Title: Director, Western Region, Ironworker Management Progressive Action Cooperative Trust
Favorite Quote: “Lost ground can always be regained, lost time never.” (Teddy Roosevelt)
Inspiration: Rank feels that John Lamberson, with Lamberson Consulting, has been an inspiration to the ironworkers and IMPACT because of his deep knowledge of workers’ comp issues and his ability to provide alternative solutions to help employers and labor reps throughout the country.

A strong advocate for safety, Rank has been head of the Ironworker Management Progressive Action Cooperative Trust since 2004. He is a former member of the Cal/OSHA Standards Board and currently serves on State Compensation Insurance Fund’s Board of Directors. He served as director of safety for the California Ironworkers Employers Council from 2002 to 2004, and director of safety and health for the National Erectors Association from 1998 to 2001 and Ben Hur Construction from 1998 to 1999. From 1990 to 1998, he was national safety director for the Ironworking Contractors Insurance Program.

What are the top three issues in California workers’ comp today? What is the chief concern for labor unions?  
Preventing workplace accidents should be the primary focus of all California employers. Second, it’s important for California employers to work closely with their injured workers and their carriers to avoid unnecessary medical costs, avoid unnecessary litigation, and return workers back to work as soon as possible. Third, employers need to have accident prevention and claims management programs instituted in company operations as a function of their company operations. Labor unions should work closely with employers and injured workers to help return members to work as soon as possible. They need to understand things that they can do to help as well.

Are we headed for a hard market, and if so, when will it come? How long should we expect it to last? What are the repercussions?  
I don’t see it coming for another year and half, but when it starts turning, it’s going to get real hard. All of these claims costs now, that were premiums taken in a soft market, the investments did not pan out. These claims are coming mature now, but their investment income is not going to pay for these claims. Investors are going to take heavy losses. The market will turn hard.

It’s no longer a question of if but when we enter a hard market, so what is in the future of State Compensation Insurance Fund? Will its market share climb back to historic levels? Do you think that further reforms are needed for the governance of State Fund, for example, does it make sense to have Senate confirmation for board members?  
I know that the State Fund is positioning [itself] to the best of [its] ability to provide the best services to California employers despite where the marketplace is going. They are doing the best job they can to provide the best services to their policyholders, regardless of where the market is.

Are medical provider networks a help or a hindrance? How should they be improved?  
providers versus one or two, you can imagine how much easier it would be to work with one or two processes instead of 50. Consistency and uniformity saves time and money and prevents misunderstandings. They can constantly identify the best doctors and specialists, and at the same time, they need to purge or remove doctors or specialists from their system that overbill or who don’t provide good services from the feedback of injured workers and providers. They need to cut the dead wood, to be blunt.

What needs to be done to improve return-to-work?  
What needs to be done is the medical community needs to be educated and provided with extensive, detailed lists on work activities within their company. So if you have a broken finger, you can answer the phone or do something else in the office and be as productive as someone without a broken finger. Can you explain to that doctor that you don’t need to be home on pain medications for seven days? You can be at work and be productive within restrictions.

What do you see, other than medical, as the next big cost driver?  
I think that medical is first and unnecessary litigation is a cost driver, that employers and carriers need to utilize collectively bargained workers’ comp programs whenever possible to help mitigate unnecessary litigation and medical costs. The success of these programs is published. They all have shown less lost-time work days, and they have shown reduced medical costs and reduced litigation in the number of claims. The results speak for themselves.

Where do you see applicant attorneys focusing litigation in the future?  
I think that applicant attorneys do have a place when there are a third-party claims and for when insurance carriers knowingly and willfully do not provide workers with fundamental information and services. Applicant attorneys always want the big claims; the big claims are not in workers’ comp but in third-party liability suits that come on the tail of these types of workers’ comp claims.

Now that the federal health care bill has become law, what impact, if any, do you see that having on workers’ compensation and do you have any concerns?  
I do have concerns, because I don’t understand 19,000 pages of it. I don’t know what will happen.

What is the effect of more than $1 billion in payroll being absorbed by the self-insured groups?  
What’s that tell you? That shows you they’re not satisfied… they go out and hire all these consultants and gurus. They don’t have control of medical—of a lot of stuff—and that has resulted in them doing what they have to do to protect themselves. I understand why they’re doing it. Do I know what the effect is? If it takes a lot of money out of workers’ comp, then the market needs to look at why are they leaving? If someone didn’t like something, and they started leaving, wouldn’t you want to know why you were losing all that business?

Governor Schwarzenegger signed bills allowing predesignation to continue (SB 186), tweaking utilization review (AB 361), and limiting the denial of benefits (AB 1093). What impact could these, if any, have on costs? What is the long-term benefit to the injured worker?  
Predesignation is a good thing. If people have something to say about it, you wouldn’t want to be told that you’d go to one treating physician. Predesignation is something anyone would want to do if they’re going to be footing the bill. That’s not a bad thing. I haven’t seen all of that, but there’s a place for it if it’s used appropriately. There are cases where you want to deny a claim, but not every time. There has to be accountability for claim denial, that’s all. [With regards to costs or long-term benefits to injured workers,] I haven’t studied that.

Does it make sense for premiums to go up in light of the increase in medical severity and the Almaraz/Guzman & Ogilvie decisions?  
If you’re paying more for medical costs, someone has to pay for that. Once the medical costs go up, the insurance carriers are going to have to increase premiums to cover these medical costs. They’re not going to just accept it and take it out of profits if there are any. They have to adjust it just like the price of electricity. You have to pay for that. Wages go up. It’s just a fact of life. Medical prices go up, and then you have to build that into your costs.