Alcohol and Workers Compensation

Alcohol abuse in the workplace has long been a contention for denial of workers compensation benefits.  However, while most jurisdictions have either legislated or set precedence for these declinations, it is still the employer’s burden to prove the injury was solely caused by alcohol intoxication.  In addition,the employer must have a low to zero tolerance in their job site alcohol policies, and the employer must furnish proof for enforcement of the alcohol program.

 

Unlike other substance abuse items, alcohol puts one toxic component (ethanol), in the body.  This tends to limit damage for underlying pathologies.  Still, over time alcohol can have pronounced effects on health, life style, and job performance.  Slowness of comprehension and speech, malnutrition, poor job performance, loss of personal hygiene and appearance are to be observed.  Frequent confrontations with fellow and supervisory personnel are often a sign that the employee’s behavior is not normal.  There may be physical deterioration such as weight loss, slower physical responses and judgment issues.   The most commonly known damage occurs in the liver.

 

 

Policy

 

Set guidelines that are legal, clear, comprehensive and enforceable.  Obtain professional assistance in developing the plan.  Include methods of dealing with enforcements, punishments, and confrontation.  It is also a wise idea to have a rehabilitation program as an alternative to termination. A good employee is worth salvaging. Be sure every employee is made aware of the program and obtain their written confirmations.

 

 

Front Line Notice

 

It must be noted that many persons with alcohol abuse issues may easily subdue the outward signs of alcoholism.  This makes it difficult for the employer to realize a problem exists.  It behooves the immediate supervisor in close contact with the employee to observe and document any changes in the employee’s behavior, attitude, or other outward appearances noted above.

 

One sign that the employee may be drinking on the job is a change in personality after arriving on the job.  Dullness to euphoria or vice-versa is often a sure sign. Frequent visits to the restroom or locker room with changes of personality after return are another sign.  Containers with alcohol can be easily hidden under clothing.  Thermos or other liquid holding containers may even be in plain sight.

 

 

Approach

 

Great care needs to be taken in confronting the employee for an alcohol situation.  Any case controverted by the employer needs proper preparation for defense.

 

Begin by careful and complete documenting of events, situations and observances by supervisory persons.  Make note of fellow employee complaints (these should come from the employee and not solicited by the supervisor).  However, once the offending employee is challenged it may be necessary to obtain statements form these employees to act as witnesses.

 

Obtaining a medical physical examination must be considered.  The doctor will also serve as an expert witness to confirm the alcohol problem.

 

Be certain that the confrontations and claim denials are done in accordance with the alcohol policy.

 

 

Rehabilitation

 

When the employee is valued enough to merit retention, supply a rehabilitation effort to correct the alcoholic abuses.  Such programs could be relatively inexpensive and done in accordance with local government sponsored rehabilitation programs for substance abuses.  Monitoring the progress is often all that the employer need do.

 

Work with the employee to re-establish a working relationship with fellow employees.  This will also show the fellow employees that the employer has employee best interests at heart.

 

 

Summary

 

Injuries on the job caused by the employee’s alcohol abuse can be successfully defended for declination of benefits.  However, the employer has a heavy burden of proof to have a successful ruling by a workers compensation judge or referee.  Policies for alcohol abuse must be properly established and enforced.  Strong investigation and evidence gathering is mandatory for a successful denial of benefits and medical care.

 

If the employee is valued, vocational and/or medical rehabilitation  might be a contingent for allowing a compensation claim to be absolved.

 

 

 

Author Michael Stack, Principal of Amaxx Risk Solutions, Inc. He is an expert in employer communication systems and helps employers reduce their workers comp costs by 20% to 50%. He resides in the Boston area and works as a Qualified Loss Management Program provider working with high experience modification factor companies in the Massachusetts State Risk Pool.  As the senior editor of Amaxx’s publishing division, Michael is on the cutting edge of innovation and thought leadership in workers compensation cost containment. http://reduceyourworkerscomp.com/about/.  Contact: mstack@reduceyourworkerscomp.com.

 

©2015 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

SALES TO PAY FOR ACCIDENTS CALCULATOR:  http://reduceyourworkerscomp.com/sales-to-pay-for-accidents-calculator/

MODIFIED DUTY CALCULATOR:   http://reduceyourworkerscomp.com/transitional-duty-cost-calculators/

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

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

 

Injured Worker’s Personal Problems Lead To Dangerous Workers Comp Claims

There are classes of comp claims that start as ordinary reports of injury but quickly turn into claims nightmares. Among these is the younger worker claim in which an otherwise healthy person develops an inexplicably complicated claim. An explanation that needs to be considered is “trouble at home leads to trouble at work”.

 

Younger workers often have not yet gained the life experience to deal with routine problems, especially if they are on their own for the first time. A marriage, rather than being a stabilizing factor, often produces confusion. Your correspondent learned early in his career as a comp lawyer that comp claims are often seen as a good way to get rid of a bad marriage. And not just for younger workers. Mid-life claims often have a similar motivation.

 

 

An Employees Private Life Can Be As Much Of A Problem  As The Injury

 

Anyone can make a situation worse than it is; improvements take skill, especially with claims. The comp investigation process, governed by the carrier, not the employer, is too remote and impersonal to provide the hands-on approach required where an employee’s private life is as much a problem as the injury. This is where sensitive involvement by an employer can prevent a person from using a claim to derail not only a job but a private life.

 

The employer needn’t intrude – or wait until it earns a degree in counseling. Chatting goes a long way. If there are serious personal problems present they will quickly manifest themselves – no matter what the topic of conversation. Your correspondent, as a lawyer handling workers’ claims, learned the value of seemingly idle conversation with clients. Eventually, the true sources of frustration would surface and the relationship would quickly improve.

 

 

Communication Is A Powerful Tool & Neglected Art

 

Conversation is a powerful tool and is a neglected art. Scowling interrogation produces results – but not the kind you want. Communication skills look effortless but are acquired through a lot of practice. Is it worth the effort? Well, what better way to avoid a $100,000+ claim? Litigation is no substitute.

 

 

 

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

 

©2015 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

SALES TO PAY FOR ACCIDENTS CALCULATOR:  http://reduceyourworkerscomp.com/sales-to-pay-for-accidents-calculator/

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WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

 

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

A Workers Comp Claim’s Iceberg Effect

Workers in the claims profession and also on the employer side will often only think of claims as costs of wage loss and medical exposure.  It is true that those costs are the ones on the surface.  The injured worker has created a monetary exposure of their loss of wages covered by work comp payments, and also their medical expenses.

 

But we like to remind employers of the hidden costs.  To create the picture of hidden exposures we like to use an iceberg floating in the ocean.  On the surface, you see the iceberg.  But hidden underwater, the extent of the iceberg can stretch to great depths.  It is the hidden hazards that can create as much havoc as the iceberg you see above the water surface.  You need to think of the costs and expenses that you can and cannot see.

 

 

Time spent dealing with the claim

A worker at the employer has to deal with the paperwork end of the claim.  This can take their time away from other tasks they have to deal with on a daily basis.  Time spent on paperwork filing the claim.  Time spent getting medical updates and discussing the claim with the adjuster.  Time spent getting wage histories, reviewing state forms, completing OSHA reports, and so on.  While it may seem like nothing, if you look at the time spent over the course of the year dealing with claims paperwork, emails, conference calls, etc., the production time lost can be quite significant.

 

Loss of production on the job floor

The worker that was injured had a job they were hired to complete.  If you remove them from work, someone has to cover their shift.  Another worker has to complete their job and maybe the job of the injured worker.  Do you keep the injured worker as an active employee or do you terminate their employment and look for someone else to replace them?  Who has to cover their shifts?  Does this lead to increased injury exposure by stretching your current workforce too thin?  Does production suffer due to injuries and a lack of depth of workers?

 

Morale of other workers

Other workers hear gossip about the injury, what is happening, what the injured worker is dealing with, and so on.  Time around the water cooler or lunch room can be spent talking about work injuries and the ramifications involved with filing a claim.  Workers can see this as an “Us vs Them” mentality (this is why communication is so important) where the workers feel as if they have to fight for what they are entitled to should a work injury occur.  Distrust between floor level workers and management can develop, and it can hinder the overall atmosphere at an employer creating a negative connotation.

 

Creating light duty jobs can be seen as favoritism for certain workers

Those employees that are longer term workers will recall a time when they were not allowed to come back to work until they were fully released from care.  Now the environment can be one of creating light duty work to bring workers back while on restrictions.  Maybe not all workers are allowed to come back to work depending on their job (we don’t recommend this).  However they see worker X brought back right away, being paid their normal wage for completing a “cake job” while other workers in other departments are not allowed to come back at all.  This situation will create a labor issue, perhaps more so in a union environment, and it can now lead to wage grievances and meetings between management and workers about this issue.  This is time consuming and usually does not lead to a positive proactive result.

 

 

Time Is Valuable, Use It Effectively

So as you consider your claims at your workplace, think of the hidden costs and expenses that are associated with these claims.  The biggest trend you will see will be that of time spent on the claim on the back end.  Yes the adjuster has the task of handling the claim to resolution, but the employer is also actively engaged in the process. Most employers are not large enough to have a dedicated claim liaison where their only job is to deal with the insurance carrier or following the claim to its end.

 

Time is a valuable asset.  Production is valuable.  Work floor morale is valuable.  Everything has a cost and an expense tied to it.  Safety is everyone’s job at any employer.  If you are avoiding claims, you are performing at your peak of production.  Every claim you have, even minor in nature, can rob your workers of their ability to be focused on the job they were hired to do.

 

 

 

Author Michael Stack, Principal of Amaxx Risk Solutions, Inc. He is an expert in employer communication systems and helps employers reduce their workers comp costs by 20% to 50%. He resides in the Boston area and works as a Qualified Loss Management Program provider working with high experience modification factor companies in the Massachusetts State Risk Pool.  As the senior editor of Amaxx’s publishing division, Michael is on the cutting edge of innovation and thought leadership in workers compensation cost containment. http://reduceyourworkerscomp.com/about/.  Contact: mstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

SALES TO PAY FOR ACCIDENTS CALCULATOR:  http://reduceyourworkerscomp.com/sales-to-pay-for-accidents-calculator/

MODIFIED DUTY CALCULATOR:   http://reduceyourworkerscomp.com/transitional-duty-cost-calculators/

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

 

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

 

Communicate, Communicate, Communicate, With Doctor And Injured Worker

As a business owner, there are times when there is nothing you could have done to prevent an employee injury.

 

According to OSHA information:

 

  • Every day, more than 12 workers die on the job – over 4,500 a year;
  • Every year, more than 4.1 million workers suffer a serious job-related injury or illness.

 

Running a business takes much time and effort, but one area of focus that can oftentimes be overlooked is the follow-up time needed to make sure injured workers are recovering properly. If they are not, it ends up costing your business more money.

 

One way to make sure your injured employees are receiving the best care possible is to stay in regular communication with your employee and stay on top of their recovery efforts.

 

 

Develop a Relationship With Medical Professionals

 

It is common that many business owners fail to visit the medical professionals to which they refer injured workers. In dropping the ball on this important task, they miss out on the chance to integrate medical services into their workers compensation cost containment program.

 

So, why do many employers fail in this arena?

 

In a number of cases, they are at a loss as to what to search for and  they do not know what questions to ask.  They can also be under the assumption that the claims administrator has put the relationship in place so a personal one-on-one visit is not needed, or they simply do not understand this is an important best practice.

 

It is best to come up with and adhere to guidelines to meet with your medical providers, including personal visits.

 

 

Relationships are Important

 

The reasoning behind such visits is to formulate a relationship with the doctors who are responsible for treating your injured employees.

 

Face it; the medical personnel must know you are a caring business owner and are as concerned about the health of the employee as the doctor is and that you are a partner in the worker’s rehabilitation.

 

A face-to-face meeting is crucial to establish rapport and to demonstrate you are open to be held accountable for your employee’s recovery. You are holding them accountable, so you must also be accountable so the relationship is viewed as a partnership.

 

With the meeting in place, you should be able to confirm that the medical facility chosen for treatment is a high quality to provide a range of treatments.  If not, your post-injury response should incorporate methods to access off-site treatments when required.

 

Hours of operation are important too. Check to confirm that they are they open the hours your employees are likely to be injured.

 

 

Invite Medical Provider To Your Facility

 

Medical provider visits give you a chance to offer your contact information, go over in detail what your business does, demonstrate what forms of transitional duty are available and seek the medication restrictions on the first visit with the employee.

 

Fees are not as important as the other criteria, as paying a little more for better results is fine.

 

Lastly, the medical providers should be welcomed to your facility to view what you do, meet with your staff and see potential transitional duty assignments.

 

 

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.
Editor Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

SALES TO PAY FOR ACCIDENTS CALCULATOR:  http://reduceyourworkerscomp.com/sales-to-pay-for-accidents-calculator/

MODIFIED DUTY CALCULATOR:   http://reduceyourworkerscomp.com/transitional-duty-cost-calculators/

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

 

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

 

 

 

Remember What Mama Taught You For Work Comp Claimant Success

Dealing with injured workers can create many challenges for claims professionals and defense attorneys.  These difficulties arise from a number of factors and are a reality of the adversarial workers’ compensation system.  It is important to remember this issue when dealing with claimants.  The following are some tips that can help your practice handle claims in an effective manner.

 

 

Remember the Golden Rule: Treat others the way you want to be treated!

 

Put yourself in the shoes of an injured party for a minute.  They are experiencing not only physical pain, but there is a psychological component to the injury that is often not addressed during a claim.  When someone becomes injured, that person will likely have a decreased functional ability.  They are also dealing with loss of wages and possibility unpaid medical bills.  Treating that person how you want to be treated can pay dividends in the end, including when you are trying to settle the claim if a dispute arises.

 

 

Be a professional at all times—especially when the party is not represented by an attorney.

 

Like it or not, attorneys sometimes create more problems in the long term when they represent an injured party.  Numerous studies indicate that injured workers seek an attorney when they feel they are not being dealt with in an honest and professional manner.  While you have an ethical obligation to your employer and client, treating the injured worker professionally can be the first step resolving a claim.

 

 

Treat the injured person with dignity—especially during the course of litigation

 

It is important for attorneys to be mindful of how they come across to applicants during the course of litigation.  If an attorney represents the injured party, you should never talk to the claimant outside the presence of their attorney.  In instances where you are taking their deposition or recorded statement, be aware of the old saying: You can catch more flies with honey than with vinegar.  Always be respectful and stay calm, especially if the worker becomes combative.  If they happen to get upset, maintain your professionalism and do not “fight” with them.

 

 

Always be ethical during the course of a claim

 

Claim handlers should understand applicable company policies on how they are to deal with claimants.  They should also be aware of how to deal with them if they are represented and what matters are not to be discussed if their attorney is not present.  In the same regard, attorneys should also be mindful of rules governing their professional conduct.  This is especially important in how to deal with unrepresented claimants, witnesses and other third-persons.

 

 

Avoid Unfair Claims Practices

 

When working for or representing an insurance carrier, it is important to remember that you are also bound by the applicable state law governing claims practices.  Failure to comply with recognized standards can result in a bad faith action being brought against the carrier.  Some unfair claims practices include:

 

  1. Failure to thoroughly investigate;
  2. Exploiting the financial vulnerability of the policyholder;
  3. Making unreasonable demands on the policyholder during claims;
  4. Claims “extortion” – g. – accusing the policyholder, without reasonable basis, of wrongdoing; and
  5. Spoliation of evidence

 

Remember that participating and promoting unfair claims practices at a minimum can result in judicial sanctions, additional litigation and admissions against your interests.

 

 

Conclusion

 

The modern claims environment creates a tension that sometimes makes it difficult to resolve workers’ compensation claims in a timely manner.  Claims handlers and attorneys can be proactive in their approach when dealing with claimants to resolve these matters by following best practices in an ethical manner.

 

 

 

Author Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com.  Contact: mstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

SALES TO PAY FOR ACCIDENTS CALCULATOR:  http://reduceyourworkerscomp.com/sales-to-pay-for-accidents-calculator/

MODIFIED DUTY CALCULATOR:   http://reduceyourworkerscomp.com/transitional-duty-cost-calculators/

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

 

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

 

Communicate Your Work Comp Program So Employees Use It

Having a great workers’ comp program is meaningless if your employees don’t know about it and use it. To get your employees to know about the program, you have to tell them about it, not just once. After initially delivering the information about your workers’ comp program, you need to reinforce and remind them of its importance. And it is not enough that the employees know about it, they have to be willing and able to use the program you have in place. All necessary information must be readily and easily accessible to all your employees and so familiar to them that they instantly know where to find all necessary information.

 
Make the Message Fit the Environment

 

Design your workers’ comp materials to fit the environment. A printed brochure may work for clerical employees who work at a desk and can put them in a file folder. But will a brochure work for a factory floor worker without file space? Probably not. A brochure handed to that worker will likely end up in the round filing cabinet, i.e. a waste receptacle after being piled somewhere with other papers.

 

Think about where your employees work, take breaks, gather and socialize when thinking about how and where to communicate your workers’ comp messages. The delivery of information must take into consideration the location where the communication is occurring. An auto visor packet might be good in a company vehicle. Wallet cards might be good for employees who go into the field. Signs near water coolers and restrooms are good reinforcers. Lamination of the materials is important where there is the potential for dirt or moisture in an environment that can ruin plain paper.

 
Combine Methods to Maximize Impact

 

Think about how you want to deliver your message. Using a combination of methods may be the best way to continually drive home your messages. For example, you may want to hand out or mail brochures to new employees with an annual update. Then you can also put up posters throughout the work area and in break rooms, give employees wallet or lanyard cards, and put a zippered three-ring mobile folder in all vehicles and toolboxes.

 

Another constant reminder is a sticker label to be put on telephones. This way the name and numbers of who to call when there is an injury or a claim is called in are immediately accessible to those making the calls.

 
Tailor the Message to the Audience

 

Think about your audience when designing your message materials. Do you have non-English speaking workers? Then your materials should also be translated into their first language. Are your employees eighth grade or college graduates? Make sure that your messages are clearly communicated in the simplest language possible. Don’t use several ten-dollar words where one ten-cent one will work. Your materials for your supervisors and upper management can be more in depth than is needed for your line workers. Also, the materials in your employee handbooks and safety plans can have much more detail than is needed in your program posters and wallet cards.

 
Make the Messages Easy to Read

 

Are your materials well lit and in big and dark enough font to be easily readable? As any middle aged worker in desperate need of reading glasses will tell you, they cannot see the same font size in a lighter color or that is against a non-contrasting background. Test their readability before their final printing. A clearly worded message won’t be read by employees who can’t easily see it.

 

 

 

 

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.
Editor Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

WORK COMP CALCULATOR:   http://www.LowerWC.com/calculator.php

MODIFIED DUTY CALCULATOR:   http://www.LowerWC.com/transitional-duty-cost-calculator.php

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

 

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

Grief Counseling For Work Comp Saves In More Ways Than One

Severe injuries can take a tremendous personal toll on a work force, as well as the families of the injured worker.  Employers are also recognizing this grief, associated with workers compensation losses, has adverse cost impact on claims. A few cost items are, lost production, extended disability, extra medical treatment, extended weekly benefits, possible need for temporary employees, higher risks for more disabling situations, possible fraud, and potential fellow employee lost production. A total composite list of cost items, both personally and professionally, will show that the dollar value can be very large.

 
Types of Workers Compensation Losses Likely to Cause Grief:

 

Losses involving death of an employee, death of a fellow employee, a serious injury, poor injury recovery, amputations, loss of sight, loss of hearing, mental deterioration during disability, depression brought on by the injury, lengthy loss time from work, feelings of inadequacy for not being able to be a family provider, and inability to return to former occupation can bring on the grieving process.

 

In some instances, the death of a fellow employee can be devastating. Certain key persons or very beloved persons can leave a large void by their passing. This can cause group depression that slows production. Depending on the length of time required for the staff to recover from their grief the cost impact can be significant.

 

Employee grief may have impact on the families, friends, and fellow associates.

 
The employee’s reactions to handling grief may be subtle, so may not be easily recognized. The employee is usually the last to recognize any problem. On the other end of the spectrum, employee reaction may be strong enough to warrant intervention by a medical provider, or professional grief counselor.

 

Catastrophic work place events caused by fire, explosion, weather, collapse, or other cause failure, can be stunning and devastating. Normal coping mechanisms for grief can totally shut down or be severely delayed. In these instances professional grief counseling is recommended.

 
Employer Grief Policy Steps:

 

When an injury involves a death there is little the employer can do to replace the loss for the family. Expressions of sympathy, offers of support, attending the funeral, providing for prompt payment of insurance, as well as corporate and legal benefits, are important as the family goes through a extremely difficult time.

 

Employees suffering from grief issues or problems also need employer intervention. The employer should establish a grief program that includes the following:

 

1. The seven step definitions of the grieving process: Acceptance, Anger, Denial, Depression, Fear, Guilt and Shock. Aside from listing their definition, be alert for their appearance.

 

2. Keep in constant touch with the employee during lost time disability.

 

3. Reinforce all positives when talking to the employee.

 

4. Listen and acknowledge all of the employees concerns.

 

5. Address all of the employees concerns within the employer’s ability to perform.

 

6. Share all common interests of fellow employees. Encourage fellow employees to talk to the injured employee.

 

7. Keep contact with the employee when returning to work.

 

8. If it was necessary for the employee to take another job, be sure to train, praise, and reinforce all accomplishments positively.

 

9. Encourage communication and show real interest in the responses.

 

10. Offer assistance when needed.

 

11. Provide professional grief counseling as needed.

 

12. Be sure the injured employee is welcomed back by fellow employees and made to feel part of the team again.

 

13. Even if the injury may preclude the employee’s participation in a group activity, extend an invitation anyway.

 

14. Allow and participate in fellow employee discussions about any grieving process.

 

Add any other steps that might be needed for employee closure. Remember, grieving employees, no matter what the circumstance, need to get their feelings expressed in order to heal, reach closure, and recover from grieving.

 
Summary:

 

The grieving process is very real. It can be triggered by many workers compensation type injuries and death. There is real increased claim cost associated with grief. An employer policy is necessary to address grief in the claim process.

 

Many types of trauma trigger the grieving process. When incidents are catastrophic grief can be so stunning or devastating that professional grief counseling may be needed. Compassion and real concern for all employee well-being during the grieving process is vital.

 

Employees who know their employer is in tune with these principals will heal quicker personally and professionally providing for increased employee morale, better production and employee stability.

 

 

 

Author Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com.  Contact: mstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

WORK COMP CALCULATOR:   http://www.LowerWC.com/calculator.php

MODIFIED DUTY CALCULATOR:   http://www.LowerWC.com/transitional-duty-cost-calculator.php

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

 

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

 

Case Study: How an International Media Giant Reduced Workers’ Compensation Costs

A worldwide publishing business employing 30,000 employees in diverse positions (clerical, reporters, heavy-machine operators, and fleet drivers) was having little success containing workers’ compensation costs, which were rising every year.

 

 

The employer knew they were vulnerable to work comp claims. Back injuries, carpal tunnel syndrome, repetitive stress disorders, slips, trips, falls, and motor vehicle accidents were all common; machinery related accidents resulted in more serious and costly claims for amputation and broken or crushed limbs. Repetitive trauma claims were common among employees such as reporters using computers constantly. Professionals with repetitive trauma syndrome (RTS), fearful of losing their careers, often worked through pain, causing their injuries to become far worse than normal.

 

 

Goal Was To Put The Employer “In Charge Of” The Work Injury Process 

 

The Risk Manager selected our team to help identify their main issues, develop solutions, and create a training program. The goal was to put the employer “in charge of” the work injury process. Once these changes were in place the employer noted improvements with the following:

 

  1. Adjusters learned the program and brokers gained more trust by showing them these resources.
  2. The company reported a 20% reduction in number of claims, and
  3. There was a 30% reduction in workers’ compensation losses in the first year, and in each ongoing year.

 

 

Here’s How They Did It!

 

After surveying their workers’ compensation management practices, the team discovered the company was strong in:

 

  • Hiring Practices: Using background checks, drug testing, and reference checks.
  • Medical Care Coordination: Employing a nurse at the on-site core facility to manage/document injuries; assist in drug testing.

 

 

However, they also identified three areas needing improvement:

 

  • Communication with Employees. (Chapter 7)
  • Reduce Repetitive Injuries. (Chapter 10)
  • Direct Medical Care by improving penetration rate to company PPO network (Chapter 13)

 

The team began by assessing what was currently in place, they then compared their results to industry Best Practices and developed Plan for Action Improvement tailored for the employer’s workplace.

 

 

These areas were revised as described in Chapter 7: Communication with Employees.

 

  • Weekly meetings were scheduled with injured employees. At these meetings, the focus was placed on the return-to-work aspect for the worker, especially setting up a target return-to-work date and assignment of a modified duty job.
  • An experienced technical writer was hired to draft a brochure telling employees what to do when they feel pain — even the very slightest pain. The brochure described how an injury starts when they feel pain; it is then they need to start taking steps such as icing the wrists. Most importantly, they need to do simple exercises such as stretching, and take frequent breaks to avoid injury.
  • Automated computer alerts reminded workers to take a break once an hour and workers were taught mild stretching exercises.

 

 

These areas were revised as described in Chapter 10: Wellness Programs

 

  • The risk assessment team was surprised to learn that repetitive trauma claims (carpal tunnel syndrome and tendinitis) were common among employees such as reporters using computers constantly. Often, employees work through pain rather than seeking treatment immediately and actually end up worsening their condition, due to their job dedication.
  • A wellness program was instituted to teach workers how to both avoid and treat repetitive trauma. An ergonomic specialist was called in to review the chairs and desks and to teach workers how to sit and what aids to use such as wrist supports at the keyboard, small bench under the feet to give correct alignment to the back, and use of light-weight hand “gloves.” Small packets of ice were kept in nearby refrigerators so employees could apply ice to the problematic areas of hands and wrists. They were taught that often the first symptom of carpal tunnel syndrome is pain at night, and that using wrist supports at night is helpful.

 

 

These areas were revised as described in Chapter 13: Directing Medical Care

 

 

  • The employer started using their third-party administrator’s medical reviewer to review medical records on all claims to be sure the injured employee is being treated appropriately and returns to work as soon as medically able either to full duty or in a transitional duty position.
  • A part-time Medical Director was hired for their on-site clinic to treat workers immediately and to track workplace safety. The Medical Director also makes referrals to other medical services as needed, and supervises the return-to-work process.

 

 

Our training manual discusses all of these techniques and suggests ways to bring workers’ compensation practices into line with industry best practices. 2014 Your Ultimate Guide to Mastering Workers’ Comp Costs: Reduce Costs 20% to 50% (Comprehensive Edition) discusses all of these techniques and suggests ways to bring workers’ compensation practices into line with industry best practices. Many forms and documents are available through Advisen at mbastone@Advisen.com.

 

 

 

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.
Editor Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

WORK COMP CALCULATOR:   http://www.LowerWC.com/calculator.php

MODIFIED DUTY CALCULATOR:   http://www.LowerWC.com/transitional-duty-cost-calculator.php

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

 

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

 

Will I Be Fired Is Biggest Employee Concern In Workers Compensation

In the course of my travels, I talk to many people. Mostly people in the insurance world as you can imagine.

 

Every now and then when I am on location I like to talk to the employees if my partners or employer hosts are not around. This is when you will get the truth about everything at this employer. Some of the common questions I ask are “How bad is the work comp situation here—anyone get any big cases or settlements? Is there a safety team? Do you know what to do if you cut half your hand off in that press while talking to me?”

 

 

Employees’ Most Common Question Is If They’ll Be Fired

 

The last question usually gets their attention. However it is the questions they ask me that make it interesting. The question that I get asked a lot is “How will my bad shoulder (or whatever body part it is) affect getting another job if I get laid off or fired here because I can’t work full duty?”

 

That is an interesting question, and one that has many answers. This question is also one that can send otherwise good people off the deep end of malingering and secondary gain. This malingering, however, does not have to be the case. It all lies in the hands of how the adjuster handles the file combined with the relationship between the employer and employee.

 

 

Employee Answer #1: Do Not Worry If You Can Not Perform Your Job 100% Right Away

 

First of all, if you are worried because you have a heavy duty job and you need to be able to work full duty, don’t worry. You are not going to be full duty overnight. It is going to take some time, and a lot of rehab, but it can be done. You have to do the work, there is no magic pill that will make your shoulder or lower back 100% again. That is if it can even be 100% again, ever. Only time will tell.

 

 

Employee Answer #2: Communicate With Your Employer

 

Second, communicate with your current employer. If it has been a year since your surgery and you are only 75% better, try to work. Make yourself available. The worker still has the responsibility to take their medical slips to their employer each time they see the doctor. This is a good time for a conversation about the future and about light duty work. If you fail to properly communicate with your employer regularly, I could bet you will be terminated. If you are out of sight, you are out of mind.

 

 

Adjusters: Be Sensitive to Employees Real Concerns Regarding Future Income

 

Third, if I am the adjuster and my claimant says “Boy I don’t know if I can ever return to work again, I don’t know what I am going to do” I am immediately calling that employer and forcing him back to work in some capacity within the next 3-5 days. This is because the claimant is at the crossroads of not knowing about future income. If they are unsure about work, they are going to try and stretch that comp case out for all it is worth. If the employer cannot work the claimant, then I am going to place them in a non-profit or some sort of light duty somewhere through a re-employment facility.

 

If you fail to work the claimant in some capacity at this crucial apex then you are going to be in trouble. All of the sudden the pain is back, and worse, and radiating all over the place. Prescriptions are not working. This case is going to plummet into a disaster within 30 days and exposures are going to skyrocket.

 

Any adjuster would just set up an IME at this point. But remember this is for a legitimate, compensable, and complicated injury that you have already accepted. What is your IME going to tell you that the treating doc didn’t already say—that this person can work with restrictions?

 

 

Many Malingering Claims Can Be Solved With Light Duty Work

 

This highlights only a fraction of the reasoning as to why having a light duty job program is so important at every employer. I see tons of malingering claims, just hanging out there. They could be resolved by light duty work. It doesn’t have to be great work or work that pays a lot. It just has to be work. Just providing some work, and a purpose, can be the answer this person was looking for. Plus if they fail to comply now you can stop their wage benefits for non-compliance.

 

The work comp game is all about money and wages to the injured worker. They can deal with the pain, it is the unknown that worries them. These workers are providers for their family. They are going to do whatever it takes to secure income, even if that means stretching a comp case out as far as they can, selling their medications to friends, doctor shopping to get results they desire, retaining counsel, and so on.

 

So when I get asked the question about work comp cases affecting future employment my answer is this: “Why give your employer a reason to terminate you in the first place? If you are doing your job and doing it well, and you show up on time and work hard each and every day, you sound like an asset to this company. Not a liability.”

 

 

Author Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com.  Contact: mstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

WORK COMP CALCULATOR:   http://www.LowerWC.com/calculator.php

MODIFIED DUTY CALCULATOR:   http://www.LowerWC.com/transitional-duty-cost-calculator.php

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

 

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

 

Injured Workers Hire Attorneys Due To Lack of Employer Communication

Employers, in their efforts to control workers’ compensation claim cost, often go to great lengths to manage their safety program, provide medical management, and analyze data.  Employers also often incorporate computer programs with the latest technology in their quest for work comp cost control.  All of this is good, but employers often overlook one of the simplest ways to control claim cost – staying in touch with the injured employee.

 

 

Work Comp Communication Should At Date of Hire

 

As a part of the new hire package, every employee should be told what to do in the case of an on-the-job injury, including how to report the injury to the employer and the requirement to continue the communications after the injury. This sets the stage for on-going communication with the employee when a work comp injury occurs.

 

Communication with the injured employee is of upmost importance from the moment the injury occurs until the last aspect of the worker’s compensation claim is concluded.  When an accident happens, the first focus should be on what are the immediate medical needs of the injured employee.  Communication at this point should be limited to the question of what happen, if immediate medical attention is needed.

 

If the injury is severe, the workers’ compensation coordinator or the employee’s supervisor should accompany the injured employee to the emergency clinic or hospital.  The work comp coordinator should contact the employee immediately following the initial doctor’s visit to determine the diagnosis, the prognosis, the treatment plan and what the injured employee’s work restrictions are. 

 

 

Employees Hire Attorneys Due To Lack of Communication

 

The most needless way of dramatically increasing the cost of a workers’ compensation claim is to ignore an injured employee, causing the employee to hire an attorney.  There are three primary reasons an injured employees hire attorneys.  They are conflict, fear and greed.

 

  • Conflict:  The injured employee gets into a dispute with either the employer or the adjuster.  Conflict normally occurs when all necessary information about the claim handling process has not been provided to the employee.  By communicating frequently and completely with the employee, conflict can be avoided.

 

  • Fear:  The employee is concerned about his/her future employment, his/her future income, and/or his/her ability to provide for his/her family.

  

  • Greed:  The employee sees the accident as a way to gouge the employer or insurer for some extra money.

 

There is not a whole lot an employer can do about an employee’s level of greed, but an employer can prevent most employees from hiring an attorney by staying in touch with them.  When employers have on-going communication with injured employees, conflict and fear are greatly reduced or eliminated.

 

The immediate contact after the first doctor’s visit reassures the employee that the employer is concerned about the employee’s wellbeing. It also lets the employee know that the employer is keeping the employee’s job for him/her and the employer wants the employee back at work when the employee is physically able to return to work.

 

If the injured employee is not released to return to work following the initial medical provider visit, the employer must make a point of staying in touch with the injured employee. The injured employee can be instructed to phone the work comp coordinator following each doctor’s visit to advise what the doctor’s treatment plan is.  Also, the employee should be reminded that he/she is still required to attend all employee/staff meetings if the employee is physically capable of doing so.

 

 

Regular Contact Reassures Employee They Are Still Wanted At Work

 

The work restrictions provided by the doctor should be reviewed and discussed with the employee. If at all possible, a transitional duty job within the boundaries of the work restrictions should be provided to the employee.  The work comp coordinator should also be in touch with the adjuster and the medical provider to be sure the adjuster and medical provider are aware a transitional duty job is being provided to the employee.

 

On-going communications with the injured employee should continue for as long as the employee is off work, even with severe injuries where the employee is off for an extended period of time.  By continuing regular contact with the injured employee, the employee is reassured that the employer does want him/her to return to work.

 

Staying in touch maintains the employee’s morale, builds rapport with the employee, keeps the employee from hiring an attorney and lowers the overall cost of the workers’ compensation claim.  Employers should make staying in touch with the injured employees a central tenet of their work comp cost control program.

 

 

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

 
Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com

 

©2013 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.  


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

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