PSWCT

Executive Director’s Corner: Preparation is Key

Clairmonte Cappelle Executive Director

Clairmonte Cappelle
Executive Director

Elementary schools across the state welcomed a new class of kindergartners last month. While the first-day-of-school pictures that pop up on social media feeds capture the joy and excitement of this milestone, what you might not see is the preparation done by parents, schools, and communities that build to this moment. Years of nurturing, early childhood education, and kindergarten registration efforts lay the groundwork for a confident and capable 5-year old to stride through those classroom doors.

Preparation lays a strong foundation for everything we do, and risk management is no different. “Begin with the end in mind” is wise advice as we launch into a new year. Does your district have a return-to-work program that could use some attention? Have you spent time revisiting whether your new employee orientation includes the proper safety protocols and procedures? Spending time thinking these things through now could prevent a difficult situation later.

This issue of Sound Advice is all about preparation. Would it surprise you to learn that the likelihood of an on-the-job injury is at its highest in a new employee’s initial period of employment? This doesn’t have to be the case. Read through our article on how to have a Safe Start for New Employees. Similarly, as the country’s workforce increasingly consists of more workers over the age of 65, you may want to give some thought to how to keep these workers safe. We’ve compiled some statistics and strategies to create a low-risk environment for older workers.

While workers’ compensation issues typically concentrate on district staff, one area where employee health and student health overlap is maintaining a healthy classroom. Dust, mold, and other irritants in a classroom can contribute to absenteeism on the part of both teacher and student, particularly if either is prone to asthma or allergies. You’ll find advice here on how to keep your classroom healthy for the entire year.

I encourage you to take the necessary steps to prepare for a safe and healthy school year.

A+ Reasonable Assurance Letters

With the end of the school year quickly approaching, we know many districts are caught in a flurry of activity, with tasks to complete before summer. Sending out your Reasonable Assurance letters to next years’ subs may be on your checklist.

The link provided shows an example with suggestions that limit the district’s liability during scheduled holiday breaks.

Feel free to contact Elisabeth Heerema with any other unemployment-related questions.

RA Letter Image

Dates + Distribution = Successful Reasonable Assurance

By: Elisabeth Heerema, Unemployment Pool Coordinator

iStock_000007676646_SmallSchool holidays can be a confusing time for substitute employees in terms of whether or not they are entitled to unemployment benefits.

This leads to many substitutes applying for benefits when they are not eligible, which creates more work for school district staff.

We suggest using a simple formula to eliminate the confusion.

Dates plus distribution equals a successful reasonable assurance letter.

Dates
Details are your friend when it comes to reasonable assurance letters.  Highlight the exact dates of scheduled school breaks during  winter, mid-winter, spring, and summer. This will align your message with RCW 50.44.050, which indicates that substitutes are not eligible for unemployment benefits during the customary vacation or holiday breaks.

Distribution
Provide reasonable assurance letters to all substitutes regardless of when they are hired.  Without reasonable assurance, substitutes are eligible for unemployment benefits compensation during scheduled school breaks.  All schools districts have a plan in place to distribute these letters at the end of the current school year for the upcoming school year.  And that practice has saved school districts countless dollars.  We encourage you to follow the same practice all year for substitute hires.

Grand Tally
We want the grand tally to work in your favor.  With this reasonable assurance equation, your district will get the results you want – money and time saved.

Executive Director’s Corner – Autumn

Clairmonte Cappelle

Clairmonte Cappelle

Change is in the Air
September is traditionally a time of change. Summer fades and our children return to school. This summer brought with it many sunny days, but also marked a period of historic drought and wildfire in our region.  We send our condolences to those who have lost so much.

We would also like to remind our members to be aware of air quality. The smoke in the air can be noticeable even though the wildfires are miles away. We encourage our members to contact our loss control staff if they have concerns about their school’s air quality.

Increased Benefits
Another change impacting our state this year is the increase in the state’s average wage. This summer, the Employment Security Department announced that Washington’s average annual wage increased by 4.2% in 2014 to $54,829.  This is the largest percentage increase since 2007.  While this is good news for Washington’s workers, it will have an impact on Washington’s employers.

Employment Security uses the average annual wage to calculate unemployment benefits for jobless workers.  The minimum weekly unemployment benefits, calculated at 15% of the average weekly wage, will increase from $151 to $158 for new claims opened on or after July 5, 2015.  The maximum weekly benefit, calculated at 63% of the average weekly wage, will increase from $637 to $664.

The Department of Labor and Industries also uses the state’s average wage to calculate workers’ compensation benefits.  For most workers injured before July 1, 2014, time-loss and pension benefit payments will increase by 4.168%.  As a result of the increase, the new maximum monthly benefit will be $5,482.90, or 120% of the state’s average monthly wage.  The increase became effective on July 1, 2015.

New Partnership
This month brings an exciting change to the Trust.  Effective September 1, we will partner with a specialty workers’ compensation company, RTW, Inc., to integrate nurse case managers into our claims management process to identify potentially complex claims at the onset of an injury and work with our school districts, injured workers, and their medical providers to facilitate a swift recovery and return-to-work.

We are committed to delivering the best care for our injured workers. RTW’s nurse case managers will use their specialized medical management skills to ensure our injured workers benefit from best-practice treatment. Nurses will work hand-in-hand with our claims staff, enhancing our adjusters’ extensive claims handling knowledge and experience with their medical expertise.

As you prepare to head back to school, we encourage you to be safe and healthy.

 

Legal Corner: Determining “Good Cause”

By: Natalee Fillinger, Attorney

The State of Washington recognizes twelve specific reasons to allow unemployment benefits for employees who voluntarily leave their employment.

iStock_000006638199_SmallThese reasons are generally referred to as “good cause,” and include scenarios where a worker’s spouse relocates due to a job transfer, usual pay or hours decrease by 25 percent, the worksite becomes unsafe, or the claimant or an immediate family member becomes sick or disabled. A complete list can be found here.

A recent case decided by the Washington Supreme Court examines the issue of “good cause” in terms of (1) whether employees who voluntary quit their jobs must show how a disability necessitated leaving that job; and (2) whether part-time workers who are being required to work additional hours are entitled to unemployment benefits after they quit.

The case of Darkenwald v. State of Washington Employment Security Department addresses a denial of unemployment claims to the petitioner, a dental hygienist. In 1998, the petitioner suffered a back and neck work-place injury, which left her with permanent restrictions.  Even with her restrictions, she continued to work three to four days per week until 2006, when she reduced her work days to only Mondays and Wednesdays.  In 2010, her employer asked her to also work on Fridays.  The petitioner did not want to do so, but her employer made it clear that working on Fridays was a requirement of her employment.

The petitioner interpreted her employer’s request as a termination of her employment, and indicated in a meeting with her employer that she was being fired.  Her employer indicated that it was never its intent to fire the petitioner, and in fact believed that she had voluntarily quit.  The petitioner filed for unemployment benefits, and her employer fought her entitlement, indicating that she had voluntarily quit, thus making her ineligible for unemployment benefits.

At hearing, the petitioner argued that her prior disability precluded her from working the additional day requested by her employer. Illness or disability is a grounds for asserting that one has “good cause” to quit.  However, in order to assert disability as a “good cause” basis for quitting, the petitioner needed to show she had exhausted her remedies with her employer prior to quitting or filing a claim.

In this case, the petitioner did not reference her disability on her initial application for benefits with the Department, only stating “wanted me to work more days” as the reason for her separation from her employer. The first mention of her prior disability was at the unemployment hearing.  Additionally, under the statute, the petitioner was required to present a doctor’s note, which included physical restrictions, to her employer and seek accommodations before she quit her job.  Because she had not exhausted all reasonable alternatives prior to quitting, she was not entitled to benefits under the statute under a theory that a medical condition necessitated quitting.

Finally, the petitioner argued that because she was a part-time worker, she was not required to take accept more hours in order to receive unemployment benefits, citing a statute.  The court rejected her argument.  The statute makes clear that workers actively receiving employment benefits, whose prior work pattern had been part-time, do not need to accept full-time work to continue receiving benefits.  The court made clear however, that only workers who are receiving benefits are entitled to reject full-time job offers.  It is not a basis to voluntarily quit gainful employment and then receive unemployment benefits.  Of note, had the petitioner’s employer reduced her hours by 25 percent, it would have been considered “good cause” and established a basis for the petitioner to receive unemployment benefits.

Many people who leave their jobs due to disagreements or dissatisfaction with their employer may genuinely feel that they are being “forced” to quit.  Historically, the statute was amended to only allow for very specific reasons to quit, providing greater guidance to courts when considering whether to grant unemployment benefits to workers claiming they had no choice other than to quit their job.

In this case, the Supreme Court reinforced that the enumerated exceptions specifically stated in the statute are the only basis to grant unemployment benefits to workers who voluntarily quit their jobs. Merely feeling like one will be fired or even rationally believing that being terminated is eminent is insufficient to obtain unemployment benefits.

References
RCW 50.20.050
RCW 50.20.119
Darkenwald v. State of Washington Employment Security Department

 

Executive Director’s Corner – Summer

Clairmonte Cappelle

Clairmonte Cappelle

As we quickly approach the end of the school year and the start of summer, the Puget Sound Workers’ Compensation Trust and Unemployment Pool hope that our member districts had a successful year.  We look forward to working with you throughout the summer and into the next school year.

It is easy to get caught up in the excitement and anticipation of summer, and while the summer break provides the opportunity for relaxation and renewal, we want to remind our member districts to also take this time to pause and consider safety.

This issue of Sound Advice offers members valuable information on staying healthy during the final weeks of the school year.  We encourage you to share it with your staff as they work to prepare for the summer break.

In addition to implementing behaviors to keep staff safe and healthy, we also advise our members to think about their claims processes, and how they can be refined to control claims costs for their districts.  Below I have highlighted a few best-practice approaches to consider for better claims outcomes.

Timely and Accurate Reporting – The implementation of our online SIF-2 claim reporting system has significantly shortened the amount of time between when an injury occurs and when a claim is opened. This reduction in lag time greatly improves our adjusters’ ability to manage and investigate claims, which leads to better outcomes.

A key factor in this process is ensuring that Trust staff, district claims contacts, and medical providers all communicate promptly and efficiently with one another, minimizing any opportunity for unnecessary delays. The Trust is currently undergoing a review of all  business processes, including when, how, and to whom we communicate during the initial claim reporting process as well as throughout the claim lifecycle.  We look forward to working with our school districts and injured workers toward this end.

Post-Job Offer Assessment – This is the time of the year when school districts’ budgets for the next fiscal year are finalized and plans for new or replacement positions are contemplated.  For positions or job classes where the essential job functions involve some degree of physical activity with frequency, we encourage our school districts to adopt a post-job offer assessment program to ensure that selected candidates can physically perform the essential functions of the job.

School districts who have implemented this program have experienced tremendous success in recruiting the right candidate who indeed can physically perform the essential functions of the job with or without accommodations.  The alternative is potentially for a claim to occur when the selected candidate sustains an injury performing physical activity associated with the essential functions of the job.  As a benefit of membership, Steve Lyons and Matt Tardif are available to assist you with implementation of such a program.

Early Return-to-Work – If your district does not currently have an early return-to-work program, we encourage you to develop one with the assistance of our expert loss control staff, a benefit of your Trust membership.  There is a direct correlation between early return-to-work programs for injured workers and reduced indemnity and medical costs. Moreover, according to the Washington State Department of Labor and Industries, the sooner an employee returns to work after an injury, the more expedited his/her recovery is, and the more likely s/he experiences a sustainable return to the job of injury.

Education – An injured worker’s or provider’s unfamiliarity with the workers’ compensation process sometimes can lead to unfavorable unintended consequences.  To minimize this result, we recognize that the Trust’s processes need to be  transparent and easily understood by school employees, school districts and medical providers.

To that end, we have created a Frequently Asked Questions (FAQ) page for both the Unemployment Pool and Workers’ Compensation Trust. These FAQs discuss issues regularly experienced by our customers, and are a good first resource for questions that arise for both districts and their staff.  Our staff is also here to help answer questions and coordinate care.

If you are experiencing challenges navigating through the unemployment or workers’ compensation claims processes, please either get in touch with your main contact with the Trust or Pool, or Susanne McIntyre, our Director of Client Relations. We understand that education is an important part of making these processes work as intended.  Please continue to access our knowledgeable and caring staff.  We are here to guide you and your injured worker to a mutually rewarding outcome.

Have a safe and enjoyable summer!

Unemployment Wage Verifications Made Easy

By: Susanne McIntyre, Director of Client Relations

Time-saving Tip

iStock_000012518071_Medium2One of our districts asked a great question about Wage Verification Requests from Employment Security.  Wage Verification forms include a lengthy weekly hour chart which can be time consuming to complete.

Our district wanted to know if there was another way to provide the wage and hour information.

Employment Security indicated there is a much easier process.  Simply:

  • Indicate the rate of pay for the time period requested
  • Attach the appropriate timesheets

Keep sending in your questions and we’ll share good tips.

Executive Director’s Corner – Spring

By: Clairmonte Cappelle, Executive Director

Clairmonte Cappelle

Clairmonte Cappelle

As we once again mark a change in season, the Puget Sound Workers’ Compensation Trust and Unemployment Pool would like to wish all of our member districts a happy and healthy start to Spring.

Just as we know districts are preparing for the wind down of the school season, we are continuing to work on service enhancements to our school districts as laid out in our new vision and mission.

New Staff
The Trust and Pool recently welcomed two new members to our management team in the last month. Diana Brown joined us as the new Director of Information Technology, and Susanne McIntyre, previously the Pool’s Unemployment Consultant, was promoted to Director of Client Relations.

The addition of Diana and Susanne to these new functions strengthens the leadership capacity necessary to further enhance our relationships with member districts and to build the infrastructure for improved workflow efficiency, data reporting and business intelligence that will better serve our members as we collectively pursue a best-practice risk reduction culture.

Current Board member Diana Seeley and former Board member Carolyn Webb were recognized for their service on the Executive Advisory Board. Former Board member Ruth Russell (not pictured) was also recognized.

Current Board member Diana Seeley and former Board member Carolyn Webb were recognized for their service on the Executive Advisory Board. Former Board member Ruth Russell (not pictured) was also recognized.

Annual Trustee Meetings
The Pool and Trust both held their Annual Trustee meetings in February and March, respectively. These meetings provide wonderful opportunities for networking among member districts and Trust and Pool staff.

This forum also provided a venue for Trust and Pool staff to update member districts on the state of the organization, for members to provide guidance on the bylaws that govern the Pool and Trust, and for transparency in the decision-making that goes into rate-setting and member contribution requirements.

I would like to thank member districts for their participation in voting in our Executive Advisory Board elections and for taking the time to attend these important meetings. The actions taken by Pool and Trust members at these meetings are highlighted below.

Board Decisions

We Asked and You Listened

By: Susanne McIntyre

iStock_000003272572_SmallOur vision at the Puget Sound Workers’ Compensation Trust and Unemployment Pool is to be the industry leader in claims and risk management solutions to regional education communities.

The first step towards achieving this goal is ensuring that we are providing the services Districts need to minimize risk, and just as importantly, ensuring that Districts are aware of these services.

With these goals in mind, we teamed up with Puget Sound ESD’s Communications staff to develop a marketing plan to improve our communications with Districts and find out if we are meeting their needs.

Survey Results

A key component of this plan was to gain District feedback. During the final week of February, a survey was sent to PSWCT and UP trustees and contacts.  A total of 26 member school districts responded to the survey – almost all of the districts we serve. We were pleased with the results.

Members indicated they were pleased with our services:

  • 84 percent of members rate the overall quality of PSWCT as high or very high.
  • 76 percent of respondents rate the overall quality of UP as high or very high.
  • 97 percent of members would recommend the PSWCT service to others.
  • 85 percent of respondents would recommend the UP services to others.

Members also let us know what else they want:

  • Legislation and news updates.
  • Continued training in multiple areas, including return-to-work and filing claims online.

New Communication Tools

Thank you for taking the time to provide us with this important feedback.  It will be incorporated into our plans to improve services to our Districts.  Recommendations for our new communication tools will be presented to our leadership team and ready for roll out by September 1, 2015.  Highlights will include a new social media presence and regular communications from us featuring in-depth articles about topics suggested by members.

Watch for our new look and please continue to share your feedback!

Legal Corner: Unemployment Case Review

By: Natalee Fillinger, Attorney

iStock_000006638199_SmallMaking the decision to terminate an employee can be one of the most difficult issues an employer faces, and one that can be fraught with legal issues regarding the payment or denial of unemployment benefits.

A recent decision by the Washington Court of Appeals may help shed light on part of this multi-faceted issue.

The Case

Kopp vs. Washington Department of Employment Security dealt with the termination of an employee of a plastic molding company. The company had a rule requiring that employees immediately report all fires on company property to their supervisors.  The employee was trained on this rule and signed an acknowledgment that she understood it.

One evening, the employee was standing outside a company building while on break when she noticed some bark smoldering on the ground.  She returned to the building, and informed her co-worker, who was not her supervisor, about the fire. The employee then filled a small trash can with water and repeatedly doused the bark before returning to work.

The employee neglected to inform her supervisor about the fire, in violation of the company’s fire policy.  About an hour after the employee doused the smoldering bark with water, flames broke out in the bark and the fire department was called to put out the fire.

Subsequently, the employee was terminated and denied unemployment benefits due to employee misconduct, which occurred when she disregarded a reasonable rule by failing to immediately notify a supervisor of a fire.

The Legal Argument 

In her defense the employee asserted: 1) her actions were less like misconduct and more like an error in judgment, and 2) firing her over one small error in judgment was too harsh of a consequence for a first time offense.

In order to find misconduct for violating a rule: 1) the rule must be reasonable, and 2) the employee must know or should have known about its existence.  No one would argue that it is unreasonable to make employees report every fire that occurs at a chemical manufacturing plant, even small fires.  The rule is reasonable.  It is also clear that the employee knew about the rule, as she signed a document verifying that she understood it.

Finally, the employee described not informing her supervisor of the fire as an “error in judgment” for which termination of employment was too harsh of a response.  However, the Employment Security Department does not consider whether an employer’s termination policies are too strict.  Employment Security only looks at whether an employer has satisfied the requirements of proving an employee engaged in misconduct.  Therefore, whether or not the termination of this employee was too harsh of a consequence is irrelevant to determining the employee’s entitlement to unemployment benefits.

In the end, the employee was denied unemployment benefits.

The Take-Away

The main take away: make sure as an employer that your rules make sense and are regularly and clearly communicated to your staff.  If it is appropriate, have your staff sign an acknowledgement of key rules, especially in cases where the violation of the rule may result in termination and denial of unemployment benefits.

Susan R. Kopp vs. Washington Dep’t. of Employment Sec (December 2014)

Washington Court of Appeals – Division I – Unpublished Decision

http://www.courts.wa.gov/opinions/pdf/710257.pdf

 

Report Fraudulent Claims

  • Workers' Compensation Fraud
  • Unemployment Fraud