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) |
As members of a management team, around the winter season, reevaluate for the upcoming year. Set goals, benchmarks, implement new techniques, purchase new materials, etc. But there is one area that seems to be focused on more than others: And that is ‘how can we use what we have to be better?’.
Chances are in a medium to large shop, there is plenty of talent, in more than one form. The workers can be your most important capital. So why not focus on how to better use that talent? (WCxKit)
1. Provide the best tools so employees can perform efficiently
As an example, if you drive cars, this does not mean that all all drive a top of the line Cadillac. But this is meant more to show how to provide the best output for workers. Make workstations adjustable so workers can perform at the levels they need to. This will increase output and performance, not to mention that it will make workers less prone to injury, especially in repetitive-motion workstations. Extra lighting can provide clarity and precision. Hand trucks and dollies can make moving heavy materials easier and quicker, and so on and so on.
2. Don't run it like a prison
The workplace does not have to run hard-nosed and rigid. As an employer allows some flexibility such as flex work hours, rotating job tasks, allowing hourly breaks, then you can best utilize workers time at work for production. A rested workforce is your best workforce. Sometimes having job rotation can provide breaks for those that do heavy duty work day in and day out. Also this can reduce injury since those workers that just do heavy lifting or moving of materials can get a much needed break from time to time throughout the day. You could also discover that one of your workers may be better suited for another type of job task, versus the one they are currently in now. This could lead to increased production, and better efficiency.
3. Keep an open mind
Time and time again we recommend listening to employees and their suggestions as to how changes can be made to make production better. Discuss alternative job tasks and how things could be done quicker and easier. Remember these are the people that do these jobs all day, sometimes for years. They have ideas and suggestions and you have to make management become approachable. If someone knows that you will take the time to listen to them, you may get an idea that you can implement. Not everyone will hit the ball out of the park every time, but you could stumble upon something that can really make a difference, and it could change the way things are done on a daily basis.
4. Encourage healthy lifestyles and reward those that make a change
A healthy body is one that comes ready and able to work, and able to take on the challenges of the day. Healthier employees also have less sick time away from work, and have fewer injuries. A lot of companies now offer discounts to local gyms, reduced medical premiums for wellness exams, smoking cessation programs for free, etc. The HR department probably has a lot of ideas and plans that are already in place to promote a healthier lifestyle, and the incentive programs to go with it, so check in to some of them and try to implement some over the course of a year. Provide some incentives for the workers to participate, and see what happens. I bet that more will participate than you thought.
5. Launch a return to work program
It has been well documented that the longer a person is out of work, the harder it is to get them back to productive employment and there is a strong correlation between a high return to work ratio and a low mod. Older employees also take longer to heal than younger ones, so consider home-based employment. If you provide some light duty work, employees know that even though they have an injury, they can still work and make a decent wage. This will help them transition back into full time work once they are released from medical care, and will reduce claims dollars that are spent on lost wages while injured. It will also free up full duty employees to do something more productive, while those with medical restrictions can take care of the lighter tasks you need done day in and day out. Make a "wish list" of tasks you wish you had someone to help perform, then use the wish list to create transitional duty tasks. For instance, I wish I had someone to proofread my writing.
6. Set up a mentoring program
It is always hard to start a new job. Nobody wants to be the new person, so set up a mentoring program to help those new or less-experienced employees. Shadowing programs work well also. The new employee can gain some great knowledge from the veteran worker, including how to do things quicker, properly, and more efficiently. A good mentoring program will improve productivity of the newer, younger employees while making veteran workers feel like they can contribute more to the company other than just cranking out their job tasks day after day. The more you make workers feel like they are involved, the better, harder, and more dedicated they will work for you.
7. Do not be afraid to hire experienced workers
There are many benefits to hiring experienced workers. These workers already have sound work habits, years of experience in the field, and the skills the company needs to take you to the next level of competition. These workers also have less out of work distractions, such as needing more time off for child care or more time off for school commitments. Experienced workers will also add some diversity in workforce, contributing their ideas and experience to the team projects and ideas. If you utilize their assets, the workplace will benefit. (WCxKit)
Summary
A New Year means it is time to reflect on the year to date, and focus on what you can do better for the upcoming New Year. But you should also think about what the veteran workers can bring to the table for the company. Experienced workers are a great untapped resource, and their ideas and work ethics can be beneficial in more ways than one, especially in fields other than just being at their workstation. Tap the greatest free resource- the employees. Listen to their ideas, and make the management team approachable when someone has an idea about how something may be able to be done better. If you make this one of several things to focus on, accomplishing the rest of the goals could just be that much easier.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com.
Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
Info@ReduceYourWorkersComp.com.
Few people realize the workers’ compensation industry is actually 100 years old. It’s one of the most-successful public-private partnerships in U.S. history.
Since 1983, the Workers Compensation Research Institute
(WCRI) has been providing the public with research on WC public policy issues. Based in Cambridge, Mass., the organization includes among its members employers, labor organizers, public and private insurers, health care providers, managed care companies, and state government representatives from the U.S., Canada, New Zealand, and Australia.
Dr. Richard Victor, WCRI executive director, oversees the institute’s studies and analysis that has added ammunition for the reforms to various aspects of the workers' comp system. Prior to working at the institute, he spent seven years conducting research at The Rand Corporation in Washington , D.C., and Santa Monica , Calif. His law degree and Ph.D. in economics is from the University of Michigan.
LowerWC recently asked Victor for his impressions of the industry. What follows are some of his comments:
“One of the most important, and troubling, areas for workers’ compensation systems is to find the appropriate ways to use narcotics – and to discourage abuse and diversion. A second critical issue is to find new and innovative ways for help workers return to productive employment,” Victor says.
To this end, WCRI is conducting several research phases to help find answers for WC narcotic use and return-to-work issues, he says.
Victor says the latest trends in workers’ compensation also include medical cost management. “Medical costs now represent more than half of workers’ compensation costs in most states. There is increasing focus on pharmaceutical costs and utilization and the payments made to hospitals and ambulatory surgery centers,” he says.
Further, everyone wants to know how to save the employers money. Victor says, “Most large employers are focused on three legs of the four-legged cost containment table – risk financing, injury prevention, and claim management. The fourth leg is a large opportunity because employers have underinvested in it – improving the ‘rules of the game’ to make the system more effective for workers and more cost effective for employers.”
He continues, “This requires that employers join together to formulate political positions and strategies and gather available evidence about how a given state system is performing, how it might be improved, and what lessons can be learned from other states.”
California and Texas are good examples of where employers have taken collective action and costs have fallen significantly, Victor says. One of the chief objectives of the WCRI CompScope benchmarking studies is to help stakeholders and public officials set priorities and debunk myths.
One important part of this research is an upcoming conference. The WCRI Annual Issues and Research Conference will be Nov. 16-17 in Boston with keynote speaker Peter Barth, professor of economics emeritus at the University of Connecticut. This will be its 28th year.
The goal there to present new ideas and alternative views, Victor says. “Whether you are managing workers’ compensation claims, involved in strategic planning, concerned with medical costs and utilization, or just looking for a better understanding of workers' compensation – this is the conference for you.”
All of the sessions highlight the first presentations of the latest research findings from WCRI while drawing upon the diverse perspectives of highly-respected workers’ compensation experts and policymakers from across the country, he says. “Attendees tell us that they value the large attendance because it allows them to leverage their time while at the conference. There are also opportunities to meet and interact with WCRI researchers.”
“The most important advice I can give remains a secret until the WCRI conference, when I (present) ‘The Elephant in the Room.’ It will highlight some things that are underappreciated, but are likely to shape workers’ compensation systems for the next decade. The future is not always like the past,” Victor says. “Of course, I would like to see your readers attend to stretch their thinking, gain a competitive edge, and network with peers.”
Author Rebecca Shafer
, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of Manage Your Workers Compensation: Reduce Costs 20-50% on cost containment techniques. www.WCManual.com.
Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
Posted in
Assessment & Diagnostics,
California Workers Comp,
Communication with Employees,
Drug, Alcohol & Impairment Testing,
Employment Law Issues,
Federal Workers Compensation,
Implementation and Rolling Out Your Program,
Management Commitment,
Professional Development Issues,
Return to Work and Transitional Duty,
Seminars and Courses |
The LexisNexis Workers Compensation Law Community Staff plans to make its selections for the annual Top 25 Blogs for Workers Compensation and Workplace Issues.
They will be honoring ongoing achievement by blogsites as well as point out the best newcomers and are focusing on quality of writing, frequency of posting, topics covered, interaction with the Internet community, format and design of blogsite, impact on workers compensation and workplace issues, Google ranking and/or mentions by other sites.
The LexisNexis Staff will review all comments through October 21, 2011, and then make final determinations for the top 25 blogs.
"Talk up" your favorite blog at the Workers Compensation Law Community. Go to
Copyright 2011 LexisNexis. All rights reserved. This material is excerpted from Larson’s Workers Compensation Law. Reprinted with permission.
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.
Comparison Report Generator is one of the new features on WorkCompResearch
WorkCompResearch (WCR), the nation’s leading workers compensation Compliance and Regulatory Research System, has recently been enhanced with a new Custom Comparison Report Generator (CCRG), designed to allow members to create and print instant comparative reports for a variety of compliance topics for up to 53 jurisdictions. The CCRG is based on a more limited Topic Comparison service previously offered in the WCR Compliance Center.
WorkCompResearch is one of several comprehensive data services offered by WorkersCompensation.com .
The report generator is now positioned with the State Comparative Charts that the company has maintained for years, but, according to Robert Wilson, WorkersCompensation.com President & CEO, the CCRG represents the future of WCR comparative data systems. “The Comparison Report Generator is the first generation of dynamic data manipulation, and represents the future for our custom information delivery services,” Wilson says. “Eventually our 50 State Comparative Charts will be driven by similar systems, being dynamically generated for the end user in real time, and on demand.” (WCxKit)
According to Wilson, the underlying system will allow the WCR service to provide even greater flexibility for their subscribers, while easing the maintenance burden on their Compliance Department. In addition to the Comparison Report Generator, which is now available in a beta format, the WCR service is expanding its Compliance offering with the addition of comprehensive Utilization Review and Medical Billing information. Kathy Lella, Vice President of Compliance and Research for WorkersCompensation.com, says that these additional topic areas have been among the most requested from the company’s existing subscribers.
For more information, visit WorkCompResearch.com or WorkersCompensation.com.
Robert Wilson, President & CEO, WorkersCompenstion.com.
WorkCompResearch (WCR), the nation’s leading workers compensation Compliance and Regulatory Research System, has recently been enhanced with a new Custom Comparison Report Generator (CCRG), designed to allow members to create and print instant comparative reports for a variety of compliance topics for up to 53 jurisdictions. The CCRG is based on a more limited Topic Comparison service previously offered in the WCR Compliance Center.
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.
Every day employers introduce increased risk for worker injury. At any given time, outside or internal forces can create a new hazard for injury. With the injury comes medical cost, lost wages, decreased production, decreased profit margins, more strain on current workforce, and other negative issues.
Below we will discuss a few factors involved in the increased risk of worker injury, and the way to decrease the hazard when these forces are present in your workplace.(WCxKit)
1. New equipment in the workplace:
Your workforce has a span of experience that varies by employee. Some workers are new to your industry, whereas others may have decades of experience. But new equipment is a great equalizer.
When there is hazardous equipment on the work floor unknown to your operators, the risk of serious injury increases dramatically. Your workers are unfamiliar with these machines, and, without proper training, a severe injury may occur.
The way to prevent injury is to take the time to properly train each employee on proper use of the new machine. Make sure they complete the training course and can pass a safety test before operating the equipment. This should decrease your risk, and make your workers safe.
A lot of employers ignore training, letting experienced workers train others. Managers can be surprised that older workers typically do not have the advanced technological experience to know these new machines inside and out, and therefore, without a properly trained workforce, you run the risk of increased worker injury.
2. Benefit reductions:
As the economy continues to struggle, employers are scrambling to find ways to continue to stay above water. Some are experimenting with decreasing fringe benefits made available to employees, or by decreasing the employer contribution which increases employee cost for the same benefit package they may have had for years.
Backlash against this can lead to an increase in workers compensation claims. It is not going to be across the board, but some people may adopt the attitude they want to show the employer what happens when they alter the benefits. This is done by workers who stop caring about their jobs. They do not do safety checks or machine checks before operation. They do not clean up as they used to. They do not work as hard as they once did. The end result is other workers injured by someone else’s carelessness.
3. Demotions within the company:
Similar to what was discussed in item two, workers who are demoted or moved to another job title may hold a grudge. They become upset and want to sabotage their employer through a lackluster work performance, decreased safety awareness, decreased work production, etc. All of these are detrimental to the employer, and another employee may become injured inadvertently by the disgruntled employee’s issue with the employer.
When job titles change or people get moved around to other job duties, watch for an increase in claims. If this happens, employers should talk to employees immediately. Let them know that these moves are not a personal attack and may not be permanent. You need to make those workers feel like they are part of the team again, so they stay on board and on top of their safety protocol.
4. Plant shutdowns/layoff notices:
Probably the most common time a claim count increases is when workers are notified of a potential layoff or worse — an entire plant shut down. Workers with any type of injury feel if they do not report it now they will miss out. Often any worker who has ever had any sort of pain while working is going to come forward to tell you how injured they are, and how they kept working to try and be of some benefit to the employer and keep earning a paycheck.
Not all of these types of last-minute claims are fraudulent. In fact, some long-term employees may have an occupational claim that is compensable. All claims need to be reported to your workers comp carrier so the adjuster can investigate the claims and get them taken care of, whether they are denied or compensable. Any delay can cause an increase in claim cost, especially if said employee is laid off, or terminated when the shop closes down. The sooner the adjusters get the claims, the better your company will be protected.(WCxKit)
In conclusion, several issues can contribute to a spike in an employer's claims count. But with proper communication, thorough training, and a good safety team you should be able to weather the storm and keep your claims count in check.
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://www.wcmanual.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 most common and often the most expensive workers compensation claim is the back injury claim. Back injury claims often are associated with lifting heavier objects, twisting, bending, or falling. When the injured employee goes to the doctor, the doctor will normally treat the injury conservatively with rest and medication to see if the back injury is a sprain or strain of the musculoskeletal system.
If the injury does not respond to rest, the doctor will consider various types of diagnostic testing. There are several types of diagnostic testing the doctor can consider and request to determine the nature and extent of the back injury. The six most common diagnostic test are x-rays, MRIs, cat scans, EMGs, myelograms, and discograms.(WCxKit)
1. X-rays
The most well known diagnostic test is the x-ray. It is often the first diagnostic test when the employee has fallen or suffered some other type of impact. The purpose of the x-ray is well known – to see if the injured employee has fractured any bones. The x-ray also allows the doctor to examine the vertebrae for other causes of back pain including osteoarthritis and for deformities like scoliosis.
The days of x-rays produced on film are no more. Today, x-ray images created by radiation are reproduced in a computer. There is very little risk to the employee in having an x-ray, unless the employee is pregnant, as radiation could harm a baby in utero. The results of x-rays are often available immediately, but there is usually a wait for the doctor to review results.
2. MRIs
Magnetic Resonance Imaging (MRI) is a way for the doctor to examine soft tissues in an employee's body. The MRI machine uses radio waves, a large magnet and a computer to create images of soft tissue. In some cases, it is necessary for a dye to be inserted via a intravenous line (IV) into a vein to make it easier to detect inflammation or abnormality. Each MRI picture shows a view of the area being examined. Each picture is about a quarter inch deeper (or shallower) than the prior picture, allowing the doctor to get a detailed view of the area being examined. With a MRI of the spine, it shows areas where other structures may be impinging on nerve root areas. An MRI has no side effects, but occasionally there is a reaction to the dye.
The MRI machine is a circular tube with a table in the middle that the injured employee lays on — though response to claustrophobic patients has encouraged the creation of standing MRI machines. Typically, the MRI technician moves the table back and forth in and out of the tube while each MRI scan is taken. If dye is needed, it is injected about halfway through scanning. The employee will be told to hold their breath while each picture is taken. The MRI pictures are recorded on film which the MRI technician develops. It takes a doctor trained in reading the images to examine and interpret the images. Many physicians consider and MRI to be the best use as a pre-surgical tool.
3. CT Scans
A Computed Tomography scan, referred to as a CT scan, or a Computerized Axial Tomography Scan, or CAT scan, is another way of taking pictures of the body using a specialized x-ray machine. The machine circles the employee's body and scans the area from every angle. The machine measures how x-ray beams change as they pass through the body. A computer generates a series of black and white pictures each showing a slightly different cross section.
If the x-rays and the MRI have not identified the cause of the employee's back pain, the doctor may request a CAT scan. The CAT scan is not often used for back injuries. When the treating doctor asks for a CAT scan instead of an MRI, the doctor is looking for some other reason the employee is experiencing back pain including problems with the kidneys and pancreas.
A CAT scan is done much the way a MRI is done. The employee lies on a table that passes in and out of the tube-shaped machine. The CAT scan is done with dye to outline the soft tissues and blood vessels. There is a small amount of risk from the dye. Some people have an allergic reaction to it. Also, since the CAT is a specialized x-ray machine, it should not be used on pregnant employees.
4. EMG
An electromyography (EMG) is used to test the employee's nerve and muscle electrical activity. EMGs are usually done with a nerve conduction study (NCS). If the treating doctor suspects the back injury and resulting pain is to muscles or a pinched nerve, an EMG may be requested. In the EMG test, the employee has fine needles inserted into the muscles. Each needle is attached to a wire that sends signals to the EMG machine. The electrical patterns inside the muscles can be analyzed to determine which muscle is damaged. The EMG portion checks on muscle responses and the NCS checks nerve velocities. Together both are interpreted to help diagnose many problems from nerve
impingement to neuropthies and more.
EMG needles are too small to cause bleeding but most employees find the test uncomfortable. The electrical shocks that occur in the test are too mild to cause any permanent damage.
5. Myelogram
A myelegram is an x-ray combined with a dye that is injected directly into the spinal canal. The myelogram is used to identify the point(s) in the employee's back where vertebrae are pinching the spinal cord. It is often used prior to surgery to confirm the MRI results. The myelogram is also used to diagnosis leg pain problems occurring in conjunction with back injury.
As with other dyes used in testing, some people have an allergic reaction. Also some people experience headaches from the dye, and pregnant women should not have the test done.(WCxKit)
6. Discogram
Under monitored conditions, sterile water is injected into several adjacent disc spaces to attempt to reproduce symptoms (i.e., parasthesias, pain). This test is subjective but common preoperatively to help doctors make sure they are operating at the source if the pain — which is not always the "worst disc."
Now when you hear the employee is having one of these tests done, you will have an idea what is happening to diagnose the employee's back problem.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
This week at the Workers Compensation Roundtable on LinkedIn there are two still-active discussions from last week. One is in regards to when first aid crosses the line to workers compensation. Follow this topic
here. The other asks about what to do when an injured employee says they are fine initially and then the problem worsens throughout the day. Read more
here.
Our Group Manager, Bob Wilson president & CEO of WorkersCompensation.com, LLC, posted
this article, “California Supreme Court Reverses Retro-Active COLA's in Baker V WCAB” this week as his manager’s choice. Go to read and comment.
Wilson also posted
this link to a story about cyber liability in Florida.
Alberto Salgado, MPN coordinator/lead client services liaison at GENEX Services, Inc., in Orange County, Calif., asks, “Medicare Conditional Payments and WC – Can reimbursements to CMS be re-calculated at states' WC fee schedules (FS)?” He includes this background: "Under the MSP laws (42 U.S.C. § 1395y(b)), Medicare does not pay for items or services to the extent that payment has been, or may reasonably be expected to be, made through a no-fault or liability insurer or through Workers' Compensation (WC). Medicare may make a conditional payment when there is evidence that the primary plan does not pay promptly, conditioned upon reimbursement when the primary plan does pay. … If the claimant is a Medicare beneficiary, I understand that WC payers are responsible for reimbursement of conditional payments only to medical expenses related the accepted industrial injury and diagnosis. But, can the conditional payment be audited per FS or does it have to be paid at the demanded amounts by CMS?
Jeff Knipper, MSCC, CMSP, medicare services director at CCS Holdings is one of several respondents. He writes, “(In the) Dallas/Fort Worth Area, with few exceptions you're going to find that Medicare's reimbursement rate was lower than WC fee schedule allowances so if the ‘conditional payment’ made by Medicare was made for treatment ‘reasonable, necessary, and related’ to the WC claim then the payer realized savings in this scenario.”
John Link, vice president/Tribal Consulting at Cottingham & Butler in Dubuque, Iowa posted this article:
Workers' comp costs from musculoskeletal disease reach $850B a year. It generated this response from
Jack Kanner, CEO, COO at P.S.R. Corporation [aka] Professional Safeguard Resources, “Cost containment by workforce cultural change. advise reading attached – link to article – sustainable employees in the infrastructure industries. Musculoskeletal disorders are a by-product of work performance demand and therefore 'the attitude' to the work. That may sound like a 'given' but I daresay we are eminently qualified to quantify in that we (PSR) have worked with 10s of thousands of varying workforces over 25 years: e.g., firefighters, paramedics, nurses, law enforcement, utilities, manufacturing, warehouse, freight distribution: 100 cities, 3 federal agencies, fortune 500 companies from Chevron Refineries, and Pacific Gas & Electric Co., to Coca Cola, the Federal Reserve Bank. and Mohawk industries (largest flooring co in U.S. – Work Comp $ losses are down millions within 18 months of installation of licensing PSR and certifying facilitators).” Kanner attached this link to an article published by PERI Public Entity Risk Institute:
https://www.riskinstitute.org/peri/component/option,com_deeppockets/task,catContShow/cat,91/id,1146/Itemid,84/
There is lots more going on at Linkedin's Workers Compensation Roundtable right now and
right here! Better yet,
invite your friends so they too can become informed on hot topics in the Workers Compensation industry.(WCxKit)
Workers Compensation Roundtable is jointly managed by people dedicated to the concept that workers compensation is a manageable line on your expense ledger, and that informed professionals are empowered achievers. Workers compensation is not simply a cost of doing business, it is a cost that can be controlled. Beginning with an assessment of cost drivers, benchmarking data, and integrating the solutions, employers can reduce workers comp costs 20 to 50 percent. With proper information, professionals managing compensation claims can reduce costs and improve outcomes for all stakeholders in the process. This group is for employers, business owners, risk managers, HR managers, insurance executives, and brokers to discuss the obstacles and strategies to overcome them.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
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.
