Address These 7 Most Common Workplace Safety Concerns

There are many things interested stakeholders can do to reduce workers’ compensation costs.  In doing so, they can make their programs more effective and efficient.  This requires engagement by all interested stakeholders and a willingness to review the workplace and beyond for safety hazards.  Once they are identified, changes need to be made to reduce or eliminate the chance of injury.

 

 

Regular Safety Review of Workplaces

 

Most people are accustomed to an annual “spring cleaning” and regular chores around their home.  The same should apply to the workplace.  Interested stakeholders should make a regular walk-through of their workplaces and make sure everything is in order.  Additional steps and emphasis should occur when spills happen in the work place.  In other instances, employers should engage their employee’s to clean up their workstations and make sure it is clean at all times.

 

 

Addressing Common Safety Concerns

 

Additional steps must be taken to ensure a safe and secure workplace.  Some easy to implement suggestions include:

 

  • Fire extinguishers: State laws and local ordinances typically provide guidance on what types of fire extinguishers should be in a work place and their quantity.  They should be visible and in proper working order at all times.  They also require regular servicing;

 

  • First Aid Kits: Every workplace should have a First Aid kit that meets basic emergency needs.  In addition to Band-Aids, tape and gauze, it is also important to include ice packs and other essentials.  What is stocked in a kit should be consistent with the type of work performed in your workplace.  Always be ready to dial 9-1-1 if a severe injury occurs;

 

  • Emergency evacuation plan: Having an effective plan that is understood by all employees is important.  Evacuation plans should also be posted around the workplace and pointed out to new employees when they first start.  Reminders should occur that involves all employees and contractors on an annual basis;

 

  • Fire and severe weather drills: Planning for a fire or severe weather is often overlooked in workplaces.  Planning for the unexpected is critical and can pay dividends in moments of danger.  It is also important to remind all employees what they are to do in these instances on an annual basis;

 

  • Workplace violence: It is a sad reality of modern society that violence takes place in the workplace.  Proactive stakeholders can implement several strategies to prevent this from occurring and mitigate their risk.  Identifying potential violence issues is the first step to successfully addressing this issue.  It is also important that employers effectively deal with it when it occurs, which can include termination of an employee.  Having an “active shooter” protocol is also something to consider.

 

  • Other Workplace Safety: Employers can also be proactive on issues of workplace safety by reviewing their policies and procedures related to safety.  Important steps one can take include making sure all employees wear proper identification while in the work environment.  Badges can also be used to unlock/lock critical access points.  Keep in mind that certain entrances must remain unlocked during normal business hours.

 

  • Safety Requires Everyone: Workplace safety requires the engagement of all employees—from upper management to the newest employee.  When leadership within an organization takes the lead, others will take notice and follow.

 

Conclusions

 

Reducing workers’ compensation costs starts with a safe work environment.  Some of these program-enhancing steps are simple, yet require everyone to be fully engaged.

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is 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 of COMPClub, an exclusive member training program on workers compensation cost containment best practices.

 

Contact: mstack@reduceyourworkerscomp.com.

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

Live Stream WC Training: http://workerscompclub.com/livestreamtraining

 

©2017 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.

10 Ways to Kick Start a Workers’ Comp Stewardship Program

If you’re trying to improve your workers’ comp program, ask for an annual stewardship meeting with your insurer/third-party administrator. But if you really want to see game changing results, initiate a stewardship process. It’s a collaborative approach that takes some leg work and elbow grease, but can truly push your workers’ comp program to the next level.

 

In a typical stewardship meeting a representative for the employer and insurer or third party administrator discuss a pre-prepared report that shows your claims and program trends from the previous year and discuss goals for the next year. While it can be beneficial to get this snapshot of your workers’ comp program, there is much more that can be done.

 

Best outcomes for injured workers, optimized claims performance, and a reduction of your total cost of risk should be the goals. Savvier companies find more value and better outcomes through an intensive coordinated approach that starts long before the actual stewardship meeting.

 

Prep Work

Conversations with a multitude of people ahead of time can help you define what you want included in the report, the metrics you want analyzed and the parameters. Among those you may want to consult with are your carrier or TPA account manager, risk management information systems personnel and data analysts; claim and safety consultants; your insurance broker or agent; and others within your own organization.

 

Key steps in the process at this point include:

 

1. Set the date. Decide when you want the report completed.

 

2. Review past reports. This can help you establish a baseline.

 

3. Formulate a concept for the report.

 

4. Discuss the format and content of the report; set goals, objectives, metrics, deliverables, ideal takeaways, and the list of attendees.

 

5. Review preliminary data. Easily available analytical reports can be your starting point until you determine what needs to be customized, depending on what you are trying to accomplish. Not all data is going to be relevant. Some examples of the types of data may include:

  • Frequency analysis: claim volume, litigation, examiner caseload and lag time.
  • Severity analysis: average/total incurred, average/total paid, loss stratification, lag analysis, litigation, subrogation/recovery.
  • Ratio analysis: closure, medical vs. indemnity, payment analysis.
  • Managed care analysis; case management, PPO penetration, diagnostic, physical therapy, bill review.

About two months before the meeting, you can conduct a preliminary data review and determine what additional data you need.

 

6. Draft a preliminary report. Conduct a collaborative review of it and make any changes based on feedback.

 

7. Finalize the report.

 

The Meeting

 

A key to a truly effective stewardship process is to avoid the inclination to only see the positive trends of your workers’ comp program. Equally, or even more important are the areas for improvement, which is where you can make a significant impact. Often carriers or TPAs will avoid showing you potential problem areas, for fear they might be held liable. But it’s important to see both. For example, an increase in frequency does not necessarily signify a problem — if your payroll has increased through company growth. You need to see all of the trends.

 

8. No finger pointing. Honesty and openness are imperative among all parties to the stewardship process for better analysis and improvements. Each should have a sense of collective buy in to the purpose and outcome of the session.

 

9. Evaluate the results. Discuss the reasoning behind any emerging trends to see what they mean and what might be done to ensure they lead to best outcomes. Look at any services, initiatives and program enhancements that may be impacting them. Changes to the company’s financial stability, openings or closings of new facilities, or natural disasters may have occurred that could affect trends.

 

10. Set measurements. Determine goals and metrics to better understand the success of strategies you have implemented. Create a detailed action plan with target dates.

 

Summary

 

The stewardship process can be a rich tool to raise the bar on your company’s workers’ comp program. But failing to properly plan, having unreasonable expectations, inviting the wrong attendees and having an inability to be completely open can make the stewardship meeting a disaster. Getting commitment from all parties to a specific plan with responsibilities and due dates will lead to a successful stewardship process and best outcomes for your injured workers and your company.

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is 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 of COMPClub, an exclusive member training program on workers compensation cost containment best practices.

 

Contact: mstack@reduceyourworkerscomp.com.

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

Live Stream WC Training: http://workerscompclub.com/livestreamtraining

 

©2017 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.

How To Guarantee Better Workers’ Comp Outcomes

 

Big data. Predictive analytics. Very sophisticated modeling to predict claims outcomes versus a paper and a pen. I’m Michael Stack with Amaxx and today I’m going to be telling you how to guarantee better claim outcomes without spending any additional money and only maybe about 20 to 30 minutes of additional work on your claim.

 

Now, don’t get me wrong. Big data, predictive analytics, sophisticated claims modeling to predict claims outcomes, incredibly valuable tool and resource that the companies are specializing in this information and then bringing it to the market place give for our industry. But for your employee, Tom Smith, who gets injured today, you’re going to have the most impact and guarantee a better outcome for Tom’s claim with a paper and a pen.

 

 

Look at Your Last 5 First Report of Injury

 

Let me tell you what I mean. What I want you to do is pull out your last five first-reports of injury. Go ahead and pull those out and take a look at them. How well are they completed? How well are they, on a scale from one to ten? What would you get it? Would you give it a one, would you give it three, would you give it a five, would you give it a ten? I’m going to bet that there’s room for improvement in the completion of your first reports of injury. Here’s what I want you to do, is that I want you to realize that how well that first report of injury is completed is a huge determining factor in how well that claim is going to go. I want you to step up your game in the completion of those first reports of injury because it’s going to guarantee for Tom’s claim, who gets injured today, a better outcome for Tom and thereby a better outcome for you in reduced worker’s comp cost.

 

 

4 Points To Properly Execute

 

When you’re taking a look at these first reports, here’s the information that I want you to look at and see if you can have room for improvement here. First point is who’s responsible for completing these? Is it Jane, Jane the low-level employee and Jane just whips through this in three minutes and says, “I don’t know, that was Tom and he fell off a ladder,” and check-check-check and leaves a whole bunch of blank information? Or, is it a highly responsible accountable person, is it you that’s completing this, or is it you that’s holding that person accountable for getting all the information that you need?

 

Step number two is, is all the basic information right? Do you have the name right, do you have the social security right, do you have the average weekly wage correct, do you have the date of injury correct? This happens so often it is criminal that this basic information is wrong and the amount of litigation a problem that it causes in a claim just because you didn’t get this right, is incredible.

 

Number three is I want you to look at the mechanism of injury. Do you have information about the mechanism of injury or is it just written, “Tom fell of a ladder and hurt his low back”. Sorry, that’s not really going to help me very much. That’s not going to cut it in the investigation of a claim. The mechanism of injury, was Tom lifting, was he pulling, was he twisting? Was he carrying paint buckets when he was going up that ladder? Was it against the roof, was it against the siding? Was it a big ladder, was it a small ladder? What was it that caused that injury? What was that mechanism of injury? What are those details surrounding that?

 

Finally, what is the context of the injury. Again, painting that picture of what actually happened. Was Tom inside, was he outside? Was he in the warehouse? Was he lifting up and putting something in the third shelf or was he lifting up and putting it up on the second shelf? What happened? What is that picture making that very crystal clear for what actually happened on that claim? Without good information we can’t make a good decision and the processing of big data, without good data going in you’re not going to get good data going out. Spend that extra 15, 20, even 30 minutes on Tom’s injury, detailing this out, take a look at your first reports of injury, step up our game in getting information ready and you will guarantee yourself better worker’s comp claim outcomes.

 

 

Learn More About Reducing Workers’ Comp Costs

 

Again, I’m Michael Stack with Amaxx and if you’re watching this video somewhere other than reduceyourworkerscomp.com, go ahead and go to that website, sign up for a lot more free information on how to control your worker’s comp costs. To take it one step further, you can go to workers compclub.com/livestreamtraining and sign up for my next live stream training. Again, I’m Michael Stack with Amaxx, remember your success in worker’s compensation is defined by your integrity, so be great!

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is 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 of COMPClub, an exclusive member training program on workers compensation cost containment best practices.

 

Contact: mstack@reduceyourworkerscomp.com.

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

Live Stream WC Training: http://workerscompclub.com/livestreamtraining

 

©2017 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.

How Technology Is Changing Workers’ Compensation And Other News Tidbits

How Technology Is Changing Workers’ Compensation

New technologies are improving workers’ compensation programs in everything from communications and training to health care delivery and claims, according to experts. Tom Ryan, market research leader for Marsh’s Workers Compensation Center of Excellence, speaking during a recent Marsh broadcast, identified several areas of workers’ compensation that can benefit from technology.

 

 

 

Treating Syncope: Helping Your Heart

If heart trouble caused your fainting, treatment may improve blood flow, stop syncope, and help prevent further heart problems. Your healthcare provider can explain the benefits and risks of each treatment. Treating Syncope: Helping Your Heart

 

 

 

 

 

Keeping Copays Affordable

As an independent pharmacy benefit manager, we are uniquely and completely aligned with the best interests of our clients and members. Some pharmacy plans require their patients to pay a full copayment for a prescription drug even though a retail pharmacy’s price for the drug may be less costly than their copayment under their pharmacy benefit. And then they require the pharmacy to return the difference between the copay amount and the price for the drug back to them.

 

 

 

NAMSAP Announces Leadership Team and Goals for 2017

The board of directors of the National Alliance for Medicare Set-Aside Professionals has elected the following officers for 2017: “Promoting payer participation in NAMSAP is another high priority” President: Shawn Deane, JD, MEd, MSCC, CMSP – assistant vice president of Product Development of ISO Claims Partners, Vice President: Greg Gitter, CMSP – president of Legacy Claims Solutions, Inc. (a Gitter Company), Treasurer: Rita M. Wilson – CEO of Tower MSA Partners, Secretary: Christine Melancon, RN, CCM, MSCC, CNLCP, CMSP – vice president of Operations for EZ-MSA Services

 

 

Structured Settlements in the Media

When used as part of a comprehensive settlement plan, structured settlements can be invaluable to injury victims and their families and it’s important to find a way to tell our success stories. The guaranteed income replacement, college payments and benefits that cover medical needs help to provide the financial security and peace of mind that is so important to people that have suffered a loss.

 

 

WCRI Conference – See You There – March 2-3, 2017

Close to 400 people will be taking their seats next Thursday for our annual workers’ compensation conference, March 2-3, in Boston, MA.  Should we hold a seat for you?  For those still on the fence, below are three great reasons to attend. #1) Content  #2) Networking: #3) Continuing Education Credit.

 

 

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is 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 of COMPClub, an exclusive member training program on workers compensation cost containment best practices.

 

Contact: mstack@reduceyourworkerscomp.com.

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

Live Stream WC Training: http://workerscompclub.com/livestreamtraining

 

©2017 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 Strategies to Eliminate Chronic Pain Claims

Chronic pain is the most prevalent health condition in the U.S. workforce with cost estimates of more than $100 billion annually in lost productivity, healthcare, and workers’ comp/disability payments.

 

The good news is medical science and research has evolved to enable the workers’ comp community to effectively address this prevalent and costly issue. The bad news is many employers and payers believe the steps needed to move injured workers from chronic pain status to productive individual are too complicated and too expensive. They are wrong.

 

 

Typical case

 

A 45-year old male sustains a ‘minor’ twisting injury while lifting something at work. He’s anxious to get back on the job and optimistic about his recovery, based on what his physician tells him. Seven years later — after umpteen surgeries and a smorgasbord of additional medical procedures — his chronic back pain is such that he cannot stand longer than 2 minutes, uses a walker and is afraid to move off the coach for fear he might cause more damage and more pain. He takes a long list of medications, especially opioids and other drugs to counter their side effects, and his wife is threatening to take the kids and leave. One can only imagine how much is being spent on this injured worker.

 

What could have helped this injured worker soon after his injury — and even years later, is a combination of coordinated care, more accurate diagnoses, and attention to issues beyond just his physical ailment.

 

 

Approaches to Pain

 

In the scenario above as in many other cases, the physician took a biomedical approach, which assumes all pain symptoms have a specific cause and once alleviated, the pain will disappear and the patient will be fully recovered. But for many people, this method just doesn’t work.

 

Research shows that chronic pain is a complex and dynamic interaction of psychological and social factors as well as biological conditions. A biopsychosocial approach is what is needed; a multidisciplinary effort that includes physical therapy, occupational therapy, psychology, neuromuscular massage and other experts. There are several things that could have been done in the above situation..

 

  1. Identify at-risk injured workers

A variety of potential red flags could have alerted the injured worker’s case manager and others involved in his claim to issues that might exacerbate the patient’s pain. Among them are:

 

  • Getting medications dispensed from his physician.
  • Recommendations for implanted devices.
  • Getting medical treatment outside the network.
  • High medication costs and increased use of medications.
  • No functional improvement by anticipated dates, despite various treatments.
  • Adverse childhood experiences — such as verbal, physical or sexual abuse; neglect; family dysfunction.

 

Chronic pain cases require interventions early on to prevent them from digressing to the point of the patient described above. The claims management team should have had weekly conversations with the medical providers to get updates on his progress. A thorough medical history should have been done to find out of the initial medical diagnosis was correct. A look at the injured worker’s family situation and other psychological challenges should have been investigated and addressed.

 

 

  1. Set Realistic Goals

 

All human beings are not alike and treating people for chronic pain should not be a one-size-fits-all method. However, the goals of treatment for anyone with chronic pain should be the same. These should include:

 

  • Ensure the patient has realistic expectations. An injured worker may not be able to be completely pain free, but he can still be a functioning member of society. Patients in pain need to understand that, and be given tools to help them manage their pain.
  • Provide education to help the person gain a locus of control, instead of feeling he is at the mercy of others. The injured worker should be just as involved in medical decision-making as anyone else involved in the claim.
  • Quality medical care that is evidence based. Treatment should be based on scientific studies to guide clinical decision making; ensure consistent, proven medical practices are used; and reduce unproven, ineffective care. The effect is better medical outcomes at lower costs.

 

 

  1. Use elements of Biopsychosocial Approach

 

There are a variety of treatments available that have been shown to help at-risk injured workers in chronic pain return to work. Whatever is used should be a process that helps the person gain the skills, knowledge and behavioral change necessary to avoid medical complications and take charge of his physical and emotional well-being after the injury. Treatments may include:

 

  • Pharmacological interventions to wean the person off opioids.
  • Psychological aspects to assist with psychosocial issues.
  • Cognitive behavioral sessions that focus on function and coping with pain. They may include relaxation training, guided imagery, desensitization, and addressing anger and entitlement issues.
  • Physical and occupational therapy. This may involve aquatics therapy, Tai Chi or Yoga, spine stabilization and stretching, and aerobic conditioning.
  • Follow-up care. Since at-risk workers may be vulnerable to reinjury or lapsing into disability mindset, there should be consistent communication with various referral sources, either face-to-face or by phone.
  • Include family and friends. The home and social lives of injured worker are key factors in recovery, so enlisting family members and friends to support the patient and reinforce positive outcomes should be strongly considered.

 

All treatments should be undertaken within a coordinated, goal oriented, functional restoration approach

 

 

Conclusion

 

Employers and payers that fail to recognize and deal with injured workers with psychosocial issues are doing their companies a disservice. Instead, they should be proactive and identify those with the potential for delayed recoveries, support and encourage early intervention, ensure quality medical providers using evidence-based medicine are employed, and provide whatever elements are needed to help workers in chronic pain regain their functionality.

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is 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 of COMPClub, an exclusive member training program on workers compensation cost containment best practices.

 

Contact: mstack@reduceyourworkerscomp.com.

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

Live Stream WC Training: http://workerscompclub.com/livestreamtraining

 

©2017 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.

 

Do High Heels Mean A Compensable Workers’ Comp Claim?

Navigating issues of compensability in workers’ compensation has become a complicated task for members of the claims management team and interested stakeholders.  This is highlighted by developing case law that scrutinizes the facts surrounding work-injuries when they occur at special events, company meetings or special occasions outside the employee’s usual work functions.  It also stresses the importance of a careful investigation of the facts and elements connected to the work-injury

 

 

Dykoff:  An All Too Common Scenario

 

The facts of Dykhoff v. Xcel Energy, 840 N.W.2d 821, 73 W.C.D. 865 (Minn. 2013), read like a law school hypothetical or test question meant to challenge students.  The employee in this case was a middle-aged journeyman electrician, whose job duties included electronically monitoring power and transmission lines.  Her work duties were performed at a desk, where she usually wore jeans and other casual clothes to work.  Presumably, this did not include high heels.

 

On the date of injury, Ms. Dykhoff was instructed to attend a training session.  Employees attending this event were advised to wear “dress clothes.”  While attending the event, the employee wore two-inch high heels.  She suffered a knee injury while walking on a dry floor.  A post-injury investigation noted there was no debris on the floor.

 

The case was found not compensable after initial hearing.  These conclusions were reversed at the first level of appeal.  Ultimately, the Minnesota Supreme Court upheld the hearing judge’s determination of non-compensability after a close evaluation of the facts and application of developing case law.  Central to the Court’s conclusions were three common tests used in many workers’ compensation cases when the law and careful review of the facts drive issues of compensability:

 

  • Increased Risk Test: The employee must show that she is exposed to a greater risk than the general public;

 

  • The Positional Risk Test: The employee need only show that her employer placed her in the position where she was injured; and

 

  • The Work-Connection Balancing Test: Where the arising out of/course of elements are evaluated.

 

In reversing the lower court decision, the Minnesota Supreme Court noted, “the employment creates a special hazard from which injury comes, then, within the meaning of the statute, there is that ‘causal relation’ between employment and the injury.”

 

 

Lessons Learned and Application

 

There is obviously no way an employer or other stakeholders can prevent a claim from being filed in instances like those described above.  On the other hand, there are important take-aways anyone can implement to avoid adverse findings and increased workers’ compensation program costs:

 

  • Maintaining a safe and properly functioning workplace environment is the surest way to prevent injuries. This includes making sure all walking surfaces are clear of debris and spills are immediately cleaned up in a proper manner.  All employees within an organization should receive annual safety training and understand the importance of their role in the process.

 

  • Setting proper expectations of employees when they attend meetings or other special functions during customary work hours or outside the normal workday. It is unclear what role the employee’s healed footwear played in the minds of judges when considering the Dykhoff  Notwithstanding its significance or lack thereof, it is something important to employers and other stakeholders to consider when holding workplace meetings where the posted attire exceeds those set during normal business hours.  This includes footwear.

 

  • A careful and complete investigation of all work injuries after they occur is important. Due to the interest in workplace “risk” by the Minnesota Supreme Court and other judicial bodies, it is important to note an uneven walking surface, a missing floor tile or floor mat can result in paying for someone’s medical bills and wage loss benefits under a workers’ compensation program.

 

Conclusions

 

Members of the claims management team and other interested stakeholders should take note of ways to keep their workers’ compensation costs in check.  Part of this includes an analysis of employee expectations and an awareness to dangers that lurk around the corner.  This includes an awareness to workplace safety and demands on employees.

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is 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 of COMPClub, an exclusive member training program on workers compensation cost containment best practices.

 

Contact: mstack@reduceyourworkerscomp.com.

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

Live Stream WC Training: http://workerscompclub.com/livestreamtraining

 

©2017 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.

 

9 Steps to Foster a Mentally Healthy Workplace

Mental health, especially depression is one of the leading causes of workplace absenteeism and lost productivity.  Estimates are that around $12 billion in lost workdays annually are attributed to depression-related illnesses. Injured workers are often susceptible to depression, especially those who have been prone to it previously.

 

There are a variety of factors that can lead to depression; life events, physical conditions, medication, stress and lack of sleep. The workplace itself can by a source of, or exacerbate depression — unless employers take a proactive approach to the issue.

 

Employers can help their employees and their own bottom lines by promoting a culture of overall well-being, encouraging personal growth and empowerment among workers, and ensuring benefits adequately address mental health needs.

 

 

Workplace Environment

 

A culture of wellness that includes emotional and mental health can go a long way toward reducing the stigma attached, leading workers to get the help they need sooner.

 

  1. Inclusive language. Mention of depression, anxiety, post-traumatic stress disorder and other mental health-related conditions should be as common as diabetes, hypertension and heart disease. The environment should be one that supports and encourages people to seek help. People suffering are more likely do so when they feel supported rather than embarrassed.

 

  1. Engage leaders. Managers and other supervisors should be trained to use language that does not project negative attitudes about mental health issues. They should also understand how to identify emotional distress and respond promptly and constructively to behavioral performance issues.

 

  1. Provide information. The entire workforce should be educated about mental health issues. Your workers’ comp insurer and/or third-party administrator can help with various programs.

 

  1. Work/life balance. Time off for rest and relaxation is essential to a balanced life. Employers should provide adequate vacation time and consider a policy that encourages, if not mandates it be taken. Also, companies should make sure the workload is not continuously extreme, as a large workload without adequate time to complete tasks is viewed as a big stressor among many workers..

 

 

Personal Development

 

  1. Encouragement and support. Employees should have access to a variety of opportunities to improve their competencies, as it helps them with their current positions and can prepare them for promotional opportunities, and acquiring new skills and career development has been shown to enhance well-being. Learning new personal and interpersonal skills also contributes to a person’s overall psyche.

 

  1. Recognition. Everyone likes to be appreciated for a job well done. Employers should acknowledge such employees, whether through financial rewards, time off, or just celebrations during the workday. Such actions help build self-esteem and motivate workers to exceed expectations.

 

  1. Inclusion. Where possible, include workers in decisions about how work is done, whether their own or the organization as a whole. Encouraging workers to ask questions, suggest new ideas and provide feedback gives them a sense of pride in the workplace. Employees who have input into their work lives feel more empowered and have improved morale, along with psychological wellbeing.

 

 

Benefits

 

Individuals with depression and other emotional challenges can be valued employees — if they get the help they need. As an employer, you can make sure workers know where and how to seek help.

 

  1. Employee Assistance Programs. While many larger companies have Employee Assistance Programs, few employees actually use the services. Many don’t know they exist or understand how to access them. If your company has an EAP, make sure your employees are well informed about what is included and how to access the offerings.

 

  1. Health insurance. If your company offers health insurance, review it to see if and to what extent mental health programs and services are included. Where possible, make any necessary changes to foster engagement by workers, especially for early intervention. Educate workers about your health insurer’s mental health services through an intranet, pamphlets, and meetings from an insurer representative. If there are no mental health benefits included for workers, learn about community resources and inform workers about them.

 

Mental illnesses cost employers through direct and indirect costs and can be significant. Make sure your company does everything possible to encourage workers with depression or other mental health challenges to seek help early.

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is 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 of COMPClub, an exclusive member training program on workers compensation cost containment best practices.

 

Contact: mstack@reduceyourworkerscomp.com.

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

Live Stream WC Training: http://workerscompclub.com/livestreamtraining

 

©2017 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.

2 New Tricks for New Workers’ Comp Claims

Published originally on February 6, 2017 on WorkComp Wire

 

As discussed in last week’s article, old dogs can be taught new tricks. A proactive settlement initiative can not only get legacy claims off the books, but it can also dramatically reduce costs and improve patient care. In one case, a man who suffered a minor back injury at work more than 25 years ago was weaned off fentanyl, hydrocodone, and several other drugs. The claim’s pharmacy spend went from $1,200 to $600 a month and a settlement is planned.

 

An employer that inherited legacy claims in an acquisition initiated an aggressive settlement program that produced $6.5 million savings on 43 MSAs during a 10-month period.

 

Yes, the settlement initiatives produce excellent outcomes for old dog claims. But the lesson here is that these so-called new tricks are available throughout claims handling. Adopting a settlement mindset from day-one can prevent claims from spiraling out of control and becoming old dogs. Think of the medical and indemnity cost savings as well as litigation costs that can be saved as a result of settling these claims short of attorney referral.

 

Remember these two new tricks:

 

  • Proper medical documentation of a file results in better claims handling. If medical treatment records are missing from the file, prescription history is absent or inconsistent with the medical records, or medical care is left open ended, it is difficult to assess the appropriateness of ongoing and future medical care.
  • Pharmaceutical intervention does not need to wait. A claim must be consistently evaluated for the appropriateness of recommended and ongoing prescription medication use. The addition of opioids weeks into the claim is a red flag. Do not wait until on the brink of settlement negotiations to intervene on prescription medications use, do it now.

 

Clinical and legal partners must drive a successful outcome for employer and employee. Every stakeholder (nurse case manager, adjuster, pharmacy benefit manager, defense attorney, or physician) should watch for red flags and intervene themselves or relay issues to the claims handler to determine the necessary action plan to right the ship before the claim gets more difficult to control.

 

When pursuing a settlement initiative involving complex, “old-dog” claims, savvy payers price out future medical exposure, identify cost drivers, and decide which claims to settle right away and which warrant intervention. The smart payers also learn from these old dog claims and put best practices in place to address cost drivers early on in claims handling. What is the impact of pursuing such a claim strategy? Here are the results from an employer who converted an old-dog settlement initiative into a standard for new claims handling:

 

  • 29% reduction in open claims after one-year
  • 43% reduction in open claim after three years
  • 14% reduction in total costs after one-year
  • 26% reduction in total costs after three years
  • 40% reduction in attorney referrals after three years
  • 25% reduction in pharmacy costs after three years
  • 55% reduction in CMS-approved MSA amounts after three years

 

It’s never too early or too late for clinical intervention on a claim with the purpose of driving a successful resolution to the claim. While old dogs can be taught new tricks, the best strategy is to incorporate settlement initiative protocols into claims handling best practices.

 

 

About Dan Anders

 

Daniel M. Anders, Esq., MSCC is the Chief Compliance Officer for Tower MSA Partners. A certified Medicare Set-Aside Consultant and attorney, he oversees the Medicare Secondary Payer (MSP) compliance program. Mr. Anders is responsible for ensuring the integrity and quality of the MSA program and other services and products and he provides education and consultation to Tower MSA clients on all aspects of MSP compliance.

 

Mr. Anders is the former Senior Vice-President of MSP Compliance for ExamWorks Clinical Solutions and he has extensive litigation experience from his prior position with the Chicago law firm of Wiedner & McAuliffe. He holds a Juris Doctor from Chicago-Kent College of Law and a Bachelor of Arts degree from Loyola University Chicago.

 

Contact Mr. Anders at 847.946.2880 or daniel.anders@towermsa.com

 

 

About Tower MSA Partners
Tower MSATower MSA Partners is a national provider of Medicare Secondary Payer services, including Section 111 Reporting and Conditional Payments along with Medicare Set-Aside preparation, submission and oversight. Its proprietary MSP Automation Technology Suite drives MSP compliance best practices and provides end-to-end visibility into each activity. Tower’s other services include pre-MSA Triage, physician peer reviews, MSA administration, medical cost projections, and life care plans. With more than 50 years combined experience in pharmacy, legal oversight and medical care, Tower proactively stages claims and works collaboratively with clients to identify issues and intervene to modify outcomes. Tower remains involved in the claims, through final resolution, MSA and/or other settlement. This model enables Tower’s clients to provide better care to injured workers, reduce claim and MSA costs, and obtain CMS acceptance of the MSA. For more information, visit www.towermsa.com and subscribe to Tower’s www.mspcomplianceblog.com.

WCRI Preview: Impact of Trump, Congress, & Legislature on Workers Comp

 

Donald Trump, the House, the Senate, 68 out of 99 State Legislative Chambers, and the highest number of Governors since 1922. I’m Michael Stack with Amaxx, and what I’m referring to is the amount of political control for the Republican Party as the result of the 2016 election.

 

Now if you’re a Democrat, and frankly even if you’re a Republican to some degree and even if you voted for Donald Trump, there is a little bit of fear, even if it’s for you it’s just a tiny bit, of how that change is going to impact our country and if you’re in the workers’ comp industry, how that change is specifically going to impact us in our industry, and the answer to that is frankly, I’m not really 100% sure. It’s not my area of expertise but I’m looking forward to learning about it at the upcoming WCRI Conference, which is going to be held March 2nd and 3rd in Boston.

 

 

Impact of the 2016 Election

 

The first session is the Impact of the 2016 Election on the Work Comp industry. I will be there in attendance and I will be taking a lot of notes because it’s something that I want to learn about and add to my toolbox and my bag of resources. Now, the second session at that conference is called Worker Outcomes and Return to Work. This topic is right in my wheelhouse. I get questions a lot of times from people. They’ll send me and e-mail and say, “Hey, Mike, do you have a study? Anything that I can reference about X, Y, Z topic?”

 

 

Worker Outcomes and Return to Work

 

Depending on the topic, sometimes I’ll have a study that I can reference and sometimes I won’t, but WCRI is one of my favorite resources and one of my often, most often quoted resources for studies and this is one I am sure I will be quoting often because they’re going to be taking a look at Return to Work and Worker Outcomes from the employee perspective, the employer perspective, medical providers, insurers of how different things really impact the outcome of those particular individuals in those claims, so that’s a session I’m very much looking forward to.

 

 

Opioids, Value Based Health Care, & The Grand Bargain

 

The rest of the agenda is going to be hitting some very important and timely topics like opioids, does value-based healthcare work in work comp and really an appraisal of the entire work comp system and if the grand bargain is still the right answer, so WCRI is one of my most highly respected organizations. I love that conference. It’s one of my favorite to attend all year. It also happens to be a local conference for me, which is great. I’m Kennebunkport, Maine so a short drive down to Boston. I’m looking forward to being in attendance and I hope that you will too and I look forward to seeing you there.

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is 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 of COMPClub, an exclusive member training program on workers compensation cost containment best practices.

 

Contact: mstack@reduceyourworkerscomp.com.

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

Live Stream WC Training: http://workerscompclub.com/livestreamtraining

 

©2017 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 Strategies To Reduce Workers Comp Legal Costs

Litigation management is a crucial element of controlling your workers’ comp costs. Otherwise, you may be paying significant dollars for a variety of seemingly miniscule costs — all of which are easily avoidable. Your company’s mindset toward a layer should be that of a partner who can bring value to your worker’s comp program.

 

 

The Right Fit

 

Partnering with the right lawyer is the first step to reigning in legal costs. Rather than hiring someone ‘off the rack,’ your defense attorney should be someone who understands and shares your company’s culture and works with your organization to find ways of achieving best outcomes while keeping an eye on costs. You want someone with whom you can easily communicate — even on cases that are not being litigated.

 

Here are some factors to consider in deciding on a lawyer:

 

  • Ask for recommendations. Seek input from others in similar businesses to yours. L-ook for attorneys who are considered part of the team.
  • Get references. Especially if you are not sure whom to ask for recommendations, talk to clients of attorneys you are considering.
  • Do a meet-and-greet. Don’t rely on phone or email interviews. You want to feel comfortable with the person you hire and vice versa. Bring him to your company, show him your facilities and see how he interacts with others involved in your workers’ comp program and other areas of your organization. Also, see how your TPA gets along with the person and vice versa.
  • Ask questions. Find out the fees he charges as well as overall litigation costs.

 

 

Best Bang for the Buck

 

Once hired, your attorney should help you manage claims by showing what he can and should do and what you and your company can do.

 

  • Accident investigations. Work with your attorney to find out what information you should obtain immediately following an injury that will help in the long run. Interviewing all relevant witnesses, taking recorded statements and creating a paper trail are among the best practices. These actions will cut down on the amount of work required of the attorney or other outside vendors later on, should the claim be litigated.
  • Approvals/denials. Your attorney can help your claims adjusters better understand which claims can be defended if they are denied, and which are clearly compensable. You don’t want to waste time and money fighting losing battles.
  • Determine who has responsibility for what. Defense counsels should do the work that is in their areas of expertise; likewise the claims adjuster, nurse case manager, TPA, etc. Completing wage forms, for example, should be the duty of the adjuster in most cases; however, they attorney may be better served taking on this responsibility if, say, the injured worker was employed for only a short period of time or was paid in a nontraditional manner. In that case, the attorney may be better able to calculate the wages. While nurse case managers and others are aptly qualified to complete many forms, the attorney should at least be consulted if the injury is complex or multiple body parts are involved. An attorney should be the one to obtain medical records when a case is in litigation — even if a nurse case manager has already obtained them. By using a subpoena, an attorney can get a more complete set of records.

 

 

Check the Facts

 

Even if you have hired the best workers’ comp defense attorney who is doing a great job helping your company, you still need to understand his bill and see if there are areas for reductions. Audit companies can help review the numbers. If anything looks too legalese or vague, ask questions until you are clear on what is being charged for what. Make sure you are paying for actual time spent on your claims and not on administrative tasks.

 

 

Summary

 

Instead of a necessary business expense, your attorney should be an asset to your company — someone who helps streamline the claims process.

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is 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 of COMPClub, an exclusive member training program on workers compensation cost containment best practices.

 

Contact: mstack@reduceyourworkerscomp.com.

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

Live Stream WC Training: http://workerscompclub.com/livestreamtraining.com

 

©2017 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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