ISSUE 3 | VOLUME 4 | MAY - JUNE Florida Department of Financial Services

Division of Risk Management

200 East Gaines Street

Tallahassee Florida, 32399

► NATIONAL

SAFETY MONTH 1

► HEAT ILLNESS

AWARENESS 3 ► SAFETY & LOSS

PREVENTION

SPOTLIGHT:

MIKE

McHARGUE

4

► CLAIM SPOT-

LIGHT: IT’S

JUST A SIMPLE

BACK STRAIN;

HOW MUCH

COULD IT COST?

6

► WORKERS’

COMPENSATION

FRAUD - PART I

8

► SFLPP

LAUNCHES

ONLINE SAFETY

ACADEMY

10

► CROSSWORD

PUZZLE 11

E ach June, the National Safety Council (NSC) encourages

organizations to get involved and participate in National Safety

Month. This year’s theme is “Safety Starts with Me.” We all know a

healthier employee is a happier, more productive employee. Encourage

your employees to become more involved in their personal health and

safety at work and at home. The NSC distributes information promoting

this month and the safety issues below. You may obtain these materials by

contacting the State of Florida Loss Prevention Program (SFLPP). The

NSC also offers limited safety information and training materials at no cost

to the public.

Each week in June, The NSC and other safety organizations highlight a

different safety issue:

Week 1: Preventing Slips, Trips, and Falls

Week 2: Employee Wellness

Week 3: Emergency Preparedness

Week 4: Ergonomics

We encourage all agencies and universities to participate in this event and

continue your safety and loss prevention practices year round. The Division

of Risk Management assists you by providing training materials—and

there are numerous websites with free material—which you may distribute

noncommercially. Below are just a few of the sites you can visit:

OSHA.GOV—National Occupational Safety & Health Regulations

NSC.ORG—Training Material and Information from the National Safety Council

CDC.GOV—Safety and Health Training Information from the Center for Disease

Control

IN THIS ISSUE:

P A G E 2

S A F E T Y & LO S S P R E V E N T I O N

SAFETY STARTS WITH ME: CONTINUED FROM PAGE 1

Here are two actions you can take to promote safety awareness:

Place posters and tip sheets throughout your facility.

Have 5-minute meetings on relevant safety topics.

Occupational Safety and Health Administration (OSHA)

pamphlets offer brief, focused training topics that can be

covered in a short amount of time. Click the following link:

OSHA SAFETY TRAINING PAMPHLETS

The most important people in National Safety Month are your employees

and coworkers; hence the theme, “Safety Starts with Me.” Employees are

your best source of knowledge regarding the perils that exist throughout

your workplace. They can provide new ideas on ways to avoid accidents

because they are most familiar with the daily activities of your agency or

university. Poster and safety slogan contests are another way to get your

employees involved in a safety culture. You may consider involving their

families in the fun, too. This promotes safety to everyone; the children

grow up realizing the importance of the subject, and your employees are

happy knowing you are including them in your program and that you

truly care about their well being.

Remember, safety starts with you!

For additional information and materials regarding National Safety

Week, contact StateLossPreventionProgram@myfloridacfo.com.

For additional tips, tools, and content on this subject, visit:

http://www.nsc.org/NatlSftyMonth/NSC-2013NSM_Planner.pdf

Florida Department of Financial Services

Division of Risk Management

200 East Gaines Street

Tallahassee Florida, 32399

SAFETY & LOSS PREVENTION OUTLOOKSAFETY & LOSS PREVENTION OUTLOOK

“You cannot escape

the responsibility of

tomorrow by

evading it today.”

~Abraham Lincoln

M A Y - J U N E 2 0 1 3

H eat is the deadliest weather-related killer in

the world. Between 1936 and 1975, almost

20,000 people in the United States died from

the effects of excess heat in the body. In 2003,

an estimated 50,000 Europeans died as the result of an unrelenting heat wave (Porter, 2004).

Living and working in a hot, humid environment is something that most Floridians accept as part

of their daily routine. While this, like most environmental hazards, cannot be eliminated, there are

many highly effective ways that we can reduce the likelihood of illness or injury.

The Center for Disease Control and Prevention (CDC) continues to improve its heat-illness

prevention and awareness website. This site provides endless resources that help to identify causes,

symptoms, and prevention of heat-related illness. Take a moment to review this site. It may

include information that could help you improve or augment your existing safety program (CDC,

2012).

CDC HEAT ILLNESS AWARENESS WEBSITE

As with most hazards, awareness and common sense are the first and best lines of defense. The

National Oceanic and Atmospheric Administration (NOAA) developed a public awareness tool

that is helpful in educating employees and supervisors on the hazards of excessive heat (NOAA,

2005).

NOAA HOT WEATHER AWARENESS WEBSITE

Most state employees carry phones with the capability to

download and use mobile applications. This application—

available on the OSHA website—provides real-time heat

warnings and instructions on how to identify and treat heat

illnesses. It is available at no cost to the user. For those working

at off-site locations, this free application could provide valuable

information to an employee responding to a heat illness. The

application can be viewed and downloaded by clicking on the

image:

As an additional tool, OSHA’s Dr. David Michaels presents a short video discussing the

importance of heat illness awareness in the workplace. Click the link below to view the video:

OSHA HEAT AWARENESS VIDEO

P A G E 3

P A G E 4

I n this issue of the

Safety & Loss

Prevention

Outlook , The State of

Florida Loss

Prevention Program is

proud to recognize the

outstanding safety and

emergency operation

efforts of Mr. Mike

McHargue, Emergency

Coordinating Officer

with the Florida Department of Health, Division of Emergency Preparedness

and Community Support, Bureau of Preparedness and Response.

Our interview with Mr. McHargue began in late May 2013 as he was

preparing for the start of the 2013 Atlantic Hurricane Season by participating

in the annual statewide hurricane exercise drill hosted by Florida’s State

Emergency Response Team (SERT) Monday, May 20 through Thursday,

May 23 at the State Emergency Operations Center in Tallahassee.

Here are highlights from the interview:

SFLPP: Good morning, Mr. McHargue, and thank you for taking the time out

of your busy schedule to share with us some best practices as we start the 2013

hurricane season.

Mr. McHargue: It is my pleasure to share my knowledge with other members

of the emergency management and public safety community.

SFLPP: Let’s get right to it. What are some best practices you would share

with emergency and public safety professionals that you have learned over the

years?

Mr. McHargue: Trust, but verify! Preparedness and response capabilities

cannot be assumed. Throughout my career, the truly successful emergency

management and public safety professionals have demonstrated constant

attention to solid planning, training, exercise, and evaluation. The best

practices I have observed are from professionals across the country that

mentor others to promote common understanding of potential threats and

actions that are required to prevent or mitigate them, and they also follow

through to demonstrate the ability to implement plans. Emergency

management is all about the team and its ability to perform, and ultimately

succeed, in its efforts to help communities prepare for and recover from an

emergency or disaster.

MIKE MCHARGUE

Florida Department of Financial Services

Division of Risk Management

200 East Gaines Street

Tallahassee Florida, 32399

“A genuine leader is

not a searcher for

consensus, but a

molder of

consensus.”

~Dr. Martin Luther King, Jr.

Continued on next page.

P A G E 5 M A Y - J U N E 2 0 1 3

SFLPP: What are some emergency preparedness tips you would offer for hurricane season, which starts June 1?

Mr. McHargue: The first thing we each should consider is personal and family preparedness. We all have home life and

personal responsibilities that must be addressed before the emergency happens or disaster strikes. Having a plan to account

for the needs of family, our homes, pets, and other important personal considerations is critical to enable us to assume the

professional duties required during a response of any type. Floridians can visit Flordiadisaster.org to access “Get a Plan.”

The Department of Health offers the Family Preparedness Guide for its members. Simply follow the instructions to complete

the family planning guide and discuss it with those we are responsible for taking care of during emergencies.

SFLPP: Let us talk now about your role at the Department of Health and your educational background. Can you describe

your duties and responsibilities as director of Emergency Operations for the Florida Department of Health, Bureau of

Preparedness and Response?

Mr. McHargue: As the Emergency Coordinating Officer for the Florida Department of Health Emergency Support Function

(ESF) 8 (Health and Medical), we are responsible for pre-incident planning through the development of preparedness and

response plans for the Florida public health and health care system. We work with public and private partners to promote

integrated planning, training, and exercises that demonstrate actual preparedness and response capabilities. During times of

emergency or periods of disaster, we provide support to the local health and medical communities in the impacted areas,

including county health departments and hospitals, to assist them toward a speed system recovery.

SFLPP: What is one accomplishment you are most proud of as the Emergency Coordinator for DOH and ESF 8?

Mr. McHargue: As a member of the State Emergency Response Team (SERT), I am most proud of the commitment that

DOH has made to emergency preparedness and response through dedicated planning, training, and exercise programs. DOH

established the Bureau of Preparedness and Response with dedicated staff to support the full range of local health and

medical capabilities within ESF 8. This includes partnerships with other state and federal agencies that have the

responsibility for licensed health care facilities of all types, emergency medical services, vulnerable populations, as well as

the traditional public environment and epidemiological health services.

SFLPP: Hurricane season starts June 1, but how important is it for state agencies to have an updated Continuity of

Operations Plan (COOP) at all times?

Mr. McHargue: Continuity of Operations Plans (COOP) are an extremely important aspect of emergency and disaster

planning. COOP allows government and private businesses to continue essential functions during or following an emergency

or disaster. COOP identifies mission-essential functions and the staff to perform them in advance to ensure the welfare of

employees and that critical services can continue. These plans can also identify emergency duty roles for leadership and

members and provide specific instructions for staff accountability, work locations, and other specific instructions.

SFLPP: How often should a state agency or university review their COOP?

Mr. McHargue: Plans should be reviewed on an ongoing basis to account for staff changes and training needs. Annual

review and updating COOP is recommended, especially as we approach the hurricane season that begins June 1.

SFLPP: Mr. McHargue, we cannot thank you enough for talking with us and sharing emergency operations best practices

with our safety professionals.

Mr. McHargue: It was my pleasure. Best wishes as we approach the 2013 hurricane season!

P A G E 6

Florida Department of Financial Services

Division of Risk Management

200 East Gaines Street

Tallahassee Florida, 32399

T he Division of Risk Management receives hundreds of strain claims

each month and many are due to the person performing the task not

being physically capable of, or properly trained for, completing the task.

Let us review a claim which occurred and outline elements to consider. No

personal information is provided and the exact details are changed to

protect the privacy of the claimant and agency or university.

The employee is a 39-year-old male who works in a maintenance

department. Based on this information, the employer could easily assume

he would be trained in proper lifting techniques and be physically capable

of moving items. On this particular day, the employee had to move a large

table that was approximately 8 feet long by 5 feet wide by 2 feet deep and

weighed 200-300 pounds: not your typical table. Not surprisingly, he

strained his back while attempting to move the table.

The table was not a normal size and weight, so you would want to consider

how often your employees are required to lift and move items and what the

average weight is. This is something you should have outlined in your job

safety analysis for your maintenance personnel. You should include a

procedure to follow in the event a task falls outside the limits. The addition

of simple wording such as, “In the event of a task requiring working above

the outlined dimensions and/or weight limits, please consult your

supervisor,” would suffice. You would want to then train your supervisors

to assess these situations and provide solutions to avoid these incidents.

You should conduct an accident investigation to determine if proper

procedures were followed. Was the supervisor aware the item was being

moved? Were additional personnel assigned to assist the employee, and, if

so, did they help and did anyone else report an injury? When conducting

your investigation, interview as many people as you can who have factual

information; do not interview personnel who were not directly involved.

The more information you have, the easier it is to develop procedures in the

future to avoid similar injuries. Also, many claims become litigated and

information obtained at the beginning of a claim is helpful. Over time,

information changes and people forget details of events. For this reason,

you should conduct your investigation as soon as possible after the incident.

Continued on next page.

P A G E 7 M A Y - J U N E 2 0 1 3

Among other things to consider when assigning a task is

whether an employee has any prior injuries. In this case,

the employee had previously filed a workers’

compensation claim for a back strain lifting a much lighter

item. This would be an indicator that this person may not

be the best choice for the task. Many times employees

volunteer to assist others to be helpful, especially when

moving items. It doesn’t have to be a large item; even a

box of paper is heavy and without thinking, an employee

will bend over and pick it up and you have a back or

shoulder injury. Put flyers on bulletin boards around your

office to remind people the proper way to lift or to ask for

help.

This claim began as a simple strain and ultimately cost the State very close to $100,000 in just

seven months. There were also the unseen costs, such as replacing the employee when he was

unable to work, employee morale, and training considerations. Additionally, it became litigated,

surveillance was assigned, and the employee chose to accept a settlement offer and had to

terminate his employment to do so. He had been with the State for over 20 years and was a

respected employee. What seemed like a simple task turned out to be a costly mistake. Train your

supervisors and employees to look for potential perils. It doesn’t have to be a serious injury to cost

a lot. Put safety first.

For additional information pertaining to your agency/university claims, contact the Division of

Risk Management, Bureau of Risk Financing & Loss Prevention at:

StateLossPreventionProgram@myfloridacfo.com to

request reports and/or claim specifics.

The CDC has developed mobile

applications that can be viewed on

most smart phones and tablets. The

topics cover health & safety issues

from back strains to global epidemic

preparation and response. You can

download and view the application by

clicking the image to the right:

P A G E 8

Florida Department of Financial Services

Division of Risk Management

200 East Gaines Street

Tallahassee Florida, 32399

W orkers’ compensation fraud is an intentional act of deceiving,

concealing, or misrepresenting information. This results in the

injured worker receiving medical benefits, indemnity benefits (lost-time

wages), and/or working in a modified- or alternate-duty position. Annually,

an estimated 10% of all workers’ compensation claims are fraudulent

(National Insurance Crime Bureau [NICB]). The NICB states, “Workers’

compensation claimant fraud and medical fraud are significant

contributors to our nation’s annual $30 billion insurance fraud problem

(NCIB.PDF).”

This is the first of a three-part series on workers’ compensation fraud:

Part 1 – What is workers’ compensation fraud and why do employees

commit it?

Part 2 – What are red-flag indicators? How are red-flag indicators used

to determine a fraudulent workers’ compensation claim?

Part 3 – How are we doing when it comes to workers’ compensation

fraud defense? What is the legal outcome?

Generally, workers’ compensation fraud falls under one of three categories:

Claim Fraud – The claimant is not injured, is exaggerating symptoms,

and/or is malingering.

Benefits Fraud – The claimant is performing activities outside of the

functional limitations and restrictions set forth by the authorized

workers’ compensation medical provider and receiving undue medical

and/or indemnity benefits.

Disability Fraud – The claimant is working for another employer while

receiving indemnity benefits from the Division of Risk Management due

to restrictions from the medical provider stating the employee is unable

to work.

Continued on next page.

P A G E 9 M A Y - J U N E 2 0 1 3

The chief motivators of workers’ compensation insurance fraud are financial gain, paid time off

from work, or being allowed to work a light-duty position. Workers’ compensation fraud costs us

all in the long run. Additional costs associated with workers’ compensation fraud include the

expense of hiring temporary help, training replacement employees, paying overtime associated

with covering shifts, decreasing employee morale, and increasing medical and indemnity expenses

paid on fraudulent claims.

Workers’ compensation fraud can be committed by both healthcare providers and employees.

Healthcare providers may bill for services not rendered or provide unnecessary medical

treatment resulting in overutilization. This type of fraud is monitored by a third-party vendor or

the Division of Risk Management, through utilization reporting.

Another area of concern is claims for soft-tissue damage, such as muscle strain/sprain, as they are

not always based on relevant medical findings. Instead, these are based upon subjective findings

such as the claimant symptoms of tenderness, pain, throbbing, etc., in the absence of x-rays or

other diagnostic testing as proof of the injury.

Should you suspect workers’ compensation fraud, please call the Division of Risk Management at

(800) 262-4402 and speak with the assigned claim adjuster or call the Antifraud Reward Program

Hotline at (800) 378-3445.

Remember, never make accusations to or about the claimant regarding fraud; this may create

legal problems. Only discuss the claim with people associated with the investigation, such as

management and supervisors. Forward any pertinent information to the nurse case manager and

the adjuster at the Division of Risk Management; they will provide guidance on what to do next.

In most cases, once you provide your initial information to the adjuster, they will handle it from

there; the employer should be involved as little as possible. The Division of Risk Management will

be responsible for managing all of the benefits due and owed, obtaining surveillance if necessary,

and notifying the Special Investigative Unit.

In Part 2 of this series we will discuss red-flag indicators of the possibility of a fraudulent claim

and how to properly document a claim for a solid fraud defense.

Click on the badge for news and announcements from the Division of Insurance Fraud:

P A G E 1 0

Florida Department of Financial Services

Division of Risk Management

200 East Gaines Street

Tallahassee Florida, 32399

J une marks the beginning of National Safety Month, and it also

marks a new beginning for the State of Florida Loss Prevention

Program’s (SFLPP) training unit. After hosting the Loss Prevention

Academy for over 12 years as a two-day, instructor-lead event held each

July, SFLPP will make history by launching our very first online training

academy.

The purpose of the

online training

academy is to better

serve agency and

university safety

coordinators and

alternate safety

coordinators in

Tallahassee and

throughout the state.

No longer will safety

coordinators have to

wait until the month of

July to participant in valuable safety and loss prevention training sessions.

With the new online academy, safety coordinators can take safety training

classes produced by SFLPP’s training unit at anytime and at any place.

The only thing participants will need to access the training is a computer

with internet capabilities, which will not only improve your organization’s

safety program, but also its bottom line by reducing travel costs associated

with the annual Safety Academy.

The initial training module within the online academy is the course Safety

Coordinator Training 101: The Basics. This course is an introduction, and it

discusses the responsibilities of a safety coordinator as outlined in section

284.50, Florida Statutes. The other courses within the online academy will

go into more detail on the duties of a safety coordinator. The other training

modules within the academy will be made available within the upcoming

months.

As part of the online academy, participants will still receive certificates of

completion for their records and they will be able to test their knowledge.

through our interactive quiz assessments which are included in each online

training module.

Continued on next page.

P A G E 1 1

Florida Department of Financial Services

Division of Risk Management

200 East Gaines Street

Tallahassee Florida, 32399

Remember, the first Agency Safety Coordinator to return a correct crossword puzzle will

receive a prize! Submit your completed puzzle (or just the answers) by clicking on the follow-

ing link. Good Luck! SUBMIT MY ANSWERS

Across.

2. Heat related Illness can occur when an individual is exposed to ________ heat.

4. Wearing light-weight, ________ colored, loose fitting clothing will keep you cooler.

7. Taking prescription or over-the-counter _______ can affect your body’s ability to cool itself.

12. Personal Protective _______ may hold in body heat and increase core temperature.

13. Sweating depletes the body of ______ and moisture, which leads to muscle cramps.

Down

1. Heat stroke victims have a core body temperature of over one hundred _____ degrees.

3. Immediately try to cool a heat illness victim while someone seeks ________ attention.

5. Victims should not return to work until they have no symptoms and are fully _______.

6. To rapidly cool a victim, place ice on the neck, groin, and ________.

8. Seek medical attention for heat cramps that last more than _______ hour.

9. Monitoring body _____during exercise can help keep track of the amount of moisture lost.

10. Heat and ______ are extrinsic factors contributing to heat related illness.

11. Brain damage or _____ may occur if heat illness is not treated fast enough.

P A G E 1 2

S A F E T Y & LO S S P R E V E N T I O N

R. J. Castellanos, ARM, JD

Division Director

Molly Merry, CPA

Assistant Director

Shannon Segers, ARM-P

Bureau Chief, Bureau of Risk Financing & Loss Prevention

Joshua Davis, MPA

Manager, State of Florida Loss Prevention Program

Office of the Director (850) 413-4700

State of Florida Loss Prevention Program (850) 413-4756

Bureau of State Liability & Property

Claims (850) 413-3122

Bureau of State Employees’ Workers’

Compensation Claims-* (850) 413-3123

State Liability Claim Change Form (850) 413-4852

Safety Coordinator Appointment Form (850) 413-4756

Workers’ Compensation Claim Change Form (850) 413-4802

REFERENCES

Safety & Loss Prevention

Outlook Team:

Deidra Jones, CPM

Managing Editor

Juana Powell

Writer/Researcher/Editor

Melanie Cowgill

Writer/Design and Layout

To provide feedback, share

future article ideas, or to add

contacts to our distribution

list, please use the links below:

Feedback

Article Ideas

Distribution List

Florida Department of Financial Services

Division of Risk Management

200 East Gaines Street

Tallahassee Florida, 32399

NSC. (2013) NSC.org Retrieved 2013, from National Safety Month

2013:

http://www.nsc.org/nsc_events/Nat_Safe_Month/Pages/

PALAPlus.aspx

CDC. (2012). CDC.gov. Retrieved 2013, from heatandcold:

http://www.cdc.gov/nceh/hsb/disaster/heatandcold.htm

CDC. (2012). CDC.gov. Retrieved 2012, from heat stress:

http://www.cdc.gov/niosh/topics/heatstress/

DOL. (2011). DOL.gov. Retrieved 2013, from 20110426-heat-

michaels:

http://www.dol.gov/dol/media/webcast/20110426-heat-michaels/

index-english.htm#.UPcSV6zRh8E

NOAA. (2005). NOAA.gov. Retrieved 2013, from heatwave:

http://www.nws.noaa.gov/om/brochures/heat_wave.shtml

OSHA. (2012). OSHA.gov. Retrieved 2013, from heay_app:

http://www.osha.gov/SLTC/heatillness/heat_index/heat_app.html

Porter, K. A. (2004). CNN.com. Retrieved 2013, from heat-

wavw.europe:

http://www.cnn.com/2004/TECH/science/08/02/heatwave.europe/

NCIB.PDF. (n.d.). Retrieved 2013, from WorkcompProfession-

als.com:

http://www.workcompprofessionals.com/advisory/archive-0000/

images/ncib.pdf

NICB. (n.d.). Theft and fraud awareness. Retrieved 2013, from

nicb.org: https://www.nicb.org/theft_and_fraud_awareness/fact_sheets