construction injury

Preventing the Fatal 4 Construction Casualties

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Construction is known to be one of the most dangerous industries in the U.S. In one year alone, over 5,000 workers died on the job — about 15 deaths each day. These astounding numbers make the danger clear, but unfortunately, solutions aren’t as easy to identify as the hazards. Still, it is the responsibility of every construction manager and safety specialist to prevent potential deaths and injuries by proactively identifying risk factors. One of the best ways to do this is to focus on the 4 major causes of fatalities in construction. If you want to protect construction workers, pay attention to these four most common worksite hazards.

Falls

Falls are commonly identified as the single most common cause of injury and death on construction job sites, and it’s easy to see why. As construction workers are perched atop scaffolding, one misstep can result in a tragic accident. Injuries and deaths would be reduced massively by consistent use of protective equipment such as harnesses, but sometimes this equipment malfunctions due to extensive wear and tear. Scaffolds and protective equipment should always be inspected for safety to ensure that workers’ risk is minimized while they are working on an elevated surface.

Electrocution

Another common cause of death and injury is the prevalence of electrocution accidents on construction sites. Because of the nature of the job, power lines are often exposed, and insufficient warnings can cause workers to come into contact with these exposed power sources. Sometimes tools are the culprit when power cords become frayed because of wear and tear. If left unaddressed, this can cause an electrocution risk, too. Electrocutions don’t always result in death, though, and sometimes a worker is injured. In these instances, a CA workers compensation claim may follow the injury.

Struck By Objects

Sometimes, height-related construction hazards can cause the most harm when a worker is actually on the ground. These incidents occur when a worker is struck and injured by an object. This most commonly happens on construction sites when a person is working underneath scaffolding and a tool or object falls from above. If the item hits the person below, it can cause a serious injury or even death. This can be prevented by securing all loose objects that are used on an elevated surface.

Caught Between

Finally, the fourth most common cause of construction site injuries and death is the occurrence of caught-between accidents. As the name implies, this happens when a construction worker is caught between two objects that collide. This can cause the worker to become compressed between the objects, resulting in injuries or death. Construction managers should prevent caught between accidents by encouraging distance workers to maintain distance between themselves and large objects.

About Coastal Oak Insurance Services

At Coastal Oak Insurance Services, we strive to protect your personal and business assets from coast to coast. When you work with us, you’re family. Contact us today at (949) 519-3738 to learn more about how we can provide you with comprehensive and tailored insurance coverage.

workers comp fraud

Ways to Identify Workers’ Comp Fraud

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Workers’ compensation insurance is an essential part of the modern business landscape. Most businesses are required to obtain workers’ comp policies, which are designed to provide financial assistance for employees injured on the job. In the state of California, CA workers’ compensation fraud is a growing risk; employers must be watchful for warning signs that employees are filing fraudulent claims. In this guide, we will explore some of the most common red flags that may indicate workers’ comp fraud.

How Does CA Workers’ Compensation Work?

Most California business owners are required by law to have CA workers’ compensation policies in place. These policies are typically obtained from private insurers or state-run insurance companies. If an employee is injured or made ill on the job, he or she is eligible to file a claim. As a valuable employee benefit, workers’ comp helps to cover costs associated with:

  • Medical care
  • Rehabilitation
  • Lost wages
  • Training or retraining for employees to reenter the workforce

Under most state laws, if an employee is injured in the course or scope of work, he or she is covered. Certain injuries are not covered; claims against a CA workers’ compensation policy may be denied if the injury resulted from violations of company policy, self-inflicted injuries, or injuries occurring outside the work environment.

The Risks in Workers’ Comp Fraud

Employers know that fraudulent claims against any insurance policy may result in skyrocketing premium expenses and the costs associated with managing claims. The same is true with fraudulent claims associated with workers’ comp. For California employers, the risk of CA workers’ compensation fraud looms large. The COVID-19 pandemic led to a rise in fraudulent claims, especially as state legislations made it easier for employees to file claims that they were infected by the virus in their workplaces. It is not only employees filing an increasing number of fraudulent claims; employers may engage in fraudulent practices and medical providers may also make fraudulent claims to get more money from treating injured workers. Because workers’ comp fraud costs about $7.2 billion each year, according to the National Insurance Crime Bureau, employers have a financial stake in fighting against insurance fraud.

Red Flags to Watch Out For

Bogus claims against CA workers’ compensation policies can take many forms. Typically, a claimant will:

  • Fake an injury
  • Claim an injury that happened outside the workplace.
  • Claim an old injury that may not have healed properly.
  • Claim that an injury is worse than it is.

What are the warning signs or red flags of a fraudulent claim? As with the claims themselves, the red flags vary and may include:

  • No witnesses to the initial injury.
  • Injured workers refusing treatment.
  • Injuries that occur just before an employee is disciplined, demoted, or terminated.
  • Conflicting information or changes in an injured worker’s story after an injury occurs.
  • Injuries that occur just before a weekend or holiday.
  • Injuries that occur just before a contract expires.
  • Employees that may be difficult to contact after the injury occurs.
  • Delays in reporting an injury incident.
  • Delays in seeking medical care for a workplace injury.

Employee history is another potential red flag. Employees with a track record of filing CA workers’ compensation claims – even from previous employers – may continue to file fraudulent claims in order to get extra money. Employers must carefully scrutinize potential employees during the hiring and onboarding process to weed out those with excessive or spurious claims in their work histories.

Providers in the medical and legal fields may also attempt to commit fraud. Warning signs for provider-based fraud may include:

  • Billing for services not rendered.
  • Inflating the cost of medical care and services.
  • Billing for treatment of workers who were never seen by the provider.
  • Billing for services that do not make sense in relation to the claimed injury.
  • Billing for medical care continues for a long time with no apparent improvement in the employee’s injuries.

CA Workers’ compensation continues to be a valuable and important benefit for employees. With careful management of claims, including evaluating claims for potential fraud, employers can minimize the risks associated with this insurance. Workers’ comp fraud harms everyone, not just the employer.

About Coastal Oak Insurance Services

At Coastal Oak Insurance Services, we strive to protect your personal and business assets from coast to coast. When you work with us, you’re family. Contact us today at (949) 519-3738 to learn more about how we can provide you with comprehensive and tailored insurance coverage.

workers' comp costs

How Small Businesses Can Manage Workers’ Comp Costs

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Required for most employers, workers’ compensation insurance is a valuable benefit for employees who become injured in the workplace. For employers and their workers in the state of California, CA workers’ compensation covers expenses associated with medical care, rehabilitation, and lost wages, allowing injured employees to rejoin the workforce as quickly as possible. Businesses must control the costs of workers’ compensation plans. Controlling claims costs is a risk management approach that is just as important as CA workers’ compensation benefits themselves.

Direct and Hidden Costs in CA Workers’ Compensation Insurance

Many small businesses that obtain workers’ compensation plans for their employees discover that there is more to these plans than the direct costs of providing financial support for injured employees. In fact, so-called “hidden costs” of workers’ comp plans can derail even the most financially-stable small business. According to one study conducted by the Occupational Safety and Health Administration, hidden costs may exceed direct costs by as much as 4.5 times. Some of these hidden costs include:

  • Attorney fees associated with legal claims against the business
  • Lost time and productivity
  • Business interruption
  • Insurance premium increases resulting from frequent or high-value claims
  • Safety violations and subsequent penalties

Workers’ compensation plans offer many benefits to both employer and employee. Unfortunately, excessive claims can result in skyrocketing premium costs. This is perhaps the most common hidden cost for small business owners, yet the easiest to address, as we will explore in the next section. In general, failure to account for or manage hidden costs represent the biggest factors employers face when administering a CA workers’ compensation plan.

Safety-Oriented Workplaces: Key to Saving on Workers’ Comp Expenses

It should go without saying that reducing the frequency and severity of workplace injury claims is the leading way that small business owners can save money on CA workers’ compensation. There are several steps businesses can take to implement or improve safety-oriented programs in the workplace. First, safety begins with training. Employee and staff safety training should include:

  • OSHA regulations specific to your industry.
  • Safe use and maintenance of equipment.
  • Safe lifting practices.
  • Hazard identification and reporting practices.
  • Incident reporting – who to call and when to call if an injury incident occurs.
  • Proper use of personal protective equipment (where applicable).

Safety training is always an important part of onboarding new employees, but training should also be conducted on a regular and ongoing basis for all company stakeholders.

Managing injury claims is another important aspect of controlling CA workers’ compensation expenses. While a claim-free workplace should be the goal of every small business owner, the reality is that at some point, an employee can and will become injured. To manage claims, industry best practices include:

  • Seeking medical care for the injured worker immediately.
  • Collecting and maintaining documentation related to the injury.
  • Reporting the claim to insurance carriers promptly.
  • Provide options for light-duty work once a worker is released from medical care, allowing the injured worker to return more quickly.

After an injury incident, it is crucial to conduct a safety audit to uncover the circumstances leading up to the injury. All hazards or unsafe workplace conditions must be identified; armed with this information, employers can correct these conditions to help prevent a subsequent employee injury from occurring. With safety-oriented practices, claims management, and the valuable benefits of CA workers’ compensation insurance, small businesses can maintain control over insurance expenses while helping to ensure a safe workplace for their employees.

About Coastal Oak Insurance Services

At Coastal Oak Insurance Services, we strive to protect your personal and business assets from coast to coast. When you work with us, you’re family. Contact us today at (949) 519-3738 to learn more about how we can provide you with comprehensive and tailored insurance coverage.

workers' compensation

Debunking Prevalent Workers’ Compensation Myths

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Most California employers are required to carry worker’s compensation insurance, a valuable employee benefit to those workers injured on the job. CA workers’ compensation also provides certain benefits to employers by helping to reduce liability exposures related to workplace injuries. Unfortunately, there are many myths surrounding this insurance protection; in this guide, we will uncover the truth behind some of the most prevalent CA workers’ compensation myths. 

The Role of Workers’ Compensation Insurance

Workers’ compensation (“workers’ comp) insurance is designed to provide financial support for employees injured or made ill in the scope of their work activities. It serves as an important employee benefit to most employees in the state of California, helping to cover costs associated with medical care, lost wages, and training or retraining to reenter the workplace after recovery. Most states require employers to obtain and to maintain this insurance coverage; CA workers’ compensation laws benefit both employee and employer, as the typical workers’ comp helps to shield employers from liabilities associated with a workplace injury or illness.

The Myth About Injury Occurrence

Many employees believe that in order to be covered by a CA workers’ compensation insurance plan, they must have received their injury on the jobsite. This is not accurate; while most injuries do occur on work premises, employees who are injured while conducting work operations are covered regardless of where the incident takes place. For example, a worker traveling between jobsites or in a remote work area is covered. As long as the worker was injured in the course or scope of their employment duties, they can receive benefits under the workers’ comp plan.

Injuries in the Workplace: A Pervasive Myth

One of the most common myths associated with CA workers’ compensation insurance is that workers must be injured doing their jobs in order to receive benefits. The truth is a bit more complex, however; while most injuries occur as a direct result of workplace activity, workers are generally covered in both job-related and non-job-related injury events. An example of this would be a worker who is walking between locations in a warehouse and is struck by a piece of equipment or falling materials. This worker was not injured directly as a result of conducting workplace activities but was on the job site. Again, injuries in the course or scope of employment duties are covered.  

The Myth About Qualifying Injuries

Workers and employers alike do not always have a clear understanding of what types of injuries are covered under CA workers’ compensation plans. Because of confusion or fear, many employees do not report their workplace injuries, potentially because they believe such an injury is not covered. Instead, workers will use other healthcare insurance or pay out of pocket for medical treatment.

To dispel this myth, it is critical to understand that according to most state workers’ comp guidelines, any injury occurring at work will qualify for a claim, no matter how trivial the injury may be. Employees injured at work can and should file a claim; in most cases, their injuries are eligible for benefits. 

Getting Maximum Benefits: The Employer Assistance Myth

When a worker is injured on the job, he or she may believe that the employer has a duty to help the injured worker get the most benefits available under the CA workers’ compensation plan. Unfortunately, this is a common myth. The reality is that once an injury report is completed, the employer has little to do with the claims process and the insurer handles distribution of benefits. It is only when the employer disputes the material facts of an injury claim that they have an active role in the claims process. It is up to the employee to do what is necessary to receive maximum benefits if he or she is injured in the workplace.

The Retaliation Myth

If a worker is injured and files a claim to receive CA workers’ compensation benefits, can the employer retaliate by firing the injured worker? This myth is so common that many injured employees fail to file injury claims out of fear of retaliation. To dispel this myth, it is essential to understand that retaliation is expressly forbidden by a wide range of local, state, and federal regulations. An injured worker has specific rights under these regulations and are allowed to seek workers’ compensation benefits if they are injured in the course or scope of their work duties. 

Final Thoughts on Workers’ Compensation Benefits

CA workers’ compensation remains an important employee benefit that protects both workplace injury victims and their employers. With this insurance in place, injured workers can return to the workplace more quickly while avoiding many of the financial hardships associated with an injury. For employers, maintaining workers’ comp insurance helps to avoid regulatory penalties as well as legal claims filed by injured workers, ultimately saving money over the long term. 

About Coastal Oak Insurance Services

At Coastal Oak Insurance Services, we strive to protect your personal and business assets from coast to coast. When you work with us, you’re family. Contact us today at (949) 519-3738 to learn more about how we can provide you with comprehensive and tailored insurance coverage.