WCRI Report on IL Work System Highlights Opportunity for Savings

A recent study by the Workers’ Compensation Research Institute (WRCI) regarding the Illinois workers’ compensation system is worth paying attention to for all interested stakeholders across the United States.  The findings of the study highlight the need for claims management teams to not only be proactive in their approach to claims, but engaged with state policymakers regarding the direction of their system.  By taking these steps, programs can reduce costs in their programs and ensure injured workers receive the medical care and treatment they deserve.

 

 

WRCI Study Overview

 

The CompScore™ report reviewed areas concerning medical payments, prices and service utilization of the Illinois workers’ compensation program compared to 17 other states.[1]  It also analyzed how medical payments changed over time through 2016.

 

According to the study findings, the following conclusions were reached related to the Illinois workers’ compensation program:

 

  • Payments per claim were higher than the median of all other study states from 2013 through 2015;

 

  • During this same time frame, medical payments per claim grew an average of 3.1%;

 

  • While Illinois had a lower price paid on claims for non-hospital medical services (patient evaluation and office visits), costs were higher for other medical services. This included the price paid on surgical and other professional medical services; and

 

  • Medical costs continue to be a significant driver in workers’ compensation claims. Areas that were identified as leading to this were medical utilization factors, which included more visits per claim and services performed by health care professionals per visit.

 

 

Reducing Work Comp Costs Via Proactive Claims Management

 

There are many lessons proactive members of the claims management team can learn from the WCRI report regarding workers’ compensation claims in Illinois.  This should serve as a reminder for those seeking to make a difference that good claims management skills require one to be proactive on all files.

 

  • Medical treatment parameters. Proactive claims management teams need to aggressively use these rules to minimize costs.  This includes asking an independent medical examiner to review and provide a professional expert opinion on the care received.  It is also important to receive comment on what care, if any, exceeded the medical treatment parameters;

 

  • Medical fee schedules. Claims management teams should regularly conduct internal audits to determine if medical care is being reimbursed via the applicable medical fee schedules.  Failure to do so can result in paying more than required, which reduces the effectiveness of a program and the bottom line;

 

  • Using litigation as a settlement tool. Workers’ compensation claims sometimes languish, which results in excessive and unnecessary costs to a program.  Claim handlers and others on the team need to be proactive and look for opportunities to place matters into litigation to force settlement discussions.  All affirmative defense must be made in good faith.  It is also important to remember that simply calling the injured worker or their attorney regarding settlement may be all it takes to resolve an ongoing claim.

 

 

Reducing Work Comp Costs Via Public Policy Engagement

 

The findings of the WCRI report demonstrate the importance of engagement by interested stakeholders with lawmakers and state program regulators.  Not being involved in the public square can result in increased workers’ compensation costs.  Workers’ compensation fee schedules and treatment parameters serve as the basis for reimbursement and treatment available to cure and relieve the effects of a work injury.  The impact on the cost of medical claims becomes noticeable in jurisdictions with reimbursement is noticeable in Illinois based on the following study findings:

 

  • Higher than average medical payments; and

 

  • Higher than average provides paid for professional medical services.

 

 

Conclusions

 

The recent WCRI report highlights ongoing areas of concern in Illinois and across the country when it comes to growing workers’ compensation costs.  Proactive stakeholders seeking to reduce workers’ compensation costs need to be engaged in their file load and within the public square to run effective programs.

 

[1] States reviewed included: AR, CA, FL, GA, IN, IA, KY, LA, MA, MI, MN, NJ, NC, PA, TX, VA, and WI.

 

Access the above reference study and learn more about WCRI: https://www.wcrinet.org/reports/compscope-medical-benchmarks-for-illinois-18th-edition 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO 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.

Enhance Cheer and Happiness to Prepare for 2018


Hey there. Michael Stack here, CEO of Amaxx. This is my final video blog of 2017. As we’re in the very heart of the holiday season, there’s two wishes that I wanted to pass along for you. One is cheer and the second is happiness. One is cheer and the second is happiness.

 

 

Cheer & Happiness Often Lack Meaning but Are Powerful

 

Now, while those two words sound like they’re on the front of a holiday card and lack meaning, when you actually drill down into the real essence of both of those words, cheer and happiness, it could do such a profound impact on your life, both personally and professionally. When you can bring that cheer, when you can bring that happiness, when you bring that smile to the office, when you bring it to your family, when you bring it to your work comp program, it’s amazing the impact it can have on your life, both personally and professionally.

 

I wish you a very sincere amount of cheer and happiness to bring that to the table, to finish up this year, appreciate all the good that’s happened, and there’s been a lot of nonsense that’s happened this year as well, but taking the time to appreciate the good and focus on bringing that cheer, bringing that happiness, so that we can go back after it again in 2018.

 

 

Take the Time to Prepare for 2018

 

I won’t be sending out my newsletter for the week of Christmas or the week of New Years, so I’ll be taking two weeks off, so that I can enjoy that cheer and happiness with my own family. We’ll be heading to New York City. We’re going to see the Radio City Rockettes, we’re going to go to Central Park, see the windows, see the Rockefeller tree, and really take that time so that I’ll be ready to go after it right along with you.

 

Thank you very much for your support this year. Thank you very much for your interest in this material. It allows me to do this work that I love. I very much appreciate you and your support. I hope you have a merry Christmas. I hope you have a happy holiday, and hope all of us have a wonderful New Year.

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO 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.

 

Key Steps to Avoid, Manage, and Win Workers’ Comp Litigation

Key Steps to Avoid and Manage Workers’ Comp Litigation You’re missing a great opportunity if you view your defense attorney as a necessary expense rather than an asset to your workers’ compensation program. Employers who partner with their lawyers throughout the entire claims process can see fewer litigated claims and more wins when they do go to court.

 

While some workers’ compensation payers say defense counsel are not their friends, those who do find they have better outcomes and lower overall program costs. It involves getting the right attorney and treating each other as a fiduciary.

 

 

Attorney’s Role

 

The main function of your attorney is to represent your organization’s interests in legal battles. However, many employers are expanding the role of lawyers; making them part of a team focused first and foremost on reducing your losses. Rather than trying to control costs by keeping attorneys at bay unless and until a suit is filed, they have realized better results by working closely with them throughout the process.

 

The idea is to get the perspectives of several professionals before making decisions, such as whether to accept or deny a claim and how to proceed. The team approach creates a synergy, yielding better outcomes. Your defense attorney should play a prominent role in the group.

 

Ideally, the attorney should be involved from the very beginning — sometimes, even before a claim has been filed. Employers and payers should be able to contact their defense attorneys by phone or email and:

 

  • Ask questions based on the information you have.
  • Get advice on whether to accept or deny the claim.
  • Find out their thoughts on how best to limit exposure.
  • Get recommendations for particular experts, such as independent medical examiners.
  • Hear suggestions for investigative techniques.

 

It’s also incumbent upon payers to provide their attorneys with as much information as possible about the injury and the affected worker. For example, letting the lawyer know about an injured worker’s preexisting condition or the fact that he has been in therapy for three months could change his opinion and advice on how to move forward.

 

 

Getting the Right Attorney

 

If you wouldn’t feel comfortable contacting your attorney early in the claim process, you might want to find another attorney. If the lawyer starts billing you as soon as she picks up your phone call, she is not a ‘team member’ invested in your program.

 

To ensure you have the best attorney, look at his bills. He should not nitpick or overcharge you for simple questions or advice, and should be willing to explain all his charges.

 

Avoiding contact with your attorney at the beginning of a claim as a way to control costs should not be an issue. Your attorney should treat you as a friend and be willing to provide his thoughts without increasing his fee.

 

 

Winning in Court

 

Despite the best efforts of all involved, some claims will be contested. Having your defense attorney involved from the beginning gives you a leg up in court Additionally, you’ll have a competitive advantage if you investigate every case early and thoroughly, and be ready to try every single case.

 

While the employer technically does not have the burden of proof, in reality, that is how they should proceed. Payers should prepare based on the premise that they, not the injured worker, have to prove their case.

 

Among the most effective tools to gather early in the claims process are:

 

  1. Written statements. The injured worker, supervisor, and any witnesses should be questioned and asked to sign statements attesting to their recollection of the incident. These can be a great tool later in court if these same individuals have different memories of the incident.

 

  1. Videos. A recording of the actual event as it happens is ideal, but not always available. However, several types of videos can help with a case:

 

  1. Video of the area. The judge and others will have a clearer understanding of how the incident occurred if they can see the actual conditions.

 

  1. While an actual recording of the incident may not be available, you can try to recreate it. This might show that the incident could not possibly have occurred in the way it was described.

 

  1. Short video of the job. This will help educate the judge, as well as the treating physician, IME, and the attorney. For example, it might show a different version of the worker’s tasks than what he has described, leading a physician to clear him to return to work.

 

  1. Outside angles. Cameras outside the area or the building may provide valuable insight, such as if the injured worker suddenly loses his limp when he steps out of the building.

 

  1. Social media. Payers should peruse a variety of social media sites. Younger workers, especially, are prone to post themselves in many environments and activities, some of which may be in direct contrast to their alleged injuries.

 

An effective defense attorney goes above and beyond the norm. That means presenting the evidence in the most persuasive manner possible.

 

Rather than just going to court with written statements, the attorney should bring people to testify, including the supervisor, the physician — in person or via phone — and witnesses who have signed statements. Live testimony from the injured worker or witnesses who recall the incident differently than they had originally can be asked to read aloud their written statements. The attorney can also ask the supervisor and witnesses to dress the way they were on the day of the incident as it lends more credibility.

 

 

Conclusion

 

Working closely with your defense attorney can help you identify the cases you should accept and those you should fight. Getting the attorney involved early in the process and doing a comprehensive investigation can avoid litigation in many cases, and help you win cases that do go to court.

 

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO 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.

The Significance of Maximum Medical Improvement in Worker’s Comp

The Significance of Maximum Medical Improvement in Worker’s CompThe concept of “maximum medical improvement” (MMI) is an important notion in workers’ compensation claims.  This concept is based on the fact that it often triggers the discontinuance of various wage loss benefits.  In other instances, once an employee reaches MMI, cases are prime for settlement.  Failure to identify this status promptly can add unnecessary costs to claims and the bottom line of a workers’ compensation program.

 

 

What is MMI?

 

Maximum medical improvement (in some instances referred to “end of healing period”) is a legal concept where no further significant recovery from or lasting improvement to a personal injury can be reasonably anticipated, regardless of subjective complaints from the employee.  In essence, additional medical care and treatment may still be required to keep the employee in a stable condition, but no noticeable improvement will take place in that medical care.

 

Each jurisdiction has a legally defined standard for MMI.  This standard is defined in statute or rule and interpreted via case law.  Any doctor or health care provider can usually declare an injured employee to be at MMI if they have an adequate foundation to issue their findings and opinions within a reasonable degree of medical certainty.

 

 

Significance of MMI in Your Claim

 

Placing an employee suffering the effects of a work injury at MMI has a significant impact on the employee’s ability to receive future workers’ compensation benefits including entitlement to wage loss.  In some jurisdictions, it can reduce or limit the employee’s ability to receive future medical care via a workers’ compensation program.

 

Regarding wage loss benefits, many jurisdictions allow the employer and insurer to discontinue wage loss benefits once a medical opinion of MMI has been given and notice given to the employee.  This primarily includes the discontinuance of temporary total disability benefits and in other cases temporary partial disability benefits.  Once this occurs, a workers’ compensation claim can take several directions:

 

  • The employee can challenge the MMI determination and seek to have temporary total or temporary partial disability benefits reinstated;

 

  • Forces the employee to return to work in some capacity; or

 

  • Encourages the employee to be open to settling their workers’ compensation claim.

 

In many jurisdictions, wage loss benefits such as temporary total or temporary partial disability benefits can be reinstated should the employee’s condition worsen.  If a medical opinion is given regarding MMI from an independent medical examiner, it is important to receive that medical expert’s opinions on the following issues:

 

  • Additional medical care and treatment the employee may require;

 

  • Restrictions and limitations on the employee’s condition; and

 

  • Applicable permanent partial disability ratings. This rating should also include a detailed description as to why it is appropriate per the applicable guidelines.

 

 

Using MMI to Settle Your Claim

 

Once an employee reaches MMI, it is important to move a workers’ compensation claim toward settlement.  This is important for several reasons:

 

  • Once the employee reaches MMI, there will typically be a finding regarding additional future medical care and treatment. This allows for the preparation of a Medicare Set-aside allocation, if appropriate;

 

  • Allows for the defense interests to evaluate future indemnity exposures better. This also allows for reserves to be more accurately set and also to receive settlement authority; and

 

  • Facilities a better transition for the employee to return to work, even in a restricted capacity. This is based on the establishment of permanent work restrictions.

 

Interested stakeholders should never wait for the employee to make the first move when it comes to settling a workers’ compensation claim.  Be proactive and contact the employee or their attorney regarding this matter.

 

 

Conclusions

 

MMI is an important legal concept for members of the claims management team to understand.  They should also view it as an important milestone in their case and an opportunity to settle a workers’ compensation claim.  By taking these steps, interested stakeholders can reduce costs in their workers’ compensation programs.

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO 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.

Overcoming Barriers to Effective Return-to-Work

There are many barriers the claims management team must overcome when seeking to return an employee to work following an injury and disability.  These barriers include those posed by the employee.  Taking a proactive approach to these issues can reduce workers’ compensation costs and boost workplace morale.

 

 

Importance of Return-To-Work

 

Return-to-work is an important aspect of any workers’ compensation claim.  This is based on a number of factors:

 

  • Increased spending on medical care and treatment;

 

  • Increased exposure to ongoing wage loss and other benefits, including claims for permanent total disability (PTD) benefits; and

 

  • Costly claims for retraining benefits.

 

Effective return-to-work starts at the moment an injury occurs.  Part of the process includes identifying barriers the employee may raise.

 

 

Avoiding Medical Issues and De-Conditioning

 

Employees suffering a work injury are likely to have other co-morbid conditions that prevent a successful return to work.  Common ailments include:

 

  • Obesity;

 

  • Learning disabilities;

 

  • Diabetes;

 

  • Drug/alcohol use/abuse; and

 

 

According to the National Council on Compensation Insurance (NCCI), there has been a steady increase in the percentage of employees suffering a work-related injury who have a comorbid diagnosis.  Some insurance experts estimate nearly 10% of all claims involve this stumbling block.

 

Proactive members of the claims management team also need to take measures to keep their injured workforce active.  Keeping employees active while under restrictions can include:

 

  • Locating sedentary or other light-duty volunteer opportunities;

 

  • Seek non-profit partners in the community who will hire people recovering from work injuries. This partnership is often referred to as a “work on loan” assignment; and

 

  • Providing the employee with a health club membership.

 

Being creative is key!

 

 

Financial burdens, Day Care Challenges and Lack of Transferable Skills

 

People who suffer from a work-injury face many everyday challenges on a reduced income—even when receiving ongoing wage loss benefits.  This is due to the structure of the workers’ compensation system with average weekly wage caps and reduced wages due to statutory payment limits.  This results in a challenge for many as they are still faced with financial burdens and familial responsibilities.

 

Examples of helping injured workers’ through challenging financial times, while at the same time representing the interests of the insured do not necessarily conflict.  Claims management teams can assist by developing a database of local and nationwide social services agencies.  This can include food shelves, and local human services agencies.

 

Claims management teams can also encourage their employer clients to investigate services such as “Ticket to Work.”  Under this program, persons on SSDI can work for qualifying employers and not receive a reduction of their government benefits.  Employers benefit by developing a workforce and receive applicable tax deductions or qualify for certain government contracts.

 

 

Employee Perceived Work Restrictions

 

Another barrier that prevents employees from returning to gainful employment is malingering and self-imposed restrictions.  This is a challenge every claims handler must overcome at some point in their career.  There are many tools one can use to move the employee past this psychological barrier and into the workplace.

 

  • Effective discovery including recorded statements and depositions. It is important to obtain information from the employee about their interests outside of work and what limitations they have when performing those activities.

 

  • Use of Independent Medical Examinations and Independent Vocational Evaluations. IMEs and IVEs are a tool one can use to have the employee seen and examined by an expert.  This allows the defense interests to obtain an opinion on the employee’s limitations and physical abilities.

 

  • Use of surveillance. This is a costly method of discovery and should be used with care.  When used, a claims handler should consider having the employee subjected to scrutiny over the period of several days and during periods when information suggests they will be outside and engaging in physical activity.

 

 

Conclusions

 

There are many barriers members of the claims management team face when it comes to returning an employee to work, and the employee imposes one of these barriers.  It requires the claims handler to be proactive in their approach to reduce future costs on the claim.

 

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO 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.

Work Comp Compensability – Understanding Jurisdictional Questions

Work Comp Compensability – Understanding Jurisdictional QuestionsProactive members of the claims management team need to be fully engaged on important issues.  This includes handling various questions of compensability that need to be answered on every claim.  Common questions include applying the law to the facts of the claim and often making decisions with little to no legal guidance.  Questions of jurisdiction are something all proactive team members must understand to run an effective program.

 

 

Questions of Jurisdiction

 

Issues of workers’ compensation jurisdiction vary from state to state.  It is important for members of the claims management team to understand the special rules that apply and seek legal counsel if they have any questions.

 

As a general rule, an employee is covered under a state workers’ compensation act in the state where they are hired or regularly employed.  When examining questionable claims from a jurisdictional standpoint, the following questions need to be asked:

 

  • In what state did the injury occur?

 

  • What state did the “last necessary act” of the hiring process take place? This is mainly a question in cases where the employee is hired via a telephone interview or travels to a different location during the hiring process.

 

  • Where does the employee spend a majority of their time or work activities? This is something that needs to be examined in instances where the employee travels or works remotely.

 

 

Issues Concerning Concurrent Jurisdiction

 

In some instances, more than one state can have jurisdiction over a workers’ compensation claim.  Members of the claims management team should pay close attention to these cases and engage legal counsel as necessary.

 

Concurrent jurisdiction in workers’ compensation claims typically arises in instances where the employee was injured in one state but performs a majority of their primary work activities in another.  Depending on the text of a workers’ compensation law, or case law interpretation, it can also occur based on the nature of an employment contract or collective bargaining agreement through a labor union.

 

 

Investigating Claims with Jurisdictional Issues

 

Claims that involve jurisdictional issues require immediate action by members of the claims management team.  Failure to do so can have a negative impact on the insured and possibly result in penalties.

 

  • It all starts with a quick investigation. Find out the specific location of the injury and determine what state it is in.

 

  • Review the applicable state law regarding jurisdictional issues. There may also be an issue of “concurrent jurisdiction.”  This is the result of conflicting state workers’ compensation laws and may allow the employee to choose the more favorable location to venue their claim.

 

  • Review applicable union and employment contracts. This includes a determination on how the employee was hired and where each actor (employee and employer representative) was at the time the hiring process was made official.

 

  • Obtain the assistance of legal counsel as necessary. This may include a legal opinion on what exposures are present in various jurisdictions.  Using the insurance “roundtable” to discuss these matters is another option.

 

  • Communicate findings to your claims management team and insured. It is important to do this promptly so thoughtful decisions can be made.

 

 

Conclusions

 

Although questions or jurisdiction are often clear-cut, it is important for members of the claims management team to understand the nuances of this confusing issue.  It all starts with a prudent and effective investigation, understanding of the law and use of legal counsel when necessary.  By taking the time now, all claims handlers can reduce workers’ compensation costs and confusion by adding jurisdictional matters to their initial survey of all incoming claims.

 

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO 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.

A Common Sense Approach to Job Hazard Analysis

workers comp job hazard analysisEvery article, book, blog or pamphlet written on safety will tell the employer to identify the hazards and correct them. By identifying the hazards that cause injury to the employees and removing or mitigating the hazards, the number of workers compensation claims is reduced. What is often not addressed is how you go about doing a job hazard analysis. While this topic could be an entire book, I will summarize what to do to identify and correct your hazards.

 

A hazard can be anything that has the potential to cause injury or illness if left uncontrolled. The job hazard analysis is used to identify these hazards before the injury or illness occurs. To do this, the relationship between the employee, the tools or equipment, the work to be accomplished and the work environment is examined. This allows for identification of what the hazards are and then you can decide on the steps to remove the hazards.

 

 

Begin By Reviewing Workplace Records


A job hazard analysis should begin with a review of the workplaces records for accidents and injuries. If you are not already receiving a monthly loss run from your insurance carrier, ask your broker to obtain one for you. This will provide you with information on the nature and type of injuries that have occurred in your workplace. The known hazards can easily be identified in this manner, and this will show you where the existing methods of hazard prevention are not working.

What the loss run does not include is the “near misses” where the employee was lucky enough to escape an incident without injury. This is why the employees in the trenches need to be involved in the identification of hazards. Their knowledge of their job and what can go wrong will assist you in building a completed job hazard analysis. By asking the employees for their input into their safety, the employees will become much more involved in providing valuable insights into the hazards in the workplace.

 

 

Obtain Ideas on Eliminating Hazards

 

Ask the employees what they would do to make their work and their workplace safer. Discuss with the employees their recommendations on how to improve the safety of the work process they follow. Obtain their ideas on eliminating the hazards. Questions you can ask the employees about their work include:

  1. What has gone wrong before?
  2. What is likely to go wrong?
  3. If something goes wrong, what will happen?
  4. How could the occurrence be prevented?

5.      What are other factors that come into play?

  1. What are the chances that the hazard will occur?

 

Repeat the list of questions for each hazard each employee identifies. The answers to each question should be written down. The same format should be used with each hazard discussed with any employee. This will assist you in identifying the hazards and provide you with suggestions or recommendations on how to curtail the hazards.

 

If the employees express their concern about an imminent danger, address the problem immediately. This will show the employees you are serious about protecting them from the hazards of the job. Also, if several employees identify the same hazard, the likelihood of someone getting injured due to the hazard is greater.

 

After you have been through each of the jobs in the workplace, make a list of the identified hazards. Rearrange the list to rank the hazards that are the highest risk of causing severe injuries. The hazards at the top of your new list should be carefully analyzed to determine how the hazard can be eliminated or at least reduced.

 

 

Knowledge of Workplace and Prior Injuries

A job hazard analysis can be conducted on any job in the workplace from clerical to production. Knowledge of the workplace and what injuries have previously occurred is an excellent place to start. Look for:

  1. jobs that have had the most injuries or illnesses
  2. jobs with the potential to cause severe injury, even if no prior accidents have occurred
  3. jobs where a mistake could cause a severe accident
  4. jobs that have been recently redesigned or changed
  5. jobs that require written instructions


 When you have finished compiling your list of hazards, decide on how the hazards will be reduced or eliminated. The three main ways of dealing with the hazards are engineering controls, administrative controls, and personal protective equipment.

 

With engineering controls, the facility, equipment or process is redesigned to remove the hazard or to lessen the chance of the hazard occurring. There are many ways this can be accomplished including machine guards, blast shields, lockout systems, hazard enclosure, noise reduction systems, ventilation systems, etc.

 

Administrative controls would include better employee training, written operating procedures, time limits, changes in workflow, alarms, monitoring and closer supervision.

 

Many types of personal protective gear can be utilized to reduce or eliminate hazards including safety glasses, hearing protection, hardhat, steel toe shoes, leather gloves, respirators and protective clothing.

 

 

Engineering Controls

Normally, the most effective way to control hazards is through engineering controls – for example covering a conveyor belt with a side shield to prevent clothes or jewelry from coming into contact with it. If engineering controls are not feasible or possible, then administrative controls by management changing the work process should be considered. If engineering controls and administrative controls will not prevent the hazard, the introduction of protective gear and equipment should be mandated. A simple thing like steel toe boots and leather work gloves can eliminate some hazards.

With some hazards, a combination of engineering controls, administrative controls, and protective clothing should be used. The job hazard analysis should direct you in determining the hazard control method to be used. By eliminating or reducing the hazards in the workplace, there will be fewer employee injuries and illnesses which will result in lower workers compensation cost and increased employee productivity.

 

 

 

3 Steps to Reduce Your Workers’ Comp Litigation Rate

workers comp litigation rateIs your litigation rate higher than you’d like? Do you know why?

 

There are myriad reasons injured workers hire attorneys to defend them, but there is often one overarching theme: fear.  By taking simple but highly effective steps, you can reduce the anxiety and significantly lower your litigation rate.

 

 

Why Hire Attorneys

 

Put yourself in the shoes of an injured worker, and you can begin to understand what they fear and how that drives them to hire attorneys. Say you’ve been in a particular job for several years, are doing well and suddenly you’re involved in an incident that renders you unable to work. And let’s supposed you like most people are unfamiliar with the specifics of the workers’ compensation system.

 

Now suppose you’ve been at home nursing your injury for a week. You’re in pain, the bills are piling up, your spouse is asking questions, and you haven’t yet heard from anyone connected with your employer or the workers’ compensation system. What would you do?

 

That scenario, in a nutshell, describes what far too many injured workers go through. Increasingly, they have fear:

 

  • Fear they won’t have money to pay their bills.
  • Fear they won’t have access to or money for proper medical care.
  • Fear they will lose their jobs.

 

While sitting at home seeing TV commercials for plaintiffs’ attorneys, many injured do what might be considered normal – they call a lawyer.  This situation is typical, and yet avoidable in the workers’ compensation system.

 

Showing empathy, communicating, and providing information are the primary tools to prevent a worker in the above scenario from hiring a lawyer. Creating an atmosphere of trust before injuries will help lower your litigation rate even more.

 

 

Eliminate the Fear

 

Knowing the fears mentioned above can help you avoid them. Here are some simple steps:

 

  1. Communicate. Getting in touch with the injured worker as soon as possible after the injury is crucial. The message should convey that you value the employee and want him back on the job as soon as he is ready. You can do this in a variety of ways:

 

  • Call. Just as you might call a worker who was out due to a non-work related injury, a brief phone call to inquire as to how the worker is doing shows you care about the person. You can also reassure the employee that his claim is going through the workers’ compensation process and let him know he will hear from those who are handling his claim.
  • Send a card. If another worker sustains a severe injury while boating over the weekend and is out of work, you might send a get-well card, right? It should be the same for an injured worker. They also want to know their employer and coworkers are concerned and thinking about them, and – especially in the case of injured workers – that their jobs will be waiting for him upon their return. A simple, inexpensive card with good wishes can make a world of difference to someone in pain and afraid.
  • Text. If it is a younger worker and someone who prefers texting to phone calls, send one. It can be short, ‘how are you doing today’ message.
  • Email. A quick email sends the message that you are thinking about the worker. You might also include something about the company – some news or a funny incident that happened with the employee’s coworkers.

 

  1. Explain the System. Those of us in the industry know the complexity of workers’ compensation. Imagine you are an injured worker, thrust into the middle of this process you don’t understand – or trust. You’d need someone or something to explain it to you. There are a couple of ways to do this:

 

  • Employee Brochure. A short, simple brochure should be given to all injured workers. It should tell them:
    • What to expect. It should say, for example, that the visit to the emergency room and follow-up medical bills will be paid. It should also include information about the workers’ compensation system and when and how determinations are made as to whether a claim will be accepted. It should also include a brief section explaining the consequences of fraud. You want the injured worker to know you care about them, but that you won’t tolerate abuse.
    • Who is in charge? Unless the company is self-insured, it should explain that the X company is the employer’s workers’ compensation insurer and that someone from that organization will contact the injured worker.
    • When/how. It should explain how and when the worker will receive benefits.
    • Perhaps most importantly, it should convey that you want the injured worker to return to the company as soon as possible, and provide information about light-duty work and other aspects of the employer’s return-to-work program.

 

  1. Create an Environment of Trust. Some organizations have a culture that discourages employees from reporting on-the-job injuries. There’s a message that doing so can hinder chances of a promotion or transfer, or may even result in firing. Ultimately, some injured worker in such a company will hire an attorney. Instead, you want to create an environment of transparency and trust. If your employees trust you, they are much less likely to engage attorneys when injured.

 

Talking openly about the workers’ compensation system is one way to do that; whether during safety meetings or through internal newsletters or emails. A brochure should be given to all employees to explain the workers’ compensation process and what to expect if injured, as well as provide information on how to report workplace injuries and illnesses.

 

 

Conclusion

 

Injured workers, like all of us, want to be treated with dignity and respect. Being injured and thrust into a system, they don’t understand people more vulnerable and insecure. By reaching out to them, showing empathy and explaining next steps, you create a trusting environment and can significantly reduce your litigation rate.

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO 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.

5 Sessions Not to Miss at National Workers’ Comp & Disability

national workers' comp and disability conferenceIt’s the week of our industry’s biggest conference of the year.  There will be a lot of great content, but I’m looking forward to these 5 sessions:

 

The Nordstrom Way: Boosting Injured-Worker Engagement

 

  • Speaker: Janine Kral, VP Risk Management, Nordstrom
  • Room: South Pacific C Session Number: K1
  • Time: Wednesday, December 06, 2017: 8:30 AM – 10:00 AM

 

At Nordstrom, injured-worker advocacy isn’t just a recent strategy. Learn how the retailer — widely recognized for its customer service culture — has applied its customer-focused approach when engaging injured workers and advocating for their care. Janine Kral will describe how the company’s practices have evolved over time to ensure that injured employees are able to stay on the job and deliver the service level crucial to the company’s bottom line.

 

 

Steal These Ideas! Teddy Award-Winning Employers Showcase Their Successful Strategies

 

  • Speaker: Frank Altiere, President, PMA Management Corp
  • Speaker: Roberto Ceniceros, Senior Editor, Risk & Insurance Magazine
  • Room: Islander B-C Session Number: M2
  • Time: Thursday, December 07, 2017: 8:30 AM – 9:45 AM

 

 

Gain direct insight into how risk managers and safety professionals created some of the most successful programs in the nation in this roundtable discussion featuring winners of the 2017 Risk & Insurance Teddy Award. Learn their key strategies and tangible practices that drive documented and sustainable results at their companies. You’ll leave inspired with real take-home ideas to elevate your program to the next level!

 

 

The Intersection of Medicine and Disability — A Doctor’s View

 

  • Speaker: Marcos Iglesias, CMO, Broadspire
  • Room: South Pacific F Session Number: DM3
  • Time: Thursday, December 07, 2017: 10:45 AM – 11:45 AM

 

With qualification for benefit programs like non-occupational disability insurance, social security and workers’ compensation often dependent on a doctor’s determination, claims payers can play a crucial role in helping them make sound assessments. A popular NWCDC speaker, Dr. Marcos Iglesias will help you understand disability-assessment methods and decipher what makes someone disabled, whether it’s a diagnosis or an impairment — and who gets to decide. You’ll discover the value of accurate communications with medical providers and how they can help the injured regain an active life.

 

 

Old Dogs, New Settlement Tricks

 

  • Speaker: Beth Savelli, Former Risk Manager, Swissport USA Inc.
  • Speaker: Daniel Anders, Chief Compliance Officer, Tower MSA Partners
  • Room: Islander F-H Session Number: CM1
  • Time: Wednesday, December 06, 2017: 11:00 AM – 12:15 PM

 

A successful settlement initiative requires analyzing cost drivers across legacy claims to eliminate barriers to resolution, establish whether to settle immediately, or match cases with optimal interventions, such as physician peer review, clinical oversight or legal action. Learn how Swissport, an employer in a high-risk industry, initiated an aggressive settlement process, and discover how you can adopt those lessons to create new claims management practices.

 

 

60 Tips in 60 Minutes — Sage Advice for Overcoming Complex Claim Challenges

 

  • Speaker: Barry Bloom, Managing Principal, The bdb Group
  • Speaker: Caryl Russo, SVP Corporate Care, RWJBarnabas Health
  • Speaker: Kathleen Bray, Corporate Counsel, SFM Mutual Insurance Co
  • Speaker: Stuart Colburn, Shareholder, Downs Stanford P C
  • Speaker: Bill Wainscott, Manager Occupational Health & International Paper Company
  • Speaker: Dawn Watkins, Director of Integrated Disability, Los Angeles Unified School District
  • Speaker: Marcos Iglesias, CMO, Broadspire

 

  • Room: Islander F-H Session Number: G1
  • Time: Friday, December 08, 2017: 8:30 AM – 9:45 AM

 

There is greater likelihood now than ever for worker injuries to develop into complex claims. Flawed claims decisions, inadequate medical attention and other missteps can exacerbate resolution challenges. Fortunately, there are opportunities to prevent complex cases and mitigation measures when they reach that scale. In one of the conference’s most popular sessions, a panel of experts from different workers’ comp disciplines will reveal the lessons they learned — providing their sage advice in a lively, fast-paced presentation that will jump start your Friday morning.

 

See you there!

 

Michael Stack - AmaxxAuthor Michael Stack, CEO 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.

 

Why Your Work Comp Program May Have Fallen Short This Year

 

Register: 3 Part Training Series – Power of One

 

Hey there, and happy holidays. Michael Stack here, CEO of Amaxx. It’s getting to be that time of the year, where we really start to look back and reflect on the year that has passed, and in your work comp program, you may have achieved incredible results, and you may have fallen a little bit short.

 

I want to talk about, today, this really sequence of buy-in, because a lot of times, what I’ll find is that a risk manager will put some thought into saying, “I want to really improve my program. I want to create this system.” But you’re just not getting the buy-in. You’re not getting the results. You’re not getting your company on board with what it is that you’re trying to accomplish, with this very specific sequence and steps that you need to take, and that’s what I’m going to be walking you through today.

 

 

4 Steps to Gain Organizational Buy-In

 

When you start out your program, you’ve created your system, and you want to really start to create and realize these results. There’s some very specific steps that you need to take. First piece is to sell to management, next is to get your management on board to endorse your program to your company or to your organization, then you bring your supervisors on board, and then finally, you bring your employees on board. I want you to think about these four steps really as almost like a rope or links in a chain, and if one of these links are broken, it’s going to make everything below it fall.

 

What do I mean by that? Let’s say you’ve created your system, but you’re really having a very difficult time getting your supervisors on board. They could care less, they’re not involved in reporting the claims, they’re not involved in your return-to-work program, they’re not cooperating with creating transitional duty jobs, so your supervisors are not engaged. They’re not on board with what it is that you’re trying to accomplish.

 

Let’s say that this link in this chain is broken. Your supervisors are not engaged, and so that means that there’s really almost no way that your employees are going to be on board either. This whole thing is going to fall off below. If your supervisors aren’t engaging your program, if they’re not involved, if they could care less, your employees could care less too, because they’re often going to follow the lead of their direct supervisor.

 

Let’s talk about this next step. Let’s say you haven’t been able to engage your management. Much like your supervisors, maybe your senior managers are somewhat aloof to what it is that you’re doing, and they could care less about your program. Maybe they ask for a report about once a year, but that’s about the extent of it. You haven’t done a good job in selling to management, so if you haven’t done a good job in selling to management, if this link is broken, then everything below that is going to fall as well. The management wouldn’t have endorsed your program to the company. Your supervisors then wouldn’t be following the lead of your managers.

 

 

Review Sequence 

 

As you look back at your program, at you look at this past year, take a look at this sequence. Have you done a good job of engaging your senior management, in your work comp program, of what it is that you’re trying to accomplish? If you haven’t done this first step, everything below it is going to very much suffer, because it’s a very sequential set of action steps in order to realize that engagement, and build that culture of what you’re looking to accomplish.

 

If you want further information or further step-by-step approach on how to do this very specific step of selling to management, or maybe you’re a service provider, maybe you’re an insurance broker, how do you win that client’s trust? How do you get your clients engaged in your program? It’s a very similar set of steps.

 

I encourage you to register for my current Power of One: How Your Impact on Worker’s Comp Will Change Your Career training series. It’s a three part series, and in the second part of the series, it’s called Expand Your Influence, and I walk through the exact process that you need to take in order to sell to management, or build your clients trust, and once you do that, then you could set yourself on the path to now realize those results.

 

Again, I’m Michael Stack, CEO of Amaxx, and remember, your work today in workers’ compensation, it can have a dramatic impact on your company’s bottom line, but it will have a dramatic impact on someone’s life, so be great!

 

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO 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.

 

Professional Development Resource

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