By Donna Motley, Director of Claims

Medical expenses always seem to be on the rise. The Workers’ Compensation weekly benefit (the amount paid to the injured worker) usually increases annually even though it is based on the State Average Weekly Wage. Workers’ Compensation coverage is mandatory in the State of Michigan – part of the cost of doing business!

Once a Workers’ Compensation claim is turned in to our office, we take the reins and take control, attempting to minimize all the costs involved, the length of disability, and to assure a successful return of the injured worker to productivity. Everyone benefits. But, as an employer, there are things that you can do to help mitigate the expenses or costs on the claim.

Obviously, one of the most important things an employer can do, is report the claim As Soon As Possible! That way, we are controlling treatment (and costs) from the onset. As an employer, NEVER tell an injured worker to seek treatment with their primary care physician or a physician of their choosing. Any treatment outside the Occupational Clinic results in a delay in obtaining medical records that are required before authorization to treat can be rendered. If an employee is off work during this period – the cost of the claim has just increased significantly. If the injury is questionable and/or you are unsure of the direction that should be taken, PLEASE call our office for advice.

(more…)

By Chris Demeter, Senior Loss Control Consultant

OSHA has expanded the list of severe injuries & illnesses that employers must report and updated the list of industries who are partially exempt from routinely keeping OSHA records.

“OSHA will now receive crucial reports of fatalities and severe work-related injuries and illnesses that will significantly enhance the agency’s ability to target our resources to save lives and prevent further injury and illness. This new data will enable the agency to identify the workplaces where workers are at the greatest risk and target our compliance assistance and enforcement resources accordingly.”
— Assistant Secretary of Labor for Occupational Safety and Health, Dr. David Michaels

For workplaces under Federal OSHA jurisdiction

• Final rule becomes effective January 1, 2015 For workplaces in State Plan States (MIOSHA)
• States encouraged to implement new coverage provisions on January 1, 2015, or as soon after as possible.

The rule expands the list of severe work-related injuries and illnesses that all covered employers must report.

(more…)

The MTMIC Marketing Staff are in the process of mailing out the updated State and Federal Labor Law Posters for 2015. Your company will be receiving them in the next couple of weeks. Contact Patty Allen at patricia.allen@mtmic.com/blog if you will be in need of more than one set of posters.

Please let us know if we can assist you in any manner and thank you for being a customer of MTMIC, we value your business.

By Donna Motley, Director of Claims

Communication in our industry is crucial. We have at our disposal multiple ways to communicate, telephone, computer (e-mail), faxing, even the old fashion form of “written” communication. In the Workers’ Compensation arena, we still need “written” proof of a claim. As you are aware, the Employers Basic Report of Injury (Form 100) must be submitted before we can physically set up a claim file. Obviously, the form needs to be completed properly in order to fill in the fields required by the computer. Claim information is tracked by the State of Michigan – hence the required fields.

(more…)

By Donna Motley
Director of Claims

The cost of insurance, any kind of insurance, is not cheap. As premiums escalate, there appears to be a new “buzzword” – FRAUD. While the notion of fraud is not new, more and more people are starting to get angry and show interest in putting a stop to it. Some states (not Michigan) have started movements to prosecute those committing insurance fraud. I read recently that Michigan’s automobile premiums had the largest increase in the U.S. in 2013 because of claims paid outside of property damage. That would mean the bulk of payments were for “alleged” injuries and medical care.

(more…)

By Glenda Moyle
Premium Accounting Manager

Every year after the final audits are completed we have a few companies who have a significant audit balance due. As much as you hate paying these surprise audits we dislike collecting on them.

One way to avoid this would be to take a look at your estimated payrolls and compare it to your actual payrolls. You can find your estimated payrolls on your current declaration page broken down by class code.

If you find that your actual payrolls are above your estimated payrolls and you wish to revise them please contact me at glenda.moyle@mtmic.com/blog or you can call me at (800) 274-5606 X1315 with any questions you might have.

By Donna Motley, Director of Claims

Late reporting of employee injuries can be costly in multiple ways.

We received a claim on August 16, 2013 for a July 3, 2013 injury date – approximately 6 weeks after the injury allegedly occurred. The employee said they “bumped” their elbow on a part. The diagnosis was “post traumatic olecranon bursitis”. The employee did not lose time from work. The employee treated for the condition on July 3, 2013 (the day of injury), July 8, 11, 22, 29, and October 8, 2013 when they were discharged from care.

Notice there were five visits with the medical provider before we even received the injury report. Per the Workers’ Compensation Act, the W/C provider/insurance carrier exclusively directs all medical treatment for the first 28 days! In this particular case, we lost that opportunity. Could we have shortened the length of this claim and thereby the amount spent – very likely!

(more…)

By Cindy Boyce, Senior Claims Adjustor

In the majority of Workers’ Compensation cases employees who are injured at work recover and return to work. In some cases employees do not return to work claiming that they are still disabled from the work injury. A small percentage will end up in court and enter into litigation by filing an Application for Hearing. Shortly after the Application is filed, it is processed by the Workers’ Compensation Agency and the employer will be served with an Acknowledgement and Notice of Hearing. Below are a few recommendations that will assist you in understanding the litigation procedure.

1. Once a claim is disputed, the employee may resort to filing an Application for Hearing.

When you are served with the Acknowledgement and Notice of Hearing, you will note the Magistrate assigned to hear the case, the hearing site and the date of the initial pretrial hearing. In most cases, the adjuster will also be served. However, it is recommended that you contact MTMIC upon receipt of the Application to confirm that we have been served.

Once we receive the Application for Hearing, we will retain an attorney to represent your company’s legal interests.

In most cases you will not be required to attend the pretrial or subsequent hearings unless we have notified you otherwise.

(more…)

INCLUSIONS:

1. Payroll wages and salaries, including retroactive pay.
2. Commissions.
3. Bonuses.
4. Stock bonus plans — Shares of stock in lieu of cash. (Not stock options)
5. Extra pay for Overtime — less the premium portion. (more…)

By Glenda Moyle, Premium Accounting Manager

Wow, can you believe another year has gone by. And what that means is its final audit time again for our January renewals. When we issued your policy, you gave us estimated payrolls by class codes on which we were to base your premium. The final audit will give us actual payrolls, by class codes, to see if you owe us more premium or we owe you a refund of premium. About half of our policyholde

rs will be going through their final audit in the next couple of weeks. If you haven’t already been contacted by our audit company, The Aprise Group, you will be shortly.

Your renewal packet consisted of all of your renewal documents as well as a sheet titled, “Guidelines for Your Premium Audit.” Please use that document as well as the information in the list of inclusions and exclusions on the back side of the newsletter when preparing for your upcoming audit.

For over 30 years I have been helping you with this process and I continue to be ready to answer your questions.

Patty Allen Sales & Marketing Assistant

As with our renewal process, many departments work together to get the Labor Law Posters prepared for delivery to our 725 policyholders. We provide these posters as a courtesy to all of our insured’s.
The Marketing department begins working on the process approximately six months in advance of the mid-January mailing. Our Loss Control team researches the labor laws to make sure that we have the most current information at the Federal and Michigan level. We then work with our printer to produce a poster in the correct size and font. Once the posters are printed and mailing tubes ordered; the posters are rolled and stuffed into the tubes with the mailing labels affixed to the outside. Additional care is taken so that you don’t receive an empty tube with no posters. We then complete the mailing by affixing the proper postage based on zip code and arrange for a special pick-up by the USPS.

By the time you are reading this article, your company should have received the updated 2014 State and Federal Labor Law posters.

We thank you for your continued business and if you need additional posters, please contact me at patricia.allen@ mtmic.com/blog.