Andrea Collins, Sienna Staffing, Inc.

“Dwell on the positive” is the mantra of my friend and the Editor of Adjusting World. Those of you, who know Joe Aytch, know he is slowly recovering from the heart attack he suffered in February. He has a long road ahead of him, but I know the strength of his beliefs will bring him back full circle.

I take heart that he is not a lone believer in the effects of positive thinking when I see the popularity of Chicken Soup for the Soul, All I Really Need to Know I Learned in Kindergarten and Don’t Sweat the Small Stuff, seems to me a testament to our need to be better people for our families and maybe even ourselves.

What lies behind us and what lies before us are small matters compared to what lies within us.

--Ralph Waldo Emerson

I hope what lies within all of us will always be positive.

Friends of Joe Aytch have organized a fundraiser to help his family with the cost of his care. Joe is a much published writer in the Bay Area and a big Reggae fan. Many of his friends will be reading from some of his work between sets. Join us for this positive tribute.

By Anthony L. Alford
Marsh Risk Consultant

According to the New England Journal of Medicine, Severe Acute Respiratory Syndrome (SARS) is a condition of unknown cause that has recently been recognized in patients from Asia, North America, and Europe.

SARS was initially identified in Canada in early March 2003. The most common persisting symptoms were fever, malaise, nonproductive cough, and dyspnea (shortness of breath). SARS is also a condition associated with substantial morbidity (a state of illness or disease) and mortality.

Business can be affected through their employees. Since technology companies have a concentration of purchasing, manufacturing, and business interaction ranging from computer to mobile communications in Asia, high tech firms have begun to feel the impact of SARS. According to a recent statement from the semiconductor giant Intel, they are canceling major technology forums in Taipei and Beijing due to SARS. Other affected industries include toy manufacturing, aerospace and aviation to name a few.

SARS and workers’ compensation has been identified as a potential issue. While it is difficult to exactly determine if there is coverage for SARS, both insurance carriers and their underwriters are examining the issues. As an example, if an employee is traveling in Asia or any other affected area and has contracted the SARS virus, the workers’ compensation carrier or claims administrator should be put on notice immediately. Since coverage depends on the claim investigation and the individual claim’s circumstance, each case will have to be evaluated based on its facts. If the facts determined indicate the virus was contracted in the course and scope of business travel, then a decision has to be made as far as coverage under the domestic workers’ compensation or the foreign voluntary workers’ compensation, if one exists. To further complicate the matter; if treatment is received in a foreign country, then any unpaid medical costs may have to be converted to foreign currency for payment.

One key component for employers is to report any suspected claims in a timely manner. Delays in reporting claims can result in possible reduced investigation timeframes and increased claim costs.

By William Nathans
Senior Claims Examiner
Athens Administrators

The legislature is at it again.

Assemblyman Keith Richman has proposed AB 1480. This bill would amend Labor Code Sections 4603.2,and 4650, repeal 5814.5 and rewrite 5814.

This bill would shorten the time frame for payments to medical providers to 45 days instead of 60. The employer would be liable for penalty and interest only on the contested portion of a medical bill. It would limit the total amount paid to a medical provider allowing remedy exclusively through the Official Medical Fee schedule.

The way permanent disability is paid would be changed. Under the proposal, the benefit would be paid at the same rate as temporary disability.

Labor Code Section 5814 would be rewritten. The new 5814 would change the penalty from 10% of the entire species to 25% of the missed or delayed benefit up to $500.00 whichever is greater. It would also impose a one-year time limit and other procedures before a claim can be made.

The bill would add two new sections, 4062.7 and 5705.1, to the Labor Code affecting permanent disability. These two sections would limit the cumulative total permanent disability level to 100%, prohibit permanent disability unless at least 10% was industrially caused, and would require physicians to use permanent disability language from established guidelines or the report would be inadmissible and the physician would be subject to non-payment.

With regards to the medical services, all medical services would be subject to the official medical fee schedule regardless of whether the claim is accepted or not. Outpatient surgery centers would be subject to the fee schedule. The Administrative Director would have to consult with the IMC before changes could be made to the fee schedule and would limit the total fees paid to a provider to the fee schedule.

Now, my thoughts…. It is my opinion that a large segment of the workers compensation community is ignored whenever the subject of reform comes up. The legislature gets lobbied by the medical providers, applicant attorneys, defense attorneys, rehabilitation counselors, insurance companies and third party administrators, the only people that they do not talk to is us, the claims examiners, who have to try and work the system that they have created.

We need to have our voices heard as part of the process since it is my belief that until that happens there will be no reform, since the system will just become more unworkable, continuing to be bogged down by form over substance. We need to express our concerns to our legislators and become part of the process to expedite benefits to legitimately injured workers, while making our jobs workable.

Katherine Jones
Katherine@adjustingworld.com

We have conquered the examiner’s desk monster, and now it’s time to put in place strategies that will maintain control over the beast. You already know the problem areas on the desk and the days that are busier than others, so let’s set up a system that will allow you to work productive and stress free.

1. Set up a daily schedule that has time slots to process mail, diaries and open time for the unforeseen. Be realistic, you know the amount of mail that is received everyday and the number of cases in the caseload so do not set a goal you cannot meet.
2. Process your mail every day. It may take a few minutes or a couple of hours but if you do it every day you will not have to worry about late payments or missed permanent and stationary reports. You can also adjust the diary as you review the mail.
3. Work your diary every day. You may not complete all the files that are due that day but you will decrease the number of files that need some action taken on them. Keep a count of how many diaries you set for each day and do not schedule diaries on Saturday, Sunday or holidays.
4. Process reserve changes as needed and for the life of the case. Do not adjust your reserves for one bill this will result in monthly if not weekly adjustments.
5. Pay awards immediately!!! Do not look at the award and say it is not due for a few more days – an unforeseen delay or emergency may occur and you could miss the due date.
6. Answer the phone when it rings, usually the call will only take a few minutes but if you have to return calls, it can develop and result in frustrated claimants or providers.
7. Talk with your claims assistant and file clerk, ask them what procedures do they think can be streamlined and how can the three of you work together to keep the files and mail moving.
8. Ask for help from your supervisor. Your supervisor is the best person to bounce issues off when you are not sure you are moving a file in the right direction.
9. Develop a form letter you can send to doctors, rehabilitation counselors and defense attorneys to obtain information on current file status if immediate action is not needed. It is less time consuming to send a letter than to call everyone, you will also have documentation if needed at the W.C.A.B. or Rehabilitation Unit.
10. Keep only the files you are working on at the desk and only have one file opened at a time. Misfiled mail or lost sections of files can occur when there are multiple files open and being reassembled.
11. Set-up a monthly calendar and place it where you will see it everyday. Log in: due dates for 90 day decisions, legal and rehab conferences and any other dates like file reviews to keep you on track and on time. Color code the entries for faster identification.
12. Know your peak hours, when you are most productive and do those tasks that are the hardest and will give you the ego boost needed when completed.

Presented by Clarian Health
Committed to excellence in patient care, education and research

You can get there on time

When the Toronto Star asked 1,000 executives nationwide to recount the best excuses that they had heard from tardy employees, one told of a chronically late woman whose excuses grew increasingly incredible.

"One morning, more than 2 hours late, she called to explain that she'd awakened to discover two male window washers on scaffolding outside her bedroom window," he said. "Because she slept nude, she said, she was waiting for them to leave before she could get up and come to work.". Read more...

Deidre Rogers, RN, CAE
President of Ergovera Ergonomic Consulting
www.ergovera.com
drogers@ergovera.com

Recently, after having laser work done on my eyes, I experienced eyestrain while viewing my VDT monitor. I began to wonder about the monitor's height and my distance from it (i.e., I felt too close). When I changed to smaller casters for my office chair, in order to protect the wood floor, it lowered my sitting height, effectively raising my monitor and my chin as I extended my neck.

Moving my monitor lower and slightly farther away immediately decreased eyestrain and repositioned my head and neck to a more comfortable posture.

As I began to research the topic in the literature, I found disagreement regarding optimal monitor placement. However, the newer research seems to have greater agreement. The variation in recommended monitor height or viewing angle (as is more frequently studied) goes from eye-level (0°) to mid-level, (-15° or - 17.5° depending on the study), to a low level of -35° or -40°.

The studies that support the extremely low monitor position have the monitor submerged below the desk surface. They claim that their findings indicate an increase in blink time, more frequent body movements, and a variety of neck positions.

The recent studies I summarize disagree with the extremely low monitor position. They all agree on a mid-level or somewhat higher position for the monitor. In addition they found:

• Head/neck position was best at a mid-level (-15° or -17.5°).
• Decreased muscle activity for the majority of upper back and neck muscles was found with the mid-level position.
• Individual preferences reflected the benefits of the above findings, with the majority of subjects preferring a mid-level or slightly higher monitor placement.
• Monitors positioned at eye-level are associated with a slight decrease in performance.

So, encourage your employees to assess their monitor position carefully, and educate them on recent research. If there are special conditions (such as bifocals, work tasks or workstation design issues), optimal placement may vary even more, and some employees may need their monitor lower than the recommended mid-level or slightly higher position.

Have a safe day,
Deidre Rogers, RN, CAE