Double-check to make sure you Job Classification Codes are Accurate Why does every employer need to check their job codes? Job codes are a huge component of the premium you pay for workers' compensation. Therefore it's critical codes be applied correctly. The reality of our fast-paced world is businesses change constantly. As a business evolves, the type of worker needed changes to fit the new business model, and as the type of worker changes, so do the job codes. Save your business premium dollars by reviewing your job codes periodically - whether the business has changed or not. Either way, you save money! Where does an employer find these job codes? Most states have adopted a job classification system devised by the National Council on Compensation Insurance (NCCI), consisting of some 600 job codes. Since workers' compensation is a state-driven system, applying the correct codes is not always an easy task. A few states have adopted the NCCI classifications system, but have unique classifications for certain workforce exposures. Other states (California, Delaware, New Jersey, New York and Pennsylvania) have adopted their own classification systems. To make this even more complicated, NCCI doesn't publish its complete list of codes on the Internet. You can buy the list from NCCI, but it is not practical for most businesses to do so. Why are there so many job codes? Jobs having low risk exposure carry a low rate; high risk jobs carry a higher rate. As an example, the rate for clerical workers is much lower than workers who handle chemicals because the potential workplace injury exposure associated with the two jobs is quite different. No matter what system your state uses, each job code has an associated rate used to calculate your worker's compensation premium. A business may also have multiple classifications. A chemical manufacturer is further classified by the types of chemicals it produces. Once the business classification is properly identified, classifications drill down to the type of work performed (such as chemical material handler, clerical, sales, etc.). So, where do you turn? Your insurance carrier and broker have a list of job codes by state and will work with you to identify the correct codes for your business. As this review may save premium dollars for you, it also benefits the carrier by ensuring the risk they cover is a known risk. For corporations with multiple sites in several states and thousands of employees, reviewing job codes involves several stakeholders and takes time, perhaps many months. At the table should be the insurance risk manager, insurance carrier and broker. You also want to invite division representatives who are well acquainted with site operations and the actual work performed there. You may want to include a payroll representative who actually assigns job codes to individuals within your payroll system. Once the stakeholders are identified, begin a systematic review of the operations and its jobs. As a possible approach, first identify those job titles that are can be grouped into large classifications, such as clerical and sales, which are most easily assigned to a job code. Then, move into the more specialized areas such as the chemical material handler mentioned above. (workersxzcompxzkit) Repeat! Repeat! Enough cannot be said of the importance of reviewing your job codes periodically, particularly if your operation has changed in recent years. A thorough review ensures all codes are correctly applied for all workers and will likely result in a lower workers' comp premium for the company. Podcast/Webcast: How To Prevent Fraudulent Workers' Compensation Claims http://www.workerscompkit.com/gallagher/podcast/Fraudulent_Workers_Compensation_Claims/index.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent 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
A report on workplace fatalities has been called for by New Zealand Minister of Labor Kate Wilkinson, after 30 New Zealanders died from accidents on the job between July and November of 2009. In the same five month period in 2007 and 2008, 15 and 18 deaths were recorded, respectively. In December 2009, one additional death, a 38-year-old pulp mill worker, brings the total to 31 for this financial year. All 31 were men.
“I’ve asked the Department of Labor to take a close look at these deaths, whether there is any underlying cause and if so, then what can be done about it,” Wilkinson commented. ”It’s not acceptable that 31 families are now without husbands, fathers and brothers. I want to know why and how these men died.
“It may be there were factors outside anyone’s control, but if employers have failed in their obligations to keep their staff safe then they must accept the consequences. At the very least, these deaths must serve as a wake-up call to all employers and workers that health and safety is very serious – complacency and simple mistakes are killing people needlessly.”
Most of the 31 workplace fatalities remain under investigation. The Department was to report back to the Minister with its preliminary findings in less than a month.
According to Wilkinson, “Summer traditionally brings with it a higher number of fatalities, particularly in agriculture, construction and forestry, and its important we combat that.”
The Department has begun a project to reduce the number of fatalities and serious harm in agriculture and horticulture. It is also working closely with businesses to build the leadership on workplace health and safety essential to reducing this toll.
“There’s so much more that can be done by employers, employees and the Department to ensure that workers go home safe each night,” Wilkinson added. (workersxzcompxzkit)
Background Statistics
Although a little frightening to know, it’s important New Zealand employers be aware of these stats.
1. From 1 July 1, 2000 to December 8, 2009: 535 out of 556 deaths (96%) were men.
2. A total of 55 people were killed in the last financial year (08/09) – more than 1 per week – with 53 in 07/08.
3. 14 of the 31 killed this financial year were aged 45-64 — consistently the worst affected demographic group over the past 10 years.
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 860-553-6604.
Podcast/Webcast: How To Prevent Fraudulent Workers’ Compensation Claims
http://www.workerscompkit.com/gallagher/podcast/Fraudulent_Workers_Compensation_Claims/index.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent 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
Workers' Compensation is a type of insurance all states (except Texas) require businesses meeting certain criteria to carry. Laws requiring this type of insurance were created around the time of the industrial age to guarantee wage continuation and medical benefits to employees injured at work regardless of fault, in exchange for civil immunity for the employer. Workers' Compensation is a single line of insurance or business considered part of the Property Casualty group of coverage encompassing general liability, property, auto and others lines. Workers' Compensation insurance may be purchased as part of a package or "mono-line," as an individual policy. There are choices involved and decisions to be made in purchasing workers' compensation coverage just as when you purchase your own auto policy and select a deductible. Generally, in purchasing a guaranteed cost policy, your premium remains at the price quoted regardless of the cost of the losses. Because premiums are in part based on payroll multiplied by a rate, premium audits are conducted generating either additional premium or a premium refund. Other than that, the price paid in the end should be the price your agent/broker negotiated and quoted. The insurance company funds losses and bears the lion's share of the risk however it's in an insured's best interests to reduce claim frequency and severity to minimize loss costs. Loss experience is another facet of premium calculation and out of control losses will drive premium costs up. Depending on the financial strength of your company and your appetite for risk, there are also programs available allowing a company to participate in the losses financially. These programs include deductibles and retro's (retrospective rating). These vehicles allow a company to participate to a large degree financially to control their insurance and claim costs and essentially bear much of the risk themselves. Such programs may make good sense for organizations with sophisticated loss prevention and strong claim management or oversight in place. (workersxzcompxzkit) While workers' compensation policies may be generic in meeting your statutory requirements, claims and loss control services vary greatly and differentiate one company from another. Choose wisely. The effectiveness of these areas will reduce loss costs and even prevent losses from occurring, which in turn reduce your premium. Evaluate the financial strength of your company, the loss prevention and claim management programs in place and importantly, the appetite for risk at your organization, to decide whether a guaranteed cost or shared risk program is the way to go. Also be sure to evaluate the financial strength of the insurance carriers under consideration.
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 860-553-6604.
Podcast/Webcast: How To Prevent Fraudulent Workers' Compensation Claims http://www.workerscompkit.com/gallagher/podcast/Fraudulent_Workers_Compensation_Claims/index.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent 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
When you review the workers’ compensation adjuster’s file notes, what should you expect to see? [You do have access to your adjuster's electronic file notes, right? If not, it should be a condition of claim handling agreement with your third party administrator (TPA) or insurer.] A properly documented file answer all your questions and concerns about the claim.
Properly Documented File Notes
Coverage: Addressed as the first step in every claim. File notes contain:
1. The policy number
2. The policy period
3. The states covered by the policy
4. Endorsements to the policy
5. Exclusions from the policy
If there is any coverage question, it should be addressed immediately before the adjuster proceeds with the contacts and with the investigation.
Contacts: Prompt contact with all parties should be initiated the same day the claim is received or within 24 hours if not the same day. Contacts include:
1. The employee
2. The employer
3. Any witnesses on any questionable claim
4. The medical provider(s)
Initial Investigation: When the work comp adjuster makes the contacts needed, the file notes reflect:
1. The accident details as stated by the employee in the recorded statement, the employer’s version of the accident and any witnesses’ version of the accident
2. Index Bureau information and any history of prior insurance claims
3. The potential for subrogation
4. The current disability status of the employee and the projected return to work date
5. Description of the employee’s job title, job duties, equipment utilized, etc.
6. Length of time the employee has worked for the employer
7. The availability of modified duty for the employee not yet back to work
8. Information on the nature of the injury, the treatment plan and the prognosis
9. Information on the employee’s attitude toward the employer, returning to work, the quality of the medical treatment
10. The explanation of benefits provided to the employee and the action plan information provided to the employee
11. If there is an attorney representing the claimant, obtain the letter of representation
Claim Resolution Documentation: Documentation the adjuster needs to obtain to move the claim forward toward a resolution includes:
1. Employer’s First Report
2. The recorded statements of the employee, the employer (if needed) and any witnesses (if needed)
3. A medical authorization in those states that require one for work comp
4. A wage statement from the employer covering the state required calculation period
5. Current medical records
6. Past medical records on employees with prior insurance claims
7. Index Bureau filing
8. All required state forms or filings
9. Police reports, EMS reports, OSHA reports, other governmental reports on an accident
10. Independent medical evaluations (IME) or peer review
11. Vocational and rehabilitation reports
12. Subrogation documentation
13. Second injury fund correspondence and/or documentation
14. Correspondence to/from employee’s attorney
15. Correspondence to/from defense counsel
16. Workers’ Compensation Board/Industrial Commission correspondence
17. File notes on every telephone call, e-mail or any other activity related to the file
Evaluation/Settlement: The adjuster’s file notes also contain the information on the adjuster’s efforts to resolve the claim including:
1. The adjuster’s evaluation of compensability
2. The exposure or value of the claim and how it was calculated
3. A synopsis of any legal questions and the efforts to resolve those questions
4. The disability rating or the potential disability rating
5. The jurisdiction and the impact the jurisdiction will have on the claim
6. The Action Plan to bring the claim to a conclusion
7. A history of the settlement negotiations
Summary: The adjuster’s file notes reflect the main details of all file documentation received either by postal mail or electronic mail. (workersxzcompxzkit) The file documentation itself, whether maintained in the computer or by paper, must be complete and answer any questions you have about the file.
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 860-553-6604.
Podcast/Webcast: How To Prevent Fraudulent Workers’ Compensation Claims
http://www.workerscompkit.com/gallagher/podcast/Fraudulent_Workers_Compensation_Claims/index.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent 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
A New York man is charged with wrongfully receiving nearly $47,000 in workers’ compensation benefits while working secretly as a disc jockey for a strip club, according to the New York State Insurance Fund.
Officials said they found the defendant was spinning music at the strip club for the past five years – the same time period he also collected work comp benefits from an accident 23 years ago.
The man was charged with third-degree felony insurance fraud and fraudulent practices, for alleged crimes taking place from January through December 2009. It is also alleged the individual not only misrepresented his return to work, but also his physical capabilities and condition.
Authorities say the man was injured in 1986 while working as a painter for a Central New York cheese company, and he previously denied in three separate written statements to the state Insurance Fund that he had returned to work. During an investigation, (by the state Insurance Fund’s Division of Confidential Investigations, Insurance Department’s Frauds Bureau and the Workers’ Compensation Board Inspector General’s Office) the man admitted he was working as a DJ at the club. On Dec. 14, Utica police took the man into custody on.
During this past year alone, the individual received nearly $3,600 in wage replacement benefits to which he was not entitled, officials said. The potential total for the benefits that he wrongfully received is estimated at $46,815. (workersxzcompxzkit)
“This case underscores an important element of what makes workers’ compensation fraud so expensive,” said Francine James, NYSIF chief deputy executive director. “This case has gone on for 23 years and could have continued for many more had our people not been vigilant.”
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 860-553-6604.
Podcast/Webcast: How To Prevent Fraudulent Workers’ Compensation Claims
http://www.workerscompkit.com/gallagher/podcast/Fraudulent_Workers_Compensation_Claims/index.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent 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
Every company wants their workers’ compensation claims settled fairly and for the proper amount, but what is the proper settlement amount and how is it calculated?
While it is difficult to quantify the financial impact of any one step in the handling of a work comp claim, it is a well proven fact that a properly handled claim will have a lower settlement value then a poorly handled claim. The work comp adjuster can and should influence the settlement value of the claim by utilizing the established Best Practices for Workers’ Compensation including (but not limited to):
1. Immediate contact with the employee, employer and physician at the start of the claim.
2. Complete investigation of the accident details.
3. Pursuing a modified duty/light duty return to work program.
4. On-going contact with the employee, employer and medical providers.
5. The integration of medical management and/or rehabilitation.
When the workers’ compensation adjuster completes the investigation, and the investigation reveals the claim is compensable, the adjuster (and sometimes with the adjusters’ supervisor’s assistance) evaluates the value or the financial exposure, taking into consideration the medical issues, the disability issues and the legal issues associated with the claim.
The settlement evaluation reflects what the claim should settle for. The settlement evaluation is a settlement range, not an extreme result. The settlement evaluation should not be based on the possibility of a highly favorable board ruling and it should not be based on the possibility of an unfavorable/adverse trial result. In short, the settlement evaluation should be close to the mid-point or the middle settlement range, not reflective of either end of the settlement range.
Factors to be included in the settlement evaluation for a work comp claim include:
1-Jurisdiction
2-Permanency Ratings
3-Employee’s Wage Rate (with max cap or minimum amount, if applicable)
4-Medical Information
5-Value of Future Medical
6-Value of Future Wage Loss
7-Rehabilitation, if necessary
8-Death/Funeral Benefits
9-Disputed Issues
10-Offsets/Medicare/Other Deductions
11-Pre-existing Conditions where permitted
12-Strengths and Weaknesses of Both Sides in Negotiations
The work comp adjuster reviews all information available to establish the causal relationship of the injury to the medical treatment. The adjuster separates the diagnostic treatment from the actual treatment by the physician. The lost wage information is reviewed and the days missed from work verified by the medical reports. The value of permanency, disfigurement (where permitted) and future medical is established. If the employee is attorney represented and the settlement value is being contested, the cost of legal defense should be considered.
The settlement evaluation factor most difficult to quantify is the jurisdiction. As the jurisdiction can play a critical role in the determination of the settlement value, it is essential for the work comp adjusters to have complete knowledge of their state laws. Any time the adjuster has any doubt about the way their state will handle a work comp issue, they should consult with their supervisor or a trusted defense counsel in regards to the jurisdictional issue. The adjuster should know if the jurisdiction they are in is plaintiff-oriented or if it is more conservative. The adjuster should keep in mind the effect the work comp commission will have on the final result. This will allow the adjuster to properly evaluate how the jurisdiction will impact the settlement evaluation. Resource: http://reduceyourworkerscomp.com/workers-compensation-state-laws-and-regulations.php
The reserve worksheet, whether paper or electronic, is essential in the evaluation process and the place to bring it all together. The reserve worksheet should be completed with as much as information as possible to establish the settlement value. (workersxzcompxzkit)
Upon receipt of the final medical report establishing the employee’s maximum medical improvement and disability rating, if any, the adjuster should verify the reserve worksheet is correct. If the reserve worksheet is not correct, it should be updated. The employee or the employee’s attorney, if represented, should then be contacted to discuss settlement based on the settlement evaluation established through your reserve worksheet.
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 860-553-6604.
Podcast/Webcast: How To Prevent Fraudulent Workers’ Compensation Claims
http://www.workerscompkit.com/gallagher/podcast/Fraudulent_Workers_Compensation_Claims/index.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent 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
Nothing Succeeds Like Success…
A leading international third-party administrator for large self-insured organizations, provides workers’ compensation, auto, and general liability claims handling.
Part of this multi-national company’s success stems from their best practices regarding workers’ compensation procedures. The claims staff divides procedures into fourteen discrete areas. Let’s look at four steps.
1-Loss Reporting
Prompt loss reporting is a key aspect of timely loss notification. Prompt reporting has three advantages.
1. Prompt quality contact with all involved parties results in reduction of claimant representation and litigation.
2. Prompt investigation
3. Reduction of overall cost per claim
2-Claim Assignment
An effective assignment process helps to ensure proper handling of claims at the appropriate technical level. The claim assignment process may include gathering additional information beyond what is available in the Employer’s First Report of Injury.
The TPA practices a team approach to claim management, distributing the work to the most appropriate level of technical expertise to gain the highest possible efficiency.
3-The Assignment Procedure
Upon receipt of a first report from the call center, fax or e-mail, a four-step process is initiated.
1. Supervisory evaluation of first report of injury for type of loss (medical only/lost time).
2. Supervisory review and direction to the appropriate claims examiner.
3. Creation of a Central Index Bureau referral for lost time claims and medical-only as required.
4. Case management services should be utilized as appropriate. (It should also be noted the claim classification and technician assignment can change throughout the life of the claim if a significant change in complexity level occurs.) (workersxzcompxzkit)
4-Coverage Verification
Coverage verification process includes confirmation of the client’s self-insured retention and valid contract and/or verification of a client’s policy of insurance with the carrier, limits of coverage, and effective dates. Coverage issues are recognized, investigated and addressed with the carrier.
All of the i’s are dotted and t’s are crossed…the claims are handled well.
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 860-553-6604.
Podcast/Webcast: How To Prevent Fraudulent Workers’ Compensation Claims
http://www.workerscompkit.com/gallagher/podcast/Fraudulent_Workers_Compensation_Claims/index.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent 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
Trinity International Corp., (name changed) a holding corporation for 60+ companies, reduced incurred workers’ compensation losses by 60%; medical costs by approximately 50% and 99% of injured employees returned to work within 10 days. Trinity teaches its divisions to manage claims internally, returning employees to work as soon as medically able.
When Trinity reduced incurred losses by 79% at one location and by 84% at another, people wanted to know what Trinity was doing right. Trinity developed modified jobs for injured employees who cannot return to work at 100% capacity thus avoiding the curse of “psychologically disemployment.”
What is Psychological Disemployment?
The key to modified duty is to limit the duration of time away from the job to the period of time medically necessary. Research shows once a worker goes off on work comp and loses the all-important connection to the workplace, slowly the incentive to return to active, productive employment fads. The injured worker becomes used to staying at home, likes it and may eventually attempt to extend the duration of the absence.
When an employer provides modified duty (adding a cushion, providing a chair) to bring a worker back to work quickly, the worker stays connected to the workplace and co-workers, heals quicker and is in a better “psychological” frame of mind about work. Trinity found most job modifications cost less than $300. It’s a matter of being creative.
Using Documentation to Control Claims
Proper documentation is very important to maintain an organized program of injury management because the program requires constant communication with the employees, the doctors and the insurance company. To facilitate implementation and to avoid duplication of effort, Trinity provides each of its companies with many sample form letters suitable for various situations.
For small companies, this means putting together a set of comprehensive form letters of the required information, especially as it pertains to your state law. In addition to these form letters, Trinity also maintains an Employee Contact Log, so each contact with an employee or a doctor is recorded. Such a document makes it possible to substantiate company action in court or at a hearing.
Coordination of Medical Care
Proper and timely medical care is crucial to ensure the length of disability matches the length of absence. In many cases, Trinity found the original injury claim was legitimate, but the employee’s absence was extended unnecessarily.
To coordinate care, the company encourages constant correspondence and telephone communication with the doctors, physical therapists and chiropractors to ensure treatment is appropriate and provided according to a “treatment plan.” (workersxzcompxzkit)
Medical Provider Cost Containment
Medical cost containment for all workers’ compensation medical costs is aggressively managed to ensure the cost of care is appropriate and the duration and number of treatments are necessary. Trinity implemented these steps.
1. A medical consultant reviews each file.
2. Mandates compliance to a fee schedule.
3. Audits all medical and hospital bills.
4. Uses preselected “company” doctors.
5. Negotiates provider fees.
6. Conducts a precertification utilization review of all hospital admissions.
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 860-553-6604.
Podcast/Webcast: How To Prevent Fraudulent Workers’ Compensation Claims
http://www.workerscompkit.com/gallagher/podcast/Fraudulent_Workers_Compensation_Claims/index.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent 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
A Reader Asks:
How DO I put a Workers' Comp Program Together Using My Safety Experience? Recently my company tasked me with managing workers' comp costs because I have a background in safety. I really don't know where to begin. I tried expressing my reservations to management, and they just said, "Nonsense! If you have a background in safety, you can handle all the workers' comp stuff."
Now I am panicking because to be honest, I don't have a clue as to where to begin. I used to think that workers' comp was the flip side of safety and to some extent it is, but I'm finding safety only works up to the point where a work-related accident occurs. Once the accident occurs, I find our company doesn't have any stop gap measures in place to protect ourselves. Where do I begin and how do I get something concrete off the ground quickly so I can keep my job?
Help! Bob Elliott Replies:
Yes, you're right, workers' comp management is the flip side of safety if you look at it from the vantage point of pre- and post-accident. Safety measures are critically necessary to ensure work related accidents don't occur. However, if and when accidents do occur, you must have post-injury procedures in place to quickly address that accident, provide medical care to the employee if necessary, and return the employee to work in a modified or full time duty position as soon as possible. I think you can design a program that will enable you to manage both safety and workers' comp if you build upon what you have.
You can use the same tools you used to build your safety program to build a workers' comp management program. Since a strong safety program is in place, one all employees are trained in as to signage, work place safety, toolbox safety, handrail safety, etc., a post-injury response training program can also be developed. Since communication is such a large part of safety, workers' comp management communication can be also be developed.
Use templates adaptable to develop a workers' compensation policy such as: an employee brochure, post injury response documents, letters to medical people and claims handlers, a communication strategy.
Assessment
Since workers' compensation management isn't a mirror image of safety, you need to acquaint yourself with the myriad factors impacting your workers' comp costs. Taking a workers' comp assessment is a great place educate yourself about all the costs you may not have noticed that are driving your comp costs out of control.
I recommend taking an assessment to discover where you are with your current workers' compensation program. Once you have this information design an action plan. I suggest using a timeline so you can prioritize your action plan because otherwise you will feel overwhelmed.
Make sure you obtain adequate resources for program development and training up front. Based on the assessment, create a short presentation for senior management to show comp costs and cost savings of comp management.
Planning Tools
You can use several free planning tools to illustrate the costs (known and hidden) of a workers' compensation program and to bring management on board.
1. The Sales to Pay for Accidents Calculator:
This tool (below) dramatically illustrates comp costs Use your laptop with a projector, and let management key some numbers into the calculator so they can draw their own conclusions. Management will love it because this calculator drives the point home as nothing else can.
2. The Transitional Duty Cost Calculator
Use the TD calculator (below) in the same way to show how implementing a modified duty program can save the company big money right away. Let management manipulate the calculator if they wish. This will bring your point home, and ensure you're receiving the financial backing you need to develop and implement a program.
3. What to Present to Management
Provide management with a prioritized list you've developed from the assessment and recommendations and a calendar plan of action items, together with a cost estimate so you can ask for and receive adequate resources to do the job management gave you based on your "safety experience."
Implementation will derive from your assessment answers, but for the sake of illustration, let's assume your immediate goals are:
1. Instituting a strong post-injury response procedure.
2. Instituting transitional duty program.
3. Reviewing your claims handling practices to ensure claims handlers are responsive and plugged into your situation.
4. Bringing injured employees back to work.
5. Launching a communications program for the employee population (this includes writing a workers' comp policy, a brochure detailing the policy and post injury response procedures, and a get-well component for keeping the lines open with out-on-comp employees.
Returning Employees To Work: A Two-Pronged Approach
1. You can design modified duty positions as part of your transitional duty program for employees out a work for a short period of time.
2. You can convene file reviews to develop remedial action plans for those employees who are out of work forever. File reviews would typically take place at the insurer's worksite. You should invite the case handler, a physical consultant with a background in workers' comp, together with any one else who touches the case. Discuss each case and decide next steps for bringing the case to resolution.
Issues in Workers' Comp Management Safety Doesn't Touch
1. You must establish, to the extent your state laws allow, the best medical care coordination possible.
2. Ensure every cost containment measure is in place.
3. Work closely with your insurer to have regular file reviews to begin dealing with ancient comp claims and either bring those workers' who are out on comp back to work or resolve and close the file in some way.
4. Schedule visits to your company's preferred medical clinic – if that's possible in your state – to make sure they are in step with your post injury response procedures.
5. As part of your claims handling, you should schedule a periodic visit with your insurer to be sure they are paying out what you want them to on open claims.
6. Use a calendar and plot your strategy, along with your other duties so you can coordinate with your safety initiatives, organize your thoughts and your time more efficiently. (workersxzcompxzkit)
7. Divide implementation into immediate and longer-range action items for both safety and workers' comp management. The important thing to remember is that everything occurs over time.
8. Organize your strategy as it occurs over time.
A cost-effective workers' compensation program is like Rome, it can't be built in a day.
Bob's Sign Off Tip: "Good luck comes with good management!"
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 860-553-6604.
Podcast/Webcast: How To Prevent Fraudulent Workers' Compensation Claims http://www.workerscompkit.com/gallagher/podcast/Fraudulent_Workers_Compensation_Claims/index.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
The safety of employees at industrial estates across Sunderland in Great Britain came under the microscope recently as the Health and Safety Executive and Sunderland City Council launched a joint inspection on premises. More than 65 businesses were inspected in the crackdown resulting in 15 Improvement Notices being served and only one company received a Prohibition Notice.
HSE Inspectors say these statistics are an encouraging sign that the health and safety message is getting through to businesses, but more needs to be done. HSE served the Improvement Notices demanding additional safeguards be provided within a certain time frame after inspectors identified health and safety concerns at several premises. Further action is also being taken in relation to property owners’ responsibilities under health and safety legislation at several of the industrial estates visited.
A Prohibition Notice was issued to one company in relation to unguarded, dangerous machinery and work was stopped at the firm immediately and will remain stopped until remedial action is taken.
HSE Inspector Jonathan Wills explained serving Improvement Notices is not a decision taken lightly, but was in the interests of preventing potential accidents.
“We’re very pleased to see the health and safety message is getting through in Sunderland and businesses are taking the necessary steps to ensure a safe and healthy environment for their employees,” Wills said. “It’s important to stress though more needs to be done, proved by the Improvement Notices issued. The Notices are used to direct a business to take action to comply with health and safety law.
“If an inspector decides a Notice is necessary, the requirement is discussed with a senior person in the company to try and resolve any issues before serving it. The Notice will say what needs to be done, why, and by when. Preventing an accident occurring is better than dealing with the consequences and we were able to offer constructive, practical advice to many of the companies we visited.” (workersxzcompxzkit)
All businesses were reminded of their duty to manage asbestos on the back of the 2009 ‘Asbestos: the Hidden Killer’ campaign begun in early November 2009.
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 860-553-6604.
Podcast/Webcast: How To Prevent Fraudulent Workers’ Compensation Claims
http://www.workerscompkit.com/gallagher/podcast/Fraudulent_Workers_Compensation_Claims/index.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent 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
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