Make Your Work Comp Message Stick Like Gorilla Glue

This Is Part 2 in a 3 Part Mini Series.

 

The Tipping Point in Workers Compensation

  1. Paul Revere, Workers Compensation, and the Tipping Point
  2. Make Your Work Comp Message Stick Like Gorilla Glue
  3. How Work Comp Can Be Just Like Prison

 

I’m Michael Stack with Amaxx and welcome back to The Tipping Point mini series where we’re reviewing the elements discussed by Malcolm Gladwell in the book The Tipping Point: How Little Things Can Make a Big Difference. When you’re trying to implement change, when you’re starting to try to implement an epidemic of proper work comp management to reduce your work comp costs and really create a better outcome for your injured workers.

 

In the first series, I talked about the law of the few and really that’s very relevant when you’re trying to get buy in to your program. The CEO and senior management are onboard, but don’t forget about those employees that have an influence over others. They have those innate skills that connectors, the mavens, and the sales people.

 

 

Stickiness Is Message Into Memory

 

In this session, I want to talk about the stickiness factor and how memorable your message is. Maybe you’ve created a brochure, maybe you’ve done some training, maybe you’ve had safety meetings in regards to your work comp management, but you’re not getting your claims reported timely, which is really where this is very, very important in how memorable your message is, particularly at the time of injury to get that claim reported immediately. You have a very low cooperation or a very low implementation rate in getting those claims reported. Here’s the study, Yale University 1960s, what they were trying to do is get the students to get their tetanus shot.

 

It was a free tetanus shot at the health clinic. They did two different types of brochures, a high fear and a low fear, and they wanted to see if it made a difference and really gory photos of what happens if you get tetanus and why you should get the shot. Then, a very less intrusive or less fearful brochure. Here’s what was interesting that a month later, only 3% of students ended up getting the shot, very, very low cooperation with what they were trying to do and it didn’t matter whether they were in the high fear or the low fear group to get those outcomes.

 

 

Not The Message, But The Package

 

Often times, it’s not the quality of the message and you’re beating your head against the wall with why aren’t my employees reporting their claims when I’ve told them 100 times maybe it’s the way that you’re telling them that’s going to make a difference. In this study, all they did is they put a map of the campus of where the health center is as well as the times that it was open and they saw those rates increase to 28% of their students cooperating and going to get the shot. It didn’t matter what the message was from these groups. It was both relatively equal. When you’re trying to get by them, when you’re trying to get cooperation, particularly with your claims reporting for your program, don’t forget or discount the stickiness factor of how you’re packaging the message.

 

Maybe you have an injury triage hotline and you need to give them a wallet card, you need to put it on your lanyard, you need to create a new sign. You need to make some changes and do some testing in how you’re displaying or packaging that message. Remember the stickiness factor in getting your claims reported.

 

I’m Michael Stack with Amaxx. This is the Tipping Point In Worker’s Compensation mini series. Remember, your success in worker’s compensation is defined by your integrity, so be great!

 

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

Nebraska Worker Killed, Employer and Contractor Fined

A mere 20 minutes after an 8-foot deep trench collapsed, burying a 61-year-old Nebraska plumber under thousands of pounds of soil, emergency responders pronounced the man dead. Partially buried, his co-worker escaped the trench and frantically tried to rescue the man until help arrived.

 
An investigation by the U.S. Department of Labor’s Occupational Safety and Health Administration found neither the men’s employer, nor project’s contractor provided trench cave-in protection for the workers as they installed sewer lines at a residential home project in the 2800 block of Toluca Street in Alliance on March 21, 2016.

 

Federal inspectors have cited both Clau Chin Construction LLC, the men’s employer, and Larry Kessler Construction LCC, the project’s contractor, with three serious violations following their investigation.

 

“This tragic death is a reminder of just how quickly an unprotected trench can become a death trap as a worker is buried under thousands of pounds of soil,” said Jeff Funke, OSHA’s area director in Omaha. “Soil dynamics are an unpredictable aspect of all trenching and excavations. Soil gives no warning prior to giving away, burying workers in just seconds. Inspection, protective systems and training are the difference between life and death in cases like these.”

 

In addition to citing the companies for failing to provide trench protection, inspectors said the employers did not have a competent person inspect the trench before allowing workers to enter. The companies also permitted soil piles within two feet of the excavation site, also a violation.

 

OSHA has issued citations as follows:

 

  • Clau Chin Construction of Alliance, the homebuilder, faces $31,000 in fines for five serious safety violations.
  • Larry Kessler Construction of Scottsbluff, the excavating contractor, faces fines of $21,000 for three serious violations.

 

OSHA’s trenching standards require protective systems on trenches deeper than 5 feet and that soil and other materials are kept at least two feet from the edge of trench.

 
Both companies had 15 business days from receipt of its citations and penalties to comply, request an informal conference with OSHA’s area director, or contest the findings before the independent Occupational Safety and Health Review Commission.

 

 

 

Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com.  Contact: kstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

WORK COMP CALCULATOR:   http://www.LowerWC.com/calculator.php

MODIFIED DUTY CALCULATOR:   http://www.LowerWC.com/transitional-duty-cost-calculator.php

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

Manitoba WCB Sees $95 Million Surplus

The Workers Compensation Board of Manitoba’s (Canada) 2015 Annual Report was tabled in the provincial legislature recently.

 

The highlights include a surplus of $95 million, implementing a fairer and balanced assessment rate model and enhancing customer services for injured workers. The WCB also released its 2016 – 2020 Five Year Plan.

 

“Strong financial stewardship and investments in prevention and return to work efforts by the WCB, its partners and the workers and employers of Manitoba have allowed us to decrease the average assessment rate for 2016 by five cents to $1.25 per $100 of assessable payroll,” said Winston Maharaj, WCB President and CEO. “The time loss injury rate is moving downwards as well to stand at 3.0* per 100 workers.”

 

“We are transforming our organization to more readily meet the changing demands of our customers,” added Maharaj. “Our strong financial foundation and systems are allowing us to decrease rate volatility and provide more collective liability protection through the introduction of a new assessment rate model.”

 

In 2015, the WCB also introduced new best practices to ensure consistency in providing services to severely injured workers. As well, the WCB established a telephone claims service center that helps answer the majority of injured workers questions and approves some medical expenses.

 

These improvements, and others, are focused on providing injured workers with compassionate care while also encouraging safe and timely return to work.

 

The WCB also introduced a new team that helps employers develop or strengthen their return to work programs. Effective return-to-work programs minimize the duration of an injury, promote recovery and benefit both workers and employers.

 

The WCB also made further inroads in implementing Manitoba’s Five-Year Plan for Workplace Injury and Illness Prevention through SAFE Work Manitoba. New industry-based safety programs were established and work began on a new province-wide safety certification program. The annual report includes SAFE Work Manitoba financials that show the WCB’s investment in prevention.

 

* Estimated, to be confirmed in mid-2016.

 

 

 

Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com.  Contact: kstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

WORK COMP CALCULATOR:   http://www.LowerWC.com/calculator.php

MODIFIED DUTY CALCULATOR:   http://www.LowerWC.com/transitional-duty-cost-calculator.php

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

Paul Revere, Workers Compensation, and The Tipping Point

This is part 1 in a 3-part mini series.

The Tipping Point in Workers Compensation

  1. Paul Revere, Workers Compensation, and the Tipping Point
  2. Make Your Work Comp Message Stick Like Gorilla Glue
  3. How Work Comp Can Be Just Like Prison

 

“One if by land and two if by sea,” April 18th 1775, Paul Revere was sent on a midnight ride to notify John Hancock and Samuel Adams that the British were coming. He was also tasked with notifying the countryside to be prepared for battle in one of the first stages of the revolutionary war. We all know that story, we all know the name Paul Revere, but there was a lesser known name, William Dawes. He was sent with that same task but why is Paul Revere famous in American history and William Dodd is a relative unknown?

 

I’m Michael Stack with Amaxx and I just finished reading for the second time The Tipping Point by Malcolm Gladwell. I read it a number of years ago but I just read it again. I really thought it would be fun to do a little mini series about some of the lessons and the stories that Mr. Gladwell teaches in there about starting change, about starting an epidemic, which is what you’re often trying to do in a work comp management program and in implementation particularly in organization that has a significant difference in how things maybe have been done.

 

 

Law of the Few, Stickiness, and Power of Context

 

There’s 3 three elements that he talks about in there and I did a short mini-series, one on each. The first one is the law of the few. The second one is the stickiness factor, and finally the power of context. The law of the few comes into play when you’re trying to get buy-in. You’re trying to get buy-in from your organization that this is how we’re going to do things moving forward. How do you get that message across? How do you get people to buy into your program?

 

 

 

Certain Individuals Are Exceptional People

 

Three different types of people that he talks about in the book. The first is the connectors, second is the mavens and finally the sales people.  It’s a very popular book and many people have probably read it, but I want to have you not forget about these people, these innate skills. I’ll run through them quickly. The connectors are the people that know everybody, that have a lot of friends, have a lot of acquaintances, know everyone at the organization. The mavens are the researchers. These are the educators; these are the people that really read the policy in detail. When you’re looking to buy a new equipment you know you’ve got to to talk to Sue because you know she’s the only one that has really read everything in detail, researched it, looked it up. You have that level of trust in her because you know that’s an innate skill in her. The sales people are those people that are super smooth. You know that they have the charisma, they have that personality that people follow what they do, because that’s built into their personality.

 

 

 

Leverage The Exceptional People To Obtain Buy-In

 

When you’re trying to get buy-in the first step is to get your CEO involved as well as these people that have these innate skills. It’s critical to have people buy into your organization. Do not forget about the connectors. Do not forget about the mavens, the people that maybe will have researched all the doctors in your program, have researched all the vendors, have read through your entire policy, something that no one else probably did. Make sure you bring Sue on board. Make you bring your sales people on board. Make sure you bring your connectors on board. When you’re working with senior management, rolling out this program, do not forget about the law of the few and it can make a difference at your organization.

 

I’m Michael Stack with Amaxx. This is The Tipping Point mini series. Remember your success in workers compensation is defined by your integrity, so be great.

 

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

Washington State Employer Hit for Repeated Safety Violations

Repeated serious safety violations have resulted in a serious workplace injury and in a large fine for a potato processer in Warden, Wash.

 

Washington Potato Company was cited for five repeat-serious and three repeat-general violations, and an additional 15 serious violations, for a total of $213,160 in penalties. The employer has also been identified as a severe violator and will be subject to follow-up inspections to determine if the cited conditions still exist in the future.

 

The Department of Labor & Industries (L&I) began an investigation after a worker was seriously injured when his arm got caught in an auger that started moving while he was cleaning it. The investigation found that another employee had started the equipment without realizing someone else was working on it.

 

Working in and around hazardous machinery and equipment requires “lockout/tagout” safety procedures to prevent the machinery from starting or moving during service and maintenance. The employer had been previously cited three times for lockout/tagout violations. This repeat-serious violation has a penalty of $56,000.

 

L&I also found a number of other hazards during the comprehensive safety inspection, including two instances where rotating shafts weren’t equipped with safety guards. The employer was cited for the same violation a year ago; consequently, the violation was deemed to be repeat-serious with a higher penalty of $14,000.

 

A repeat-serious violation with a penalty of $14,000 was cited for use of an aluminum ladder with two broken feet. The employer was cited a year ago for using a broken ladder. Ladder falls are a leading cause of serious workplace injuries and account for several deaths each year.

 

The employer was cited for another repeat-serious violation with a penalty of $10,400 for not properly guarding a belt and pulley drive that powers the waste pump in a 10-foot deep pit. This exposed workers to risk of broken bones or cuts.

 

In addition, a 15-foot-deep wastewater well was uncovered, which exposed employees to a drowning hazard. This repeat-serious violation carries a fine of $14,000.

 

The investigation found that the employer did not identify “confined space” hazards, including waste-water pits, vaults, boilers and other areas workers were required to enter to perform maintenance or repairs. These types of confined spaces are not designed for human occupancy and contain various physical hazards, including limited ways to enter and exit the spaces.

 

When a confined space has one or more hazardous characteristics, such as moving machinery or a potential for engulfment that may harm workers, it’s considered a “permit-required” confined space. That means employers must control access to the area and use a permit system to prevent unauthorized entry. Anyone working in or around a permit-required confined space must be trained and safety measures and rescue procedures must be in place.

 

Employer Hit with 11 Serious Violations

 

The employer received 11 serious violations, each with a penalty of $7,000, for failing to implement safe work practices when workers entered a permit-required confined space.

Three serious violations with penalties of $7,000 each were cited for lack of a written energy-control program to prevent inadvertent startup of machine or equipment; not assessing fall protection needs for employees who worker 10 and 12 feet above a concrete floor; and lack of guard rails on an open-sided floor with a fall hazard of as high as 15 feet. A serious violation with a penalty of $5,200 was cited for slip, trip and fall hazards on floor grating.

 

The employer was also cited for three repeat-general violations, each with a penalty of $520, for not ensuring that all electrical wiring was covered to prevent accidental contact with exposed wires, and for not ensuring that extension cords and power cords were in good working condition.

 

The employer was given 15 working days to appeal the citation.

 

Penalty money paid as a result of a citation is placed in the workers compensation supplemental pension fund, helping workers and families of those who have died on the job.

 

 

 

Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com.  Contact: kstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

WORK COMP CALCULATOR:   http://www.LowerWC.com/calculator.php

MODIFIED DUTY CALCULATOR:   http://www.LowerWC.com/transitional-duty-cost-calculator.php

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

Buyer Beware – 5 Things To Know About Lowest Work Comp Bidder

buyer-bewareResist the temptation to sacrifice great service for cheap workers comp insurance. It is certainly good business to watch the bottom line, but you must find a balance between cost and great service. Everyone watches the bottom line – that is just good business. Of course, a “low bid” does not necessarily mean getting bad claim service, and going with the most expensive carrier will not guarantee great service.

 

 

Employers do not want to sacrifice service for cost so here are five tips to be mindful of when dealing with the lowest bidder.

 

 

1-The lowest bidder may have the least amount of staff

Less staff equals less cost. Less cost means the bidder can offer a lower premium and still make a profit on the claim ratio — premium collected vs claim expense paid out.

 

 

Fewer adjusters to handle more claims are good claims adjuster’s biggest enemy — high pending claim count. Get to know your claim adjusters and see what their pending caseload looks like. The higher the caseload, the more likely something will fall through the cracks. You do not want it to be your claims.

 

 

2-All the adjusters may be in one location

You want an adjuster who will be on top of all local aspects of your claims. Adjusters in your local jurisdiction know about local doctors, judges, attorneys, vendors, etc. They know the good from the bad. Adjusters in other states may not be as privy to this information, and that can prolong a claim or affect the compensability. If you do business in California, and your adjuster is in Florida, the adjuster can miss local information crucial to the claim.

 

 

3-The lowest bidder may want any premium possible

Some carriers need premium dollars so badly; they underbid their competition just to collect premiums. They gamble on not paying off on a severe workers comp claim under their coverage. You might get decent service, but the stereotype is that the lowest bidder from the smallest carrier usually results in mediocre service to the employer. Make them prove this wrong.
4-Does low bidder have a poor reputation?

Ask these questions of your peers, broker and others you trust:

 

  1. How does this carrier stack up against their competition?
  2. Are they known for denying every case or settling every case?
  3. Do they have poor communication?
  4. Do other employers avoid this carrier at all costs?
  5. Are they familiar to local judges pre-conditioned on how to decide the case?
  6. Does the carrier pair underbidding premiums with poor adjusting?
  7. Does the plaintiff’s attorney know your carrier settles and does not push cases to trial? If so, that means anyone coming into their law office with a disputed workers comp claim will ask for the moon – benefiting the claimant and the attorney, but not you, the employer.

 

 

5-Make sure your broker provides broad spectrum of pricing

At renewal of your workers comp insurance policy, ask for a spectrum of premium costs from cheapest to most expensive, from a variety of carriers. Agents affiliated with only a few carriers (or only one) limit an employer’s choices. If you only get two choices, and you choose the cheapest, you may be missing another carrier perhaps slightly more expensive, but with a better reputation for service.

 

Do your homework. Look around, do some research, ask people in the business. Most carriers have established a reputation. Find out how they do business. You want to be represented by the best of the best. You do not cut corners in your business and you do not want a carrier cutting corners at your expense.

 

 

Summary:

Even if a carrier has a lower price than their competition it does not necessarily mean you will get poor claims service; but, history shows a good reputation is not always on the side of the lowest bidder when it comes to handling claims. Do your research. Ask questions. Make sure the carrier you select will work diligently on your behalf. You have enough to worry about as an employer; do not make your insurance needs another item on the list.
Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

Nebraska Employer Cited for Putting Workers in Danger

The deadly fact is this: nearly 40 percent of all deaths in the construction industry are the result of a preventable fall. Yet, some employers continue to ignore the dangers and put their workers at risk of a debilitating or fatal fall.

 
At an apartment complex construction site in Lincoln, (Nebraska) the U.S. Department of Labor’s Occupational Safety and Health Administration found construction contractors jeopardizing the safety and health of workers. The agency’s inspection resulted in citations for five companies working at the three-building complex.

 

Federal safety investigators observed seven workers employed by East Framing Inc. of Grimesland, North Carolina, exposed to fall hazards up to five stories high while they did framing work at the site in the 1800 block of P Street.

 

In addition to East Framing, OSHA cited South Georgia Framers of Statesboro, Georgia, for willfully exposing employees to falls and other safety hazards. The agency cited ProCon Construction Services LLC of Ailey, Georgia, and America’s Best Siding of Fort Collins, Colorado, for exposing workers to hazards on the site.

 

Inspectors also cited Aspen Heights of Austin, Texas, the controlling employer contractor on the project.

 

Following its December 2015 investigation, OSHA has issued citations as follows:

 

  • East Framing Inc., subcontracted for framing work, faces $65,450 in fines for one willful and three serious safety violations.
  • South Georgia Framers faces fines of $33,000 for one willful violation and three serious violations.
  • America’s Best Siding of Fort Collins, Colorado, was issued six serous safety violations and faces proposed penalties of $9,100.
  • Aspen Heights faces proposed penalties of $4,500 for three serious violations.
  • ProCon Construction Services LLC, faces $3,150 in proposed penalties for three serious violations.

 
Each company was given 15 business days from receipt of its citations and penalties to comply, request an informal conference with OSHA’s area director, or contest the findings before the independent Occupational Safety and Health Review Commission.

 

 

 

Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com.  Contact: kstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

WORK COMP CALCULATOR:   http://www.LowerWC.com/calculator.php

MODIFIED DUTY CALCULATOR:   http://www.LowerWC.com/transitional-duty-cost-calculator.php

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

Give Your Work Comp Adjuster A Hand To Achieve Better Outcomes

Adjuster Objectives:

 

Some objectives of every workers compensation claim adjuster should be to:

  • Promptly investigate.

 

  • Monitor medical care.

 

  • Process the workers compensation claim to a timely full disposition.

 

  • Maintain constant dialogue with employee, employer, and all other entities directly connected to the loss.

 

  • Secure any potential recoveries.

 

  • Develop the loss for the best outcome possible.

 

  • Be adequately educated, trained and continually self-educated for continued professional growth.

 

Additional adjuster objectives:

 

  • Clearly compensable claims should be paid promptly at the proper benefit rate, medical care should be the best available, and prompt return to work should be a priority.

 

  • The adjuster should be available to assist the injured employee as needed.

 

  • Good claim work results in minimal disability, good employee relations, and lower claim cost.

 

  • Conversely, claims that are questionable, malingered, fraudulent, or suspect for any reason, require the claim adjuster to be extra determined so that a good investigation and claim preparation can sustain declination and litigation.

 

  • Workers Compensation Claims are always under time guideline and handling pressure. Decisions and actions must be made or done quickly.

 

 

Employer Injury Coordinator & Assisting The Adjuster

 

The adjuster has primary responsibility for successful claim disposition.  However, the adjuster can only be as effective as the information gathered during investigation.  Therefore, every employer should strive to get the full facts, and supporting documentation to the adjuster as soon as possible after the loss occurs.

 

Every employer should have at least one person assigned to establish policy and procedures to implement when an injury occurs.  The person should know and understand all requirements of the workers compensation management program, including the employer and employee responsibilities.

 

One of the biggest responsibilities of the employer injury coordinator is communication with the claim adjuster.  This should be done as necessary, and during acute stages of a claim it may be daily.   As time passes on this claim this should continue on a regular weekly schedule.

 

 

Conclusion:

 

Worker’s Compensation Adjusters need to have good education, training, and the highest objective standards in order to reach proper handling and resolution of claims.  However, they cannot achieve this without proper employer support and interface.

 

Employers who designate an employee to be the workers’ comp injury coordinator to assist the claim adjuster will reap the benefits of better claim handling and cost.

 

 

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

NAMSAP Endorses Surgeon General’s “Turn the Tide Rx” Campaign

namsap-imageNAMSAP says workers’ compensation MSAs are still allocating for high doses of long-acting opioids, against evidence-based guidelines.

 

Business Wire version: NAMSAP Endorses Surgeon General’s “Turn the Tide Rx” Campaign

 

Elmhurst, Illinois (September 12, 2016) — The National Alliance of Medicare Set-Aside Professionals has endorsed the U.S. Surgeon General’s “Turn the Tide Rx” campaign to end the opioid epidemic. The campaign’s goals are to educate prescribers and the public about opioids, change the cultural perception of addiction, and mobilize health care professionals to improve prescribing practices.

 

NAMSAP wants physicians to adhere to evidence-based guidelines pertaining to opioids. The organization also would like to see the Centers of Medicare and Medicaid Services follow its own Part D guidelines when reviewing and approving Workers’ Compensation Medicare Set-Asides (WCMSAs).

 

The Turn the Tide Rx website promotes guidelines that encourage physicians to prescribe the lowest effective dose of immediate-release opioids only for acute pain and only for short durations, usually three days or less and rarely more than seven days. It says: “Higher dosages of opioids are associated with higher risk of overdose and death, but higher dosages have not been shown to reduce pain over the long term.  Extra precautions should be used when increasing to greater than 50 morphine milligram equivalents (MME) per day.”

 

“Opioid guidelines have been around for years, but there are situations where the treating physician is writing for high doses of long-acting opioids. In those cases, CMS requires that the WCMSA allocate for these opioids for the patient’s life expectancy,” says NAMSAP President Gary Patureau. “Our members often see more than 50 MME per day on workers’ compensation and general liability claims for people with chronic pain who have life expectancies of 20 to 40 years or more. Essentially, CMS is condoning the dangerous and inappropriate use of opioids.”

 

The campaign’s website also warns, “It is is especially dangerous to combine opioids with alcohol or sedatives, like benzodiazepines (e.g., lorazepam/Ativan, alprazolam/Xanax, diazepam/Valium).” Patureau says opioids and benzodiazepines are frequently prescribed together and allocated on WCMSAs.

 

“Post settlement, many Medicare beneficiaries do not reach their life expectancies,” he notes.  “What is causing their deaths?  No one is tracking this, but we suspect overdose is responsible for some.”

 

For more information on the Surgeon General’s campaign and to download educational materials, please see www.turnthetiderx.org. The Turn the Tide Rx endorsement is the latest of several NAMSAP initiatives to reduce opioid use in MSAs. The organization has conducted webinars on the topic and proposed evidence-based limits on opioids in MSAs in March.

 

 

About NAMSAP

 

Headquartered in Illinois, NAMSAP is the only non-profit association exclusively addressing the issues and challenges of the Medicare Secondary Statutes and its impact on workers’ compensation and liability settlements.  Its members are comprised of MSA providers, insurance carriers, and third-party administrators. Contact NAMSAP at 855-677-2776 or via www.namsap.org.

 

# # #

 

 

Media Contact:  Brian S. Bailey, NAMSAP Executive Director, (855) 677-2776; Brian@NAMSAP.org
Web: www.NAMSAP.org

What Is The Claim Handling Score At Your TPA?

claim-handling-scoreEmployers often wonder if they are getting quality claim handling on their workers’ compensation claims.  At the same time, the third party administrators (TPA) providing claim services to employers often struggle with producing a quality product due to the facts and circumstances of each claim being different.

 

 

 

Top-Tier TPAs Evaluate Every File for Claim Quality

 

Each TPA will have a set of Best Practices stating what is expected on every claim.  A top-tier TPA will not only have the written set of Best Practices, they will evaluate the adjuster’s claim quality using both performance measurements and diagnostic indicators to evaluate the adjuster’s performance.

 

As every activity of the adjuster on the claim file is recorded in the electronic notes of the computer file, it is simply a matter of data mining to determine if the adjuster is complying with the established Best Practices.  When the workers’ compensation adjuster enters a new file note, the date and time is automatically recorded.  Each file note has two drop-down selection codes, one for type of activity being completed and one for the type of person contacted – employee, employer, medical provider, employee’s attorney, defense attorney, etc.  After the note is coded, the actual details of what was accomplished are entered.  For example: “Requested Dr. Smith’s office to email us the office visit notes.”

 

With all this data, the grading and evaluating of the adjuster’s performance becomes highly measurable.  To prevent ‘gaming’ of the system, the TPA will have internal auditors reviewing select files, or with some top-tier TPAs all files, to insure accuracy of what is recorded in the system.  For example, if the adjuster coded the file note ‘contact – employee’, but the details of the file note reflect only left a voice mail, the proper coding should have been ‘attempted contact – employee’, and the file note coding can be corrected.

 

 

 

Areas of Evaluation

 

The areas of quality evaluated and graded through performance measurement include:

 

  • Initial employee contact within 24 hours

 

  • Initial employer contact within 24 hours

 

  • Initial medical provider contact within 24 hours

 

  • Initial reserve within 72 hours

 

  • Reserve review with 30 days

 

  • Initial report to client within 14 days

 

  • Status reports to client every 30 days, or as previously indicated in a prior report

 

 

The areas of quality evaluated and graded through diagnostic indicators include:

 

  • File on diary

 

  • Proper completion of claim progress notes

 

  • Reserve worksheet to support reserve changes

 

  • Timely ISO filing

 

  • Timely supplemental ISO filings

 

  • Payments made on closed files

 

With all the data generated, the computer program calculates the adjuster’s performance.  The computer program can be set to select only indemnity claims or it can include all claims.  The computer identifies all claims reported within the reporting month (normally a calendar month, but data can also be compiled on any 30 day period).  For example:  The computer identifies all indemnity claims assigned to Adjuster Jones during July, it reviews all data for the claims that had initial employee contact within 24 hour, and calculates the percentage of claims where the employee was contacted within 24 hours of the initial report of the claim.

 

The computer program completes the calculation for each of the performance measurements and diagnostic indicators and assigns a numerical percentage score to each category.  The computer combines all the categories into a numerical score for each adjuster to provide the TPA management a quality score for each adjuster.

 

 

Claim Quality Scores are Invaluable Tool for TPA

 

The quality scores compiled by the TPA are an invaluable tool that can be used for several different purposes. The score results can be used as:

 

  • A component of the adjuster’s semi-annual or annual performance review

 

  • A promotional tool to sell the TPA services

 

  • A motivational tool to encourage the adjusters to perform at their maximum

 

  • A way to encourage friendly, internal competition in each office to see which adjuster can provide the highest level of service

 

In addition to building adjuster’s pride by scoring well, some TPAs offer bonuses for top scores or a bonus to everyone who exceeds a predetermined mark.  For example – $100 monthly bonus for a score of 95% or higher, or a $500 annual bonus for averaging 97% or higher for the entire year.  Other prizes can be offered for the most improvement, the highest overall performance, etc.

 

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

Professional Development Resource

Learn How to Reduce Workers Comp Costs 20% to 50%"Workers Compensation Management Program: Reduce Costs 20% to 50%"
Lower your workers compensation expense by using the
guidebook from Advisen and the Workers Comp Resource Center.
Perfect for promotional distribution by brokers and agents!
Learn More

Please don't print this Website

Unnecessary printing not only means unnecessary cost of paper and inks, but also avoidable environmental impact on producing and shipping these supplies. Reducing printing can make a small but a significant impact.

Instead use the PDF download option, provided on the page you tried to print.

Powered by "Unprintable Blog" for Wordpress - www.greencp.de