C L A I M S M A N A G E M E N T & M I T I G A T I O N - W O R K I N J U R I E S I N T H E T R U C K I N G I N D U S T R Y M a y 6 , 2 0 1 5
T R A N S P O R T A T I O N
THE DEADLI EST JOBS T R A N S P O R T A T I O N
STAGGERING NUMBERS AVE RAG E ACCI DE NTS AN D I N JURI E S E ACH Y E AR • 475,000 large trucks with a gross vehicle weight rating of more than 10,000 pounds are involved in crashes each year • 5,360 fatalities and 142,000 injuries each year • Of the 5,360 fatalities – 74% were occupants of other vehicles – 3% were pedestrians – 23% were occupants of trucks. • The unsafe actions of automobile drivers are a contributing factor in about 70 percent of the fatal crashes involving trucks. • Exceeding the speed limit was a factor in 22 percent of the fatal crashes. https://www.osha.gov/SLTC/trucking_industry/safetyinfo.html T R A N S P O R T A T I O N
PRI MARY CAUSE S • Traffic accidents • Climbing in and out of the cab or trailer • Loading or unloading the trailer • Slips and falls on loading docks • Roadway vibrations and/or poorly adjusted seating • Improper maintenance of equipment MOST COMMON I N JURI E S • Musculoskeletal disorders of the neck, back and upper extremity – Truck drivers have a disproportionate number of musculoskeletal injuries compared to other industries • Wrist & leg fractures • Internal derangement of the neck and back T R A N S P O R T A T I O N
EXACERBATI NG FACTORS OTHE R CON TRI B UTI NG FACTORS • Comorbidities – Obesity (53.3% with BMI > 30) – Morbidly Obese (26.6% with BMI > 35) – Heart Disease – Hypertension – Diabetes – Chronic Low Back Pain – Drug Abuse • Mental Health Issues – Loneliness (27.9%) – Depression (26.9%) – Chronic sleep distubances(20.6%) – Anxiety (14.5%) – Emotional problems (13%) • Due to the nature of work, involving many hours of seating, following by brief periods of strenuous labor loading/unloading, drivers are more prone to injury. T R A N S P O R T A T I O N
COMPENSABI LI TY WA S THE RE A COMPE N SAB LE I N JURY ? • Generally Yes if occurred within course and scope of business • Exacerbation/Aggravation of a preexisting injury • Increased Symptoms vs. Actual Injury – Temporary exacerbation vs. permanent aggravation (varies by jurisdiction) • Sequelae of Injuries • Occupational Disease – Person is exposed to work-related hazard over extended period of time – Hazardous conditions must be more prevalent during employment when compared to everyday life • Idiopathic injuries – Heart attack, stroke, syncopal event, etc. – May need medical opinion to determine if compensable injury T R A N S P O R T A T I O N
MEDI CAL BENEFI TS I N S U R A N C E C O M P A N Y W I L L P A Y F O R : • Physician • Emergency Room Visit • Hospitalization • Therapies • Work Hardening • Prescriptions • Nurse Case Managers • All medical treatment deemed to be reasonable and necessary related to the work injury or illness T R A N S P O R T A T I O N
I NDEMNI TY BENEFITS OCCUPATI ON AL ACCI DENT • Waiting Period – Usually 7 days • Temporary Total Disability Benefit (TTD) – Pays up to a maximum dollar amount per week and usually up to 104 weeks • Continuous Total Disability Benefit (CTD) – Begins after TTD benefits cease, provided you apply for and receive a Social Security Disability Award for the covered injury – Payable up to a certain age • Accidental Death & Dismemberment Insurance • Non-Occupational Accident Coverage – Accidental Death & Dismemberment Insurance – Accidental Medical Expense – TTD benefits – 14 day waiting period and 10 week duration – No CTD benefits T R A N S P O R T A T I O N
I NDEMNI TY BENEFITS WORK E RS’ COMPE N SATI ON • Waiting & Retroactive Periods – Range from 3 – 14 days • Temporary Total Disability Benefit (TTD) – Benefits are paid until the employee has reached Maximum Medical Improvement (MMI) • Permanent Partial Disability Benefit (PPD) – Calculation varies based on jurisdiction • Permanent Total Disability Benefit (PTD) – 100% permanently and totally disabled – Industrial disability • Death Benefits – Funeral Expenses – Benefits paid at TTD weekly rate – Benefits for surviving spouse, children and other dependents • Other dependents may include elderly parents, adult children with physical or mental handicaps – Benefits payable until spouse has passed away and children reach adulthood (varies) T R A N S P O R T A T I O N
MODI FIED DUTY I MPORTAN T TO AVOI D N E G ATI VE CON SE QUE N CES • Increased level of physical deconditioning • Loss of marketable employment skills • Driver’s routine changes to no longer include a regular daily work routine • Multiple studies conclude lack of active employment can lead to depression • Ongoing indemnity payments increase the cost of the claim • Attorney involvement • Fear of re-injury • Higher PPD/PTD rating T R A N S P O R T A T I O N
MODI FIED DUTY B E N E FI TS • Transportation Company – Reduces the cost of indemnity benefits – There is a direct correlation between RTW and the Experience Rating Modification Factor – Reduction in OSHA lost time days – Maintaining the services and skills of a trained employee – Improving employee retention • Injured Worker Benefits – Maintains wage-earning power – Facilitates a quicker recovery and transition back to work – Promotes emotional health – Helps reduce deconditioning T R A N S P O R T A T I O N
MODI FIED DUTY WHAT I F MODI FI E D DUTY I SN ’ T AVAI LABLE ? • Have you considered a Modified Duty Offsite(MDOS) program? – MDOS provides volunteers to non-profit organizations – Physician must release injured worker with documented temporary restrictions – Placement is usually up to 90 days but can be extended – Placement is based on the temporary restrictions and skills of the injured workers – Case Manager can facilitate ongoing communication between all parties • Employers may be eligible for tax benefits secondary to contributing to a non-profit organization. We recommend you consult with your legal team and accountants for eligibility. • Multiple vendors across the country T R A N S P O R T A T I O N
E X P E R I E N C E R A TI N G M O D I F I C A TI O N F A C TO R WHAT DOE S THE E X PE RI ENCE RATI N G DO? • Method for tailoring the cost of insurance to the characteristics of an employer or risk • It gives the employer the incentive to manage its own costs • Predicts whether an employer is likely to develop loss experience that is better or worse than the average risk in a particular classification • Modifies premium by a factor that is designed to more accurately price insurance • Uses the employer’s past experience to project future losses https://www. ncci .com/documents/abc_Exp_ Rating .pdf T R A N S P O R T A T I O N
E X P E R I E N C E R A TI N G M O D I F I C A TI O N F A C TO R E X AMPLE • Employer A – 1 loss totaling $50,000 • Employer B – 10 losses totaling $50,000 • Which employer would you expect to incur the higher workers’ compensation costs in the future? APPLI CATI ON T R A N S P O R T A T I O N
CONTI NGENT LI ABI LI TY DE FI N I TI ON • This coverage provides a layer of protection by providing defense to the Motor Carrier when a qualified Independent Contractor attempts to collect Workers' Compensation benefits as an employee. If the Independent Contractor is deemed an employee, benefits will be paid equivalent to those payable under the Workers' Compensation statutes and Employer's Liability law that apply. I MPORTAN T STE PS • Notify TrueNorth or your agent as soon as possible! • TrueNorth will engage with the OA/CL and Motor Carrier WC adjuster to seek dismissal of the WC claim • TrueNorth will see the claim through dismissal to ensure the Motor Carrier is protected from any WC claim http://www.greatamericaninsurancegroup.com/Insurance/Trucking/Products/Pages/Contingent-Liability.aspx T R A N S P O R T A T I O N
SUBROGATI ON DE FI N I TI ON • Subrogation is defined as a legal right that allows one party (e.g., your insurance company) to make a payment that is actually owed by another party (e.g., the other driver’s insurance company) and then pursue reimbursement from the responsible third party. WHY SUBROG ATE ? • Cost savings for the employer/insured WHE N I S SUBROG ATI ON USE D? • When a claim is filed with your insurance company and another party is at fault, your insurance company will generally: 1. Pay the claim in order to indemnify you (cover your damages and injuries) 2. Seek to recover the money they paid – or at least a part of it – from the at-fault party T R A N S P O R T A T I O N
1 0 0 VE HI CLE PI LE UP ON • I N TE RSTATE 8 4 I N ORE G ON SAN DWI CHE D BE TWE E N • TWO TRUCK S SURVI VE D WI TH TWO • BAN D -AI DS T R A N S P O R T A T I O N
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