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To lower Workers’ Compensation Insurance costs for your business, you may want to consider a wellness program. Wellness programs offer many benefits and aren’t just for big companies. Statistics show that 58% of small to medium-sized businesses (3-199 employees) provide wellness programs. The return on investment (ROI) for employee wellness programs is $6 for every $1 spent.

What is a Wellness Program?

SHRM states, “Wellness programs are provided to employees as a preventive measure to help avoid illness while improving and maintaining the general health of the employees. This can be accomplished through education, communication, and a supportive work environment.”

Wellness programs may address physical health, mental health, substance abuse, or chronic pain. They may or may not include incentives - such as health insurance premium discounts, contributions to health savings accounts, cash or gift cards, etc. - to participate in the program. SHRM cautions, “Employers should make sure their wellness incentives are designed, so they do not inadvertently lead to unhealthy behaviors. For example, a per-pound weight loss incentive with no limits may encourage unhealthy weight loss practices. Or an incentive for attending a fitness center that expires after one year may result in employees ending their regimens.”

Wellness programs may include one or more of the following:

• Nutrition education
• Diabetes management programs
• Weight-loss programs
• Preventative health screening
• Health risk assessments
• smoking cessation programs
• Stress management programs
• Gym memberships
• Worksite exercise programs and activities
• Vaccination clinics
• Health fairs
• Wellness publications
• 24-hour nurse hotline
• CPR or first-aid training
• Massage therapy services
• Financial wellness
• Recreational programs, such as company-sponsored sports teams

What are the Benefits of a Wellness Program?

Employees spend a substantial amount of time at work, and unfortunately, workplaces often lead to ill health. For example, desk jobs can lead to inactivity and weight gain, and work stress has been shown to cause many health issues. So, it’s no surprise that wellness programs provide many benefits for employers and employees alike:

• Reduction in healthcare costs. In 2019, 72% of employers implementing a wellness program saw reduced healthcare costs.
• Reduction in absenteeism (14-19%).

• Increased productivity. 84% of employers reported higher productivity and performance from their employees due to wellness plans in 2019.

• Reduced injuries.
• Reduced Workers’ Compensation and disability-related costs.
• Increased employee morale. More than 80% of employees who work for an employer engaged in their wellness enjoy their work. On the other hand, of those whose employers aren’t engaged in their wellness, only about 40% say they enjoy work.
• Attract and retain employees. Research shows that 87% of employees consider if an employer offers any type of wellness program when choosing an employer. In addition, 85% of employees who work for an employer engaged in their wellness say they intend to stay at their jobs. On the other hand, of those whose employers aren’t engaged in their wellness, only 58% say they plan on staying with their current employer.

*Statistics from Zippia.

How is a Wellness Program Established and Designed?

SHRM suggests the following steps to establish and design a wellness program:

1. Conduct assessments
2. Obtain management support
3. Establish a wellness committee
4. Develop goals and objectives
5. Establish a budget
6. Design wellness program components
7. Select wellness program incentives or rewards
8. Communicate the wellness plan
9. Evaluate the success of the program

Easy Workers’ Comp Insurance Savings

The independent agents at American Insuring Group will work hard to get you the best price on quality insurance to protect your employees and your business.

Give us a call today at (800) 947-1270 or (610) 775-3848 or connect with us online.

Within small to medium-sized businesses (SMBs), the role of Workers' Compensation manager is often given to someone who has other roles within the business and little to no experience with WC. Unfortunately, Workers' Compensation can be complicated, and mistakes can be costly. So, if you find yourself in the role of WC manager, here are eight tips to help.

1. Know What Your State Requires -Your state will determine whether or not you are required to carry Workers' Compensation Insurance, the WC regulations you need to follow, and how you can purchase the insurance. Click here for a state-by-state comparison and links to the entities responsible for Workers' Compensation. And remember, even if you are not required to purchase WC insurance, it may be worth having.
   
   
2. Understand WC Basics – You need to know what WC does and doesn't cover, what WC classification codes and experience modifiers are, etc. Check out these 10 PA WC FAQs.
   
   
3. Know How Workers' Comp Premiums are Calculated - Your Workers' Compensation premium is based on the following formula: WC Premium = Classification Code Rate X Experience Modifier X payroll/$100. Understanding this calculation helps you 1) ensure no errors are made and 2) see where you can save money on WC costs.
   
   
4. Understand the Effect of Safety on WC Costs – According to The Pennsylvania Compensation Rating Bureau (PCRB), your experience rating is based on past claims and helps determine your experience modifier, which is an adjustment of your annual premiums based on the likelihood that you will file a claim. The safer your workplace, the fewer claims you will file, which lowers your experience modifier and what you pay for WC insurance.
   
   
5. Realize That Timing is Crucial – Injuries should be treated immediately and reported promptly. Failure to report an injury promptly can jeopardize investigations, increase potential litigation, violate state law, and increase the cost of the claim. You must also manage WC claims (see below) to ensure quicker resolution.
   
   
6. Consider a Return-To-Work Plan – The sooner you can get an employee safely back to work, the better. Studies show that returning to work after an injury is essential for recovery and can help reduce your WC costs. One way to get an injured employee back to work sooner is with a return-to-work program (RTW). An RTW is designed to get injured employees back to work as quickly as possible (based on their doctor's recommendation). That could mean the injured employee returns to modified duties or a temporary position to accommodate any limitations caused by the injury.
   
   
7. Manage WC Claims – An employer's role does not end with filing a WC claim. Managing a WC claim is key to a quicker resolution, which includes ongoing communication with the injured employee, their medical team, and your insurance company during the claims.
   
   
8. Learn How to Read a Loss Run Report - Loss Run Reports list the date of each loss and claim, a brief description of each claim, the amount paid to the insured, and whether or not the claim is closed. Insurance companies use this information to determine how risky your business is to insure, which can affect your premium. Therefore, you should check that the information is accurate, and you can use the information to lower insurance costs and improve other areas of your business.
   
   
9. Protect Your Business from WC Insurance Fraud – Most injured employees are honest; however, some employees commit Workers' Compensation fraud, costing companies billions of dollars every year in rising insurance premiums, production delays, and training costs. Protect your business from WC insurance fraud by recognizing the warning signs of fraudulent claims.
   
   
10. Review Annually - Your insurer will conduct an annual audit, and so should you. It's an opportunity to check for errors and provide any updates.

Bonus Tip: SAVE by Working With the Right Insurance Company

Each business has particular needs, and American Insuring Group specializes in commercial insurance for small to medium-sized businesses. In addition, we offer cost-effective Worker's Compensation insurance from various competing insurance companies. We'll work hard to get you the best price on quality insurance to protect your employees and your business!

Get a free quote today by calling (800) 947-1270 or (610) 775-3848, or connect with us online.

There are many myths or misconceptions about Pennsylvania Workers' Compensation Insurance that can end up costing business owners time and money. So let's set the record straight on these myths once and for all. 

What is Pennsylvania Workers' Compensation (WC) Insurance?

Most states, including PA, require employers to carry WC for their employees. The PA Department of Labor & Industry states, "If you employ workers in Pennsylvania, you must have workers' compensation insurance -- it's the law." This includes both full and part-time employees, even if they are family members. There are very few exceptions. 

If a worker is injured in the workplace or becomes ill because of their work environment, Workers' Compensation (WC) helps cover medical costs and lost wages if the employee cannot work. In Pennsylvania, it doesn't matter who or what caused the injury. If the injury or illness occurred during the course of their employment with you, WC would pay those expenses. 

WC also limits an injured employee's right to sue an employer directly for damages that injury or illness causes. 

Most Common Workers' Compensation Myths

MYTH 1: You don't need WC coverage for your business.

FACT: In Pennsylvania, if you employ even one person, even if that person happens to be your brother-in-law, you probably need to carry WC coverage for that employee. The only exceptions are If ALL employees fall into one or more of the following categories:

• Federal workers
• Longshoremen
• Railroad workers
• Casual workers
• Persons working out of their own homes or other premises not under the control of management
• Agricultural laborers making less than $1200 per calendar year
• Domestic workers who have not elected to come under the provisions of the Workers' Compensation Act
• Sole proprietors or general partners
• Those who have been given an exemption by the Department of Labor and Industry due to religious beliefs
• Executive officers who have been granted exclusion by the Department of Labor and Industry
• Licensed real estate salespersons or associate real estate brokers affiliated with a licensed real estate broker or a licensed insurance agent affiliated with a licensed insurance agency, under a written agreement, remunerated on a commission-only basis and qualifying as independent contractors for State tax purposes or Federal tax purposes under the Internal Revenue Code of 1986. 

If a business does not qualify for one of these exceptions, it must carry Workers' Compensation Insurance for its employees. Failure to do so can result in the employer being required to pay back any costs paid by the Uninsured Employers Guaranty Fund or a work-related injury or illness, including interest, penalties, and fees. An uninsured employer may also face civil and criminal risks that can result in fines and imprisonment. 

MYTH 2: Your company must be at fault for Workers' Comp to pay.

FACT: As mentioned above, Pennsylvania WC is a no-fault system. Regardless of the cause of the injury - a faulty machine, a mistake made by an employee, etc., if the injury occurred in the course of their employment, WC will pay. 

MYTH 3: An injury must happen on-site to file a WC claim.

FACT: If an employee is injured while driving to a meeting, at a work conference, etc., while conducting business for you, you can (and should) file a WC claim. 

MYTH 4: All work-related injuries are covered by Workers' Comp.

FACT: In Pennsylvania, Workers' Compensation claims can be denied to employees whose injuries are caused by the use of illegal drugs or alcohol intoxication. 

MYTH 5: Your role ends once the WC claim is made.

FACT: When an injury occurs, you are responsible for submitting the claim form and supporting documentation promptly; however, your responsibilities don't end there. 

You also need to manage the WC claim, continue cooperating with your insurance carrier, help ensure the claim is resolved quickly, keep in touch with the injured employee, and consider return-to-work options when appropriate. 

MYTH 6: A minor injury is not worth reporting

FACT: Injuries that initially seem minor may become more severe and require additional medical treatment. Not reporting work-related injuries can keep your employees from receiving proper care and put your WC policy at risk. 

Reduce Your Workers' Compensation Insurance Cost

Understanding these common myths and working with one of the experienced independent insurance agents at American Insuring Group can help ensure you get the best coverage at the lowest cost. Our independent agents shop the market to help you save on the proper insurance protection for your business.

Contact us today at (800) 947-1270 or (610) 775-3848, or connect with us online.

If you’ve ever worked with Workers’ Compensation Insurance, you’ve probably come across the term “indemnity.” So let’s take a look at both Workers’ Comp Insurance and indemnity entail. 

What is Workers’ Compensation Insurance?

In Pennsylvania, Workers’ Compensation (WC) Insurance is “mandatory, employer-financed, no-fault insurance which ensures that employees disabled due to a work-related injury or disease will be compensated for lost wages and provides necessary medical treatment to return them to the workforce.” 

If an employer fails to carry WC and an employee suffers a work-related injury, they will be required to reimburse the PA Department of Labor & Industry for money paid by the Uninsured Employers Guaranty Fund concerning the claim, plus interest, penalties, and fees. In addition, an uninsured employer may face civil and criminal risks. 

A misdemeanor conviction could result in a $2,500 fine and up to one year of imprisonment for each day the employer is in violation. Felony convictions could result in a $15,000 fine and up to seven years in prison for each day the employer is in violation. 

What Are Indemnity Benefits?

An indemnity benefit is the money an injured employee receives for lost wages while they are unable to work due to a work-related injury or illness. There are basically four different types of indemnity benefits. 

1. Temporary Total Disability (TTD) benefits are paid when an injured employee is temporarily unable to return to any job with the same employer – neither the work they performed before the injury nor any other position with that employer. This is the most common type of indemnity benefit. Typically, with a TTD benefit, injured employees are paid two-thirds of their pre-injury average weekly rate. 

2. Temporary Partial Disability (TPD) benefits are paid when an injured employee can return to work (as determined by the treating physician) for a limited time. For example, if an injured employee was working an eight-hour day before their injury, but following the injury, their physician stipulates that they can only work four hours per day, they would receive TPD benefits. The amount of the payments is typically the difference between the injured employee’s average weekly wage (AWW) and the amount they are able to currently earn, multiplied by two-thirds. TPD = (AWW – current wage) x 2/3. 

3. Permanent Partial Disability (PPD) is defined by the International Risk Management Institute (IRMI) as “a workers compensation disability level in which the injured employee is still able to work but not with the skill and efficiency demonstrated prior to the injury. As a result, the earning capability of the worker is affected.” These payments are typically based on the percentage of the disability. 

4. Permanent Total Disability (PTD) benefits are paid when the physician determines that the employee will never be able to return to work. The IRMI states, “Under most statutes, the employee will receive weekly wages for life.”

 NOTE: When discussing indemnity, you may also hear the term “maximum medical improvement” or MMI. MMI is “a legal concept where no further significant recovery from or lasting improvement to a personal injury can be reasonably anticipated, regardless of subjective complaints from the employee. In essence, additional medical care and treatment may still be required to keep the employee in a stable condition, but no noticeable improvement will take place in that medical care.” 

How to Lower Workers’ Compensation Insurance Costs?

Workers’ Compensation Insurance can be complicated, but the more you understand it, the more likely you can lower your WC costs.

The agents at American Insuring Group specialize in Workers’ Compensation Insurance and would be happy to work with you to explain the ins and outs of this – and all your commercial insurance needs – and help ensure that you have the right coverage at the lowest cost.

Contact us today at (800) 947-1270 or (610) 775-3848, or connect with us online.

In most states, including Pennsylvania, Workers’ Compensation Insurance (WC) is required by law. But, truthfully, even if the insurance isn’t required in your state, WC is an excellent investment as it helps protect your employees and your business.

We’re sure you have a lot on your plate as a business owner or manager, and conducting an annual review of your insurance policies – including WC – may not be high on your to-do list. It’s so much easier to renew the policies you currently have. However, an annual review helps ensure you are not underinsured or overpaying for your coverage.

Here are three steps to make the annual review process as painless as possible.

Step 1: Review Your Business

Look at how your business may have changed since you purchased your existing WC policy. Ask yourself the following questions:

1. Did your business needs change? For example, did you switch from an independent contractor to an LLC?
2. Did you hire new employees or let old employees go?
3. Has the classification code for any of your existing employees changed?
4. Has your payroll changed?

Step 2: Look at Your Current Policy

The next step is to take a look at your current WC policy, keeping in mind how your WC premium is calculated:

WC Premium = Classification Code Rate X Experience Modifier X payroll/$100

Look at the declaration page to see how your workers are classified and the estimated payroll for each, and determine if this information is still accurate.

Classification Codes - A classification code is a 3-digit number assigned to every type of job. It is based on the likelihood of that employee being injured on the job and helps determine your WC premium. Typically, the more risk of injury, the higher your WC costs. Therefore, assigning the wrong classification code can lead to overpayment, insufficient coverage, or even WC fraud.

Payroll - “Initially, the payroll used to calculate your premium is an estimate. Once your actual payroll has been determined, adjustments may have to be made, and you could be audited and billed accordingly,” Pennsylvania Insurance Department reports.” Any changes to your business within the policy term that affect the rate of your policy can lead to an audit and possible billing.”

Experience Modifier - Finally, review your loss run report, which shows your company’s claim activity for the policy period. Loss Run Reports list the date of each loss and claim, a brief description of each claim, the amount paid to the insured, and whether or not the claim is closed. You can think of it like a credit report or report card for insurance companies.

This information is used to determine how risky a business is to insure, which can affect the premium you pay for insurance or even if an insurance company will issue a policy or renew a policy for your business. You can use the information to lower your insurance costs and even improve other areas of your business.

Step 3: Renew Your WC Insurance (Contact us for great rates!)

Armed with this information, you are ready to renew your WC coverage and ensure that you have the right coverage at the best price.

American Insuring Group agents have years of experience with Workers’ Compensation and other commercial insurance policies to ensure that you get the right coverage for your business needs. As independent agents, we check with multiple insurance companies to ensure you pay the lowest premium for that coverage.

✅ So give us a call today at (800) 947-1270 or (610) 775-3848, or connect with us online.

Most states – including Pennsylvania – require nearly all employers to carry Workers' Compensation (WC) Insurance, but shopping for WC insurance can be frustrating. American Insuring Group is here to help simplify the process and ensure you have the right coverage at the lowest cost.

What is Workers' Compensation Insurance?

Before we get into the nuts and bolts of purchasing WC Insurance, let's discuss what it is and how your premium is calculated. We will focus on PA WC, but many other states are similar (see first tip below).

The PA Department of Labor & Industry states, "The workers' compensation system protects employees and employers. Employees receive medical treatment and are compensated for lost wages associated with work-related injuries and disease, and employers provide for the cost of such coverage while being protected from direct lawsuits by employees."

In Pennsylvania, whether you have one employee or one hundred employees, full or part-time employees, or your employees are family, you are probably required to have Workers' Compensation Insurance. There are few exemptions, such as railroad workers, federal employees, domestic servants, etc. Failure to provide WC for your employees can lead to significant fines, lawsuits, and even criminal prosecution.

Your Pennsylvania Workers' Compensation premium is based on the following formula:

WC Premium = Classification Code Rate X Experience Modifier X payroll/$100

Here are seven tips for purchasing WC Insurance to ensure you have the right coverage at the lowest cost.

Know What Your State Requires

Your state will determine whether or not you are required to carry Workers' Compensation Insurance, the WC regulations you need to follow, and how you can purchase the insurance. Click here for a state-by-state comparison and links to the entities responsible for Workers' Compensation. And remember, even if you are not required to purchase WC insurance, it may be worth having.

Provide Your Existing Policy

If you already have WC coverage, keep your policy handy. Providing information – such as your employees' class codes, your experience modifier, and loss run reports – from that policy can help expedite the process.

Choose the Right Classification Codes

As shown in the formula above, the classification code will affect your WC premium. Classification codes are based on the likelihood of an employee being injured on the job. For example, the classification code for an accountant or someone with administrative responsibilities will represent less risk than a classification code for a driver or contractor. Typically, the more risk of injury, the higher your WC costs.

You don't want to misclassify an accountant as a driver because you'll pay more than necessary for your WC coverage. On the other hand, you don't want to misclassify a driver as an accountant because if caught during the annual audit or a claim, you may be required to pay the outstanding amount owed and/or severe penalties.

Monitor Your Payroll

When purchasing WC coverage, your annual payroll will be estimated based on your current circumstances, which of course, can change. When your insurance carrier conducts its annual audit, you may receive a credit or a bill based on the actual payroll. Monitoring and reporting your payroll throughout the year can help improve your business cash flow.

Ask About Discounts and Credits

Yes, your WC premium is based on the formula above, and most of the components of that formula are out of your control. However, you may be entitled to discounts and/or credits for lowering risk with workplace safety or formal training programs.

Review Annually

Your insurer will conduct an audit each year, and so should you. It's an opportunity to check for errors and provide any updates. Reviewing your loss run report – a report issued by your current insurance provider that shows your company's claim activity for the policy period - may also help lower your WC insurance costs.

Work With a Workers Comp Expert!

Working with an independent agent with experience in Workers Compensation insurance at American Insuring Group is a great way to lower your WC costs. We will compare costs and options among competing worker's compensation insurance carriers to be sure you get the right insurance at the best price.

Call today at (800) 947-1270 or (610) 775-3848, or connect with us online.

Good communication is key to lowering Workers’ Compensation (WC) Insurance costs. Unfortunately, many business owners are under the false impression that communicating with injured employees can cause WC claims and increase the cost of those claims. Nothing could be further from the truth.

Lack of communication and miscommunication in the claims process can cost your business more. For example, injured employees typically hire a lawyer – not to get more money but because of inadequate communication with their employees. For example, one study found that “46% [of injured employees] said they hired attorneys because they felt the claim had been denied when, in fact, it had not yet been accepted into the process.” And the truth is that WC cases that involve attorneys often cost more. 

An injured employee may be worried about their injury, recovery, and how they will continue to support their family. In addition, they may be in pain or facing unfamiliar medical treatments or medication. Plus, WC claims can be complicated. This can result in a scared, stressed, confused, and possibly angry employee. If the injured employee understands that you are concerned about their well-being and are willing to help them through the WC claims process, you become an ally (rather than an adversary). The only way to accomplish that is through good communication before, during, and after a workplace injury. 

Workers’ Compensation Communication

Good communication should be part of the onboarding process of new employees:

• Foster a Positive Culture of Safety – From the start, you need to create a culture of safety that emphasizes safety as a core value of your business.
• Foster Ongoing Communication – Employees need to know that it is safe for them to report safety concerns and injuries without fear of retaliation.
• Provide WC Information – Employers should provide all employees with information about WC, including how to report an injury, what type of injuries are covered, who to contact if they have questions, a list of designated medical providers, etc.
• Training – All employees should receive ongoing safety training to minimize the risk of injury and to know what to do if an injury occurs. Supervisors should receive training regarding Workers’ Compensation in addition to safety training. CFO advises, “Supervisors are often in the best position to shape workers’ initial expectations about what should happen, post-injury.”

Good communication is also crucial when an injury occurs:

• Seek Appropriate Medical Attention – When an injury occurs, your first priority should be to ensure that the injured employee receives appropriate medical attention.
• Thorough Investigation – Every time an injury occurs, a thorough investigation of the incident should occur. The investigation should include interviews with the injured employee and any co-workers who witnessed the incident.
• Documentation – Every incident should be well-documented while everything is still fresh in everyone’s mind. 

Ongoing communication during the claims process is critical for a timely resolution:

• Designate one employee to be the primary contact point for injured employees. That employee should be patient, kind, understanding, and familiar with the WC claims process.
• Provide written and verbal information about the claims process, what the injured employee should expect, etc.
• Regular communication (at least every other week) throughout the recovery process allows employers to monitor the recovery process, update the injured employee on the progress of the claim, and answer any questions or concerns the injured employee may have.
• Communicate Genuine Empathy and Trust. Regular informal phone and in-person conversations and get-well cards show the employee that you are concerned about their well-being.
• Discuss Return-to-Work Assignments. Communicate to injured employees that you are concerned about their well-being and that you are looking forward to them returning to work when it is medically safe to do so. Discuss the possibility of light-duty or transitional duty opportunities with medical providers and the injured employee. 

The Key to Lowering Workers’ Compensation Costs

Good communication should begin with your insurance provider. The independent agents at American Insuring Group listen carefully to better understand your needs, so we can ensure that you get the right workers' compensation insurance coverage at a great price!

Get started today by calling (800) 947-1270 or (610) 775-3848, or connect with us online.

Workers’ Compensation Insurance (WC) is mandatory in most states, including Pennsylvania. WC helps cover lost wages, health care expenses, disability payments, death benefits, and permanent injury payments (such as the loss of a body part) when an employee suffers a work-related injury or disease. It also helps protect your business against lawsuits related to the injury. 

According to the Bureau of Labor Statistics, 2.7 million nonfatal workplace injuries and illnesses were reported by private industry employers in 2020. In addition, 1,176,340 of those injuries and illnesses caused workers to miss at least one day of work. 

The longer an injured employee is out of work, the less likely they will return to work. The longer a claim remains open and an injured employee is off the job, the more it costs the employer. 

The Society for Human Resource Management (SHRM) reports that absenteeism costs exceed $40 billion a year. Here are a few of the absenteeism costs cited for employers:

• Recovery of production
• Quality and hiring of replacement workers
• Lower employee morale
• Increased training costs
• Overtime

 A Return-to-Work (RTW) program gets injured employees back to work more quickly and safely and provides many benefits to both employees and employers.

 What is a Return-to-Work Program?

An RTW program is designed to get injured employees back to work as soon as possible (based on their doctor’s recommendation). That could mean the injured employee comes back to modified duties or a temporary position to accommodate any limitations caused by the injury.

 The Department of Labor & Industry defines RTW as “a proactive approach, endorsed by many health care providers, designed to help restore injured workers to their former lifestyle in the safest and most effective manner possible. A partnership among workers, union representatives, employers, and health care providers stakeholders is developed in a collaborative effort to return the injured worker back to his or her pre-injury status.”

 What are the Benefits of a Return-to-Work Program?

Studies have shown that getting an injured employee back to work as quickly and safely as possible is the best approach for both the employee and the company.

 Here are a few benefits of an RTW for the employer:

• Claims are resolved more quickly
• Reduced WC claim costs
• Increased productivity
• Retention of experienced employees
• Reduced accidents
• Reduced absenteeism
• Reduced staff turnover
• Lower training costs
• Reduced overtime pay
• Reduced administrative costs
• More experienced and knowledgeable workers
• Decreased number of grievances and arbitrations
• Improved employee morale and employee relations
• Shows employees that the employer cares about the well-being of its employees

 Here are a few benefits of an RTW for the injured employee:

• Maintained employment relationship
• Minimize loss of physical fitness
• Maintained skills
• Maintained pension plans, medical benefits, and group life insurance
• Maintained vacation and sick day benefits
• Maintained social connections and a sense of purpose
• Focus on abilities rather than disabilities
• Quicker recovery time

 Research shows that even co-workers can benefit from an RTW program.

 How Can We Create a Return-to-Work Program?

Despite common misconceptions, back-to-work programs don’t need to be costly or complicated but benefit everyone. SHRM recommends following the following steps to create an effective RTW program:

Step 1 – Determine who will be included in the RTW/light-duty program

Step 2 – Define what will be included in the program

Step 3 – Develop a written policy

Step 4 – Review the organization’s current job descriptions

Step 5 – Develop a bank of light duties

Step 6 – Develop a form

Step 7 – Designate an RTW coordinator

We Help You Save on Workers’ Compensation Insurance Costs!

The independent agents at American Insuring Group can help ensure that you pay the lowest premiums on WC and all your insurance needs. We shop the market for you to get you the best deal on quality insurance protection in Pennsylvania and elsewhere.

Call today at (800) 947-1270 or (610) 775-3848, or connect with us online to discover how we can help save you money!

In Pennsylvania, Workers' Compensation Insurance (WC) is based on a no-fault liability premise, which means a workplace injury is covered by Workers Comp regardless of who is at fault. However, there are a few exceptions, such as the "intoxication defense."

"This is a relatively new defense. The Workers' Compensation Act, when originally drafted and enacted, had no intoxication defense," Rothman Gordon Attorneys states. "It was not until 1993 that the Intoxication Defense was added as a part of a nationwide trend of cracking down on drugs and alcohol in the workplace.

A string of drunk driving offenses established that because a blood alcohol content (BAC) over the legal limit (currently .08) established a presumption of intoxication, employers argued they could establish the same presumption in the workplace."

Furthermore, "Pennsylvania is the only state that does not oblige the employer to prove intoxication was the proximate cause (a material contributing factor) of the accident."

Today, the Pennsylvania Workers' Compensation Act states, "In cases where the injury or death is caused by intoxication, no compensation shall be paid if the injury or death would not have occurred but for the employee's intoxication." However, it is important to note that the burden of proof is with the employer.

Over time, alcohol can affect job performance and threaten the health and safety of all employees and the security of your equipment and facilities. So, what can an employer do to protect itself and its employees regarding the use of alcohol? 

Create a Policy

Set a clear, legal, and enforceable written policy regarding the use of alcohol that includes enforcement, punishments, and drug and alcohol testing policies. Ensure that you have written confirmation that each employee understands the policy. 

Pay Attention to Employees

Pay attention to how your employees are acting. The U.S. Office of Personnel Management states, "Even though you must not try to diagnose the problem, there are many signs that may indicate a problem with alcohol…" Those signs include the following:

• Unexplained or unauthorized absences from work
• Frequent tardiness
• Excessive use of sick leave
• Patterns of absence such as the day after payday or frequent Monday or Friday absences
• Frequent unplanned absences due to "emergencies" (e.g., household repairs, car trouble, family emergencies, legal problems)
• Missed deadlines
• Careless or sloppy work or incomplete assignments
• Production quotas not met
• Many excuses for incomplete assignments or missed deadlines
• Faulty analysis
• Relationships with co-workers may become strained
• The employee may be belligerent, argumentative, or short-tempered, especially in the mornings or after weekends or holidays
• The employee may become a "loner"
• The smell of alcohol
• Staggering or an unsteady gait
• Bloodshot eyes
• The smell of alcohol on the breath
• Mood and behavior changes such as excessive laughter and inappropriate loud talk
• Excessive use of mouthwash or breath mints
• Avoidance of supervisory contact, especially after lunch
• Tremors
• Sleeping on duty

Document Reasonable Suspicion

SHRM states, "Concerns that an employee is under the influence often come from co-workers or even clients or vendors before a supervisor or manager notices." If you receive a complaint or suspect an employee is under the influence of alcohol (or drugs) at work, you need to document it properly. SHRM suggests the following steps:

1. Receive complaints
2. Observe the Employee
3. Remove the Employee from Safety-Sensitive Areas
4. Document Observations
5. Assess the Situation
6. Meet With Employee
7. Prepare Transportation
8. Send the Employee for Testing
9. Wait for Test Results
10. Respond to Employee's Refusal to Take the Test
11. Respond to Negative Test Results
12. Respond to a Positive Test Result

Workers' Compensation Benefits

If you suspect the use of alcohol caused a workplace injury, you can fight the claim; however, the burden of proof is on you as the employer. Policies regarding alcohol must be established and enforced, everything must be well documented, and a thorough investigation with evidence is crucial for successful denial of claims.

Here's How to Save on Workers' Compensation Costs!

The independent agents at American Insuring Group specialize in WC Insurance and are dedicated to helping you save on WC and other insurance costs. As independent agents, we shop the market, comparing rates and coverages among competing insurers. We shop so you can save!

So, call us today at (800) 947-1270 or (610) 775-3848, or connect with us online.

In most states, including Pennsylvania, almost all employers are required to carry Workers’ Compensation (WC) Insurance. WC helps cover lost wages, health care expenses, disability payments, death benefits, and permanent injury payments (such as the loss of a body part) when an employee suffers a work-related injury or disease. It also helps protect your business against lawsuits related to the injury. 

How is Your WC Premium Calculated?

Your Workers’ Compensation premium is based on the following calculation:

          WC Premium = Classification Code Rate X Experience Modifier X payroll/$100.

Your experience modifier compares the history of your losses to what is typically expected in a class similar to your company. It is based on the following:

• Number of Claims
• Cost of Claims
• Frequency of Claims
• Severity of Claims
• Closed vs. Open Claims
• Claims History of other businesses in your industry
• Years in business
• Number of employees
• State minimums

 The lower your experience modifier, the lower your premiums. Unfortunately, WC fraud, waste, and abuse can raise your experience modifier and increase your WC premiums. In fact, the Insurance Information Institute reports, “workers’ compensation insurance fraud alone costs insurers and employers $30 billion a year.”

 What is WC Fraud, Waste, and Abuse?

The first step to minimizing WC fraud, waste, and abuse is the ability to recognize each.

• Fraud – According to the PA Department of Labor & Industry, “An employee commits fraud by knowingly and intentionally receiving wages while collecting total disability benefits or receiving partial disability benefits in excess of the amount permitted while receiving wages.” Examples include faking an injury, inflating an injury, and reporting an injury that happened off the job. Employers and medical providers can also engage in fraudulent WC activities.
• Waste – WC waste occurs when an injured employee overutilizes WC benefits. An example of WC waste is an employee who injures their back on the job and continues to see a chiropractor after full recovery.
• Abuse – WC abuse occurs when an employee who is injured on the job expands their symptoms to receive additional benefits. For example, an injured employee may falsely report symptoms to prevent them from participating in a return-to-work program.

 Signs of Possible WC Fraud, Waste, and Abuse

There are a few common signs of WC fraud, waste, and abuse that you can watch out for:

• No witnesses to an incident
• Conflicting diagnoses
• Refusing treatment
• Not reporting injury immediately
• Inconsistent or suspicious recount of the injury
• A history of WC claims
• A history of frequently changing physicians, jobs, and addresses
• An injury that occurs right after a weekend, strike, or holiday
• The inability to reach an injured employee
• A post-termination claim
• Pre-existing medical conditions
• Financial problems
• An unwillingness to cooperate in the injury investigation

 11 Tips to Prevent WC Fraud, Waste, and Abuse

Industrial Safety & Hygiene News offers the following tips to “keep claims above board”:

1. Create a fraud-free work environment by having a strong policy against fraud.
2. Establish a culture of safety.
3. Hold regular safety meetings.
4. Institute sound hiring procedures by screening potential employees.
5. Communicate regularly with injured employees.
6. Follow proper WC reporting and investigating procedures.
7. Educate employees on WC fraud, waste, and abuse and their consequences.
8. Make it easy to report injuries
9. Use surveillance equipment
10. Implement a drug testing policy
11. Choose credible medical providers that have WC experience.

 Lower Your Workers Compensation Insurance Premiums:

In addition to preventing WC fraud, waste, and abuse, another way to lower Workers’ Compensation Premiums is to work with one of the experienced independent agents at American Insuring Group. Our independence gives us the freedom to shop the market to find the right insurance to meet your specific needs at the best price.

Call American Insuring Group today at (800) 947-1270 or (610) 775-3848, or connect with us online.