What Is a Return to Work (RTW) Ratio?
The Return To Work Ratio (RTWR) measures the effectiveness of your transitional duty program. The ratio calculates how long it takes employees suffering a lost time injury to return to work in either a transitional duty assignment or full duty
The RTW Ratio accurately assesses how well your company manages the return-to-work process. Before you go to a lot of trouble to start measuring this, find out what your TPA has to help you. Perhaps they are already have a similar measurement.
The Focus is on Lost Work Days
For every day an employee is out of work, the cost of the claim increases; therefore, it is of critical importance to actively manage your claims using techniques designed to return injured workers to active work status as quickly as possible. At the same time, it is critically important to be able to track and know exactly how well the return-to-work process is proceeding.
Here is an example of “good” and “bad” outcomes RTW RATIO EXAMPLE
You can develop the RTW Ratio using a simple list, a spreadsheet or the online Workers’ Compensation Tool Kitâ„¢. The RTW Ratio allows you to calculate lost days quickly and see at a glance how well you are doing. The graphic visualization is helpful and motivational. Then you can take appropriate action as needed to improve your company’s rate of returning workers. More about bringing employees back to work sooner: http://reduceyourworkerscomp.com//employees-back-to-work-sooner.php
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.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
Companies with low loss experience (best practice companies) tend to use many resources to learn about workers’ compensation cost containment. Each resource has strengths and limitations, but all resources used in combination provide the knowledge and tools for a company to reduce their workers’ compensation costs.
1-Printed Books – the printed book is the most in-depth resource and it is “at your fingertips.” Like a library book or text book, it is a source of theoretical information which provides a foundation of knowledge about the subject. However, one must have a starting point and a structure within which to apply this knowledge and turn it into every day activities to fix the problem of high workers’ compensation costs. Risk managers need a practical way to turn this information into action.
2-Online Newsletters - an excellent source of timely topical information.
3-Magazines – Articles are by their nature topical information that deals with only one aspect of workers compensation cost containment; it’s strength is that it provides up-to-date information and usually points you toward more in depth publications and resources.
4-Seminars and Conferences – This is a venue to establish a network of contacts and learn about resources. At conferences and seminars, particularly those with exhibit halls, risk managers immediately come face-to-face with resources and are able to discuss their situation with a range of professionals face-to-face. It provides a good beginning to find the tools you need to embark on a workers’ comp cost containment program. You will need to follow up or you are back where you started, so the onus is on you to make the best use of the conference experience. Virtual solutions also exist.
5-Attend Professional Organizations, Meetings, Online Communities & Forums – These are the face-to-face follow up and are an opportunity for continued networking, staying up-to-date on current events and issues. Follow-up is necessary and “if you don’t use it, you’ll lose it.” Online Forums are excellent opportunities to ask specific questions and meet peers. And you can do it at times convenient to you.
6-Search the Internet -You can find tools, strategies and methods you did not even know existed.
7-Webinars - Online seminars are a fast, easy-to-use way to learn the basics, however, there aren’t many about workers’ compensation cost containment. That’s OK, grab the ones about specifics such as medical cost containment techniques offered by the carriers. Knowledge about any aspect of workers’ comp never hurts, it broadens your understanding.
8-Online Tools and Resources – These provide immediate concrete tools to use that you can apply to existing business processes. An online resource allows you to take those tools to create a program and you can do it from your own office. In a way, it’s your best means to follow-up because after you’ve learned all of the above; it gives you the framework to integrate the other resources.
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.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
I’m often asked why an interactive tool kit is an effective means of transforming a company’s workers’ comp program. It’s a good question and the answer isn’t obvious.
The answer: This is how you bring it down to your workplace, superimpose it on YOUR culture; this is where you “bring it home.” Often an employer has many ideas of how to reduce their costs, but does not have the structure to make changes needed. In traditional programs, a consultant walks a company through the process, a technique that is very effective. Online resources serve the same purpose — automation of the process.
For example, just like when the CEO says “there will be a safety culture,” employees begin pushing their chairs in and engaging in concrete practices where a safety culture is superimposed on the workplace. In the workers’ comp cost containment context, the employee will start taking the Work Ability Form to the doctor, faxing it back, and working in a transitional duty assignment to keep the circle contained. This brings the book information down to the day-to-day implementation level. Tools provided by the online resource such as timetable, checklists and brochures are the conduit between the aggregate of knowledge and the individual employer. They are the pipeline for an individual to be able to transform thoughts to action. It provides the framework – it gives the tools to “eat elephant in one bite”.
Online tool kits are interactive not passive; this allows you to apply knowledge to the workplace. Every time you click, you move forward, a step closer to solving your problem. As an example, with Workers’ Comp Kit® you get your National Workers’ Compensation Management Scoreâ„¢, then move to the recommendations checklist, plot these on the timetable, and continue moving forward. It provides the structure needed to move forward.
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.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
I am often asked why, when doing an assessment, I ask “Do you have at least one book about workers’ compensation on your shelf?” It sounds so silly, but it’s really not. The companies with the lowest workers’ compensation costs have resources! I’ve seen it over and over. It goes like this … there are three divisions in a company and two don’t have any books about work comp on their shelves and one DOES have a book. The one with the book always has lower losses and employees back to work sooner.
Companies in the know, know what they don’t know and almost 100% of the time have at least one book on workers’ compensation on their shelf. I’m not just saying this because Amaxx publishes a book on Workers Comp Cost Containment (although it’s a great book), I’m telling you this because it’s the truth.
Clients argue that “they ask their brokers and their TPAs” about workers’ compensation cost containment so on the National Workers Compensation Management Score, they should get an extra point for asking a broker, carrier or TPA about workers’ comp cost control. But, there’s a difference. Much of the time that’s reactive, not proactive. And you don’t have it “at your fingertips” to browse at will.
Newsletters, conferences, and your brokers, TPAs and carriers offer great information, but you need a resource at your fingertips, especially if you plan to teach others on your team about workers’ comp cost control, but it’s not realistic to rely on your broker for a complete education. Many offer excellent seminars and have consulting expertise which can supplement the other tools you have at your disposal.
Over the years, I’ve used several resources including IRMI. You can read about that on my site at IRMI Manual. And U.S. Chamber of Commerce WC Analysis. I bet your broker has this and you can get a free copy from them.
Learn about IRMI WC Manual: http://www.reduceyourworkerscomp.com/IRMI-Workers-Comp-Guide.php You’ll receive a 10% discount if you use our WC8 Code.
Read about Amaxx book here: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php Receive a 20% RIMS Member discount.
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.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
It is often hard to get started, just getting the momentum to get moving sometimes seems overwhelming especially when the task is as large as “reduce your workers comp costs.” It’s so difficult to get started, in fact, that many companies don’t EVER get started.
Several things that may help:
1- Choose 1-2 changes – Eat elephant in small bites — not all at once. It’s a big task, so break it down into smaller ones.
2- Start Now – Don’t wait until all the “lights are on green” to drive down Main Street. Everything doesn’t have to be perfect for you to get started. The important thing is to JUST START.
3- Delegate some of the load - If you plan many changes, learn to delegate to others. You can plan, but you may need help with the execution of the tasks.
4- Hold Everyone Accountable – Use a Timetable which is updated every week — list each task, who is responsible for completion of the task, and the time-frame for completion. Click here to see a sample: TIMETABLE SAMPLE
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
Learn about our BOOKS and MANUALS for sale.
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.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
More than half the patients who see a doctor for back pain undergo X-rays, a CT or MRI scan. But new research shows scanning to find the source of back pain may do more harm than good.
Researchers reviewed six clinical trials comprised of nearly 2,000 patients with lower back pain. The data indicated that patients who get scanned for back pain may end up with more pain than those who are left alone.
The problem is that back scans can turn up physical changes in the back that are not really causing any problem. One study from The New England Journal of Medicine gave 98 people with no back pain an MRI. Two thirds had MRI reports showing they had disk problems.
With a positive scan, people start to think of themselves as having a terrible back problems. They stop doing exercise and things that are good for them, when in reality, most people have degenerative disks and arthritis and have no pain at all.
Even if there is a documented herniated disk, 90% will be pain-free in six weeks anyway. So rather than immediately getting an MRI, a better criteria for a scan should be if back pain persists for longer than a month, or if symptoms suggest a more serious problem like an infection or tumor, which are actually quite rare.
David Dubin, MD. is an emergency room physician who serves as a medical advisor for several companies. Formerly president of Aon Medical Consultants, he has been helping employers and insurance companies develop innovative cost containment programs and reduce workers comp costs for over 20 years. He can be reached at: MD@WorkersCompKit.com or 503-753-0168.
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 program.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
Here’s what happened
An Salem, MA city employee sustained a disabling heart attack at home one hour after she was told that her employment position would be eliminated in the city’s upcoming budget process. She learned of the budget cuts at 3:20 pm, was allowed to go home because she was upset, and suffered the attack at approximately 4:00 pm. She sought disability benefits as she was unable to return to work. The city contended that the former employee was ineligible for benefits under Mass. Gen. Laws ch. 152, § 1(7A), of the Massachusetts workers’ compensation statute, as she suffered an emotional disability as a result of a personnel action. Massachusetts, like a number of states, has a statute limiting compensability of claims involving bona fide personnel actions. She died sometime after filing her original claim.
Can the former employee’s estate nevertheless prevail?
Here’s what the court decided
In Retirement Board of Salem v. Contributory Retirement Appeal Bd., 2009 Mass. LEXIS 28 (February 24, 2009), the Supreme Judicial Court of Massachusetts held the “personnel action” exception applied only to emotional or mental disabilities, that the employee’s heart attack, though caused by the emotional stress of learning of her termination, resulted in a physical disability. The heart attack was “sustained” during her conversation with her supervisor in that the conversation caused the emotional stress which, within an hour, caused the debilitating heart attack. The employee’s compliance with her supervisor’s direction to speak with him about her job status qualified as being actively engaged in the performance of her duties.
See generally Larson’s Workers’ Compensation Law § 56.04[5].
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
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.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
Injury Duration Guidelines are a tool for employers. They are helpful to know approximately how long an injured worker may be out of work. It is a way to compare against what the doctor and/or the employee say is the expectation of time out of work. If there is a discrepancy in the what you are told, ask your medical advisor. Many employers do not know that this type of tool exists.
Keep in mind any length of disability depends on many factors such as the severity of the injury and other medical conditions. For example, it may take a person with diabetes much longer to heal, than someone who does not have this condition so check with your medical advisor about lengths of time a person should be out of work.
When using these guidelines as a tool, minimum times equate to clerical, light-duty job. Maximum time-frames are for heavy industrial type jobs. All time-frames are measured in weeks, unless otherwise noted.
AND, you can figure out the potential cost savings by using the Transitional Duty Calculator to see that this can save up to $126,000 enter 21 days X $200/day plus $1,500 replacement costs X 4.5% profit margin. Change the data to your own data. This is an example. Transitional Duty Calculator at www.reduceyourworkerscomp.com/calculator.php
Injury Duration Guidelines-Lower Extremity Injuries
| Type of Injury Lower Extremity |
Area #Weeks |
Area #Weeks |
Area #Weeks |
Area #Weeks |
Area #Weeks |
Area #Weeks |
| |
Thigh |
Knee |
Leg |
Foot |
Ankle |
Toes
|
| Abrasion Contusions |
1-2 |
1-2 |
0-1 |
1 |
0-1
|
1
|
| Burns |
1-12 See Note 4 |
|
1-10 |
1-5 |
1-5
|
0-2
|
| Dislocation |
|
1-16 |
See Part |
2-4 |
1-5
|
2-4 See Note 5
|
| Fractures |
8-24 |
6-12 |
5-18 |
1-6 Months |
6-8
|
2 See Note 4
|
| Incisions |
1-15 |
0-1 |
2-6 |
4-6 |
0-3
|
0-3
|
| Lacerations |
2-6 |
0-10 |
1-2 |
2-6 |
0-3
|
1
|
| Punctures |
1-2 |
1-4 |
1-3 |
1-2 |
1-2
|
1-2
|
| Sprains/Strains |
0-1 |
1-4 |
See Part |
0-3 |
0-3
|
0-3
|
| Repetitive Motion Tendonitis |
|
|
|
|
|
|
Note 1: Burn healing depends on degree (area and depth)
Note 2: Dislocations and Fractures apply to ribs. Punctures and incisions are those penetrating the thoracic cavity.
Note 3: Punctures and incisions are those penetrating the abdominal cavity.
Note 4: 2nd or 3rd degree, area variable.
Note 5: Total recuperation. However, there may be little disability during that time if walking is minimized.
Note 6: Time for carpal tunnel syndrome is quite variable, in part because factors other than workplace injuries are often involved.
Injury duration timeframes provided by Leslie J. Hutchinson, MD, MPH, FACOEM and Sanford S. Leffingwell, MD, MPH, Board-Certified in Occupational and Preventive Medicine. They can be reached at: 1-770-963-1223 HLM Consultants or hlm@hlmconsultants.com
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 before implementing any cost containment programs.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com www.ReduceYourWorkersComp.com
A procedure for recovery of payment of medical bills in NY work comp exists but is little known outside of groups that handle a large volume of work comp claims.
The procedure is:
1- A bill for medical services must be sent to the correct comp carrier together with medical reports on an approved form (C-4, C-4.2, C-4AMR or C-4.3, new forms in effect since 1/1/09. After 4/1/09 all reports submitted must use these forms.)
2- If the bill is not paid within 45 days of the date sent, the medical group has 120 days, from the 45 day period, to file with the Workers’ Compensation Board Form HP-1 requesting administrative review of the bills and setting the appropriate fee.
3- Unpaid bills may not be “bundled”. Each unpaid bill requires a separate HP-1 form.
4- C-4 reports must be attached to the HP-1. Office notes should be attached if they clarify why the services are work related.
5- If the bill has not been paid because the claim is being contested requests for payment will not be considered until a determination is made. Requests for payment, under such circumstances, may be directed to a medical plan. The plan can seek repayment from the comp carrier if the comp claim is established as work-related.
6- Payment for services will be at medical fee schedule for NY work comp claims.
This is important because employers need the cooperation of medical providers, and employees want to be assured their medical bills will be paid. The process goes much smoother when medical bills are paid on time and this procedure will help.
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.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
The fundamentals of any workers compensation insurance scheme in Canada is quite similar to that in the United States. Attorney David W. Brady of the law firm Hicks Morley gives a few specifics about how the workers compensation laws in Canada operate.
Early Safe Return To Work – In Ontario, for example, the legislation is designed to reward early and safe return to work(“ESRTW”). This is an essential part of our experience rating systems, where there are rebates and surcharges depending upon how well private sector employers manage (their claims). Public sector employers are, in effect, self insured. They pay the Workplace Safety and Insurance Board (“WSIB”) to manage claims and have to pay the WSIB a 24% admin fee for doing the job.
Duty to Keep in Touch – ESRTW is also part of the legislated duty to co-operate. The duty requires workers and employers to be in contact and remain in contact with each other while the worker is off work with the goal of identifying employment that is suitable for the worker’s functional abilities.
There are Return to Work Requirements – The WSIB has mediators who assist the workplace parties to get injured workers back to work. If either one of the parties is not co-operating, there are penalties – the worker may have benefits reduced or eliminated. The employer can be fined. Section 40 and Section 41 of the Act are applicable. Section 40 is really a human resources regime where the law can be pro-actively used to help return injured workers to work. This is consistent with research that shows that workers who do not return to work reasonably quickly will have less and less chance of ever returning to work in a productive manner.
Most of Canada’s other 9 Provinces operate in a similar manner though each has its own statute and case law. This is particularly true of Quebec. There is also a federal statute, but it piggy backs on the legislation in each Province.
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
© Copyright 2009 Hicks Morley Hamilton Stewart Storie LLP
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.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
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Benchmarking & FTE & Operational Comparison, Return to Work and Transitional Duty |
