AgriTrust of Georgia 2020 Regional Seminar€¦ · AgriTrust of Georgia - Board of Trustees...
Transcript of AgriTrust of Georgia 2020 Regional Seminar€¦ · AgriTrust of Georgia - Board of Trustees...
AGRITRUST OF GEORGIA2020 REGIONAL SEMINAR – A LIVE WEBINAR
WELCOME TO THE FIRST AGRITRUST OF GEORGIA
LIVE WEBINAR ON WAYS TO SAVE $$$
AgriTrust of Georgia - Board of Trustees
Chairman
E. Raybon Anderson, Bulloch Fertilizer Co. Inc., Statesboro
Vice Chairman
Wayne Christian, Christian Family LLLP, Dublin
Cader Cox, III, Riverview Plantation Inc. & Plantation Precooler, Inc., Camilla
Tyler Johnson, Tyler Johnson Enterprises, Inc. DBA Smith Farm Supply, Warrenton
Becky Kilby, Southern Pride & Heritage Produce Inc., Tifton
Ben Lancaster, Jr., Crystal Farms Inc., Chestnut Mountain
Randall Morris, Morris Enterprises, Inc. DBA Morris Farms, Uvalda
Van F. Murphy, Van Murphy Farms, Quitman
Bonnie Sutherland Wilson, Sutherland’s Foodservice, Inc., Forest Park
SPEAKERS
A WELCOME from AgriTrust of Georgia
Chairman E. Raybon Anderson
Eddie Kinnard
President & Fund Pool Manager
AgriTrust of Georgia
3001 Monroe Hwy, Suite 700A
Bogart, GA 30622
Tash Van Dora
The Van Dora Law Firm, LLC
21 Vickery Street
Hartwell, GA 30643
Jimmy Doolittle
Senior Claims Representative
Georgia Administrative Services
1775 Spectrum Drive, Suite 100
Lawrenceville, GA 30043
WELCOME!!! FROM
CHAIRMAN RAYBON ANDERSON
AGRITRUST OF GEORGIA2020 REGIONAL SEMINAR – A LIVE WEBINAR
• Drug Testing
• Independent Contractor or Employee?
• Claims Reporting 101
• Light-Duty Job Offer and WC-240a/ WC-240
• State Board of Workers’ Compensation Petition for Medical Treatment(b)
(WC-PMT(b))
• Claims Settlements
• Various Ways To SAVE $$$ with AgriTrust Premium Credits
DRUG TESTING
• The Four Times to Drug Test
• Should All Employees Involved in the Accident Be
Tested?
• Drug Testing Time Constraints
• What if Employee Refuses a Drug Test?
• How Drug Testing Can $AVE Money
THE FOUR TIMES TO DRUG TEST
1. Pre-Hire
2. Random
3. Reasonable Suspicion
4. Post-Accident
SHOULD ALL EMPLOYEES INVOLVEDIN ACCIDENT BE DRUG TESTED?
YES –Test ALL Involved!!• Helpful in determining why an accident occurred
• May expose a dangerous employee
• Possibly encourages less on-the-job drug use
DRUG TESTING – TIME CONSTRAINTS
• Whenever a worker gets injured, it is imperative that a
drug/alcohol test is administered as soon as possible.
• If an employee tests positive for alcohol (.08 or greater)
within 3 hours of the accident, then there is a legal
presumption that the claimant is NOT entitled to workers’
compensation benefits.
DRUG TESTING – TIME CONSTRAINTS CONTINUED
• If an employee tests positive for other controlled substances
within 8 hours of the accident, then there is a legal
presumption that the claimant is NOT entitled to workers’
compensation benefits
• If a drug test is performed more than 8 hours after the
accident, it is still evidence but does not give the presumption
of non-compensability.
WHAT IF EMPLOYEE REFUSESA DRUG TEST?
• Drug testing is very important as it may help the employer/insurer deny a
claim, even when it may have been a compensable claim.
• If the worker tests positive or unjustifiably refuses a drug test, the burden
of proof switches to the claimant, and there is a rebuttable presumption that
they must overcome to prove that the injuries were not caused by the
drugs/alcohol in their system.
A refusal of the drug test is the SAME as a positive drug screen.
HOW CAN DRUG TESTING $AVE MONEY?
Let’s look at an example of how
Drug Testing Can $AVE MONEY!
These scenarios have been calculated using NCCI
Experience Modification (Mod) worksheets
FUND MEMBER – ABC
Estimated Annual Premium $21,081.00
Experience Mod 0.99
SCENARIO
A worker takes a bad fall and has multiple injuries that result in $100,000.00 in
medical bills (after being fee scheduled).
Injured worker will be out of work for four months (16 weeks) before returning
to work.
Injured worker makes $750.00/week, so weekly benefits will be $500.00/week.
Impact on Experience Mod:
Since the drug test conducted was positive for marijuana and meth and AgriTrust
paid the $5,000.00 initial medical treatment, the Experience Mod would only
increase from 0.99 to 1.02. This would be a Medical-Only claim.
If NO DRUG TEST had been conducted, AgriTrust would have paid $100,000.00
in medical bills and $8,000.00 in indemnity benefits. In this scenario, with this
Lost-Time claim, the Experience Mod would increase from 0.99 to 1.44!
The injured worker was drug tested, and test results were positive for
marijuana and meth. In this instance, AgriTrust denied the claim and
only paid for the initial medical treatment which is $5,000.00 (fee
scheduled amount).
SUMMARY OF $AVING$
DRUG TESTED (Positive Results) NO DRUG TEST CONDUCTED
Fund Member Premium: $21,081.00 Fund Member Premium: $21,081.00
Experience Mod (before accident): 0.99 Experience Mod (before accident): 0.99
Experience Mod Increase (post-accident): 1.02 Experience Mod Increase (post-accident): 1.44
Difference of Mod Increase: 1.02 - 0.99 = 0.03 Difference of Mod Increase: 1.44 - 0.99 = 0.45
Premium Increase: $21,081.00 x 0.03 = $632.00 Premium Increase: $21,081.00 x .045 = $9,487.00
This is why post-accident drug testing is so important
AND how it can and does $AVE money!
INDEPENDENT CONTRACTOR OR EMPLOYEE?
Independent Contractor
• Worker sets his own schedule
• Worker has agreement to begin work on the 1st and work every day until the 15th of the month
• Worker brings his own employees and tells them how and when to do their jobs
• Worker also does his work for other employers
Employee
• Worker comes to work as
employer schedules
• Worker wears a uniform
supplied by employer
• Employer supplies tools to
worker
• Employer takes out taxes
from worker’s paycheck
THINGS ARE NOT ALWAYS AS THEY SEEM
EMPLOYEE STATUS – EXAMPLE ONE
Durham Land Co. v. Kilgore, 56 Ga. App. 785, 194 S.E.2d (1937).
Employer leased a coal mine and equipment to a “contractor” who was the immediate superior of
Claimant, and the “contractor” agreed to mine the coal and deliver the coal to Employer at a
stipulated price per ton and, there was a contract that intended to create an employer-independent
contractor relationship.
However, Employer assumed and did exercise the right to fix the rate of pay, hours of labor, power of
discharge, and the working conditions of the employees of “contractor,” through contracts with the
miner’s union (which claimant and all other employee’s belonged). They also kept books, paid the
miners, and furnished the pay roll.
Court found that, despite the terms of the contract, the real agreement and understanding of the parties was that the employer was to have control over the manner and means of doing the work, and as such, an Employer-Employee relationship was found.
EMPLOYEE STATUS – EXAMPLE TWO
Georgia Power Co. v. Safford, 171 Ga. App. 387, 319 S.E.2d 537 (1984).
Claimant was hired to make houses more energy efficient. He had a contract that had no end date, and that provided for payment by the hour by Employer. It was also found that the contract allowed Employer to terminate the contract and that Employer was responsible for providing necessary materials.
Court found that based on those facts, an Employer-Employee relationship existed.
INDEPENDENT CONTRACTOR STATUSEXAMPLE ONE
Coastal Timberlands, Inc. v. Brown, 141 Ga. App. 800, 234 S.E.2d 373 (1977).
Employer instructed Claimant as to boundaries of the tract from
which timber was to be removed, told him when they wanted
hardwood rather than other types of timber, and to which
lumber yard the timber was to be delivered. Employer also let
Claimant have one of its saws.
Claimant was free to cut or not cut as he chose, paid his own employees, furnished his own equipment other than the saw he borrowed from Employer, used his own truck, paid for his gas and operating expenses, and was free to cut and sell timber from property other than that which he had contracted with Employer to cut. He was paid by the unit according to its agreement, made no deduction for social security taxes, and never treated him as an employee. Claimant described himself as “self-employed” when he was admitted to the hospital following his injury.
Court found this to be an employer-independent contractor relationship.
INDEPENDENT CONTRACTOR STATUS
EXAMPLE TWO
Simpkins v. Unigard Mut. Ins. Co., 130 Ga. App. 535, 203 S.E.2d 742 (1974).
Employer orally agreed with Claimant to do the cornice work and installation of
siding on a building being constructed. Employer agreed to pay a specific amount
per foot to run the cornice work and $22 per square for siding.
Claimant was injured after only two days and had his step-son complete the work
for him. When the work was completed, Claimant submitted a statement for the
entire job and directed that two checks be issued, one for the work his stepson had
done, and the other for the work he had done.
Employer furnished the material and had the right to choose the kind of siding that he desired.
Employer did not have the right to control the time, manner or method of executing the work but had the right only to require certain results. He did not have the right to require Claimant to remove work that had been performed if he did not like it and have it done again in accordance with new instructions. Nor did he have the right to hire additional men to speed up the job he had contracted for Claimant to perform.
Employer testified that “The only thing I am concerned with is the end product, how the men put it up I don’t care so long as it looks right after it’s finished.” He also had the right to terminate the contract at any time if he became dissatisfied with the quality of the work.
Claimant had control over who he hired and how he completed his work. No income tax or social security was withheld from paychecks.
Court found this to be an employer-independent contractor relationship.
INDEPENDENT CONTRACTOR OR EMPLOYEE?
• Look at method of payment
• Length of employment
• Selection of materials and tools
• Control of hours
• Ability to hire and fire
• CONTROL of ALL details – who has it?
INDEPENDENT CONTRACTOR OR
EMPLOYEE? HOW DOES THIS $AVE MONEY?
Who Has Coverage?
• If Fund member hires an independent contractor, Fund member
is not responsible
• If employee, AgriTrust would pick up this payroll amount at audit
• Get a copy of certificate of insurance to verify coverage
CLAIMS REPORTING 101
• Take care of the employee first.
• Obtain facts about the accident/injury.
• Report claim to GAS within
24-48 hours with a WC-1.
• Make sure injured worker is drug tested.
• Refer to the laminated reporting poster,
When An On-The-Job Injury Occurs,
provided by AgriTrust.
WHEN AN ON-THE-JOB INJURY OCCURSCLAIMS POSTER AND VEHICLE CARD
• 2-sided Vehicle Cards are also
available
• Fit in vehicle glove box
• Both are available in Spanish too
• Claims Posters and Vehicle Cards
at available from AgriTrust – just
contact the AgriTrust office
EMPLOYER’S FIRST REPORT OF INJURY OR OCCUPATIONAL DISEASE (WC-1) FORM IS REQUIRED
• Claim must be reported using a SBWC Form WC-1
• ACORD Form OR Supervisors Report are not
acceptable forms to use when reporting a claim
SBWC Form WC-1
First Report of Injury
WHERE CAN I FIND THE WC-1 FORM?
The WC-1 First Report of Injury can be found:
• Members Resource Manual
• Renewal Packet you receive at the end of the year
• GA State Board of Workers’ Compensation website under Forms:
https://sbwc.georgia.gov/forms/board-forms
• AgriTrust of Georgia Website
• Email or Call Jimmy Doolittle! [email protected] or 678/325-2696
LIGHT-DUTY JOB OFFER AND WC-240A/ WC-240
RETURNING TO WORK
The goal of the workers’ compensation
system is to return the injured worker
to the job (workforce).
LIGHT-DUTY JOB OFFER
• Helps to suspend income benefits.
• State Board of Workers’ Compensation Form Notice To Employee Of Offer
Of Suitable Employment (WC-240) process.
• By having a light-duty job available for the claimant/employee, it puts the
responsibility back to the claimant/employee to either return to work or
risk having benefits suspended. Employee must work one full day (8 hours
or one regularly scheduled shift). If the next day employee calls saying they
cannot perform the job, the employer/insurer shall immediately reinstate
wage benefits. We then will request a hearing to determine if employee put
forth a good-faith effort in returning to work.
• Limits the total exposure of the claim from 400
weeks to 350 weeks.
• Gives employer/insurer substantial leverage in
any settlement negotiations. Leverage is
essential in settlement mediation negotiations
(for our problem children), and light-duty helps
with leverage.
SBWC FORM – JOB ANALYSIS (WC-240A)
EMPLOYER PLAYS HUGE ROLL HERE
• Two-page form may be filed with the WC-240 by employer/insurer
• Provides detailed job description when notifying an employee of suitable employment to his/her impaired condition
• Shall provide it to the employee and his/her attorney at least 10 days prior to the date the injured worker is scheduled to return to work
• Attach this form with WC-240 form and file as an attachment to form WC-2, Notice of Payment or Suspension of Benefits, when unilaterally suspending income benefits
SBWC FORM JOB ANALYSIS
(WC-240A)
SBWC FORM - NOTICE TO EMPLOYEE OF OFFER OF SUITABLE EMPLOYMENT (WC-240) PROCESS
• Notifies the injured worker of an offer of employment suitable
to his/her impaired condition
• Provide to injured worker and attorney at least 10 days prior
to date the employee is scheduled to return to work
• Attach SBWC form WC-240 to SBWC form WC-2, Notice of
Payment or Suspension of Benefits, when unilaterally suspending
income benefits
SBWC FORM NOTICE TO EMPLOYEE OF
OFFER OF SUITABLE EMPLOYMENT
(WC-240)
LIGHT-DUTY JOB OFFER
HOW THIS $AVE$ MONEY…..
EXAMPLE (date of injury January 1, 2020):
• Claimant is drawing $675/week (maximum compensation rate under present law)
• After 6 months (26 weeks), claimant is released to light-duty work
• A WC-104 form is filed – states that after 52 weeks, benefits will be reduced to
$450/week (maximum temporary partial disability benefits)
• From July 1, 2020 (6 months after accident when claimant was returned to light-
duty work) to July 1, 2021(52 weeks), the claimant draws 52 weeks x $675/week,
totaling $35,100.00
• Because a WC-104 form, Notice to Employee of
Medical Release to Return to Work with
Restrictions or Limitations, was filed, maximum
exposure changed to 350 weeks from January 1,
2020 date of injury.
• Maximum exposure without a WC-104 would be
$675/week x 400 weeks = $270,000.00.
• Maximum exposure with a WC-104 would be
350 weeks total
$AVING$Light-Duty Work
Temporary Partial Disability
No Light-Duty
Total Disability
350 weeks of indemnity benefits 400 weeks of indemnity benefits
78 weeks x $675.00 (max.) = $52,650.00 400 weeks x $675.00 (max.) = $270,000.00
272 weeks x $450.00 (max.) = $122,400.00 Full 400 weeks at maximum of $675.00/week
Total Indemnity Paid = $175,050.00 Total Indemnity Paid - $270,000.00
At least a $94,950.00 savings because of light-duty work (or more if injured
worker released to full-duty work before the 350 weeks)
STATE BOARD OF WORKERS’COMPENSATION PETITION FORMEDICAL TREATMENT(B) (WC-PMT(B))
PETITION FOR MEDICAL TREATMENT(B)
(WC-PMT(B))
Employer/insurer can now petition the State Board of
Workers’ Compensation for a conference call with a Board
Administrative Law Judge during which the
employee/claimant must “show cause” why an order should
not be issued directing the employee/claimant to attend an
appointment with an authorized treating physician.
This form will be used when an
employee/claimant is not attending
medical appointments to attempt to
obtain a Board order directing
employee/claimant to attend the
appointment or face a suspension of benefits.
Previously, if an employee/claimant was refusing
to comply with medical treatment,
employer/insurer had to file a motion or request
a hearing to instruct employee/claimant to
comply with their medical care. The PMT(b)
form has streamlined the process.
PMT(b) form is not to be used when an
employee/claimant misses an Independent
Medical Examination (IME) – a motion must
be filed.
SBWC FORM WC-PMT(B)
CLAIMS SETTLEMENTS
• Two Types of Settlements
• Why Settle a Claim?
• How to Value a Case for Settlement Mediation
• Cost If Not Settled – Catastrophic vs. Non-
Catastrophic Cases
• Is a PPD Rating the Same as a Settlement?
THE TWO TYPES OF SETTLEMENTS
1. Bona Fide Dispute Settlement
2. No-Liability Settlement
Almost every settlement will include a separate General
Release of All Claims and a Resignation and Agreement
not to reapply….Employer CANNOT RE-HIRE employee
after settlement.
WHY SETTLE A CLAIM?
Claims are not like wine – they don’t get
better with age!
Settlement of a claim provides permanent
closure for the employer and the Fund
HOW IS A SETTLEMENT VALUED AT MEDIATION?
• Future medical costs
• Future weekly indemnity benefits
•Both reduced to present value
•Disability rating under workers’ compensation laws
•Pain and suffering are NOT included
COST IF CLAIM IS NOT SETTLED
CATASTROPHIC CLAIM
• Lifetime medical and
indemnity benefits
NON-CATASTROPHIC CLAIM
• 400 weeks medical/possible
• 400 weeks indemnity
DO THE MATH…..
PERMANENT PARTIAL DISABILITY (PPD) RATING VS. SETTLEMENT
•Another benefit the employee is due
•Settlement brings permanent closure to
the claim
COST OF SETTLEMENTS – A CASE STUDY
• Laborer fell approximately 30 feet off a bridge where he was working and hit the ground (the water).
• He suffered severe internal injuries of the kidney and intestines. He also suffered broken pelvis, leg, shoulder and arm. Injuries resulted in a one-month hospital stay. He was barely able to walk after his recovery.
• Medical bills approached 2 million dollars.
• His case clearly catastrophic – lifetime benefits at approximately $500.00/week. (Claimant was around 30 years old with a life expectancy of approximately 40 years.)
• Claimant tested positive for marijuana (but defense was going to be difficult to prove).
SETTLEMENT CASE STUDY – CONTINUED
LEVERAGE AND NEGOTIATION
• Leverage – positive drug screen. Employer was
able to cast enough doubt on the case that the
claimant’s attorney wanted to settle (and get
paid).
•Negotiation – had to take place as the hospital
wanted its 2 million.
CASE STUDY - OUTCOME
• Claimant’s attorney was able to convince hospital to take
$250,000.00 or receive $0.00 as claim was not compensable
(positive for marijuana)
• Employer’s settlement offer - $500,000.00
• Injured worker received $250,000.00
• Employer dodged a 3 million payout, saving 2.5 million!
VARIOUS WAYS TO $AVE MONEY
WITH AGRITRUST PREMIUM CREDITS
•Per-Claim Deductibles
•Drug Testing
•Regional Seminars
•Quarterly Conference Calls
•Quarterly Safety Initiatives
•Ginner’s Safety Roundtables
PER-CLAIM DEDUCTIBLES
Per-Claim Deductible Premium Discount
$100.00 .6%
$200.00 1.0%
$300.00 1.4%
$400.00 1.7%
$500.00 2.1%
$1,000.00 3.4%
$1,500.00 4.5%
$2,000.00 5.4%
$2,500.00 6.3%
DRUG TESTING
• 7½% Credit – Certification in the State Board of Workers’ Compensation “Drug-Free Workplace” Program.
• 5% Credit – All employees, full-time, part-time, seasonal or otherwise, shall be drug/alcohol tested at least once during a calendar year. This drug/alcohol testing can be done based on a pre-employment, random, post-accident and/or reasonable suspicion basis.
• 3% Credit – Pre-employment, post-accident and reasonable suspicion drug/alcohol
testing.
• 1% Credit – Post-accident and reasonable suspicion drug/alcohol testing.
REGIONAL SEMINARS
Audited Premium Amount Seminar Credit
$0 - $5,000 $50.00
$5,001 - $10,000 $100.00
$10,001 - $15,000 $150.00
$15,001 - $25,000 $200.00
$25,001 - $50,000 $250.00
$50,001 & Up $300.00
QUARTERLY CONFERENCE CALLS
Audited Premium Amount Credit per Call (Affidavit)
(minimum of 2 calls/year)
$0 - $5,000 $25.00
$5,001 - $10,000 $50.00
$10,001 - $15,000 $75.00
$15,001 - $25,000 $100.00
$25,001 & Up $125.00
QUARTERLY SAFETY INITIATIVE
• Promotes employee safety
• Monthly Safety Alert and Safety Mentality information is provided by
AgriTrust for training purposes
• Fund members have access to dozens of safety videos through Midlands
Management Corporation
• Submit Entry Form for every training session/meeting
• One winner will be selected quarterly and can win up to $2,000.00
GINNER’S SAFETY ROUNDTABLES
A motion was made by AgriTrust of Georgia Trustee Ben Lancaster,
seconded by Trustee Becky Kilby and unanimously passed by all approving to
increase the premium credit for companies attending the Ginners’ Safety
Roundtables to:
• $100.00 per attendee up to 5 attendees
• $50.00 per attendee from 6 to12 attendees
• Total premium savings for a cotton gin could be up to $850.00
• Effective in 2020
GINNERS’ SAFETY ROUNDTABLES
The 2020 Ginner’s Safety Roundtable will be video
recorded and made available to all cotton gins.
The gins can present the information to their
employees and earn premium credit as verified by
affidavit submission.
THANK YOU FOR CHOOSINGAGRITRUST OF GEORGIA
P.O. BOX 167, WATKINSVILLE, GA 30677
678/753-0016 • TOLL FREE 855/753-0016
FAX 678/753-0056
WWW.AGRITRUST.BIZ