Workers’ Compensation Costs Can Be Reduced by Implementing Operational Best Practices: Learn How With This New Guidebook.
A company that wants to implement a new workers compensation program or revamp an existing system will find this book helpful. Maybe your company has recently expanded and you realize the need to train a workers compensation manager or regional coordinators how to hold down compensation costs. Whatever your need, here is the answer:
Workers Compensation Management Program: Reduce Workers’ Comp Costs 20%-50%.
Used by more than 150 firms across the country, this is THE book to help every employer develop a more effective workers compensation program to reduce workers compensation costs. It is based on field research and decades of experience in workers compensation from all aspects of the business. Best practices are described in detail for each person in the injury process.
This easy-to-read manual has been updated for 2012. It now includes:
An index for quick topic look-up so you can view a term or a procedure and see all relevant references.
NEW – Workers Compensation Basics
Purpose of Workers Compensation
Who Pays for Workers Compensation?
Parties Involved in Workers Compensation
Benefits for the Employer
Independent Contractors
Benefits for the Employee
Injuries Covered
Types of Workers Compensation
How Losses are Categorized
How Losses are Reported
Calculating Your Premium
How Mod Effects Your Premium
Good/Bad Mod Example
Five Ways to Reduce Your Mod
NEW – Fundamentals of Cost Containment
Reasons Workers Compensation Costs are High
Who is in Charge?
Work Ability Form Properties
Who is Responsible for Managing Workers Compensation Claims?
Who is Responsible for Managing Workers Compensation Process?
Hidden (Indirect) Costs of Workers Compensation
Additional Costs
Calculating WC Costs
External Obstacles to Cost Control
Internal Obstacles to Cost Control
NEW – Working with Your Adjusters or TPA
Account Handling Instructions
MD Participation
NEW- Reporting a Claim
Critical Issues
Essential Intake Considerations
Nurse Triage
NEW- Directing Medical Care
Occupational Health Clinics
Remote Health Services
Directing Medical Care in California
NEW- Return to Work
What to Include in a Transitional Duty Policy
Non-Profit, Volunteer or Charitable Positions
Employees Who Never Return to Work
Coordinating WC with Federal and State Leave Statutes
NEW – Other Indemnity Cost Containment Services
Telephonic Disability Intervention
NEW – Medical Cost Containment
URAC Certification
Mental Health RNs
Chronic Pain Programs
An Aging Workforce
At Home Recovery Services
Medical Fee Schedules
Fee Schedule Coding
ICD-9 and CPT Codes
NEW- Physical Therapy and Physical Rehabilitation
Differences between Physical Rehabilitation Programs
Pharmacy Benefits Management Program
Authorized Drug Formulary
Toxicology Screening
NEW – Fighting Fraud and Abuse
Medical Terminology Used to Identify Malingering
Reviewing Investigation Reports and Videos
Avoid good Day/Bad Day Syndrome
NEW – Claims Resolution and Settlements
Conditional Payment and Final Demand
Pharmacy Component of MSA
California Settlement Process
A 183-page guide covering how to assess your workers compensation program, design program materials, roll out a program to the organization, and monitor and manage the program once implemented.
Written by a national expert on workers compensation cost containment with over 25 years experience helping companies reduce their losses 20% to 50%.
T. Ronca, a workers’ compensation defense attorney from Long Island, NY, said the
book is an invaluable desk reference. “It is one of the tools that should never be out of reach for a risk manager. Direct employer involvement with claims in the first weeks is the difference between success and failure. This manual will guide the conscientious employer through the pitfalls,” Ronca said.
What’s more, the book can be delivered with your company logo on the cover and a full-color ad for your company on the back cover.
Take it out to the field. Text tabs are available to put on each chapter and it is ready to go as your company training manual. All you will have to do is customize the Training Agenda that is in Part I of the book.
Included in the manual are topics such as: Return to work and transitional duty, claim reporting, employee communications, controlling fraud and abuse, directing medical care, medical cost containment solutions, post injury response procedures, reporting procedures, working with your carrier and third party administrator. There is information about physical therapy, pharmacy benefits management programs, training supervisors and gaining management commitment. It also contains concepts of claim settlement and resolution as well as safety and loss control. New areas are identified above.
There are 5 sample worksheets in the manual to help organize an efficient workers’ compensation program. These include: timetable for implementation, the injury coordinator job description, and several sample roll-out letters. We recently received a terrific phone call from a third-party administration firm saying how the manual provided an organized way to train clients at loss prevention and has helped their clients put "layers of better WC management" in place. Everyone benefited.
One large distribution firm wrote to us to say the chapter on safety and loss control led to a company-wide safety change that only cost a few hundred dollars but prevented a specific type of injury that had been draining its budget, says Rebecca Shafer, Esq., President of Amaxx Risk Solution, Inc. who authors the book. Shafer is a national expert on workers’ compensation cost containment with more than 25 years of industry experience helping many companies reduce their losses 20-50%.
When you order your copy of Manage your Workers’ Compensation Program from Advisen at
http://corner.advisen.com/wcbooks, the 183-page guidebook shows how to assess your program, design program materials, roll-out a program to the organization, and monitor and manage the program once implemented.
The workbook is also available with a customized front and back cover for bulk purchases. Discounted rates apply to bulk orders.
One company said, "After reading the manual, we took a look at past workers comp practices and saw that every department did things differently. Manage Your Workers’' Compensation Program 2012 gave us the guidance we needed to standardize our workers’ compensation programs across the country. It was like a pre-prepared lesson plan," according to the risk manager.
A regional hospital in North Dakota wrote that, "Our small company expanded rapidly and we actually didn’t have any official workers’ compensation program in place. This manual gave us step-by-step procedures from the first meetings with management to monitoring the final program. Buying and reading the book was almost like hiring another employee – one who was an expert in workers’ compensation."
Who Uses the Workers’ Compensation Book?
Risk Managers and Workers’ Comp Managers find it useful learning about the cost containment niche and use it for themselves and to bringing new team members up to speed very quickly. The book becomes a “lesson plan” tool.
Safety Directors use the book to train supervisors in workers’ compensation claims management. They learn more about their area of responsibility — post loss cost containment — adding to their overall knowledge. They also learn what to do after an injury and what steps are supposed to take place during the first 24 hours.
Brokers use it for prospects, as well as, to learn about specific aspects of cost containment, passing their knowledge on to their clients. For example, when discussing how to develop a return-to-work program and a client asks about, “off-site return-to-work programs,” the broker quickly finds the relevant section in the book, reviews it and passes the answer on to the client, along with a copy of the cost containment book with the broker’s logo.
Adjusters use the book to gain a better understanding of the employer’s perspective. Adjusters also want to learn more about cost containment to add to their overall workers’ compensation knowledge in order to grow their careers and stay abreast of new services.
Account Producers give the book to prospects during formal presentations to illustrate their company is on top of the workers’ compensation industry. The book makes an excellent client gift.
Vendors such as doctors, physical therapy networks, occupational clinics and medical management firms learn how their service might fit into the workers’ compensation marketplace, what is important to employers, and what they look for in medical services to enable the vendors to enter the workers’ compensation marketplace.
The manual is a cost-cutting tool to learn more about systematic and operational techniques for reducing workers compensation costs.
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 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, Workers Compensation Management Program: Reduce Costs 20% to 50%. 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.
©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.
Posted in
Claim Audits & File Review,
Communication with Employees,
Coordinating Medical Care,
Federal Workers Compensation,
Fraud and Abuse,
Insurance Issues, Rates, Premiums,
Lowering Premiums & Experience Mod,
Management Commitment,
Medical Cost Containment & Managed Care,
Medicare Set Asides (MSAs),
Professional Development Issues,
Return to Work and Transitional Duty,
Risk Management,
Safety and Loss Control,
Settling WC Claims,
TPA and Claims Administration,
WC 101,
WC in Other Countries (International) |
The Saskatchewan WCB recently announced its plan for a modest reduction in the average employer premium for 2012.
The 2012 average premium will be $1.60 per hundred dollars of payroll, down one cent from 2011. According to the Board, stable claim costs and injury frequencies contributed to the WCB’s decision. The proposed 2012 premium is the lowest average premium rate in a decade, and nearly 22 per cent lower than the 10-year high of $2.05 in 2004. (WCxKit)
Premiums for 28,071 employers stay the same or are lower. The average decrease is 5.3 per cent; the range is 1.0 to 21 percent. According to the WCB, 14,115 employers pay higher premium rates next year, as a result of their claims experience. The average increase is 5.1 percent; the range is 1.0 to 17.8 percent.
It is expected Saskatchewan will have the fourth lowest average employer premium in Canada for 2012.
Peter Federko, the WCB’s chief executive officer, said that recent investment market volatility did not impact the decision on rates. A new funding policy directs that only realized gains and losses – that is, gains and losses from the sale of investments – are used to determine the WCB’s funded position.
According to Federko, “As required, the WCB has adopted the new international financial reporting standards. The new policy recognizes this financial statement reporting requirement and brings more stability to our calculations, and that includes calculating our employer premium rates.”
The province has seen an almost 40 percent drop in the workplace injury rate since 2002. (WCxKit)
Officials credit business owners and Saskatchewan’s working men and women for the huge shift towards safer workplaces, adding that, “workplace safety is the surest way for an employer to bring down WCB costs. It’s a management practice with paybacks for everyone: employers, workers, families and neighborhoods all benefit when we go home safely from work.”
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
The average active measures used by an employer on a New York comp claim consist of filling out the three most common forms (C-2, C-11 and C-240) and little else, unless they are called to testify.
Employers are rarely asked to do more. But doing more lowers costs, reduces litigation, prevents fraudulent claims and gets the proper benefits faster to the honest workers. (WCxKit)
There are many things an employer can do, but the five most basic are:
1. Have a plan for dealing with the worker, starting as soon as a report of injury is received
2. Know how to fully complete the first report (C-2) and know what additional document should be attached to the C-2 and forwarded to all parties.
3. Have a plan for a return to work (RTW) meeting with an employee out of work due to a work related (or allegedly work related) injury.
4. Have a plan for communicating with the law firm that will be handling the comp hearings for the carrier.
5. Know how to detect and make inquiries about possibly fraudulent activity on the work comp claims.
There are many other things that an employer can do, but the above are indispensably important.
A full description of how the above five can be carried out will vary from employer to employer but the basic measures will serve the following purposes:
1. Dealing with the worker.
Many claims that are filed are due to improper understanding of comp by the employee, or poor leadership by the employer. A surprising number of potential claims are never pursued with proper employer handling. This is called the post injury process, by cost containment experts such as Rebecca Shafer, and should be a tightly controlled process of each step that takes place after an injury. Of course, the process must be in place before the injury occurs, so planning ahead is critical.
2. Completing and documenting the first report (C-2).
A C-2 form must be filed for all reports of an injury involving more than first aid. However, much more information is usually required for proper handling. That can only be put into the WCB’s, or the carrier’s, file if additional documents are attached. The C-2 form simply does not have enough space to properly report for all claims. Never leave spaces blank because that gives the other side an opportunity to provide such information, and that might not be good for the employer.
3. A return to work (RTW) meeting.
In the past, return to work discussions rarely occurred until after a major claim was settled and closed. That, however, is far too late to achieve positive results. A return to work meeting should be held with the worker no later than 6-9 months after the date of accident and ALWAYS before the carrier makes a settlement offer for a serious claim.
4. Communicating with the carrier selected law firm.
If there are hearings, and most claims have hearings, the employer will be represented by a law firm selected by the carrier. In NY, the law firm represents the employer, not the carrier, but that is frequently forgotten and the employer then loses most of its opportunities to engage in a useful way.
The employer should always know who is representing their company and should communicate frequently.
5. Being active in reporting and suppressing fraud.
Most information necessary to defeat a pattern of fraud will come from the employer’s files. Employers frequently suspect fraud, but few are trained in how to detect it and defeat it. Anti-fraud measures require a certain amount of special training to be effective. (WCxKit)
An employer who incorporates the above into its workers comp plan will see a dramatic decrease in comp costs. The measures do not cost much and do not require much effort, with proper training.
Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100. medsearch7@optonline.net
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.
Oklahoma Insurance Commissioner John Doak, recently reported the company, which manages the nation’s largest database of workers compensation insurance information, has filed a request with the Oklahoma Insurance Department to decrease the cost of workers comp insurance in Oklahoma.
According to Doak, the National Council on Compensation Insurance Inc. (NCCI) filed to reduce workers compensation insurance rates in Oklahoma by 1.7 percent starting Jan. 1, 2012. The Commissioner said NCCI attributed the rate drop to this year’s passage of Oklahoma Senate Bill 878. Before the passage of SB 878, rates were expected to increase again. (WCxKit)
Reforming Oklahoma workers comp law was high on Governor Mary Fallin’s agenda, and SB 878 received overwhelming support from both parties in the Legislature.
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.
For the employee or the employer unfamiliar with workers compensation terminology, the terms medical management and utilization review sound similar. An employee should be accustomed to workers compensation terminology in case of injury and to understand the medical treatment process. The differences between medical management and utilization review should be understood by the employee and the employer alike. While both medical management and utilization review involve the use of a nurse, the two areas are quite different.
Medical management is the coordinating and planning of medical care provided to expedite the employee's return to work or to help the employee maximize medical improvement. Medical management is normally the responsibility of the nurse case manager (NCM). (WCxKit)
Utilization review is the evaluation of medical care being provided to the employee to determine the medical necessity and appropriateness of medical treatment being provided for an injury. The utilization review is conducted by a registered nurse (RN) who has a utilization review physician available for a medical opinion should the nurse be unsure of medical treatment.
8 Responsibilities of the NCM Involved in the Workers Compensation Claim
1. Facilitating the medical rehabilitation of the injured employee.
2. Coordinating the medical care between different providers to achieve the best possible results in a cost-effective manner.
3. Consultation with the medical provider to determine the best treatment plan for the injured employee.
4. Act as a liaison and facilitating the communication between employer, employee, and insurance adjuster.
5. Monitoring the employee’s medical progress.
6. Assisting the employer in identifying the return to work options.
7. Coordinating the employee's return to work, whether full or modified duty, with the employer, the employee, and the medical provider.
8. Insure utilization review is brought in on all medical care and/or medical services when appropriate
Note: not all NCM is alike – look for providers who use licensed RNs and are URAC Certified. Determine how much clinical experience the NCM's have — good ones have 3 years minimum clinical experience and 15 years average clinical experience. Senior Nurse Reviewers (SNR) are a higher level of NCM that provides medical oversight on the file the whole way through. The SNR sees the Triage File, Treater File, 3-point contact, and Duration Guidelines.
4 Types of Utilization Reviews Used by the Nurse Involved in the Workers Compensation Claim
1. Pre-certification reviews occur prior to the medical care being provided. The RN collects all the necessary information including the symptoms, diagnosis, results of tests, and the reasons the physician is requesting the medical service. The RN compares the information against the normal criteria for treating a specific type of injury. If the medical care is deemed necessary, it is approved. If the medical service is not necessary, the utilization review physician is asked to verify the denial of the service requested is correct. Nurses use medical guidelines such as MDGuideines which tell the appropriate length of time out of work or disability for any given injury, co-morbidity and even zipcode. Good TPAs have these guidelines at their fingertips.
2. Concurrent reviews occur during the time medical treatment or service is being provided. This can be either for a patient in the hospital or for on-going outpatient care. The RN follows the same approach with the concurrent review as followed in the pre-certification review.
3. Retrospective reviews occur after the medical service has been provided for either an in-patient or out-patient service. The RN again follows the same criteria as with a pre-certification review.
4. Re-reviews occur when the pre-certification review, concurrent review, or retrospective review result in medical care or medical payments being denied. When a re-review is requested, the utilization review physician will go over all the information to determine if the prior decision was or was not correct. (WCxKit)
Utilization Review provides an objective opinion as well as a client liaison, to ensure the right treatment is received at the right time based on evidence-based medicine. The review considers medical necessity and sometimes causal relationship to the injury, not cost.
It is in the employers and the insurers best interest to provide both medical management and utilization review on any indemnity claim or enhanced medical only claim. By combining medical management with utilization review, the employee receives the best medical care at the optimum cost. This has a positive impact on the employer's future workers compensation premiums and builds employee loyalty as the employee feels he or she is given the best possible medical care, a win-win situation for all. It can be very effective to use Nurse Triage at the time of injury, Senior Nurse Reviewer throughout the life of the claim and Utilization Review
Note: All utilization review and medical management providers should be URAC Certified. This rigorous credentialing process has separate categories of for Utilization Review and Nurse Case Management. Your providers should be certified in both areas if they are providing both services. ASK THEM.
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.
The Ohio Bureau of Workers Compensation has proposed an economic development initiative that could discount a new Ohio employer’s premium by as much as 51 percent. If approved by the BWC Board of Directors, Grow Ohio would offer eligible employers a 25 percent discount on their workers compensation premiums for two years. Or they give them immediate access to participation in the Group Experience Rating Program.
“Employers have many factors to consider when choosing a location, and the costs of conducting business, including workers compensation, are high on that list,” said BWC Administrator/CEO Stephen Buehrer. “By lowering the initial premium of new businesses, Grow Ohio is freeing up more money for those companies to invest in job growth and help restore prosperity to Ohio.” (WCxKit)
Under Grow Ohio, new employers will receive the 25 percent discount on their workers comp premiums, unless they elect to participate in another program incompatible with the Grow Ohio discount. The discount will be applied for the effective new employer’s coverage date and the four subsequent six-month payroll periods.
If new employers prefer, they may instead elect to immediately participate in the Group Experience Rating Program. This program normally is inaccessible to new employers until they have had workers comp coverage for a full year. Employers have 30 days to pursue the Group Rating option, or the 25 percent Grow Ohio discount will be automatically applied.
Participation in group rating could reduce their premiums up to the maximum allowable amount, Currently that amount is 51 percent for the July 1, 2011 policy year. (WCxKit)
If approved by the board on Sept. 29, the incentives will apply to new Ohio business entities or out-of-state businesses and report payroll in Ohio on or after July 1, 2011. Those incentives will be reflected on bills employers pay beginning in February 2012.
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.
Work Comp Roundup attends the National Workers Compensation and Disability Conference® & Expo (NWCDC) at least every other year.
As seasoned conference goers, we offer some hints and tips on how to make the most out of our experience.
You might wonder why those already established in the industry attend still attend conferences…
The reason is that the workers compensation industry is always evolving – new players, new laws, and new equipment. We recommend everyone who is new to our field attend industry conferences often. This time of year, it's the National Workers Compensation and Disability Conference® in Las Vegas in November to learn what is new.
At Roundup, we always learn new techniques, meet new vendors, and discover the latest service enhancements. In fact, when I began, I learned this field from the ground up — NWCDC was a part of that education! 20 years ago, in Chicago — my, how time flies.
A conference of this scale can help you expand your knowledge and gain new solutions directly related to:
1.Workers compensation,
2.Disability management,
3.Return-to-work programs,
4.Better Claims Management,
5. Health/Medical Management,
6. Solving Legal/Regulatory Issues, and
7. Strategic Views
The National Workers Compensation and Disability Conference® & Expo Nov. 9-11 in Las Vegas is the nation's leading event for dedicated to the workers' comp and disability management industries. Hundreds of our colleagues gather each year to expand their knowledge and gain new solutions directly related to their workers' comp, disability, and return-to-work programs.
Celebrating its 20th anniversary, the conference offers more than 30 breakout sessions organized by type and level. Plus, there will be an in-depth pre-conference symposium, “Awesome New Technologies: What You Need to Know to Drive Improvement.” The Expo portion of the conference hosts more than 260 exhibitors providing an additional venue to gather knowledge to take home plus numerous opportunities to network and glean insights from top experts on how to solve your problems in claims management, strategic program planning, health/medical management, plus legal and regulatory issues.
As a seasoned conference goer and industry leader, here are ideas about how to get the most out of this large national conference:
Eleven Ways to Get the Most Out of the National Conference:
1. Attend the Opening Session. This is a large session for all attendees where awards are given to the best companies in the industry. Don't miss this because the award recipients will describe their programs, what works, what doesn't, how they overcame challenges specific to their industry and company, and likely the same obstacles YOU are also encountering. You will hear many ways to reduce costs, and you will take many notes.
2. Focus on your specific goals, for example, attend sessions about return to work programs or allocation systems, if you need to learn more about how to implement these cost containment techniques. I use my Program Planner like a lesson plan, circling the first and second choices.
3. Read the brochures you collect when you return home; use them as your own private educational program to LEARN what is available. How could you possibly request an off-site vendor be added to your list of service providers if you do not that such as service exists? You can't! How could you ask for nurse triage if you do not know the service exists? You can't.
4. Pass your business card out and do not be afraid to network – that is part of this business. Meeting knowledgeable people gives you a resource when you encounter a problem. Sitting at the round tables encourages discussion. Don't be afraid to tell people at your table you are new. They may be too, and if they are experienced, they'll be happy to help you. We've all been new at some point in our career.
5. Learn what you don’t know you don’t know. We often find employers who have misidentified the cause of their high work comp costs. They think it is nurse case management or bill review that is driving costs, when it is really poor management and operational practices. Being exposed to new ideas presents an opportunity to learn things you don’t even know you are missing!
6. Chat with people who do the same things that you do and see where you differ. One thing I like about the conference is that some of the most popular sessions are repeated at different times, and if I begin a session that does not interest me, or isn't applicable (which doesn't happen often), it is not a problem to quietly sit in another session down the hall. CAVEAT: Be courteous if you think you might do this as it's not fair to distract the speakers or other participants by being noisy or disruptive, so take care to come and go quietly, and sit in the back of the room near the door. Many sessions are very close in proximity to each other — in the same large hallway – which makes entering another session easy.
7. Learn Key Cost Drivers. Find people who work in workers compensation departments you know next to nothing about and ask them whether they are satisfied with their workers comp vendors. Ask them what drives their costs. We speak daily with companies unhappy with their TPA or insurance carrier, but are only guessing about what is driving their costs. If you are even thinking of changing carriers or TPAs, I suggest you attend the sessions at the conference to make sure you are on the right track.
8. Roam through the exhibit hall speaking to vendors and learning about the types of services that are available to reduce workers comp costs. THIS will be the best education you will ever get!
9. Wear comfortable attire. Bring comfortable shoes. I call my black flats my "conference shoes." You will be on your feet a lot, so be comfortable. The first day, people are a bit more dressed up than the following days. The last day is more casual because people are traveling back home. You will definitely want to dress professionally because some of the people you meet with become lifelong contacts, so making a good impression is important, but you can be comfortable, too. For an ounce of prevention, bring moleskin to protect the areas of your feet most likely to get blisters.
TIP: Visit the Exhibit Hall and the Educational Sessions. Attend both. Try to visit every single vendor in the exhibit hall. Start on the right, and move systematically through the rows.
TIP: Start early, leave late, and remember … although your feet may hurt, this is only once a year!
TIP: Before the Exhibit Hall opens, have breakfast in the Continental Breakfast Hall to network with new friends. You will find people are very friendly and helpful. I love the 8-round tables which make it so easy to introduce yourself to those at your table.
HINT: Bring band-aids – you will do a lot of walking, and you may get a blister or two, so come prepared.
10. It is affordable. If the CEO or business owner does not want to spend the money for you to attend the conference, show them the TRUE cost of your workers’ compensation losses with the Sales To Pay For Accidents Calculator to gain management commitment here: http://www.reduceyourworkerscomp.com/calculator.php.
For example, if you have just one $40,000 loss, it will take your company $666,666.00 in new sales to replace the $40,000 lost on that single claim. Learning how to reduce your costs is a wise business investment. It also makes you more valuable in the marketplace.
Yes, it is in Las Vegas, and if your CEO bemoans the fact that the conference is in a city more known for partying than workers’ compensation, let him or her know that Las Vegas is one of the most affordable travel destinations, which is undoubtedly one of the reasons the conference organizer chose that destination this year.
11. Keep your conference guide for future reference. You may want to have this handy on your desk for the time you want to try a new service or ask a question about a new service. Or, if you are putting out a Request For Proposal, this will be your ultimate list of those companies to bid on your project.
See you there!
Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation, and has attended the National Workers Compensation and Disability Conference® many times. 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.
There are many adages out there about circumstances just not adding up. Two of my favorites are “Don’t judge a book by its cover,” and “Things aren’t always what they seem.”
This can be especially important when it comes to
new hires for your company. The greatest, most amicable person can walk through your doors and they could be the perfect worker in your mind. They could be experienced, charismatic, professional, and give you the best interview you have ever conducted.(WCxKit)
However, there can be issues lurking underneath that can expose your company to workers compensation costs.
What your new hire may not have told you:
1. They have had four knee surgeries.
2. They have been out of work watching TV for six months — or six years for that matter.
3. They are just lackluster work performers bouncing from one job to the next.
4. They lack the personality to deal with customers.
6 Ways Pre-employment Physicals and Background Checks Protect your Company:
1. Have all applicants complete a pre-employment physical before they can be accepted as new hire.
This should be standard for any position. Whether it is a sedentary desk job, or a job out on the production floor, having a physician do a physical exam on your candidate can save you a lot of aggravation down the road. This potential new hire may carry a lot of baggage medically that could become your responsibility after their first day of work. Physicians can spot surgical scars or other objective findings on exam that this person may not have indicated to you during their interview. Often it is thought that only workers performing heavy tasks should be considered for physicals. However, sedentary jobs can lead to back pain, neck pain, and repetitive injuries that may have been prevented if a physician noticed it during a physical exam before they were accepted as a new hire within your workforce.
With the current economy, a significant number of people have been
out of work for a very long time. This leads to general de-conditioning, and since they are a new hire they want to work as hard as possible to gain your trust and acceptance. Oftentimes these people out of work that start work again are the first to be injured, since they are physically unable to perform the job at the pace required without injuring themselves. Monitor your loss runs, and if new hires are accountable for the majority of your injuries, then you have identified a problem that needs immediate correcting. It can be corrected by modifying your new hire screening by implementing a physical exam before they are hired and start work
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2. Have a detailed job description for your physician to review while performing the physical.
Just saying a worker will spend 90 percent of their time at a desk and 10 percent of their time walking to the printer and back is not a fantastic job description. Consider what goes in to a particular job day after day:
1. Talking on the phone.
2. Staring at a computer screen.
3. Reaching for things in a file cabinet.
4. Bending and squatting.
5. Reaching overhead.
6. Frequently lifting 40 pounds or more.
Whatever it may be the more detailed you are in your job description the better the doctor can assess your candidate and decide if they can physically do this job on a long-term basis in a safe manner. In the end, nobody knows the jobs within a workplace better than the employer. Additionally, the more detailed and elaborate you are in your job description, the safer your workforce will be because you will be hiring qualified, fit workers that can safely perform their job day after day.
3. Make passing a drug screen mandatory for all new hires.
This should go without saying. With prescription drug use on the rise, even though your potential hire looks on the outside to be healthy and responsible, there could be a lot internally that is physically wrong with them. For example, in one claim a worker sustained a back strain. During the interview, he said he did not go to the doctor right away because he had just taken muscle relaxers. Now, how did he get those? Were they his prescription? Does he take them every day? Does he have a prior comp claim that is active with another employer? Does his doctor refill the prescription without actually doing an exam? If this new hire already has some type of injury before even starting at your jobsite, how can you safely protect yourself and your fellow employees from being injured by someone under the influence of narcotics legally or illegally?
4. Ask for professional references and call them.
Most job applicants bring a reference sheet with them to the interview. Often these are professional references, but at times, a neighbor or relative could be used. Not that a relative could not be used as a potential reference, but they are not always unbiased? Calling all references should be standard practice in all HR departments. Again, not only to protect the company from making a bad hire, but, since this person will be working in and around all your other employees, you should not put them at risk by hiring an employee who past employers labeled as lazy, unsafe, or unreliable.
Make sure the references consist of previous employers – where the employees no longer work. Calling a current employer can be deceptive since they may give a good reference to get rid of a bad employee.
5. Have a private investigation firm run a background check on your applicant
Most PI firms have access to an insurance claims database, civil court records, police records, etc. This is especially important if you have workers driving your vehicles. Past traffic violations, DUIs, and other vehicle violations can be very detrimental to your company. By hiring such a person and putting them on the road in your company vehicle, that person is representing you and your company. The risk involved in vehicular accident claims is huge. You should only have workers with the greatest of safety records on the road representing your company. Equal attention should be given to potential new hires with extensive workers compensation histories, including litigation. This shows that they know the comp system, and are not afraid to retain counsel and litigate a claim if need be. Litigation increases your claims expense, and often a settlement will include their resignation from your company anyway, so before they start work for you, make sure they are not a “career claimant” bouncing from job to job looking for a settlement.
Beware: This is not foolproof: In one situation, a women in Charles Manson’s group did not show up on a criminal background check because the arrest was more than 25 years ago. She had turned state’s evidence and thus had not ever been “convicted” of the crime. The job she was applying for: childcare provider. Yes, this is true. Fortunately, someone in her neighborhood let the company know about her past track record. Hardly the type of person suitable for childcare.
6. Personality Profiling
Consider personality screening. Not every employee is suitable for every job. Customer service jobs require a pleasant, patient personality, and not everyone fits that mold. Personality profiling evaluates whether the moral compass is pointing the right direction. They check for traits such as entitlement mentality, theft, deception, cheating, dishonestly, drugs, hostility, and propensity to violence. In some situations the lost time rate dropped dramatically when using this type of testing. (WCxKit)
In conclusion, hiring new employees involves bringing a certain risk to your company. By being attentive and properly screening your new hires before they start work at your company, saves time and headache down the road by keeping the bad employees out, and only having a reliable, safe, productive workforce that is capable of doing their day-to-day jobs in the safest manner possible.
CHECK WITH LEGAL COUNSEL BEFORE IMPLEMENTING ANY TYPE OF EMPLOYEE SCREENING. STATE LAWS MAY LIMIT OR PROHIBIT THE TYPE OF TESTING THAT CAN BE DONE IN YOUR JURISDICTION.
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.
Our WC Book: http://corner.advisen.com/partners_wctoolkit_book.html
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@WorkersCompKit.com.
Workers Comp: Ripe For Cost-Cutting – Two Places To Check
Despite devotion to corporate cost cutting, there is one expense that still gets very little attention: workers compensation.
And the cost is very high.
According to the 2010 RIMS Benchmark Survey, the average Cost Per Full-time Equivalent Employee for all industries combined is $701 Cost Per FTE for workers compensation. The Cost Per Employee is normally lower for companies with greater than 1 Billion in revenue and higher for companies with less than 1Billion in revenue. The 2010 RIMS Benchmark Survey contains tons of useful information. It's definitely an excellent resource — either online or in print and companies that contribute their data get a huge discount, so that's something to consider. The 2011 RIMS Benchmark Survey should be published soon. I get the print version, and keep it handy, on my desk, from the past 8 years.
Both the 2009 and 2010 RIMS Benchmark Surveys contain workers compensation best practices, indicating which best practices employers have implemented. This is excellent information to compare your company's performance and build management committment for programs such as transtitional duty, employee communication, cost allocation, post injury response procedures and many more operational best practices. It's well worth spending some time reviewing this information to see what your company can do better. For example, the RTW Ratio is closely tied to the mod and how much a company pays for their workers compensation, a fact that we have been waiting years to learn.
Many signs point to larger workers compensation tabs in the future. A good cost reduction goal for companies is half national average or half industry average.
As with other outlays, employers can trim with some thought and effort.
Costs need not be this high. Insurers, unions, workers, lawyers and doctors are all contributing to the current waste and the employers who finance workers compensation must bear much of the fault, too.
Why is this?
Employers are unwittingly encouraging employees to remain on workers compensation much longer than necessary.
When executives at a large publishing company were pondering their burgeoning workers compensation costs last year for example, they found a fairly convincing explanation.
Their employees who were getting such compensation were effectively receiving 10% of their salaries.
This company is not alone.
Here are some of the main reasons why workers compensation is often needlessly expensive:
Double Dipping
Like many other employers, a national construction company had a group disability insurance policy. Thus, one employee was receiving workers compensation following back surgery and, after 26 weeks, began receiving disability payments too.
Combined with some personal insurance policies, this double income meant the worker’s at-home pay exceeded his at-work pay. Naturally, in 1993, when the company offered him a job with light duties but at his full salary during his recuperation, he turned it down
The lesson: Eliminate double dipping. While workers personal insurance is their own, employers should deduct workers compensation from other duplicative company payments. To do otherwise encourages malingering.
Idle Income
In Massachusetts and a few other states, employees on workers compensation can qualify for unemployment benefits under certain circumstances.(WCxKit)
To prevent this outrageous form of double dipping, companies should offer all injured workers transitional jobs they can perform even with their physical restrictions. Under the eligibility rules, workers who refuse such offers will not be deemed unemployed.
Double Dipping and Idle Income are two ways your out-of-work employees may be milking the system. Find out more #WorkersComp.
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.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
When you review your broker's or insurer's website, there is one subject in workers compensation that most brokers and insurers never mention – leakage.
Leakage in an insurance claim is any payment that is more than the payment should be. Leakage is defined as the difference between what the claims office spent and what they should have spent. Leakage is also been defined as lost opportunities to save money.
As workers compensation premiums are directly tied to the frequency and severity of employers' claims, you will never hear the workers comp insurer say, “We did a poor job controlling the cost of your claims.” Their leakage becomes the employer's expense through higher insurance premiums. (WcxKit)
5 main causes of workers compensation claims office leakage:
1. Inadequate claims handling.
2. Judgmental mistakes.
3. Poor claim processes.
4. Over payments.
5. Bad customer service.
While leakage can be caused from any one of these areas, it is often a combination of them that results in leakage.
There are about as many forms of leakage in workers compensation as there are workers comp subjects to be discussed.
10 examples of leakage in workers compensation:
1. Payment of medical bills without adjustment to the fee schedule.
2. The failure to properly investigate compensability and payment of claims that are not covered.
3. The failure to pursue subrogation.
4. The failure to utilize the early return-to-work program of the employer.
5. The failure to properly manage utilization review opportunities.
6. The failure to control the selection of the medical provider in those states where the employer controls the medical provider selection.
7. The selection of inadequate defense counsel.
8. The failure to pay medical benefits or indemnity benefits timely resulting in fines and/or penalties.
9. The lack of automation and/or technology in the process where it could be utilized.
10. The additional management and administration time due to any mistake in the claims handling.
The list could go on and on. Any failure to control the insurance claim can result in leakage.
Some consultants and
insurance brokers who attempt to identify leakage by the use of computer outcome modeling or algorithms. These provide a detailed report reflecting payment areas in which the employer's claim cost exceed the average for their industry or the employer's prior lost history. When the employer has thousands of claims, automated methods can identify some possible areas where there is leakage, but will miss many others. When the employer does not have thousands of claims, the cost averages can be influenced by a few outlier claims making the identification of leakage by computer averages less reliable.
An example of how computers and algorithms fail to identify leakage: A computer average for indemnity paid will not show the failure to contest small claims that should been investigated and denied. Because it is easier for the adjusters to pay numerous small claims rather than contesting them, the behavior looks like superior performance on a computer average, though, in fact, every small claim that was paid but should not have been, is leakage.
A better way to control leakage is the utilization of these 6 time-proven methods:
1. Having an established set of best practices for workers compensation claims.
2. Proper education and training of the workers comp adjuster including state statutes, customer service, and claims-handling practices.
3. Excellent education and training of all support staff.
4. Linking salaries and pay raises to compliance with best practices.
5. Having an established work-flow process. WcxKit
6. Incorporating automation and technology into the claims process.
An integrated approach incorporating all of the methods will eliminate most leakage. WcxKit
If you feel like there is leakage in handling your workers compensation claims, there probably is. Identification of various forms of leakage on your claims can be done through a claims audit. An experienced quality assurance auditor will be able to point out where leakage has already occurred
and identify situations where mistakes have already been made, but can be corrected before additional money is paid. If you would like to discuss a leakage audit of your insurance claims, please contact us.
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@WorkersCompKit.com.
