Eliminate 20% Of All Workplace Injuries

Major drivers in workers’ compensation programs continue to be injuries resulting from slips/falls and when working at heights.  While these injuries will never be eliminated, employers can take a proactive approach to reducing their prevalence in the workplace.

 

 

Caution: Slippery When Wet

 

Injuries sustained from slips/falls continue to be the most common workplace incident.  The result of this ongoing trend is that employers pay countless dollars every year in increased workers’ compensation premiums for incidents that are preventable.  Employers seeking to reduce their workers’ compensation costs must become serious in addressing this issue.

 

The National Safety Council has opined based on research that slip/fall injuries account for over 20% of all work-related injuries in the United States.  The actual impact is hard to quantify given the varying resulting injuries.  These incidents can be as minor as a sprain/strain-type injury to severe trauma that includes traumatic brain injuries (TBIs) and back injuries requiring spinal surgery.

 

There are many common elements in any slip/fall workplace injury.  These often include:

 

  • Liquid on the walking surface that was never cleaned up properly or in a timely manner;

 

  • Cracks on flooring, carpeting, or uneven surfaces;

 

  • Failure or of an employer to place required signage warning people of danger;

 

  • Inadequate lighting;

 

  • Exposed cables that result in someone tripping; and

 

  • Stairs, ladders or scaffolding that is not properly maintained.

 

Employers and other interested stakeholders need to take proactive measures on this issue.  Taking time to inspect visually a worksite is an important first step.  This should also include measures where employees can report situations that are unsafe.  Management must then take immediate corrective action to remedy the situation.  Doing so creates a positive safety environment and forces employees to see value in safety measures.

 

 

Look Out Below!

 

Falls from heights are a frequent hazard that result in countless injuries.  A majority of the injuries that occur while working at heights cause catastrophic claims.  According to the Bureau of Labor Statistics, falls from heights in the workplace account for roughly 14% of all workplace deaths.  It is also a frequent source of citations from OSHA.  These mainly occur when work is performed on scaffolding and ladders.

 

Working from heights can never be eliminated in the workplace.  Proactive employers can prevent these incidents by taking the following steps:

 

  • Educating all employees on the dangers working at height presents and how to be safe when working in these environments;

 

  • Reducing the amount of time and number of employees that need to work on ladders and scaffolding; and

 

  • Educating all employees on the use of proper safety equipment. This includes exercising caution before working at heights and using only equipment that is free from defect that fits correctly.

 

Management and other interested stakeholders need to be proactive on this issue.  In many instances, this not only includes ethical obligations, but legal standards.  This is also includes making sure employees are given equipment that works.  Other steps include replacing equipment that is outdated or replacing something when it breaks.  Quick fixes do not relay confidence in employees and may be illegal.

 

 

Conclusions

 

All employers must take proactive steps when it comes to a safety work environment and reducing the probability of work injuries.  Two areas of focus should be in the reducing of slip/fall incidents and providing the proper equipment and training for those working at heights.  The immediate benefits of following these best practices will be a reduction in workers’ compensation costs.

 

 

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

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

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

 

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

 

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

5 Ways to Get to the Bottom of Work Injury Causation

Some things were a lot simpler back in the day, like determining whether an employee’s injury or illness should be compensated through workers’ comp. Workers tended to stay with the same employer throughout their careers, creating a solid trust level on both sides. Employees also were more inclined to retire earlier, before the onset of age-related and comorbid conditions.

 

But things are more complicated now and proving causation can be a tricky business. You want to ensure that injured workers who sustain work-related injuries at your company are duly compensated, but you certainly don’t want to pay for injuries that did not result from your employ. While determining causation is not an exact science, there are some tools you can use to assure you pay only for those injuries truly related to your workplace.

 

  1. Investigate

The best place to start is at the beginning, as soon as you get word of an injury or illness. Work with your team to find out what happened. In addition to speaking with the injured worker, talk to any witnesses. Drill down to the details. Ask lots of questions – of witnesses and others who may have been aware of potential problems in the area in question. Take pictures of the area, since that may shed some light on what was happening at the time. If nothing else, you may at least uncover a festering problem in your workplace that can be corrected to prevent another injury.

 

 

  1. Look at the mechanism of injury

The MOI can reveal valuable details to medical professionals about injuries to the bones, skin, muscles and organs. Did the person fall from a height? How high? Or, was it a ground level fall? If it involved a motor vehicle accident, what speeds were involved? Get as many details as possible as soon as possible after the injury is reported.

 

 

  1. Understand chronic vs. acute

While the medical nuances are best left to those in the biz, you can at least have a general idea so you can speak the lingo with medical providers, adjusters and others. The problem with chronic conditions is that they affect just about everyone on the planet in some way, at some time, and often we don’t even know it’s happening to us. Degenerative changes may build up somewhere in the body yet the person has no awareness of it until an awkward movement at work renders him wracked with pain. Of course, he assumes it is work related. But maybe it’s not.

 

For example, arthritis is not typically aggravated by soft tissues trauma, so check that out before you agree to pay for a knee replacement in such cases. Researchers have found that low back pain — one of the most common ailments among injured workers — often has a genetic basis rather than a link to an occupational activity. A rotator cuff injury may be chronic, especially if it is associated with muscle atrophy; however, such a tear may become larger after acute trauma.  And, contrary to what many believe, carpal tunnel syndrome does not necessarily result from keyboarding. It behooves you to request and get medical evidence to help identify what is your responsibility under workers’ comp and what is not.

 

 

  1. Use quality providers

Seek medical providers who use evidence based medicine, especially in jurisdictions where you have a say in the physician the injured worker sees; look at their credentials — board certification, etc., and check out their educational backgrounds. Same with other providers and medical facilities — you want to make sure the MRI that’s the basis of your decision on a claim is of high quality and read by a top notch radiologist.

 

If you use a medical expert in a challenge to a claim denial, find one that is believable. Ask questions such as how the provider arrived at a certain diagnosis, whether the MOI was accurately described and applied, and how EBM pertains to the case.

 

 

  1. Know the law

 

Causation standards have changed in a number of states in recent years, with many requiring work to be the major contributing cause of injury. However, some injured workers and their attorneys have become more adept at challenging those standards.

 

There are also legislative proposals in several states that would ensure first responders are compensated for instances of post-traumatic stress following an incident on the job. Still other statutes or proposals would guarantee benefits to firefighters who contract certain cancers. It would be a mistake to assume all states have the same types of allowances for workers’ comp benefits.

 

 

Conclusion

Weeding out the legitimate claims can be tough, as there is often no black and white answer. By being proactive when a claim is first reported and using the right experts, you can save yourself headaches, time and money.

 

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

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

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

 

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

 

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

Watch Evidence: Hitting Yourself Does Not Equal A Workers Comp Claim

Florida’s Department of Financial Services’ Division of Investigative and Forensic Services (DIFS) recently announced the arrest of Sheyla Veronica White following her attempt to fraudulently collect workers compensation payments following an alleged on-the-job injury.

 

 

Claimed Sprinkle Head Fell From Ceiling and Struck Head

 

White claimed that a sprinkler head fell from the ceiling, bounced off her desk, and struck her in the head. Her employer, Cinque Terre Energy Partners, LLC promptly filed a compensation claim related to the alleged injury. Video surveillance footage later proved a different series of events surrounding the alleged injury.

 

Cinque Terre’s insurance company, AmTrust North America, grew suspicious of White’s claim and referred the incident to the Division of Investigative and Forensic Services for review and possible investigation. As part of their subsequent investigation, DIFS detectives requested video footage from Cinque Terre’s security cameras, which confirmed AmTrust’s suspicions that the claim was fraudulent.

 

The video clearly shows a piece of a sprinkler head falling onto White’s desk, but it does not bounce and strike her in the head as she alleged. Instead, the video shows White picking up the broken item, looking around to ensure she was alone in the room, and then striking herself in the head with the item. Watch video here.

 

 

Arrested and Transported to Jail

 

White was arrested and transported to the Broward County Jail. She faces two counts of workers comp fraud, and faces up to five years in prison if convicted.

 

White was previously arrested in 2010 for stealing students’ personal identification information while working as a teacher at Monarch High School in Coconut Creek.

 

Sheyla White was using the named Sheyla Diaz at that time, and she was sentenced to six months house arrest for that offense.

 

 

Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com.  Contact: kstack@reduceyourworkerscomp.com.

 

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

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

 

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

 

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

 

 

 

3 Actions to Weed Out Marijuana-Related Workers’ Comp Challenges

The trend of legalizing marijuana for medical and/or recreational use is growing and may soon affect nearly all states. The recent election brought the number of ‘medical marijuana’ states to 28 plus the District of Columbia; while eight states now allow it for recreational use. Add to that the fact that several states have seen cases that allow injured workers to obtain the drug through their workers’ comp systems, and you’ve got a veritable nightmare for employers — especially those in multiple jurisdictions.

 

But employers don’t have to sit by and watch your workforce go up in smoke. You can — and should — take steps to keep your workers, property and the business itself safe.

 

 

Drug testing

 

The most effective way to prevent drug-related workplace injuries and illnesses is to avoid hiring drug users. While passing a drug test certainly doesn’t guarantee an employee won’t use marijuana or other drugs down the road, it is at least a way to eliminate habitual users from entering your workforce.

 

Even in states where marijuana is legal — for medicinal or recreational purposes — private employers still have the right to test conditionally-hired job applicants. How you handle a positive test result, however, likely differs among states; so it behooves you to understand the laws in your jurisdiction.

 

Beyond pre-employment testing, employers may also do drug testing randomly, based on reasonable suspicion, for return-to-work screening and post-accident. OSHA’s new injury reporting rule has raised many questions about whether employers that conduct post-accident drug testing may run afoul of the agency.

 

OSHA has tried to clarify the confusion by saying drug testing policies should be limited to situations where drug use is “likely to have contributed” to the incident, and for which the test can “accurately identify impairment.” Injuries such as bee stings, repetitive strain injuries or one caused by a machine malfunction would not qualify for mandatory testing, under OSHA’s explanation. Federal drug testing has not changed.

 

There are generally three types of drug tests:

 

  • Urinalysis. The first and still most widely used, this is less expensive than some other test methods. It detects most drug use for the previous 2–3 days and is the only type allowed for federal testing. On the downside, it is easily manipulated and cannot measure the frequency of drug use.
  • Oral fluid. These are collected under supervision, making tampering impossible. It determines drug use for up to 48 hours and is generally inexpensive. It also does not measure frequency of use.
  • Hair. Perhaps the best for pre-employment tests, as its detection window is generally 3 months. However, it is the most expensive type of test. Also, it typically takes longer — up to 10 days versus 1 or 2 — for the results.

 

 

Create/Update Drug-Free Workplace Policy

 

Lower job performance, reduced productivity, absenteeism and higher workers’ comp costs are among the results of workers who abuse drugs. As an employer, you are obligated to provide a safe work environment for all employees. Those are among the biggest reasons to have a workplace drug and alcohol policy — and communicate it clearly to your workers. A policy can include the following:

 

  • Basic assumptions. The policy should spell out why the company is establishing it, what is expected of employees and the consequences for violations, including dismissal.
  • Broad statement. The policy should clarify that employees may not perform their job duties under the influence of alcohol, illegal drugs, or mind-altering prescription medications — including marijuana. In states where marijuana is legal you should include a section with clear guidelines devoted to that drug.
  • Drug testing. If your company conducts drug tests, that should be included with the specific procedures outlined. It should also say that workers with prescribed medical marijuana may not use the drug while at work. The policy should be similar to that for narcotic prescriptions.

 

Workers in states that have medical and/or recreational marijuana laws on the books are likely confused about their rights to the drug in the workplace. Therefore, you should train supervisors on it and ensure all employees understand it. Employee handbooks, posters, intranet messages and other technology-related approaches are ways to disseminate the policy.

 

 

Know the law

 

Before drafting or changing a policy you need to understand the specifics of all the jurisdictions in which you operate. Much like the workers’ comp system itself, marijuana laws vary by state. Statutes may have vastly different provisions, especially when it comes to the workplace.

 

In states where the drug is legal, courts have taken different actions as to whether marijuana is reimbursable through the workers’ comp system. Following several court rulings, New Mexico passed a reimbursement rule.

 

In other states, however, laws say workers’ comp payers are not compelled to pay for the drug. They include Arizona, Colorado, Michigan, Montana, New York, Oregon and Vermont.

In some states, employers that can prove the drug is the cause of a work-related injury are off the hook for reimbursement. In others, the injured worker may be entitled to payment even if the drug caused the accident.

 

Summary.

The laws surrounding marijuana are changing rapidly. Employers are well advised to stay abreast of this constantly changing situation through legislation and case law; review and update workplace substance abuse policies often; and consider drug testing — at least for pre-hiring.

 

 

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

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

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

 

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

 

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

Address These 7 Most Common Workplace Safety Concerns

There are many things interested stakeholders can do to reduce workers’ compensation costs.  In doing so, they can make their programs more effective and efficient.  This requires engagement by all interested stakeholders and a willingness to review the workplace and beyond for safety hazards.  Once they are identified, changes need to be made to reduce or eliminate the chance of injury.

 

 

Regular Safety Review of Workplaces

 

Most people are accustomed to an annual “spring cleaning” and regular chores around their home.  The same should apply to the workplace.  Interested stakeholders should make a regular walk-through of their workplaces and make sure everything is in order.  Additional steps and emphasis should occur when spills happen in the work place.  In other instances, employers should engage their employee’s to clean up their workstations and make sure it is clean at all times.

 

 

Addressing Common Safety Concerns

 

Additional steps must be taken to ensure a safe and secure workplace.  Some easy to implement suggestions include:

 

  • Fire extinguishers: State laws and local ordinances typically provide guidance on what types of fire extinguishers should be in a work place and their quantity.  They should be visible and in proper working order at all times.  They also require regular servicing;

 

  • First Aid Kits: Every workplace should have a First Aid kit that meets basic emergency needs.  In addition to Band-Aids, tape and gauze, it is also important to include ice packs and other essentials.  What is stocked in a kit should be consistent with the type of work performed in your workplace.  Always be ready to dial 9-1-1 if a severe injury occurs;

 

  • Emergency evacuation plan: Having an effective plan that is understood by all employees is important.  Evacuation plans should also be posted around the workplace and pointed out to new employees when they first start.  Reminders should occur that involves all employees and contractors on an annual basis;

 

  • Fire and severe weather drills: Planning for a fire or severe weather is often overlooked in workplaces.  Planning for the unexpected is critical and can pay dividends in moments of danger.  It is also important to remind all employees what they are to do in these instances on an annual basis;

 

  • Workplace violence: It is a sad reality of modern society that violence takes place in the workplace.  Proactive stakeholders can implement several strategies to prevent this from occurring and mitigate their risk.  Identifying potential violence issues is the first step to successfully addressing this issue.  It is also important that employers effectively deal with it when it occurs, which can include termination of an employee.  Having an “active shooter” protocol is also something to consider.

 

  • Other Workplace Safety: Employers can also be proactive on issues of workplace safety by reviewing their policies and procedures related to safety.  Important steps one can take include making sure all employees wear proper identification while in the work environment.  Badges can also be used to unlock/lock critical access points.  Keep in mind that certain entrances must remain unlocked during normal business hours.

 

  • Safety Requires Everyone: Workplace safety requires the engagement of all employees—from upper management to the newest employee.  When leadership within an organization takes the lead, others will take notice and follow.

 

Conclusions

 

Reducing workers’ compensation costs starts with a safe work environment.  Some of these program-enhancing steps are simple, yet require everyone to be fully engaged.

 

 

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

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

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

 

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

 

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

10 Ways to Kick Start a Workers’ Comp Stewardship Program

If you’re trying to improve your workers’ comp program, ask for an annual stewardship meeting with your insurer/third-party administrator. But if you really want to see game changing results, initiate a stewardship process. It’s a collaborative approach that takes some leg work and elbow grease, but can truly push your workers’ comp program to the next level.

 

In a typical stewardship meeting a representative for the employer and insurer or third party administrator discuss a pre-prepared report that shows your claims and program trends from the previous year and discuss goals for the next year. While it can be beneficial to get this snapshot of your workers’ comp program, there is much more that can be done.

 

Best outcomes for injured workers, optimized claims performance, and a reduction of your total cost of risk should be the goals. Savvier companies find more value and better outcomes through an intensive coordinated approach that starts long before the actual stewardship meeting.

 

Prep Work

Conversations with a multitude of people ahead of time can help you define what you want included in the report, the metrics you want analyzed and the parameters. Among those you may want to consult with are your carrier or TPA account manager, risk management information systems personnel and data analysts; claim and safety consultants; your insurance broker or agent; and others within your own organization.

 

Key steps in the process at this point include:

 

1. Set the date. Decide when you want the report completed.

 

2. Review past reports. This can help you establish a baseline.

 

3. Formulate a concept for the report.

 

4. Discuss the format and content of the report; set goals, objectives, metrics, deliverables, ideal takeaways, and the list of attendees.

 

5. Review preliminary data. Easily available analytical reports can be your starting point until you determine what needs to be customized, depending on what you are trying to accomplish. Not all data is going to be relevant. Some examples of the types of data may include:

  • Frequency analysis: claim volume, litigation, examiner caseload and lag time.
  • Severity analysis: average/total incurred, average/total paid, loss stratification, lag analysis, litigation, subrogation/recovery.
  • Ratio analysis: closure, medical vs. indemnity, payment analysis.
  • Managed care analysis; case management, PPO penetration, diagnostic, physical therapy, bill review.

About two months before the meeting, you can conduct a preliminary data review and determine what additional data you need.

 

6. Draft a preliminary report. Conduct a collaborative review of it and make any changes based on feedback.

 

7. Finalize the report.

 

The Meeting

 

A key to a truly effective stewardship process is to avoid the inclination to only see the positive trends of your workers’ comp program. Equally, or even more important are the areas for improvement, which is where you can make a significant impact. Often carriers or TPAs will avoid showing you potential problem areas, for fear they might be held liable. But it’s important to see both. For example, an increase in frequency does not necessarily signify a problem — if your payroll has increased through company growth. You need to see all of the trends.

 

8. No finger pointing. Honesty and openness are imperative among all parties to the stewardship process for better analysis and improvements. Each should have a sense of collective buy in to the purpose and outcome of the session.

 

9. Evaluate the results. Discuss the reasoning behind any emerging trends to see what they mean and what might be done to ensure they lead to best outcomes. Look at any services, initiatives and program enhancements that may be impacting them. Changes to the company’s financial stability, openings or closings of new facilities, or natural disasters may have occurred that could affect trends.

 

10. Set measurements. Determine goals and metrics to better understand the success of strategies you have implemented. Create a detailed action plan with target dates.

 

Summary

 

The stewardship process can be a rich tool to raise the bar on your company’s workers’ comp program. But failing to properly plan, having unreasonable expectations, inviting the wrong attendees and having an inability to be completely open can make the stewardship meeting a disaster. Getting commitment from all parties to a specific plan with responsibilities and due dates will lead to a successful stewardship process and best outcomes for your injured workers and your company.

 

 

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

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

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

 

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

 

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

How To Guarantee Better Workers’ Comp Outcomes

 

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

 

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

 

 

Look at Your Last 5 First Report of Injury

 

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

 

 

4 Points To Properly Execute

 

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

 

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

 

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

 

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

 

 

Learn More About Reducing Workers’ Comp Costs

 

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

 

 

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

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

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

 

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

 

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

How Technology Is Changing Workers’ Compensation And Other News Tidbits

How Technology Is Changing Workers’ Compensation

New technologies are improving workers’ compensation programs in everything from communications and training to health care delivery and claims, according to experts. Tom Ryan, market research leader for Marsh’s Workers Compensation Center of Excellence, speaking during a recent Marsh broadcast, identified several areas of workers’ compensation that can benefit from technology.

 

 

 

Treating Syncope: Helping Your Heart

If heart trouble caused your fainting, treatment may improve blood flow, stop syncope, and help prevent further heart problems. Your healthcare provider can explain the benefits and risks of each treatment. Treating Syncope: Helping Your Heart

 

 

 

 

 

Keeping Copays Affordable

As an independent pharmacy benefit manager, we are uniquely and completely aligned with the best interests of our clients and members. Some pharmacy plans require their patients to pay a full copayment for a prescription drug even though a retail pharmacy’s price for the drug may be less costly than their copayment under their pharmacy benefit. And then they require the pharmacy to return the difference between the copay amount and the price for the drug back to them.

 

 

 

NAMSAP Announces Leadership Team and Goals for 2017

The board of directors of the National Alliance for Medicare Set-Aside Professionals has elected the following officers for 2017: “Promoting payer participation in NAMSAP is another high priority” President: Shawn Deane, JD, MEd, MSCC, CMSP – assistant vice president of Product Development of ISO Claims Partners, Vice President: Greg Gitter, CMSP – president of Legacy Claims Solutions, Inc. (a Gitter Company), Treasurer: Rita M. Wilson – CEO of Tower MSA Partners, Secretary: Christine Melancon, RN, CCM, MSCC, CNLCP, CMSP – vice president of Operations for EZ-MSA Services

 

 

Structured Settlements in the Media

When used as part of a comprehensive settlement plan, structured settlements can be invaluable to injury victims and their families and it’s important to find a way to tell our success stories. The guaranteed income replacement, college payments and benefits that cover medical needs help to provide the financial security and peace of mind that is so important to people that have suffered a loss.

 

 

WCRI Conference – See You There – March 2-3, 2017

Close to 400 people will be taking their seats next Thursday for our annual workers’ compensation conference, March 2-3, in Boston, MA.  Should we hold a seat for you?  For those still on the fence, below are three great reasons to attend. #1) Content  #2) Networking: #3) Continuing Education Credit.

 

 

 

 

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

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

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

 

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

 

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

3 Strategies to Eliminate Chronic Pain Claims

Chronic pain is the most prevalent health condition in the U.S. workforce with cost estimates of more than $100 billion annually in lost productivity, healthcare, and workers’ comp/disability payments.

 

The good news is medical science and research has evolved to enable the workers’ comp community to effectively address this prevalent and costly issue. The bad news is many employers and payers believe the steps needed to move injured workers from chronic pain status to productive individual are too complicated and too expensive. They are wrong.

 

 

Typical case

 

A 45-year old male sustains a ‘minor’ twisting injury while lifting something at work. He’s anxious to get back on the job and optimistic about his recovery, based on what his physician tells him. Seven years later — after umpteen surgeries and a smorgasbord of additional medical procedures — his chronic back pain is such that he cannot stand longer than 2 minutes, uses a walker and is afraid to move off the coach for fear he might cause more damage and more pain. He takes a long list of medications, especially opioids and other drugs to counter their side effects, and his wife is threatening to take the kids and leave. One can only imagine how much is being spent on this injured worker.

 

What could have helped this injured worker soon after his injury — and even years later, is a combination of coordinated care, more accurate diagnoses, and attention to issues beyond just his physical ailment.

 

 

Approaches to Pain

 

In the scenario above as in many other cases, the physician took a biomedical approach, which assumes all pain symptoms have a specific cause and once alleviated, the pain will disappear and the patient will be fully recovered. But for many people, this method just doesn’t work.

 

Research shows that chronic pain is a complex and dynamic interaction of psychological and social factors as well as biological conditions. A biopsychosocial approach is what is needed; a multidisciplinary effort that includes physical therapy, occupational therapy, psychology, neuromuscular massage and other experts. There are several things that could have been done in the above situation..

 

  1. Identify at-risk injured workers

A variety of potential red flags could have alerted the injured worker’s case manager and others involved in his claim to issues that might exacerbate the patient’s pain. Among them are:

 

  • Getting medications dispensed from his physician.
  • Recommendations for implanted devices.
  • Getting medical treatment outside the network.
  • High medication costs and increased use of medications.
  • No functional improvement by anticipated dates, despite various treatments.
  • Adverse childhood experiences — such as verbal, physical or sexual abuse; neglect; family dysfunction.

 

Chronic pain cases require interventions early on to prevent them from digressing to the point of the patient described above. The claims management team should have had weekly conversations with the medical providers to get updates on his progress. A thorough medical history should have been done to find out of the initial medical diagnosis was correct. A look at the injured worker’s family situation and other psychological challenges should have been investigated and addressed.

 

 

  1. Set Realistic Goals

 

All human beings are not alike and treating people for chronic pain should not be a one-size-fits-all method. However, the goals of treatment for anyone with chronic pain should be the same. These should include:

 

  • Ensure the patient has realistic expectations. An injured worker may not be able to be completely pain free, but he can still be a functioning member of society. Patients in pain need to understand that, and be given tools to help them manage their pain.
  • Provide education to help the person gain a locus of control, instead of feeling he is at the mercy of others. The injured worker should be just as involved in medical decision-making as anyone else involved in the claim.
  • Quality medical care that is evidence based. Treatment should be based on scientific studies to guide clinical decision making; ensure consistent, proven medical practices are used; and reduce unproven, ineffective care. The effect is better medical outcomes at lower costs.

 

 

  1. Use elements of Biopsychosocial Approach

 

There are a variety of treatments available that have been shown to help at-risk injured workers in chronic pain return to work. Whatever is used should be a process that helps the person gain the skills, knowledge and behavioral change necessary to avoid medical complications and take charge of his physical and emotional well-being after the injury. Treatments may include:

 

  • Pharmacological interventions to wean the person off opioids.
  • Psychological aspects to assist with psychosocial issues.
  • Cognitive behavioral sessions that focus on function and coping with pain. They may include relaxation training, guided imagery, desensitization, and addressing anger and entitlement issues.
  • Physical and occupational therapy. This may involve aquatics therapy, Tai Chi or Yoga, spine stabilization and stretching, and aerobic conditioning.
  • Follow-up care. Since at-risk workers may be vulnerable to reinjury or lapsing into disability mindset, there should be consistent communication with various referral sources, either face-to-face or by phone.
  • Include family and friends. The home and social lives of injured worker are key factors in recovery, so enlisting family members and friends to support the patient and reinforce positive outcomes should be strongly considered.

 

All treatments should be undertaken within a coordinated, goal oriented, functional restoration approach

 

 

Conclusion

 

Employers and payers that fail to recognize and deal with injured workers with psychosocial issues are doing their companies a disservice. Instead, they should be proactive and identify those with the potential for delayed recoveries, support and encourage early intervention, ensure quality medical providers using evidence-based medicine are employed, and provide whatever elements are needed to help workers in chronic pain regain their functionality.

 

 

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

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

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

 

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

 

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

 

Do High Heels Mean A Compensable Workers’ Comp Claim?

Navigating issues of compensability in workers’ compensation has become a complicated task for members of the claims management team and interested stakeholders.  This is highlighted by developing case law that scrutinizes the facts surrounding work-injuries when they occur at special events, company meetings or special occasions outside the employee’s usual work functions.  It also stresses the importance of a careful investigation of the facts and elements connected to the work-injury

 

 

Dykoff:  An All Too Common Scenario

 

The facts of Dykhoff v. Xcel Energy, 840 N.W.2d 821, 73 W.C.D. 865 (Minn. 2013), read like a law school hypothetical or test question meant to challenge students.  The employee in this case was a middle-aged journeyman electrician, whose job duties included electronically monitoring power and transmission lines.  Her work duties were performed at a desk, where she usually wore jeans and other casual clothes to work.  Presumably, this did not include high heels.

 

On the date of injury, Ms. Dykhoff was instructed to attend a training session.  Employees attending this event were advised to wear “dress clothes.”  While attending the event, the employee wore two-inch high heels.  She suffered a knee injury while walking on a dry floor.  A post-injury investigation noted there was no debris on the floor.

 

The case was found not compensable after initial hearing.  These conclusions were reversed at the first level of appeal.  Ultimately, the Minnesota Supreme Court upheld the hearing judge’s determination of non-compensability after a close evaluation of the facts and application of developing case law.  Central to the Court’s conclusions were three common tests used in many workers’ compensation cases when the law and careful review of the facts drive issues of compensability:

 

  • Increased Risk Test: The employee must show that she is exposed to a greater risk than the general public;

 

  • The Positional Risk Test: The employee need only show that her employer placed her in the position where she was injured; and

 

  • The Work-Connection Balancing Test: Where the arising out of/course of elements are evaluated.

 

In reversing the lower court decision, the Minnesota Supreme Court noted, “the employment creates a special hazard from which injury comes, then, within the meaning of the statute, there is that ‘causal relation’ between employment and the injury.”

 

 

Lessons Learned and Application

 

There is obviously no way an employer or other stakeholders can prevent a claim from being filed in instances like those described above.  On the other hand, there are important take-aways anyone can implement to avoid adverse findings and increased workers’ compensation program costs:

 

  • Maintaining a safe and properly functioning workplace environment is the surest way to prevent injuries. This includes making sure all walking surfaces are clear of debris and spills are immediately cleaned up in a proper manner.  All employees within an organization should receive annual safety training and understand the importance of their role in the process.

 

  • Setting proper expectations of employees when they attend meetings or other special functions during customary work hours or outside the normal workday. It is unclear what role the employee’s healed footwear played in the minds of judges when considering the Dykhoff  Notwithstanding its significance or lack thereof, it is something important to employers and other stakeholders to consider when holding workplace meetings where the posted attire exceeds those set during normal business hours.  This includes footwear.

 

  • A careful and complete investigation of all work injuries after they occur is important. Due to the interest in workplace “risk” by the Minnesota Supreme Court and other judicial bodies, it is important to note an uneven walking surface, a missing floor tile or floor mat can result in paying for someone’s medical bills and wage loss benefits under a workers’ compensation program.

 

Conclusions

 

Members of the claims management team and other interested stakeholders should take note of ways to keep their workers’ compensation costs in check.  Part of this includes an analysis of employee expectations and an awareness to dangers that lurk around the corner.  This includes an awareness to workplace safety and demands on employees.

 

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

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

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

 

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

 

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

 

Professional Development Resource

Learn How to Reduce Workers Comp Costs 20% to 50%"Workers Compensation Management Program: Reduce Costs 20% to 50%"
Lower your workers compensation expense by using the
guidebook from Advisen and the Workers Comp Resource Center.
Perfect for promotional distribution by brokers and agents!
Learn More

Please don't print this Website

Unnecessary printing not only means unnecessary cost of paper and inks, but also avoidable environmental impact on producing and shipping these supplies. Reducing printing can make a small but a significant impact.

Instead use the PDF download option, provided on the page you tried to print.

Powered by "Unprintable Blog" for Wordpress - www.greencp.de