The Workers’ Compensation Institute’s 78th Annual Conference brought together 5,000 industry professionals in Orlando last week to discuss the key issues and topics facing the sector throughout the remainder of 2024 and into 2025.
1. Legislation governing first responders’ presumptions of entitlement has evolved into increasingly active litigation as the number of psychological injury claims increases and discrepancies in state laws are challenged.
A panel discussed whether alleged claims by first responders related to PTSD, heart disease and cancer in the fire service have become one of the most difficult and contentious areas of law for claims adjusters and risk managers in the public sector.
Mark Walls, vice president of communications and strategic analysis at Safety National, moderated a conversation with panelists Marguerite Jonak, Esq., Greg McKenna, national practice leader at Gallagher Bassett, and Florida-based attorney Geoff Bichler.
Because each State addresses the specific problems of this group of civil servants individually, there is no uniform approach to processing these claims and great uncertainty regarding coverage, in accordance with Insurance Insider US reports.
In addition, many presumption laws are relatively new and there is no case law defining the parameters of scope or interpreting ambiguities in the law.
According to the panelists, this means that alleged claims are often disputed and technical rejections are often made without taking into account the associated subsequent costs.
In the audience, a congresswoman from Florida described the plight of her community, where 19 firefighters and police officers have died by suicide this year alone.
The Florida legislative process, influenced by the 2016 Pulse movie theater shooting, resulted in a bipartisan bill for PTSD benefits, but many applications are still denied due to unclear provisions.
The panelists and participants stressed the need for independent, bipartisan and community-driven legislation that addresses the specific problems of these entitlements at balanced costs.
However, determining these costs remains difficult because the data is incomplete and there is no data on self-insurance, panelists said.
The conversation offered some hope, highlighting the successes of the approach in San Diego, where presumption laws have been expanded to include heart, cancer and other conditions for various first responders and health care workers.
These assumptions are likely to expand further as more arguments are made to include other professions, such as correctional officers and parking attendants.
Walls addressed the issue of creating distinctions between the public and private sectors and the potential impact on the workforce in general, reinforcing that this issue will continue to exist and have implications for all workers’ compensation insurers.
2. “Are injuries getting worse?” – The data suggests this is true.
The trend in occupational accidents has fluctuated over the past decade. The number of claims for compensation increased slightly in 2022 compared to 2020, but was still below the pre-pandemic level in 2019.
Lower injury rates have provided only marginal relief to overall claim costs, with medical inflation rising over 3% in the first seven months of this year alone and disability costs rising nearly 4%.
Industry participants highlighted other key influencing factors and analyzed unemployment rates and the impact of an ageing workforce.
The unemployment rate of around 4%, panelists said, is having an impact on injury rates, particularly among workers with lower tenure, as studies show higher rates of injury among younger and older workers.
Studies by WCRI and Travelers suggest that higher unemployment rates may lead to more or fewer injuries because workers adopt one of two mindsets: While some workers file more to keep their jobs, others file less to keep their jobs.
The biggest factor appears to be the demographic composition of the age group: injuries are concentrated primarily among younger workers aged 22 and under and older workers aged 55 to 64.
Travelers reported that 35% of workplace injuries occurred among employees who had been with the company for less than one year, and WCRI found that people ages 25 and under reported injuries more frequently than people ages 55 and older.
Studies show that the proportion of workers aged 55 to 64 will have doubled since 1996, and the proportion of workers aged 65 and over will triple by 2026.
The cost of workers’ compensation claims increases with age as injuries become more likely and more severe. Older workers are also slower to return to work after an injury, further worsening claim costs, treatment times and treatment outcomes.
3. Workplace violence is one of the leading causes of fatal workplace accidents.
According to a 2024 Trailant survey, workplace violence is now the third leading cause of fatal workplace accidents in the United States.
Each year, two million people in the United States are victims of workplace violence, 20,000 of whom suffer physical injuries. These incidents cost employers $121 billion annually, according to the U.S. Department of Justice.
Marsh panelists – William Liebler, Dennis Tierney and Renata Elias – discussed the risks and consequences of workplace violence and how the issue impacts workers’ compensation claims for mental illness.
The discussion highlighted the importance of recognizing warning signs, implementing preventive measures and being aware of the legal and financial consequences of violence in the workplace.
In California, this issue is timely because Senate Bill 553 went into effect on July 1, requiring most employers to take basic protective measures to protect their employees in the workplace.
The bill requires employers to implement a comprehensive workplace violence prevention plan, maintain and retain a log of violent incidents, develop and conduct training for employees, and establish a documentation program.
