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I Was Injured at Work. What are My Legal Rights?

What are your legal options when you’re injured at work? Read on to find out how to deal with a work injury.

Employers in every state are required to provide to their employees a reasonably safe and healthy work environment. Sometimes employers fail to fulfill this duty, and employees are injured as a result. Occasionally, however, employees can still be injured on the job even when every effort has been made to make a workplace safe. These injuries may include everything from broken bones, aggravations of pre-existing conditions, occupational illnesses, even psychological injuries. Every state has some type of system that helps employees with work-related injuries.

In this article, we’ll look at workers’ rights when they are injured on the job.

If I am Injured on the Job, How Can I Protect My Rights?

The most important way, and also the easiest way, to protect your legal rights is to report your injury to your employer. Most states require that you report your injury within a certain period of time, typically the same day or within a few days of the incident. Depending on the circumstances of the injury, this may not always be possible, but it is important to report the injury as quickly as is practical.

The next step you can take to protect your rights is to file a claim with the workers’ compensation court or industrial court in your state. Again, this puts your employer, the court and your employer’s insurance company on formal notice of your injury.
Once your claim is filed, certain automatic protections are immediately put in place, and we’ll look at those in the next section.

What are My Rights?

Workers’ compensation laws vary widely from state to state. The rights afforded an injured employee vary widely as well, as do the different legal procedures that ensure those rights.

Generally speaking, however, there are a number of legal rights that are common across most states:

  • you have the right to file a claim for your injury or illness in workers compensation court or the state industrial court
  • you have the right to see a doctor and to pursue medical treatment
  • if you are released to return to work by your physician, you have the right to return to your job
  • if you are unable to return to work because of your injury or illness, whether permanently or even temporarily, you have the right to some type of disability compensation
  • if you disagree with any decision by your employer, the employer’s insurance company, or the workers’ compensation court, you generally have the right to appeal that decision, and
    you have the right to be represented by a lawyer throughout the process.

In understanding your rights to act, as an employee it is just as important to understand your right to refuse certain requests or offers. For example, if you are injured and your employer encourages you to use your own health insurance to pay for your medical treatment, you have the right to say, “no.”
And if your boss offers you some incentive in an attempt to persuade you against filing a workers compensation claim, this is illegal. You have the right to say, “no.”

The laws in each state provide that you can pursue a workers’ compensation claim without fear of reprisal or harassment from your employer. If your employer makes it difficult for you to freely exercise these rights, the penalties imposed upon the employer can be quite severe. It is illegal for your boss or supervisor to harass you at work or otherwise make it difficult for you to do your job, if your filing of a workers compensation claim is the motivation for that behavior.

What Are My Rights Against Parties Other Than My Employer?

Sometimes your on-the-job injury might have been caused by the negligence of a third party. Depending on the circumstances, this other person or entity may be a designer or manufacturer of a defective piece of equipment or perhaps the driver of a delivery truck. If you are injured while at work due to the negligence of another party, you may have the right to bring a claim against that person or entity. These are known as “third party claims.” Typically, these claims are not filed in the workers’ compensation universe. Rather, they take the form of civil lawsuits and are filed in state or federal courts.

Civil lawsuits for work-related injuries can typically seek additional personal injury damages that are not recoverable in a workers’ compensation claim. For example, the benefits you receive in a workers’ compensation claim are typically intended to reimburse you for your medical expenses and lost wages — you are usually not allowed to seek compensation for pain and suffering. In a third party claim, you generally are allowed to seek compensation for pain and suffering, which is a category of “non-economic” damages.

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Can You Be Sued for Performing CPR?

In March of 2013, a resident at a nursing home—an 87-year-old woman—stopped breathing. The nurse on the premises told a 911 dispatcher that she would not perform CPR, because of the facility’s rules against it. Unfortunately, the woman died before emergency response could arrive.

This tragic event has raised a lot of questions—not least about policies nursing homes and other assisted living facilities might have against giving out life-saving treatment. But it also raises the question of whether or not, if you jump in to perform CPR—whether or not you’re a medical professional—you can actually get sued.

It’s a fairly timely question. The American Heart Association consistently supports and promotes CPR classes for people not in the medical profession—so when someone has a cardiac arrest outside of a hospital or medical facility, there will be a higher chance of a bystander stepping in to perform lifesaving CPR while the victim waits for emergency response teams to arrive. Studies show that brain death begins within four to six minutes after a cardiac arrest, and those who do not get CPR within that time are extremely likely not to survive. Getting CPR immediately—and if you’re not in a hospital, that usually means from a bystander—could mean the difference between life and death.

But with occurrences like this in the news, will bystanders be scared off providing lifesaving CPR in the first place? And is it actually a possibility that you could get sued for trying to save someone’s life? Here’s a look at the issues.

First, whether or not you can be sued will vary depending on where you are and who you are. The 2000 Federal Cardiac Arrest Survival Act grants those who administer CPR or use an AED immunity from civil charges, except in instances of willful misconduct or gross negligence.

Good Samaritan laws exist on a state-by-state basis. Mostly, they provide at least some protection for those who perform CPR or use an AED. Some states actually require you to step in if you know CPR or, in some cases, if you are a medical professional. In Vermont, for instance, requires bystanders to give “reasonable assistance” or face a $100 fine.

Generally, however, Good Samaritan Laws are there to protect bystanders who perform CPR. Mostly, you are required to ask permission before performing CPR if a person is not already in your care. If they cannot reply, then consent is implied.

You will not be protected by Good Samaritan laws if you try to go outside your area of training—if you try to perform an impromptu tracheotomy to save a choking victim, for example, and you are not a trained surgeon. If your behavior has been judged to be reckless or negligent, or if you leave the victim after initially providing care, you could also be sued.

If someone has a Do Not Resuscitate (DNR) order that specifies lifesaving care must not be provided in case of a sudden cardiac arrest or another health crisis, you must do as it says and avoid giving CPR—if you know about it. If you didn’t know about it, you generally can’t be prosecuted for giving lifesaving CPR anyway.

Medical professionals who give CPR to people with a DNR order can potentially be in trouble—if they know about the DNR. The issue of giving CPR to someone with a DNR is complicated, however. In some states, DNR orders are only valid inside a hospital setting; outside the hospital, they do not apply. This means that an emergency response team can legally give someone CPR even if they have a DNR order. In other states, however, emergency medical responders are allowed to abide by DNR orders when responding to emergency calls in the victim’s home.

In addition, in some states, patients who move from one healthcare facility to another are required to tell their medical teams about the DNR. Usually, medical professionals are not required to abide by a DNR order they do not know about.

The truth is that you can be sued for anything, at any time. The question is not whether you can be sued for performing CPR; the question is whether you can be successfully sued. The answer in most cases is no; Good Samaritan laws in most states protect bystanders from legal consequences if they act prudently and in keeping with their training. Hopefully, widely publicized cases of people being refused CPR will not keep non-medical citizens from getting certified for CPR—and providing lifesaving care if it is required.

Disclaimer: This information is not a substitute for legal advice. Laws change from time to time, so if you are injured, protect your rights and call today at 1-800-598-2440 or contact the Womick Law Firm online.

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When To Hire A Personal Injury Attorney After a Car Accident

Many people choose to hire an accident lawyer after they’ve been involved in a car crash that results in personal injury and monetary losses.

Why Should You Hire a Lawyer?

Technically, you can file a personal injury claim against an insurance company by yourself. Some people choose this route when they’ve suffered only mild injuries and have the time to research the legal claims process themselves. Also, skipping an attorney will save you some money in legal fees.

However, an accident attorney— especially a personal injury attorney—can help you go up against big auto insurance companies and their team of lawyers. Your attorney already knows the personal injury laws and procedural rules and can effectively handle all the legwork for you. He or she will act as your advocate throughout the entire case.

Because an insurance company’s lawyers have the knowledge to reduce compensation and even deny the claim altogether, hiring an accident attorney is the best option for people who:

  • Have suffered severe injuries.
  • Are faced with expensive medical bills.
  • Have experienced a significant loss of wages due to their injuries.
  • Reasons to Consult an Accident Attorney

Consider hiring an accident attorney if any of the following apply to you.

Severe Injuries
Generally, the severity of your personal injuries is measured by the:

  • Type of injury (or injuries) you’ve sustained.
  • Length of time it takes (or will take) for you to recover.
  • Cost of medical bills (and any other therapeutic procedures) you’ve incurred.
  • This also can include the estimated cost of future medical procedures.
  • Long-Term or Permanently Disabling Injuries

Generally speaking, a long-term injury is one that lasts for around a year or longer, while a permanent injury is one that disables you for life. These types of personal injuries seriously affect your ability to become and stay employed—not to mention the quality of your life.

Proving long-term and permanently disabling injuries can be tricky business, and your personal injury attorney probably will consult with each medical professional you’ve seen. He or she even might request the presence of your medical professionals during any legal proceedings.

Disputed Liability
When an insurance company disputes its policyholder’s liability for the car crash, the company is basically saying that the policyholder is not at fault (or is at least claiming you don’t have enough proof of fault) and, therefore, the insurance company is not responsible for paying for your damages.

An accident attorney will help you provide this proof and show that the other party was indeed at fault.

Refusal to Pay
Refusal to pay (which can but doesn’t necessarily stem from a disputed liability) or refusal to pay a fair amount is when an insurance company outright won’t make a fair settlement offer—or any offer at all.

Tips for Hiring an Accident Lawyer

Because of possible situations such as statutes of limitations (which can vary by state), it’s important to hire a personal injury attorney and get the claims process going as quickly as possible; however, you don’t want to hire the first attorney for whom you see a billboard on the highway.

Consider these tips as you look for the right accident lawyer.

Personal Injury Focus

Just as there are many different doctors who focus on many different areas of medicine, there is a wide range of lawyers from which to choose.

As you choose your accident lawyer, make sure he or she focuses on personal injury accidents.

NOTE: Some states’ State Bar websites have directories of attorneys organized by their areas of practice.

Car Accident Experience

Not all personal injury attorneys have experience with cases that deal with personal injury caused by a car accident. Some focus more on slip-and-fall accidents, others on work-related injuries, and others still on premise liability cases.

Make sure the attorney you choose has represented individuals who’ve suffered personal injuries specifically related to car crashes.

Attorney’s Reputation
Perhaps nothing spreads reputation more powerfully than word of mouth, and in this day and age you can go beyond just talking to people about their own personal injury attorney experiences to actually researching these attorneys yourself. Simply hop online, search the attorneys’ names, and see what others have to say about him or her.

Dedication to Your Case
Here, you’ll want to consider a couple of factors.

First, take a look at the attorney’s current caseload. While it’s not impossible for a skilled lawyer to juggle multiple cases at one time (actually, it’s pretty normal), you probably don’t want to put your trust in the hands of an attorney whose focus is spread uncomfortably thin.

Second, consider how the attorney treats you and your case. Sure, you probably won’t communicate every day, but does your lawyer regularly update you on your claim’s status? Make him- or herself available to answer your questions? Return your phone calls in a timely fashion?

Comfort Level
Finally, evaluate your comfort level with the attorney.

You can start gauging your comfort level from the beginning (for example, how do you feel about the attorney’s success rate with car accident cases?) and continue beyond the time you hire him or her.

Sometimes, evaluating your comfort level can prevent you from hiring a personal injury attorney who isn’t well suited for your case; other times, it might convince you it’s time to change course with a new attorney.

Just remember, you suffered personal injury and monetary loss due to a car crash you believe someone else caused. Use these tips—and trust your gut—as you search for the right accident lawyer.

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February is Aggressive Driving Month

February is when drivers are asked to reflect on their driving behavior and the way that they react when other drivers make poor decisions. Think about the last time you were cut off by a speeding motorist and how you responded. Your heart probably started pumping faster and you may have even yelled or made an impolite gesture. The question is, did you respond by driving inappropriately? Aggressive driving is extremely dangerous, and it can result in devastating, high-speed collisions.

According to the National Highway Traffic and Safety Administration (NHTSA), there are over six million car crashes in the United States each year that are caused by road rage. This means that a large number of drivers who get upset on the roadway choose to channel their anger through reckless driving behavior. Make sure that you are not a part of the problem. Find ways to direct your anger in a positive way and find ways to stay calm when behind the wheel.

Of course, you don’t have to be an aggressive driver to be involved in an aggressive driving accident. It is likely that you will encounter a number of hostile and dangerous drivers someday while driving in Southern Illinois. Here are a few tips to keep in mind that could protect you and your family from road rage:

• Don’t make eye contact with drivers who are gesturing, yelling or honking their horn at you. Ignore them while staying in your lane at a safe speed.
• Let the aggressive driver pass you as soon as possible. Pull over or simply get out of the way so that he or she can move on.
• Call the police if a driver is behaving dangerously. Have a passenger write down the driver’s license plate and call the police to report them. Do not, however, try to report them while you are driving. That would make you a potentially dangerous distracted driver.

If an angry driver injures you, do not hesitate to research your legal options. Dangerous drivers can be held accountable for the injuries they cause. You may be able to receive support for medical bills, lost wages, suffering and other related damages. Contact the Womick Law Firm and our experienced team of personal injury lawyers to obtain more information about pursuing your legal rights.

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Why Employers Need Worker’s Compensation Insurance

If you have employees, you need workers’ comp insurance. We’ll help you wrap your head around what you need to do to ensure your business is covered.

Almost every business in the United States that has employees has to handle the problem of workers’ compensation. Most states (with a few important exceptions) essentially require employers to purchase an insurance policy to handle their statutory obligations to workers who are injured or made ill due to a workplace exposure. Whether your business is small or large, handling the expense and effort of meeting those statutory obligations is an ever-present challenge.

As a consultant to employers on their workers’ compensation cost and coverage, I’ve seen firsthand that the cost of workers’ compensation is a universal concern of business owners and managers. Whether working with a small machine shop that employs 30 people or a Fortune 100 corporation that employs thousands across many states, I’ve found that the details may vary but the concern remains the same: how can the voracious cost of workers’ compensation be controlled effectively?

Some researchers have suggested that the earliest roots of workers’ compensation can be traced back to the code of Caribbean pirates: those who were injured plying their dangerous trade would be compensated with shares of booty taken by their able-bodied fellow buccaneers. Colorful as that conjecture may be, workers’ compensation requirements in the United States began early in the 20th century, back in 1911.

Before then, workers who’d been injured or made ill on the job had to take legal action against their employers, resulting in a system that simultaneously made it difficult for workers to obtain compensation for such injuries and yet exposed employers to potentially devastating financial penalties under the tort system. Beginning in 1911, an historic compromise solution was devised by the various states. Wisconsin was the first, but other states quickly followed, enacting a “no fault” system intended to make sure workers received fair and prompt medical treatment and financial compensation for workplace injuries and illness. This compromise system also established limits on the obligations of employers for these workplace exposures, so that the costs could be made more predictable and affordable.

Today, modern workers’ compensation laws provide fairly comprehensive and specific benefits to workers who suffer workplace injury or illness. Benefits include medical expenses, death benefits, lost wages, and vocational rehabilitation. Failure to carry workers’ compensation insurance or otherwise meet a state’s regulations in this regard can leave an employer exposed not only to paying these benefits out of pocket, but also to paying penalties levied by the states.

But our federal system in the United States means that workers’ compensation regulations, for the most part, are the jurisdiction of the individual states. There are some federal workers’ compensation statutes, such as for longshoremen and harbor workers, but for most employers, the system of workers’ compensation rules and regulations they usually deal with is enacted by the states (along with Washington D.C. and Puerto Rico). This means that workers’ compensation in the United States has something of a patchwork quality to it. There are great similarities among the workers’ compensation systems enacted by the various jurisdictions, but also important differences.

How States Differ
In most jurisdictions, employers can meet their workers’ compensation obligations by purchasing an insurance policy from an insurance company. However, five states and two U.S. territories (North Dakota, Ohio, Puerto Rico, the U.S. Virgin Islands, Washington, West Virginia, or Wyoming) require employers to get coverage exclusively through state-operated funds. If you’re an employer doing business in any of these jurisdictions, you need to obtain coverage from the specified government-run fund. These are commonly called monopoly state funds. A business cannot meet its workers’ compensation obligations in these jurisdictions with private insurance.

Nevada was a monopoly state until recently, but now it’s shifted to a system of private insurance and the former state fund has morphed into a mutual insurance company. Thirteen other states also maintain a state fund, but the state funds compete with private insurance. In these states, an employer has the option (at least theoretically) to use either the state fund or private insurance. Those states that offer employers this option are Arizona, California, Colorado, Idaho, Maryland, Michigan, Minnesota, Montana, New York, Oklahoma, Oregon, Pennsylvania and Utah.

The State-by-State Mosaic
Since workers’ compensation is primarily regulated by the individual states (and territories), there is no single cohesive set of rules governing benefits, coverage, or premium computation. Even if you have considerable experience in dealing with one state’s workers’ compensation system, if your business expands to a different state, you can easily find yourself dealing with very different rules.

The closest thing there is to a uniform set of rules for premium computation are those established by the National Council on Compensation Insurance (NCCI, This organization creates policy forms and writes the rules for premium computation in the majority of states.

NCCI is what used to be called a “rating bureau.” Nowadays the organization tends to prefer the term “advisory organization,” although a lot of folks still use the older term. NCCI performs a number of important tasks for the workers’ compensation system in the states that use NCCI. It gathers the statistical data from insurance companies that is used to develop rates, for instance. It also creates the standardized policy forms that are approved by state insurance regulators. Perhaps most importantly, from the standpoint of those who buy workers’ compensation insurance, NCCI writes the manuals that govern how workers’ compensation insurance premiums are calculated.

If you have a high tolerance for technical and obtuse language, try reading the fine print of your workers’ compensation insurance policy. If you stick with it, you may notice something interesting: the policy itself doesn’t really spell out how the premiums for the insurance are calculated. Instead, the policy states that premiums on the policy are just an estimate and that the final actual premiums for the coverage will be calculated in accordance with the insurance company’s manuals of rules.

But in practice, insurance companies don’t write their own manuals of rules. Instead, they find it more practical to use the manuals developed by rating bureaus like NCCI. (Remember: NCCI isn’t the rating bureau in all states. Some states maintain their own independent rating bureaus. These other bureaus also develop manuals that govern premium computation in their particular states.)

Also, even among the various NCCI states there can be important differences. Some states tinker with NCCI rules in various ways, so that in some fundamental rules there can be very important differences even among NCCI states.

So to figure out what rules govern the computation of your workers’ compensation insurance premiums, you have to first identify the states and then figure out which rating bureau (and thus which manual of rules) has jurisdiction in those particular states.

Workers’ Comp–Who Needs It?
That may be the first important question that a business needs to address, because not every business is required to purchase workers’ compensation insurance. Generally speaking, sole proprietors and partnerships aren’t required to purchase workers’ compensation insurance unless and until they have employees who aren’t owners. Most states will allow sole proprietors and partners to cover themselves for workers’ compensation if they choose to, but it isn’t required. (An important note, though-these rules vary from state to state and can change over time. So it’s always a good idea to check with your particular state’s regulatory agency to make sure what the rules are for your state jurisdiction.)

Some states don’t require an employee to be covered if he or she is paid solely by commission. Again, check with the workers’ compensation regulators in your particular state to see how they handle this.

Interestingly, a few states even give employers the option to not purchase workers’ compensation insurance at all. These states are few and far between: Texas and (at least in theory) New Jersey. Remember, though, that just because the state may allow an employer to go without workers’ compensation insurance, the employer is still liable under the state’s workers’ compensation laws for injured workers. Not having workers’ compensation insurance, even if allowed by a particular state, does not relieve the employer of financial responsibility for injured workers.

Most states also allow large employers to self-insure for workers’ compensation, but the rules about who can and cannot self-insure again vary significantly from state to state. Typically, your state department of insurance can help you determine if your business is required to purchase workers’ compensation insurance. A general rule is that if you have employees who aren’t owners of the company, you probably need workers’ compensation insurance. Speaking of employees, here’s a potential trap to be aware of and avoid: under most state’s workers’ compensation laws, you might have employees you don’t know about. That’s because most states will treat an uninsured contractor or subcontractor as your employee if he or she is injured while doing work for your company.

Let’s say you’re operating as a sole proprietor and your state doesn’t require you to purchase workers’ compensation insurance on yourself. Then you hire a painter to paint your office. If that painter doesn’t have workers’ compensation insurance on himself and gets hurt working on your premises, he may well be able to make a claim against you. The same holds for a roofer, or a glazer, or a cleaning contractor. Anyone you hire to do work for your company could be eligible for workers’ compensation benefits from your company.

That’s why many larger companies will contractually require anyone doing work for them to show proof of workers’ compensation insurance. A cleaning service operating as a sole proprietor may not be required by the state to purchase workers’ compensation insurance, but its clients would be wise to insist on it before hiring that service.

Understanding Your Policy

The Standard Workers’ Compensation insurance policy is a unique insurance contract in many respects. Unlike other liability insurance policies, it doesn’t have a maximum dollar amount limit to its primary coverage. Your auto insurance policy, for example, has certain specified maximum amounts the policy covers per accident; if the cost of a particular accident exceeds that limit, you’ll need to look elsewhere for those additional dollars (either your own pocket or an excess or umbrella liability policy). Workers’ compensation insurance policies have a dollar limit also, but only for Part Two of the coverage, employers’ liability. But Part One, the part that responds to an employer’s statutory workers’ compensation liability, has no set limit. Once the policy is in force, the insurance company is responsible for all that employer’s claims that arise for workers’ compensation benefits in the states covered by the policy.

That’s the really beneficial aspect of workers’ compensation insurance from the employer’s point of view. It’s impossible to know in advance how great an employer’s liabilities may be in a year due to workers’ compensation obligations and thus impossible to budget ahead of time with any certainty. A company might run several months with almost no claims and then be hit with a claim that ultimately costs hundreds of thousands of dollars. But an insurance policy has a predictable cost for which a company can plan and budget-at least in theory. Sometimes in practice, this isn’t the case.

Part One of the standard workers’ compensation insurance policy (what used to be called Coverage A, for us old-timers) transfers liability for statutory workers’ compensation benefits of an employer to the insurance company, whether that liability turns out to be small, medium, or crushing. If a state increases benefit levels during the term of the policy, the employer doesn’t have to make any adjustments to the policy-the policy automatically makes it the responsibility of the insurance company to pay all claims due for workers’ compensation insurance for the named employer in the particular states covered by the policy.

Employers’ Liability Coverage
We’ve already made reference to Part One of the coverage provided by the workers’ compensation insurance policy. But we haven’t talked in detail about Part Two-employers’ liability coverage. Most workers’ compensation claims come under Part One of the coverage-the statutory state benefits for injured or ill workers. But don’t ignore Part Two, as it can be very important to make sure this sometimes overlooked area of the policy is set up correctly.

This is the section of the policy that does have a set dollar limit. But employers’ liability coverage is not always well understood by employers (or even by some insurance people). Employers’ liability insures the employer for liability to employees for work-related bodily injury or illness that isn’t subject to the statutory benefits imposed by state or federal regulations. For example, a lot of states exclude certain employees from the statutory benefits covered by Part One or Part Three of the policy. Employers’ liability coverage would insure the employer for liability to such employees.

Employers’ liability also insures an employer in cases such as third-party over suits, where an injured worker files suit against a third party and that third party then seeks to hold the employer responsible. For example, an employee injured by a piece of machinery at the workplace might file suit against the manufacturer of the machinery. The manufacturer might claim that the employer modified the machinery or used it improperly and is thus responsible for the liability. But since employers’ liability has a set limit, it is vital that this limit be correctly coordinated with the excess or umbrella liability coverage that is purchased separately. If the amount of employers’ liability coverage on the workers’ compensation policy is lower than the amount that the umbrella or excess policy requires for underlying coverage, there can be an uninsured gap. So it is vital to make sure that the employers’ liability limit on the workers’ compensation policy matches what is shown on the umbrella or excess liability coverage that sits on top of the primary workers’ compensation policy.

Steps to Take to Evaluate Your State-by-State Workers’ Comp Exposures

  1. Examine your company’s possible exposures to workers’ compensation claims from different states. If you have employees who live and work or who travel to other states, you need to make sure you are properly covered in each state. Remember, many states treat uninsured independent contractors or subcontractors the same as if they were your employee.
  2. If you have workers in monopoly-fund states, you’ll need to arrange coverage through those state funds. Private insurance cannot satisfy coverage requirements for monopolistic states.
  3. If you’re based in a monopoly-fund state but have workers based elsewhere, you will need to arrange coverage for those states separate from your state fund.
  4. If you’re self-insured in your primary state of operations but have employees or uninsured contractors in other states, you’ll need to arrange coverage for those other states.
  5. If you’re operating in multiple states, check into possible different classification definitions that apply in different jurisdictions for your operation. Make sure you’re properly classified in each state, to avoid either hidden overcharges or an unpleasant audit surprise of an additional premium.
  6. A few states do not use the interstate experience modification factor system, but instead calculate a modifier only for use within that state, based on prior losses and payrolls within that state.These “stand-alone” states are California, Michigan, Pennsylvania, Delaware and New Jersey. If you have operations in these states but also operate elsewhere, make sure proper experience modifiers are used for the stand-alone states.

Controlling Your Costs

Here are some particular areas you may want to focus on to make sure your workers’ compensation insurance costs aren’t out of control.

. Determine if you’re in an assigned risk plan. Sometimes an insurance agent handling the workers’ compensation insurance for a small employer doesn’t make it clear that the policy procured is an assigned risk policy. And in many states, the rates and premium for an assigned risk policy are much, much higher than for the same policy written through the voluntary market. An assigned risk policy doesn’t look different from any other workers’ comp policy, except for some subtle differences. So make it a point to insist on knowing if your policy has been written through an assigned risk plan.

If you’re in an assigned risk plan, check with your state’s insurance regulators to see if assigned risk policies in your state have higher rates and premiums. If this is the case, then do everything in your power to find coverage outside the assigned risk plan. Talk with other agents, talk with direct-writing insurance companies, talk with employee leasing companies, investigate group self-insurance programs available in your state-but don’t let it be your agent’s responsibility to get you out of the assigned risk plan. Your agent just may not have a viable alternative for you, but that doesn’t mean that such an alternative doesn’t exist.

. Check what credits may be available to you in your state. If you’re not in an assigned risk plan, make sure your policy gives you whatever credits you might be eligible for in your state. If your state offers credits for a drug- and alcohol-free workplace, find out if you’re eligible. If your state offers merit rating, see if you’re eligible for that from an insurer. If your premium is appropriate, make sure you’re getting the proper experience modification factor. If your state offers a small-deductible credit, look into obtaining it.

. Insist on getting audit workpapers after any audit. If the insurance company sends out an auditor to determine your final premium, make sure to request a copy of the audit work papers so you can review them carefully and make sure payroll computation adjusts overtime properly and allocates payroll of different employees correctly.

. Check into alternative sources of workers’ compensation insurance. Many business and trade associations sponsor insurance programs that include workers’ compensation insurance. Check into all organizations to which you belong or that you might be eligible to join; they may offer sponsored insurance programs that could reduce your rates or premium.

Operating a Safe Workplace
Most of this article focuses on actions employers can take to reduce workers’ compensation insurance costs by spotting common mistakes made by the insurance industry that inflate premiums. But keep in mind that workplace safety is also a necessary part of any program to control the cost of workers’ compensation insurance. As you’ve seen earlier in this article, there are direct mechanisms that tie the cost of workers’ compensation insurance for most employers to their own company’s past losses. The experience modification factor is the most well-known and obvious such mechanism, but there are others as well. The simple truth is that controlling workplace safety is a very effective way to control your company’s workers’ compensation cost. In the long run, catching the typical insurance industry mistakes that inflate premiums is only half the battle. Here are some tried and true steps that employers can take to improve their workplace safety.

  • Discuss safety at every opportunity. Make workplace safety efforts an important part of every meeting. Don’t just make it a part of your managers’ meetings-make it a constant topic at meetings with workers. Make sure you communicate to them why safety is so vital, and how it affects the cost of workers’ compensation coverage and thus the bottom-line of the company. You might be amazed at how many of your employees don’t really understand how expensive workers’ compensation coverage is for the company-or even that it’s a cost for the company at all. Some employees think it’s just some kind of government program that doesn’t really translate back to direct costs for the company. So share information about the cost of the company’s workers’ compensation insurance and how the cost of claims drives up that cost. Post the company’s safety goals, and how well the company is doing in regard to meeting those goals. Compare current injury information (without disclosing confidential information about injured workers) with information on recent years.
  • Examine trends in workplace injuries. You can’t rely solely on your insurance company to analyze this data and alert you to trends you need to address. Get all the information you can about what kinds of claims are occurring and in what part of your operations. Only by understanding what’s causing your claims can you begin to address the causes. It’s a terribly overworked clich�, but it’s also very true: Safety is no accident. It takes planning, effort and thought.
  • Utilize modern resources. Don’t be afraid to search the internet for information about what’s working at other companies, safety advice from government agencies, insurance companies, insurance regulators, or even special interest groups. Do a Google search under “workers compensation safety programs,” and you’ll get over six million sites with information.

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Carbondale, IL 62901
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Herrin, IL 62948
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