Work Comp Roundup - Reduce Your Workers Compensation Insurance Coverage Costs with Timely Information for Employers Workers » 2009

Use New NY Work Comp Medical Forms As Of April 1 and Fill Out Completely

On 4/1/09 a new set of forms to be used by medical providers will go into effect. They are:

1-C-4. Doctor’s Initial Report

2-C-4.2 Doctor’s Progress Report

3-C-4 AMR (Ancillary Medical Report) for providers of ancillary services

4-C-4.3 Doctor’s Report of MMI/Permanent Impairment

Get the FORMS – The forms can be found on the NY WCB website or Google “NY”, “WCB” and “C-4″

The C-4.3 is necessary for a judge to close a claim. Even if there is no permanent damage as a result of the injury, failure to have this form in the file will cause the judge to adjourn the claim for it to be produced.

The C-4.2 progress reports should be filed every two weeks to ensure that a employee’s benefits will not be halted. New Board procedure strictly enforces a policy that there is no longer an informal presumption that disability continues until a report says that it no longer exists.

A funding crisis in workers’ compensation is driving efforts at stricter laws and rules. Medical practices that comply will face far fewer problems since the majority of medical groups make good faith efforts which fall short of Board requirements. These result in delay of payments and duplication of efforts.

Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100.

WC Cost Calculator www.ReduceYourWorkersComp.com/calculator.php REAL COST of work comp.
WC 101 www.ReduceYourWorkersComp.com/workers_comp.php for the basics about workers comp.

Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.

Posted in NY Workers Comp Issues |

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Charging Losses To Responsible Unit Is Key to Workers Comp Cost Reduction

This is a key to holding management accountable for results of safety and post loss programs. Employers with charge-back systems understand the need to bring accountability down to the facility level. Doing so brings accountability down to the unit level, middle management level and departmental level. With financial accountability, middle management enforces the rules at a local level such as bringing the employees back to work in transitional duty assignments. It brings people closest to the employee into the loop by localizing accountability.

Accountability becomes up close and personal. For example, a division manager who has been “hit” with a sizable charge-back will call the general manager of the operation where the loss occurred, who then calls the department responsible for transitional duty, who then customizes a temporary assignment and contacts the employee with a job offer. It’s just like when a company establishes a safety program and the CEO says “YOU WILL USE SAFE WORK PRACTICES” then everyone starts pushing in their chairs, using proper lifting techniques, etc. They have imposed the safety culture on the rest of the company by holding everyone accountable.

With companies that do not charge-back losses to the operation where those losses were incurred we may want to ask why they are not doing so. Is it because there losses are so low they feel the do not need it or is it because they feel it is too onerous to set up a system to do so. Or, do they question the effectiveness of such a program.

WC Calculator www.ReduceYourWorkersComp.com/calculator.php
TD Calculator www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
WC 101 www.ReduceYourWorkersComp.com/workers_comp.php

Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel or other professionals before implementing any cost containment programs.

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Ten Things You Should Include In A Brochure to Your Workers Comp Medical Provider

It is important to have a brochure for the physicians and clinics that treat your injured employees.

Here are 10 things to include in your brochure:

1-What Your Company Does – a brief description about your business
2-Where Your Company is Located – if it’s close encourage the providers to visit
3-Several Job Descriptions – describing the original work performed
4-Description of Your Transitional Duty Program – include the purpose and importance to your company
5- Necessity for Medical Limitations /Abilities on FIRST Visit – this is crucial so the claim does not become a lost-time claim.
6-Some Sample Transitional Duty Job Descriptions -describing potential modifications and alternative positions as examples, and be clear you will customize positions to fit whatever restrictions are given.
7-How To Referral To Specialists – provide an easy process.
8- How Bills Will Be Paid – Make sure your doctors know his/her bills will be paid quickly and what the procedure is. If you provide extra pay for extra-long office visits, mention that. Instead of reducing the bills, consider paying a bit more to obtain the quality care your employee’s deserve and is necessary to place employees on transitional duty.
9-If You Have a Medical Advisor, RNs, PT, etc. on-site or on retainer. Doctors respond most quickly when other doctors contact them. Best practice companies often have in-house medical advisers or part-time contract medical advisers. Both are cost-effective. In addition to enabling you to get accurate restrictions quickly, establish causation (or not), having a medical advisor can also serve as a deterrent for employees who may be trying to malinger or exagerate symptoms.
10-Contact Information for Adjuster, Work Comp Manager, Medical Advisor -including phone, fax and email

It is amazing how many companies miss the opportunity to set the stage with the medical professionals that treat their employees. Up front planning can make the medical treatment aspect of a claim much smoother and more effective.

Posted in Coordinating Medical Care |

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Best Practice Companies Take Charge of Workers Compensation in Webinar Series

Best Practice Companies “Take Charge” of Their Workers’ Compensation Costs by Advisen
Many employers believe that workers’ comp is simply a cost of doing business, not a controllable cost. However, there are many things a company can do to control and reduce their workers’ compensation costs.
Advisen’s new line of workers’ compensation cost containment products includes Workers Comp Kit®, an online tool kit with best practice assessment, scoring & recommendations for improvement; data benchmarking; and “knowledge modules” including over 60 forms, documents and checklists.

The Advisen Team will discuss workers’ compensation cost containment tools.

Four Webinars will be held (all times Eastern, click to register):

Tuesday, March 24, 2009 at 11:00 AM
https://www1.gotomeeting.com/register/189453098

Tuesday, March 24, 2009 at 3:00 PM
https://www1.gotomeeting.com/register/693078424

Thursday, March 26, 2009 at 10:00 AM
https://www1.gotomeeting.com/register/206514758

Thursday, March 26, 2009 at 2:00 PM
https://www1.gotomeeting.com/register/995884118

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WC Calculator www.ReduceYourWorkersComp.com/calculator.php
TD Calculator www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
WC 101 www.ReduceYourWorkersComp.com/workers_comp.php

Posted in Professional Development Issues, Seminars and Courses, Workers Comp Kit |

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How To Coordinate FMLA Leave With Workers Compensation Leave

Many employers, when crafting their return to work policy, have the Family and Medical Leave Act (FMLA) run concurrently with workers’ compensation. When an employee is injured they are not only given information about workers’ compensation and transitional duty, they are also given notice of their entitlement to leave under the FMLA. The FMLA covers unpaid time off over a 12-month period of time for employees who are recovering from a serious illness or injury, or for family issues such as caring for a seriously ill relative or after the birth of a child.

Under the FMLA, employers who are subject to the FMLA, must provide up to 12 weeks of unpaid leave to a full-time employee (who qualify for FMLA benefits) who has a serious health condition that keeps him or her from performing essential job functions. The employee’s job or a similar job must be reinstated at the end of the FMLA leave. The purpose of the FMLA is job protection/entitlement.

In most workers’ compensation and/or absence policies, return to work for occupational injuries is addressed. If an employee is able to perform transitional or full-duty, but does not want to accept those positions when offered they have the option of taking unpaid leave under the FMLA. Thus, when an employee is injured on the job, they received appropriate FMLA notification, as well as, an employee brochure provided about workers’ compensation benefits and obligations.

Some companies require an injured employee to use paid time-off benefits (accrued sick and vacation days) before unpaid time off. Injured employees receive their workers’ comp benefits but are also required to sue existing accrued sick leave and vacation days at the same time.

Employees can continue to receive workers’ compensation until they are able to return to work, however, if they do not return to work and have exhausted their sick and vacation benefits and are at the end of the FMLA entitlement period, they lose thier jobs and must reapply for hire. The workers’ comp program runs concurrently with the FMLA period. Companies that do this find that employees get back and back to work very quickly.

Despite using their benefits, some attorneys still encourage their clients to stay out of work longer than necessary even though this is not necessarily the best decision for the employee, but it’s done to build up the settlement value of the workers’ compensation claim.

Posted in Return to Work and Transitional Duty |

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Sample Return To Work Letter for Illinois Employers Workers Compensation Cost Reduction

One of the easiest ways to cut workers comp disability losses is to offer light duty employment, says workers’ comp authority Attorney Brad Bleakney of the Chicago firm Bleakney & Troiani. There are several things that should be kept in mind with an offer of transitional light duty employment:

1. Provide documentation with a letter stating temporary restricted work is available while a worker is recovering from a work-related injury/illness.

2. Include details on Where, When and to Whom to report to for the position

4. Include a general description or title for the position

5. Explain that this is a temporary position and that permanent placement will be reviewed as soon as restrictions are permanent or medical care ends.

6. Make it clear that a return to their former position is dependant on the availability of positions at the time of medical discharge and depends upon whether they can perform essential job functions given the permanent restrictions, if any.

7. Add a Signature Line or Check box for the worker to acknowledge the offer and either Accept or Reject the light duty employment and date it.

When the restrictions become permanent and as positions are available, make every effort to move the worker into a permanent position. This is the best possible evidence of a resumed earning capacity. If an economic layoff should later be necessary, the lack of work can be said to be economic related and not due to medical restrictions from the injury.

In Illinois, as long as an injured worker remains under active medical care with temporary restrictions, the employer’s failure to provide work within the restrictions will result in liability for ongoing payment of temporary disability payments.

When an injured worker has been given permanent restrictions and is given a permanent job placement, the employer is relieved from any vocational rehabilitation costs, “maintenance” disability payments, wage supplement claims or permanent total disability pensions. If a layoff should occur after permanent placement, the burden shifts to the injured worker to try to prove the lack of employment is due to the restrictions rather than the economy.

Remember, a permanent job position avoids the biggest settlements for wage loss claims and permanent total disability claims which cost the employers the most money and create the biggest attorney’s fees. Cut your workers comp costs with an effective return to work program.

Brad Bleakney of Bleakney & Troiani in Chicago, IL practices in the areas of work-related injury claims third party litigation for accidental work injuries. He has a background in industry where he helped a Fortune 500 company reduce their workers’ compensation losses significantly. Brad can be reached at: Brad Bleakney, Bleakney & Troiani, 1 North Franklin (2625) Chicago, IL 60606 312-541-0045 or fax 312-541-0041 info@WorkComp-Chicago.com

Try the WC Cost Calculator to show the REAL COST of work comp.
Look at WC 101 for the basics about workers comp.

Workers’ Comp Kit^® is a web-based online Assessment, Benchmarking and Cost Containment system for employers. It provides all the materials needed to reduce your costs significantly in 85% less time than if you designed a program from scratch.

Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.

Posted in Return to Work and Transitional Duty |

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Five Key Questions To Ask All Employees To Improve Return To Work Programs

Computer Literacy Trends are an opportunity in workers’ compensation return to work. Jobs such as dishwasher, laborer, truck driver, janitor, housekeeping, heavy equipment operator are not jobs normally requiring computer use. Yet, statistics indicate that use of home computers and PDA’s are off the charts. Since computer literacy dramatically improves an injured worker’s chances to secure alternative or modified duty work, it makes sense for employers to key in on the home computer craze.

From working in the return to employability field for 20 years, Gordon R. Butler has insightful advice to provide. Gordon advises, take the time to determine your employees technology skills before injury or illness occurs. One savvy employer thought ahead to include a few key questions of all staff during the standard hiring and performance evaluation process. This equipped the company to discuss return to work options via email while the employee was recuperating and unable to come to the workplace.

Make sure to ask:
1-Do you have a home email address?
2-What type of computer do you have at home? PC/MAC?
3-Do you have internet access from home?
4-If you have typing skills, are they Beginner/Intermediate/Advanced?
5-List all types of software you like to use?

The questions serve two purposes. They were preparing to explore the option to telecommute and wanted to monitor how many employees might already be equipped to take advantage of this option. In the process, they discovered the information was valuable in workers’ compensation RTW program efforts also.

From working in the return to employability field for 20 years, Gordon R. Butler has insightful advice to provide. Gordon R. Butler, national authority/consultant on employability & wage capacity in workers’ comp, liability, PIP and LTD Claims. He can be reached at 321-377-1164 (cell) or email gbutler@gbutlerconsult.com www.gbutlerconsult.com

Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.

Posted in Communication with Employees, Return to Work and Transitional Duty |

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Ten Steps to Return To Work in Canada Workers Compensation

RETURN TO WORK – ONTARIO, CANADA

Attorney David Brady with the Toronto law firm HicksMorley offers the following for employers with operations in Ontario, Canada. Many US-based employers believe that the Canadian workers’ comp laws are totally different than in the U.S. but that’s not the case. Many aspects of the system are similar, including returning injured employees to work as soon as they are medically able to do so. Each province’s laws vary, just like in the U.S. each state’s laws vary. This advise is specific to Ontario.

Attorney Brady advises employers to:

1. Have a modified work policy which assists injured workers to return to work to perform the essential duties of their own jobs, or if that is not medically appropriate, to perform the essential duties of another job that is suitable and available.

2. Ensure that the injured worker’s health care professionals are given a copy of the modified work policy as soon as reasonably possible.

3. Seek functional abilities medical information, with employee consent, from the injured worker’s health care professionals as soon as reasonably possible. The health care professionals should be provided with a job description and a physical demands analysis for the work offered.

4. Explain to the injured worker the injured worker’s duty to co-operate with the employer respecting access to necessary medical information and the identification of jobs that may be medically suitable if the worker cannot reasonably be expected to return to his/her own job.

5. Explain to the injured worker the consequences of not co-operating in the return to work effort. Workers’ compensation benefits may be reduced or eliminated.

6. On good medical and workplace information, offer the injured worker a return to work plan consistent with the worker’s functional abilities. The return to work plan should be in writing.

7. Copy all return to work correspondence and documents to all concerned including the injured worker’s health care professional(s), the Workplace Safety and Insurance Board (WSIB) case manager, the injured worker, and the injured worker’s union representative if the injured worker has authorized the union representative to act on his or her behalf. Care should be taken not to communicate the worker’s medical information except as authorized.

8. If necessary, involve a return to work WSIB mediator to resolve return to work barriers. This may result in an agreed-to Return To Work Plan signed by the workplace parties.

9. Communicate with the WSIB case manager during the return to work effort to enable the WSIB case manager to make evidence-based decisions about the worker’s benefit entitlement.

10. Ensure the injured worker’s immediate supervisor(s) and the worker clearly understand what is expected of the worker consistent with the worker’s functional abilities and the return to work plan.

Our advice takes into account Ontario’s Human Rights Code and the Workplace Safety and Insurance Act.

Many thanks to Attorney David W. Brady, Hicks Morley Hamilton Stewart Storie, LLP, Toronto, ON. Attorney Brady can be reached at 416-864-7310 or david-brady@hicksmorley.com www.hicksmorley.com

Posted in Return to Work and Transitional Duty, WC in Other Countries (International) |

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Employer Not Responsible for Motor Vehicle Injuries When Employee Deviated from Shortest Route Home From Doctor Appointment

“The Road Not Taken”: Colorado Claimant Seeks Additional Compensation For Injuries Sustained on “Longer” Route to Medical Appointment by Tom Robinson, JD. primary upkeep writer for Workers’ Compensation Law Center powered by Larson’s, the leading authority on workers’ compensation law.

Here’s What Happened
Claimant, a resident of Gypsum, Colorado, employed by Western Eagle Ambulance District, required knee replacement surgery to treat an admitted industrial injury he had sustained in 2003. While claimant was on vacation in Reno, Nevada, he learned that there was an earlier opening in the surgeon’s schedule and that he needed to return to Colorado to attend a preoperative appointment in Denver the following day. Within an hour, claimant began the drive toward Colorado. Claimant had two essential choices for his return route. The shortest highway route from Reno to Denver involved traveling on Interstate 80. Claimant instead chose to travel on Interstate 70, which would have taken him past his home. At a later hearing, claimant testified, however, that it was his intention to drive straight to the appointment and not stop by his home. After driving about 300 miles, claimant sustained multiple injuries in a motor vehicle accident near Elko, Nevada. Claimant contended his injuries were compensable since he was en route to an authorized medical appointment to treat his 2003 industrial injury. The ALJ denied the claim, concluding that claimant failed to prove that he was within the quasi-course of his employment while driving in Nevada based.

Should claimant recover for the injuries sustained in the automobile accident?
In Kelly v. Industrial Claim Appeals Office, 2009 Colo. App. LEXIS 322 (March 5, 2009), the Court of Appeals of Colorado (Division 7) acknowledged that it was well settled in Colorado that the quasi-course of employment doctrine extended workers’ compensation benefits to injuries sustained while traveling to and from treatment by an authorized provider, but noted that compensation for injuries sustained in a motor vehicle accident became more complicated when there was a deviation from the route of travel for medical treatment. Observing that the Colorado courts had not been called upon to answer the specific question related to such a deviation, the court looked to the general discussion of deviations found in Larson’s Workers’ Compensation Law § 10.07, and noted the issue was highly fact specific. Adopting the substantial deviation test found in Larson, the court observed that the ALJ had not been persuaded that claimant was en route to a medical appointment at the time of the motor vehicle accident; instead, the ALJ determined that claimant was returning to his home in Gypsum. The ALJ, based on the evidence that the longer route claimant was taking would have taken claimant past his home and, if he continued without stopping, he would have arrived at his appointment several hours before it was scheduled, concluded that claimant was not in fact traveling to the medical appointment at the time of the motor vehicle accident; rather claimant had substantially deviated from the route of travel. That determination could not be disturbed on appeal.

See generally Larson’s Workers’ Compensation Law §§ 10.07, 17.01, 17.04.
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Tom Robinson, J.D. is the primary upkeep writer for Larson’s Workers’ Compensation Law (LexisNexis) and Larson’s Workers’ Compensation, Desk Edition (LexisNexis). He is a contributing writer for California Compensation Cases (LexisNexis) and Benefits Review Board – Longshore Reporter(LexisNexis), and is a contributing author to New York Workers’ Compensation Handbook(LexisNexis). Attorney Robinson is an authority in the area of workers’ compensation and we are happy to have him as a Guest Contributor to Workers’ Comp Kit Blog. Tom can be reached at: compwriter@gmail.com.
http://law.lexisnexis.com/practiceareas/Workers-Compensation
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WC Cost Calculator to show the REAL COST of workers www.ReduceYourWorkersComp.com/calculator.php
WC 101 for the basics about workers comp. www.ReduceYourWorkersComp.com/workers_comp.php

Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.

Posted in Insurance Issues, Rates, Premiums |

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Employers Need To Visit Medical Providers Where Injured Workers Are Treated

Many companies I speak with indicate they have not visited the medical providers to whom they send their injured workers. In not doing this, they miss an opportunity to integrate medical services into their workers’ compensation cost containment program.

Many employers don’t make these visits because they do not know what to look for, they do not what to ask, they assume the claims administrator has set up the relationship so a personal visit from their company is unnecessary or do they not understand this is an important best practice. We are developing Guidelines for Meeting With Your Medical Providers.

The purpose of these visits is to establish a relationship with the doctors who are treating the workers. The doctors need to know you are a caring employer and are as concerned about the health of the worker as the doctor is and that you are a partner in the worker’s recovery. The face-to-face meeting is critical to establish rapport and to show you are willing to be held accountable for your employee’s recovery. You are holding them accountable, so you need to be accountable too so the relationship is seen as a partnership.

You need to know that the medical facility is adequate, or hopefully excellent, and provide a range of full services, e.g. can x-rays and physical therapy be done on site. If not, your post-injury response needs to incorporate methods to obtain off site treatments when necessary. Hours of operation are important also. Are they open 7 days/week, the hours your employees are likely to be injured?

Medical provider visits are an opportunity to provide your contact information, explain what your company does, show what types of transitional duty are available and request the medication restrictions on the first visit with the employee.

Fees are not as important as the other criteria. In fact, I often suggest paying the going rate since you want better than “average” service. You want the best for your employees, and that my mean paying a little more.

Next, the medical providers should be invited to your facility to see what you do, meet your staff and view possible transitional duty assignments. Learn more about working with medical providers: http://reduceyourworkerscomp.com//wasteful-workers-compensation-practices.php

Posted in Coordinating Medical Care, Implementation and Rolling Out Your Program |

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Use New NY Work Comp Medical Forms As Of April 1 and Fill Out Completely

Charging Losses To Responsible Unit Is Key to Workers Comp Cost Reduction

Ten Things You Should Include In A Brochure to Your Workers Comp Medical Provider

Best Practice Companies Take Charge of Workers Compensation in Webinar Series

How To Coordinate FMLA Leave With Workers Compensation Leave

Sample Return To Work Letter for Illinois Employers Workers Compensation Cost Reduction

Five Key Questions To Ask All Employees To Improve Return To Work Programs

Ten Steps to Return To Work in Canada Workers Compensation

Employer Not Responsible for Motor Vehicle Injuries When Employee Deviated from Shortest Route Home From Doctor Appointment

Employers Need To Visit Medical Providers Where Injured Workers Are Treated

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