Janitorial Contractor Fights to Regain Business
An Oklahoma-based janitorial contractor who claims Missouri wrongly put him out of business two years ago over allegations he employed illegal immigrants said this week in court that he wants to once again clean buildings, according to The Associated Press.
Missouri canceled nine contracts with the business after state and federal authorities detained approximately two dozen of the company’s Jefferson City workers during a March 2007 immigration sting. The janitorial service, which also serviced buildings in Kansas City and Columbia, was prohibited from applying for new state contracts.
The owner filed a lawsuit in fall 2007 and accused Missouri’s governor at the time of abusing his power. The owner contends he checked his employees’ documents and denied knowingly hiring any illegal immigrants.
Missouri‘s assistant attorney general, who backed terminating the contracts, said the employer was required to follow local, state and federal laws and that a clause allowed for the contracts to be ended without notice if laws were broken. The assistant AG claims that the immigration raid gave the state a reasonable belief that a federal law was violated. He added that the contract also permitted the state to terminate it for any reason with 30 days notice. A Cole County judge gave attorneys two weeks to submit any written arguments. (workersxzcompxzkit)
Only a small number of the janitors caught in the immigration sting were found guilty or pleaded guilty to any crimes.
Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: Robert_Elliott@ReduceYourWorkersComp.com or 860-786-8286.
We are accepting articles on WC cost containment. Contact us at: Info@WorkersCompKit.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker about workers’ comp issues.
©2009 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
For an employer, the return to work process is no less daunting than that same process is to the injured worker. While claims professionals and attorneys are adept at managing a successful return to work, employers are ill prepared to navigate the various rules, forms and procedures necessary to accomplish what should be a very simple task. The good news is the correct process is entirely consistent with good business practices, a productive workforce and the Americans with Disabilities Act. The most ineffectual programs are those offering no real work, make-work if you will, with the focus on getting benefits suspended rather than returning the employee to productivity. With advance preparation, the employer can prepare the way for a successful return to work after injury or, at the very least, prepare the evidence needed at trial for a court ordered suspension of income benefits. ESSENTIAL STEPS 1. Employer Attitude – The course of your WC claims are determined in the minutes after the injury happens. This includes supervisor attitude, accident investigation and medical care. An injured worker met with derision, resentment or impatience is not likely to look forward to a return to work with restrictions. 2. Control of Medical Care – For those states with employer control or employer input into the pool of physicians eligible to treat injured workers, selection of physicians with familiarity or sophistication in occupational injuries will provide a competent diagnosis and treatment plan as well as a more accurate assessment of whether the injured worker can safely return to work without presenting a danger to himself or others. 3. Job Descriptions – An accurate assessment of each occupation to be performed should be prepared by the employer well in advance of the occurrence of any injury. These descriptions should be expressed in ergonomic terms so the treating physician knows precisely what the employee will be required to do when returning to work. 4. Team Concept – Return-to-work programs are not the sole province of the HR/Safety Departments. Successful programs rely as well upon supervisory personnel and the active support of other employees. 5. Transitional Duty Agreement – Before the return to work happens, management, supervisory personnel and the injured worker should discuss the job description approved, the work to be performed and understand that management will not direct or request the employee to work beyond the stated restrictions. Nor will the employer tolerate the employee working voluntarily beyond the restrictions. 6. PATIENCE! – The employee returning to work while still suffering the effects of an injury is understandably concerned with potentially making the injury worse while continuing to work. If the employee has been out of work for an extended period of time s/he will undoubtedly experience muscle stiffness associated with the deconditioning that comes from inactivity. The employer on the other hand tends to focus on the work at hand and may not be mindful of the legitimate concerns of the employee. The Transitional Duty agreement will help one anticipate and understand the concerns of the other. (workersxzcompxzkit) 7. Continuation of Medical Care – In most states, a return to work does not end the employer's ongoing obligation for medical care. Understanding that the employee may need the reassurance from the treating physician that continued work is therapeutic or, at worst, not harmful, will assist the employee in continuing to work with the proper mindset. For the employee who does not really want to work , timely medical appointments provide the employer with contemporaneous evidence of the employee's capabilities and effort. Be prepared to take these steps irrespective of the employee's attitude and you will have prepared your file for litigation. Be prepared to take these steps and you will find that those employees that want to work, respect the employer effort while those that do not want to work will understand that a WC claim won't be a free or easy ride. Author: Kevin O. Skedsvold, J.D. We welcome our guest writer, Kevin O. Skedsvold, a 20-year Insurance Defense Litigation attorney with Skedsvold & White in Atlanta, GA; CEU instructor for the Georgia Insurance Commissioner's Office and Wickstrom Insurance and Risk Training Center. Chairman of Compworx LLC, a workers' compensation process management platform. He can be reached at kskedsvold@skedsvoldandwhite.com or 770-392-8610. www.skedsvoldandwhite.com. Follow at: www.Twitter.com/WCEmployersatty FREE TOOLS: WC Calculator: www.reduceyourworkerscomp.com/calculator.php WC 101: www.ReduceYourWorkersComp.com/workers_comp.php Follow Us On Twitter: www.twitter.com/WorkersCompKit Return to Work in Unionized Companies http://reduceyourworkerscomp.com/Return-to-Work-Programs-Unionized-Companies.php Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker about workers' comp issues. Workers' compensation was formerly referred to as workman's compensation. ©2009 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com� �
A Look at Today and a Quick View to Tomorrow
Today
Most of us are aware at the macro level an Independent Medical Exam (IME) is a medical exam meant to deliver an independent medical opinion for the purpose of determining, if possible, root causation of a given condition and the necessity along with appropriate level of any further treatment. The IME should be performed by a physician with credentials and training necessary to deliver the opinion and with no connection to the current patient treatment. The independent physician will first review the case medical file with all associated films and medical history, then, if not just simply doing a Record Review, see the patient for an exam. The physician will dictate notes from the exam and a final report will be delivered back to the IME requestor.
Several factors play into a well delivered IME.
1. First and foremost, a qualified physician must be found to execute the exam. Qualifications vary by state in terms of Workers’ Compensation certification, but in all cases an IME is best executed by a State Board Certified physician. In a very close second, validation must be made that the physician has never had a loss of license to practice, never had a loss of drug license and is currently seeing patients with no more than 20% of patient load being devoted to IME work. If a physician has been reported to a medical review board, records should be fully reviewed to determine if the incident could have any negative impact down the road should the physician need to go to deposition or take the stand. The above precautions on physician selection all play a part to lowering workers’ compensation costs by making sure only well-qualified physicians are handling these cases. IMEs performed by physicians not meeting the above conditions will most likely be thrown out under cross in court and new IME’s will have to be ordered.
2. The requester’s part in this process should be to deliver to the physician a set of questions outlining exactly what needs to be answered by the exam. The number of questions is generally less than 10 but in some very complicated cases can be as many as 15 – 20. By committing every time to taking this step, the requester draws a firm line around what should be discussed by the physician. This is the one step where the requester can take a forward leadership role versus having tangents or introducing elements that were of no concern. This in no way means that there is influence over the unbiased nature of the opinion, but it does mean the requester offers guidelines to what needs to be discussed.
3. Once a competent physician is found, the goal is to deliver an IME report that answers the requester’s questions in an unbiased, medically sound manner based on current accepted literature within a given medical specialty. Preferably, the IME report will give a brief synopsis of medical history and how it relates to the current condition followed by answers to the questions, and ‘only’ the questions, in order, using language similar to that posed by the requester. This method of reporting provides clarity while following the requester’s direction.
The following items of concern are controlled differently in almost every state and include the allowance of videotaping during an IME, attendance by court reporters, and audio only recording. These concerns will not be elaborated on here as this is a whole discussion in and of itself. Next, fees for executing an IME may also be predefined under a given state’s laws or may have no boundaries at all. The key here is to be well versed in the laws of each state where one must request an IME as they directly affect process, level of effort and cost.
IME Companies
Digging a bit deeper, as most are aware, the process around delivering an IME has many more moving parts and several of which are highly time consuming, hence costly. IME companies began with the idea to not only connect physicians with requesters, but also to take over many of the time-consuming processes to offer requesters savings in personnel, level of effort and of course financials. Most IME companies have a panel of physicians they offer their clients. IME company physician panels vary greatly in number of physicians, geographic scope and specialties covered. Some IME companies will offer to search out physicians for a requester for a fee or for free. A good IME company’s physician panel should already be prescreened for the physician conditions noted earlier.
Additional services offered by IME companies can include some or all of the following: collecting medical records, scanning paper records into electronic format, using medically trained personnel to thin and organize medical records, setting up patient appointments, offering dictation and transcription services for physicians, and offering requesters standard report formatting. Some IME companies offer medical/legal review by nurse paralegals who make sure the medical opinions fulfill all of a requester’s questions and do so in a legally meaningful way. This quality control check acts as a large cost saver by reducing the need for addendums and reducing the number of additional IMEs.
In addition to offering the full range of services, there are several other key points to factor in when searching for a good IME company:
1. Make sure the company follows the three main areas of a well delivered IME from above.
2. A requester should have a list of physicians to select from within one (1) business day if no physician search is required. If a search is required, a list should be delivered within five (5) business days of a request.
3. Creating an appointment should happen within 24 hours of selecting a physician with most within a few hours. Specialty does not matter to make an appointment.
4. The actual appointment, pending on specialty, should be set generally within two weeks (10 business days) of selecting the physician. One note, it is not uncommon for ‘highly specialized’ physicians to take up to 25 business days to work in an appointment.
5. The best fee structures are typically “all-in” fees. This means whatever has to occur to get the report delivered for the IME is covered. Just think the spaghetti sauce motto – “it’s in there.” A la carte pricing may look good on the face, but time has generally proven this scenario ends up costing more to the requester in the long run.
6. Web access in a HIPAA compliant environment to review case files and check status has begun to be a bigger part of the process. This can be a plus and, in larger customers, may be a requirement.
Tomorrow
As we move toward the current administration’s healthcare reform, the amount of oversight and influence of laws being set up by the federal government will play in this field is still unclear. The one thing that is certain is more influence is surely coming.
Almost as a preemptive move, the trend at the top end of IME delivery is rapidly moving to consolidation of IME companies into larger national IME provider networks. The insurance industry at the very top end has also started to pick up on this trend by eliminating regional IME companies and building central processes to utilize only a handful of national IME provider networks. The move is stated by the carriers as a cost saving effort. In their defense, the point of safety in numbers because of uncertainty must be considered. The concern in this move for the carriers and IME providers will be in taking greater effort with quality control and patient care.
More workers re-entering or moving to litigation because of a lack of proper care in the system does not save anyone. Unfortunately, in the short-term, most of the level of effort of quality control and problem solving will be placed on the shoulders of already stretched front line claims adjusters. Ultimately this trend toward consolidation will need to be watched to see if it is truly in the best interest of the patients and actually supports the purported cost savings.
In the middle portion of the market and for the foreseeable future, regional IME companies are still strong and viable choices for assisting with this type of work and many times offer similar or more services for similar costs. These regional companies are motivated to earn a requester’s business and should be more responsive to a requester’s needs in order to secure longer term relationships. The service relationships should bare additional cost savings for requesters coupled with an ease on the constraints of requester’s own work force. (workersxzcompxzkit)
At all levels, the industry will be keeping a watchful eye as to the final direction of the federal government and its reform efforts. This legislation will surely make changes for all of us. Until then, smarter IME companies will find a way to continue to improve and put themselves into the best position possible to take necessary advantage of whatever the administration finally delivers and use that for the continued service of requesters.
Author: Dr. Jared Salinsky, D.O. We welcome as a guest writer, Dr. Jared Salinsky, DO, Chief Medical Officer with InMedEx. Contact him at email: JSalinsky@inmedex.net; www.InMedEx.com or by phone: 727-514-2259.
Budding authors? Contact us at: Info@WorkersCompKit.com.
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FREE WC IQ Test: http://www.workerscompkit.com/intro/
WC Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
TD Calculator: www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
Return to Work in Unionized Companies
http://reduceyourworkerscomp.com/Return-to-Work-Programs-Unionized-Companies.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker about workers’ comp issues.
©2009 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
2009 Drug Free Work Week Myth: In 2006, the next drug-class abused after alcohol by individuals 12 years of age and older was THC (marihuana etc.), as it has been for decades. Reality: Surprisingly, for the first time in years, "illicit pain-relievers" inched out THC as that next class of drugs abused after alcohol. Employer Tip: Stay current with the latest drug addiction trends, some of which are geographically specific. It is best-practice to add oxycodone to drug testing regimens, especially in the northeast, where epidemic abuse is emerging. Additionally, parent education must stress this startling development. Myth: The DOT's standard drug test detects oxycoton, because one of the "standard panels" measures for the opiate class of drugs. Reality: Not so! In fact most standard drug screens will not detect oxycodone (semi-synthetic opiate) unless it is present in very high quantities. A survey of MDs at a major academic hospital found most physicians to be unaware of this. (workersxzcompxzkit) Employer Tip: Annually consult a clinical substance abuse expert to review your DFW plan. Immediately add oxycodone to all drug screening protocols. Authors: Bill White MSN and Katharine White MSN About the authors: K & B White are leadership entrepreneurs who co-founded DFW-Renaissance Inc. (www.dfw-r.com) and co-developed managerial science innovation DFW-R Lean CultureTM (to create/sustain highly engaged drug free workforces). Both are former hospital C-Suite executives with extensive drug treatment, leadership and behavioral health experience. Look for their upcoming headline article in DATIA Focus on DFW Culture Change and Employee Morale. They can be reached by email at billtwhite@cox.net and phone at 401-615-8775.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workman's comp issues. ©2009 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
Airbag DNA Nails Employee Who Crashed Boss's Truck – Interesting situation given it is Drug Free Workplace Week A Canadian judge fined a man more than $5,000 after investigators relied on DNA evidence and cell phone records to catch a North Vancouver man who crashed his boss's truck and then fraudulently claimed it had been stolen. According to the Canadian Broadcasting Corporation, the incident took place in the early-morning hours of when someone crashed a truck into a road sign on the Upper Levels section of Highway 1, north of Vancouver. Police discovered the truck with the keys in the ignition, both airbags deployed and the engine still warm, but the driver gone. Later in the same morning a man reported the same truck stolen to the Royal Canadian Mounted Police at approximately 11:30 a.m., a man called the RCMP to report the truck stolen, a claim he repeated later that evening and again a few days later in a theft claim to the Insurance Corporation of B.C. The insurance company concluded the truck was a write off, but investigators were concerned about the man's claim that the truck was stolen prior to the crash. ICBC's special investigation unit tested the driver's airbag for DNA, and then checked the man's cell phone records, and were led to his girlfriend's home nearby. The girlfriend initially backed up the man's story, but later admitted he told her he was drinking and crashed the truck, abandoned it and decided to submit a theft claim. According to an ICBC spokesperson, DNA testing from the airbag in the truck determined that the man was behind the wheel when the airbag deployed. (workersxzcompxzkit) The man eventually pled guilty to making a false or misleading insurance claim.
Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers' Compensation costs, including airlines, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: Robert_Elliott@ReduceYourWorkersComp.com or 860-786-8286.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workman's comp issues.
©2009 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
2009 Drug Free Work Week 10/19-10/25, HI-LITES Myth: Absenteeism is the leading substance addiction expense for employers. Reality: Untrue! It is estimated that "presenteeism" (present at work but impaired) may be 6.5X more costly than absenteeism. In fact, many substance addicted workers are never intoxicated on the job, but are in an acute phase of detoxification, given the short acting pharmacology of alcohol and most illicit drugs. In simplest terms, this is brain-impaired presenteeism. Employer Tip: Be vigilant for substance related presenteeism (i.e. alcoholism: tremors, sweating, irritability, mistakes, poor judgment, injuries etc.). Best practice mandates immediate feedback re: symptoms/behaviors, and facilitated discussions with managers and staff to explore presenteeism solutions. Myth: Recent data published in the Wall Street Journal showing a declining rate of positive urine drug tests means that workplace substance abuse is decreasing. Reality: No scientific conclusions* can be drawn from this data about workplace substance abuse. What definitely is true is that urine drug test adulteration and substitution is big business. On the day this article was written, a web-search of "How to beat a urine drug test" returned 976,000 results! These results showed how to beat employment screening, return to duty and random drug testing, even naming specific companies and their urine drug testing protocols to ensure best-practice adulteration method! SAMHSA's substance abuse survey data shows worker substance addiction to be over 10% for decades, including the latest results from 2007 (8.8% illicit drugs and 8.9% for alcohol). The Supreme Court shares our concern, recently ruling that regardless of company policy/preference, all workers who test positive must be observed during return to duty drug testing. (workersxzcompxzkit) *[The authors have contacted the Wall Street Journal Editor to clarify any misperceptions]. Employer Tip: Consult a clinical expert about drug test contamination and the latest drug testing technologies, some of which help minimize adulteration (i.e. lab-based oral fluids testing with "non-mandated" companies). Be cautious of any research study interpretations which do not match up with SAMHSA's data. Authors: Bill White MSN and Katharine White MSN About the authors: K & B White are leadership entrepreneurs who co-founded DFW-Renaissance Inc. (www.dfw-r.com) and co-developed managerial science innovation DFW-R Lean CultureTM (to create/sustain highly engaged drug free workforces). Both are former hospital C-Suite executives with extensive drug treatment, leadership and behavioral health experience. Look for their upcoming headline article in DATIA Focus on DFW Culture Change and Employee Morale. They can be reached by email at billtwhite@cox.net and phone at 401-615-8775.
Follow Us On Twitter: www.twitter.com/WorkersCompKit Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workman's comp issues. ©2009 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
NEW YORK Horsing Around with Workers Comp
A deputy sheriff, out of work for the past 14 months was indicted for allegedly stealing $56,000 in workers’ compensation benefits by falsely claiming she was injured by falling down the stairs at the sheriff’s office. In fact, she was thrown off her horse. (workersxzcompxzkit)
As a result of collecting workers’ comp, the employee received her full salary, tax-free, without using accrued sick time.
CONNECTICUT Getting Paid Three Ways
A correctional worker received $12,656 in workers’ compensation benefits based on his claim of being injured at the state’s correctional facility.
While out on work comp, the man operated a pellet business for which he just happens to be in the eye of the state’s attorney general for non-performance of his delivery agreements after accepting advance payments from customers for pellets. (workersxzcompxzkit)
He now faces charges of first-degree larceny, work comp fraud and failure to maintain workers’ compensation.
The alleged fraudster, is on paid administrative leave from his job as a corrections officer until the investigation against him is resolved.
Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: Robert_Elliott@ReduceYourWorkersComp.com or 860-786-8286.
We are accepting short articles* (300-800 words) on WC cost containment. Contact us at: Info@WorkersCompKit.com. *Non-compensable.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workman’s comp issues.
©2009 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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Why Is It Important To Begin with the Assessment? Workers' compensation is a multi faceted issue. Often there is no "one thing" driving your costs upward, but a confluence of issues, a perfect storm, if you will, resulting in hemorrhaging workers' comp costs. People often don't know what they don't know. Much like going to a doctor's office for a physical, a diagnosis isn't made until all the tests, x-rays and specimens are taken. Then and only then can the physician come up with a complete picture of the patient's health and identify key issues causing distress. A workers' comp assessment does the same thing. One day I sat down and captured the key areas I've seen come into play in virtually every workers' compensation management project. Once you take this assessment, you can see it isn't just one driver sending your costs spiraling, rather it's several factors, acting together, causing costs to spiral. Over the past twenty years, I've identified ten key areas impacting workers' comp costs. My observations are based on hundreds of client projects I've assessed and resolved with succinct recommendations designed to build an action plan. Ten years ago, we conducted client assessments on-site for every site and the mere experience of assessing took over six months to a year. Often the project fixated on the assessment and it became very difficult to move the project into recommendations and implementation. The WorkersCompKit(R) assessment can be completed in an afternoon and yield recommendations immediately to move the project from concept to action. The assessment is not only quick, but also comprehensive — touching on topics raging from management commitment to programmatic aspects such as post injury response, return to work, communication and training. The assessment helps you to identify aspects of issues like claims handling that perhaps you never thought of before. 10 Key Assessment Areas 1. Management Commitment The assessment helps you determine the level of management commitment. How involved is your management in day to day operations? How cognizant are they are workers' compensation issues? Are there consequences for divisions having poor performance? 2. Insurance Company and Claims Administration Controls Claims handling can be overwhelming, but if you start with a phone call to your handler, you have taken the first step to gaining control in this area. Make it a point to meet regularly with your claims handler to review open claims, to document activities to date, and to plan strategies going forward. 3. Performance Goals Since workers' comp is measured in dollars and cents, performance goals should be couched in measurable statistical goals, so you can document progress at every step of the way. 4. Post Injury Response It is critical to have a solid post injury response procedure in place so within minutes of a work-related injury occurring, all parties know their roles and responsibilities to resolving the incident. Use the assessment to determine how well you are prepared to respond to injuries. 5. Communication Communication must be intentional not incidental. Use the assessment tie down the lines of communication. Do you have a workers' comp management brochure or a laminated card that employees can put on their lanyards along with their badges. Have you determine how well the communication programs you have in place are working. How to communicate with injured employees. Do you make every effort to stay in touch, keep the lines of communication open. Do you send a get well card, and call them every week? You should make sure all employees know transitional modified duty is expected as part of their recovery process. The assessment will tell you how far in line your practices are and identify specific areas where you need to improve. 6. Return to Work and Transitional Duty When employees are injured on the job, your goal is to return them to work as soon as they are medically able. Transitional duty (TD) enables injured workers to remain "on-the-job" while recovering from a work-related injury. You must have a transitional duty policy in place. Transitional duty is important to both employees and management as a tool to avoid the negative consequences occurring when employees are out of work for a long time. For employees, returning to work allows them to maintain important job skills and be part of the daily work routine. They avoid becoming "psychologically disemployed" and distanced from their work environment. Employers experience lower work comp costs by keeping the services and skills of trained employees (versus paying for temporary workers – always costing more), improving employee retention and avoiding costly lawsuits. You are also able to monitor employee recovery and prevent re-injury. 7. Medical Care Coordination How medical care is handled during recovery is another determinate of cost savings. Examine your medical cost containment and care coordination practices to discover the best ways for employers to insinuate themselves into this process. Too many employers believe the medical aspects of workers' comp management are outside their realm of control. The assessment shows the areas where you do have control, and helps you examine ways to exert this control. 8. Medical Cost Containment Often employers think medical cost containment is an area of which they have little control. Controlling medical costs is achievable by reducing the number of treatment and/or reducing the cost of treatments. Think about engaging the services of a third-party administrator (TPA) to administer your claims. Although there will be fees, the benefits outweigh the investment. The key to using a cost containment service is to thoroughly vet them and know exactly what is being offered and how they match your needs. Organize a vendor day to learn about your claims handler's services and explore services companies in your area to supplement what your adjuster offers. 9. Fraud, Abuse & Malingering The main point in controlling fraud is to jump on it immediately. DON'T WAIT. While it's true most injury claims are legitimate, it's the tiny few fraudulent claims that will cost you the most in time and money. Investigations are a useful tool to control workers' compensation costs when you need to determine the legitimacy of a claim. Be prepared to document and substantiate any suspicious claim from simple observation to videotaping activities. Communicate to your employees your "anti-fraud" policy, to make sure all employees know EVERY suspicious claim will be investigated and if found legitimate, prosecuted. You know what is said about an "ounce of prevention." So, when it comes to controlling fraud don't be the 200 pound gorilla in the room. 10. Training Initiatives Training is key to turning employee cultures around and integrating workers' comp management into the culture so it is practiced along with the other business practices employees engage in. Use the assessment to help you examine training initiatives you can use to augment implementation. Trained employees are more likely to respond appropriately in the event of a work-related incident, thus avoiding unwanted, unnecessary costs and bringing incidents to resolution quickly and efficiently. (workersxzcompxzkit) Sounds overwhelming?!? Maybe — but taking the assessment will help you pinpoint what areas you have in place, and what areas require implementation. In this way, you don't start from scratch, because the assessment shows where you are on the journey to best practices — your ultimate goal. From there, you can formulate the recommendations into an action plan, a timeline to success, and, I predict, much lower costs associated with workers' compensation. Author: Rebecca Shafer, J.D. consults for mid-market and national accounts focusing on project management, risk management assessments, data review, benchmarking, and development of Workers' Compensation and Injury Management Programs. Projects focus on development of training and education programs, document design, evaluation and integration of insurance claims administration and TPA services. Contact her are: RShafer@ReduceYourWorkersComp.com Budding writer? Contact us at: Info@WorkersCompKit.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workman’s comp issues. ©2009 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
While many companies continue to battle with added costs and continuing layoffs, the financial impact of ever-increasing workers’ compensation insurance costs often goes unrecognized.
For many companies, getting a handle on workers’ comp costs is something that is absolutely possible, but it takes time and effort to do so.
Whether companies are major players in the business world or mid-level employers, their workers’ comp costs can be managed, with the average reduction being anywhere from 20 to 50 percent.
For those not comfortable in dealing with their workers’ comp costs, finding a qualified insurance broker or agent to explain the methodology of premiums and more is easier than you think. At the end of the day, all workers’ comp coverage will be decided by how much in losses the insurer believes your company will undertake.
For the majority of companies, workers’ comp ranks as the greatest percentage of their insurance dollar; often as high as 30%, according to the 2009 RIMS® Benchmark Survey. For Professional Employee Organizations (PEO), and trucking companies, workers’ comp cost is many times trailing only their payroll expense. (workersxzcompxzkit)
Employers, insurers and brokers that team together have major incentives to trim the cost of workers’ comp.
When starting such an initiative, the risk manager needs to obtain the support of senior management, employees and physicians to put in place a holistic program. The broker must obtain the numbers to substantiate development of cost containment initiatives.
Editor’s Note: Look for how to implement a proven workers’ comp program in the next installment.
Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: Robert_Elliott@ReduceYourWorkersComp.com or 860-786-8286.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workman’s comp issues.
©2009 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
Privacy On-Line – At Work and At Home
As more and more Canadians live their lives on-line, the Privacy Commissioner is cautioning them to take greater responsibility for securing their privacy and thinking twice about what they post on the Internet.
”Many young people are choosing to open their lives in ways their parents would have thought impossible and their grandparents unthinkable. Their lives play out on a public stage of their own design as they strive for visibility, connectedness and knowledge,” said Jennifer Stoddart, the Privacy Commissioner of Canada.
“Such openness can lead to greater creativity, literacy, networking and social engagement. But putting so much of their personal information out into the open can also. . .leave an enduring trail of embarrassing moments that could haunt them in future,” the Commissioner said in her annual report to Parliament.
The Commissioner’s 2008 Annual Report to Parliament on the Personal Information Protection and Electronic Documents Act (PIPEDA) highlights the issue of youth privacy. It also looks at 2008 privacy complaint investigations; technology and privacy issues; and the Commissioner’s efforts to encourage the development of international privacy standards.
Stoddart noted many people are fired, missed out on job interviews and academic opportunities, and are suspended from school for instant messages, wall posts and other types of on-line correspondence they mistakenly thought were private conversations with friends. There is also a risk that unguarded personal information could be exploited by identity thieves.
“As Canada’s privacy guardian, it is our role to create awareness of privacy risks, show people how to address those risks, and make it easy for them to make informed decisions,” said Stoddart. (workersxzcompxzkit)
The annual report, available on the OPC Web site at www.priv.gc.ca, includes details of complaints received and investigated by the Office in 2008. The OPC received 422 new PIPEDA-related complaints for investigation in 2008, ending a downward trend that had lasted for several years. In 2007, there had been 350 complaints, fewer than half the 723 received in 2004.
Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: Robert_Elliott@ReduceYourWorkersComp.com or 860-786-8286.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workman’s comp issues.
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