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Amaxx Details 2012 Workers Compensation Management Program Updates

Rebecca Shafer, J.D. — Mon, 06 Feb 2012 00:28:30 +0000

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.

2012 NEW WORKERS COMP MANAGEMENT GUIDEBOOK: www.WCManual.com

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

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

WC GROUP: 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 or agent about workers comp issues.

WC Basics 101 – Kansas Workers Compensation

Rebecca Shafer, J.D. — Fri, 27 Jan 2012 00:42:10 +0000

Workers Compensation Laws change frequently. This is only a summary; a complete copy of the most up-to-date version can be found at: www.WorkCompResearch.com , an excellent service.

In Kansas workers compensation coverage is compulsory as to all employment, including corporate executives and employees of charitable organizations. Coverage is elective for individuals, partners or the self-employed. There are some exceptions. Real estate brokers and real estate salespeople on commission are excluded from the compulsory requirements. Also, farm labor and employees of any employer whose gross annual payroll is $20,000 or less are excluded from compulsory coverage.

Obtaining Coverage

To obtain workers compensation coverage in Kansas, the employer has three options which are

purchasing a workers compensation insurance policy from a state approved insurance company
applying to and being approved for self-insurance status with the Kansas Department of Labor.
being a part of a group-funded self-insurance plan that has been approved by the Kansas Department of Labor

Claim Reporting

The employee must provide notice of the injury to the employer with 10 days and up to 75 days with just cause. The actual claim of the employee must be served on the employer within 200 days after the accident, or last payment, or within 1 year of the employee’s death with death occurring within 5 years after the date of the accident. WCxKit

Medical Benefits

In Kansas, the employer selects the medical provider for workers compensation claims. The employer is required to provide all reasonable and necessary medical care free of any charges to the employee. The employer is also liable for up to $500 of employee incurred medical bills at a non-authorized doctor. The employee can also apply to the Director of Workers Compensation for a change of doctors. The employee is entitled to all medical treatment needed to cure or relieve the effects of the injury. Prayer or spiritual treatment is permitted by agreement.

Temporary Total Disability Benefits

The temporary total disability (TTD) benefits are calculated as two-thirds of the employee's average weekly. The maximum amount of TTD benefits that can be paid is $555.00 per week. The state maximum is subject to annual increase/decrease each July 1st, based on the state’s average weekly wage. The state minimum weekly benefit is $25.

The first 7 days of disability (the waiting period) is not paid to the injured employee unless the employee is disabled for more than 21 days. TTD benefits can be paid until a cap of $100,000 has been reached.

Temporary Partial Disability Benefits

In Kansas if the employee is able to return to any type of work, but at a lesser rate of pay then the amount the employee was earning prior to the injury, the employee is entitled to temporary partial disability (TPD) benefits. The TPD benefits are paid at two-thirds of the difference between the pre-injury wage and the post-injury wage. The TPD benefits are paid for up to a maximum of $100,000. The TPD benefits plus the post-injury pay rate cannot exceed the state's maximum indemnity benefits rate.

Permanent Partial Scheduled Disability

Kansas uses a Schedule to establish the value of an injury to all extremities, the shoulders, eyes and hearing. Each body part has a set number of weeks it is worth with a shoulder being worth 225 weeks of compensation and the number of weeks decreasing with other extremity body parts having lesser value down to a toe, other than a big toe, being worth 10 weeks of compensation. A 20% loss of use of the arm, which is scheduled at 210 weeks, would result in a permanent partial scheduled disability award of 42 weeks (210 weeks X 20%).

Permanent Partial General Disability

When the employee sustains a permanent partial general disability of a body part not listed on the Kansas Scheduled Injuries list and the employee is not permanent totally disabled, the employee receives permanent partial general disability. If the employee is able to return to work and is earning at least 90% of the average weekly wage, the employee is given a percentage of the whole body impairment based on the AMA Guidelines, Fourth Edition. The maximum in weeks is 415 weeks. An employee with a 10% rating would get an award of 41.5 weeks of compensation. The maximum an employee can collect for permanent partial disability is $100,000.

Permanent total disability

Kansas permits the employee to collect a maximum of 415 weeks of indemnity benefits for all types of indemnity combined, but the total amount of benefits collected for permanent total disability is $125,000 instead of $100,000 (the amount of TTD benefits paid to the employee is included in the $125,000 indemnity benefit cap).

Death Benefits

The burial expenses in Kansas are covered for a work-related death up to $5,000. The death benefits for a dependent spouse and children follow the same guidelines as TTD benefits – two-thirds of the average weekly wage – currently a maximum of $555 week, and a minimum survivor’s benefit of $370 per week, except there is a dollar maximum for death benefits in the amount of $250,000 with children, or $200,000 without children. If there is no spouse and no dependents, the death benefit is reduced to $25,000. WCxKit

Vocational Benefits

Vocational Rehabilitation is on a voluntary basis in Kansas. However, once it is started, it cannot be terminated without the agreement of the employee. The vendor of the vocational rehabilitation may be changed for good cause supported by substantial evidence. If so, the employee may select the replacement vendor from a list of three qualified vendors provided by the employer.

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.

NEW 2012 WORKERS COMP BOOK: www.WCManual.com

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

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

WC GROUP: 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 or agent about workers comp issues.

Out of State Insurance Coverage for Workers Compensation

Rebecca Shafer, J.D. — Thu, 26 Jan 2012 01:34:20 +0000

As any employer with locations in more than one state knows, the workers compensation policy is written specifically for the states where the employer has physical facilities. On the Information Page that comes with each new policy or policy renewal, is Item 3.A (for most insurance carriers) which designates the states where the workers compensation policy is applicable. Workers compensation coverage does not apply to claims filed in other states.

While the insurance carriers attempt to limit the exposure to claims occurring where they may not have claims offices, or knowledge of the workers compensation statutes, the states take a much broader approach. The workers comp statutes of most states specify when and how the workers comp act applies out of state. Normally, the state statute will indicate that if the contract to hire was negotiated within the state, the workers comp laws apply regardless where the injury occurs. (WCxKit)

Most state workers comp statutes will have extraterritorial provisions that state if the principal place of employment is within the jurisdictional boundaries, a workers comp injury occurring outside of the state boundaries is still covered by the state law. The workers comp statutes also normally specify that any work related injury occurring within the borders is subject to the workers compensation statutes, even for employers and employees whose place of business is not within the state line boundaries.

When the employee is injured in another state where the employer does not normally do business, the extraterritorial provisions of the state workers comp act work great, as long as the employee elects to utilize the benefits of the home state workers compensation act. The problems occur when the employee elects to file the claim in a state where the employer does not have a physical location and the employer does not have workers compensation coverage.

The usual reason an employee files for benefits in a state other than the home state is the amount of temporary total disability (TTD) benefits that will be paid. Consider the highly successful salesman from Georgia earning $1,500 per week. If he is injured in Iowa with its high maximum weekly TTD rate, he will receive $1,000 per week while he is unable to work, if he elects Iowa for workers comp benefits. If he elects Georgia benefits, the TTD rate is capped at $500 per week.

This creates a coverage issue for the employer. When the workers comp policy is purchased, the employer should have the insurance agent or broker specify in Item 3.C of the Information Page the other states for which coverage is requested. Some agents will approach this by listing every state and territory except North Dakota, Ohio, Washington, Wyoming, Puerto Rico and the US Virgin Islands (the four monopolistic states and two monopolistic territories where the state/territorial governments provide the workers comp coverage). This can result in an accidental oversight where the agent leaves out a state.

A better approach is to insert the following on the Information Page in Item 3.C: “All states and US territories except North Dakota, Ohio, Washington, Wyoming, Puerto Rico and the U.S. Virgin Islands and those states listed in Item 3.A of the Information Page.” While this is the best approach to out of state coverage, some insurers, especially single state insurers or small regional insurers, will object to providing workers comp coverage in other states where they are not licensed to do business.

Most employers think of the workers compensation policy and the workers compensation coverage as one and the same. Actually, the workers comp policy is divided into several sections with Part 1 being the actual workers comp coverage. Part 2 is employer’s liability insurance which covers injuries to employees when workers comp coverage does not apply. Part 3 is Other States Insurance. With this coverage, workers compensation and employers liability insurance is provided for incidental exposure in states not listed in Item 3.A of the Information Page.

It should be noted that Other States Insurance covers only incidental exposures. When the employer starts to have employees in a state on a regular basis, the states needs to be included in those listed in Item 3.A of the Information Page. If your business has employees who occasionally travel out of state, it is a good idea to routinely review your coverage with your insurance agent to confirm that your policy provides for incidental out of state exposures.

NEW 2012 WORKERS COMP MANAGEMENT GUIDEBOOK: www.WCManual.com

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

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

WC GROUP: 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 or agent about workers comp issues.

Washington State Workplace Injury Rates Continue Improving

Robert Elliott, J.D. — Wed, 18 Jan 2012 00:35:13 +0000

Washington's job sites were safer in 2010, continuing a trend that began nearly a decade ago, according to survey results released recently by the Department of Labor & Industries.

The Occupational Injury and Illness Survey for Washington State noted that 5 out of every 100 full-time workers in Washington in both the private and public sector industries suffered a job-related injury or illness in 2010, down from the 5.3 rate in 2009. (WCxKit)

It is the lowest rate recorded since 2003, when the injury rate in Washington state was 6.9. That is when L&I began using the North American Industry Classification System (NAICS) which had been adopted by the U.S. Bureau of Labor Statistics (BLS).

For private industry alone, Washington's reported injury and illness rate remains higher than the national rate. For Washington, that rate was 4.8 per 100 full-time workers in 2010, while the national rate was 3.5.

Almost all major industry sectors in Washington reported improved numbers in 2010. In construction, for instance, the injury and illness rate dropped from 8.2 in 2009 to 7.2 in 2010. Nursing and Residential Care Facilities saw a decline of 11.4 injuries per 100 workers in 2009 to 9.4 injuries last year. (WCxKit)

Also declining in the latest survey was the rate of injuries serious enough that a worker had to miss work. In 2010, 2.5 of those 5 workers who were injured or became ill needed time off or modified work duties while they recovered. That rate is down from 2.6 in 2009.

Author Robert Elliott, executive vice president, Amaxx Risk Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.

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.

Our WORKERS COMP BOOK: www.WCManual.com

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

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

WC GROUP: 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 or agent about workers comp issues.

OSHA Review Upholds Citations against Connecticut Contractor

Robert Elliott, J.D. — Wed, 11 Jan 2012 20:45:59 +0000

The independent Occupational Safety and Health Review Commission has upheld willful and serious citations and $137,200 in fines issued by the U.S. Department of Labor's Occupational Safety and Health Commission to Sand Cut Properties LLC, a Danbury, Conn., contractor.

According to information from OSHA, the agency cited Sand Cut Properties in November 2008 after inspectors at a Brookfield, Conn., work site found an employee working in a collapsing 6- to 9-foot-deep excavation that lacked cave-in protection and had piles of excavated materials overhanging its edge as well as water seeping into its bottom. The employee was exposed to an additional crushing hazard when he exited the excavation by riding in the bucket of an excavator. The citations and fines reflected the seriousness of the violations and the employer's knowledge of and failure to prevent the cave-in hazards. (WCxKit)

The company contested the willful violations cited and accompanying fines to the review commission in December 2008. A hearing was held before Administrative Law Judge Dennis Phillips on June 28, 2011. On Sept. 22, Judge Phillips issued a decision affirming the citations and ordering Sand Cut Properties to pay $137,200 in fines. The decision will become a final order on Nov. 10 if Sand Cut does not appeal to the commission.

"This was an imminent danger situation that could have resulted in a fatality and should not have existed in the first place," said Marthe Kent, OSHA's New England regional administrator. "This decision should remind employers in Connecticut and elsewhere that failing to supply basic, common sense and legally required safeguards will result in financial and legal consequences, just as employees face the consequences of death or disabling injuries when such safeguards are absent from their workplaces." (WCxKit)

"The U.S. Department of Labor will actively pursue the appropriate legal measures to protect the lives and well-being of America's workers when their employers fail to do so," added Michael Felsen, the Labor Department's regional solicitor for New England.

2012 is here! WORKERS COMP PROGRAM: www.WCManual.com

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

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

WC GROUP: 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 or agent about workers comp issues.

What to Tell Employees Who Are Injured On The Job

Rebecca Shafer, J.D. — Wed, 11 Jan 2012 20:17:20 +0000

We are always writing articles to assist the employer in dealing with the complexities of the workers compensation system. We thought for a change of pace we would provide an article to assist the employees in dealing with the tangled web of workers compensation.

The following suggestions will make the workers compensation claim go smoother and alleviate the angst that naturally occurs when an employee is injured on the job. (WCxKit)

1. Report your workers compensation claim immediately, even if you do not need medical care at the moment. What may feel like a pulled muscle today may be a major problem next week. It is better to have a record of your injury when it occurs rather than trying to explain why you are reporting the injury late.

2. Ask your supervisor to prepare a written report of the incident. Your supervisor should willingly do so, but if for any reason the supervisor does not act immediately, submit your own written report providing all the details of what you were doing when you got hurt. Be sure the details of your incident are accurate, as the fastest way to lose credibility is to allow inaccurate information to be reported.

3. Select a medical provider from the list posted. If you do not understand the different specialties, ask for guidance. A medical provider close to work or close to your home is often the easiest one to reach.

4. All the medical care related to your injury will be provided until you have recovered from the injury.

5. If you have a pre-existing medical condition, which can be anything from a prior back injury to diabetes, do not try to hide that fact. To get the appropriate medical care you need, all medical conditions or issues should be disclosed to the medical provider.

6. Keep track of your mileage to and from every medical appointment and to/from the pharmacy. Your mileage can be reimbursed in most states, but only if you have a record of it. Keep a copy of all mileage logs turned into the adjuster.

7. Obtain a written copy of the report your employer submits to the insurance claims office. If anything is incorrect on the report, now is the time to correct it, not later.

8. Attend all doctor appointments and all diagnostic testing. If you do not think you are hurt enough to attend the medical appointments, neither will the adjuster.

9. Provide a copy of all off-work (disability) slips to your employer and to the insurance adjuster, and keep a copy for yourself. Ask your employer if they have a more complete form to use, often called an Injury Treatment Form or Accident Report Form that gathers enough information about your injury so your employer can locate a transitional duty job for you.

10. Keep in touch with the employer and the insurance adjuster. After each doctor's visit, call both the employer and the insurance adjuster and give them an update on what the doctor said about your medical progress and when you may be able to return to work. If you are on transitional duty and your capability increases (it should) let your employer and insurance adjuster know about this.

11. Every work place has co-workers that will want to give you unsolicited advice on your workers comp claim. Follow the real doctor's medical guidance not your friends and co-workers.

12. Every state has a waiting period before lost wage compensation can be paid. Ask the claims adjuster what the waiting period is in your state. If you are out of work longer than the waiting period, you will be paid a percentage (often 66.67%) of your average weekly wage.

13. Ask about your employer's return to work program while your doctor has you off work with restrictions. Often your employer can modify your current job duties so that you can return to work sooner.

14. Do not violate the work restrictions placed on you by your doctor while working light duty. You will most likely end up aggravating your prior injury and extending the period of time it will take for you to recover from your injury.

15. If a nurse case manager is assigned to your claim, keep the nurse informed as to your medical progress and understand he/she is there to make sure you obtain the appropriate medical care. (WCxKit)

Your employer hopes you will never get hurt, but if you do, keep the workers comp claim suggestions in mind to improve the claim experience and the overall outcome of your claim.

If you are an employer reading this, the above items can be included in an employee brochure.

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. Rebecca is the author of Workers Compensation Management Program: Reduce Costs 20-50%. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.

NEW! 2012 WORKERS COMP BOOK: www.WCManual.com

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

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

WC GROUP: 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 or agent about workers comp issues.

LexisNexis Gives Great Review of Roundup Book

Rebecca Shafer, J.D. — Sat, 07 Jan 2012 22:17:02 +0000

A review titled “Cost Containment From Soup to Nuts: Rebecca Shafer’s Workers Compensation Management Program: Reduce Costs 20% to 50%, 2012 Edition” recently raved about our manual’s latest edition on the LexisNexis Workers Compensation Law Community powered by Larson’s.(WCxKit)

Author Karen C. Yotis writes, “When a workers’ compensation maven of Rebecca Shafer’s caliber shares her expertise about implementing cost containment best practices, industry professionals can’t afford to do anything but listen.” She, of course, also continues to say, “risk managers, adjusters, vendors, attorneys, agents and brokers, carriers, and employers can’t afford to do anything but click here to purchase the book, and start reading.”

We like her.

Yotis explains our book is a roadmap that has sharp teeth and notes that its author, Shafer, has more than 25 years of experience in the industry. “This is NOT an intellectual discussion about workers comp issues and trends, but rather a hands-on practicum written from years of field research with a host of companies.” Yotis writes.

She goes on to review and explain both parts of the manual, An Action-Oriented “How To” Template and Cost Containment from Soup to Nuts noting where updates from previous editions make this the one to buy.

To read her full review, follow the link here. Or, just click on over here and get your own copy!

WORKERS COMP MANAGEMENT GUIDEBOOK: www.WCManual.com

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

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

WC GROUP: 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 or agent about workers comp issues.

LexisNexis Work Comp Law Community Experts Sound Off About Top 10 Myths of the Workers Comp Industry

Rebecca Shafer, J.D. — Thu, 05 Jan 2012 22:53:42 +0000

LexisNexis Workers Compensation Law Community directed by attorney Robin Kobayashi recently teamed up with Work Comp Roundup to deliver expert opinions on the 10 most critical myths and facts about workers compensation.

What Kobayashi found were 10 top representatives from varied segments of the WC industry. Questions and comments to these experts are encouraged on the LexisNexis Workers’ Compensation Law Community, which provides all the contact information one would need.

The article goes into depth on the following 10 myths, in no particular order:

Myth #1: Large discount networks are the key to success in workers compensation managed care – from Kenneth F. Martino, president and CEO of Broadspire Services, Inc.

Myth #2: The employer’s role ends once the workers’ comp claim is paid from Emily Holbrook, editor, Risk Management and co-editor of Risk Management Monitor.

Myth #3: Workers compensation claims improve with age, by Mark Walls, assistant vice president of claims at Safety National.

Myth #4: Technology will cure all of our ills, from Robert Wilson, president & CEO of WorkersCompensation.com, LLC.

Myth #5: Because FECA is so different from state workers compensation systems, private sector case management best practices won’t work, contributed by Marianne Cloeren, MD, MPH, FACOEM, and medical director of Managed Care Advisors, Inc.

Myth #6: The vast majority of all medical reports using the AMA guides are inaccurate, from Robert G. Rassp, Esq. of the Law Office of Robert G. Rassp and author of The Rassp Report and The Lawyer’s Guide to the AMA Guides and California Workers’ Compensation (LexisNexis).

Myth #7: CMS’ approval of an MSA is binding from Jennifer C. Jordan, Esq., general counsel at MEDVAL, LLP.

Myth #8: Doctors prescribe narcotic pain medications because of concerns they may be sued if they don’t treat pain from Stuart D. Colburn, Esq., shareholder in Downs Stanford, P.C.

Myth #9: Workers Compensation Costs Are Out of Control, discussed by Rebecca Shafer, Esq., president of Amaxx Risk Solutions, Inc. author of WCManual.com and LowerWC.com.

Myth #10: The exclusive remedy defense is being eroded from Thomas A. Robinson, J.D., author of the WorkCompWriter.com.

Remember, these are all MYTHS! The article itself goes into depth explaining why they are not FACTS. Work Comp Roundup considers it required reading for everyone in the field – it’s a great way to start the new year.

WORKERS COMP MANAGEMENT GUIDEBOOK: www.WCManual.com

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

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

WC GROUP: 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 or agent about workers comp issues.

Quick Tip: Keep Excellent Workers Compensation Records

Rebecca Shafer, J.D. — Sun, 01 Jan 2012 22:46:32 +0000

Document, Document, Document

Carriers preach the importance of documentation in claim files using this pithy saying: " If it is not documented, it did not happen." The same should be true for every employer. Risk management or safety team members must properly document everything. This includes tracking numbers and incidents, recording safety problems, and keeping a close watch on injuries and incidents on the work floor.

Why record keeping is important

All workers arrive on the job with various physical issues related to their personal life. Perhaps the worker did a lot of yard work over the weekend and is sore. Maybe the employee fell shoveling snow and has a back injury. Maybe personal turmoil is affecting safety and work. Regardless of cause, it is important to keep proper records on everything heard on the job floor. No one can recall every single detail of a day, so writing it down is critical to document the situation.

When talking to employers, I ask the employer how aware they are of an employee’s personal life. Some answer that question by saying little to no social contact with employees. Other employers will report being friends with coworkers and socializing on a regular basis. Some are right in the middle, reporting casual exchanges in the hallway or break room but not really knowing the employee.

The medical worlds of insurance are interwoven between personal injuries and workers compensation injuries. Some workers have a good combination of both. Some workers never take any time off for a medical condition, whereas others will be off of work frequently for some reason or another.

Many HR people have access to personal medical leave papers. The importance of keeping records shows itself when the time comes and they are needed. If an employee had a knee surgery last year then suddenly claims to injure the same knee at work, a review of personnel files may show the alleged knee injury is not work related. But if the records do not exist, then there is no way to question the claim.

When filing the compensation claim for the knee injury, the adjuster calls and probes about any other past injuries. If the employer is only able to give a vague account of a past injury, the adjuster lacks information to judge the claims compensability. If the claimant does not bring it up to the adjuster, and there are no records as to the employee’s medical leave, there is no way to prove a pre-existing knee injury is present. So with any injury, it is important to keep proper records in every personnel file. No matter the reason for the medical leave, documentation with as much information as possible must be gathered at the time of medical leave. This will help in the future should an issue like the one described happen. The impact documentation has on a workers comp claim can be priceless, in that the employer may not pay workers comp benefits.

Document, document, document …. oh, and write it all down.

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, Workers Compensation Management Program: Reduce Costs 20% to 50%. www.WCManual.com
Visit www.LowerWC.com for more information for cost saving hints and tips. Contact: RShafer@ReduceYourWorkersComp.com.

WORKERS COMP GUIDEBOOK: www.WCManual.com

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

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

WC GROUP: 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 or agent about workers comp issues.

Indiana Workers Compensation Basics 101

Rebecca Shafer, J.D. — Tue, 20 Dec 2011 00:27:53 +0000

Workers Compensation Laws change frequently. This is only a summary; a complete copy of the most up-to-date version can be found at: www.WorkCompResearch.com an excellent service.

In Indiana, every employer who has one or more employees, whether full time or part time is required to carry workers compensation insurance. There are some exceptions. Railroad workers, real estate professionals, independent contractors, inmates and volunteers of non-profits are not covered by workers compensation. Employers of casual laborers, household employees, agriculture employees, and migrant farm workers may elect to buy workers compensation insurance. All county and municipal governments, and all school districts must carry workers compensation insurance, but police officers and firefighters may not be covered if they are covered for injury through a pension fund.

Obtaining Coverage

To obtain workers compensation coverage in Indiana, the employer has two options of either

purchasing a workers compensation insurance policy from a state approved insurance company

applying to and being approved for self-insurance status with the Indiana Workers Compensation Board. (WCxKit)

Claim Reporting

The employee must report the injury to the employer as soon as practical after the occurrence. If the injury is reported after 30 days, benefits start as of the date of the notice. If the employee incurs disability of one or more days, the employer is required to report the claim to the Board of Workers Compensation within 7 days. If the employer (insurer) fails to report the claim timely to the board, the employer (insurer) can be fined $500.00.

Medical Benefits

The employer selects the medical provider in Indiana workers compensation claims. The employer is required to provide all reasonable and necessary medical care free of any charges to the employee. There is no time limit on how long medical care can be provided.

In cases involving permanent injury, the Board may order future medical care to limit or reduce the extent of the employee’s injury.

Temporary Total Disability Benefits

The temporary total disability (TTD) benefits are calculated as two-thirds of the employee's average weekly wage over the 52 weeks prior to the date of injury, not counting the week of the injury. The maximum amount of TTD benefits that can be paid is $650.00 per week. There is no automatic cost of living increase. The state minimum weekly benefit is $50.

The first 7 days of disability (the waiting period) is not paid to the injured employee unless the employee is disabled for more than 21 days. TTD benefits can be paid for a maximum of 500 weeks

Temporary Partial Disability Benefits

In Indiana if the employee is able to return to any type of work, but at a lesser rate of pay then the amount the employee was earning prior to the injury, the employee is entitled to temporary partial disability (TPD) benefits. The TPD benefits are paid at two-thirds of the difference between the pre-injury wage and the post-injury wage. The TPD benefits are paid for up to 300 weeks. The TPD benefits plus the post-injury pay rate cannot exceed the state's maximum indemnity benefits rate.

Permanent Partial Impairment

It should be noted that Indiana is one of the few states that does not have a schedule for injuries to limbs, sight, hearing, etc. Instead, the treating physician will assign to the employee a permanent partial impairment rating, with the whole body being considered 100 degrees. Limbs and other body parts are worth so many degrees, and then the number of degrees is multiplied by the percentage of disability. The Board maintains a chart that shows what each degree of injury is worth. Interestingly, with this system, the high wage earner does not receive any more than the low wage number when they have the identical degree of injury. However, if the injured employee has already received in excess of 125 weeks of indemnity compensation, the insurer does receive a partial credit against the PPI award.

Permanent total disability

Indiana permits the employee to collect a maximum of 500 weeks of indemnity benefits for all types of indemnity combined, unless the employee is classified as permanent total disability. If the employee is permanently and totally disability, the state’s second injury fund will pay up to 125 weeks of additional benefits after the insurer has paid for 500 weeks.

Death Benefits

The burial expenses in Indiana are covered for a work-related death up to $7,500. The death benefits for a dependent spouse and children follow the same guidelines as TTD benefits – two-thirds of the average weekly wage – currently a maximum of $650 per week, up to a maximum of 500 weeks, except there is a dollar maximum for death benefits in the amount of $294,000. If the spouse remarries, the spouse receives the lesser of 104 weeks or benefits or the remainder of the 500 weeks. (WCxKit)

Vocational Benefits

The employer is not required to pay for vocational rehabilitation under the Indiana workers compensation act. Injured employees who need vocational rehabilitation can obtain assistance through the Office of Vocational Rehabilitation operated by the State of Indiana.

WORKERS COMP NMANAGEMENT GUIDE: www.WCManual.com

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

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

WC GROUP: 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 or agent about workers comp issues.