COMPACT

CONTENTS
2 Pharmacy fee rules approved, adopted 2 From the State Register: Provider participation list available 3 Research highlights: Minnesota Workplace Safety Report 5 Workers' Compensation Division developing performance plan 6 Future direction: forms versus data? 7 Employers reducing the number of injuries to teenage workers 9 Minnesota OSHA programs target lower injury, illness rates D-1 Court decisions: January through March 2006

for workers' compensation professionals

Minnesota Department of Labor and Industry

May 2006

TABLES
7 Indemnity claims for workers 14 to 18 years old

TRAINING
10 Registration form: Basic adjuster's training 2006

Research highlights: Minnesota Workplace Safety Report

Workers' Compensation Division developing performance plan

Court decisions: January through March 2006

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5

Decisions

Summaries of

D-1

Pharmacy fee rules approved, adopted
The Department of Labor and Industry's proposed rules related to pharmacy fee and medical coding and billing have been approved by the administrative law judge, with minor updates to the names and location of some of the documents incorporated by reference. The Notice of Adoption was published in the State Register on April 3, 2006 (online at www.comm.media.state.mn.us/bookstore/state_register_ archives.asp), which means the rules became effective April 10, 2006. The Notice of Adoption shows modifications to the amendments as initially proposed: • Proposed Amendments to Rules Governing Workers’ Compensation Medical Coding and Billing; Maximum Fees for Drugs; Minnesota Rules Parts 5221.0100; 5221.0405; 5221.0700; and 5221.4070 – www.doli.state.mn.us/pdf/pharmrul.pdf – The final adopted rule consists of the rules as proposed with the modifications shown in the Notice of Adoption.

From the State Register

Provider participation list available
Notice is hereby given that the Minnesota Health Care Programs provider participation list for April 2006 is now available. The provider participation list is a compilation of health care providers that are in compliance with the Department of Human Services (DHS) Rule 101. If a provider name is not on the list, the department considers the provider noncompliant. The list of providers is separated by provider type, each section is in alphabetical order by provider name and there is no additional information on the list other than the provider’s name. This list is distributed on a quarterly basis to the Department of Employee Relations, the Department of Labor and Industry, and the Department of Commerce. To obtain the list, call Taylor Carik, Rule 101 specialist, at (651) 431-2723 or toll-free at 1-800-366-5411. You may fax your request to (651) 431-7462 or mail it to the Department of Human Services, P.O. Box 64987, St. Paul, MN 55164-0987. Minnesota Statutes §256B.0644 and Minnesota Rules parts 5221.0500, subp. 1 and 9505.5200 to 9505.5240, also known as DHS “Rule 101,” require health care providers that provide medical services to an injured worker under the workers’ compensation law to participate in the Medical Assistance Program, the General Assistance Medical Care Program and the MinnesotaCare Program.
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Research highlights:

Minnesota Workplace Safety Report
By Brian Zaidman, Senior Research Analyst, Research and Statistics

The number of workplaces injuries and illnesses continued to decline during 2004. The most recent occupational injury and illness figures show there were an estimated 105,500 recordable injury and illness cases in 2004; about 28,700 cases involved one or more days away from work. The comparable figures for 2003 were 111,600 total cases and 29,900 days-away-from-work cases. There were 80 work-related fatalities in 2004, up from 72 in 2003, but below the 81 fatalities in 2002. The Department of Labor and Industry recently released its annual Minnesota Workplace Safety Report, detailing injury and illness rates and workplace fatalities for 2004. The report is based on the U.S. Bureau of Labor Statistics’ Survey of Occupational Injuries and Illnesses and Census of Fatal Occupational Injuries (CFOI). The report online at www.doli.state.mn.us/rsreport.html. The following are the major highlights from the report.
Nonfatal occupational injuries and illnesses

• Minnesota’s total rate of workplace injuries and illnesses was 5.3 cases per 100 full-timeequivalent (FTE) workers in 2004. This represents a 4 percent decrease from the 2003 rate of 5.5 cases per 100 FTE workers. • The rate of cases with days away from work (the most severely injured workers) was 1.5 per 100 FTE workers in 2004 and 2003. • Minnesota’s industry sectors with the highest total injury and illness rates per 100 FTE workers were: 1. construction (8.6); 2. agriculture, forestry, fishing and hunting (8.6); and 3. transportation and warehousing (7.6). • Four of the 10 industry subsectors with the highest total case rates were in private-sector and public-sector health care and social assistance. • The industry subsectors with the highest numbers of cases with days away from work were specialty trade contractors (1,970 cases) and private-sector nursing homes (1,800 cases). The top 10 industry groups accounted for 12,510 days-away-from-work cases, 44 percent of the total. Additional statistics about the characteristics of the injured workers, the characteristics of their injuries and the amount of time away from work are available for cases with days away from work. • Sprains and strains accounted for 43 percent of the cases with days away from work. The secondhighest category was soreness and pain, with 10 percent of the cases. • The back and lower extremities were the most commonly injured body parts, accounting for nearly half the cases.
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• Overexertion, often while lifting people or objects, falls and contact with objects and equipment were the most common injury events. • "Floors and ground surfaces" was the most frequent source of injury category, followed by the injured worker’s own motion or bodily position.
Fatal occupational injuries

The CFOI covers all fatal work injuries in the private and public sectors, regardless of program coverage; thus, it includes federal workers and selfemployed workers, along with all others. However, fatal illnesses (such as asbestosis) are excluded. • In 2004, 80 Minnesotans were fatally injured on the job. For 2000 through 2004, Minnesota had an average of 75 fatal work injuries a year, consisting of approximately 59 wage-and-salary workers and 17 self-employed people. • Among industry sectors, agriculture, forestry, fishing and hunting recorded the highest number of worker fatalities, with 19. Construction, with 16 cases, had the second-highest number of fatalities. • The most frequent causes of Minnesota’s fatal work injuries for 2004 were: highway transportation accidents (36 percent); contact with objects and equipment (23 percent); falls to a lower level (14 percent); and assaults (14 percent).
Minnesota OSHA activities

During federal fiscal-year 2005 (October 2004 through September 2005), Minnesota OSHA: • conducted nearly 2,600 compliance inspections affecting the workplaces of 128,000 workers; • found violations resulting in the assessment of more than $4 million in penalties; • conducted nearly 1,000 worksite consultations, affecting the workplaces of 73,000 workers, and helped employers avoid more than $4 million in penalties; and • provided 98 safety and health seminars, plus many other safety presentations and onsite training visits.

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Workers' Compensation Division developing performance plan
By Patricia Todd, Assistant Commissioner Workers' Compensation Division

To focus the Department of Labor and Industry’s Workers’ Compensation Division toward a path of continual improvement, a performance plan for state-fiscal-years 2006 through 2010 is under development. The plan includes a mission, strategic goals, strategies, actions and performance goals: • the mission defines the global job of the division; • the strategic goals define the tasks required to meet the mission; and • the strategies and actions clarify the strategic goals into a more concrete form. The Minnesota Legislature declared in Minnesota Statutes, section 176.001, that the intent of the workers’ compensation law is: “to assure the quick and efficient delivery of indemnity and medical benefits to injured workers at a reasonable cost to the employers who are subject to the provisions of this chapter.” Therefore, the following Workers’ Compensation Division mission was developed: “to assure, in an equitable and impartial manner, the quick and efficient delivery of benefits to injured workers at a reasonable cost to employers.” The strategic goals outlined in the performance plan focus on: • reducing the concerns within the system; • quick and effective delivery of benefits; and • improving the Workers’ Compensation Division’s infrastructure. The performance plan will be available in June on the Minnesota Department of Labor and Industry's Web site at: www.doli.state.mn.us/workcomp.html.

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Future direction: forms versus data?
By Patricia Todd, Assistant Commissioner Workers' Compensation Division

The Department of Labor and Industry’s Workers’ Compensation Division regulates largely through the receipt of forms submitted by workers’ compensation insurers, employees, qualified rehabilitation consultants and attorneys. Each of the forms is scanned into the document imaging system, employed by the department since the mid 1990s, and certain data elements are entered into the department’s database. The data and images of forms comprise the claim file for each workers’ compensation claim. The Workers’ Compensation Division staff uses the data and images to monitor and react to actions on each case to ensure compliance with the workers’ compensation laws. The nature of the forms, through which the data related to a workers’ compensation claim is provided to the agency, requires that certain data be captured repeatedly. This is necessary because each form effectively “stands alone” and provides no meaning unless certain identifying information (employee name, Social Security number, employer name and address, insurer name, etc.) can be attached to it. While critical to ensure the data is appropriately associated, the repeated submittal of this data means the external stakeholder must record duplicate data and the data is manually entered into the department’s databases, increasing the chances that forms may not get associated with the proper files. The Workers’ Compensation Division is evaluating the cost, time and stakeholder impact of moving from a “form driven” system to a “data driven” system. To determine the scope of this change, a high-level requirements document will be developed to: provide a technical “roadmap”; determine the impact to the workers’ compensation community and the stakeholders; and identify statutory, process and business changes. A consultant will work with various internal and external stakeholders to develop the requirements document that will: • identify stakeholders whose role in the workers’ compensation system would be impacted by the move from a “forms driven” system to a “data driven” system and respond to specific concerns raised by stakeholders, including the capacity of stakeholders to participate in a new system; • review statutes and agency rules that might impact the Workers’ Compensation Division move to a data-driven system; • develop a formless business process model for workers’ compensation case management and monitoring; and • develop cost and time estimates to complete the changes defined in the requirements document. The requirements document is the first of many steps in moving from forms to data. The intent of this project is to determine what will be required to reduce the amount of forms, duplicate data and manual processing used in the workers’ compensation system.
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Employers reducing the number of injuries to teenage workers
By Brian Zaidman, Research Analyst Research and Statistics

Summer approaches, and so does the teenage worker injury season. Since 1995, 36 percent of all injuries to workers 14 to 18 years of age have occurred during the months of June, July and August. Employers are responsible for providing a workplace that protects workers from injury, disease and fatalities. These responsibilities are even more important when there are teenage workers, who may not fully appreciate the potential dangers of work situations. Minnesota’s employers have made great progress in reducing the number of injuries to teenagers. From 1998 through 2002, there was an annual average of 664 workers’ compensation indemnity claims for teenagers. For the 2003 through 2005 period, there has been an annual average of 336 indemnity claims, a 51 percent decrease. While there has been a slight decrease in the youth employment rate since 2000, it cannot account for this large a decrease in injured workers. Workers’ compensation indemnity claims require a work disability of more than three days, and only about one-fifth of all workers’ compensation claims reach this level of severity. Thus, there are an estimated 1,700 to 2,000 claimed injuries to workers age 14 to 18 years old annually. Workers’ compensation indemnity claims from workers aged 14 to 18, for injuries that occurred between January 2003 and August 2005, were analyzed to provide the most common features of these injured workers and their injuries. • Older teenagers dominated the injury statistics; 57 percent of the injured teenagers were 18-year-olds and 27 percent were 17-year-olds.

Indemnity claims for workers 14 to 18 years old
800 700 600 500 400 300 200 100 0 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

• Workplace injuries were more likely among male workers, who accounted for 61 percent of the claims. Females accounted for 52 percent of employed Minnesotans age 16 to 19 in 2004. • As expected among this population, 58 percent of the injured teenagers had part-time or seasonal jobs.
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Employers, continues ...

Employers, continued ...

• Only 41 percent of the injured teenagers lived in the Twin Cities metropolitan area, compared to 48 percent among all indemnity claimants. As might be expected, injuries to teenagers were more common in the resort areas, which employ many youths during the summer months. The central lakes region, which includes the areas around Brainerd and Alexandria, accounted for 11 percent of the teenagers with claims, while only 6 percent of all workers’ compensation claimants lived in that area. • Teenager injuries were reported most frequently in the accommodations and food services industry (20 percent of claims) and in retail trade (19 percent of claims). • The two most common occupation types among injured teenagers were food preparation and serving occupations, and transportation and material moving occupations (mostly unskilled general laborers). Each occupation group accounted for 21 percent of the claims. • About 33 percent of teenager claims were for burns, cuts or fractures; 29 percent were for sprains and strains. This compares to 18 percent and 42 percent, respectively, among all workers. • Consistent with the types of injuries, the arms and hands were the most frequent body parts injured, accounting for 36 percent of the claims. • The types of events causing the injuries were most commonly bodily reaction and exertion and contact with objects and equipment. Each category accounted for 35 percent of the claims. Bodily reaction and exertion includes injuries caused by overexertion in lifting, pulling or pushing objects, and injuries due to movements such as bending, crawling or twisting. Some common events in the contact with objects and equipment category include being struck by falling or flying objects and being caught in running equipment. The OSHA Web site includes information for teenage workers and their employers at www.osha.gov/SLTC/ teenworkers/index.html. The Web site includes online tools that describe common hazards and potential safety solutions for teen workers and employers in the restaurant and agriculture industries. The Department of Labor and Industry’s Web site includes child labor standards information that summarizes state and federal laws concerning child labor and contains a list of prohibited work for minors under 18 years of age. The Web site is at www.doli. state.mn.us/childlbr.html.
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Minnesota OSHA programs target lower injury, illness rates
By Patricia Todd, Assistant Commissioner Workers' Compensation Division

Employers in Minnesota may be surprised to learn about a potential partner in their efforts to lower the injury and illness rates at their worksite – Minnesota OSHA (MNOSHA).

DEPARTMENT OF LABOR AND INDUSTRY Often thought of as citation-wielding regulators, MNOSHA's mission is actually to make sure every worker in the state has a safe and healthy workplace. MNOSHA has two distinct parts:
• Compliance, authorized to conduct unannounced workplace inspections to determine whether employers are complying with standards and providing a safe and healthful workplace; and • Workplace Safety Consultation, which provides consultation assistance on request to private- and public-sector employers that want help establishing and maintaining a safe and healthful workplace. Minnesota has attempted to link companies that have certain injury and illness rates to incentive programs available through MNOSHA: the Minnesota Star (MNSTAR) program, Minnesota Safety and Health Achievement Recognition Program (MNSHARP), formal partnerships and the 75/25 program.

osha

Workplace Safety Consultation (WSC) coordinates MNSHARP and the MNSTAR program; both are designed to recognize and promote effective safety and health program management. Participants are a select group of facilities that work with WSC to design and implement outstanding safety and health programs. As a result of obtaining MNSTAR or MNSHARP status, a company is exempt from MNOSHA Compliance inspections, except where there is an employee complaint, a significant chemical leak or spill, a fatality or a catastrophic situation. MNOSHA Compliance has developed formal partnerships with various industry associations to work together with employers and employees to reduce injury and illness rates. Based upon the safety and health commitments and the injury and illness rate of an employer, partners can be exempt from certain inspections and citations.

MNOSHA: 'READ ALL ABOUT IT!'
Access Minnesota OSHA's quarterly newsletter, Safety Lines, at www.doli.state. mn.us/safeline.html. To receive e-mail notification when each new edition is available online, send an e-mail message to dli.communications@state. mn.us with: 1. Safety Lines in the subject line; and 2. your first name, last name and e-mail address in the body of the message. 9
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The 75/25 program was established to create a link between workers’ compensation claim rates and MNOSHA Compliance penalties. The program is a penalty-reduction incentive program available to qualified employers. Following a MNOSHA Compliance inspection where citations and penalties are issued, a qualifying employer is provided a significant penalty-reduction if it is able to reduce its workers’ compensation claim rates. Additional information about these programs is available at www.doli.state.mn.us/mnosha.html.

labor & industry
Workers' Compensation Division www.doli.state.mn.us/workcomp.html

minnesota department of

Basic Adjusters’ Training 2006
Oct. 3 and 4
8:30 a.m. to 4 p.m.
This training is recommended for claim adjusters who have less than one year of experience in Minnesota workers’ compensation. Session topics include: • • • • • • • • • Overview of Minnesota workers’ compensation Waiting period Liability determination Indemnity benefits Rehabilitation benefits and issues Medical benefits and issues Penalties Dispute resolution How to file forms Minnesota Department of Labor and Industry 443 Lafayette Road N. St. Paul, MN 55155 Minnesota Room $175 for the two-day session (includes lunch)

Location:

Cost:

Early registration is encouraged. Each session is limited to 30 people. Classes will be filled on a first-come, first-served basis. If your reservation is not one of the first 30 received, you will be contacted about other available sessions.
If you need special accommodations to enable you to participate in this event or have questions about this training, call Jana Williams at (651) 284-5304, toll-free at 1-800-342-5354 or TTY (651) 297-4198. The Department of Labor and Industry reserves the right to cancel a session if there are not enough participants registered.

Registration form Please register me for the Basic Adjusters’ Training session checked below. Enclosed is my check made payable to: Minnesota Department of Labor and Industry. Oct. 3 and 4, 2006 Name and phone: E-mail address: Company name and address:

Number of months of experience with Minnesota workers’ compensation:
To register more than one person from your company for this class, attach a sheet listing additional names, telephone numbers and number of months of experience. Send form and check to: Attn: Chris Beaubien, Minnesota Department of Labor and Industry, 443 Lafayette Road N., St. Paul, MN 55155.

Minnesota FEI #416007162