Reasons why you should read these slides: It’s totally focused on your industry, versus a general industry session. We discuss the new prospective billing - you need to know about this! The Ohio Bureau of Workers’ Compensation (BWC) requires employers who participate in a group/group retrospective rating plan and have had a workers’ compensation claim within the “green year” to complete two hours of mandatory safety training during the each policy year. This means that companies who are group/group retrospective rated participants with an injury claim must attend safety training, regardless of the size or severity of the claim. Per BWC guidelines, each company policy owner is required to fulfill separately the two-hour training requirement and may designate any company representative to attend. Failing to meet this requirement could jeopardize your group/group retrospective rating program status. The ORA is one of Ohio’s leading providers of foodservice-specific health and safety educational initiatives. The association links members of the foodservice industry with industry leaders that take an active involvement in educating them about procedures and policies that can reduce and prevent accidents in their establishments. The association understands that members don’t have the time and availability to sit through hours and hours of educational meetings that focus on addressing all of the health and safety concerns that can befall a restaurant. That’s why we target our educational seminars to specific areas of operation, like back-of-the-house and front-of-the-house training programs. Reading these slides will not give you credit. You must participate in live educational event.

1. June 30, 2014
1:30 p.m. - 3:30 p.m.
Heartland Payment Systems is the Lead
Sponsor of all RES events.
The ORA Restaurant Education Series (RES) provides
members free access to educational events that help them
sustain and grow their businesses and are developed based on
member feedback. RES events support a key ORA initiative:
the education of our members.

3.  Brad Hunt, RiskControl360° Moderator of the conversation
 Developing a Culture of Safety: Strategies to Support Safe
Work Practices: Doug Wiegand, National Institute for
Occupational Safety & Health
 Controlling the Cost of Injuries - Third-Party Administrator
Perspective: Jim Wirth, CareWorks Consultants, Inc. (CCI) &
RiskControl360°
 Controlling the Cost of Injuries - Managed Care Organization
Perspective: Derek Stern, CareWorks
 Safety & Labor Law - Top OSHA Citations for Restaurants:
Keith Pryatel, Kastner, Westman & Wilkins, LLP
Expert Speakers

5. • Open and close your Panel
• View, Select, and Test your audio
• Submit text questions
• Q&A addressed at the end of today’s
session
• Everyone will receive an email with a
link to view a recorded version of
today’s session
• Your feedback is important! You will
receive a prompt to complete a
survey at the end of the session

6. When a 1,000 things pile up, it’s easy to overlook the importance of
health & safety issues - that’s dangerous!
The Health & Safety section of the ORA’s website helps you stay on
top of concerns, offering solutions to today’s restaurant, food, and
alcohol safety issues.
www.ohiorestaurant.org/healthandsafety
Health and Safety
 Restaurant Safety &
Training
 Information Resources
 Policies & Guides
 Videos & Multimedia
 Restaurant Safety
Consultants
 Food Safety
 Alcohol Safety

8. Douglas Wiegand, Ph.D.
National Institute for Occupational Safety
and Health
Disclaimer: The findings and conclusions in this
presentation have not been formally disseminated by
the National Institute for Occupational Safety and
Health and should not be construed to represent any
agency determination or policy.

9.  The safety culture of an organization is the
product of individual and group values, attitudes,
perceptions, competencies, and patterns of
behavior that determine the commitment to, and
the style and proficiency of, an organization’s
health and safety management (HSC, 1993).
 Or, the way we do things around here.

10.  John’s manager sees that John is chopping
vegetables at an amazing speed…
 Should the manager:
A: Nod in approval; the food will be prepped on time
B: Say nothing
C: Tell John “Be Careful”; we don’t want him to cut
himself and stop working
D: Ask John why he is working so fast; try to understand
why John feels like he needs to rush

11.  Attitude vs. behavior change
 Behavior is easier to see, and easier to change
 Change the behavior and attitude may follow

12. Attribution of the causes of injuries
 Chance vs. “person” causes vs. latent causes
 Look at the whole picture
 Injury logs can help identify trends and problem areas.
 Exploring and documenting near-misses
Thorough walk-through
 Identify trip/slip/fall hazards
 Employee involvement for continuous improvement
What types of controls can be implemented?
 Ongoing monitoring and review to ensure controls are
effective
 How can we be preventive rather than reactive?

13. Most Effective /
Protective
Elimination
Substitution
Engineering Controls
Administrative Controls
Personal Protective Equipment

15. Coworker
reminder to
use
protective
glove
Employee
safely cuts
food
Employee
receives
appreciative
comment from
manager

16. Restaurant
owner attends
ORA training
event on
safety culture
Restaurant
owner provides
safety training
and equipment
to employees
Restaurant
owner
experiences
lower
probability of
worker injury

17.  Safety does not end with training
 Must check for employee understanding
 Have employees demonstrate safe behaviors
 Practice with feedback as part of training
 Integrate behavior-based safety coaching into the culture
 Management commitment and employee involvement
 Peer observation and feedback
 Ongoing monitoring and review

18. Behavior Safe At-Risk
Load appropriate?
Back straight?
Use legs?
Hold load close to body?
Shoulders and hips aligned?
TOTAL
Total Safe Behaviors / Total Safe + At-Risk Behaviors
X 100 = % Safe

19.  Consult managers and employees to get their
impressions of the problem areas and ideas / areas for
improvement
e.g. Have them help to develop checklists
 When people contribute to a safety effort, their
ownership and commitment to safety increases.
Employees communicate about safety
 Perception of management / owner’s total buy-in for
safety practices and procedures increases employees’
participation
 Unsafe behavior is a symptom, not the disease
Unhealthy safety culture is a system problem

20. Email: dwiegand@cdc.gov
Phone: 513.841.4240

21. The Third Party Administrator Perspective
Jim Wirth,
CareWorks Consultants / RiskControl 360

22. Introduction - What is the best way to control
workers’ compensation costs?
 Maintain a healthy, cooperative relationship with your
associates where communication is open and encouraged
 Safety/Prevention:
Make safety a priority for your organization
Create and promote a safety process that reduces the
occurrence of incidents/accidents…and claims
Involve all associates in your safety efforts

23. Claims
 Medical Only Claims:
Usually a minor injury
Claims with seven or fewer days of disability usually results in a
small reserve for a limited period of time
 Lost Time Claims:
Claims with eight or more calendar days of disability
Reserves can occur in lost-time claims
 Occupational Disease Claims:
Claims where an employee contracts a disease in the course of
employment.
These claims often develop over time

24. Cost Control Tools
 Safety
 Accident Investigation
 Communication
 Salary / Wage Continuation
 Deductible
 Vocational Rehabilitation
 Transitional Work
 Lump Sum Settlements
 Handicap Reimbursement
 Subrogation
 BWC/Employer
Sponsored IME
 Surveillance
 Work with Third Party
Administrator (TPA) /
Managed Care
Organization (MCO)

25. Accident Investigation
 Communicate with your CareWorks Consultants
claims examiner as soon as the injury occurs
 Report to the MCO
 Thoroughly investigate the circumstances of the
incident / accident
 Document evidence in writing
 Utilize accident report and photographs
 Obtain witness statements
 Utilize classes at BWC Training Centers
 Important for PREVENTION…and hearings

26. Salary Continuation
 Should be considered for any claim if eight or
more calendar days of work will be missed, even if
claim is not certified by employer
 CareWorks Consultants can provide the employer
with a premium impact study to help make a
decision on whether salary continuation should
occur

27. Transitional Work
 Reduces cost of hiring and training replacements
 Helps prevent injured worker’s adjustment to disability
lifestyle
 No break or loss in income
 Gradually returns employee to full duty work
 Lower costs contribute to reduced premiums
 Works in conjunction with salary continuation
 Consists of short term and temporary tasks

28. Vocational Rehabilitation
 Surplus charge for most services
 Return-to-work focused
 Closely monitored, individualized programs
 Case management professional assigned to each case.
 Participation is voluntary…but make it an interesting and
positive experience.

29. Lump Sum Settlements
 CareWorks Consultants helps identify claims appropriate
for Lump Sum Settlements (LSS) and determine settlement
amount.
 Employer directs CareWorks Consultants to offer
settlement.
 Employer, injured worker and BWC must agree to LSS.
 BWC pays settlement.
 Settlement will eliminate the reserve portion of the claim
and prevent future payments.
 Claim will remain in employer’s experience for four years.

30. Handicap Reimbursement
 Epilepsy
 Diabetes
 Cardiac Disease
 Arthritis
 Loss of sight
 Poliomyelitis
 Cerebral palsy
 Multiple sclerosis
 Parkinson’s disease
 Cerebral vascular accident
 Tuberculosis
 Silicosis
 Psychoneurotic disability
 Hemophilia
 Amputation foot, leg, arm or hand
 Chronic osteomyelitis
 Ankylosis of joints
 Hyperinsulinism
 Muscular dystrophy
 Arteriosclerosis
 Thrombophlebitis
 Varicose veins
 Cardiovascular & pulmonary disease
(firefighters)
 Coal miner’s pneumoconiosis
 Completion of Industrial Commission or
similar rebab program
 Service related disability

31. Subrogation - A type of third party recovery
 Motor vehicle accident
 Medical malpractice
 Exposure to toxins
 Machinery malfunctions
 Animal bites
BWC generally pursues

32. Independent Medical Exams (IME)
 BWC Independent Medical Examination - used to determine
whether the injured worker is capable of returning to his/her
former position of employment, or if the allowed conditions
have become permanent.
 Employer-sponsored IME / IMR (Independent Medical
Review) - used to provide medical evidence in support of an
employer’s objection to the claim allowance or
compensation.
 Fee for this exam/file review is paid by the employer.

33. Surveillance
 Employer hires a private investigator if red flags exist
that may point to fraudulent activity.
 Employer contracts directly with the investigator.
 If fraud is identified, it can be reported by calling BWC at
1-800-OHIOBWC or logging on to www.ohiobwc.gov
 BWC generally does not allow a TPA to report fraud - it
must be reported by the employer.

34. Summary
 Contact CareWorks Consultants and your MCO
immediately when an accident occurs
 Thoroughly investigate the accident
 Document evidence in writing
 Understand how a claim impacts your rates
 Consider salary continuation on all lost-time claims
 Offer transitional work when worker is on restrictions
 Lump sum settlements / Handicap reimbursements
 Subrogation

35. BWC Prospective Premium Payment Transition
 The Ohio Bureau of Workers’ Compensation (BWC) is
transitioning to a prospective billing system.
 According to BWC, this change aligns them with
standard industry practices.
 Employers will see an overall base rate reduction of 2% as a
result of this change.
 The transition becomes effective July 1, 2015, for private
employers, and January 1, 2016, for public employers.

36. How it Will Work
 Earlier opportunities to sign up for incentive programs
Beginning in the fall of 2014, employers looking to
participate in programs such as group rating,
group-retrospective rating or other rating plans will
have the opportunity to make those selections sooner.
 A one-time credit in July 2015
 Employer will receive a one-time premium credit, as BWC will
cover their August premium payment (covering the January to
June 2015 premium) as well as the first two months of 2015
policy year (July and August) prospective premium.

37. How it Will Work (continued)
 A new payment schedule
Employers will receive their invoice in June 2015 and begin paying
premiums before July 1, 2015. While that is earlier than before, all
employers will be able to make quarterly or semi-annual payments,
and some employers will be able to pay up to as many as
12 installments.
 A true-up process
Because BWC is providing workers’ compensation insurance
coverage based on estimated payrolls, they will ask businesses to
report or “true-up” their actual payroll for the prior policy year. This
begins in August 2016.

38. What to Expect
 Industry TPAs will be contacting employers to inform them of the
changes. Be prepared to receive information from multiple TPAs.
 It is important for employers to make sure they do not
have a lapse in their workers’ compensation coverage.
 Be sure you are current on all BWC payments.
 June 2014 - BWC will mail letter to employers announcing
change in alternative rating plan sign-up deadlines.
 October 2014 - BWC will mail letters to employers to
explain the upcoming premium payment changes and
remind them about the new plan enrollment deadlines.

39. Timeline
 August 31, 2014 - Payroll reports/premium due for
1/1/14 - 6/30/14 period (as normal)
 November 24, 2014 - Group rating program filing
deadline (tentative deadline for the 2015 policy year)
 January 30, 2015 - Group retrospective rating program
filing deadline (tentative deadline for the 2015 policy
year)

40. Timeline (continued)
 February 28, 2015 - Payroll reports/premium due for
7/1/14 - 12/31/14 period (final retrospective premium
payment)
 May 2015 - BWC will mail Estimated Premium Notice for
2015 policy year
 Note: If the employer does not agree with estimation of payroll,
BWC says they will be able to have it adjusted.

41. Timeline (continued)
 June 2015 - BWC will mail payroll reports for 1/1/15 -
6/30/15 period. Employers will report payroll as normal,
but will not be required to pay premium for this period.
Payroll reports will be due as normal (8/31/15).
 August 1, 2015 - BWC will mail first prospective premium
invoice to employers for 7/1/15 - 6/30/16 policy year.
First payment due 8/31/15, for the 2015 policy year only.
Note: In August 2015, employers will send in their payroll report for 1/1/15 -
6/30/15 period along with their first prospective payment for the 2015 policy
year.

42. Timeline (continued)
 November 2015 - Group rating program filing
deadline (tentative deadline for the 2016 policy
year)
 January 2016 - Group retrospective rating
program filing deadline (tentative deadline for the
2016 policy year)

43. Jim Wirth, CPEA
jwirth@riskcontrol360.com
614-827-0370

44. Workers’ Compensation
Best Practices:
Managed Care Organization (MCO)
Perspective
Derek Stern, CareWorks

45.  Safety
 Flow Chart
 Role of the MCO
 4 “R”’s
 Transitional Work

46. Safety should always be in the forefront.
When there is a safety breakdown or the unforeseen occurs…injuries
happen.

47.  Try to anticipate ANYTHING
that could happen in the
workplace.
 If an injury does occur, have
a process in place to ensure
injured workers receive care
and claims are reported
immediately.
 Work with your MCO, TPA
and BWC.

49.  Claim intake and reporting to BWC.
 Ensure injured workers receive appropriate
medical care.
 Authorize or deny medical treatments requested
by physicians.
 Assist employers and injured workers with
successful return to work.
 Payment of medical bills (excluding prescriptions).
 The MCO is a neutral party to the claim.
Responsibilities of the MCO.

50.  Ensure injured workers and employers are
aware of the latest progress in the claim.
 Assist employer with the development of
programs to enhance their workers
compensation program (Transitional Work,
Injury Reporting Packets).
 Assist employer with identifying local initial
treating providers.
 Ensure medical documentation is transmitted to
BWC.
Responsibilities of the MCO

51.  Early Reporting is crucial.
 Early investigation is important.
 Collect facts and documentation.
If You Have a Workplace Injury:
 Early and effective medical management.
 Early return to work management.
 Lower claims costs.
Early Reporting Leads to:

52.  Your Managed Care Organization (MCO)
can help establish good reporting
practices.
 MCO can provide injury reporting packets
to assist with claims filing.
 No one can help with a claim they don’t
know about.
Early Reporting Strategies

53. Claim scenario: WITH early reporting (Part I)
 Date of Injury: 12-1-2011
 Claim reported: 12-1-2011.
 Employer, TPA and MCO discuss case. Determine if
the claim is compensable.
 Facts reveal claim not legit, employer decides to reject
claim.
 Claim goes to hearing and employer has claim denied
by IC.
 No impact on employer’s EM or premiums.

54. Claim scenario: WITH early reporting (Part II)
 Date of Injury: 12-1-2011
 Claim reported: 12-1-2011.
 Employer, TPA and MCO discuss case. Determine if the
claim is compensable.
 Facts reveal claim IS compensable. Can we mitigate the
claims cost?
 TPA advises employer to continue salary. MCO and TPA
discuss transition work options with employer.
 Result: Compensable claim, but costs significantly
reduced due to early intervention.

55. Witness Statements are important

56.  Identifying an initial treating provider.
 Communication.
 Set expectations.
 Introduce the provider to the workplace.
 Employers have the right to recommend a
treatment facility to an injured worker.
 Injured workers have right to select any
provider.

57.  Keep in touch with the Injured Worker.
 Contact your MCO/TPA/BWC claims
rep if you have claim updates.
 No such thing as too much
information.

58.  Communication is vital to
the success of your
program.
 If you are in doubt about
anything, call your MCO
Account Executive.
 Don’t “assume” anything.
Communication is Key.

59.  Defining Transitional Work
 How is it best used?
 Transitional Work Best Practices
 BWC’s Transitional WorkGrants

60.  A work site program that provides an individualized
step in the recovery of an injured associate with job
restrictions resulting from the allowed conditions in
their claim.
 A successful transitional work program provides
meaningful work which allows an injured worker to
increase strength and endurance while decreasing
restrictions.
 Transitional work is not LIGHT DUTY!
 Take advantage of BWC’s Transitional Work
Grants.
What is Transitional Work?
Return to Work

61.  Aggressive return to work program that assists
employers in the temporary “job placement” of
injured workers with temporary restrictions that
cannot be accommodated onsite.
 The goal of MDOS is to help facilitate a timely
and safe return to work while realizing cost
savings.
 Employer Benefits
 Employee Benefits
 Non-profit Benefits
Modified Duty Off Site (MDOS)

62.  MDOS program should have an established
positive outcome success rate.
 Placements are made by an MDOS
coordinator and managed by a Vocational
Case Manager.
 Programs are customized to each employer,
including policy and program
documentation.
MDOS (continued)

63. WITHOUT transitional work
 Medical = $2,500
 Compensation = $5,000
 Reserve = $25,000
 Total cost = $32,500
Why Transitional Work?

64. WITH transitional work
 Medical = $1,500 (vs. $2,500)
 Compensation = $0 (vs. 5,000)
 Reserve = $25,000*
 Total cost = $26,500
*In general, utilizing transitional work can
reduce the overall reserve in the claim
Why Transitional Work?

65.  Call your MCO and TPA immediately.
 You’re going to pay them, or you’re going
to pay them – it’s a matter of which pot it
will come from.
 Consider paying salary continuation (after
first discussing with TPA).
 Injured worker must not miss regular pay cycle.
 Injured worker should receive regular pay.
What to do if a Claim is Going to be Lost
Time.

66. An employer should
never feel like they
are alligator food.
Your MCO can help
you avoid the
workers
compensation “pit.”

67. Thank you
Derek Stern
Director of Customer Relations
(734) 944-2193 direct
(888) 627-7586 ext. 3554 toll free
derek.stern@careworks.com
www.careworksmco.com

68. Keith L. Pryatel, Esq.
Kastner Westman & Wilkins, LLC.

69.  National study on HR Practices and Employee
Turnover in the Restaurant Industry Jan. 15, 2014
Rockefeller & Ford Foundational Funding
Studies show 1 of 2 fast food workers turnover each
year; 40% turnover rate for “moderately priced”
restaurants; lower rates for “fine dining”, but higher per-
employee turnover costs

70.  Turnover costs -- $18,200/annual for 30
employees or less; $182,000 for 10 restaurant
chain; $1.8 million for 100 restaurant chain
 Most important HR practices that significantly
reduce turnover and lengthen job tenure
 high relative wages
 job security
 longer work hours
 more discretion at work
 policies for promotion from within

71.  Less than 20% of restaurant employers offer any level
of paid sick time or paid time off; only 33% offer
vacations or subsidized health insurance even “fine
dining” is low. 30% offer paid leave or PTO; 5% offer
paid vacations or subsidized health insurance.
 Employee discretion is low in all restaurant
establishment. Only 5% allow front-of-house
employee discretion in their communications with
customers without consulting managers; or in problem
solving.

72.  Annual pay for fast food employers:$13,257
($255/52 weeks); $18,720 (back-of-house / BOH)
and $24,123 (front-of-house / FOH) for
“moderately priced restaurants”; $20,902 (BOH)
and $34,990 (FOH) for fine dining.
 Restaurant industry traditionally offers few
employee benefits e.g. paid sick leave; paid time
off; paid vacation; subsidized health insurance
because: part-time; seasonal; student; immigrant
workers

73. High turnover is costly; Raises curb of
selecting, recruiting and training
replacements
New employees are less proficient until they catch up
on the learning curve (less knowledgeable about
menu - no customer relations)
Disruption of operations - manager attention to other
areas is shifted.
How investment in HR reduces turnover

74. Hourly wages and job security are two
most important factors.
Hours available to work and discretion
exercise are other important facts.

75.  PPE Survey
 Identifying workplace violence risks – cases / door
markers / drop sales / windows
 Disciplining for safety violations
 HazComm Program
 Lock Out / Tag out
 Voluntary OSHA Log (300 and 300A)
www.osha.gov

76. Thank you!
Keith L. Pryatel, Esq.
kpryatel@kwwlaborlaw.com
Kastner Westman & Wilkins, LLC.
3480 W. Market Street, Suite 300
Akron, OH 44333

78. Social Media Webinar Series sessions:
Every Tuesday at 2:00 p.m.
 July 1st Foursquare, Urban Spoon and Yelp - Time for a little R & R
(Revenue and Reviews)
 July 8th Instagram - Pics and Profits
 July 15th Pinterest - Pin to Win
 July 22nd Google + - Just Another Pretty Facebook?
 July 29th Mobile apps - So Many Apps. So Little Time.
Other RES events
 August 6th - "Is Franchising the Right Choice?" 2:00 p.m.
Go to www.ohiorestaurant.org/res NOW to register!
Heartland Payment Systems is the Lead
Sponsor of all RES events.