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The Value of Knowing Who You Are Hiring

Many Self Insured Group Members sometimes forget the importance of knowing the full story of the person they plan on hiring. Often these prospective employees bring added baggage with them, including a previous workers’ compensation injury or claim. By taking the right steps you can protect your business from a workers’ compensation claim that should not be the self insured group’s responsibility.

Many years ago the State of Nevada put in place the “Subsequent Injury Account” (SIA). The primary purpose of the Subsequent Injury Account(s) is to encourage employers to hire workers who have suffered a permanent physical impairment.  The impairment is any permanent condition, whether congenital or caused by injury or disease (diabetes), that is serious enough to cause a hindrance or obstacle to obtaining employment or to obtaining re-employment, if the employee is unemployed. The costs of the subsequent injury are paid from a designated “subsequent injury account” (SIA) which is supported by assessments received from workers’ compensation insurers rather than having the current insurer pay the entire costs of a qualifying claim.

The ability to submit a claim to the SIA for recovery is first researched by Claims Staff at ARMI as well as Kris Louisiana of Pro Group Management.

Key components of the SIA accepting a claim are:

  • Verification of the employer’s knowledge of impairment at the time of hire (a note or letter to personnel file upon learning of impairment) or retention in employment after obtaining knowledge of the impairment (payroll records)
  • The job has to be physically appropriate for the worker and the employer must accommodate any restrictions the worker may have.

The makings of a successful SIA claim are outlined below.

The fan belt broke on his truck so the IW decided he should take a quick look under the hood.  In doing so he injured his back.  The IW followed protocol for reporting his injury, received treatment and was released to return to work and the claim was closed.   The IW appealed claim closure and the Hearing Officer ordered the claim to be reopened.  The IW went on to receive back surgery.  Fortunately, his employer had knowledge that his employee had a pre-existing back injury from several years earlier and the employer had properly documented this knowledge in their file.  Associated Risk Management, Inc. (ARMI), the third party claims administrator, obtained the IW’s prior medical records with the IW’s approval and upon review of these records it was determined that the compensation for disability on the subsequent injury was substantially greater due to the combined effects of the preexisting impairment than that which would have resulted from the subsequent injury alone.  Pro Group Management, Inc., on behalf of this member, was able to qualify this claim for relief from the Subsequent Injury Account.  Had the employer not documented their file about their knowledge of their employee’s preexisting condition, relief would not have been found on this claim and claims costs would not have been reduced.

Since 2003 Pro Group’s Subrogation Analyst, Kris Louisiana has recovered over $300,000 in subsequent injury reimbursements. However, over $450,000 in subsequent injury reimbursements was denied because the employer did not document pre-existing conditions appropriately and/or did not retain the employee after the subsequent injury.

A tool available to all  members involved in self insured groups administered by Pro Group Management is employee background checks offered by Employer Lynx. These background checks offer the group member the opportunity to learn more about their potential hire, including a record of previous workers’ compensation claims. And, as we have learned “Knowing and Documenting” a previous disability can help keep claims costs down and help the group continue to perform successfully. We encourage you to utilize the employee background checks offered through your SIG. By doing so you will protect both your company and your self insured group.

For more information on handling the documentation process or to discuss a potential SIA claim contact Kris Louisiana of Pro Group management at (800) 859-3177.

In This Issue

CLAIMS
SAFETY

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Dear Nicole,
I am in the home health business and I have a wonderful employee who has been with us for several years.  This care giver has daily contact with our patients and has never disclosed any personal medical issues to us.  Recently, this employee has decided to cut back on her work hours and as a result some of her patients had to be reassigned to other care givers.  When our office called to notify one of her clients that they would be sending a new employee from now on, his response was, “okay because she has an infectious disease anyway.”  What are my rights and responsibilities as the employer? - Signed, Worried

Dear Worried,
This can be a sticky situation.  Because a client has provided you with this information, you can go to your employee and let her know that a client has informed you that this is the case.  If she denies the information is true, your hands are pretty much tied.  However, if she confirms that she does in fact have this infectious disease, you can ask her to provide you with a medical release stating that is okay for her to safely perform her job duties.  You might also provide her with a job description of her duties to take with her to her doctor’s appointment.  If her doctor is unable to give her medical approval for this, you may have to let this employee go or move her into a position that is more suitable for her condition, one that would not include any patient care.  - Signed, Nicole

Dear Nicole,
As an employer, I was under the impression that if my employee was injured on the job, and they had a pre-existing condition that they had disclosed to me, the claim would be denied because they had previously injured that same body part.  However, I recently had an employee sustain an injury on the job to a body part that he had previously injured and you accepted the claim. - Signed, Confused

Dear Confused,
Although a Pre-existing condition is definitely considered in the acceptance of a claim, it is not automatic grounds for denial of a claim.  If a pre-existing condition becomes aggravated, accelerated or exacerbated by a work related injury the workers’ compensation carrier is usually responsible for the increased disability of that injured worker.  If your employee sustains a work-related injury to a previously injured part of their body, regardless of whether the previous injury was work-related, their claim is not going to be automatically denied.  If they have an accident that aggravates their pre-existing physical condition, such as arthritis, a back condition or a prior surgery, they are still entitled to all the rights and benefits provided by the workers’ compensation law in the state of Nevada.  If you do have a claim that is accepted on a body part that was previously injured we may be able to recover some or all of the costs of the claim through the Subsequent Injury Account (SIA).  This is a fund set up by the State of Nevada that a portion of all workers’ compensation assessments go to.  This recovery of funds would happen at the end of the claim, so the claim would go along like all claims and once the claim comes to an end and we know the total claims costs, we then attempt to recover those costs through this account. - Signed, Nicole

Submit Claims questions to Nicole Lovec at
Pro Group Tel: (800) 859-3177,
Fax (866) 439-9701 or email: nicolelovec@pgmnv.com
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NTNSIG NEWS  
 

NTNSIG NEW MEMBERS

Awesome Construction LLC
LM Munns General Engineering
Superior Sweeping
Water Pros

For those of you who are new members, have new employees handling claims, or just missed the previous workshops... Pro Group Management 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 sign up for Claims Workshops and other training classes offered through Pro Group Management use the master fax registration form found as an insert of the SIG Alert or contact Kelly Woodward at 1-800-859-3177 or register online at www.saveoncomp.com.
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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!"

See Site Specific Training List (PDF)

See Safety Training Insert for
Specific Class Locations and Times
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PGM Safety Services  

Water is a Vital Key to Summer Survival

Are you carrying any water in your car or truck right now? Whether you spend the entire summer just driving around town or are involved in outdoor activities a supply of emergency water is a necessity. With weather getting warmer it may not be uncommon to have temperatures in the triple digits and being hydrated may save you from heat exhaustion.

Every year, people drive into the desert heat without thinking to keep a supply of water in their vehicles. For those who may experience an automotive breakdown such a mistake can be fatal. The Nevada sun can dry you out in a short period of time and dehydration can cause a complete physical breakdown.

Over the years there have been accounts of local residents travelling into the desert for a day of fun and have never returned. In most of these cases dehydration has been either a direct cause of death or a contributing factor. With bottled water so readily available, there is no reason to not have a supply of drinking water with you wherever you go.

Take the time now to prepare yourselves for travel by having a good supply of drinking water in your vehicle. It could mean the difference between life and death.

For more information on this subject contact Bob Arnold of PGM Safety Services at bobarnold@pgmnv.com or at (800) 859-3177.

Keeping Your Skin Injury Free

Maintaining healthy, intact skin and preventing skin injury is important both at work and at home.  A large portion of occupational illnesses involve injury to skin tissue in the form of irritation, inflammation, and chemical burns.  But not all skin injuries are work related.  Each year thousands of people suffer tissue injury from exposures to plants, bacteria and chemicals commonly found around the house.  Exposures to plants such as poison ivy, poison oak and poison sumac can produce severe and painful irritation.  Exposures to bacteria and fungi can also cause irritation and infection.  Improper use and over exposure to household cleaners, pesticides and other chemicals can and will cause skin damage.

There are three elements to protecting our skin.  First, we must be able to recognize the hazards of harmful substances we may encounter.  Product labels and Material Safety Data Sheets provide information about the hazards associated with the materials that you may be working around or using.  These resources should always be consulted to make sure that the harmful properties of a substance are understood.

Secondly, safe work practices, should be used when working with materials that are potentially harmful.  Every precaution should be taken to avoid skin and eye contact with hazardous substances.  When using chemical agents, it is advisable to practice good personal hygiene and wash your hands before and after using the restroom to avoid contamination of other body areas.  If your skin is accidentally exposed to a harmful substance, the risk of serious injury can be reduced if you are familiar with first aid procedures for that particular product.  You should seek medical attention immediately if you experience any changes in the skin from an exposure to a substance.

Third, use appropriate personal protective clothing and equipment.  It is important to understand that no single piece of protective clothing and equipment can protect you from all types of hazardous substances.  Follow the manufacturer’s recommendations, and select the personal protective clothing and equipment that will protect you from specific hazards of a substance.

When working with any harmful substance on the job, work areas should be kept clean and free of debris, and containers should be labeled and stored according to established state and Federal regulations and your company’s safety policy.  You should also know the location of eyewash stations and emergency showers.  In the event of accidental exposure, notify you supervisor immediately.
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PGM Safety Services  

Tips:  Lawn Equipment Safety

Many injuries result from the misuse of power mowers and power line trimmers.  Many accidents involving power lawn equipment result in severe lacerations and often amputations.  Wounds caused by these accidents are prone to infection by the unsanitary conditions of the environment.  Help reduce these accidents by following a few simple safety precautions.

Power Push Mowers

  • Read the operator’s manual and know how to operate the machine properly.
  • Don’t disable or bypass safety devices.
  • Read all equipment warning labels.
  • Protect yourself and others against thrown objects by clearing the work area of rocks, sticks, toys, or any other materials that could become a missile if struck by the mower blades.
  • Keep the discharge chute guard or grass catcher in place at all times.
  • Keep bystanders, especially children, away from the mowing area.
  • Keep hands and feet away from the mower blades while it is running.  If the discharge chute clogs or the grass catcher is full, stop the engine before attempting to clear the clog or empty the grass catcher.
  • Never leave a running mower unattended.
  • Stop the engine before adjusting the wheels of the mower.
  • Mow in a forward direction whenever possible.
  • Do not walk backwards while pulling the mower toward you.  If you trip, the mower could end up on top of you or on top of your feet or legs.
  • Mow across the slope of hillsides.  Do not mow up and down the slope.
  • To ensure good footing, wait until the grass is dry before mowing.
  • Handle fuel safely.  Before refueling, stop the engine and allow it to cool.  Wipe up spilled fuel or allow it to evaporate before starting an engine.
  • Never refuel gasoline-powered equipment indoors.

Power Line Trimmers

  • Read the operator’s manual and get proper instructions before operating a trimmer.
  • Never operate the trimmer with the guard removed.
  • Clear the work area of objects, sticks, rocks, wire, etc., before starting work.
  • Clear the work area of people and animals for a radius of approximately 35 feet around the operator.
  • Always wear eye protection.
  • Keep the cutting line or blade away from your feet and legs.
  • Position the trimmer away from your body to avoid contact with the muffler or other hot engine parts.
  • Move the trimmer in a sweeping motion away from your body.

Clothing and Maintenance

  • Wear close-fitting clothes, long pants or slacks, and closed-toe shoes with traction soles.  Do not operate any power equipment while barefoot, or when wearing thongs or sandals.
  • Loose clothing, scarves, dangling jewelry, and untucked shirt tails can snag on controls or get caught in moving parts.
  • Protect your eyes with safety glasses or goggles, and ears with earplugs.
  • Wear gloves to service or adjust equipment, especially when working on the blades.
  • When working on equipment with blade guards removed, take out the spark plug and ground the spark plug wire to prevent accidental engine start.

Tips:  Choosing the right clothing and PPE for welding

Every occupation has its own unique safety issues.  These tips courtesy of the Ohio Bureau of Workers’ Compensation Division of Safety & Hygiene offer personal protective equipment recommendations specifically for workers in the welding industry.

  • All welders should wear fire-retardant gauntlet gloves.
  • Fire-retardant aprons of leather or other suitable materials provide additional protection against sparks, spatter and radiated heat.
  • All welders should wear high, snug-fitting safety shoes; low or loose-fitting shoes may catch hot spatter.
  • Wear safety glasses with side shields under your helmet when arc welding.
  • Woolen clothing is recommended rather than cotton.  Wool offers more protection against temperature changes and is not as easily ignited.  Cotton, however, can be treated chemically to reduce flammability.  Outer clothing should be as oil-free and grease-free as possible.
  • Wear cuff less pants and overalls without pockets; to prevent sparks from lodging in clothing, aprons also should not have pockets.  Sleeves and collars should be buttoned.
  • Very heavy work demands fire-resistant leggings, high boots or similar protection.
  • Leather capes or shoulder covers are suggested for overhead work.  Wearing leather skull caps under helmets prevents head burns.  Wood or rubber ear plugs or wire screen protectors are sometimes required for overhead work.
  • If there is a danger of falling objects, hard hats are required.
  • Store protective clothing and equipment in a clean, dry, well-ventilated place when not in use.

Eye Protection

Everyone in a welding area should wear eye protection.

  • The electric welding arc sends out intense, visible rays, as well as infrared and ultraviolet rays.  The rays or even the reflection of the rays can burn the skin much like strong sunlight, but the harm they can do to the eyes is far more serious.  As a precaution against direct or indirect exposure, all skin surfaces should be covered and proper eye protection must be worn.  The correct lens shade number should be worn under the helmet.
  • Resistance welders should wear transparent face shields or goggles.
  • People near arc welding areas should be protected from the arc welding rays; noncombustible screens should be used, or they should wear proper goggles.
  • Workers should not use helmets or goggles that have been worn by another employee unless the equipment has been sterilized.  Helmets and goggles should be carefully selected and handled.
  • Safety lenses in all goggles and helmets used by welders must pass the test for transmission of radiant energy prescribed in ANSI Z97.1.
  • When performing light welding work or inspections, spectacles with proper lenses are sometimes acceptable.
  • Lenses designed for eye protection during oxyacetylene welding or cutting do not provide dependable protection against electric arc rays.
For more information on this subject contact Bob Arnold of PGM Safety Services at bobarnold@pgmnv.com or at (800) 859-3177.
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As you may be aware skin cancer is on the rise in the United States, especially for those whose jobs keep them outside or whose jobs take them outdoors.

As we enter the dog days of summer, chances of severe sun burn which may lead to skin cancer is increased. Since many of our SIG Members work under the sun’s rays on a daily basis it is recommended that those that  do cover up as much as possible, including the back of your necks, heads, legs and arms. You may have noticed that desert dwellers in other parts of the world keep their bodies almost entirely hidden from the sun.

For the added protection use Dermitone SPF 45+ Endurance Gel (www.dermatone.com). In tests run at sea level and at 14,000 feet the Endurance Gel retained its effectiveness for about 80 minutes, even when the test subjects were perspiring. Your lips and nose will require extra protection. Products like Anthony Logistics for Men Sun Stick SPF 15 (www.anthony.com) offers ingredients that work to hydrate and condition the skin.

Treat all sunburns appropriately and check with a doctor immediately if your sunburn is accompanied by purple blotches or discoloration with excessive blistering. Such symptoms may indicate internal complications. Watch for any unusual signs of possible skin cancer and remember that melanomas generally occur as one gets older as a result of too much sun exposure earlier in life.

For more information on this topic or other safety issues contact Bob Arnold of PGM Safety Services at bobarnold@pgmnv.com or 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

Considering Selling Your Business?

Opportunities sometimes arise allowing the sale of your business. When this happens, you should be aware that your Self Insured Group membership may be easily transferred to the new owner. 

When it comes to selling your business, many SIG members overlook the value of their workers’ compensation program. You may recall that as a member of your SIG there were significant qualification requirements that you had to meet. Once those requirements were met you were rewarded with lower rates and better service. You have received assistance with creating a safer work place and possibly benefited from employee background checks or the establishment of a post-accident drug test program. Hopefully, these services have assisted with a reduction in losses and further savings on workers’ compensation assessments.

Potential buyers may not be thinking of their workers’ compensation requirements. In fact, when they become aware of the State requirement they may just pick up the phone book and call the first name they come across. You can help them by informing them of your involvement in your SIG and having them contact Pro Group Management to discuss transfer of your SIG membership. It may be as easy as completing an application and signing a new Joint and Several Liability agreement.

Remember that your participation in the SIG has assisted in increasing the value of your operation. Help pass this value on by explaining your involvement in your SIG. If you would like Pro Group Management’s assistance with this process contact Elaine Agnason of Pro Group Management at (800) 859-3177.

 
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