issue 3 | volume 4 | may june e€¦ · week 1: preventing slips, trips, and falls week 3:...
TRANSCRIPT
ISSUE 3 | VOLUME 4 | MAY - JUNE Florida Department of Financial Services
Division of Risk Management
200 East Gaines Street
Tallahassee Florida, 32399
► NATIONAL
SAFETY MONTH 1
► HEAT ILLNESS
AWARENESS 3 ► SAFETY & LOSS
PREVENTION
SPOTLIGHT:
MIKE
McHARGUE
4
► CLAIM SPOT-
LIGHT: IT’S
JUST A SIMPLE
BACK STRAIN;
HOW MUCH
COULD IT COST?
6
► WORKERS’
COMPENSATION
FRAUD - PART I
8
► SFLPP
LAUNCHES
ONLINE SAFETY
ACADEMY
10
► CROSSWORD
PUZZLE 11
E ach June, the National Safety Council (NSC) encourages
organizations to get involved and participate in National Safety
Month. This year’s theme is “Safety Starts with Me.” We all know a
healthier employee is a happier, more productive employee. Encourage
your employees to become more involved in their personal health and
safety at work and at home. The NSC distributes information promoting
this month and the safety issues below. You may obtain these materials by
contacting the State of Florida Loss Prevention Program (SFLPP). The
NSC also offers limited safety information and training materials at no cost
to the public.
Each week in June, The NSC and other safety organizations highlight a
different safety issue:
Week 1: Preventing Slips, Trips, and Falls
Week 2: Employee Wellness
Week 3: Emergency Preparedness
Week 4: Ergonomics
We encourage all agencies and universities to participate in this event and
continue your safety and loss prevention practices year round. The Division
of Risk Management assists you by providing training materials—and
there are numerous websites with free material—which you may distribute
noncommercially. Below are just a few of the sites you can visit:
OSHA.GOV—National Occupational Safety & Health Regulations
NSC.ORG—Training Material and Information from the National Safety Council
CDC.GOV—Safety and Health Training Information from the Center for Disease
Control
IN THIS ISSUE:
P A G E 2
S A F E T Y & LO S S P R E V E N T I O N
SAFETY STARTS WITH ME: CONTINUED FROM PAGE 1
Here are two actions you can take to promote safety awareness:
Place posters and tip sheets throughout your facility.
Have 5-minute meetings on relevant safety topics.
Occupational Safety and Health Administration (OSHA)
pamphlets offer brief, focused training topics that can be
covered in a short amount of time. Click the following link:
OSHA SAFETY TRAINING PAMPHLETS
The most important people in National Safety Month are your employees
and coworkers; hence the theme, “Safety Starts with Me.” Employees are
your best source of knowledge regarding the perils that exist throughout
your workplace. They can provide new ideas on ways to avoid accidents
because they are most familiar with the daily activities of your agency or
university. Poster and safety slogan contests are another way to get your
employees involved in a safety culture. You may consider involving their
families in the fun, too. This promotes safety to everyone; the children
grow up realizing the importance of the subject, and your employees are
happy knowing you are including them in your program and that you
truly care about their well being.
Remember, safety starts with you!
For additional information and materials regarding National Safety
Week, contact [email protected].
For additional tips, tools, and content on this subject, visit:
http://www.nsc.org/NatlSftyMonth/NSC-2013NSM_Planner.pdf
Florida Department of Financial Services
Division of Risk Management
200 East Gaines Street
Tallahassee Florida, 32399
SAFETY & LOSS PREVENTION OUTLOOKSAFETY & LOSS PREVENTION OUTLOOK
“You cannot escape
the responsibility of
tomorrow by
evading it today.”
~Abraham Lincoln
M A Y - J U N E 2 0 1 3
H eat is the deadliest weather-related killer in
the world. Between 1936 and 1975, almost
20,000 people in the United States died from
the effects of excess heat in the body. In 2003,
an estimated 50,000 Europeans died as the result of an unrelenting heat wave (Porter, 2004).
Living and working in a hot, humid environment is something that most Floridians accept as part
of their daily routine. While this, like most environmental hazards, cannot be eliminated, there are
many highly effective ways that we can reduce the likelihood of illness or injury.
The Center for Disease Control and Prevention (CDC) continues to improve its heat-illness
prevention and awareness website. This site provides endless resources that help to identify causes,
symptoms, and prevention of heat-related illness. Take a moment to review this site. It may
include information that could help you improve or augment your existing safety program (CDC,
2012).
CDC HEAT ILLNESS AWARENESS WEBSITE
As with most hazards, awareness and common sense are the first and best lines of defense. The
National Oceanic and Atmospheric Administration (NOAA) developed a public awareness tool
that is helpful in educating employees and supervisors on the hazards of excessive heat (NOAA,
2005).
NOAA HOT WEATHER AWARENESS WEBSITE
Most state employees carry phones with the capability to
download and use mobile applications. This application—
available on the OSHA website—provides real-time heat
warnings and instructions on how to identify and treat heat
illnesses. It is available at no cost to the user. For those working
at off-site locations, this free application could provide valuable
information to an employee responding to a heat illness. The
application can be viewed and downloaded by clicking on the
image:
As an additional tool, OSHA’s Dr. David Michaels presents a short video discussing the
importance of heat illness awareness in the workplace. Click the link below to view the video:
OSHA HEAT AWARENESS VIDEO
P A G E 3
P A G E 4
I n this issue of the
Safety & Loss
Prevention
Outlook , The State of
Florida Loss
Prevention Program is
proud to recognize the
outstanding safety and
emergency operation
efforts of Mr. Mike
McHargue, Emergency
Coordinating Officer
with the Florida Department of Health, Division of Emergency Preparedness
and Community Support, Bureau of Preparedness and Response.
Our interview with Mr. McHargue began in late May 2013 as he was
preparing for the start of the 2013 Atlantic Hurricane Season by participating
in the annual statewide hurricane exercise drill hosted by Florida’s State
Emergency Response Team (SERT) Monday, May 20 through Thursday,
May 23 at the State Emergency Operations Center in Tallahassee.
Here are highlights from the interview:
SFLPP: Good morning, Mr. McHargue, and thank you for taking the time out
of your busy schedule to share with us some best practices as we start the 2013
hurricane season.
Mr. McHargue: It is my pleasure to share my knowledge with other members
of the emergency management and public safety community.
SFLPP: Let’s get right to it. What are some best practices you would share
with emergency and public safety professionals that you have learned over the
years?
Mr. McHargue: Trust, but verify! Preparedness and response capabilities
cannot be assumed. Throughout my career, the truly successful emergency
management and public safety professionals have demonstrated constant
attention to solid planning, training, exercise, and evaluation. The best
practices I have observed are from professionals across the country that
mentor others to promote common understanding of potential threats and
actions that are required to prevent or mitigate them, and they also follow
through to demonstrate the ability to implement plans. Emergency
management is all about the team and its ability to perform, and ultimately
succeed, in its efforts to help communities prepare for and recover from an
emergency or disaster.
MIKE MCHARGUE
Florida Department of Financial Services
Division of Risk Management
200 East Gaines Street
Tallahassee Florida, 32399
“A genuine leader is
not a searcher for
consensus, but a
molder of
consensus.”
~Dr. Martin Luther King, Jr.
Continued on next page.
P A G E 5 M A Y - J U N E 2 0 1 3
SFLPP: What are some emergency preparedness tips you would offer for hurricane season, which starts June 1?
Mr. McHargue: The first thing we each should consider is personal and family preparedness. We all have home life and
personal responsibilities that must be addressed before the emergency happens or disaster strikes. Having a plan to account
for the needs of family, our homes, pets, and other important personal considerations is critical to enable us to assume the
professional duties required during a response of any type. Floridians can visit Flordiadisaster.org to access “Get a Plan.”
The Department of Health offers the Family Preparedness Guide for its members. Simply follow the instructions to complete
the family planning guide and discuss it with those we are responsible for taking care of during emergencies.
SFLPP: Let us talk now about your role at the Department of Health and your educational background. Can you describe
your duties and responsibilities as director of Emergency Operations for the Florida Department of Health, Bureau of
Preparedness and Response?
Mr. McHargue: As the Emergency Coordinating Officer for the Florida Department of Health Emergency Support Function
(ESF) 8 (Health and Medical), we are responsible for pre-incident planning through the development of preparedness and
response plans for the Florida public health and health care system. We work with public and private partners to promote
integrated planning, training, and exercises that demonstrate actual preparedness and response capabilities. During times of
emergency or periods of disaster, we provide support to the local health and medical communities in the impacted areas,
including county health departments and hospitals, to assist them toward a speed system recovery.
SFLPP: What is one accomplishment you are most proud of as the Emergency Coordinator for DOH and ESF 8?
Mr. McHargue: As a member of the State Emergency Response Team (SERT), I am most proud of the commitment that
DOH has made to emergency preparedness and response through dedicated planning, training, and exercise programs. DOH
established the Bureau of Preparedness and Response with dedicated staff to support the full range of local health and
medical capabilities within ESF 8. This includes partnerships with other state and federal agencies that have the
responsibility for licensed health care facilities of all types, emergency medical services, vulnerable populations, as well as
the traditional public environment and epidemiological health services.
SFLPP: Hurricane season starts June 1, but how important is it for state agencies to have an updated Continuity of
Operations Plan (COOP) at all times?
Mr. McHargue: Continuity of Operations Plans (COOP) are an extremely important aspect of emergency and disaster
planning. COOP allows government and private businesses to continue essential functions during or following an emergency
or disaster. COOP identifies mission-essential functions and the staff to perform them in advance to ensure the welfare of
employees and that critical services can continue. These plans can also identify emergency duty roles for leadership and
members and provide specific instructions for staff accountability, work locations, and other specific instructions.
SFLPP: How often should a state agency or university review their COOP?
Mr. McHargue: Plans should be reviewed on an ongoing basis to account for staff changes and training needs. Annual
review and updating COOP is recommended, especially as we approach the hurricane season that begins June 1.
SFLPP: Mr. McHargue, we cannot thank you enough for talking with us and sharing emergency operations best practices
with our safety professionals.
Mr. McHargue: It was my pleasure. Best wishes as we approach the 2013 hurricane season!
P A G E 6
Florida Department of Financial Services
Division of Risk Management
200 East Gaines Street
Tallahassee Florida, 32399
T he Division of Risk Management receives hundreds of strain claims
each month and many are due to the person performing the task not
being physically capable of, or properly trained for, completing the task.
Let us review a claim which occurred and outline elements to consider. No
personal information is provided and the exact details are changed to
protect the privacy of the claimant and agency or university.
The employee is a 39-year-old male who works in a maintenance
department. Based on this information, the employer could easily assume
he would be trained in proper lifting techniques and be physically capable
of moving items. On this particular day, the employee had to move a large
table that was approximately 8 feet long by 5 feet wide by 2 feet deep and
weighed 200-300 pounds: not your typical table. Not surprisingly, he
strained his back while attempting to move the table.
The table was not a normal size and weight, so you would want to consider
how often your employees are required to lift and move items and what the
average weight is. This is something you should have outlined in your job
safety analysis for your maintenance personnel. You should include a
procedure to follow in the event a task falls outside the limits. The addition
of simple wording such as, “In the event of a task requiring working above
the outlined dimensions and/or weight limits, please consult your
supervisor,” would suffice. You would want to then train your supervisors
to assess these situations and provide solutions to avoid these incidents.
You should conduct an accident investigation to determine if proper
procedures were followed. Was the supervisor aware the item was being
moved? Were additional personnel assigned to assist the employee, and, if
so, did they help and did anyone else report an injury? When conducting
your investigation, interview as many people as you can who have factual
information; do not interview personnel who were not directly involved.
The more information you have, the easier it is to develop procedures in the
future to avoid similar injuries. Also, many claims become litigated and
information obtained at the beginning of a claim is helpful. Over time,
information changes and people forget details of events. For this reason,
you should conduct your investigation as soon as possible after the incident.
Continued on next page.
P A G E 7 M A Y - J U N E 2 0 1 3
Among other things to consider when assigning a task is
whether an employee has any prior injuries. In this case,
the employee had previously filed a workers’
compensation claim for a back strain lifting a much lighter
item. This would be an indicator that this person may not
be the best choice for the task. Many times employees
volunteer to assist others to be helpful, especially when
moving items. It doesn’t have to be a large item; even a
box of paper is heavy and without thinking, an employee
will bend over and pick it up and you have a back or
shoulder injury. Put flyers on bulletin boards around your
office to remind people the proper way to lift or to ask for
help.
This claim began as a simple strain and ultimately cost the State very close to $100,000 in just
seven months. There were also the unseen costs, such as replacing the employee when he was
unable to work, employee morale, and training considerations. Additionally, it became litigated,
surveillance was assigned, and the employee chose to accept a settlement offer and had to
terminate his employment to do so. He had been with the State for over 20 years and was a
respected employee. What seemed like a simple task turned out to be a costly mistake. Train your
supervisors and employees to look for potential perils. It doesn’t have to be a serious injury to cost
a lot. Put safety first.
For additional information pertaining to your agency/university claims, contact the Division of
Risk Management, Bureau of Risk Financing & Loss Prevention at:
request reports and/or claim specifics.
The CDC has developed mobile
applications that can be viewed on
most smart phones and tablets. The
topics cover health & safety issues
from back strains to global epidemic
preparation and response. You can
download and view the application by
clicking the image to the right:
P A G E 8
Florida Department of Financial Services
Division of Risk Management
200 East Gaines Street
Tallahassee Florida, 32399
W orkers’ compensation fraud is an intentional act of deceiving,
concealing, or misrepresenting information. This results in the
injured worker receiving medical benefits, indemnity benefits (lost-time
wages), and/or working in a modified- or alternate-duty position. Annually,
an estimated 10% of all workers’ compensation claims are fraudulent
(National Insurance Crime Bureau [NICB]). The NICB states, “Workers’
compensation claimant fraud and medical fraud are significant
contributors to our nation’s annual $30 billion insurance fraud problem
(NCIB.PDF).”
This is the first of a three-part series on workers’ compensation fraud:
Part 1 – What is workers’ compensation fraud and why do employees
commit it?
Part 2 – What are red-flag indicators? How are red-flag indicators used
to determine a fraudulent workers’ compensation claim?
Part 3 – How are we doing when it comes to workers’ compensation
fraud defense? What is the legal outcome?
Generally, workers’ compensation fraud falls under one of three categories:
Claim Fraud – The claimant is not injured, is exaggerating symptoms,
and/or is malingering.
Benefits Fraud – The claimant is performing activities outside of the
functional limitations and restrictions set forth by the authorized
workers’ compensation medical provider and receiving undue medical
and/or indemnity benefits.
Disability Fraud – The claimant is working for another employer while
receiving indemnity benefits from the Division of Risk Management due
to restrictions from the medical provider stating the employee is unable
to work.
Continued on next page.
P A G E 9 M A Y - J U N E 2 0 1 3
The chief motivators of workers’ compensation insurance fraud are financial gain, paid time off
from work, or being allowed to work a light-duty position. Workers’ compensation fraud costs us
all in the long run. Additional costs associated with workers’ compensation fraud include the
expense of hiring temporary help, training replacement employees, paying overtime associated
with covering shifts, decreasing employee morale, and increasing medical and indemnity expenses
paid on fraudulent claims.
Workers’ compensation fraud can be committed by both healthcare providers and employees.
Healthcare providers may bill for services not rendered or provide unnecessary medical
treatment resulting in overutilization. This type of fraud is monitored by a third-party vendor or
the Division of Risk Management, through utilization reporting.
Another area of concern is claims for soft-tissue damage, such as muscle strain/sprain, as they are
not always based on relevant medical findings. Instead, these are based upon subjective findings
such as the claimant symptoms of tenderness, pain, throbbing, etc., in the absence of x-rays or
other diagnostic testing as proof of the injury.
Should you suspect workers’ compensation fraud, please call the Division of Risk Management at
(800) 262-4402 and speak with the assigned claim adjuster or call the Antifraud Reward Program
Hotline at (800) 378-3445.
Remember, never make accusations to or about the claimant regarding fraud; this may create
legal problems. Only discuss the claim with people associated with the investigation, such as
management and supervisors. Forward any pertinent information to the nurse case manager and
the adjuster at the Division of Risk Management; they will provide guidance on what to do next.
In most cases, once you provide your initial information to the adjuster, they will handle it from
there; the employer should be involved as little as possible. The Division of Risk Management will
be responsible for managing all of the benefits due and owed, obtaining surveillance if necessary,
and notifying the Special Investigative Unit.
In Part 2 of this series we will discuss red-flag indicators of the possibility of a fraudulent claim
and how to properly document a claim for a solid fraud defense.
Click on the badge for news and announcements from the Division of Insurance Fraud:
P A G E 1 0
Florida Department of Financial Services
Division of Risk Management
200 East Gaines Street
Tallahassee Florida, 32399
J une marks the beginning of National Safety Month, and it also
marks a new beginning for the State of Florida Loss Prevention
Program’s (SFLPP) training unit. After hosting the Loss Prevention
Academy for over 12 years as a two-day, instructor-lead event held each
July, SFLPP will make history by launching our very first online training
academy.
The purpose of the
online training
academy is to better
serve agency and
university safety
coordinators and
alternate safety
coordinators in
Tallahassee and
throughout the state.
No longer will safety
coordinators have to
wait until the month of
July to participant in valuable safety and loss prevention training sessions.
With the new online academy, safety coordinators can take safety training
classes produced by SFLPP’s training unit at anytime and at any place.
The only thing participants will need to access the training is a computer
with internet capabilities, which will not only improve your organization’s
safety program, but also its bottom line by reducing travel costs associated
with the annual Safety Academy.
The initial training module within the online academy is the course Safety
Coordinator Training 101: The Basics. This course is an introduction, and it
discusses the responsibilities of a safety coordinator as outlined in section
284.50, Florida Statutes. The other courses within the online academy will
go into more detail on the duties of a safety coordinator. The other training
modules within the academy will be made available within the upcoming
months.
As part of the online academy, participants will still receive certificates of
completion for their records and they will be able to test their knowledge.
through our interactive quiz assessments which are included in each online
training module.
Continued on next page.
P A G E 1 1
Florida Department of Financial Services
Division of Risk Management
200 East Gaines Street
Tallahassee Florida, 32399
Remember, the first Agency Safety Coordinator to return a correct crossword puzzle will
receive a prize! Submit your completed puzzle (or just the answers) by clicking on the follow-
ing link. Good Luck! SUBMIT MY ANSWERS
Across.
2. Heat related Illness can occur when an individual is exposed to ________ heat.
4. Wearing light-weight, ________ colored, loose fitting clothing will keep you cooler.
7. Taking prescription or over-the-counter _______ can affect your body’s ability to cool itself.
12. Personal Protective _______ may hold in body heat and increase core temperature.
13. Sweating depletes the body of ______ and moisture, which leads to muscle cramps.
Down
1. Heat stroke victims have a core body temperature of over one hundred _____ degrees.
3. Immediately try to cool a heat illness victim while someone seeks ________ attention.
5. Victims should not return to work until they have no symptoms and are fully _______.
6. To rapidly cool a victim, place ice on the neck, groin, and ________.
8. Seek medical attention for heat cramps that last more than _______ hour.
9. Monitoring body _____during exercise can help keep track of the amount of moisture lost.
10. Heat and ______ are extrinsic factors contributing to heat related illness.
11. Brain damage or _____ may occur if heat illness is not treated fast enough.
P A G E 1 2
S A F E T Y & LO S S P R E V E N T I O N
R. J. Castellanos, ARM, JD
Division Director
Molly Merry, CPA
Assistant Director
Shannon Segers, ARM-P
Bureau Chief, Bureau of Risk Financing & Loss Prevention
Joshua Davis, MPA
Manager, State of Florida Loss Prevention Program
Office of the Director (850) 413-4700
State of Florida Loss Prevention Program (850) 413-4756
Bureau of State Liability & Property
Claims (850) 413-3122
Bureau of State Employees’ Workers’
Compensation Claims-* (850) 413-3123
State Liability Claim Change Form (850) 413-4852
Safety Coordinator Appointment Form (850) 413-4756
Workers’ Compensation Claim Change Form (850) 413-4802
REFERENCES
Safety & Loss Prevention
Outlook Team:
Deidra Jones, CPM
Managing Editor
Juana Powell
Writer/Researcher/Editor
Melanie Cowgill
Writer/Design and Layout
To provide feedback, share
future article ideas, or to add
contacts to our distribution
list, please use the links below:
Feedback
Article Ideas
Distribution List
Florida Department of Financial Services
Division of Risk Management
200 East Gaines Street
Tallahassee Florida, 32399
NSC. (2013) NSC.org Retrieved 2013, from National Safety Month
2013:
http://www.nsc.org/nsc_events/Nat_Safe_Month/Pages/
PALAPlus.aspx
CDC. (2012). CDC.gov. Retrieved 2013, from heatandcold:
http://www.cdc.gov/nceh/hsb/disaster/heatandcold.htm
CDC. (2012). CDC.gov. Retrieved 2012, from heat stress:
http://www.cdc.gov/niosh/topics/heatstress/
DOL. (2011). DOL.gov. Retrieved 2013, from 20110426-heat-
michaels:
http://www.dol.gov/dol/media/webcast/20110426-heat-michaels/
index-english.htm#.UPcSV6zRh8E
NOAA. (2005). NOAA.gov. Retrieved 2013, from heatwave:
http://www.nws.noaa.gov/om/brochures/heat_wave.shtml
OSHA. (2012). OSHA.gov. Retrieved 2013, from heay_app:
http://www.osha.gov/SLTC/heatillness/heat_index/heat_app.html
Porter, K. A. (2004). CNN.com. Retrieved 2013, from heat-
wavw.europe:
http://www.cnn.com/2004/TECH/science/08/02/heatwave.europe/
NCIB.PDF. (n.d.). Retrieved 2013, from WorkcompProfession-
als.com:
http://www.workcompprofessionals.com/advisory/archive-0000/
images/ncib.pdf
NICB. (n.d.). Theft and fraud awareness. Retrieved 2013, from
nicb.org: https://www.nicb.org/theft_and_fraud_awareness/fact_sheets