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Workers’ Compensation Costs; Effect of Claims and Control Measures For Three Separate Farms

Workers’ Compensation Costs; Effect of Claims and Control Measures For Three Separate Farms. Safety First Mushroom Farm Safety Second Mushroom Farm Safety Third Mushroom Farm. agenda. General Overview of Workers’ Compensation System Financial Impact of Claims

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Workers’ Compensation Costs; Effect of Claims and Control Measures For Three Separate Farms

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  1. Workers’ Compensation Costs; Effect of Claims and Control Measures For Three Separate Farms Safety First Mushroom Farm Safety Second Mushroom Farm Safety Third Mushroom Farm

  2. agenda General Overview of Workers’ Compensation System Financial Impact of Claims Risk Management Strategies Claims Management Accident/Incident Investigation Approach to Safety Management

  3. Workers’ Compensation Definition: Insurance coverage required by state law to provide compensation for workers who are injured on the job in the course & scope of their employment.

  4. Benefits • Seven day waiting period • Lost wages benefits • Retroactive after specified length of disability • Generally 66 2/3 of gross wages. Most states have a maximum and minimum weekly benefit. • No time limit on benefits • Medical Benefits • Employer chooses physicians in Pennsylvania • Survivor Benefits • Rehabilitation Benefits

  5. The Cost of Workplace Accidents • Workers’ Compensation premiums are directly related to the cost of • workplace injuries • Workers’ Compensation insurance is required by state law for • workers who are injured on the job in the course & scope of their • employment. • Premium = rate x payroll/100 x experience mod • Rate is set by the state – depends on the nature of the work and hazard class • Payroll is a fixed figure • Experience Mod – based on your losses over a three-year period compared to your industries’ average losses over that • period.

  6. The Experience Modification Factor (EMF) Actual Losses EMF = Expected Losses * Three Years of Losses excluding the most recent year (i.e. 2015 EMF is based on losses in 2013, 2012, 2011) *Developed by State Workers’ Compensation Bureau or NCCI

  7. Three Companies and the EMF *Safety First Mushroom Farm – Effective Program *Safety Second Mushroom Farm- Average Program *Safety Third Mushroom Farm – Ineffective Program CostsFirst Co. Second Co.Third Co. Manual Prem. $100,000 $100,000 $100,000 EMF (X) .750 1.0 1.25 Standard Prem. $75,000 $100,000 $125,000

  8. Effects of an Injury on Cost • Your losses = $30,000 • Average industry losses = $30,000 • Premium = $100,000 • Your EMF = 1.0 • So…

  9. Claims Scenario • Harvester slips on mushroom debris in mushroom house and falls breaking his arm. • Occupational Health Center sets a cast on injured workers arm. No full duty for eight weeks. • Cost of medical treatment is $1,800. • Cost of lost wages is $3,200 (average wage is $600 per week X 8 weeks X 2/3) • Total claim cost is $5,000.

  10. Effects of an Injury on Cost • Add a $5,000 claim: $30,000 + $5,000 = 1.10 • MOD • $30,000 (was 1.0) • Cost = $100,000 X 1.10 = $110,000 • Additional Cost = $110,000 - $100,000 = $10,000 • Calculated into EX Mod for 3 years • Total Cost of one $5,000 Claim = $30,000

  11. Safety First Mushroom Farm • Offers light duty within 5 days according to medical capabilities provided by treating physician • Provides injured worker one or more light duty jobs as follows: • Cleaning • Sweeping • Painting • By providing light duty work at full pay ($600 per week) the cost of wages is $4,800 in total. • Medical costs remain $2800 raising experience mod to 1.036 or $3600 per year for three years or $10,800 • Total financial cost is $4800 (wages) + $10,800 (medical) or $15,600 • Safety First Mushroom saves $30,000 - $15,680 or $14,400

  12. Safety Second Mushroom Farm • Unaware of light duty savings potential for first four weeks after injury. • After four weeks the owner talks to the owner of Safety First. • Safety Second Mushroom Farm initiates light duty for the last four weeks of injury. • Actual wages paid to the injured worker is 4 weeks X $600 or $2400 • Safety Second Mushroom Farm has increase in Experience Mod to 1.075 or $7,500 for 3 years = $22,500 • Total cost of claim is $2,400 (wages) plus $22,500 in Experience Mod or $24,900 • Safety Second Mushroom Farm still saves $5,100 by offering 4 weeks of light duty

  13. Safety Third Mushroom Farm • Unaware of light duty savings potential for duration of claim • Injured worker stays home for eight weeks and develops a feeling of malaise • After several days back at work the injured worker says he thinks “he reinjured his arm”

  14. Financial Effect of Providing Light Duty Work for Eight Weeks

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