Month: December 2022

Retaliation claims: what they are and best practices to avoid them

Posted on by Alyssa Rass

Most states have laws prohibiting retaliation against an employee for filing a work comp claim. If an employee feels they’ve been wrongfully targeted for exercising their protected right, they may in turn file a retaliation claim.

Some examples of workplace retaliation include:

  • Failing to provide a First Report of Injury Form at the time of injury or telling the employee they can’t seek medical attention for their injury
  • Terminating, laying off, demoting or transferring the employee to a less desirable position
  • Denying the employee overtime, or denying them a promotion or pay increase
  • Reducing the employee’s pay, hours or benefits
  • Giving the employee unjustifiably low performance evaluations
  • Unexpectedly changing the employee’s schedule or work location
  • Intimidating the employee or creating a difficult or unpleasant working environment for them

The cost of termination

It’s important to know that termination of employment does not terminate the work comp claim. Some employers may try to reduce or limit the payable lost-time benefits on a work comp claim by terminating the employee for a reason unrelated to the work injury, however, this idea may ultimately make the claim more costly.

Depending on the circumstances surrounding the termination, temporary total disability and temporary partial disability benefits may still be available to an employee up to the statutory caps on the benefits. Therefore, terminating the employee may cost the employer more in wage-loss benefits compared to actively working with the injured employee to return to work.

Two other examples of benefits an employer could continue to pay after terminating employment are vocational rehabilitation treatments post-injury, and assistance in their search for a new job.

If the employer is found to have terminated the employee in relation to their work comp claim, they may be responsible for paying the employee civil damages, including punitive damages. For example, Minnesota’s work comp state statute 176.82 subd. 2 states that “an employer who, without reasonable cause, refuses to offer continued employment to its employee when employment is available within the employee’s physical limitations shall be liable in a civil action for one year’s wages.”

Insurability of a retaliation claim

Retaliation claims are civil claims made in state district court, and as such are not typically covered under work comp policies. This means you would need to hire your own attorney to defend against the claim.

Tips to avoid a retaliation claim

A work comp claim requires equal cooperation from both the injured employee and the employer, but an employer can take several steps to reduce their likelihood of a retaliation claim. Here are some tips to avoid litigation:

  • Communicate with the injured employee frequently and make sure they know the company cares about their recovery. Maintain a good relationship even if there is a dispute.
  • Include non-retaliation provisions in your company policies and educate employees.
  • Document any reports of harassment or retaliation of the injured employee and investigate them. Communicate your concern to the injured employee and keep them updated on any investigation.
  • Accommodate doctor-prescribed work restrictions.
  • Have a return-to-work plan and make sure to offer light duty job options, when appropriate.
  • Document any performance concerns as they arise, and address them with the employee in an appropriate manner consistent with company employment practices and policies.
  • Consider the possible ramifications before disciplining or terminating an employee.

This is not an exhaustive list. For tips on how to avoid litigation in general, view our Avoiding Litigated Claims webinar on sfmic.com/webinars.

This is not intended to serve as legal advice for individual fact-specific legal cases or as a legal basis for your employment practices.

Reducing repetitive motion workplace injuries

Posted on by Alyssa Rass

By SFM Loss Prevention Specialist Mike Fetting, CSP, CIEE, CSPHA

The potential for injury from repetitive motion and awkward positions in jobs is widespread across many industries and businesses.

You can greatly reduce the likelihood of these injuries by implementing best practices in workplace ergonomics.

Epicondylitis, tenosynovitis, trigger finger, tendonitis, and carpal tunnel syndrome are all common repetitive motion injuries that can develop over time without correct workplace ergonomics. While these types of injuries can occur in the lower body, they are much more common in the upper body — shoulders, elbows, wrists, hands and fingers.

Force, frequency and awkward position are the three main ergonomic hazards. Repetitive motion (frequency) alone is unlikely to cause an injury. The risk elevates when frequency is accompanied by excessive force, awkward position, or both. Vibration, static postures, contact stress and cold temperatures can also play a role in increasing risk.

There are a variety of benchmarks you can use to determine basic injury potential, but a professional ergonomic evaluation is the most accurate way to assess the risk of injury. Even without a professional evaluation, you can perform you own basic risk evaluation.

Consider the following:

  • Force/intensity of exertion – Is the effort obvious? Is there a change of facial expression? Does a task using the hands require shoulder or trunk involvement?
  • Speed of work – Is the worker visibly rushed or just keeping up?
  • Duration of the cycle – Does the specific body part ever get a break while performing this task?
  • Hours per day – Does the worker perform this same task all day?
  • Awkward position – A neutral position is one in which the upper body is in the handshake position with the elbow at the side. The further away a worker’s body is from that neutral state, the more awkward the position will be, and the higher the propensity for a variety of repetitive motion injuries.

Preventing repetitive motion injury

There are three main tools for reducing the risk of repetitive motion injury: engineering, job rotation and stretching.

Engineering is easily the most powerful intervention. Changes should focus on the main risk factors: force, frequency and awkward position. Examples include changing from pistol grip to inline drivers, tilting the work, adding fixtures to hold the work, adding automation or mechanical assist to the job (or some portion of the process). It is important to work closely with employees and supervisors since changes may cause unforeseen problems. Ask employees to have an open mind and test changes for at least several days.

Once engineering is exhausted, the next most useful tool is reducing exposure through job rotation. Ideally the tasks use very different muscles, but even moderate differences can be helpful. Reducing a specific joint’s use from eight hours per day to two hours per day can cut the risk in half, according to some ergonomic models. One popular method is to change tasks at each break, including lunch. In most places, this means each employee will have three different jobs during the day. Changing tasks every two hours is even better. Some workplaces have high-demand tasks that are rotated after just one half-hour!

Lastly, stretching and flexing to warm up the muscles and get them ready for work can be a valuable addition to a complete ergonomic program. Check out sfmic.com for stretching exercises and workplace ergonomics tips.

The best solutions preserve employee health, increase production, and can even increase your job-candidate pool. Over the long term, fewer injuries often translate into lower workers’ compensation insurance premiums.

How to prevent safety hazards due to impairment

Posted on by Alyssa Rass

Drug and alcohol use and misuse are on the rise:

Most people who misuse drugs or alcohol are employed, according the Substance Abuse and Mental Health Services Administration .

If employees show up to work under the influence, they can create safety hazards for themselves and others, since drug and alcohol use can impair senses, reflexes, memory and judgment.

In addition to creating safety hazards, workers with substance use disorder also miss two more weeks of work annually, and have higher turnover rates on average than other workers, according to the National Safety Council .

What employers can do

As an employer you can establish or update your drug and alcohol program to prevent the safety risks of drug and alcohol use on the job.

A workplace drug and alcohol program typically includes:

  • A clear and communicated handbook policy on intoxication.
  • Pre-employment drug and alcohol testing. When you make a job offer, it’s contingent on passing a screening for drug and alcohol use.
  • Reasonable suspicion testing. This requires training your supervisors to identify the signs and symptoms of impairment, such as slurred speech or stumbling.
  • Post-incident testing. You can set parameters in advance for what level of event will trigger a mandatory drug and alcohol test.
  • An Employee Assistance Program (EAP). If you learn through your drug testing program that an employee is suffering from substance use disorder, your EAP can point them to resources to support their recovery.

What if there is an injury?

You may be wondering, what happens if someone is injured on the job while using drugs or alcohol?

Many states, including Minnesota, have several exceptions to the typical workers’ compensation no-fault system. One exception is the so-called “intoxication defense.” Minnesota’s law, which was first enacted in 1953, states that if the intoxication of the employee is the proximate cause of the injury, then the employer is not liable for workers’ compensation benefits. The burden of proof, however, is on the employer.

Iowa law states that if an injured employee fails the post-injury alcohol and drug tests, they will then carry the burden of proof to show that they were either not intoxicated, or that the intoxication was not the substantial factor in causing the injury.

In Wisconsin, the law states that if the employee is in violation of an employer’s policy regarding alcohol or drug use and that violation causes a work injury, the employee would lose all their rights to workers’ compensation benefits, except medical.

Colorado, which has had medical and recreational marijuana legalization in effect for several years, has one of the tougher laws. It states that if a drug test indicates the presence of a controlled substance, including marijuana, in the employee’s system during working hours, then it is presumed that the employee was intoxicated, and the injury was caused by the intoxication. The employee would then have to rebut this presumption by presenting clear and convincing evidence. Indemnity benefits would be reduced by 50% if the employer prevailed on this defense, but medical benefits would not be affected.

It’s important to report workers’ compensation injuries to SFM in a timely manner, and if intoxication could be an issue in causing the work injury, early investigation and identification of witnesses is important.

An employer should also consult an attorney if they are considering a drug testing program as some states, including Minnesota, have complex drug testing laws.

How SFM’s helping prevent opioid addiction

SFM has experts on staff who help us protect workers from the risk of opioid painkiller addiction.

Opioids are typically recommended for short-term pain relief due to an injury or surgery. We intervene in cases when workers are still taking the addictive painkillers three weeks after surgery by sending a letter to their treating physician. Doctors have been cooperative in helping get workers off these drugs before an addiction can develop.

“Opioid addiction can destroy lives and tear families apart,” said Director of Medical Services Ceil Jung. “If we can help free an individual from addiction or prevent one from ever taking root, that’s something we can really feel good about.”

This is not intended to serve as legal advice for individual fact-specific legal cases or as a legal basis for your employment practices.

Letter from the President: Strong partnerships drive solid financial results

Posted on by Sara Goese

Terry Miller
President & CEO Terry Miller

As I look at our extraordinary results over the past 12 months, I’m struck with gratitude for the unwavering belief our partners have shown in SFM. Through the whirlwinds of a global pandemic and continued economic uncertainty, policyholders are consistently choosing to stay with SFM, and independent agents are bringing more and more new accounts into the fold.

Ever since the opening chords of the pandemic, we’ve heard the refrain: “When will things get back to normal?” Well, after three years and countless bewildering developments, I’m convinced that pre-pandemic “normalcy” isn’t on its way back anytime soon. In its place, we’re discovering new realities that present us with new challenges. I’m confident that facing these challenges together will bring out our collective best. As new realities emerge, let me assure you that SFM will be a steadfast, positive partner.

We work hard every day to live up to our reputation for providing the best customer service in the business. Our commitment to service excellence is the foundation for the success we share, and I believe the results will bear that out every time.

Reflecting on the positives of the past year

As we work to finalize year-end numbers for 2022, some remarkable highlights have emerged:

  • SFM’s policyholder retention level of over 96% demonstrates industry-leading customer loyalty
  • New business continues to come in at a record pace
  • Audit additional and endorsement premium revenue continues to track ahead of our projections
  • Impact from medical inflation has been mild
  • Paid losses on older claims have come in better than expected, signaling prior year loss reserve releases
  • Policyholder surplus generation has exceeded expectations, furthering our commitment to growing surplus faster than premium
  • Our 2021 combined ratio of 90% made it 11 consecutive years below 100, and 2022 is on track to make it 12 in a row 

New mission statement, renewed dedication to our continuing mission

As we build on our foundation of exemplary service, we’ve taken some time to reflect on the words we use to describe this commitment. We saw an opportunity to develop language that expresses the “why” that motivates each of us to make a positive impact through our work. After careful consideration, we’ve updated our mission statement to:

“Inspiring safer workplaces
by protecting workers from harm
and helping the injured recover.”

While the language itself is new, the sentiment that it conveys has been central to our company culture all along. We’ve always believed in taking care of employers and their employees, and through these words, we reaffirm the principles we’ve held since the very beginning.

I would like to thank our valued agency partners for sharing our dedication to service, safety and positive results for our customers. We look forward to succeeding together for many years to come.

 

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SFM expands appetite in Kansas, preps for entrance into Tennessee

Posted on by Sara Goese

SFM’s territory expansion hits a new high as we broaden our appetite in Kansas and continue efforts to grow in Tennessee in 2023.

Agents asked, we answered

SFM is expanding our appetite in Kansas to include policies over $25,000 in premium starting in 2023.

We’ve had tremendous success with small business since we entered the state in 2020 and our team has built terrific relationships with Kansas-based agency partners. Over the past two years we’ve written approximately 500 policies across 142 governing class codes, totaling $2 million in in-force premium.

The feedback from agency partners about our service model and ease of doing business has been overwhelmingly positive, with several agencies telling us we’re their go-to work comp carrier and requesting we write some of their larger accounts. We are excited to provide this increased appetite to our partners so that they can offer our top-notch services to more Kansas employers.

A new year, a new state

SFM will start writing business in Tennessee in the first half of 2023 and we’ve already begun appointing new agency partners.

SFM’s territory expansion team continues to meet with key industry contacts in the state to develop relationships with regulators, agencies and agency associations. The company recently joined the “Big I” Insurors of Tennessee.

SFM is now licensed in 34 states. You can view a complete state coverage list on the account types and territory page of the SFM website.

 

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Encourage employers to report injuries immediately

Posted on by Sara Goese

Employers don’t always know how important it is to report work injuries immediately.

As an agent, you can provide vital information on how timely reporting can impact the trajectory of a workers’ compensation claim.

The following are just a few of the benefits of reporting injuries right away:

  • Start the claim off on the right foot.
    Reporting injuries immediately lets workers know their employer wants to see that they’re taken care of. It also gives their claims representatives time to gather all the necessary information to determine whether a claim is compensable.
  • Avoid state penalties.
    States limit the amount of time between when an employer learns of an injury, and when the claim is accepted or denied. If the claim isn’t reported to SFM in time to meet the deadline, the employer could face fines.
  • Get more out of accident investigations.
    Reporting right away gives employers and claims representatives the best chance of finding out exactly what happened while it’s still fresh in the minds of the employee and witnesses. This helps employers take steps to ensure that a similar injury doesn’t happen again. It also helps claims representatives learn whether the employee’s account of what happened is accurate and identify any third parties that might have been at fault.
  • Take full advantage of the nurse option.
    Injured workers can get a treatment recommendation from a registered nurse when employers report immediately through the SFM Work Injury Hotline. This can prevent unnecessary hassles and costs and get the injured worker the best care for the injury — whatever that may be.

Encourage employers to report injuries to SFM first

To reap the benefits of reporting right away, it’s important to have employers report injuries directly to SFM first, rather than your agency. If you would like to be notified immediately anytime a claim is reported, you can set up alerts in SFM Agency Manager (SAM). Click on “manage alerts,” and then select the “FROI received” alert option.

For your clients, our Work injury claim packet is a handy resource that employers can reference to help them report and manage workplace injuries.

 

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Get to know a claims trainee: Elyse Porter draws on past experience to serve customers

Posted on by Sara Goese

Elyse Porter
Elyse Porter

Elyse Porter is a member of SFM’s newest class of claims trainees, which started in June of 2022. She now handles claims as part of our Small Business Accounts team. 

SFM’s claims training program helps recent graduates and those changing careers get into the field of workers’ compensation claim handling. It’s one way we’re ensuring that we continue to maintain our high standard of claim handling for years to come.

Tell us a little bit about your background.
I spent the last 10 years of my career being a preschool teacher. I was living in an early education environment throughout the pandemic and then decided I needed to make a change. I have a family connection to an SFM employee who let me know about the training program. It was the right time to make the change and she had nothing but good things to say about SFM.

Is there anything you’ve been able to carry through from your preschool teaching experience that relates to your current role?
Most of teaching 4- and 5-year-olds is related to social emotional learning and the idea that we as humans need to be taught how to self-regulate and deal with the natural emotional swings that humans have throughout the day. When helping people, especially people who are going through really challenging moments in their lives, it’s extraordinarily helpful to have the background to think, “This is a person experiencing this emotion. This explains their behavior.” And, “This then is how I need to meet them in this moment,” to help them traverse what is a really complicated system when you’re not usually in it.

How would you describe your role in a nutshell?
I tend to say that I am someone who helps people navigate the workers’ comp system. My job is to help ensure that workers can understand and get access to the things they need to recover, and also to help employers through the process. Especially in small business, this is potentially their first claim ever, so they have no experience with this system as a whole. It is a lot of teaching in that I am walking people through an entirely new system that they’re unfamiliar with, but has really substantial impacts on, especially the worker — their health, their well-being, their family’s well-being. It has really substantial impacts on their daily life.

Is there a time that stands out to you when your job was particularly rewarding?
I got an email last week from an employee who recently had surgery and is now experiencing the wage-loss benefits of workers’ comp for the first time in her career. She has been in her career for decades and she sent me this really kind email just saying that she really appreciates how competent I am and that it’s made her experience better. There’s not much better than being able to meet someone in a challenging moment and making their life easier instead of adding burdens onto their plate.

What do you like about your job?
I like the variation from day to day. There’s a joke within the claims community that there is no concrete answer because every claim is different. The reality is that I can have employees with very similar injuries in similar time frames and there’s very little overlap as far as how their claims progress or what is needed with each claim, and I like that variation. I like that every day is a little bit different, but I can still make substantial and meaningful impacts in people’s daily lives.

What’s most challenging about your job?
I think the challenging bits are trying to meet people’s needs from a distance. In my prior job, I was in person. If a family, a child had an issue, I was able to build rapport in person and have meaningful conversations face to face. With this job that’s not what it is. I’m trying to build rapport and meet needs through the phone or an email and that’s a different process and just requires a little bit of a different response to it.

What words of wisdom do you have for employers?
I think earlier is always easier, so the sooner things are reported, the easier it is to allow things to progress in an easier fashion for all parties. Also, it’s OK to not know the system. I’m here to help you navigate the system. It’s complicated and really varies from case to case. Even if it is your first claim or it’s your 10th, but this one’s different, it’s OK to not know. It’s OK to rely on SFM employees to help guide you through, because that that’s what we’re here to do.

Tell us a little bit about yourself.
I am currently trying to complete a goal of hiking in every state park in the state of Minnesota. It was a hobby I started during the pandemic to help self-regulate and really work on my own well-being and mental health through a hard time. It’s been a couple years and I’m more than halfway through. I think I’ve hiked in 47 of the 66 parks now. I just did a long weekend the beginning of November and did nine parks along the North Shore and hiked 23 miles over four days.

 

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Agents can now set up AutoPay and one-time payments at binding

Posted on by Sara Goese

You can now set up AutoPay and one-time payments for your customers while binding new business in SAM.

Quick tips:

  • To set up payments, you’ll need to have your customers’ financial account information on hand when you bind.
  • We accept credit cards for accounts under $10,000 in premium.
  • For AutoPay, we require that you keep a consent form signed by the policyholder on file at your agency. You do not need to return this form to SFM.
  • Your customer will be able to manage AutoPay after binding by creating an account at sfmic.com/pay.
  • Adding payments is optional. You’ll still be able to continue through the binding process without adding payment information.

To change or cancel AutoPay, you will still need to contact SFM’s billing department, or have your policyholder create an account at sfmic.com/pay. We plan to add this ability to SAM in the future.

We’re adding this new feature in response to agent feedback. We hope it will streamline the process of setting up AutoPay for new customers for you and your agency.

 

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SFM Wisconsin pool continues to grow

Posted on by Sara Goese

Since SFM was named a servicing carrier for the Wisconsin Worker’s Compensation Insurance Pool in late 2021, new pool business has been coming in steadily and is currently ahead of plan.

SFM is one of five servicing carriers who are each handling 20% of the Wisconsin residual market as part of a five-year contract with the Wisconsin Compensation Rating Bureau (WCRB). SFM anticipates hitting the full 20% in Wisconsin assigned risk pool premium – approximately $12 million – by the end of the first quarter of 2023.

Staff expansion

To service this continued growth, SFM is expanding its Wisconsin-based assigned risk pool operations. As part of the WCRB contract, SFM initially only onboarded new business, and renewal business was kept with existing servicing carriers. As we get close to the one-year mark and in anticipation of the first round of renewals in January 2023, we added a premium auditor to our Wisconsin-based staff. We also recently hired a local claims representative. We plan to hire a second Wisconsin auditor who also has safety experience to provide both premium audit and loss prevention services to Badger State residual market employers.

Directing your clients

Agents and employers in the Wisconsin Worker’s Compensation Insurance Pool can find resources and contact information in the “State programs” section of sfmic.com.

 

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SFM Foundation holds fall event; 2023 golf events planned

Posted on by Sara Goese

The SFM Foundation’s in-person fall fundraising event returned in November 2022 after a two-year hiatus, and the results surpassed expectations. The event took in nearly $35,000, an astounding 75% above the $20,000 goal. Taking expenses into account, this results in approximately $15,000 for the Foundation’s scholarship program.

The event was hosted at the Westin Galleria Edina and included wine, beer and cider tasting, raffles, holiday shopping and a week-long virtual silent auction.

“It was wonderful to see so many returning supporters and all the new faces at this year’s event,” said SFM Foundation President Linda Williams. “The sponsors, liquor partners, donors, vendors, volunteers and attendees all played an important role in us exceeding our fundraising goal. You truly helped make a difference in the lives of the students and families impacted by work tragedies.”

Williams and the rest of the SFM Foundation team are already planning next year’s golf events. Mark your calendars for Monday, June 12, 2023, at Prestwick Golf Club in Woodbury, Minnesota, and Monday, May 22, 2023, at Hyperion Field Club in Johnston, Iowa.

The SFM Foundation provides scholarships for students whose parents were seriously injured or killed while working for Minnesota or Iowa employers. SFM Foundation is an affiliate of Kids’ Chance of America  in Iowa and Minnesota, and is also known as Kids’ Chance of Iowa. To learn more about the cause, visit sfmfoundation.com .

 

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