5 Ways to Relieve and Prevent Chronic Low Back Pain

5 Ways to Relieve and Prevent Chronic Low Back PainExperiencing low back pain is common among adults. And as one of the most pervasive and expensive causes of workers’ compensation claims, it makes sense do everything possible to prevent LBP.

 

Our industry could prevent needless disabilities and save employers and payer’s a significant amount of money if armed with the latest research and some simple exercises.

 

About LBP

 

The biggest risk factor for a second episode of LBP is having a first episode. New research out of Australia shows that more than any other risk factor – whether it is obesity, smoking, or some other comorbidity – a single occurrence of LBP is the main commonality among those who have a second occurrence.

 

Specifically, one-third of people who have LBP will have a second episode within a year, and the chance of another recurrence triples after that. The researchers were surprised, given that preventing a recurrence of LBP is fairly easy.

 

Studies indicate that doing exercise can reduce the risk of a LBP episode by 35 percent, and combined with education about LBP, the risk drops by 45 percent.

 

That said, treatment for acute back pain is different from chronic LBP.

 

Acute LBP. This is short-term, generally lasting no more than six weeks.

 

  • The best treatment is to stay active, but avoid overdoing it. Keeping up with activities such as work is advised, and no bedrest!
  • Almost all episodes of acute back pain will resolve spontaneously, even when there is evidence of disc herniation and sciatica. So conservative measures are called for and appropriate.
  • An MRI prior to 6 weeks of persistent pain is not recommended unless various red flags are present suggesting a serious or progressive condition. Premature MRIs have a high likelihood of showing incidental chronic changes which are common in adults and are not related to the patient’s complaints.
  • Psychosocial factors play a major role in LBP and should be addressed, g., stress, job dissatisfaction and sleep disturbances.

 

Chronic LBP.  LBP is label as chronic when it persists for at least three months and is a major cost driver in workers’ compensation.

 

  • One in four injured workers with chronic LBP is out of work for up to six months, increasing the chances of permanent disability.
  • The estimated direct costs exceed $14 billion annually.

 

 

Treatment

 

While most episodes of LBP resolve themselves within a few weeks, there is no quick fix for chronic cases. The best advice is to do exercises that target specific areas, although no one exercise is ‘best.’ The best exercise is the one the injured worker does consistently.

 

Ideally, the injured worker should do movements that increase mobility and range of motion, since that will reduce their pain. Tight, weak muscles don’t allow the joints to move properly.

 

Pilates and Yoga are great ways to reduce pain and prevent LBP. Here are additional exercises that can help LBP

 

  1. Strengthening. Exercises that help strengthen muscles in the front and back of the spine are best. They should focus on the deeper, transverse abdominis that support the spine. Planks are a good example. They also help the intrinsic, tiny muscles that attach to each vertebra and provide postural support, which is important.

 

  1. Practicing good posture is key to improving stability. The goal is to have a neutral spine. Workers who sit all day put increased pressure on the spine.

 

  1. Body mechanics. Proper lifting techniques, for example, help protect the spine and prevent recurrences of LBP.

 

  1. Flexibility. Exercises that target the lower extremities are important. The hip rotators, hamstrings, and hip flexors can tighten up and cause pain. Movements that increase flexibility can relieve chronic LBP.

 

  1. Stretching. Taking the stress off the lower back can greatly relieve LBP. Gentle stretches can provide the fastest relief for LBP. The ‘cat/cow stretch’ is especially effective and easy to do. The worker is on the floor on his hands and knees, with hands under the shoulders and knees under the hips. He rounds the back, stretching the mid-back between the shoulder blades, similar to how a cat stretches. After 5 seconds, he relaxes and then arches his lower back and holds for another 5 seconds. Another is the ‘knee to chest stretch.’ In this one, the worker lies on his back with knees bent and feet flat on the floor, with his hands behind the knees or just below the kneecaps. He then gently brings both knees toward the chest, using the hands to pull them; and holds for 20 to 30 seconds.

 

 

Conclusion

 

Any worker of any age can experience LBP. Older workers typically have degenerative changes, while younger employees tend to experience soft tissue problems. Treatment will vary depending on the specific pain generator and be customized according to specific evidence-based medicine guidelines. The key is to make a correct diagnosis, and then target the best therapy beginning with conservative measures.

 

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

6 Strategies to Determine Workers’ Comp Causation

6 Strategies to Determine Workers’ Comp CausationCausation is one of the most challenging concepts in the claims community. Causes of low back pain, carpal tunnel syndrome, and other soft tissue pain are often a matter of conjecture on the part of treating physicians, leaving claims managers scratching their heads.

 

But that doesn’t mean you have to blindly accept the doctor’s diagnosis on a claim with obvious red flags. Partnering with the right experts can better ensure payers don’t end up footing the bill for a non-work related injury.

 

 

The Problem

 

The back is the most common body part facing the claims community, and causality is the challenge. That statement during a recent webinar speaks to an all too familiar problem in the workers’ compensation system: determining the cause of an injury where there is often no clear-cut answer.

 

Unfortunately, many treating physicians are not focused on causation and instead seek only to help their patients. They take the word of the patient that the pain is work-related.

 

Many payers are apt to simply accept the treating physician’s determination, figuring da challenge of the doctor’s opinion will likely end up costing more money in the end. However, the problem is often not limited to one or two such cases. “Contagious syndrome,” a term coined by attorney Stuart Colburn, refers to the phenomenon where other workers see a colleague receiving benefits for soft tissue injuries and claim their own.

 

 

Scenarios

 

A 35-year old worker files a claim for a lumbar strain he says he sustained at work. Additional facts are; he is overweight, has a new baby at home, and has expressed an interest in becoming a dispatcher on light duty.

 

In another example, an older woman claims carpal tunnel syndrome in her right wrist, has surgery and returns to work. Six months later, she says her wrist never fully healed and files a claim for CTS on her left wrist. She says both were caused by her repetitive motions at work. Her supervisor has alluded to potential psychosocial factors.

 

In both cases, comorbid factors are clearly evident. In addition to being overweight, the male with low back pain is likely losing sleep due to the new baby (an evidence-based factor for low back pain) and has indicated he would like to be transferred to a less-intensive job on light duty. The other worker has at least two comorbid factors that are indicative of CTS: being female and older.

 

 

Solutions

 

  1. Know the risk factors. Evidence-based medicine identifies clear risk factors for developing soft tissue injuries, both work-related and non-occupational. For example, CTS may be work-related if there is a combination of force and either repetitive motions or awkward posturing. But repetitive motion on its own is not an evidence-based cause of CTS. There are few work-related causes of low back pain. Job dissatisfaction is perhaps the biggest.

 

  1. ID appropriate physicians. Where possible, you want to work with physicians who understand the issues surrounding occupational injuries, such as the importance of determining causation and return-to-work. In rural areas where there are few or no occupational physicians available, payers need to educate physicians on workers’ compensation-related issues

 

  1. Provide job insights. Physicians faced with a patient in pain want to help the person and tend to believe what they are told. The worker who says he injured his back because he is routinely lifting heavy objects and/or is in awkward positions may be misrepresenting his actual job duties. Payers can clarify job duties in several ways:

 

 

  • Invite the physician to the worksite to see what the job entails.
  • Videotape someone doing the job so the physician can see the actual tasks involved.
  • Provide a thorough, detailed job description so the doctor understands what the worker does on a day-to-day basis.

 

  1. Review the history. The claims adjuster should look at the worker’s

 

  • Previous work history; i.e., what he did before working at your company. This may reveal activities consistent with his current complaint.
  • Check medical records. There could be prior injuries in the same or nearby body locations, indicating the injury is not new. This may also show comorbid conditions that could be factors.
  • Determine employment start date. See if the worker is a long-time employee or a new hire, which may be a red flag for a preexisting condition.

 

  1. Approach the physician. If your reviews uncover several red flags, your claims adjuster may be able to convince the physician to take a closer look.

 

  1. Use peer review. The insurance carrier or third party administrator who is managing the claim can request a peer review. An independent medical reviewer can look at the records, test results, etc., and may have a different opinion from the treating doctor. The peer reviewer probably stands a better chance of persuading the treating physician to consider revising his initial determination, since it is a physician to physician discussion.

 

Ideally, you should have established relationships with peer review physicians. If not, the insurance carrier or third-party administrator may have some available.

 

 

Conclusion

 

Identifying causation for a soft tissue injury is often as much of an art as a science. But following evidence-based medicine and working closely with treating physicians can get you that much closer to the true cause.

 

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

Avoid High Cost of Denied Claims With Solid Investigation Strategy

Avoid High Cost of Denied Claims With Solid Investigation Strategy

There are many reasons for members of the workers’ compensation claim management team to deny a claim.  This includes denials of primary liability based on a lack of medical support, evidence of a pre-existing condition, idiopathic claims, intoxication defenses and statutory reasons such as notice and statute of limitations.  While the facts of the case may look good at the time of the denial, studies indicate that these denied claims can become costly in the long run.  To better manage claims in a cost-effective manner, it is essential even the most seasoned claim handler think twice before issuing a denial.

 

 

Program Efficiency and Denied Claims

 

Various studies indicate that from 2013 to 2017, claims denial rates have increased from 5.8% to 6.9%.  Reasons for a workers’ compensation claim to be denied include lack of medical evidence, information indicating the injury is not related to one’s work activities, and documentation supporting the contention the person injured was not an employee.  While there has been an increase in workers’ compensation claims denied, this has not translated into program savings.  Instead, these same studies indicate that approximately 67% of all initially denied claims will convert to admitted claims within 12 months.  The result is over a 50% increase in money eventually paid out to fully resolve the matter.  This adds $15,000 to each claim.  Multiple this by many claims and workers’ compensation programs end up paying out a lot of money.

 

 

Barriers to an Effective Claim Investigation

 

Members of the claims management team face many challenges when reviewing a claim and making a determination as to primary liability – and other issues of compensability.  One of the driving factors is the rigid framework many jurisdictions place on insurance carriers.  These barriers are numerous and include the following:

 

  • Inability to issue a retroactive denial of primary liability: In some jurisdictions, members of the claim management team are not able to deny a claim once payment of medical or indemnity benefits has been made. Paying anything on a claim may also diminish the chances of obtaining a $0 Medicare Set-aside allocation under the voluntary review/approval by CMS; and

 

  • Administrative penalties for the late issuance of a denial: Paying administrative penalties does not promote program efficiency.  It also does not make a workers’ compensation insurer look attractive to prospective clients as most states publish statistics on penalties issued by a state industrial commission.  Penalties can also be cumulative, which result in a system of graduated costs for throughout the year.

 

The result of these barriers should also have an increased urgency to deny a claim if it does not pass the proverbial “smell test.” While this may seem like a good strategy, the result can lead to decreased program efficiency.  Now is the time to implement change and take a more reasoned approach to denying a workers’ compensation claim.

 

 

Improving the Claims Process — Making Better Decisions

 

Studies indicate that claims converted from denied to paid are particularly high in California, Florida, and Texas.  Claim management teams who handle claims in these jurisdictions should take note.  Additional education and coordination with other interested stakeholders such as employers and defense counsel can mitigate the payment of unnecessary benefits and reduce the percentage of converted claims.  Other strategies can include:

 

  • Better communication with insureds regarding accident reporting and injury investigation;

 

  • Education and training on workplace safety and injury prevention; and

 

  • Improvements in the claims handling process via the utilization of analytics and technology. This includes making the claims process more accessible to employers and other stakeholders through web and app-based reporting features.

 

 

Conclusion

 

The only good file is a closed file – but this does not mean files should be closed by simply denying primary liability.  Claims management teams seeking to reduce workers’ compensation program costs must make better decisions when denying workers’ compensation claims.  This needs to include better communication and involving all interested stakeholders.

 

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

School System Summer Break – 4 Proactive Work Comp Tips

School System Summer Break - 4 Proactive Work Comp Tips

Interested stakeholders in the workers’ compensation process are constantly seeking ways to reduce program costs.

 

One area includes the discontinuance of workers’ compensation benefits for school employees and teachers suffering from the effects of a work injury during the summer break period.  While statues and case law interpretations vary in each jurisdiction, employers and insurers are generally limited in their ability to discontinue or suspend various workers’ compensation benefits for school employees during this time of year – even if they have no plans of looking for work while under restrictions on their activity.

 

 

Schools Out – Time to Discontinue Work Comp Benefits?

 

While the school year typically runs from late August through late May, employees of school districts around the country sustain work-related injuries every day.  The ongoing effects of those work injuries do not magically disappear for summer break.  Sadly, those hot summer days a teacher, paraprofessional or administrative staff employee would like to spend at a beach, can be spent at home convalescing.  Proactive members of the claims management team might view this as an opportunity to discontinue ongoing wage loss and vocational rehabilitation benefits.  Unfortunately, this is often not consistent with many state workers’ compensation laws via case law interpretation.

 

One case on point comes from Minnesota, where a school district sought to discontinue ongoing wage loss benefits at the conclusion of a school year.[1]  The rationale for the discontinuance was based on the premise the employee did not intend to work during the summer months, and the result was no loss in wages.  A compensation judge rejected this argument and affirmed by the Minnesota Workers’ Compensation Court of Appeals.

 

In affirming the reinstatement of wage loss benefits, the court noted that “A teacher who has no summer school duties is presumably free to pursue other part-time or short-term employment.  Therefore, a teacher with a work injury might be entitled to continuing wage loss benefits through the summer if the teacher is totally unable to work for medical reasons attributable to the injury or has injury-related restrictions that affect is his or her ability to secure other employment.”

 

In sum, wage loss benefits are typically payable as long as the employee has a disability related to the work injury. The basis for this decision is also applicable to other forms of workers’ compensation benefits, including vocational rehabilitation.

 

 

Staying Proactive to Avoid the Summertime Claims Blues

 

Being away from work can cause the summertime blues in anyone – especially people who work in an educational environment.  Now is the time for claims professionals handling claims related to school employees to be proactive on these matters to reduce their exposure and ensure improper discontinuance of benefits is not made.

 

  • Investigate whether the school employee is engaged in seasonal employment. People who work in a school environment may be likely to work seasonal jobs during the summer months.  This can include individuals suffering from work-related  Efforts to investigate these matters may also include the use of surveillance if there is credible information the employee is working and not reporting their work activities.

 

  • Make efforts to return the injured school employee to work. Proactive return to work efforts should be made on every claim.  This is especially the case for school employees where wage loss benefits could be paid for an extended period of time.  Suggestions include developing a “Work on Loan” relationship a local non-profit, volunteer agency, or other light duty work inside school district buildings and facilities.

 

  • Monitor the status of claims involving school employees and stay in contact. Lack of communication between the employer/insurer and employee leads to conflict, fear and  Staying in contact with the injured worker provides for effective communication and minimizes problems.

 

  • Determine if the school employee is cooperating in vocational rehabilitation efforts. Summer break and time off from school does not give an injured school employee a vacation from their recovery and achieving their vocational rehabilitation goals.  Various workers’ compensation benefits can still be discontinued or suspended for failure to cooperate with a rehabilitation plan.

 

 

Conclusions

 

School employment and summer breaks create an opportunity for interested stakeholders to stay engaged with employees and reduce workers’ compensation program costs.  While most benefits typically remain payable during summer breaks, there are opportunities for motivated members of the claims management team to engage injured employees and minimize their exposure.  This includes claim monitoring, engagement and ongoing efforts to return an employee back to work.

 

[1] Qualy v. Special School District No. 1, 1994 WL 421773 (MN WCCA).

 

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

The Impact of Fatigue and 10 Ways to Mitigate the Risks

If one of your employees is sleeping on the job, he may actually be doing you a favor. Lack of adequate sleep is a major risk factor for injuries, errors, and chronic diseases. In fact, ‘shiftwork sleep disorder’ has been deemed a carcinogen because of the increased risk of breast cancer.

 

Those most at risk are workers with frequent overnight shifts, rotating shifts, or early morning start times. While you may not be able to change the need for workers on shifts other than daytimes, there are strategies you can take that can help employees be less fatigued and save you significant amounts of money.

 

 

The Sobering Stats

 

Employers and payers are likely unaware of the stunning costs associated with workplace fatigue. Here are the numbers for a hypothetical Florida construction company with 800 workers:

 

  • Decreased productivity: $590,463
  • Absenteeism: $249,962
  • Healthcare: $458,075

 

The National Safety Council’s Fatigue Cost Calculator also estimates the number of employees likely suffering from specific sleep risks at this sample company:

 

  • Obstructive sleep apnea: 101
  • Insomnia: 69
  • Restless Legs Syndrome: 40
  • Shift work disorder: 1

 

‘Shiftwork sleep disorder’ occurs when a person’s internal clock becomes misaligned with his sleep/wake schedule due to shift work. Those affected may experience excessive sleepiness during night work and/or insomnia during daytime sleep.

 

The good news is the potential savings from taking simple actions to mitigate all these conditions are $625,250.

 

The safety risks associated with fatigued workers is higher among night-shift workers and increases with each succeeding night

 

Overall statistics show:

 

  • The risk of injury or accident on the night shift is 30 percent higher than on the day shift
  • The risks are 36 percent higher on the fourth consecutive night shift compared to the first
  • 13 percent of workplace injuries are due to fatigue problems.
  • The National Transportation Safety Board says fatigue is a contributing factor in 20 percent of its investigations
  • Employer costs for one worker with an untreated sleep disorder are $3,500.
  • Up to 90 percent of sleep disorders go untreated.

 

In addition to safety risks, fatigue affects cognitive functions and reduces a person’s attention, vigilance and memory. Fatigued workers are slower, less productive and more likely to make errors. And fatigue is also a high-risk factor for developing chronic diseases, including diabetes, cardiovascular disease, obesity, and depression. One study showed that two consecutive nights with less than six hours of sleep are associated with lower performance levels for six days.

 

 

10 Ways to Mitigate the Risks of Workplace Fatigue

 

Employers should become educated and inform their employees about the problems and costs associated with fatigue. They can also look within their organizations to find the causes of fatigue.

 

Additionally, employers can consider some or all of the following strategies:

 

  1. Forward-rotate shifts, such as day to afternoon to night.
  2. Increase rest time between shifts.
  3. Limit the number of consecutive night shifts
  4. Slowly rotate shifts to reduce the impact on sleep schedules, the Panama shift schedule is a good example
  5. Promote an appropriate culture. If workers are rewarded for work they do after hours or by working longer than is typical, employees will get the message that they need to work excessively to get ahead. Instead, reward employees or teams that meet or exceed their goals within normal work hours.
  6. Discourage after-hours work. Rather than sending emails and expecting responses during off-hours, set boundaries for work to be done within certain hours, where possible.
  7. Encourage PTO usage. Workers who feel they should forego paid vacations or work when they are sick are getting the wrong message – and burning themselves out. They not only are risking their own safety and wellbeing, but could be infecting other employees.
  8. Support flextime. A one-hour start-time difference may make a big difference to some employees. Where possible, allow workers to set the hours that best accommodate their sleep needs.
  9. Provide rest areas. A short, 20-minute power nap can make a tremendous difference to at-risk workers for fatigue. Provide a location where employees can rest if the worksite allows for this benefit. Several Fortune 500 companies now provide ‘nap rooms’ for employees.
  10. Avoid screen time. Using a phone or tablet just before bed can activate areas of the brain that make it more difficult to fall asleep. Encourage workers to turn off their electronic devices when going to bed.

 

 

Conclusion

 

Lack of sleep may be costing your company hundreds of thousands of dollars, depending on the number of employees and their work schedules. Being aware of the costs associated with fatigued workers and taking action to ensure workers get enough rest can significantly help your bottom line.

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

Advocacy and Engagement: 4 Reasons Why and 7 Ways to Do It

Advocacy and Engagement: 4 Reasons Why and 7 Ways to Do It‘Advocacy and engagement’ is much more than a buzz term in the workers’ compensation system. It’s a concept that can easily cut 5 – 10 percent of your workers’ compensation costs. Not only that, but companies that embrace the idea are more profitable than those that don’t – 16 percent more, according to some estimates.

 

With approximately 70 percent of workers feeling disengaged from their companies, the task of persuading injured workers to take a vested interest in the post-injury process may seem daunting. But there are simple things organizations can do to engage their workers and reap the benefits.

 

 

What it Is

 

Advocating for injured workers and getting them engaged in the claims process means focusing on them as human beings, rather than viewing them as ‘claimants’ and being interested only in the dollars and cents part of it.

 

Engaged injured workers are a vital part of the process, starting at the beginning of the claim. Rather than having conversations about the injured worker, claim discussions need to include the injured worker. The ‘us vs. them’ approach needs to be eliminated. The goal is to get them healed and back to function. The vast majority of injured workers share that objective.

 

 

Benefits

 

Selling the idea of advocacy and engagement to the C-Suite should not be hard, once the benefits are explained. In addition to overall happier employees, studies bear out many positive outcomes among injured workers in companies that have an advocacy-based model.

 

  • Faster return-to-work rates. Injured workers heal faster when they are truly engaged in their recoveries. Rather than being passive and having things done to them, they are actively involved in their own treatments, which gets them back to work sooner.

 

  • Less litigation. Part of the engagement process is educating the injured worker on what to expect, along with his rights and responsibilities. Understanding the process and having consistent and constant communication eliminates the majority of reasons an injured worker hires an attorney. Reduced litigation can be a tremendous cost saver, as studies show attorney involvement increases the cost of a claim by an average 4.5 times.

 

  • Better network penetration. Engaged workers are more likely to go to a physician of your choosing, even in states without employer-directed care. There is a level of trust they feel and will listen to your suggestions.

 

  • Improved morale. Injured workers who feel they have been well taken care of during their absence have a positive attitude upon returning to the workplace, which typically spreads to coworkers.

 

 

Tactics

 

The idea of treating injured workers nicely and with respect should be a no-brainer. But the reality is many companies and/or key members of an organization view injured workers negatively, even with disdain.

 

Dealing with the logistics and paperwork is often seen as a deterrent to meeting production deadlines. Many view the injured worker as someone just trying to game the system.

 

Research shows that a small percentage of injured workers fit this description, but nearly all have the same interests as top managers; to recover and get back on the job as quickly as possible.

 

Best practices for engaging injured workers include:

 

  1. Staying in touch with the injured worker starting from day one and then on a consistent basis is vital to show a worker the company truly cares about him. Ideally, the supervisor or manager with whom the worker is close should call the worker. That person and other colleagues should continue the dialogue with phone calls, get well cards, and the like.

 

  1. Along with communicating with the injured worker is active listening. The injured worker may ask questions, express concerns or air complaints. It’s important to hear what the injured worker is saying and reflect that, without engaging in combative dialogue.

 

  1. Education/information. Injured workers don’t know what to expect, are worried about their financial and job security and are in pain. They need to be made aware of the process for them to be engaged. The best way is through an employee brochure that is given to workers upon hiring, and then again if and when they become injured.

 

Here are some additional advocacy strategies organizations use to better engage their injured workers.

 

  1. Onsite care. While a fulltime onsite clinic is ideal, ergonomic evaluations, biomechanics and stretching programs for workers can help them improve their physical stamina and make them feel engaged.

 

  1. Telehealth services. Some companies have a private room with a computer available for workers to speak privately with a healthcare provider. Employees given this option feel their companies truly care about their wellbeing.

 

  1. Nurses and triage. A telephonic triage system for workers who sustain on-the-job injuries is invaluable. A nurse can determine what treatment is appropriate and, at the same time, make the injured worker feel someone is there to help.

 

  1. Partner with other departments. The benefits side of an organization may offer programs that help workers feel more engaged in the company and have a sense that the company cares about them. Examples include:

 

  • Back health, where employees call a number, explain their symptoms and are given specific exercises. This is especially helpful since back injuries are among the most costly in the workers’ compensation system.
  • Second opinions. Some wellness programs include a second opinion to workers free of charge. These can be extended to injured worker as well as those not hurt at work.
  • Family health assistant. Some companies with a whole health model provide a number for workers to call for advice on health-related problems of anyone in the family.
  • Employee assistance programs are available to all workers and can be a tremendous benefit for injured workers who want to talk with someone about financial, familial or other concerns.

 

 

Conclusion

 

The value of engaged employees – especially those who become injured – are clearly borne out in the research. Companies that rethink their attitudes and demonstrate caring and concern for their employees can benefit tremendously.

 

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

3-Step Strategy to Prevent Workplace Violence

3-Step Strategy to Prevent Workplace ViolenceMore than 2 million workers are victims of workplace violence every year. While healthcare clearly leads the industries reporting workplace violence, many other industries are also at risk. Employers and payers can significantly impact the rate of violent incidents by understanding the risks unique to their industries and worksites and developing strategies to mitigate them.

 

 

The Issue

 

OSHA defines workplace violence as any act or threat of physical violence, harassment, intimidation, or other threatening, disruptive behavior that occurs at the work site. That includes everything from verbal abuse to physical assaults and even homicide.

 

The most recent statistics show that violence in workplaces is increasing, despite lower overall crime among the general population – including homicides. In healthcare, the numbers are 7.8 cases of workplace violence for every 10,000 employees. In the sales industry, half of the work-related deaths are due to homicide. School districts also report higher rates of violence, aside from the much-publicized mass shootings.

 

Despite the high prevalence of workplace violence incidents more than 70 percent of U.S. workplaces do not have a formal program or policy that addresses the issue, according to the Bureau of Labor Statistics.

 

 

Create the Policy

 

There are three steps to creating a violence-free workplace.

 

  1. Assess the risk. First, you need to determine the violence hazards affecting your workforce. They could vary among employees. A healthcare establishment, for example, could have staffers who deal with potentially violent patients in the emergency room, along with nurses in the field. The risks facing each are very different.

 

ER workers should be aware of potential incidents not only from patients themselves but from family members who may become frustrated. A nurse who conducts home health visits may be vulnerable to risks because she or he is alone. The home health worker should know to ask questions, such as whether there are firearms in the home.

 

Some ways to assess the risks facing your organization include

  • Find out from staff members whether, where and when they feel threatened.
  • Review past records. Incident reports can reveal areas where violence has occurred, and they should be a focus of prevention policies.
  • Check the research. Studies provide clues to areas vulnerable to violence. Within healthcare facilities, inpatient and acute psychiatric services, geriatric long-term care settings, and urban ERs have been shown to be at higher risk than some other areas.
  • Walk the grounds. Are there areas where outsiders can easily gain access undetected? Are there nearby parks where unsavory types congregate? Are there particular areas inside that are at high risk? These are locations where your policy can target safety efforts, such as a door in a remote part of the building that can be entered only by someone with a security badge.
  • Gauge staff understanding. It is vitally important that employees know what to do if a situation begins to get out of hand; otherwise, you run the risk of a controllable incident getting out of control. Do workers know whom and/or where to call? Is there a special emergency security code to dial and are they aware of it? Do they know what terminology to use in an emergency?

 

  1. Prevention/control. The information gathered during the risk assessment can be used to write the specific policies and procedures to minimize risks. While every workplace is unique, several elements should be considered for inclusion in the policy:

 

  • Strong pre-hire checks. In addition to the usual application and face-to-face interviews, employers should undertake background investigations, criminal history checks, drug testing and reference checks.
  • Roles during crises. Employees should know what to do and where to go if violence erupts.
  • Communication. If an incident occurs, it’s imperative to try to at least contain the situation. You should outline ways to communicate with workers so they can avoid the area in question, call for help, and warn others.
  • Reporting channels. Employees should feel comfortable and know how and where to report any suspicious behavior, as that can prevent a violent situation. The person(s) receiving the report should understand how to respond; such as alerting authorities and/or undertaking investigations.
  • Penalties. The policy should clearly spell out unacceptable behaviors and have associated penalties, such as suspension or termination.

 

  1. Train. A policy only works if all involved are aware of it, understand it, and know what to do in a given situation. Ongoing training should be conducted, at least on an annual basis and with any new hires. The training should include:

 

  • A review of the policy.
  • Role playing various scenarios that could occur. Employees should play the role of both the victim and the perpetrator to get an idea of how both sides work.
  • Personal insights. People who have experienced violent situations in that or similar workplaces should be available to discuss the realities of a violent situation.

 

 

Conclusion

 

Violence can occur in any workplace at any time. By understanding the risks, developing policies to address them, and ensuring all employees have clear expectations, employers can significantly reduce the chances of tragedy in their companies.

 

Improve Workers’ Comp Lag Time With This Single Principle

Hey, there! Michael Stack, here, CEO of Amaxx.

 

One of the most mystical powers is the ability to predict the future; which, of course, none of us can do. All we can do is put ourselves in a position to have the highest likelihood of success, to stack the deck in our favor, to stack the odds in our favor.

 

I want to talk with you today about a critical metric of your lag time reporting, what that means, and how to improve it.

 

 

Lag Time Defined

 

First, let’s talk about what lag time is. Now, this is the difference between when the time of the injury occurring, and the time it’s reported to your carrier, or TPA; so, when the time an injury happens, to the time it’s reported, to your carrier, or TPA. If the employee reports it to the supervisor, and the supervisor delays, and doesn’t report it to the carrier, or TPA, for another week or two, that’s lag time as well.

 

 

Impact of Lag Time on Litigation Rates

 

Let’s talk about what this now means, as far as predicting your claim outcome, of what actually happens on that claim. Now, much has been said about this, as far as lag time, and the impact it has on cost. But what I want to talk about today is the impact on litigation rates, as well, because when a claim gets litigated, all sorts of bad things have the higher potential of happening, as far as delayed claims, increased costs, et cetera.

 

I have these numbers up here: 23% increase, 87% increase, and 39% increase. This is a 23% increase in litigation rates. If there’s one week of delay of lag time, 23% increase after one week, 39% increase in litigation rates after two weeks, and 87% increase in litigation rates on claims after four weeks. (source: NCCI Research Brief, January 2015)

 

While we can’t predict the future, we can put ourselves in the best possible position to be successful to get those claims reported early.

 

That’s great. You may understand the philosophy. You may agree with that philosophy. But now, how do you do it?

 

 

Improve Workers’ Comp Lag Time With This Single Principle

 

Here’s the foundational principle that I want to resonate with you: it needs to be in the employee’s best interest to immediately report their claim. I’ll say that again. It needs to be in the employee’s best interest to immediately report their claim.

 

Now, a number of factors go into that: culture, and communication, and the way that you set things up. But if it’s not in the employee’s best interest to immediately report their claim, they’re not going to do it, or they’re not going to do it as often as they otherwise would.

 

Once you understand that foundational principle, the culture, or the impact it has on your employees, now you can implement tactics like injury triage. You can improve your communication. You can use an employee brochure. You can use different injury response tactics to now make sure that that, in the employee’s best interest, actually comes to fruition; and if it does, then the outcome of your claims, and the future of your claims, will be significantly improved.

 

Again, I’m Michael Stack, CEO of Amaxx; and remember your work today in Workers’ Compensation can have a dramatic impact on your company’s bottom line. But it will have a dramatic impact on someone’s life, so be great!

 

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

Partner with OSHA and Drive a Culture of Safety

Partner with OSHA and Drive a Culture of SafetyThe Occupational Safety and Health Administration (OSHA) was created at the federal level on December 29, 1970, with the goal of assuring “safe and healthful working conditions for working men and women by setting and enforcing standards and by providing training, outreach, education, and assistance.”  Since its creation, the agency has evolved and become commonplace in the workers’ compensation scene as a means of investigating work injuries and providing information to interested stakeholders.  Parties seeking to reduce workers’ compensation program costs should understand OSHA and view the agency as a partner in making workplaces safe for employees.

 

 

Understanding OSHA Basics

 

There are many misconceptions about OSHA.  It is important to those seeking to provide a safe workplace to understand better the requirements and how the agency is responsible for enforcing safety standards.

 

OSHA standards and agency overview covers most private sector employers.  While it does not cover many state and local government agencies, employees of these entities are subject to protections by the federal act and applicable state programs.

 

The federal act also allows states to create their own OSHA programs.  In these jurisdictions, the state agency receives funding from the federal government to run its program.  This allows states to develop their own standards, provided they meet the federal minimums required under the Act.  There are currently 22 OSHA approved programs that include: Alaska, Arizona, California, Hawaii, Indiana, Iowa, Kentucky, Maryland, Michigan, Minnesota, Nevada, New Mexico, North Carolina, Oregon, Puerto Rico, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, and Wyoming.

 

 

OSHA Rights and Responsibilities

 

OSHA mandates the creation of a series of rights and responsibilities that impact covered employers and their employees.  These issues are governed by the basic premise of OSHA – employees have a right to a safe workplace.  It is the responsibility of the employer to provide this environment.  Basic guidelines include the following:

 

  • Employers – Requirements to inform employees of workplace hazards and provide training on how to avoid injury. This includes information people can understand, which can include written information in multiple languages.  Accident information needs to be posted in common workspaces.  Prompt response to employee complaints and OSHA corrective action are required.

 

  • Employees – The ability to voice concerns without fear of retaliation. They also should have access to important safety information.  This includes information concerning chemicals and other harmful materials in the workplace.  All employees need to understand how and when to report workplace incidents.

 

 

Using Workplace Safety Committees to Drive a Culture of Safety

 

There are no federal requirements for employers to have an established and functioning safety committee.  However, many state-based OSHA programs require these committees based on the size of the employer.  Even if one is not required by a state program, employers have found them to be effective in identifying issues, mitigating the danger and implementing cost-effective changes that promote worker safety and injury reduction.  Important steps for a committee to take include:

 

  • Prepare a plan for a safe workplace and best practices;

 

  • Create a safety program and written forms;

 

  • Prepare and present annual training on safety-related issues;

 

  • Initiate a workplace “self-inspection” program to review all safety practices and identify corrective action; and

 

  • Generally promote a safe workplace through legal, compliance and human resources departments. Be creative.  Consider hosting events such as a companywide “safety week” to make all employees aware of safety issues and foster a workplace environment dedicated to safety.

 

Additional information and guidance can be found in federal regulations, which are located at 29 C.F.R. §1960.36 et seq.

 

 

Partnering with OSHA for Workplace Safety

 

All OSHA agencies have resources available to employers concerned about safety.  While the nature of these services varies, it does offer stakeholders seeking to create a culture of compliance to work with OSHA on preventing workplace injuries.  Resources commonly found include the following:

 

  • Seminars and education sessions: These workshops are typically offered to employers free or at a nominal cost to educate parties on common workplace safety hazards.  They also offer tips on cost-effective improvements.

 

  • Safety Partnerships: This is an opportunity for employers to have an OSHA safety inspector visit their worksite or location to identify risks without being subject to fines.  The employer is then given a reasonable amount of time to correct any identified safety issues.

 

Conclusions

 

The goal of OSHA is to promote a safe workplace.  By understanding how the agency operates, interested stakeholders can foster an environment of compliance and provide safety to its employees.  In turn, this can reduce workers’ compensation program costs.

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

Is It Time to Explore Reducing Your Work Comp Costs with Telehealth?

Is It Time to Explore Reducing Your Work Comp Costs with Telehealth?Telehealth and telepresence are changing the way members of the claims management team, and other interested stakeholders are reducing workers’ compensation program costs.  By using this advancing technology, parties looking for better ways to provide effective healthcare can manage their bottom line and provide better outcomes for injured workers.

 

Telehealth is not a magic bullet solution; however, it can be an effective tool when used in accordance with workers’ comp management best practices and evidence-based medicine.

 

 

What are Telehealth and Telepresence?

 

Believe it or not, but the concept of “telehealth” is not new.  It has been around in some manner for over 40 years.  Recent enhancements in technology have only changed how it is viewed in the delivery of scarce healthcare resources.

 

  • Telehealth: Refers to the distribution of health care services and counseling via telecommunication technology that includes the use of telephone, computer or other transmission services. In the context of health delivery, it often refers to the long-distance patient/clinician care and counseling that includes reminders, education, intervention, monitoring and remote admissions.

 

  • Telepresence: Refers to the use of technology that allows a person to feel as if they are present via telerobotics, which includes the live interaction between persons in different locations. It adds the sense of two or more parties to feel as if they are in the same location.

 

 

A Case Study: Effective Use of Telehealth in Work Comp

 

There are many complaints about the delivery of healthcare and access to quality medical care and treatment following a work injury.  This includes traveling to appointments, waiting to be seen by a doctor and other prolonged delays.  It can also mean not having access to specialists who treat a variety of injuries, which may otherwise require long-distance travel and other miscellaneous expenses.

 

On average, an employee seen by a medical professional can spend over two hours of their time for each office visit. Multiply this by many encounters and one spends countless hours just traveling to and waiting to be seen by a doctor.

 

  • Lack of access to general practitioners and other healthcare The average employee spends about 90 minutes completing paperwork in the office, waiting and actually being seen by a healthcare provider;

 

  • Time wasted traveling to/from appointments and in the waiting room. The average employee spends about 40 minutes traveling for each appointment; and

 

  • Delays in receiving medical care and treatment from a specialist. These delays are hard to estimate, but it can be substantial.  Everyone can be frustrated.

 

Imagine the following scenario:  The employee sustains a work-related injury in a rural area.  Given the nature of their condition, they need to be seen by a specialist practicing in a far away metropolitan area.  While the employee will need to be seen in person initially by this physician, the cost of follow-up appointments can be time-consuming and costly.  On average, this could cost over $300 for the office visit alone.  Workers’ compensation programs may also be required to reimburse the employee for food, lodging, and medical mileage.

 

By using telehealth and telepresence technology, the employee can have a conversation with this far away health care provider from the comfort of their own home.  Instead of spending time traveling to appointments and waiting in an uncomfortable waiting room, that time can better be spent focusing on one’s recovery.  The 1.1 billion hours wasted traveling to and waiting for appointments can be reduced to an average visit time of 15 minutes, and a fee of about $105 – nearly a 64% savings to the workers’ compensation program.

 

The net results are significant:

 

  • Less travel and waiting times = less frustration

 

  • Reduces costs to a program = greater savings

 

Advances in technology and cybersecurity are also making the use of this innovative way to treat employees suffering from a workers’ compensation claim safely and securely.  This includes the protection of someone’s Protected Health Information. (PHI).

 

Conclusions

 

Interested stakeholders seeking to reduce workers’ compensation costs should become familiar with the benefits of telehealth and telepresence technology. When used in accordance with worker’ comp management best practices and evidence-based medicine it reduces costs to programs and the time employees spend waiting to see a health care provider.  It also can allow for injured workers to receive care with a variety of experts in far away locations in an effective manner.

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

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