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Montana Workers’ Compensation Montana State Fire Chiefs Conference October 2011 Great Falls, Montana. Jeff Griffin Tammy Jeffries. A report on Firefighter Injuries and Current Coverage Issues. Four Goals. Evaluate the risk of injury to Firefighters Montana Law Current coverage practices

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montana workers compensation montana state fire chiefs conference october 2011 great falls montana
Montana Workers’ CompensationMontana State Fire Chiefs Conference October 2011 Great Falls, Montana

Jeff Griffin

Tammy Jeffries

four goals
Four Goals
  • Evaluate the risk of injury to Firefighters
  • Montana Law
  • Current coverage practices
  • Challenges
should risk leadership be a high priority in your organization
Should Risk Leadership Be a High Priority in your Organization

How big is the problem of accidents and injuries?

  • Injuries and accidents to Fire Department employees is estimated to cost over 2.7 billion dollars a year nation wide
  • Studies indicate that for every dollar an insurance company will spend in 2011 on the Public Entity claims, the Public Entity will spend an additional $4.00 in hidden costs
  • Criminal Charges - The new challenge for Public Entities
if it is predictable it is preventable
If it is PREDICTABLE It is PREVENTABLE

Regulations and standards are only the

starting point of a quality Risk Leadership

program.

  • 7.5% of all injuries and suits are attributed to “things”

Focusing on the Human Factor is the key to a successful Risk Leadership program.

  • 92.5% of all injuries have one common thread!
fundamentals of exposures
Fundamentals of Exposures

Liability

Workers’ Compensation

Property

understanding the power of the near miss
Understanding the Power of the Near Miss
  • Near Miss Relationships

1 Serious

59 Minor

600 Near Misses

understanding the power of the near miss1
Understanding the Power of the Near Miss
  • Near Miss Relationships

1 Serious

59 Minor

600 Near Misses

Cultural Drift

Flawed Behavior

rates for 2008 2009 classcode 7710
RATES FOR 2008-2009 CLASSCODE 7710
  • Alabama 3.55
  • Alaska 4.54
  • Arkansas 3.79
  • Colorado 3.66
  • Connecticut 5.02
  • Georgia 3.63
  • Hawaii 2.76
  • Idaho 3.36
  • Illinois 10.43
  • Indiana 1.88
  • Iowa 21.99
  • Kansas 4.09
  • Kentucky 2.99
  • Louisiana 3.46
  • Maine 5.18
  • Maryland 4.62
  • Mississippi 5.44
  • Missouri 4.64
  • Nebraska 9.25
  • Nevada 9.93
  • New Hampshire 9.99
  • New Mexico 4.00
  • North Carolina 3.41
  • Oklahoma 4.95
  • Oregon* 2.45
  • *Composite
  • 0.99
  • Rhode Island 3.99
  • South Carolina 4.56
  • South Dakota 10.58
  • Tennessee 10.37
  • Utah 1.31
  • Vermont 6.30
  • Virginia 2.77
  • West Virginia 4.24
  • Wisconsin 11.15
if it is predictable it is preventable1
If it is PREDICTABLE It is PREVENTABLE

Regulations and standards are only the

starting point of a quality Risk Leadership

program.

  • 7.5% of all injuries and suits are attributed to “things”

Focusing on the Human Factor is the key to a successful Risk Leadership program.

  • 92.5% of all injuries have one common thread!
workers compensation
Workers’ Compensation
  • Common-law principle – the employer was responsible for the injury or death of an employee resulting from a negligent act.
  • Achieve two goals -
    • Provide medical care and income to workers injured on the job & death benefits to families of workers killed on the job.
    • Protect employers from costly and unpredictable lawsuits by workers.
montana history
Montana History
  • 1909 - State Accident Insurance and Total Permanent Disability Fund
  • 1911 – Montana Supreme Court declares it unconstitutional
  • 1915 – Montana Legislature enacts a comprehensive Workers’ Compensation Act
exclusive or sole remedy
“Exclusive” or “Sole” Remedy
  • MCA 39-71-411

Employer is not subject to any liability whatever for the death or personal injury to an employee covered by the Workers’ Compensation Act or for any claims for contribution or indemnity asserted by a third person from who damages are sought on account of such injuries or death.

quid pro quo
Quid Pro Quo
  • Exchange of rights
    • Employees by relieving them of the responsibility of proving employer negligence
    • Employers by relieving them of liability from common-law suits involving negligence
volunteer firefighters
Volunteer Firefighters
  • Volunteers are not “employees”
    • No remuneration –they don’t receive a salary
    • Volunteer hours means – time spent in training, response time and on employer’s premise
    • Not mandatory
subsequent injury fund
Subsequent Injury Fund

Concurrent Employment39-71-118 (7) (c)

“Employment in which the employee was actually employed at the time of the injury and would have continued to be employed without a break in the term of employment if not for the injury.”

exclusions to benefits
Exclusions to Benefits
  • Owners:
    • Sole proprietor
    • Partners
  • Non- subject Corporate Officers
private carriers
Private Carriers
  • Reluctant to insure Volunteers
    • Pay benefits based upon wages where they don’t collect the premium
    • Collect premium based upon an hourly rate
    • Exposure – high risk
wage benefit calculations
Wage/Benefit Calculations
  • National Council on Compensation (NCCI) – Class Code 7704
    • Assumed wage - $300 per year
    • Minimum wage - $7.35 per hour
    • Assumed wage - $100 per year or $7.35/hr
  • Varies from Insurers – Private, Risk Pools, State Fund
independent contractor test
Independent Contractor Test
  • 39-71-120 (1): An “independent contractor” is one who renders service in the course of an occupation and:

(a) has been and will continue to be free from control or direction over the performance of the services, both under contract and in fact; and

(b) Is engaged in an independently established trade, occupation, profession, or business.

current coverage practices
Current Coverage Practices
  • Montana number of fire service agencies
    • National 300
    • Projected 400
montana number of firefighters covered by workers compensation
Montana number of firefighters covered by workers’ compensation

Covered Number of firefighters

Paid ≈ 700 ≈ 700

Volunteer  3600  5100

challenges
Challenges
  • The Law vs. common practice
    • What a court might do
    • What your liability carrier would do
challenges1
Challenges
  • The cost of workers’ compensation
challenges2
Challenges
  • Coverage Issues
challenges3
Challenges
  • Identification of agencies with little or no coverage
challenges4
Challenges
  • A possible legislative fix
challenges5
Challenges
  • Can MFCA’s have an impact on cost
montana workers compensation montana state fire chiefs conference october 2011 great falls montana1
Montana Workers’ CompensationMontana State Fire Chiefs Conference October 2011 Great Falls, Montana

Jeff Griffin

Tammy Jeffries