA regulations will be discussed with demonstrations.  Please be in attendance at the most well received training each year.

Hand and Power Tool Safety: Hands are one of the most injured parts of the body.  Misuse of hand tools and power tools are one of the major causes.  Your company can be held liable, receive citations, and fund claims for injuries from tools and equipment that your employees bring to the workplace.  Guidance and answers to questions can be yours through your attendance at this valuable seminar.

Reno & Las Vegas, Only: 
Shipping Papers & Proper Documentation for Hazard Materials Transport (NHP)

Click on your location below to see specific class locations & times on the schedule

Ely 10/7/08 - Elko 10/8/08
Winnemucca 10/09/08
Carson City 10/15/08 – Crystal Bay 10/15/08
Reno 10/16/08 - Las Vegas 10/22/08

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PGM Safety Services  

Wireless Phone Driving Law Takes Effect in California

The California Highway Patrol is ready and drivers throughout California also should be ready for a new law taking effect July 1st in the state. It bars all drivers from using hand-held wireless phones while operating motor vehicles but lets drivers over 18 use hands-free devices. The law says drivers under 18 may not use hand-held or hands-free phones while operating a vehicle.

The law permits a driver to use a wireless phone to make emergency calls to a law enforcement agency, a medical provider, the fire department, or another emergency services agency, according to CHP's FAQ page about the new law. The law applies to drivers only -- not to motor vehicle passengers. It does apply to out-of-state drivers whose home states do not have such laws. CHP said it will be legal to use a Bluetooth® or other earpiece device as long as both of the driver's ears are not covered.

The base fine for a first offense is $20, with $50 charged for subsequent convictions. A violation is a reportable offense that will appear on the driver's record, but California DMV will not assign a violation point, CHP says. This safety rule is starting to be more of the rule than the exception. Take these wireless phone tips and apply them now. It will help avoid any unnecessary accidents. For more information on this topic or other safety driving tips contact Bob Arnold at (800) 859-3177 or at bobarnold@pgmnv.com.

DOT Issues Final Rule on Drug Testing Procedures for Transport Workers

The Department of Transportation has amended certain provisions of its drug and alcohol testing procedures to change instructions to collectors, laboratories, medical review officers, and employers regarding adulterated, substituted, diluted, and invalid urine specimen results. Published in the June 25, 2008 issue of the Federal Register and effective August 25, 2008, the changes in DOT's final rule are intended to create consistency with specimen validity requirements established by the U.S. Department of Health and Human Services and to clarify and integrate some measures taken in two of DOT's Interim Final Rules. The department noted that although 49 CFR Part 40 authorized specimen validity testing under the Interim Final Rules, it was not required. Now the final rule makes the testing mandatory within the regulated transportation industries. For more information on this and other DOT requirements contact Bob Arnold at (800) 859-3177 or bobarnold@pgmnv.com.

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PGM Safety Services  

Aging Workforce Presents New Safety Challenges

As the number of employees over the age of 55 continues to rise, businesses are faced with the challenge of retaining these workers while reducing health and injury related losses. Loss control specialists Tina Minter and Russell Dronne with the Chubb Group of Insurance Companies examined this challenge and offered businesses advice in a session titled, "The Aging Workforce-- It's Not Just Ergonomics" earlier this month at the American Society of Safety Engineers' Professional Development Conference and Exposition, Safety 2008, in Las Vegas.

U.S. Bureau of Labor Statistics data show that aging workers have fewer workplace injuries, but diabetes, hypertension, and other age-related ailments are helping to increase employers' costs associated with medical insurance and lost work production; nevertheless, businesses can help mitigate their losses by improving policies and workplace design to allow employees to continue to work in a safe and healthy environment, Minter said. "Older workers are highly valued by employers for their judgment, flexibility, experience, and creativity," she noted. "Fortunately, many of them will work beyond the traditional retirement age of 65, due partly to advances in health care. This presents both opportunities and challenges to businesses, which will need to adapt to maintain a safe work environment for these workers."

Although injury rates among older workers are lower than those of their younger counterparts, other factors can contribute to increased health and safety exposures: age-related chronic disorders and diseases, loss of hearing, impaired vision, and physical and cognitive limitations. Minter advised businesses to take action to address each of these risk factors. Some examples of what businesses can do include:

  • Allow for flexible work hours so that those with poor night vision can adjust their start and finish time to coincide with daylight hours;
  • Encourage employees to use the health care system for preventative well visits;
  • Eliminate heavy lifts, elevated work from ladders, and long reaches;
  • Encourage employees working at a computer to take small breaks every 30 minutes;
  • Don't rely on sound as the sole means of emergency communications, as employees with hearing loss may not hear announcements.

"Employers should include older workers in the design process and seek outside professionals for assistance in adapting the workplace, training, and human resources policies to fit the aging workforce," Dronne said.

For more information on safety for an aging workforce contact Bob Arnold of PGM Safety Services at (800) 859-3177.

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Driving Safety - New School Year Begins

With the new school year starting it is important to be aware of your surroundings. For all of those driving remember that the quiet streets of summer have turned into pedestrian busy streets populated with unconcerned children. Take time to plan your routes so you do not enter school zones and residential neighborhoods during the early morning and mid afternoon, this way you can avoid the morning arrival and afternoon departure times for school children.

Also remember the school speed limits and approach all crosswalks with extreme caution. Finally, take the time to check your mirrors and rear and forward vision removing any identified vision blockages. It is important to act safely in these obstacle ridden environments. Do your part and plan to act safely when travelling around town and beyond. 

For more information on safety contact Bob Arnold of PGM Safety Services at (800) 859-3177.

 

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Group Self Insurance
575 S. Saliman Rd.
Carson City, NV 89701

1-800-859-3177

SIG ALERT

A Publication of Pro Group Management, Inc.

This Newsletter is published for members of the self insured groups administered by Pro Group Management, Inc.
Reproduction for member use is encouraged

Did you know that you are participating in the best managed workers’ compensation program in the State of Nevada? Being a Member of your self insured group allows opportunities for rate reductions, payment holidays and dividends. Group Members benefit from safety services, safety workshops, claims training workshops and the best service offered in Nevada.

Members have access to professionals who are there to help. It truly is “workers’ comp that works for you”. We hope you agree and that you will share these feelings with your business associates.

Should you have an associate that you would like to share membership information with, give us a call and Pro Group Management, Inc. will take it from there. We would love to present the benefits of Group membership to your potential member and we promise to make you look good. Please let us know who you have spoken to by calling 1-800-859-3177 in Northern Nevada or 1-800-480-1846 in Southern Nevada. We will share the good news and work on qualifying your referral for membership in a SIG managed by Pro Group Management, Inc. Thank you for helping to identify good businesses in Nevada and helping your self insured group grow.

 

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