The number of paid workers’ compensation claims fell 43% relative to the number of employees from 1997 to 2010, the 2010 “Minnesota Workers’ Compensation System Report” released Tuesday by the Minnesota Department of Labor and Industry shows.

The report says the workers’ compensation claim rate fell to 4.9 claims per 100 full-time-equivalent employees in 2010 from 8.7 in 1997.

Department Commissioner Ken Peterson said the report “underscores that Minnesota’s workplaces have become much safer for employees and comparatively less costly for employers since 1997.”

Peterson added that “as has been the case for the past few years, medical treatment for injuries was the chief cost driver for the system, increasing annually per claim by more than 5% above average wages since 1997.”

The report also shows that the 2010 total workers’ compensation system cost was $1.25 per $100 of payroll, the lowest since 1997.

Because of the falling claim rate, total benefits, including medical, cash and rehabilitation, fell 6% relative to payroll between 1997 and 2010, the report notes in its executive summary. Medical care accounted for the largest share of total system cost at 35%.

The total cost of Minnesota’s workers’ compensation system was an estimated $1.33 billion for 2010, or $1.25 per $100 of payroll — the lowest since 1997.

In 2010, on a current-payment basis, the three largest components of total workers’ compensation system costs were medical benefits (35%), insurer expenses (31%) and indemnity benefits other than vocational rehabilitation (30%).

Pure premium rates for 2012 were down 27% from 1997, their lowest level since that year.

Adjusting for average wage growth, medical benefits per insured claim rose 90% from 1997 to 2009, while indemnity benefits rose 34%. All of the increases for indemnity benefits occurred by 2003, the report says.

The average 2009 workers’ compensation claim cost $9,080 for medical and indemnity benefits combined (including vocational rehabilitation).

Relative to payroll, indemnity benefits were down 14% between 1997 and 2010, while medical benefits were approximately the same, the department says. “This reflects the net effect of the falling claim rate and higher benefits per claim,” the report comments.

Medical and indemnity benefits (including vocational rehabilitation) amounted to $0.87 per $100 of payroll for 2010.

The report says that “by counteracting the increasing trend in benefits per claim, the falling claim rate has kept system cost per $100 of payroll at historically low levels.”

From 1997 to 2010, after adjusting for average wage growth, paid indemnity claims showed:

— Total disability benefits rose 20%.
— Temporary partial disability benefits fell 15%.
— Permanent partial disability benefits fell 31%.
— Stipulated benefits rose 87% (stipulated benefits include indemnity, medical and vocational rehabilitation benefits).

Claims with stipulated benefits made up 24% of paid indemnity claims for 2010, up from 17% for 1997.

In vocational rehabilitation:

— The participation rate increased from 15% to 23% of paid indemnity claimants from 1997 to 2010.
— The average service cost per participant was $8,830 for 2010, 25% higher than 1998 after adjusting for average wage growth.

Vocational rehabilitation accounted for an estimated 3.0% of total workers’ compensation system costs in 2010.

Twenty-one percent of paid indemnity claims for 2010 had one or more disputes of any type, an increase from 16% in 1997.

“The leading components of this increase were medical disputes, up 92%, and vocational rehabilitation disputes, up 69%,” the report says.

The percentage of paid indemnity claims with claimant attorney involvement rose 41% during the same period.

The total number of dispute resolutions at the department rose 27% from 1999 to 2011. Most resolutions at the department are  by agreement among the parties.

“At the Office of Administrative Hearings since 2001, the numbers of settlement conferences, discontinuance conferences and medical and rehabilitation conferences have fallen, but the number of hearings has shown little net change,” the report comments.

Source:  Minnesota Department of Labor and Industry, WorkCompCentral

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The San Bernardino County District Attorney’s Office filed fraud charges against the owners of a Southern California construction company for allegedly underreporting payroll to their workers’ compensation carrier.

The District Attorney’s Office charged Gary Renshaw, 50, his wife Tammy Renshaw, 50, and their daughter Brittney Renshaw, 23, with nine felony counts of committing fraud to obtain workers’ compensation insurance at a reduced rate. Gary and Tammy owned GLR Companies Inc. in Yucaipa, and Brittney was an employee of the company.

Investigators allegedly uncovered evidence that the company was underreporting payroll and misclassifying employee information to the State Compensation Insurance Fund. State Fund said it became aware of the alleged fraudulent activities following a 2008 investigation by the Division of Health and Safety (Cal-OSHA) into a job-related death at GLR Companies, according to the District Attorney’s Office.

The three were also charged with tax evasion for failing to collect taxes from their employees or file tax returns from 2009 through 2011.

In a separate complaint, the District Attorney’s Office alleged that Andrew Renshaw, 27, the son of Gary and Tammy, Tammy’s mother Ann Louise Denos, 73, and Brittney falsified mortgage information to facilitate the purchase of homes.

If convicted on all counts, Gary and Tammy face 15 years and 4 months in state prison; Brittney faces 18 years in prison; and Andrew Renshaw and Denos face 5 years and 4 months in prison.

Source: San Bernardino County District Attorney’s Office, WorkCompCentral

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By Michael Whiteley, Eastern Bureau Chief

An auditing supervisor for the State Workers’ Insurance Fund (SWIF) was on the payroll of three Pennsylvania staffing companies for at least a decade before he was arrested on bribery charges Monday by a special investigations unit of the Pennsylvania Attorney General’s Office, according to the criminal complaint filed against him.

An affidavit filed Monday in connection with James McDonnell’s arrest alleges McDonnell became a private consultant for American Personnel Services, Wallieo Enterprises and Certified Flagger Co., three staffing companies based in Hazelton, Pa. All three companies are owned by Paul D’Andrea.

To keep the relationship a secret, D’Andrea paid the bulk of the money — $73,254.58 – to the SWIF supervisor’s wife, Michelle McDonnell, in the form of weekly consulting fees and commissions, the complaint alleges.

D’Andrea paid James McDonnell 1% commissions on every new client employer he brought to the staffing companies, according to the affidavit, written by Senior Special Agent Joseph A. Farkus.

In return, James McDonnell secured premiums refunds totaling $91,662 for D’Andrea’s staffing companies between Oct. 11, 2007, and October 8, 2010, according to the complaint. Investigators said no supporting documents were available at SWIF for the refunds.

McDonnell, 53, and 44-year-old wife were arrested on a variety of charges alleging they engaged in a conspiracy to solicit and accept bribes from at least 15 SWIF policyholders in exchange for securing policy refunds.

The McDonnells are scheduled to appear at a preliminary hearing in Pennsylvania Commonwealth Court in Scranton, Pa. on Monday.

They could not be reached for comment this week, and D’Andrea declined to discuss the case.

“I can’t discuss anything until the preliminary hearing on Monday,” he told WorkCompCentral.

SWIF, Pennsylvania’s largest workers’ compensation carrier, operates as a division of the Pennsylvania Department of Labor and Industry. The insurer, Pennsylvania’s carrier of last resort, referred all questions to the Department of Labor and Industry.

Labor and Industry spokesman Christopher Manlove said Thursday that James McDonnell has worked at SWIF for the past 20 years and 36 weeks and is paid $51,228 a year. He was suspended without pay or benefits Monday pending conclusion of the case.

Manlove referred further questions to Attorney General Linda Kelly. Lauren Bozart, Kelly’s assistant press secretary, released copies of the affidavits filed in connection with the McDonnell’s arrests, but declined to comment further on the case.

“It’s part of an ongoing investigation,” she said. “I couldn’t comment beyond that.”

The bribery case is the latest in a series of public relations problems for SWIF.

Last month, State Auditor Jack Wagner accused SWIF of lax management of a contract that paid Pennsylvania-based medical bill review firm MedRisk $4.9 million during 2009 and 2010. Wagner said $2.5 million of that went to pay MedRisk for services duplicated by SWIF workers.

Wagner said SWIF paid another $73.7 million to an unrelated vendor, StoneRiver, to provide a computer system for which costs had been projected at $10.6 million.

Wagner referred the audits to Kelly’s office for further investigation last month. His office did not return a phone call Tuesday to discuss the status of that case.

The Scranton Times-Tribune reported last September that McDonnell and SWIF were named as co-defendants in a sexual harassment suit filed by one of McDonnell’s former employees. The newspaper said the woman, identified only as Jane Doe, accused McDonnell of making sexual advances and said SWIF managers ignored her complaints. The case is still pending, according to news reports.

Manlove said Tuesday he could not provide details on the sexual harassment case.

“That’s about all I’m going to be able to say about James McDonnell at this time,” Manlove said Tuesday.

Cynthia L. Pollick, a Philadelphia attorney representing the woman, did not return a telephone call.

Another former SWIF employee, Peter David Brigido, 53, was accused in November 2010 of operating a football and basketball betting pool out of SWIF’s headquarters in Scranton. Brigido was charged with pool-selling and bookmaking, according to a news report at the time.

Monday’s charges identify three Pennsylvania employers who engaged in bribery discussions with James McDonnell.

The affidavits allege that Michelle McDonnell existed as an employee of Wallieo Enterprises only on paper. Investigators said D’Andrea spoke to her on two of three occasions during the relationship.

“For all practical purposes, Michelle McDonnell is a ghost employee,” Farkus, the state investigator, said in one of the affidavits.

Through the arrangement, D’Andrea paid the McDonnells a 1% commission for each new employer McDonnell brought to the staffing company. The payments were based on the size of each customer’s payroll.

Investigators allege that James McDonnell also struck a deal with R.N. DeMeck Roofing and Siding Co., based in Madison Township, Pa. McDonnell allegedly approved premiums reductions totaling $79,636 between March 13, 2008, and Jan. 20, 2011. Investigators said DeMeck was a client of D’Andrea’s staffing companies and obtained the refunds without proper documentation.

Robert DeMeck, the roofing company owner, told investigators that, in return for the premium reductions, he put Michelle McDonnell on his payroll from January through April 2011 to do housecleaning for him and paid her $200 a week.

DeMeck told investigators James McDonnell reversed a $54,000 premium increase for the contractor and secured a premium refund of an additional $10,000.

DeMeck said he became convinced after further discussions with McDonnell that he would have to use payroll services provided by Wallieo, one of D’Andrea’s companies, to “avoid any future hassles with SWIF.”

DeMeck told investigators James McDonnell also asked the roofing contractor for loans. He said he may have loaned McDonnell between $10,000 and $15,000 beginning in 2010. He said the loans were never repaid, according to the affidavit.

Thomas Stone, the owner of Scranton-based furniture company Stone Office, told investigators he met with James McDonnell in October 2010, after a SWIF audit boosted the company’s premiums by $50,000, according to the affidavit.

Stone said McDonnell offered to get Stone’s premiums reduced, “but you will have to pay me for the help,” investigators reported. Stone said he turned down the auditor’s offer and, instead, successfully appealed the case and got the premiums reduced by $18,000, the affidavit states.

Neither Stone nor DeMeck returned telephone calls Tuesday.

Source:  WorkCompCentral

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The president of a West Florida construction company was arrested last week on charges of falsifying payroll information to reduce workers’ compensation premiums paid to Guarantee Insurance Co. and illegally using a “shell company.”

Florida Chief Financial Officer Jeff Atwater said Friday that Randall Morton Seltzer, 43, the president of Navarre Industries, was charged with workers’ compensation fraud and grand theft, following an investigation by the Department of Financial Services (DFS) Division of Insurance Fraud.

“Workers’ compensation insurance is vital to the health and protection of businesses and Florida’s economy as a whole,” CFO Atwater said. “Just last week, the Legislature passed reforms that target schemes just like this one that are diverting a billion dollars from Florida’s economy.”

Investigators said Seltzer systematically underreported his company’s payroll and used Hip Roof & Valley, a shell company he chartered in 2011, to continue operating despite two stop-work orders issued against Navarre Industries during a five-year period.

The Florida Legislature last week passed House Bill 1277, which allows DFS to conduct unannounced inspections of check-cashing houses. Atwater contended construction businesses in Florida are obtaining minimal workers’ compensation coverage through shell companies and laundering their payrolls through check-cashing houses to avoid detection by the DWC.

If convicted, Seltzer faces up to 30 years in state prison and could be ordered to pay more than $2.8 million in restitution.

Source: DFS, WorkCompCentral

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TALLAHASSEE – Florida Chief Financial Officer Jeff Atwater announced today the conviction of aJacksonville man in an elaborate workers’ compensation fraud scheme.  David Rodriguez Socarras appeared before the Fourth Judicial Circuit Court Monday and pled guilty to five charges, including application fraud and workers’ compensation fraud, for running a “shell company” to pay undocumented workers and avoiding workers’ compensation premiums.  Socarras was sentenced to four years in prison and ordered to pay more than $400,000 in restitution.  “Employers who commit workers’ compensation fraud put workers at risk and drive up premiums for all businesses, and it will not be tolerated,” said CFO Atwater. “This conviction is an acknowledgment of the hard work and dedication of our fraud investigators. Not only are we going to track down these fraudsters, but we are developing strong cases that will get them off the streets and behind bars where they belong.”

 An investigation by the Florida Department of Financial Services, Division of Insurance Fraud, revealed that in October 2007, Socarras used a fraudulent Social Security card and birth certificate to obtain an ID card with the alias Harry Marrero Vasquez.  He then established a shell company with the name HMV Construction in order to obtain a minimal workers’ compensation policy.  With the insurance policy in hand, Socarras proceeded to cash 80 checks at a Jacksonville check cashing store for a total of more than $2.9 million.  The cash was used to pay groups of undocumented workers, and by using the shell company, Socarras avoided paying the necessary workers’ compensation premiums and taxes needed for a payroll of that size.

 In response to CFO Atwater’s continued crackdown on insurance fraud in Florida, investigators have arrested 529 fraudsters since the start of the year, including 147 workers’ compensation fraud arrests. 

 The Division of Insurance Fraud investigation was assisted by the department’s Division of Workers’ Compensation, U.S. Immigration and Customs Enforcement (ICE) and the Jacksonville Sheriff’s Office. The case was prosecuted by Assistant State Attorney Joseph Licandro from the Office of State Attorney Angela Corey.

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Each state has its own laws and regulations that control the workers compensation program in their state, and these laws vary from state to state.  In most cases, if you are an employer with at least one employee, you are required to carry workers compensation insurance, however, some states allow certain, smaller companies an exemption to their workers comp laws.  Unfortunately, these exemptions also vary from state to state making it difficult to determine if you qualify or not.  Small business owners that conduct business across different states may find the task particularly daunting.  For examples in one state, you might be exempt if you have only 3 employees, while, in others you may be exempt if you have 5 employees.

So, how can you determine the best course of action?  The easiest way is to simply pick up the phone to call your friendly advisor at the Workers Comp Co-Op.  We are always eager and willing to answer any question you might have – even if you aren’t a current client!

Remember, even if your state considers your business exempt, it may still be in your best interest to participate in a workers compensation program.  If your participation is NOT state mandated, you can still participate voluntarily. Contact WCCOP to learn more today!

Here is a list of the general state requirements:

State	Employers Subject to Workers Compensation Laws
AK	All employers with one or more employees
AL	All employers with five or more employees
AR	All employers with three or more employees, except for employers engaged in repair work (two or more), contractors who subcontract part of their work (one or more), and subcontractors (one or more)
AZ	All employers, including sole proprietors
CA	All employers and employees
CO	All employers with one or more employees
CT	All employers and employees
DC	All employers and employees
DE	All employers and employees
FL	All employers with four or more employees (one or more employees, for construction businesses)
GA	All employers with three or more employees
HI	All employers with one or more employees
IA	All employers and employees, including proprietors and partners who elect to be covered
ID	All employers and employees
IL	All employers and employees
IN	All employers and employees
KS	All employers and employees except employers whose payroll for the preceding year was less than $20,000
KY	All employers with one or more employees
LA	All employers with one or more employees
MA	All employers with one or more employees.
MD	All employers with one or more employees
ME	All employers and employees
MI	All employers with three or more employees
MN	All employers and employees
MO	All employers with five or more employees OR construction employers with one or more
MS	All employers with five or more employees
MT	All employers and employees
NC	All employers with three or more employees and all employment that exposes employees to radiation
ND	All employers and employees
NE	All employers with one or more employees
NH	All employers with one or more employees.
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NM	All employers with three or more employees OR one or more employees for state-licensed construction businesses
NV	All employers and employees
NY	All employers with one or more employees
OH	All employers with one or more employees;
OK	All employers and employees
OR	All employers with one or more employees
PA	All employers and employees
PR	All employers and employees
RI	Employers with one or more employees
SC	All employers with four or more employees
SD	All employers and employees
TN	All employers with five or more employees  OR one or more employees for employers that mine or produce coal.
TX
UT	All employers with one or more employees
VA	All employers with three or more employees
VT	All employers and employees
WA	All employers and employees are subject to workers’ compensation laws.Â
WI	Employers who pay wages of $500 or more in a calendar quarter
WV	All employers with one or more employees
WY	All employers and employees

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Creating a compensation package is not as simple as adding salary with benefits. There are many important factors to consider:

• If you offer incentives and/or bonus plans, you need to have very clear guidelines to minimize confusion and possible liability issues. These should not be seen as guaranteed, but should be rewards for performance by an individual, team or company.
• Before offering a benefit plan, know the precise cost of each component. Do not consider today’s costs only, look at long-term expenses.
• Do not forget to calculate employer payroll taxes into your overall payroll budget. Social Security, Medicare tax, unemployment insurance (both state and federal) and Workers’ Compensation all add to the total cost.
• Determine if it is better to pay an hourly wage or a straight salary to employees.
• Include payroll budgeting. Payroll budgets should include wage and salary payments, commissions, bonuses, incentive plans, payroll taxes and insurance.

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