Category Archives: Workers Compensation

Commentary by I.I.I. chief actuary published in law review

Commentary on workers compensation insurance by I.I.I Chief Actuary James Lynch is being published in the upcoming issue of the Rutgers University Law Review.

Lynch’s piece, “Comment to Economic Incentives in Workers’ Compensation: A Holistic International Perspective,” was written in response to an article by Stanford Professor Alison Morantz and others. The two spoke at a 2015 conference about the Grand Bargain in workers compensation.

Speakers discussed whether recent events were jeopardizing the so-called ‘Grand Bargain’ – workers forfeit their right to sue for on-the-job injuries in exchange for predictable benefits from a no-fault system. Professor Morantz’s article compared social safety net programs (including workers comp) worldwide and “discusses several mounting pressures that are jeopardizing the capacity of the U.S. workers’ compensation system to carry out its intended goals.”

In his response, Lynch noted that much of the current research in U.S. workers compensation “involves finding ways to reduce incentives that drive costs higher with no discernable benefit to the worker.” One example cited: When New York doctors book surgery for comp patients in New Jersey, they charge an average of $4,954, or 266 percent more than if the same surgery with the same surgeon took place in New York. (The I.I.I Blog featured this research two years ago.

Neither Morantz’s nor Lynch’s article was online as of February 16, but both should become available at the law review website soon.

WCRI conference: The annual deep dive into workers comp

If I were to pick out the hottest topics in workers compensation these days, these three would be near the top:
• Opioids.
• Marijuana.
• How technology will affect the industry.
All three will be prominently featured at the Workers Compensation Research Institute’s Annual Issues & Research Conference March 22 and 23 at the Westin Copley Place, Boston.
The research organization, known by its acronym, WCRI, has for more than three decades conducted deep, objective research into what makes the workers comp system tick. Its conference annually hosts about the deepest dive you can find into the intricacies of the largest commercial line of business. I attend every year, and am happy for the privilege.
This year attendees will hear the latest on how opioids affect the ability of workers to return to their job; how Americans deal with prescription drugs in the workplace; and how a major employer – United Airlines – addresses the issue.
And a University of Georgia researcher, Dr. David Bradford, will discuss his studies on the effect of medical marijuana programs on prescription drug spending.
And opening speaker Erica L. Groshen, former head of the U.S. Bureau of Labor Statistics, will look at how artificial intelligence, robots, driverless cars and such will affect the labor force. From the conference website:

She will argue that much of the hype about the future of work is either far too optimistic or to pessimistic. In addition, she will talk about how the official statistics are more important than ever.
They are the information infrastructure that we all need to see through the haze, so that we make good decisions for our companies, our communities and ourselves.

Conference details are here.

Ergonomics in the office

The dangers of inactivity have been well publicized. You may have seen the fear-inducing headlines that too much sitting is killing you. So it’s not surprising that office workers are turning to standing desks and exercise balls as alternatives to the office chair. However, these alternatives come with injury risks of their own, which could trigger a workers compensation claim. Exercise balls offer no back support and prolonged standing is linked to reduced circulation and discomfort in the feet and the lower back.

For the people who have eschewed chair alternatives, a recent article in the Workplace Safety section of the Travelers website lists what to look for in an office chair according to Travelers risk control ergonomics professionals:

  • A pneumatic height adjustment.
  • A height adjustable lumbar support.
  • A seat back which can either be locked in an upright position or inclined up to 110 degrees.
  • Adjustable padded armrests with rounded edges.
  • An adjustable seat pan.
  • A five caster base with appropriate casters for the flooring surface.

Some states make progress in tackling opioid epidemic

Prescription opioid use among injured workers decreased in many states, but not all, according to the Workers Compensation Research Institute (WCRI).

Find out which states saw the largest decreases in this new WCRI study.

The National Safety Council (NSC) has developed a new industry specific online calculator that informs employers how much the opioid epidemic is costing companies each year.

The tool provides business leaders with specific information about the cost of substance use (including prescription drug abuse and misuse, alcohol abuse and misuse, opioid and heroin addiction as well as abuse of other illicit drugs and marijuana) in their workplace based on size of employee base, industry and state.

Posted here, the NSC calculator combines latest government and private sector research to estimate annual costs in three categories: time lost form work, job turnover and retraining, and health care costs.

A new NSC survey found only 39% of employers view prescription drug use as a threat to safety, and only 24% feel it is a problem, despite 71% saying they have experienced an issue.

Whither the Grand Bargain?

Insurance Information Institute chief actuary James Lynch reports from the final session of #WCRI17:

The Workers Compensation Research Institute’s annual conference saved the best for last, a provocative look at comp and the Grand Bargain.

That bargain, that workers sacrifice the right to sue for workplace injuries in exchange for a predictable set of benefits irrespective of fault, is threatened, some say, by a decades-long winnowing of those benefits. The rebuttal: comp is a resilient system changing with the times.

John Ruser, WCRI president and CEO, led the discussion. Panelists were Dr. David Michaels, a former assistant secretary of labor at OSHA; Bruce Wood, former general counsel at the American Insurance Association; Emily Spieler, a Northeastern University professor specializing in workers comp and labor issues; and David Deitz, a consultant with more than 20 years’ experience designing claims management systems in both workers comp and group health.

I have some background on the debate, presenting at a symposium on the Grand Bargain last year in Camden, N.J. I’ll oversimplify a bit here by calling it a faceoff between lawyers and insurers.

The lawyers say that reforms over the past 20 years or so have continually whittled away at worker benefits, so much so that the Grand Bargain is, from the workers’ point of view, no bargain. Insurers note that both medical and indemnity benefits have been rising faster than inflation for decades and that many of the supposed benefit cuts are controls on medical costs that have little if any effect on the actual treatment that the injured worker receives.

That debate is of long standing, but Wood pointed out that the discussion used to be fairly narrow.

Several states have debated whether employers should be able to opt out of the workers comp system entirely and provide a supposedly parallel set of benefits. Opt out passed in Oklahoma (but was found unconstitutional last year) while at least two other states (Tennessee and South Carolina) have kicked the idea around.

Wood compared the changes in the debate to a football game. The old discussion shuttled between the 45-yard lines, he said. Opt out “takes the debate between the goal lines.”



Some Facts About Medical Marijuana

Insurance Information Institute chief actuary James Lynch reports from last week’s Workers Compensation Research Institute (WCRI) conference: 

I shock no one, I hope, by saying the nation’s attitude toward marijuana has loosened. More than half the states allow marijuana use, either as a medicine or just for fun. The federal government still forbids its use.

It’s a tough spot for insurers. Auto insurers worry that high drivers will cause auto accidents. Workers compensation workers are concerned that high employees will cause work accidents. Insurers want to obey the law, but federal law conflicts with the law in most states.

There are also questions about using marijuana to treat pain, as an alternative to opioids.

Not surprising that weed was the topic of conversation several times at last week’s WCRI conference in Boston.

Alex Swedlow of the California Workers Compensation Institute noted the following:

  • Six states require workers comp insurers to reimburse injured workers who use medical marijuana: Connecticut, Maine, Massachusetts, Minnesota, New Jersey and New Mexico.
  • Six states forbid insurers from reimbursing for medical marijuana: Arizona, Colorado, Michigan, Montana, Oregon and Vermont.
  • The federal laws against marijuana mean it is illegal to use the banking system to purchase marijuana. So an insurer can’t write a check against to pay for the drug. They use cash.

Dr. Dean Hashimoto of the Massachusetts Department of Industrial Accidents provided these facts. They are taken from a National Academy of Sciences report published in January, which is itself a summary of all research on the issue:

  • There is conclusive evidence or substantial evidence that marijuana:
    • Improves the lot of adults in chronic pain.
    • Increases the risk of motor vehicle crashes.
    • Increases the risk of developing schizophrenia and other psychoses.
  • There is moderate support suggesting that marijuana:
    • Improves short-term sleep outcomes for people with fibromyalgia or chronic pain.
    • Increases impairment of learning, memory and attention span.
    • Increases dependence on alcohol, tobacco and illicit drugs.
  • It is not possible to determine whether marijuana use is statistically correlated with occupational injuries.

The California WC report is here The National Academy of Sciences report is here.

Conference Shows How Workers Comp Wheels Are Turning

March brings my annual trip to the Workers Compensation Research Institute (WCRI) conference in Boston, writes Insurance Information Institute chief actuary James Lynch:

Workers comp is an intricate dance among regulators, lawyers, employers, insurers and the medical community. WCRI’s annual conference is one of the better places to catch up on the direction the many gears are turning on the workers comp machine.

Agenda items I’m looking forward to:

  • Alternatives to opioids: The opioid epidemic, until recently, was the silent mass killer in America. I first heard about this particular scourge at the 2014 WCRI conference. That year almost 19,000 people died from opioid overdoses, yet I had never heard the term opioid. After the conference, I wrote about how the workers’ comp world grappled with the epidemic for Contingencies magazine.
    This year the conference has an update on those efforts. It also has a session on emerging alternatives like mindfulness and other cognitive approaches. Included in that session is a look at medical marijuana, an issue most insurers are approaching with grave caution.
  • Appraising the Grand Bargain in 2017: Comp, of course, is the result of the Grand Bargain. Injured workers give up the right to sue and employers agree to indemnify the injured, regardless of fault. Most insurers will tell you that bargain holds up well more than a century after it was struck. But some challenge that idea. I attended a conference last year baldly titled, “The Demise of the Grand Bargain.” And a 2016 Department of Labor (DOL) study alleged states were engaged in a “race to the bottom,” scuttling benefits to keep employers happy.
    A new president may send DOL priorities in other directions, of course, but there’s still a discussion to be had. WCRI’s conference will end with a debate among experts representing government, insurers and the legal community.

The conference is, March 2 and 3 at the Westin Copley Place, Boston. Details and registration here.


D.C. Luminaries Headline Boston Workers Comp Conference

Insurance Information Institute vice president of Media Relations, Michael Barry, previews the upcoming Workers Compensation Research Institute (WCRI) annual conference:

Seldom have the political waters roiled as they have during the first weeks of the Trump presidency. A pair of political veterans will look at what that means for workers compensation insurance at a conference next month in Boston.

Former U.S. Senator Tom Coburn and former U.S. Representative Henry Waxman are appearing jointly in Boston on Thursday, March 2, to kick off the WCRI Annual Issues & Research Conference.

U.S. Senator Coburn, a Republican from Oklahoma, and U.S. Representative Waxman, a Democrat from California, will discuss the ‘Impact of the 2016 Election’ for health care, labor, and workers compensation at the Westin Copley Place Hotel in Boston, MA. Their session begins at 9:15 a.m. and will conclude at 10:30 a.m.

The two distinguished former federal legislators bring impressive credentials to these issues. Before his election to the U.S. Senate (2005-2015), Dr. Coburn, a medical doctor, was a U.S. representative (1995-2000) from Oklahoma.  Former Rep. Waxman served for four decades in the U.S. House of Representatives (1975-2015) and was chairman of the House Energy and Commerce Committee.

The theme of this year’s WCRI conference is Persistent Challenges and New Opportunities: Using Research to Accelerate the Dialogue.” The two-day program highlights WCRI’s latest research while also drawing upon the diverse perspectives of nationally respected workers compensation experts and policymakers.

The Insurance Information Institute will also be represented. Chief Actuary James Lynch will be blogging here at Terms + Conditions from the conference.

The WCRI conference is a leading workers compensation forum for policymakers, employers, labor advocates, insurance executives, health care organizations, claims managers, researchers and other interested parties.

For additional information about the conference, or to register, log onto

Most Serious Workplace Injuries Cost More Than You Think

$60 billion is a lot of money. Think about it.

For example, insured losses from global disaster events were around $49 billion in 2016, according to Swiss Re.

That’s a large number too, but not as large as the $59.9 billion cost to U.S. employers of the most serious workplace injuries and accidents in 2014, per the just-released 2017 Liberty Mutual Insurance Workplace Safety Index.

By the way, the most serious ones are injuries that cause employees to miss six or more days of work.

The nearly $60 billion in direct workers compensation costs to U.S. businesses translates into more than $1 billion a week that companies spend on these injuries, the index suggests.

As big as it sounds, the total cost actually fell from $61.9 billion in 2016, according to Liberty Mutual.

The 10 leading causes of the most disabling work-related injuries account for $49.9 billion, or 83.4 percent of the total cost of $59.9 billion.

The top three causes of the most disabling work-related injuries are:

–Overexertion ($13.8 billion, 23 percent)

–Falls on same level ($10.6 billion, 17.7 percent)

–Falls to lower level ($5.5 billion, 9.2 percent)

Collectively, these three causes represent almost half the cost of the leading accidents. Check out the chart:

Screen Shot 2017-01-25 at 2.19.16 PM

Developed annually by the Liberty Mutual Research Institute for Safety, the index is based on information from Liberty Mutual Insurance, the U.S. Bureau of Labor Statistics (BLS) and the National Academy of Social Insurance.

The index helps employers, risk managers and safety practitioners make workplaces safer by identifying critical risk areas so that businesses can better allocate safety resources.

Here are some useful additional facts and statistics on workers compensation from the Insurance Information Institute.

Workplace Safety Imperative for Truck Drivers

Transportation-related incidents were the leading cause of workplace fatalities in 2015—and by a long way—according to data just-released by the Bureau of Labor Statistics (BLS).

Of the total 4,836 workplace fatalities recorded in 2015, transportation-related incidents accounted for 2,054, or 42 percent.

The next closest major cause of workplace fatalities was falls, slips, and trips at 800, or 17 percent.

A key takeaway from the BLS figures: some 745 drivers of heavy and tractor-trailer trucks died because of injuries at work last year, more than any other major civilian occupation. The majority of these fatalities (84 percent) were caused by transportation incidents.

What are some of the factors in large truck crashes?

Truck braking capability for one. The Insurance Institute for Highway Safety (IIHS) reports that loaded tractor-trailers take 20-40 percent farther than cars to stop, and the discrepancy is greater on wet and slippery roads or with poorly maintained brakes.

Truck driver fatigue is another known crash risk. Federal regulations allow drivers of large trucks to drive up to 11 hours at a stretch, and up to 77 hours over a seven-day period.

Still surveys suggest many drivers violate the regulations and work longer hours than permitted.

Distracted driving is another key factor impacting the number of accidents.

As for insurers, a recent report by ratings agency A.M. Best noted that commercial auto insurance results continue to underperform the results of the overall property/casualty commercial lines market, due to escalating claim frequency and severity.

With more vehicles on the road, cumulative miles driven increasing, and gas prices at reduced levels, making a profit writing commercial auto insurance is a challenge few insurers have been able to meet, A.M. Best said.

It pointed to the considerable perils associated with larger vehicles, including trucks and buses, noting:

“The increased number of miles traveled over the last three or four years also factors into the rise in the fatalities associated with accidents involving larger vehicles that often produce losses exceeding $100,000 in total claim cost.”

Despite the myriad challenges, leading writers of commercial auto insurance have a track record of profitable operations, according to A.M. Best.

Still, more effective risk management and underwriting techniques focused on both covered drivers and vehicles are needed, the ratings agency said.

The Compliance, Safety, and Accountability (CSA) program implemented in 2010 by the Federal Motor Carrier Safety Administration, together with state partners and the trucking industry expanded safety reporting and enforcement measures for large trucks and buses.

Check out the Insurance Information Institute facts and statistics on workplace safety.