3 Levers To Develop TRUST In Workers’ Compensation

Hello, Michael Stack here. Principal of Amaxx, founder of COMPClub and coauthor of your ultimate guide to Mastering Worker’s Comp Cost. Today I want to do something a little bit different. I’m going to tell you a personal story about myself and my family and then relate that to an extraordinarily important concept in worker’s compensation management.

 

My wife and I lived in a town just outside of Boston called Hingham, Massachusetts. We decided to move up to Kennebunkport, Maine. The way that the housing worked out, it didn’t exactly work out the way that we wanted it to, so we had to move our stuff into storage. We didn’t really have a place to live in Maine until September 1st. Running an online company affords us some flexibility as far as location is concerned. We decided to take the summer and go on an adventure; have us some new experiences for myself, my wife, Kori, and our 4 children who are ages 2 to 6 years old.

 

We spent some time in Bend, Oregon. Had a nice time there and now we’ve landed in Steamboat Springs, Colorado and will be here for a month. Anyone that’s raised children, particularly children that are close together, know the joys that comes with that but also the stress and the challenges and the frustration that comes with that. My wife Kori and I committed to this concept of going on date nights because we felt it was important to have a united front and really raise those children as successfully as possible for our marriage as well as for our family.

 

 

Trust Is The #1 Determining Factor If Employees Hire An Attorney

 

Being here in Colorado, we wanted to continue that tradition but we were looking for a babysitter. I was looking for a babysitter which really lead me to really think about this concept of trust and how important this concept is. WCRI did a study a couple of years ago and said, “Trust was the number 1 factor in why an employee is going to hire an attorney.” Number 1 factor in the outcome in that claim, if it’s going to go south or potentially go in the right direction. It led me to start to think about this concept. I’m going to tell you a little bit more about this story of looking for a sitter and how it relates to developing this trust in worker’s compensation management.

 

In order to have someone watch your kids, particularly young kids, you need to have a high level of comfort with that person and a high level of trust. Being here in Colorado, we don’t have those babysitter relationships. I went on this website called Care.com. It has a lot of different caregivers and providers, etc. Reading the reviews about different local sitters here in Steamboat Springs. Reading through 5-6 reviews about certain sitters. They did a nice job for their kids and they’ll probably do a nice job for my kids so it gives me a certain level of comfort to have them hired even though I’ve never met them, but only so much.

 

One of the nice things this website does is it connects you through Facebook of who your shared friends are. My sister-in-law happened to have a relationship with one of the sitters. She was good friends with her. I called her up. She gave me the endorsement. “She’s a trustworthy individual.” Boom, immediately I felt comfortable with that individual that I’ve never met before and she is now signed up to babysit us to go to dinner on Friday night, which will be great.

 

 

3 Levers To Develop Trust

 

How do you now develop this trust and how does this relate to your organization, to your worker’s compensation management program? Trust is developed really through 3 different levers. 1 is through relationships. Number 2 is through communication and number 3 is through time. Relationships, communication and time. 3 different levers in order to develop a trusted relationship, particularly in a new experience.

 

 

Leverage The Supervisor Relationship

 

Here’s the important concept here. I read the reviews and had a certain level of comfort with individuals. It wasn’t until the trust of my sister-in-law got transferred. Immediately, my comfort level went up with that individual to contact her and have her come over. How does that relate here? The most trusted relationship of an employee, of an injured worker is their supervisor. That relationship needs to be leveraged, when that injured worker gets injured, of what this is going to happen. What experience is going to happen. They don’t know what’s going to happen. They’ve never been through this before. They need to leverage that supervisor relationship. Have them be involved in the process. That’s the concept, here are the tactics. That’s done through communication and that’s done over time.

 

 

Build Trust Through Active Communication

 

In communication, 3 different concepts here. A first day phone call and even better, a first day visit to the hospital. Having that supervisor contact that employee immediately. Talk about: we’re sorry you got hurt, we can’t wait for you to come back to work, how’s everything going for you so far? A lot of times companies will have someone from HR do this. They’ll reach out. It’s someone from the corporate office but there’s no relationship with that individual. Very similar to me reading those reviews on care.com. I have no relationship with these people that are writing the reviews.

 

If your organization is doing this, someone from HR’s doing it, it’s better than nothing. Reading those reviews is better than nothing but it’s nothing in comparison to leveraging a trusted relationship. That can immediately increase the comfort level just as my experience in looking with the babysitters. First a phone call or even better, going to visit the hospital. Follow this up then with a get well card that’s signed by the department and by the supervisor. “We can’t wait for you to get back to work. We’re sorry you got injured.” That’s the communication tactic, leveraging that relationship.

 

 

Solidify Trust Over Time

 

Next piece in this, this is also done immediately transferring that level of trust from that trusted relationship with the supervisor and then this is also done over time. This is done with a weekly meeting with the injured worker. In both of these incidences, it’s not just about giving care and it’s not just about understanding that you want them back to work. It’s about also understanding valuable claims management information: assessing the attitude of that injured employee, assessing how their medical treatment is going, assessing how their transitional duty job is going, if they’re in one, insuring that’s progressing and if they’re not in one yet, how can you work together to get them back to work. We know the benefits that come from that.

 

Having a weekly meeting, developing that relationship over time, leveraging that trust immediately from the supervisor, down through our first day phone call or personal visit and sending that get well card, your outcome of your claims will be significantly impacted. It will make a better outcome for your injured worker and significantly reduce your worker’s compensation claims cost.

 

Remember in worker’s compensation management, your success 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.

 

When Your Workers Compensation Insurer Goes Bankrupt

Work injured employees of self-insured businesses, and workers compensation claimants being handled by insurance carriers, generally have little to fear should the employer or insurance carrier go bankrupt.  Every state and all levels of government have two safety nets, the State Guaranty Funds and Self-Insurers’ Security Funds.

 

Facts Regarding Guaranty & Security Funds:

 

  • These funds step in immediately to take over the handling, paying and settling of claims, and they maintain coverage to protect the corporation or insurance carrier.
  • Both are financed by assessment against self-insured employers and insurance companies. Assessments are based on multiple calculations established and regulated by the States and Governments.

 

 

Operational Practices When Carrier Goes Bankrupt:

 

The Funds are designed, by statute, to protect employee benefits much like the Federal Deposit Insurance Corporation protects the public deposits in banks.  This is extended to lifetime and death cases.

 

Sometimes Guaranty Funds transfer cases to solvent carriers.  However, in most instances they retain enough insurance company employees to maintain polices, coverages and claims.  This includes gathering in unpaid premium, and following for proper reinsurance.

 

As policies expire and claims are finalized, the attending staff is reduced.  Some employees go on to other jobs immediately while others go on unemployment benefits until they obtain replacement jobs. During this period the retained employees are actually state employees.  They receive all the employment benefits the state has in place.  As a result of this operation, the retained employees do not suffer economically.

 

Claims are investigated, documented, processed, and disposed of with all the same dispatch as though the claim unit was still solvent.  Subrogation cases are placed on lien for recovery. Non-compensability, fraud, and any illegal conversion are pursued.  Fraud recoveries are collected.  All controverted cases are pressed for judicial remedy.  Claimant attorney fees honored are maintained as usual.

 

Some Guaranty Funds maintain the legal defense attorneys the carrier used.  Others transfer the cases to State Employed Attorneys designated to handle legal workers’ compensation issues.

 

For the most part claimants seldom realize the carrier no longer handles or pays the claim.  The speed and dispatch for handling workers’ compensation cases is considered to be highly efficient.

 

 

Possible Problems:

 

While the system generally operates with efficiency, there are a few possible downsides. A notable downside is that most funds do not have a cash reserve and are funded on a pay as you go system.   In other words, assessments are not prepaid.  Therefore, payments to claimants or medical providers might fall behind until funds catch up to payments due.

 

Another strain could develop if the number of carrier or employer failures or bankruptcies suddenly surged.

 

According to online reviews, and reports, there is an average of two insurance companies a year.  If you go online and type in “Insurance Company Bankruptcy”, you will be directed to various sources for information.   There are related sites that address Obamacare impact, Annuities, Accident and Health Carriers, as well as many other lines that employers might be concerned with.

 

Some Reasons for Insurance Company failure are:

  • Poor Underwriting by insuring high risk entities
  • Underfunded premiums
  • Poor Investing
  • Excessive Premium Discounts
  • Failure to properly reserve for losses
  • Not perusing 3rd party recoveries
  • Poor investigations allowing claims that might otherwise be defendable
  • Shrinking markets
  • Poor Fraud Prosecution and Recovery
  • Under funded or not reinsured for catastrophic losses
  • Inept staffing
  • Economic impact or collapse

 

 

Summary:

 

The system has been pretty effective and serves its function well.  Most workers compensation claimants have had little, if any, loss of workers compensation benefits and service due to carrier or self-insurer bankruptcy.

 

AM Best is one of the industry watch dogs that tracks insurance carriers for solvency and performance.  Their rating system is a bench mark that should be reviewed periodically.

 

 

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.

 

Work Comp Grand Bargain and The 100 yr Old Lesson

Hello. Michael Stack here, principal of Amaxx, founder of COMPClub, and co-author of “Your Ultimate Guide to Mastering Worker’s Comp Costs.” A lot of questions these days about the current work comp system and if it’s the right system to handle workplace injuries, a big question about if it’s fair and if it’s adequate. In that discussion is a lot of talk about this term “the grand bargain.” What I want to do is talk about really what is the grand bargain and why was it created, what lessons can we then take from that discussion, which was over 100 years ago, and apply that today to your organization to start to see some better outcomes and improvements in your work comp costs.

 

Anger, frustration, fear, anxiety, public uprising, political discussion, various stakeholders representing their organizations’ interests. I’m not describing 2016. I’m describing 1906. That was the state of the country at the time, the state of public opinion at the time, that injuries that were happening to individuals were not right.

 

 

Was Uproar in Public Opinion That No Value Given to Human Capital

 

There were stories of John Taylor, 27-year-old mining worker. He had a wife, Barbara, two young kids, Jane and Tommy. John would work in the mine on a day-to-day basis, very hard to support his family. One day, John got injured. He was delivered to his family’s doorstep, to Barbara’s doorstep, with a serious injury and no compensation whatsoever for that injury. No medical costs were paid; no wages were paid. The only way for John and his family to get compensation for that injury was to bring a lawsuit against his employer. It was very expensive to hire an attorney, very expensive to go through that litigation process, and also very slow. Employers had a number of defenses that they used that most of these employee lawsuits were not won, things like assumption of risk. You knew it was risky to work in that mine, or contributory negligence, that if John was somehow also responsible for his own injury, that that lawsuit would have been lost. They would have lost that claim for compensation.

 

It caused a massive uprising in public opinion, a massive view that human capital was not valued, that employees were not valued, and that that wasn’t right, that they were being treated like a machine and tossed to the side and then a new person could just come in to replace them. Something had to be done about this, because that system wasn’t working.

 

 

Work Injuries Were Putting Companies Out Of Business

 

Let’s look at the other side of the coin. Brian O’Grady came over from Ireland to start his organization. He was an entrepreneur. He was also supporting his family. He also had a couple of young children and a wife and trying to build a better future for them. He built up the Acme Company, had a couple hundred employees. One day, an employee got seriously injured, brought a lawsuit against the Acme Organization, was able to prove negligence, and got a massive award, $250,000 award that put Brian’s company out of business. Now his family was also left to struggle to support their financial needs.

 

 

System Wasn’t Working For Employees or Employers

 

The system wasn’t working for employees, and it wasn’t working for employers, either. Wild swings in these awards and most employees not being compensated for their injuries, so they created this system and came up with the grand bargain, which we talk about a lot today. What did each party get throughout the course of this discussion, also very political discussion at the time? Let’s talk about what the employees got in this grand bargain, and let’s talk about what the employers got and how it really was a benefit for both parties.

 

 

Wins For Employees In Grand Bargain

 

The employees, the biggest thing that they got was the fact that this was a no fault system. They had to prove negligence. John Stanley had to prove that his organization was negligent in order for them to be compensated whatsoever for that injury, so they got that this was a no fault system. You get hurt at your job, it’s in the course and scope of employment, your medical bills will be paid, and your indemnity will be paid, and those were the other benefits here, so indemnity, wage loss, your medical bills, and a few others. These are the most common benefits that come with worker’s compensation. There are a few other things that come with it that are less common, but are certainly important pieces of the discussion. Vocational rehab, permanency awards, and then also death benefits. Again, not as common, but certainly a very important piece of this current discussion, but those were the main benefits throughout the course of the discussion in the grand bargain. No fault, indemnity, medical, and various benefits.

 

 

Wins For Employers In Grand Bargain

 

What did the employers, then, get? What was their win in this grand bargain discussion? Two really main things that the employers got was they got the ability to transfer risk and they got the ability to budget for these workplace injuries, so those massive swings in awards, companies like the Acme Company that had to be put out of business because they couldn’t handle the award financially in order to continue to survive, they got the ability to then transfer that risk to an insurance company. They also got the ability to budget, to know that I know more or less on a monthly or an annual basis a pretty good range of how much I’m going to be paying for these workplace injuries, so they had the ability to do that.

 

That was the grand bargain. That’s what each party got, and it was a successful solution to that problem. A lot of times, when they created this, they didn’t think that they would even need any attorneys. They didn’t think we would need any litigation, because this really covered the basis of both sides. Obviously, that’s not exactly what happened, and it has gotten very complex.

 

 

100 Year Old Lesson We Can Apply Today

 

What can we now learn from this discussion? What lesson can we learn from this discussion that’s over 100 years old? Here’s, I think, the most important lesson. Worker’s compensation can be extraordinarily complex, but it also can be extraordinarily simple to make an impact at your company. Here’s the lesson. When employees and employers work together, both parties win. When employees and employers work together, both parties win. When employees and employers work together towards a positive outcome, both parties win. If you can remember that very simple lesson that was learned over 100 years ago in the initial discussion of the grand bargain, the initial discussion that solved a lot of these initial problems, your organization will win. 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.

 

Dramatically Improve Employee Goodwill with Effective Communication

Workers’ compensation program administrators and members of the claim management team are constantly seeking new methods to manage their safety program.  This includes the use of safety programs, the implementation of medical management techniques and data analysis.  All of these systems are great.  However, the best way to control the cost of any claim is to stay in contact with injured employees and empathize with their predicament.

 

 

Containment Starts at the Date of Hire

 

Effective employee engagement starts when that person walks through the door on their first day of work.  This includes providing the new employee with useful information they can use prior to a work-related injury.

 

  • Detailed new hire information regarding safety and injury prevention;
  • Policies and procedures on reporting an injury; and
  • Information on post-injury care and return-to-work best practices.

 

 

Promoting Effective Communication on Work Comp Matters

 

Effective communication is important to everyone involved in the workers’ compensation process.  This process starts before the injury takes place and steps into high gear immediately following the injury.

 

Once an injury takes place, it is important for the employer and representatives from the claim management team to focus on the injury.  It is especially important to understand that the injured person has needs—this goes beyond receiving medical care and treatment with compassion.  In cases of a severe injury, it is also important to make sure family members who are entitled to information receive it in a timely manner.

 

Severe injuries also include additional involvement from the employer and a representative with experience in handling complex matters.  Additional attention must also include a focus on accommodating the employee and returning them to work as soon as possible.

 

 

 

Lack of Communication Leads to Problems

 

There are three main reasons why parties who suffer workers’ compensation claims retain legal counsel.  These are CONFLICT, FEAR and GREED.

 

  • CONFLICT: The workers’ compensation process is adversarial.  Small disputes can escalate quickly and be the result of interactions with the employer or a member of the claim management team.  The leading cause of conflict occurs when information about the process is not openly provided to the employee.  Communication that is frequent and complete can minimize conflict and reduce the possibly of unnecessary problems.

 

  • FEAR: When an employee suffers a work-related injury, they receive wage loss benefits.  These benefits are in essence a reduction in their wages.  Unfortunately, the employee does not experience a reduction in their cost of living.  They are also faced with the unknown as it comes to future employment, income/earning capacity and ability to provide for their family.

 

  • GREED: Greed in workers’ compensation is not a one-way street.  In some instances, the rise of a work injury can lead to one party trying to take advantage of the other.  Even if this is not a reality, it can be the mistaken perception.

 

 

Benefits of Communication

 

Effective and continuous communication by the employer can reduce these reasons why injured workers retain legal counsel.  It can also reassure an employee and make them feel they are a valued member of the team.  Ongoing communications with the injured employee should continue for as long as the employee is off work, even with severe injuries where the employee is off for an extended period.  By continuing regular contact with the injured employee, the employee is reassured that the employer does want him/her to return to work.

 

 

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.

 

Employee’s Role In Workers’ Comp Cost Containment

We tend to think of workers’ compensation cost containment programs as an endeavor best left to the employer. While the employer must design the program, the employee also has a role.

 

However, to be successful, employees must also participate in the program. The following components must be followed by employees for the cost containment program to work.

 

 

Know What to Do In Case of Injury

 

Employees must know exactly what to do if they are injured on the job. Keep employees informed of their step-by-step responsibilities through employee brochures, safety trainings and handbooks. Supervisors should reinforce these requirements through regular meetings and during safety plan trainings at the start of every new project. The “What to Do in Case of An Accident” brochure should be posted throughout the work site and sent to every employee annually. This post-injury response training is crucial to ensuring the best possible outcomes for the employee and the employer when an injury occurs.

 

 

Sign an Acknowledgement of Responsbilities

 

All employees should be required to sign an acknowledgment form of these responsibilities. This should be done during their new employee orientation when they are given their brochure and at every safety meeting.

 

 

Know Where to Seek Medical Care

 

The employees need to know where to seek medical care in case of an injury. They should be required to seek care from the employer’s medical provider or their own primary treating physician, if allowed by law. The name, address and phone number of the employer’s medical provider should be included in the brochure and safety plans. If employees are working offsite, the name of the nearest hospital or medical provider to the offsite location should be included in the safety plan.

 

 

Keep the Employer Informed and Updated of their Condition

 

The injured worker must let the employer know their medical status and any changes in their condition. This is especially important to determine if the injured employee can return to work in any capacity. On-going contact with the injured employee allows for discovery of any problems – such as not keeping medical appointments or difficulty with healing or medications prescribed – before they get out of hand.

 

 

Complete Forms

 

The injured employee must complete all forms required by the employer truthfully. Make sure that the employee gets the Work Ability Form completed at every doctor’s visit.

 

 

Attend Weekly Meetings

 

This keeps the employer informed of their condition and any obstacles to return to work full duty. At weekly meetings the employee and employer can determine and address any reasonable accommodations the employee needs and whether the employee can return at modified duty. It also keeps the employee connected to the workplace and coworkers. If they are physically unable to get to the work site, the employer should provide transportation or have meetings by phone. One alternate means of having weekly meetings is by using computer technology such as skype, which allows the participants to see each other over the internet.

 

 

Participate in Transitional Duty

 

This must be a condition of employment. The employee must return to work in either transitional duty or full duty as soon as medically able.

 

 

Attend All Medical and Rehabilitation Appointments

 

Obviously, the injured worker must get required medical care to improve, including physical therapy. Identifying any barriers to attending medical appointments can be addressed at the weekly meetings. The employee should provide the work ability form to the supervisor or claims coordinator after each doctor’s visit.

 

The employee should perform all other tasks as required by the employer and allowable by law such. Each state is different.

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.

 

Winning Workers Comp Claim Outcomes With The Team Approach

Hello, Michael Stack here, Principal of Amaxx, Founder of COMPClub and co-author of Your Ultimate Guide to Mastering Workers’ Comp Costs. Some great news was released recently, actually the Work Comp Roundup was ranked number one in the best blogs contest that was put on by WorkersCompensation.com.

 

I was super-excited about that, I was obviously very happy to hear that news, and I wanted to really say thank you. I wanted to thank the Work Comp Roundup community, I know how many demands are on your time, I know how much information is thrown at you on a day-to-day basis so to take the time to read our materials, to subscribe to our newsletter and specifically those who nominated our blog in that contest, I very much appreciate that. I very much appreciate you and want to thank you for your participation.

 

 

Winning Outcomes With The Team Approach – Managing Claims

 

For my lesson today, I want to talk about this concept of winning outcomes with the team approach and how this really functions in two different capacities in the claim side and then also how I use this on the Work Comp Roundup blog itself. Let’s talk about the claim side and how this should work in your organization and how it works to create those winning outcomes in your claims and in your work comp management program.

 

 

The technique to use here, the technique to implement and leverage is called Claims Calls or it’s also called A Claims Roundtable. The idea here is that you’re bringing together the expertise knowledge and perspective of different individuals to work together towards a winning outcome and a common goal. Again, you are bringing together the expertise, the knowledge and the perspective of different individuals to work together towards a common goal of creating a winning outcome in your individual claims.

 

 

Meet Regularly

 

Here is how this looks. You’re going to want to meet regularly. On this team that’s meeting regularly, those different perspectives, that different expertise and those different knowledge, that includes your adjuster, that includes your risk manager or a representative from your employer certainly, that includes your TPA account and case managers, and you’re also going to want a medical advisor in order to bring that medical perspective to this team that’s working together, meeting regularly towards that winning outcome, that common goal, so you are going to want to meet regularly.

 

My recommendation is that this is done weekly and you are going to set a specific time, be that Tuesday at 10:00 a.m., Thursday at 3:00 p.m., whatever that time is that works for your team, but set that time and have it on your calendars. If you are meeting monthly, that should be at a specific time, maybe it’s the first Wednesday of each month at 11:00 a.m., whatever that time is, but have it on your calendar so there is that expectation that that meeting will occur.

 

 

Share Knowledge

 

Second thing is you are going to want to come to the table, those individuals that I reference are going to want to come to the table with the right attitude of sharing that knowledge, sharing that expertise and working together towards that winning outcome, that common goal. Finally, the agenda for each one of these calls, for each one of these claims that you’re discussing, and five to ten claims is a good place to start. Obviously the more claims that you can work on together, the better the outcomes for those claims, but five to ten is a great place to start. You are going to want to discuss the status of that individual claim, where the things currently stand now. You’re going to discuss the strategy for that claim, and then finally the action steps.

 

 

Discuss Status, Strategy, and Action Steps

 

You are going to want to discuss the status, the strategy and the action steps. Then for each action step, if you are meeting again the following week, you are going to discuss the status of those action steps and where things stand and continue to work towards pushing that claim forward towards that winning outcome. That team approach, gaining those perspectives will give you the best outcomes in your claims.

 

Now as I mentioned the Work Comp Roundup blog itself recently did have a winning outcome, and I want to let you know that I also leveraged this team approach in the creation of the content on the Work Comp Roundup itself. I want to recognize those individuals, those parts of mine who very willingly and openly share their expertise and share their knowledge to help in the creation of the content itself.

 

 

Winning Outcome With The Team Approach – Work Comp Roundup Blog

 

Those individuals include the senior leadership team at Broadspire: Danielle Lisenbey, the CEO; Chief Medical Officer, Dr. Jake Lazarovic; and Senior Vice President of Medical Management, Erica Fichter. From Ringler Associates, the Senior Vice President of National Marketing, Duke Wolpert; from Express Scripts President, Steven Webb; Senior Vice President, Joe McCullison, and really the rest of the Express Scripts team on the workers’ compensation side; from Tower MSA, Rita Wilson, who is their CEO; from MedSource National President, Tony Riccardi. Last but certainly not least, the Executive Vice President at Medcor, Curtis Smith.

 

As I mentioned those individuals have very openly and willingly shared their knowledge, shared their expertise and opened up the doors of their organizations to share their best practices. Thanks again for your participation and the Work Comp Roundup community. Remember your success in workers’ 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.

 

Timely Reporting Claims Is First Step In Work Comp Management

Reporting a work injury is an essential component of any successful workers’ compensation program.  Failure to do so can result in various sanctions and adverse admissions.  It also calls into question the integrity of a program.  Proactive claim management teams are able to report all claims in a timely manner and establish a partnership with the employer and other interested stakeholders to get a claim started in the right direction.

 

 

First Report Requirements

 

State workers’ compensation laws or regulations provide guidance when it comes to filing a report of injury in a timely manner.  This requires members of the claim management team and interested stakeholders to know the laws of the states they work in.  Other important factors to consider include the nature/extent of an injury or even death.  In most instances, an injury that results in death must be reported within 24 hours.

 

Failure to report injuries in a timely manner can have the following adverse consequences:

 

  • Sanctions imposed by the state industrial board or labor commission;
  • Inability to assert various affirmative defenses to deny claims. This can include arguments concerning statute of limitations, statutes or repose and notice defenses; and
  • Assessment of penalties by state and federal OSHA agencies.

 

 

Methods of Reporting Work-Related Injuries

 

State law or regulation also sets forth the requirements for what must be reported and the method of reporting.  The general rule prescribes that a “First Report of Injury” must be filed with the state labor department or industrial commission.  In order to assist clients, members of the claim management team should provide a number of options and tools to help complete this form.  This can include:

 

  • Creation of an electronic workers’ compensation forms database that include a First Report of Injury;
  • An Internet based claim platform that includes direct links to workers’ compensation forms with the option to directly file it with the appropriate state agency upon completion;
  • Telephonic access and assistance in completing forms for those who do not have direct access to the Internet; and
  • Ability to receive all claims for and First Reports of Injury via fax and e-mail.

 

Members of the claim management team should also have the ability to assist employers and other interested parties with common questions on a First Report of Injury.  It is important to remember that this form needs to be fully and accurately.  It should also be done so in a timely manner.

 

 

Going the Extra Mile for Your Clients

 

Any workers’ compensation carrier or third-party administrator can help their clients complete the necessary and routine matters for workers’ compensation claim management activities.  However, the claim management teams that provide value to their services excel in client retention and claims handling best practices.  Here are some “value add” for those wishing to be best in class:

 

  • Provide training on workers’ compensation best practices for employer clients. This includes the necessary elements of claim report on the employer end of claims.
  • Provide reference materials for employees and injured workers in the claims process. While claim management teams have a fiduciary duty to only their clients, helping those suffering from the effects of a work injury adds compassion to the process and buys good will.
  • Triage nurse services are another important component a best practices the claims industry should consider. Nurses in these triage centers can help direct care and reduce the wait time for injured parties in the need of medical care and treatment.

 

 

Conclusions

 

Timely reporting of a workers’ compensation claim is a necessary component of any program.  Successful claim management programs must provide the right type of services to assist their clients to ensure the timely and accurate reporting of all claims.  They can also add value to their programs to ancillary services that buy good will and add a human component to their program, which assists injured workers.

 

 

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.

 

Simple 3 Prong Approach To Work Comp Cost Control

Employers can save money by following the Best Practices we often recommend in our articles.  While there are numerous ways for the employer to reduce the cost of workers compensation through Best Practices, the following is a general outline of the basic approach the employer can take to manage the cost of workers compensation.

 

 

 3 Prong Approach to Work Comp Cost Control

 

We recommend a three prong approach to employer Best Practices in workers compensation cost control.  These are the three areas. While there are many best practices, these three are critical – and basic.

 

  1.           Safety
  2.           Quick Response to Injuries
  3.           Managing the Claim

 

 

Safety

 

The number one way to reduce the cost of workers compensation is to eliminate claims.  The cost of a comprehensive safety program is only a small fraction of the cost of needless employee injuries.  An employer who incorporates safety into the corporate culture will significantly reduce both the severity of injuries and the frequency of injuries.

 

 

The reduction in severity and frequency of injuries impacts both the direct and indirect cost of workers compensation.  Not only are the workers compensation premiums and assessments reduced, the indirect cost of lost productivity and retraining of replacement employees is diminished.

 

 

Every department within the company should have at least one representative on the Safety Committee.  This creates a level of involvement for all departments and facilitates the assignment of roles and responsibilities on the safety committee.  By having designated duties on the Safety Committee, the employer creates accountability and a safety discipline.

 

 

The safety committee members should be made responsible for completing a regular and thorough workplace assessment to identify potential hazards. The management at the employer is responsible for taking prompt action to remove or eliminate the potential hazard.

 

 

Quick Response to Injuries

 

A strong Safety Program will reduce the number of injuries but it will not bring about the total elimination of injuries.  When accidents do occur, a quick and well organized approach to the accident is essential.  The actions of employer in the minutes after an injury occurs can have a major impact on the overall outcome of the claim.

 

 

Each person involved in the accident response should have a set of pre-designated responsibilities.  The employee, the employee’s supervisor, any witnesses and the workers compensation coordinator should know the established procedures to follow in the event of the injury.

 

 

If on-site medical care is not available, the supervisor should immediately accompany the injured employee to the pre-selected medical provider.  The supervisor should provide the medical provider with a copy of the employee’s job description and responsibilities, including the physical requirements of the job, and a copy of the Work Ability Form.

 

 

Managing the Claim

 

The workers compensation coordinator should immediately report the claim to the claims office.  The workers comp coordinator should gather the employee’s statement of injury, the witness report form(s), the supervisor’s statement of injury and the completed Work Ability Form from the medical provider’s office.  All the documentation should be provided to the claims office.  If the injury warrants, the workers comp coordinator should contact the adjuster handling the claim to discuss and plan the course of action.

 

Don’t leave questions on the FROI blank — append additional information as needed. When the EMPLOYER leaves blank spaces on the FROI, the EMPLOYEE (and his/her attorney) has the opportunity to fill it in…and you can bet their additional information will not be helpful to the employer.

 

 

The workers comp coordinator should contact the employee within 24 hours of the injury to express the employer’s concern for the welfare of the employee.  The coordinator should inquire about the nature and extent of the injury and the diagnosis and prognosis provided by the medical provider.  If the employee is unable to return to work on either full duty or modified duty, the coordinator should follow up with the employee after each medical visit to ascertain the status.

 

 

If the employee is remaining off work, the employer should provide the medical provider with sample transitional duty job descriptions that can be offered to the employee.  By making it easier for the medical provider to return the employee to light duty work, you will shorten the length of time the employee is off work and reduce the probability of any permanent partial disability.

 

 

Safety, a quick response to injuries and claims management are a part of the Best Practices for employers.

 

 

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.

 

 

Taking the “I” Out of the Workers’ Compensation Team

 

teamworkIt is a common saying that there is no “I” in team.  This same principle applies to the workers’ compensation claim management “team.”  All interested parties have an important role in the management of a clam.  Implementation of effective teamwork will pay dividends in the long run, reduce the cost associated with a claim and promote efficiency.

 

 

Who Are the Work Comp Team Members?

 

There are many members of the “workers’ compensation team.”  Each team member has an important function.  If one team member does not do their job properly, they will only impair the other members from being successful.  As the old saying goes, “a chain is only as strong as the weakest link.”

 

  • Insurance Brokers. A broker is important as they guide the client to the best insurance carrier or third-party administrator.  They need to understand the unique needs of the client and match them with the party that best suits their needs.  They also need to understand what innovative features a carrier or administer brings to the client.

 

  • Employer. In workers’ compensation, the best offense is a strong defense.  Employers need to evaluate constantly their policies and procedures.  It is simply not enough to comply with state and federal safety regulations.  They need to be proactive and look out for the safety and well-being of the people who work in their facilities.  Having a proactive injury response is also important.

 

  • Claim Management Team. All team members need to be on the same page and have the interests of the clients they serve in mind.  This goes beyond being knowledgeable in workers’ compensation statutes and regulations.  Part of their job includes being an effective communicator with all interested stakeholders such as the injured worker, employer representatives, doctors and vocational experts, defense counsel and members of applicable state/federal agencies.

 

  • Defense attorneys. Attorneys need to be zealous advocates for their clients at all times.  This includes a number of different factors.  For starters, attorneys need to understand the law and timelines.  They need to know how to evaluate the claim and keep their client(s) advised.  It is necessary to offer suggestions on defending a claim and to provide innovative options for resolving the case.  If a case cannot settle, they must believe in their case and never be afraid to go to hearing or trial.

 

 

How Can These Members Work Together?

 

Effective teamwork starts with trust.  This concept must also include a willingness to keep an open mind and learn from other members on the team.  Workers’ compensation claims are highly emotional and fast-paced.  Failure to work together as a team can cause a number of problems:

 

  • Delays in settlement;
  • Increased litigation costs;
  • Excessive medical care and treatment;
  • Failure to make an injured worker “whole;” and
  • Fine, penalties and adverse legal decisions.

 

Effective and efficient communication is also important.  This goes beyond returning calls or e-mails in a timely manner.  It requires everyone to listen and devise a plan to mitigate exposure, provide proper benefits to the injured worker and close files in a timely manner.

 

 

What are the Benefits of Team Work?

 

The benefits to effective teamwork by members of the workers’ compensation “team” are endless.  It is important for all interested parties to understand their role and contribute to a unified effort to reduce unnecessary costs in the life of a workers’ compensation claim.

 

 

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.

 

The One Work Comp Metric To Know Starting New Year

 

 

Hello, Michael Stack here with Amaxx. So, it’s January 4, 2016, the first official work day of the year.  Happy New Year to you. So, we had a good time over the holidays, ate a bunch of cookies, drank champagne, and watched the ball drop. This was actually the first year in a number of years that my wife and I actually made it to watch the ball drop.  So, we had a good time over the holidays, hopefully you did as well. But, now it’s time to get down to business.

 

Here is our human nature, we’ll set these grandiose plans for what we want to accomplish in the new year.  We’ll say “I’m going to lose 50 lbs, and I’m going to do that by eating an all kale diet”.  Obviously that plan is doomed to fail before it even starts. And the same is true in your work comp program, you say “well I’m going to implement this program and we are going to save 50% in the first quarter, and we are going to do x, y, and z by implementing these crazy steps and getting everyone on board.  Obviously that planned is doomed to fail before it starts as well.

 

 

Build Success Through A Series Of Small Steps

 

Here is how you build lasting change in our personal lives, as well as in your work comp program. It’s by implementing a series of small successes that you can build on.  The first place to start in your personal life is to have that first healthy meal, or get to the gym, or whatever it is that you are doing in your program.  It starts with that first small success that you can easily win, and what you do in your work comp program, the first step that I want you to know if where you currently are.  Having an understanding of what those metrics are.

 

 

Look At Loss Run To Understand Date of Injury vs. Loss Reporting Date

 

Here is what I want you to do, I want you to take a look at your loss run.  On your loss run I want you to get a sense of where you are.  I want you to take a look at the date of injury vs. the loss reporting date; the date of injury, vs. the loss reporting date. You can get this information from something like a lag time summary report, to understand the first step in building momentum and building success in your program, is to know how well you are doing in the reporting of your claims.  The first step again is to understand how well you are doing in the reporting of your claims.

 

There have been numerous studies out there that have shown the impact of the claim cost, as well as the litigation rates, the longer a claim goes unreported.  But, I think the story of looking at the loss runs can really be more impactful for some people.  Some people will resonate more with the studies, some people will resonate more with the story of the claims.  If you are looking through these numbers and you are understanding the story; understanding John’s story, understanding Jeff Kelley’s story, and you see that it took 6 months for Jeff Kelley to report that claim. How is the adjuster going to be able to investigate that claim properly, how is he going to be able to establish compensability, and have any control over the outcome of that claim.

 

The first step again in the management of your program is understanding how well you are currently doing in the reporting of your claims.  Get a sense of the story from your loss runs, and then put meaning behind the lag-time summary report.

 

 

You Can’t Improve What You Don’t Measure

 

The reason that understanding the claims reporting dates, the lag time reporting is so important, you need to have that understanding because you can’t improve what you don’t measure…you can’t improve what you don’t measure.  So, having that first step, taking that first step to understanding those numbers, you’ll be well on your way to building momentum for success in your work comp program.  And if that is not a number you currently know, you need to look that up, right now.

 

Remember, your success in workers’ compensation, your success throughout the year 2016, is going to be 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.

 

 

©2015 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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