Workers’ Comp Fundamental Truth – It Doesn’t Have to Be So Hard

 

There are some things in life that you discover for the first time that you realize you’ve known all along. Hello, my name is Michael Stack. I’m the principal of Amaxx and founder of the Amaxx Workers’ Comp Training Center.

 

 

Nutrition Is Surprisingly Complex

 

A little personal anecdote, that that little message, discovering what you’ve known all along, is very true for myself and for my family. We’ve been doing all this research on nutrition, and we watched the movie Forks Over Knives. We watched the movie What the Health. We watched Fed Up. We also watched Food, Inc., and we bought The China Study book, which is a 400-page book. Very complex. There’s a lot to this idea of nutrition, the type of diet we should be eating, and what it does for our health.

 

We’re moving towards this whole foods, plant-based diet. We’ve been on it for about a week. I’ll let you know how it goes, but so far, so good. It got me thinking about this complexity, this idea of nutrition, this idea of why is it so hard for us to realize what is the right answer and what is the most healthy option for us for our long-term health. It’s baffling to me. When I think about workers’ compensation, it’s the same thing. The system is extraordinarily complex and baffling as to why it’s so hard to get that proper outcome. Why is it so complex?

 

 

Basic Fundamental Truths Will Lead to Success

 

In nutrition, there’s many layers to it, and in workers’ compensation, there are many layers to that, too, and I don’t see either one of them changing any time soon. When you break it all down, when you look at the fundamental truths of what makes you successful in nutrition, processed artificial chemicals, all that different kind of stuff, we know that that stuff is not good for us. We know the convenience and going through McDonald’s isn’t good for us. You don’t have to read a book or watch a movie to know that truth. Not caring for your injured workers or processing them like a robotic system is not good for their outcome either. You don’t have to go to a lot of national conferences and a lot of trainings to understand that fundamental truth either.

 

I want to encourage you to get back to basics in understanding in your work comp program what are those elements that you already know will lead you to success, and that fundamental truth that will take you there. Looking at our claims as just a claims number versus an individual person … Jeffrey Thomas, who has two kids and lives in Arizona and likes to fish … will lead you in a better direction. Sure, the complexity is going to always be there, but if you can get back to these basics of what we know makes us successful, we will be well on our way to mastering workers’ compensation, and workers’ compensation costs and outcomes.

 

Again, I’m Michael Stack with Amaxx. If you’re watching this video and you like the message, I encourage you to go to reduceyourworkerscomp.com and sign up for my free newsletter for a lot more information. Remember, your success in workers’ compensation is defined by your integrity, so be great.

 

 

Michael Stack - AmaxxAuthor Michael Stack, Principal, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center. .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

©2017 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

3 Factors In Determining If Employee is Independent Contractor

A common issue in the compensability of a workers’ compensation claim includes a determination of whether the injured party is an employee or independent contractor.  This is important for employer stakeholders to understand as the issue is often subject to litigation.

 

 

Important Factors to Consider

 

The law concerning employee relationships is defined by each state or jurisdiction, which results in differing interpretations.  It is important to understand the law in the jurisdiction where the claim arises or could be venued.  When in doubt, always consult with an attorney.

 

Here are some common elements found under state workers’ compensation law to consider:

 

1) Financial control.

 

This deals with issues concerning whether the employer has the right of control in the various business aspects of the relationship with the injured party.  Careful inquiry and examination must include:

 

  • How the person is reimbursed for their time. While the issuance of a 1099 tax form is key, it is not always determinative on the issue.

 

  • How the party and employer handle unreimbursed business expenses. In all instances, a true independent contractor are more likely to have unreimbursed expenses than employees.

 

  • The investment of the worker’s time. In a true independent contractor relationship, the only investment the person will have is the actual time they spend on work.

 

 

2) Behavioral Control

 

This inquiry involves the understanding on what instructions the employer will give to the person performing work.  Key questions that need to be asked include:

 

  • When and where to do the work?

 

  • What tools or equipment to use?

 

  • What workers to hire or to assist with the work?

 

  • Where to purchase supplies and services?

 

  • What work a specified individual must perform?

 

  • What order or sequence to follow?

 

Issues of “behavioral control” are often central to investigations in construction workers such as siders, roofers and other work that can be considered seasonal.  Allowing an “independent contractor” to use company tools can be fatal to an assertion the party was not an employee.

 

 

3) Types of Business Relationships

 

Courts will also examine the nature of agreements—both verbal and written.  This includes documents signed between the person and employer.  Merely calling someone an “independent contractor” does little to avoid establishing an employee-employer relationship, and thus compensability should an injury arise.  Having a written document calling someone an independent contractor can give a false sense of security and shattered hopes of defeating a claim at hearing before a compensation judge or industrial commission.

 

  • Written contracts. Courts give little deference to what a person is described as in a written agreement.  The devil is always in the details.  A potential employer should not forget to memorialize the arrangement in writing.  It is still an important piece of evidence.

 

  • Insurance agreements and other fringe benefits. An employee-employer relationship can be established if the person in question receives tangible benefits beyond payment for the labor they perform.  In many instances, court have declared a person to be an employee for purpose of workers’ compensation based on the payment of other benefits or perks such as pension plans, 401K contributions, vacation pay, sick pay or other forms of PTO.

 

  • Tenure of service. The longer a person works an employer, the greater the risk there is for them to become an employee.  In order to avoid this situation, the written independent contractor agreement should be for a defined period, or specific to a particular project.

 

 

Conclusions

 

Central to the determination of whether someone is an independent contractor revolves around issues of control.  The more control a company has over an individual, the more likely they look like an employee and resulting injuries are compensable.  It is important to be aware of these issues to avoid unnecessary costs in your workers’ compensation program.

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center. .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

Live Stream WC Training: http://workerscompclub.com/livestreamtraining

 

©2017 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

10 Common Questions Claimants Have When Filing a Worker Comp Claim

Being in the insurance or risk management field we often forget that the workers that get injured do not know nearly as much as we know about claims.  At times, adjusters forget to take the time needed to properly explain what rights injured workers have when these claims occur, and that can lead to a disconnect between the adjuster and the injured worker.  This disconnect can make the claim travel down a bumpy road rather than a nice, smooth, streamlined one.

 

Here are some common questions claimants have when filing a work comp claim.  Please note the answers to these questions can vary by jurisdiction, be sure to consult your adjuster or local legal counsel if you have questions.

 

 

  1. How do I get paid?

 

If your case is deemed compensable, you will receive a workers compensation check, probably in the mail or direct deposit, every week or two after the waiting period has subsided.  This check is meant to replace your lost wages from work.  It will not be 100% of the pay you are accustomed to receiving but rather a percentage of your gross wages based on whatever formula the state of jurisdiction uses.

 

 

  1. When will I get paid?

 

Generally wages are paid after your case has been deemed compensable by the adjuster handling the file.  Usually this can range from a period of a week or two to maybe a month or so.  Other factors can delay payment, including the investigation of the claim and the gathering of the pertinent medical records.

 

 

  1. How much will my work comp check be?

 

This will depend on your jurisdiction.  Typically you will receive anywhere from 66% of your net pay to up to 80%, maybe even more. Fringe benefits that you receive from your employer can also affect the amount of your work comp check.  Anything that you are responsible for regarding your personal medical insurance or 401k may still have to be paid by you, the injured worker.  Work comp pay is not taxable income, and you will not receive a W2 for work comp wages paid out for whatever year you received benefits.

 

 

  1. Can I go to my primary care physician?

 

This will vary by the jurisdiction, but generally the answer is yes. After a certain period of time, you can go to an appointment with your primary care doc, and usually the first one will be paid for by the insurance carrier that is handling the work comp claim.  Whether or not you can continue to treat with your personal doctor is up to your adjuster, and if your personal doctor accepts work comp patients and does proper work comp billing.

 

 

  1. Do I have to go to “your” doctor all the time?

 

Maybe, depending on the jurisdiction and if your adjuster authorizes you to treat with your physician instead of the occupational medicine doctor.

 

 

  1. Why is the work comp doctor’s opinion more important or more crediblethan my doctor?

 

This will depend on what each doctor is saying in their medical reports. Sometimes personal physicians will say one thing with you in the exam room, and meanwhile when they dictate their notes they may mention diagnoses and findings not essentially shared with you personally.  The same is true for the occupational doctor.  The best way to stay the most informed is to request a copy of your medical records from both doctors, this way you can see all of the information that the adjuster is seeing, in regards to the medical chart.

 

 

  1. What if I have two jobs? Do I receive lost wages for both jobs?

 

Usually yes, but again this will depend on the jurisdiction. You will have to provide your adjuster with a copy of your personnel file and wage records from your second employer, and be sure to tell this other employer than you sustained a work comp injury at your other job and that you may not be able to work your job during your healing period until you are fully released from medical care with no more restrictions.

 

 

  1. The light duty job assigned to me pays less than my normal job. Is this legal?

 

Yes it is legal, but the insurance carrier will be obligated to pay you a “partial” wage.  This means that they take the reduced wages you will earn and issue you a supplemental check for the difference.  The amount of this check will depend on the jurisdiction the claim is in.  If you have questions about how this supplemental check is determined, contact your adjuster and have them walk you through the process.

 

 

  1. Why isn’t my adjuster returning my calls?

 

Adjusters can handle and be responsible for hundreds of files, of which you are one of.  These files are all in different stages, and are of varying complexity.

 

Give your adjuster a day or so to have a chance to return your call.  One thing an adjuster hates is someone that calls them every hour. Sadly, the squeaky wheel rarely gets the grease.  Be patient, and allow your adjuster the professional courtesy to get to your claim.  But, you also have to be persistent.  If you have left a few messages and 3-4 days go by without a callback, you can call and ask for their supervisor.  Every adjuster has an obligation to return calls to their claimants, no matter how insignificant the question may be.  Failure to return calls can be considered “bad faith” on the part of the adjuster, and they or their company can incur penalties or fines if they do indeed fail to return your call within a reasonable timeframe.

 

 

  1. Should I consult an attorney?

 

There is no right or wrong answer to this question.  The only person that can answer this question is you.  If you will feel more at ease by talking to a legal professional, then by all means do so.  Having a phone consultation with an attorney doesn’t mean that you are filing a lawsuit against your employer. If it makes you sleep better at night knowing you talked to an attorney, then by all means do so. Better yet, talk to a few attorneys if you have to.

 

 

Summary

 

These questions are normal questions every claimant will have with their work comp claim.  Some people know more about the work comp system than others, but don’t take your fellow coworkers advice about what to do with your claim.  Many coworkers that have a vast experience in dealing with work comp situations will not always give you credible or correct advice.  Your adjuster is the one handling your claim, and they will be there to walk you through the process.

 

If you feel that the adjuster did not answer your question good enough, feel free to consult an attorney.  You want to make sure you are very involved in how your claim is handled.  After all, being injured doesn’t mean that you do not need to know anything about how the process works and what rights you have as an injured worker.

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices.

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

Live Stream WC Training: http://workerscompclub.com/livestreamtraining

 

©2017 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

How To Guarantee Better Workers’ Comp Outcomes

 

Big data. Predictive analytics. Very sophisticated modeling to predict claims outcomes versus a paper and a pen. I’m Michael Stack with Amaxx and today I’m going to be telling you how to guarantee better claim outcomes without spending any additional money and only maybe about 20 to 30 minutes of additional work on your claim.

 

Now, don’t get me wrong. Big data, predictive analytics, sophisticated claims modeling to predict claims outcomes, incredibly valuable tool and resource that the companies are specializing in this information and then bringing it to the market place give for our industry. But for your employee, Tom Smith, who gets injured today, you’re going to have the most impact and guarantee a better outcome for Tom’s claim with a paper and a pen.

 

 

Look at Your Last 5 First Report of Injury

 

Let me tell you what I mean. What I want you to do is pull out your last five first-reports of injury. Go ahead and pull those out and take a look at them. How well are they completed? How well are they, on a scale from one to ten? What would you get it? Would you give it a one, would you give it three, would you give it a five, would you give it a ten? I’m going to bet that there’s room for improvement in the completion of your first reports of injury. Here’s what I want you to do, is that I want you to realize that how well that first report of injury is completed is a huge determining factor in how well that claim is going to go. I want you to step up your game in the completion of those first reports of injury because it’s going to guarantee for Tom’s claim, who gets injured today, a better outcome for Tom and thereby a better outcome for you in reduced worker’s comp cost.

 

 

4 Points To Properly Execute

 

When you’re taking a look at these first reports, here’s the information that I want you to look at and see if you can have room for improvement here. First point is who’s responsible for completing these? Is it Jane, Jane the low-level employee and Jane just whips through this in three minutes and says, “I don’t know, that was Tom and he fell off a ladder,” and check-check-check and leaves a whole bunch of blank information? Or, is it a highly responsible accountable person, is it you that’s completing this, or is it you that’s holding that person accountable for getting all the information that you need?

 

Step number two is, is all the basic information right? Do you have the name right, do you have the social security right, do you have the average weekly wage correct, do you have the date of injury correct? This happens so often it is criminal that this basic information is wrong and the amount of litigation a problem that it causes in a claim just because you didn’t get this right, is incredible.

 

Number three is I want you to look at the mechanism of injury. Do you have information about the mechanism of injury or is it just written, “Tom fell of a ladder and hurt his low back”. Sorry, that’s not really going to help me very much. That’s not going to cut it in the investigation of a claim. The mechanism of injury, was Tom lifting, was he pulling, was he twisting? Was he carrying paint buckets when he was going up that ladder? Was it against the roof, was it against the siding? Was it a big ladder, was it a small ladder? What was it that caused that injury? What was that mechanism of injury? What are those details surrounding that?

 

Finally, what is the context of the injury. Again, painting that picture of what actually happened. Was Tom inside, was he outside? Was he in the warehouse? Was he lifting up and putting something in the third shelf or was he lifting up and putting it up on the second shelf? What happened? What is that picture making that very crystal clear for what actually happened on that claim? Without good information we can’t make a good decision and the processing of big data, without good data going in you’re not going to get good data going out. Spend that extra 15, 20, even 30 minutes on Tom’s injury, detailing this out, take a look at your first reports of injury, step up our game in getting information ready and you will guarantee yourself better worker’s comp claim outcomes.

 

 

Learn More About Reducing Workers’ Comp Costs

 

Again, I’m Michael Stack with Amaxx and if you’re watching this video somewhere other than reduceyourworkerscomp.com, go ahead and go to that website, sign up for a lot more free information on how to control your worker’s comp costs. To take it one step further, you can go to workers compclub.com/livestreamtraining and sign up for my next live stream training. Again, I’m Michael Stack with Amaxx, remember your success in worker’s compensation is defined by your integrity, so be great!

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices.

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

Live Stream WC Training: http://workerscompclub.com/livestreamtraining

 

©2017 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

Most Common Workers’ Compensation Errors

Companies with exorbitant workers’ compensation costs are doing several things wrong, however, the most common error is not properly managing their programs. Too many companies sit back, assume nothing more can be done and wait for the legislature to introduce problem-solving laws. There certainly are some laws that could be changed, but most companies don’t take advantage of the options already available to them.

 

 

Common Workers Compensation Errors

 

Employer Directed Care

 

For instance, some states allow the employer to select the doctor who will treat employees injured on the job. These are “employer directed” states. In these states employers enjoy a special opportunity to use physicians experienced in industrial/occupational medicine and also familiar with the employer’s workers’ compensation program. Despite the opportunity, only about 20 percent of employers in these states are using this tool.

 

 

Failure To Follow Up With Injured Work

 

Another common error is failure of companies to follow up on injured workers after they become disabled. The employer assumes the worker’s doctor will give the word when the employee is ready to come back to work. These employers neglect to consider the doctor probably doesn’t know about the employer’s modified duty program or an employee’s job might be changed to accommodate the applicable medical restrictions.

 

These employers typically neglect to contact the employee, a grave mistake. Without contact, the employee may lose the incentive to return to work and become “psychologically disemployed.” (As typically happens to all of us after a few weeks on vacation). The proper focus, to return the employee to work, is lost.

 

 

Lack of Workers’ Comp Understanding

 

Employers that make the most common errors often don’t know enough about the workers’ compensation system and the options that are available to control their programs.  The lack of understanding makes it relatively easy for employees so inclined to abuse the system.

 

Example: A company has operations in 15 states with “fee schedules” (a special lower rate physicians must charge for treating employees injured on the job.) for industrial accidents. No one was assigned to make sure medical bills were audited for compliance with the fee schedules in the various states. Result: The company paid out hundreds of thousands of dollars in excess medical fees.

 

 

The First Step

 

Companies need to establish an orderly process beginning in the first moments after an injury. The process must ask and answer such questions as where the employee received treatment, how the employee gets to the doctor, who contacts the employee to make sure medical care is appropriate, when the employee is expected to return to work, and so forth.

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment.

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

Control Workers Comp Losses To Control Premiums

photo-1459257831348-f0cdd359235fPremiums, being “loss-sensitive” are set according to the volume of losses. When losses are under control and at acceptable levels, the employer’s experience modification factor falls and premiums drop too. Therefore, the key to controlling premiums is controlling losses. Enlightened employers use pre-loss management techniques, such as safety programs, along with post-loss strategies like injury management to control workers’ compensation costs.

 

 

Employer Involvement Key To Success

 

Cost containment essentially comes down to how well a company proactively manages its workers’ compensation programs. The kind of management an employer needs to reduce workers’ compensation costs does not come from turning all control of claims over to the insurance carrier working entirely outside the control of the client/employer. Few managers would pass on to outside managers the responsibility for quality control, human resources or internal auditing. Unfortunately, with workers’ compensation external management is typical. These employers assume the outside firm, i.e., the insurance company to whom they pay premiums, is managing their claims programs responsibly. In fact, there is very little incentive for an insurance company to decrease a client’s losses when premiums are based on the customer’s loss volume.  Remember:  the key to controlling premiums is controlling losses.

 

 

Substantial Savings Should Be Expected

 

Substantial savings can be realized and should be expected.  Recently, a Fortune 500 corporation experienced 30 million dollars in annual losses. The company maintained very little control and allowed an independent adjusting company to make most of the decisions about the way its claims were handled. The company instituted an injury management program and reduced its incurred losses by 84 percent in the first year.

 

 

Assess & Measure Performance

 

An organization should start by gaining a basic understanding of key metrics and performance measures.

 

  1. Reporting Lag Time

For each claim, determine the number of days from the date of the injury until the claim is reported to the workers’ compensation coordinator within your company.  Total the number of days for all claims in the last 12 months and divide by the total number of claims reported. {The average should be under 1 day}.

 

  1. Annual Cost Per Full Time Equivalent Employee

To establish the annual cost per employee, use the total claim cost over the prior 12 months, divided by the total number of full-time equivalent employees.

 

  1. Average Claim Duration

To determine the average claim duration, take the total number of days – for all reported claims during the last 12 months – from the date of injury to the date a claim is closed, divided by the total number of claims reported.

 

 

The utilization of these measurements will provide your company with insight on how the baseline, as well as how your workers’ compensation cost control efforts are working.  Over time all 3 measurements will show improvement.  Also, by tracking your workers’ compensation program performance over an extended period of time, you will be able to pin-point areas where performance of your cost control efforts can be improved.

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment.

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

 

 

5 More Things The New Workers Comp Manager Needs to Know

Being new to workers’ compensation can often seem like you are trying to navigate a foreign land. It helps to know what to expect getting started.  Here are five additional items it helps to know about the job.

 

  1. Sometimes it is time to babysit.

Injuries do happen. The employee needs to know the company still cares after the worker is no longer able to work. If there is a workers compensation coordinator, you can delegate to her the job of keeping in touch with all the injured workers until they are back to work doing transitional duty. The best policy is to contact the injured employee after each medical appointment to learn of any issues with their medical treatment, their return to work status and any concerns they have about their job or their work comp claim. By showing the injured employees the employer cares, it will have an overall effect of lowering cost of workers compensation.

 

 

  1. Know the adjuster(s).

The adjuster is now a new best friend. A competent adjuster who does the job well will make the WC manager’s job easier. The better the working relationship with the adjuster, the fewer snags encountered on workers compensation claims. (The fewer adjusters to work with, the easier it is to learn their strong points and weak points. If the claims are not already consolidated with the minimum number of adjusters possible to cover the claims, work toward consolidating claims with the best adjusters available.

 

 

  1. Know your insurance broker.

The broker is now a second new best friend. A mistake a lot of new workers comp managers make is thinking the broker works for or is an employee of the insurance company. The broker is a knowledgeable business person who works for the employer as an advisor. The broker’s main job is to keep the employer (insured) happy.  Discuss with the broker what benefits are provided. Hold the broker to this, and the new job will get easier. Expect more than simply an annual stewardship report. Ask the broker to be proactive and make suggestions about your workers compensation program. 

 

  1. Know the return to work program.

The better the company’s transitional duty program, also known as modified duty or light duty, the quicker and faster the workers compensation claims will come to an end. The company is going to be paying the cost of the indemnity benefits through higher workers comp premiums. To reduce the cost of those benefits, return the employee to modified duty. While the injured employee may not be as productive as an uninjured employee, all the productivity of the injured employee on light duty is benefiting the company to some extent while reducing the cost of the claim.

 

  1. Review the claim files.

If asked, most third party administrators or insurance companies will arrange online access to the claim file notes where the adjuster records the activities and events of the claim. While the file notes are helpful, they do not tell the whole story. Go to the claims office and read everything in the claim files. The claims office will probably try to talk you into doing an on-line review, but an in-person review with the adjuster(s) about the claims will provide the most information. There are also claim consultants who do claim file audits, if that is preferable.

 

Good luck in the new role as the work comp manager. Use the ideas and consult our website often for advice on workers compensation.  For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

 

5 Things the New Workers Comp Manager Needs to Know

While more colleges are now offering majors in risk management and insurance than there were available just ten or twenty years ago, many of the people who come in to the field of risk management and the even more specialized field of Workers Compensation Manager, do not have previous experience or backgrounds in workers compensation. It is nothing unusual in this day of tight hiring practices and double duty jobs for the new workers comp manager to also be working in another department such as finance or human resources. It becomes a learn-as-you-go-experience.

 

 

The new workers comp manager, even the one who has been a workers comp adjuster, often needs a guide on what to anticipate in the new role. Therefore, we have put together a list of 5 things it helps to know about the job. Here is our list of five things the new workers compensation manager knows, but no one will tell.

 

 

  1. The Safety Manager is your new best friend. 

The better the safety manager does the job, the easier the new WC manager’s job will be, as fewer accidents means fewer workers compensation claims to be made.  Ask the safety manager what can be done to eliminate accidents and injuries.

 

 

  1. Learn how to read the loss run. 

The loss run provides tons of useful information on the nature and the extent of the injuries. Learn about the types of injuries that occur most often and discuss with the Safety Manager what can be done to eliminate the frequent reoccurrences. Review the loss run to see how much money is being spent on medical and how much money is paid out in indemnity benefits. Look for areas where costs can be reduced. Customize the loss run; ask friends about the most helpful stats they have on their loss run, and include those on yours.

 

 

 

  1. Know your insurer.

The insurance company that writes the workers compensation insurance is the insurer. The term “insurance carrier” will also be used. This does not mean they carry premiums to the bank. It is an old fashion term for carrying the burden of insurance loss. (Not to be confused with “insured” which is the employer). Learn about the insurer. Are they a mammoth insurance company who writes workers compensation as one of many types of insurance, or are they a smaller regional or local company that specializes in workers compensation. What services do they offer as part of you program or at low cost. Ask them to explain ALL of their services, not just those they pre-select.

 

 

 

  1. Know the cost of workers compensation.

Learn what is paid for workers compensation insurance each year, and if the premium is paid monthly, quarterly, or annually. Learn policy dates and which way the premium has been trending in recent years. (Declining premiums are a good sign the safety manager is doing his job well, while increasing premiums indicates a need to team with the Safety Manager to reduce the number of claims and the severity of the claims that do occur. Know how to translate this into total dollars spent on workers compensation.

 

 

  1. Timing is everything.

The most successful workers compensation managers are the ones that learn time is of the essence in almost everything done as a work comp manager. New injury? Report it immediately to the claims office and immediately advise the medical provider’s office of the transitional duty program. New disability slip? Coordinate with the injured employee’s supervisor on how to accommodate the light duty work slip. New information on an older claim? Call the adjuster and share it with her so she can act on the information while it is still beneficial.

 

Good luck in the new role as the work comp manager. Use the ideas and consult our website often for advice on workers compensation.  For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

 

Who’s In Control Of Your Workers Compensation Program?

 

We all like to be in control, right? Or at least feel like we’re in control anyway, but we know that there are times, and there are situations when the chickens are actually ruling the roost.

 

 

The Chickens Are Ruling The Roost

 

I’m going to show you a little clip. This is a YouTube clip from the show Super Nanny to really show and explain my point a little bit further. Let’s take a look at this together.

 

Donuts! Donut, donut. Please mommy! Please mommy! I’ll be extra good if you give me a donut!

 

Now anyone who has children probably knows that scene maybe all too well. My wife and I have four kids ourselves, so it’s something that we’re working on regularly.

 

If that parent gives in to the child and gives her the donut, who’s in control of that situation? If you get a note like this from Joe Martin, that says no work until seen by this office again, and you accept that note, who’s in control of that situation?

 

It’s going to create a worse outcome for that child long term if you give her that short term fix instead of working on the attitude and the behavioral challenges to create a better human being in the long term. The same is true for your work comp management program. If you accept a note like this from Joe without getting the needed information and plug him into your system, you’re creating long-term challenges and you’re creating a very expensive work comp system for your organization.

 

 

Information Needed At Time Of Injury To Take Control

 

Here’s the information that you need in order to take control of an injury at the start of that claim. You need to know the information about the injury itself, the diagnosis, the prognosis, the treatment plan. You also need to know some important information with regards to return to work. You need to know the estimated return to work date, as well as the medical restrictions from that treating physician for what that individual can and cannot do.

 

Finally you need to know some pertinent scheduling type information. Things like the next appointment date as well as that doctor’s contact phone number. If you get that information that puts you in control. If you deny that child the donut at that time, you start to get in control of that situation, creating a better long term outcome in both scenarios.

 

I’m Michael Stack with AMAXX, and remember your success in worker’s compensation is defined by your integrity, so be great.

 

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

 

Make Your Work Comp Message Stick Like Gorilla Glue

This Is Part 2 in a 3 Part Mini Series.

 

The Tipping Point in Workers Compensation

  1. Paul Revere, Workers Compensation, and the Tipping Point
  2. Make Your Work Comp Message Stick Like Gorilla Glue
  3. How Work Comp Can Be Just Like Prison

 

I’m Michael Stack with Amaxx and welcome back to The Tipping Point mini series where we’re reviewing the elements discussed by Malcolm Gladwell in the book The Tipping Point: How Little Things Can Make a Big Difference. When you’re trying to implement change, when you’re starting to try to implement an epidemic of proper work comp management to reduce your work comp costs and really create a better outcome for your injured workers.

 

In the first series, I talked about the law of the few and really that’s very relevant when you’re trying to get buy in to your program. The CEO and senior management are onboard, but don’t forget about those employees that have an influence over others. They have those innate skills that connectors, the mavens, and the sales people.

 

 

Stickiness Is Message Into Memory

 

In this session, I want to talk about the stickiness factor and how memorable your message is. Maybe you’ve created a brochure, maybe you’ve done some training, maybe you’ve had safety meetings in regards to your work comp management, but you’re not getting your claims reported timely, which is really where this is very, very important in how memorable your message is, particularly at the time of injury to get that claim reported immediately. You have a very low cooperation or a very low implementation rate in getting those claims reported. Here’s the study, Yale University 1960s, what they were trying to do is get the students to get their tetanus shot.

 

It was a free tetanus shot at the health clinic. They did two different types of brochures, a high fear and a low fear, and they wanted to see if it made a difference and really gory photos of what happens if you get tetanus and why you should get the shot. Then, a very less intrusive or less fearful brochure. Here’s what was interesting that a month later, only 3% of students ended up getting the shot, very, very low cooperation with what they were trying to do and it didn’t matter whether they were in the high fear or the low fear group to get those outcomes.

 

 

Not The Message, But The Package

 

Often times, it’s not the quality of the message and you’re beating your head against the wall with why aren’t my employees reporting their claims when I’ve told them 100 times maybe it’s the way that you’re telling them that’s going to make a difference. In this study, all they did is they put a map of the campus of where the health center is as well as the times that it was open and they saw those rates increase to 28% of their students cooperating and going to get the shot. It didn’t matter what the message was from these groups. It was both relatively equal. When you’re trying to get by them, when you’re trying to get cooperation, particularly with your claims reporting for your program, don’t forget or discount the stickiness factor of how you’re packaging the message.

 

Maybe you have an injury triage hotline and you need to give them a wallet card, you need to put it on your lanyard, you need to create a new sign. You need to make some changes and do some testing in how you’re displaying or packaging that message. Remember the stickiness factor in getting your claims reported.

 

I’m Michael Stack with Amaxx. This is the Tipping Point In Worker’s Compensation mini series. Remember, your success in worker’s compensation is defined by your integrity, so be great!

 

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

 

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