Tom Cruise was told to “Show me the money” in the movie “Jerry McGuire”. And after some trials and tribulations, he is able to get his client to the very top of his career. I have not watched that movie in a number of years, but every time I talk to an employer about the benefits of a safety program, or the benefits of pursuing a solid ergonomic program, one of the first questions is typically “Show me what it saved the other guys and what it will save me.”
If the employer believes there is a safe workplace and a good loss run, then it can be a hard sell. But what that person does not know is there is always room for improvement. Also just because it is going ok now does not mean it will be in 3 years from now. The workers comp world is always changing and morphing into the unknown, as the stressors of personal life and work life mount. Until they finally show themselves by stealing attention for 4 seconds, and a hand goes into a worker’s machine. And at that point that worker’s life is changed forever. WCxKit
That is an extreme example, but injuries do happen! Here are 4 examples of companies benefiting from the installation of an ergonomic/safety program. (References to the examples below are listed at the end of the article.)
1. Hensel Phelps Construction
This company began to notice large spikes in musculoskeletal disorders among its employees. So to combat this problem, they hired and implemented a pilot program at one of the company’s larger construction sites that consisted mainly of a customized stretching and strengthening program for the workers based on the specific jobs they were performing at that site.
After implementing the program, Hensel Phelps employees logged over 104,000 hours at that pilot jobsite without any reported work-related musculoskeletal disorders.
104,000 hours! That is 2,600 40-hour workweeks. Hensel went from having a major outbreak of a specific type of injury, to almost wiping it out. It is hard to argue with that success.
2. Quad Graphics
In 1995, Quad Graphics instituted a comprehensive ergonomics program using employee-led management teams to identify ergonomic risk factors for workplace injuries and institute training and controls to reduce the risk drivers.
Within 4 years, Quad Graphics experiences a 25% reduction in the number of work related injuries, a 39% decrease in the number of back injuries, and an overall reduction in lost work time days of 25%.
The key here is that Quad uses “employee-led” teams. We often mention using your employees as a resource. They are the ones working those same workstations day after day. They have legit ideas, so tap into your best free resource and see what they tell you.
3. Rockwell Automation
Rockwell experienced an increase in injury rates at its Milwaukee facility in the early 1990’s as the worker population and seniority rates changed.
A comprehensive approach to injury prevention is developed focusing on ergonomic training, ergonomic retrofitting, and on-site stocking of frequently used ergonomic items such as hand tools, floor mats, foot rests, and anti-vibration gloves.
Rockwell reports a significant reduction in lost time and/or restricted workdays as a result of the program.
Again the key is taking a step back, identifying the risk factors, finding out what options are available to reduce the risk, and implementing them. All you have to do then is sit back and track the numbers over the course of 6 months or a year. The more you are working at full capacity, the better the production, the stronger the profit margin.
4. Tyson Foods in Monett, MO
Tyson discovered increased musculoskeletal disorders identified at this specific location. In order to combat these numbers, Tyson instituted an on-site medical management program in March 2002 to reduce the number and severity and these injuries.
The medical management team consists of an on-site physical therapist to assist with job placement and job analyses, as well as follow up on the doctor prescribed treatment of work-related injuries. The occupational health nurses, physicians, and therapists met together at least annually as a group to discuss the successes of the program as well as to recognize any areas of improvement.
This program is successful because it produces enhanced job placement, improved and personalized modification of job duties for injured employees, improved communications between the therapist, doctor, team member, and management team, as well as faster recovery times, and in some cases it leads to prevention of work-related injuries/illnesses. Again this is a fantastic success for a large manufacturing location such as this. WCxKit
Summary
There are no more excuses for not implementing a safety team or program after reviewing these 4 examples. Each of these stories is a great example of identifying a problem, establishing a program to correct it, and tracking the successes of your implementations. Your broker/carrier/TPA has resources to get you started in the right direction. The sooner the program is implemented, the sooner to start saving on claims.
References
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com.
Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
If you are a risk manager that has been with a company for a long time, you probably have developed a relationship with some of your employees. If you are an agent, and you have been in the business a long time, you probably know your book of business very well and would do anything to keep them happy and to keep them coming back to you for their insurance needs. Same thing for the risk manager: They do what it takes to resolve their employee claim problems.
But, when workers comp is brought in, this is the elephant in the room. As much as you — the employer, agent, etc. — want to help the employee, there is only so much you can do. Comp is a separate issue, with another party handling the actual claim and the compensability of the claim. It is not like glass damage where a risk manager’s agent says, “Do not worry about it; we can file a claim with the carrier and they will pay.” Sometimes they will not. It is the same with work comp. No matter how great a person your injured worker is, there is a chance their case will not get accepted for whatever the reason.
This puts you in an awkward scenario. Your employee is coming to you for help, but you are essentially powerless. Or, you are the agent and your client is upset that the carrier you recommended will not cover this particular comp claim. What do you do? Here is some advice for when you are caught in the middle:(WCxKit)
1. Get both sides of the story.
If you are only listening to what your employee is saying, you are only getting one side of the story. This will show how involved you are with your claims. If you do not talk to your adjuster a lot, or if you do not know who your adjuster even is, chances are you will be confused as well. But you cannot take the side of your employee without also hearing the facts from your adjuster — especially if this is a questionable, subjective claim to begin with. You may want to protect your employees, but both of you cannot team up against your carrier, who, by the way, is working hard to investigate all claims and make the proper decisions, which in the end affect your overall premium.
Take the time and call the adjuster. Get their side of the story. If there is something you do not understand, ask them to explain it. Make sure you really understand what the issue is and why it is there. This way you will understand what is going on, and you can explain it to your disgruntled employee. Carriers do not create these laws, they only abide by them, and they are different state to state. Each adjuster has different styles as well, so if a worker had a comp claim similar to one six years ago and it was accepted, and now the same thing happened and now it is denied — find out why. Make sure the adjuster has legal evidence to back it up.
It could also not even be denied; maybe it is just suspended pending results of investigation or upon receipt of medical records. Whatever the case, call your adjuster and talk to them about it before you start choosing sides on who is right and who is wrong.
2. Meet and discuss in person with all parties and counsel.
The best way to decide who is right and who is wrong is to meet up. The employee can come as well, but it is probably best they do not — at least not at this point. But you, as the employer, should go discuss the case in person and roundtable it with all of the involved players.
If this case has a potential for litigation, get local counsel or the house counsel the carrier uses involved. This way you can all discuss the file in a global aspect, and also plan for the ramifications should certain decisions be made. Going over pros/cons, future exposures, and the costs involved with all of those decisions helps not only you as the employer, but the adjuster as well. This forces him to get deep into the file, discuss monetary values, develop plans of action, etc. It can only produce a better outcome for all.
3. Find a middle ground for plans of action, if possible.
Just because you talk about the file and you meet up in person does not mean you will all agree on what to do. At the end of the day, the employer gets affected by these decisions through their premium. Or, if self-insured, it is your money heading out the door on this file. This is where the employer has to be involved in some of the decisions.
If you are not satisfied with what you are hearing, see if there is a middle ground, or a non-aggressive approach everyone agrees on. This is where independent medical examinations (IMEs) can be done. Nurse case managers can help, voc assessments can be performed, etc. Then after you have compiled all this info, and go over the pros, cons and monetary values of each one, then you may choose a strategy.
Maybe you do not want the carrier to take the ultra-aggressive approach because it could backfire. But you do not want them to roll over either, so find a common ground you all agree with. This way, not only are you involved in the process, but you are also involved in decision making. The adjuster wants to make the employer happy because she is also a client. But you have to abide by the statutes within your state of jurisdiction. Explore your options, and come out of that meeting with an agreed-upon plan. Not just agreeing to disagree.
4. The adjuster knows best.
Let us say you have been a risk mgr for a long time. This does not mean you are the adjuster. The adjuster has had medical and legal training, negotiation training, and she is up to date with the current law changes and trends. Adjusters know which doctors’ opinions are not worth the paper they are written on. They also know the doctors who will “slash for cash” — meaning they will perform surgery at the drop of a hat. Those doctors are out there, and hopefully your employee is not being treated by one of them.
When push comes to shove, the adjuster and counsel probably know best about what options you should be taking. Thorough discussion should bring you to this point. At the end of the day, the carrier is going to protect themselves from exposure just as much as they are trying to protect you. But be sure you understand why they are doing what they are doing. This effective communication will help you understand why the plan is what it is, and why it is best for you and your company.
5. Leave your personal feelings behind.
The hardest part from the employer perspective is not to drag personal feelings into a decision. Whether the injured worker is your best pal or your worst hire, you cannot bring those feelings into your overall decision on what to do on the file. You can alert the adjuster to these feelings, but you cannot let it influence your decision.
In the end, the decision must be fair, and it must be backed by legal precedence. The carrier is not going to deny a claim just because they feel like it. There is a reason. On the flip side you cannot force a carrier to accept a claim they are not going to accept. They understand that this worker may be your friend and you want to do what is best for them, but you cannot force the issue. All you can tell them is that this person is your buddy and you want what is fair. Again, it comes down to communication. Know why they are doing what they are doing, and you will walk away understanding why the decisions are what they are.
In conclusion, no matter who is injured, when they are injured, or what they were doing when they were injured, you will have a personal feeling about why a claim should be accepted or denied for whatever reason. But, at the same time, you have to educate yourself on why claims are accepted or denied. You can accomplish this through communication.(WCxKit)
We talk a lot about being involved with your claims, and the examples stated above point to why you need to be involved, and why you need to understand why claim decisions are made. You need to know your carrier or third party administrator (TPA) makes these decisions to protect your company and your interests, as well as their own. The decision should be fair, backed by legal statute, and ethical. Whether the claim is accepted or denied, it will be a fair decision.
Author Rebecca Shafer
, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com.
Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
A lot of employers strive to maintain a safer, more productive workplace for their employees. Every business would love to reduce costs and increase profit margins. The cost of claims can account for a big chunk of money losses, especially for the self-insured or self-administered employer.
So how do you get started? Where do you start, or better yet when do you start? The answer is RIGHT NOW, and here is how:(WCxKit)
1. Know where your risk lies
Observe your workplace. Go through department statistics and see how they compare to each other regarding losses. Perhaps 75 percent of your injuries occur in the shipping department. Go down there and talk with the supervisor. Find out what the issues are and why they think injuries are happening. Then work together to solve the problem.
Another helpful thing to look at is your loss run. Talk to your carrier or adjuster and see if they notice any trends in injuries. Which people are getting injured? Maybe newer hires account for a lot of injuries. This may show that a focus needs to be directed toward training and safety right from day one of employment.
Look at your business. What do you do? What are the risks involved? You could have risks from several areas, stretching from workers comp, to automotive issues with your fleet and the drivers, to liability risk from customers in your store. Break it down and track your statistics. Identify issues. Work on ways you can reduce your injuries or occurrences from happening in the first place.
2. Plan your attack
OK, so you have identified a few areas where you could improve on reducing some injuries or claims reports. So, what do you do to fix it? Planning is important, but the most important thing is to start, even if that is with very small steps.
The answer lies in the resources you have all around you. The first step is to talk to your carrier. Chances are the carrier has loss prevention specialists ready to help you work with what needs to be fixed. Ergonomic professionals can be brought in to address workstations and to suggest solutions to reduce exposure. Utilize your medical clinic contacts to see if occupational physicians can watch employees working. They can then identify potential issues with certain movements or repetitive-motion injuries. Utilize your local counsel by having them come in to explain the risks and costs associated with potential serious injuries, automotive accidents, failure to drug test your employees, etc. Any or all of these will help you reach your goal of reducing risk exposure.
3. Implement your solution
Now, if you identified what needs to be fixed, and how it should be fixed, now it is time to fix it. Get rid of old equipment and bring in new equipment with better safety features. Newer equipment costs less to maintain and repair and is quicker to operate. Most new machines use less energy than old ones, reducing utility bills and creating worker ease of operation. Get some padding on the floor for workers to stand at their workstations (also known as “fatigue mats.”) This reduces strain on feet and legs, and reduces body fatigue, potentially making employees more productive after long hours at work.
Whatever the fix may be, get it done. Out with the old — in with the new.
4. Measure your success statistics
So now your new equipment is installed and in place. Now it is time to measure your reductions. Take a two, four, and six month stretch and measure your numbers. Do you see a drop in claim activity? Or, did claims increase, meaning your plan backfired? You have to see how you did, and most importantly you have to give it time. Change is disruptive to employees, but they do get used to it. Give it time, and measure your numbers post-change against the ones you first noticed back when you were figuring out where your risk was coming from. Measure lost-time days, and post your progess at the front entrance.
5. Get feedback from your workers
After all you did, you left out the most important thing: To talk to your staff of workers about the changes. How do they feel it impacted their workday? Were the changes helpful, or did they hurt production? How do they feel at the end of the day? Do they feel less sore or are the new workstations worse than the old ones?
Ask as many questions as you can. This makes your staff feel that their input is important, and taken in to account. After all who better to talk to about the implemented changes than those who are directly affected day after day?(WCxKit)
A supervisor once said, “It is hard to fully embrace change. To make things easier, you have to ‘lean’ into it a bit at a time until you have accepted the entire package of change.” This is true on many levels. Even though it is hard work to find out what your risks are, discover how to attack them, implement changes, measure success, and get worker feedback, in the end it will be worth it. Lean in to the task. Do not try to tackle it all at once. As I have always said, "Don't eat elephant in one bite."
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
As members of a management team, around the winter season, reevaluate for the upcoming year. Set goals, benchmarks, implement new techniques, purchase new materials, etc. But there is one area that seems to be focused on more than others: And that is ‘how can we use what we have to be better?’.
Chances are in a medium to large shop, there is plenty of talent, in more than one form. The workers can be your most important capital. So why not focus on how to better use that talent? (WCxKit)
1. Provide the best tools so employees can perform efficiently
As an example, if you drive cars, this does not mean that all all drive a top of the line Cadillac. But this is meant more to show how to provide the best output for workers. Make workstations adjustable so workers can perform at the levels they need to. This will increase output and performance, not to mention that it will make workers less prone to injury, especially in repetitive-motion workstations. Extra lighting can provide clarity and precision. Hand trucks and dollies can make moving heavy materials easier and quicker, and so on and so on.
2. Don't run it like a prison
The workplace does not have to run hard-nosed and rigid. As an employer allows some flexibility such as flex work hours, rotating job tasks, allowing hourly breaks, then you can best utilize workers time at work for production. A rested workforce is your best workforce. Sometimes having job rotation can provide breaks for those that do heavy duty work day in and day out. Also this can reduce injury since those workers that just do heavy lifting or moving of materials can get a much needed break from time to time throughout the day. You could also discover that one of your workers may be better suited for another type of job task, versus the one they are currently in now. This could lead to increased production, and better efficiency.
3. Keep an open mind
Time and time again we recommend listening to employees and their suggestions as to how changes can be made to make production better. Discuss alternative job tasks and how things could be done quicker and easier. Remember these are the people that do these jobs all day, sometimes for years. They have ideas and suggestions and you have to make management become approachable. If someone knows that you will take the time to listen to them, you may get an idea that you can implement. Not everyone will hit the ball out of the park every time, but you could stumble upon something that can really make a difference, and it could change the way things are done on a daily basis.
4. Encourage healthy lifestyles and reward those that make a change
A healthy body is one that comes ready and able to work, and able to take on the challenges of the day. Healthier employees also have less sick time away from work, and have fewer injuries. A lot of companies now offer discounts to local gyms, reduced medical premiums for wellness exams, smoking cessation programs for free, etc. The HR department probably has a lot of ideas and plans that are already in place to promote a healthier lifestyle, and the incentive programs to go with it, so check in to some of them and try to implement some over the course of a year. Provide some incentives for the workers to participate, and see what happens. I bet that more will participate than you thought.
5. Launch a return to work program
It has been well documented that the longer a person is out of work, the harder it is to get them back to productive employment and there is a strong correlation between a high return to work ratio and a low mod. Older employees also take longer to heal than younger ones, so consider home-based employment. If you provide some light duty work, employees know that even though they have an injury, they can still work and make a decent wage. This will help them transition back into full time work once they are released from medical care, and will reduce claims dollars that are spent on lost wages while injured. It will also free up full duty employees to do something more productive, while those with medical restrictions can take care of the lighter tasks you need done day in and day out. Make a "wish list" of tasks you wish you had someone to help perform, then use the wish list to create transitional duty tasks. For instance, I wish I had someone to proofread my writing.
6. Set up a mentoring program
It is always hard to start a new job. Nobody wants to be the new person, so set up a mentoring program to help those new or less-experienced employees. Shadowing programs work well also. The new employee can gain some great knowledge from the veteran worker, including how to do things quicker, properly, and more efficiently. A good mentoring program will improve productivity of the newer, younger employees while making veteran workers feel like they can contribute more to the company other than just cranking out their job tasks day after day. The more you make workers feel like they are involved, the better, harder, and more dedicated they will work for you.
7. Do not be afraid to hire experienced workers
There are many benefits to hiring experienced workers. These workers already have sound work habits, years of experience in the field, and the skills the company needs to take you to the next level of competition. These workers also have less out of work distractions, such as needing more time off for child care or more time off for school commitments. Experienced workers will also add some diversity in workforce, contributing their ideas and experience to the team projects and ideas. If you utilize their assets, the workplace will benefit. (WCxKit)
Summary
A New Year means it is time to reflect on the year to date, and focus on what you can do better for the upcoming New Year. But you should also think about what the veteran workers can bring to the table for the company. Experienced workers are a great untapped resource, and their ideas and work ethics can be beneficial in more ways than one, especially in fields other than just being at their workstation. Tap the greatest free resource- the employees. Listen to their ideas, and make the management team approachable when someone has an idea about how something may be able to be done better. If you make this one of several things to focus on, accomplishing the rest of the goals could just be that much easier.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com.
Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
Info@ReduceYourWorkersComp.com.
The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) has cited Illescas Brothers Construction Inc. of Paterson for exposing workers to 12 safety violations while performing masonry work on the exterior of a new home in Fort Lee. According to a report from the agency, proposed penalties total $65,340.
When OSHA inspectors arrived at the work site on June 28, they found several fall protection and scaffolding violations. For example, employees performing overhand bricklaying were permitted to climb the cross braces of the platform to access a work platform 24 feet above the ground, proper fall protection was not provided to employees trying to erect scaffolding and employees were allowed to work on an unstable scaffold 18 feet above the ground. (WCxKit)
Three repeat violations with $55,440 in penalties include failing to use proper scaffolding and provide fall protection for employees erecting scaffolding. A repeat violation exists when an employer previously has been cited for the same or a similar violation of a standard, regulation, rule or order at any other facility in federal enforcement states within the last five years. Similar violations were cited in August 2007 at an Edgewater work site.
Six serious violations with $9,900 in penalties include failing to implement a respiratory protection plan, protect employees from falling material and provide safe access to a landing surface. A serious violation occurs when there is substantial probability that death or serious physical harm could result from a hazard about which the employer knew or should have known.
Three other-the-serious violations with no monetary penalties include the absence of a portable fire extinguisher, failing to provide a written hazard communications program and failing to make a material safety data sheet readily available. (WCxKit)
An other-than-serious violation is one that has a direct relationship to job safety and health, but probably would not cause death or serious physical harm.
Author Robert Elliott, executive vice president, Amaxx Risk Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
Being a claims professional has a lot of demands. Everyday you have to juggle multiple demands on many files, sometimes within several jurisdictions. A typical caseload for the lost-time adjuster is 150 active files. The adjuster tries to handle the demands of those files in addition to the phone calls, emails, and medical records, usually without any support staff.
Every adjuster appreciates anything that helps make their job easier. Below we discuss six small items that can make a big difference to Joe (or Josephine) Claims Adjuster.(WCxKit)
1. Please complete all fields on the injury form.
When an adjuster first gets a new assignment, nothing makes them more frustrated than to see many fields missing information. This can include social security numbers, birth dates, the type of injury, the date the injury was reported to the supervisor, etc. All of these fields are equally important, and when any are empty it means another phone call to the contact at the insured to gather this information. Take the time to complete all fields, so the adjuster has the information needed to get started on the file investigation without delay.
NOTE TO EMPLOYERS: IF YOU LEAVE BLANK FIELDS, SOMEONE ELSE MAY FILL THEM IN – WITH ANSWERS THAT YOU WON'T LIKE. Attach information if there isn't enough room for the complete answer. Staple it and mail a copy to the adjuster.
2. Report All Claims in a Timely Manner.
The next thing that annoys adjusters are late claims. Depending on the jurisdiction, this can put the adjuster in a time crunch to gather as much claims information to complete the investigation, and the fact they are rushing can lead to errors, or even worse, leakage. The last thing anyone wants is money and time wasted on a claim that is not compensable. One of the best things you can do is to report a claim right away. Do not let it sit on your desk until the injured worker goes in for surgery the next day. The sooner you can get that injury report to your adjuster, the better chance they will have to do a proper, thorough investigation. This leads to correct, ethical decisions on your claims without delays, penalties, or leakage.
3. Let the adjuster know if there is lost time on a claim.
Claims that include lost wages carry a certain priority with the adjuster, since every day that clicks by means another day of potential wage loss due to the employee. As mentioned above, injuries should be reported right away. This gives the adjuster time to gather medical records to see if the claim is compensable. It also gives the adjuster a chance to get work restrictions on your employee so they can be placed in your light-duty work program. This eliminates the need for lost wages paid to the employee and keeps your claim costs down. When injuries are reported right away, everyone wins. The employee gets prompt contact by the adjuster, the adjuster gets a jump on the claim, and the employer gets to keep their costs down as low as possible.
4. Don't tell the adjuster if a claim is compensable or not. It bugs them.
As much as you think a claim is legit or not, the employer typically cannot make a decision on a claim’s compensability. This is the adjuster’s job — what they get paid to do. This is why they are licensed to be claims adjusters in your state. They have the training and certification to make the decision on compensability. It is really important to voice your opinion on the claim, and to be able to back up your assumptions with facts. This will greatly help the adjuster with their investigation, but the overall decision on if the claim is accepted or not should be left up to the adjuster. Plus some jurisdictions have steep fines if claims are denied in error, so why put yourself in that position? Leave it up to the claims professionals. IF IT IS NOT A LEGITIMATE CLAIM – TELL THEM YOU SUSPECT FRAUD. PUSH IT- so you are taken seriously. I don't always live by my own advise here, and I almost always give my opinion about what I think is compensable, or not…
5. Make yourself accessible to the adjuster and return calls as soon as possible.
Claims adjusters have to make many phone calls every day. They are constantly on the phone. If they are calling you to get facts on an injury, and they leave you a message to call them, please call them back as soon as you can. Employer input on claims is important. Bear in mind you see your employees every day. You know a lot about them that the claim adjusters do not. Your investigation is just as important to the adjuster as is theirs. They rely on you heavily to know about the injury, what happened, why it happened, and what happened after the worker left. Send them any medical information you have, as this also will give them the provider’s name, address, contact info, and initial diagnosis. If you get bills for the treatment from the provider send them to the adjuster so they can be processed for payment if the claim is compensable. Anything you get that involves the claim should be sent to the adjuster, no matter what it is. The adjuster would always rather have more information than not enough.
6. Know the details of the injury soon after it happened.
The first question the adjuster will ask you when they call is, “What happened?” Adjusters hate to hear the answer, “I do not know.” Obviously this does not help the adjuster. You should be heavily involved in any claim that occurs at your workplace, whether it is a work comp injury, a liability injury, or a property damage claim. Gather facts and witness statements to send to the adjuster. Comments the witnesses have can impact a claim because the adjuster will compare that to the history given to them by the injured worker, and what history the injured worker gave the doctor when they were first examined in a medical facility. Any facts that do not add up will raise the red flag that there may be something more to this claim than what is on the surface, and it could prevent a claim from being falsely accepted. This again will keep your costs down, since you will not incur the leakage associated with paying a claim in error.(WCxKit)
In conclusion, these are 6 items that can greatly help the adjuster, even though you as the employer may find them quite trivial. You would be surprised if you saw the amount of information adjusters have to process on their 150-200 claims each day. Every little bit of information to the adjuster helps them out, and makes their job easier. It all leads to the same goal that we have in claims, which is to properly investigate every one so the appropriate decision can be made on the compensability.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
Public transit workers in Toronto will in the near future be subject to random drug and alcohol testing as the city's transit service was given permission to start testing employees in safety-sensitive positions, according to a report from the Canadian OH&S News.
The Toronto Transit Commission (TTC) was pushing for random testing to be added to the Fitness for Duty policy because the current policy, which came into effect in 2010, has been ineffective at deterring workplace intoxication, says Brad Ross, director of public communications for the TTC. (WCxKit)
The current policy allows for workers in safety-sensitive positions – operators, maintenance staff, supervisors and executives – to be tested for alcohol and marijuana, cocaine, opiates, amphetamines and PCP, using breathalyzers and saliva swabs, when there is a reasonable cause or testing post-incident, post-violation, post-treatment and pre-employment.
Amalgamated Transit Union Local 113, which represents the majority of TTC workers, is already challenging the present policy, and random testing will be added to the grievance, commented Ian Fellows, the union's lawyer in the grievance litigation.
"It's an invasion of our members' privacy. It treats everybody as if they've done something wrong and it requires them to submit to an invasive procedure," says Fellows. "They've got to offer up a sample of their bodily fluid and their DNA. That's contrary to our agreement and we say the [Ontario] Human Rights Code and the Charter of Rights."
While specifics regarding how the program would run have not yet been worked out, Ross notes the TTC would work with a third party to develop a testing protocol and it would be at least a few months before a system would be ready to implement.
"We need to figure out what percentage of employees we'd need to test on an annual basis, but in theory the way it works is you show up for work and the system tells us it's your turn for random testing," he says.
The saliva swabs, as opposed to the traditional urinalysis when testing for drugs, only show whether a person was impaired when the swab was taken based on a pass/fail threshold, not if they had used drugs in the past. The swabs would be tested by an outside lab, Ross says. "We're interested in ensuring that when you report for work, you're fit for duty, not what you did two days ago or two weeks ago, for that matter."
This is not the first time the TTC has tried to introduce random drug and alcohol testing. When it first brought the Fitness for Duty policy to its board of directors in September of 2008, random testing was in the policy, but the board refused to give it the green light. However, the board has changed since the policy was first introduced.
Ross reports that TTC staff felt the random testing policy was needed and would revisit the proposal at a later date. Ross also dismissed a recent incident, where a TTC bus driver was found with marijuana in his possession after a fatal accident, as the reason for trying to reintroduce random testing.
"There have been a number of public incidents over the last couple of years that have been cause for great concern, and there have been incidents within the organization that have not been public but are a concern as well," he says.
The number of incidents involving drugs and alcohol has not decreased since the policy was introduced, Ross added.
Though the TTC has data comparing the number of incidents from 2006 to 2008 and 2008 to present, they are part of the grievance litigation and are not being released to the public. Hearings began in 2011 and are scheduled throughout 2012.
Random testing brings the TTC, with its 1.6-million riders a day, more in line with public transit services in the United States, where random testing of all workers in the transportation sector is the law. "We are the third largest transit agency in North America after New York and Mexico City, and we feel that this element of the policy is necessary," Ross noted. (WCxKit)
Windsor's public transit service is the only one in Canada that has implemented random testing, but only for employees who drive routes that cross into Michigan.
Author Robert Elliott, executive vice president, Amaxx Risk Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
Few people realize the workers’ compensation industry is actually 100 years old. It’s one of the most-successful public-private partnerships in U.S. history.
Since 1983, the Workers Compensation Research Institute
(WCRI) has been providing the public with research on WC public policy issues. Based in Cambridge, Mass., the organization includes among its members employers, labor organizers, public and private insurers, health care providers, managed care companies, and state government representatives from the U.S., Canada, New Zealand, and Australia.
Dr. Richard Victor, WCRI executive director, oversees the institute’s studies and analysis that has added ammunition for the reforms to various aspects of the workers' comp system. Prior to working at the institute, he spent seven years conducting research at The Rand Corporation in Washington , D.C., and Santa Monica , Calif. His law degree and Ph.D. in economics is from the University of Michigan.
LowerWC recently asked Victor for his impressions of the industry. What follows are some of his comments:
“One of the most important, and troubling, areas for workers’ compensation systems is to find the appropriate ways to use narcotics – and to discourage abuse and diversion. A second critical issue is to find new and innovative ways for help workers return to productive employment,” Victor says.
To this end, WCRI is conducting several research phases to help find answers for WC narcotic use and return-to-work issues, he says.
Victor says the latest trends in workers’ compensation also include medical cost management. “Medical costs now represent more than half of workers’ compensation costs in most states. There is increasing focus on pharmaceutical costs and utilization and the payments made to hospitals and ambulatory surgery centers,” he says.
Further, everyone wants to know how to save the employers money. Victor says, “Most large employers are focused on three legs of the four-legged cost containment table – risk financing, injury prevention, and claim management. The fourth leg is a large opportunity because employers have underinvested in it – improving the ‘rules of the game’ to make the system more effective for workers and more cost effective for employers.”
He continues, “This requires that employers join together to formulate political positions and strategies and gather available evidence about how a given state system is performing, how it might be improved, and what lessons can be learned from other states.”
California and Texas are good examples of where employers have taken collective action and costs have fallen significantly, Victor says. One of the chief objectives of the WCRI CompScope benchmarking studies is to help stakeholders and public officials set priorities and debunk myths.
One important part of this research is an upcoming conference. The WCRI Annual Issues and Research Conference will be Nov. 16-17 in Boston with keynote speaker Peter Barth, professor of economics emeritus at the University of Connecticut. This will be its 28th year.
The goal there to present new ideas and alternative views, Victor says. “Whether you are managing workers’ compensation claims, involved in strategic planning, concerned with medical costs and utilization, or just looking for a better understanding of workers' compensation – this is the conference for you.”
All of the sessions highlight the first presentations of the latest research findings from WCRI while drawing upon the diverse perspectives of highly-respected workers’ compensation experts and policymakers from across the country, he says. “Attendees tell us that they value the large attendance because it allows them to leverage their time while at the conference. There are also opportunities to meet and interact with WCRI researchers.”
“The most important advice I can give remains a secret until the WCRI conference, when I (present) ‘The Elephant in the Room.’ It will highlight some things that are underappreciated, but are likely to shape workers’ compensation systems for the next decade. The future is not always like the past,” Victor says. “Of course, I would like to see your readers attend to stretch their thinking, gain a competitive edge, and network with peers.”
Author Rebecca Shafer
, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of Manage Your Workers Compensation: Reduce Costs 20-50% on cost containment techniques. www.WCManual.com.
Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
Posted in
Assessment & Diagnostics,
California Workers Comp,
Communication with Employees,
Drug, Alcohol & Impairment Testing,
Employment Law Issues,
Federal Workers Compensation,
Implementation and Rolling Out Your Program,
Management Commitment,
Professional Development Issues,
Return to Work and Transitional Duty,
Seminars and Courses |
While more colleges are now offering majors in risk management and insurance than there were available just ten or twenty years ago, many of the people who come in to the field of risk management and the even more specialized field of Workers Compensation Manager, do not have previous experience or backgrounds in workers compensation. It is nothing unusual in this day of tight hiring practices and double duty jobs for the new workers comp manager to also be working in another department such as finance or human resources. It becomes a learn-as-you-go-experience.
We know the new workers comp manager, even the one who has been a workers comp adjuster, often needs a guide on what to anticipate in the new role. Therefore, we have put together a list of 10 things it helps to know about the job. Here is our list of ten things the new workers compensation manager knows, but no one will tell. (WCxKit)
1. The Safety Manager is your new best friend.
The better the safety manager does the job, the easier the new WC manager’s job will be, as fewer accidents means fewer workers compensation claims to be made. Ask the safety manager what can be done to eliminate accidents and injuries.
2. Learn how to read the loss run.
The loss run provides tons of useful information on the nature and the extent of the injuries. Learn about the types of injuries that occur most often and discuss with the Safety Manager what can be done to eliminate the frequent reoccurrences. Review the loss run to see how much money is being spent on medical and how much money is paid out in indemnity benefits. Look for areas where costs can be reduced. Customize the loss run; ask friends about the most helpful stats they have on their loss run, and include those on yours.
3. Know your insurer.
The insurance company that writes the workers compensation insurance is the insurer. The term “insurance carrier” will also be used. This does not mean they carry premiums to the bank. It is an old fashion term for carrying the burden of insurance loss. (Not to be confused with “insured” which is the employer). Learn about the insurer. Are they a mammoth insurance company who writes workers compensation as one of many types of insurance, or are they a smaller regional or local company that specializes in workers compensation. What services do they offer as part of you program or at low cost. Ask them to explain ALL of their services, not just those they pre-select.
4. Know the cost of workers compensation.
Learn what is paid for workers compensation insurance each year, and if the premium is paid monthly, quarterly, or annually. Learn policy dates and which way the premium has been trending in recent years. (Declining premiums are a good sign the safety manager is doing his job well, while increasing premiums indicates a need to team with the Safety Manager to reduce the number of claims and the severity of the claims that do occur. Know how to translate this into total dollars spent on workers compenstion and use this
calculator to gain managment support.
5. Timing is everything.
The most successful workers compensation managers are the ones that learn time is of the essence in almost everything done as a work comp manager. New injury? Report it immediately to the claims office and immediately advise the medical provider's office of the transitional duty program. New disability slip? Coordinate with the injured employee's supervisor on how to accommodate the light duty work slip. New information on an older claim? Call the adjuster and share it with her so she can act on the information while it is still beneficial.
6. Sometimes it is time to babysit.
Injuries do happen. The employee needs to know the company still cares after the worker is no longer able to work. If there is a workers compensation coordinator, you can delegate to her the job of keeping in touch with all the injured workers until they are back to work doing transitional duty. The best policy is to contact the injured employee after each medical appointment to learn of any issues with their medical treatment, their return to work status and any concerns they have about their job or their work comp claim. By showing the injured employees the employer cares, it will have an overall effect of lowering cost of workers compensation.
7. Know the adjuster(s).
The adjuster is now a new best friend. A competent adjuster who does the job well will make the WC manager’s job easier. The better the working relationship with the adjuster, the fewer snags encountered on workers compensation claims. (The fewer adjusters to work with, the easier it is to learn their strong points and weak points. If the claims are not already consolidated with the minimum number of adjusters possible to cover the claims, work toward consolidating claims with the best adjusters available.
8. Know your insurance broker.
The broker is now a third new best friend. A mistake a lot of new workers comp managers make is thinking the broker works for or is an employee of the insurance company. The broker is a knowledgeable business person who works for the employer as an advisor. The broker's main job is to keep the employer (insured) happy. Discuss with the broker what benefits are provided. Hold the broker to this, and the new job will get easier. Expect more than simply an annual stewardship report. Ask the broker to be proactive and make suggestions about your workers compensation program. Many brokers provide our
workers compensation manual to their clients at no charge, so make sure you get one from your broker if available, otherwise, purchase it directly from us.
9. Know the return to work program.
The better the company's transitional duty program, also known as modified duty or light duty, the quicker and faster the workers compensation claims will come to an end. The company is going to be paying the cost of the indemnity benefits through higher workers comp premiums. To reduce the cost of those benefits, return the employee to modified duty. While the injured employee may not be as productive as an uninjured employee, all the productivity of the injured employee on light duty is benefiting the company to some extent while reducing the cost of the claim. Use the
transitional duty calculator to demonstrate cost savings.
10. Review the claim files.
If asked, most third party administrators or insurance companies will arrange online access to the claim file notes where the adjuster records the activities and events of the claim. While the file notes are helpful, they do not tell the whole story. Go to the claims office and read everything in the claim files. The claims office will probably try to talk you into doing an on-line review, but an in-person review with the adjuster(s) about the claims will provide the most information. There are also claim consultants who do claim file audits, if that is preferable. (WCxKit)
Good luck in the new role as the work comp manager. Use the ideas and consult our website often for advice on workers compensation.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
NOTE: This article appeared in Utility Products magazine, which serves the utility industry — it is reprinted with permission. It details Medcor’s work onsite at wind farm construction projects. These large utility construction projects can involve hundreds of employees working over many miles for many months. The article provides general information about onsite health care, regardless of who the provider is, but also highlights some of Medcor’s specific value. Medcor has many years of experience serving the utility and construction industries and has developed specific protocols and systems for that on-site environment.
By Kate Woldhuis
During the American Wind Energy Association’s WINDPOWER 2011 Conference and Exhibition in May, Occupational Safety and Health Administration (OSHA) announced its National Emphasis Program would target safety inspections at wind farms. Because systematic inspections of safety compliance at wind farms nationwide are probably going to begin in 2012, it has become paramount for safety managers to build on existing safety knowledge and work within the workplace to promote the development of compliance requirements by the end of 2011. Many safety managers have brought in third-party contractors to support worksite health and safety goals, so they are free to focus on maintaining compliance.
Choosing the correct onsite provider, however, can be a complex task. Parties to a wind farm project must be able to support onsite health and safety initiatives, as well as understand the law and new focus of OSHA so that these projects don’t face increased costs, litigation, fines or penalties.(WCxKit)
Onsite health care firms provide first aid care for workers, which is a beneficial service for both employers and their workers. Wind farms, in particular, face the common challenge of providing their employees with access to medical services. In emergencies, the ramifications of injuries might become magnified because of their commonly rural locations. Even in non-emergency situations, employees and employers alike enjoy the convenience of staying onsite rather than leaving work for 4-8 hours for one doctor’s appointment, leading to hundreds of hours of lost productivity over the length of the project.
Onsite services generally help employers reduce OSHA recordables and lost time, allowing companies to realize significant gains in productivity and their bottom lines. David Grogg, construction manager with Duke Energy, utilized onsite health care services at two wind farm construction projects in Wyoming. In addition to providing medical response to emergencies and core health services, he appreciated the flexibility it provided.
“Helping with safety orientations and providing a service to the team of people—a majority of whom are working miles away from town and don’t have the support structure to tend to their health needs all the time—kept the workforce in place so that they’re there and productive. That’s very valuable to us,” Grogg said.
Whether its in-house or outsourced, and if the onsite provider has the right experience and expertise, they can also support safety initiatives and monitor injury trends—freeing safety managers to focus on preventive measures, maintaining compliance, investigations and other core responsibilities. For the onsite medical team to provide immediate care to workers, the team must have the resources and experience to understand how to overcome obstacles specific to a worksite—including rugged terrain, extreme weather conditions, high-angle or confined space rescues, and hazardous materials. They must also be able to support compliance with applicable regulations and coordinate with local emergency rescue personnel. This is a specialty; the average medical facility does not have the expertise, systems and protocols in place to provide such safety and compliance support.
One health company that does specialize in onsite health services for wind farms and supports OSHA compliance and safety is Medcor Inc. Headquartered near Chicago, Medcor provides onsite health services to wind farms and other remote utility projects—including pipelines and highways, as well as “turn-arounds” and other services for power companies. The company also serves hundreds of more traditional businesses throughout the nation. Medcor has developed proprietary software systems and clinical guidelines specifically for onsite settings and supports its staff with physician medical directors, a 24/7 call center, off-road response vehicles and mobile clinics to ensure rapid deployment and effective services.
Medcor’s onsite staffs assigned to utility or construction projects have extensive experience as paramedics, registered nurses, and fire and rescue members, and have safety training up to and including OSHA 500-level certifications—so they can conduct OSHA safety training, environmental safety training (i.e., HAZWOPER) and other customized safety courses specific to their client’s environment. As such, the onsite medical staff is able to closely integrate into safety programs and practices at wind farms.
In other capacities, onsite medical staffs work closely with safety managers, conducting daily meetings to review daily safety initiatives, developing strategies for preventing injuries, etc., so that safety managers are able to focus on safety leadership. As another example, Medcor’s medical professionals walk the site each day to become familiar with the workers, their jobs and the potential hazards and work-related injuries that could occur. In addition, based on injury data and experiences in the field, these medical professionals are suited to conduct trend analyses and make safety suggestions based on their findings, which further improves the site’s safety record.
Luke Wright, operations director at Medcor, specializes in onsite health services at wind farm operations. Wright described an incident last year at a wind farm construction site involving an injury high inside a tower: “Our onsite medic worked closely with local fire and rescue to extricate the patient. In the process, our medic learned that the local fire department did not have the best equipment or techniques for that situation combining high angle and confined space. During the post-incident review, she recommended they use back boards designed for vertical extraction instead of typical horizontal boards.” Wright went on to explain other safety observations that were made throughout the course of the project, including changing the type of safety goggles being used, enforcing stricter safety belt rules and providing instruction on proper use of fall protection.
“Onsite providers offer a different type of service than the safety managers,” Grogg said. “They’re there for keeping workers out of trouble on all aspects. Medcor supplements safety and is more focused on tending to the emergency response plans and tending to health care needs. The greatest value was recognized at my last project when a person fell and Medcor took leadership in working with first responders to help provide the best care possible before they were able to get there.”(WCxKit)
Many managers like Grogg have found success in outsourcing health and safety support. Contracting third party health and safety professionals to work onsite allows safety professionals to be better positioned to meet the challenges of compliance to safety regulations, provide access to health care for employees and develop more effective safety programs. The wind energy industry is developing, and, with stricter OSHA regulations being enforced in the coming years, safety professionals will need to be free to focus on the changes.
Kate Woldhuis is a business development analyst at Medcor, Inc. She received a Bachelors’ Degree in Journalism and minored in Environmental Studies at Northern Illinois University and has written several articles regarding green energy and sustainable living for various publications. As a business development analyst, Ms. Woldhuis works with companies operating within a wide variety of industries to promote onsite health, wellness and safety initiatives, as well as strategizes onsite development opportunities to potential clients.
Medcor provides telemedicine services to nearly 90,000 worksites in all 50 states and operates 174 on-site workplace clinics. Medcor also provides safety services at construction sites, wind farms, utility and power companies, and government agencies through its subsidiary, Brown Services, LLC. For additional information contact csmith@medcor.com www.MedCor.com
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
