Work Comp Roundup -

Medcor Launches New Telemedicine Service for Workers’ Comp Nationwide 24/7

December 12, 2018 by Senior Editor

Medcor, Inc., the nation’s leading health navigation firm, announces a new telemedicine service developed specifically for work-related injuries. Medcor Telemed™ will be available 24/7 in all 50 states, beginning January 14, 2019. This new service enhances Medcor’s existing injury triage service, already in use by more than 309,000 worksites, and will augment Medcor’s 240+ onsite and mobile clinics.

Medcor navigates patients to optimal care by using evidence-based medicine, proprietary clinical algorithms, and patented processes. Medcor serves employers across a wide range of industries, including
many Fortune 100 and 500 companies, as well as government agencies, TPAs and insurance carriers.

Medcor’s President and CEO Philip Seeger said, “We designed our new service to address the challenges telemedicine faces in occupational health. This service will improve outcomes, reduce costs and provide a positive user experience for patients, their employers and for the treating doctors.” Mr. Seeger added, “Avoiding the conflicts of interest so common in medicine is a tough challenge to address, and it is a cornerstone of all Medcor’s health navigation services.”

Sophisticated algorithms programmed into Medcor’s system identify cases that are appropriate for telemedicine; high-acuity conditions that require in-person care and diagnostics are directed to the appropriate offsite facilities. Identifying the needed level of care saves time and expense. Vice President and General Manager Matt Engels oversees the new service. He said, “Medcor Telemed is an early intervention opportunity to guide low- and moderate-acuity injuries onto the right path to recovery and to jumpstart the claims management process. Our system connects patients to physicians seamlessly with wait times measured in minutes and without advance scheduling. Medcor Telemed is staffed by a team
of hundreds of physicians to ensure coverage across all states day and night. Our physicians are trained and experienced in telemedicine and oriented to Medcor’s best practices in occupational health.”

Patients and physicians benefit from Medcor care navigators who stay with the injured worker through the entire telemed process, from registration to resolution. The navigators handle technical and administrative aspects of the session. They document and clarify key workers’ compensation information, such as return-to-work status and restrictions for modified duty. At the end of each session, the navigator facilitates carrying out treatment orders from the physician. The system automatically processes reports for all the stakeholders.

Medcor’s new service operates with a combination of Medcor’s technology and licensed systems. It works on desktop computers, tablets and smart phone apps, which can be downloaded at the time of service. Medcor has already provided more than 2.5 million injury triage and other telehealth visits, which represent a solid foundation of experience for its new telemed service.

For more information, watch the short video at this link https://youtu.be/CTUT5QeoQIg/, contact media@medcor.com or call 815-759-5442.

Filed Under: Workers Comp News

Surveillance is Often Used Incorrectly

December 11, 2018 by Michael B. Stack

Members of the claim management team need to be creative when investigating workers’ compensation claims and to determine issues of compensability. This includes using claim investigation techniques that go beyond interviewing the employee, witnesses, experts, and reviewing medical records. To be effective, proactive claim handlers and investigators need to do a deeper dive to reduce program costs.

Surveillance is Often Used Incorrectly

Over the years, defense interests in the workers’ compensation industry have become dependent on using private investigators to conduct surveillance on an injured worker. Surveillance is a recommended and effective technique. However, it is often :

Limiting surveillance to one day: The problem is this provides only a Not obtaining of what the employee is doing and allows for them to argue you watched them on “a good day;”

Not obtaining complete background information on the employee: This includes not knowing the habits of an employee and what activities they might be doing when under the watchful eye of an investigator. In worst case scenarios, the employee will do nothing at all – not even coming outside their home; and

Following the rules: Many jurisdictions have specific timelines as to when and how documentary evidence from surveillance needs to be disclosed to the employee and/or their attorney. Failure to follow these rules can have significant consequences.

Using Other Resources to Uncover Favorable Claim Information

Claim handlers need to be creative and ethical when uncovering information on a claim and developing their theory of the case. This requires patience, persistence, and creativity.

Job Site Videos

Job site videos are useful in a number of ways when done. For example, if an employee is claiming that a certain activity (especially those that require repetitive movements) is includes using of an injury, it allows for a medical expert to evaluate whether be effective of injury is consistent with the objective medical evidence. It also reduces or eliminates the ability ofan employee to exaggerate movements, including the frequency at which it is performed.

When creating such videos, it is important to remember key items. This includes having a workplace station or machine set up exactly how it was at the time of the injury. When possible, have the employee to perform the motions or movements. If this is not possible, itis essential to have someone of a similar size perform the activity. Failure to exactly recreate these motions in question can result in the job site video not being admitted into evidence at the hearing.

Timing and Work Schedules

Records documenting the coming and going of an employee, an employee and the number of shifts they worked can be relevant in a number of circumstances. Instances when this can be useful include the following circumstances:

Claims made by the employee as to their physical presence at a location at a specific time, or when other identified witnesses claim to have been present;

The number of hours or shifts worked by an employee. This is important information to have in workplace exposure cases; and

Tracking movements of traveling employees. This can be important when trying to determine the applicability of “portal-to-portal” coverage where an employee may have made a personal deviation, which took them outside the “course and scope of” their employment

Social Media Investigation

While fewer Americans are using social media platforms on a consistent basis, it is still relevant to any claim investigation. Key points to remember include checking common programs such as Facebook, Twitter, and Instagram. Ethical considerations apply. Do not obtain access to an employee’s account under false pretenses or by using a strawman. Attorneys representing defense interests should also take note of case law that warned, “It should now be a matter of professional competence for attorneys to take the time to investigate social networking sites.” Griffin v. Maryland, 192 Md.App. 518, 535 (2010).

Conclusions

Running an effective workers’ compensation claim program requires hard work and creativity. In order to be cost-effective, one needs to think outside the box and go beyond the “cookie cutter” approach to investigating and defending workers’ compensation claims. By looking for alternative methods, members of the claim management team can make better decisions and move cases toward settlement.

Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is a 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: https://blog.reduceyourworkerscomp.com/

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

Filed Under: Fight Workers Comp Fraud & Abuse

ACOEM 3-Part Return to Work Framework

December 10, 2018 by Michael B. Stack

ACOEM Whitepaper: Preventing Needless Work Disability by Helping People Stay Employed

Hey, there. Michael Stack here, CEO of Amaxx. One of the most fundamental goals in workers’ compensation is to return our injured employees to work and back to function. I want to draw your attention to a white paper written by ACOEM several years ago entitled Preventing Needless Work Disability. You could find a link to that white paper below. Within that paper, they talk about a three-part framework or a three-step framework to consider return to work on nearly every single workers’ comp claim. I want to walk you through what that framework is when you’re considering return to work for your injured employees.

ACOEM 3-Part Return to Work Framework

The first part is to assess where that current employee is. The next piece is compare. Then, the final piece is to create. So assess, compare, and create. Assess where they currently are. What are their current job restrictions? What restrictions do they get from the physician that say they could only lift 20 pounds or 50 pounds and they can bend this way or stretch this way X amount of times standing, whatever that happens to be? Where do they currently stand? Compare that what the job descriptions are, the physical demands of their actual jobs. You should have a very comprehensive library of what this means at your organization so you can compare one with two. It’s very, very simple when you actually break it down.

Simplicity of High-Level Understanding

Then, the final piece is to create that job. What are those action steps, then, to now put this into practice? Obviously, there’s a lot more depths to each one of these steps. But if you can understand the high level of what it is that we’re actually trying to accomplish, it can ultimately be fairly simple in your mind to now put this all together. So assess, compare, and create. Three steps in the return to work framework in ACOEM’s Preventing Needless Work Disability white paper, which I highly recommend downloading and checking out. It’s a great resource. Again, my name is Michael Stack, CEO of Amaxx. Remember, your work today on workers’ compensation can have a dramatic impact on your company bottom line. But it will have a dramatic impact on someone’s life. So be great.

Contact: mstack@reduceyourworkerscomp.com.

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

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

Filed Under: Uncategorized

The Power of A Personal Note – Legacy of George HW Bush

December 6, 2018 by Michael B. Stack

Hey, there. Michael Stack here, CEO of AMAXX. Our former president, George H.W. Bush, passed away recently at the age of 94. Mr. Bush was a tremendous leader who left a lasting impact and legacy on our nation. And more close to home for me, in my hometown where I live with my family in Kennebunkport, Maine, Mr. Bush and Barbara Bush’s impact on our small town here has certainly been felt.

Honor Life & Legacy of a Great Leader

When we look at the life of a great leader, we look at their legacy. We need to look at what are those lessons that we can learn from them and apply to our lives to improve our outcome, to improve our situation, and more specifically, for our purposes today, improve our work comp programs.

Power of Personal Notes

I want to draw your attention to one of Mr. Bush’s best practices, which was writing personal notes. It’s looked at an old-fashioned practice, but he would write notes to foreign leaders. He would write notes to celebrities if he sat by them at a dinner. He even wrote a note to his granddaughter when his granddaughter was born, and passing around the internet, the letter that he wrote to the incoming president, Bill Clinton, you can see and read the spirit of how he lived.

Send Get Well Card to Injured Workers

When we look at our work comp programs, when one of your employees gets injured, can you take the time to write them a get well card? Say, “Hey, John. I’m sorry you got injured. We look forward to having your spirit back as part of the team as soon as possible.” Something along those lines. Taking the time to put pen to paper, there is no better way through written communication to make that personal connection.

It’s not sending a text. It’s not sending an email. There’s something magical about putting that pen to paper and dropping that card in the mail. Take that lesson from Mr. Bush’s life and legacy. Apply it to our programs, and you will see dramatic results.

Again, I’m Michael Stack, CEO of AMAXX, and remember your work today in worker’s compensation 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 - Amaxx Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is a 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: https://blog.reduceyourworkerscomp.com/

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

Filed Under: Communication with Employees

Avoid Workers’ Comp Penalties and Other Pit Falls

December 5, 2018 by Michael B. Stack

Members of the workers’ compensation claims management team are on the front line when it comes to investigating a claim and making timely payments of benefits. Failure to do so can result in penalties to a workers’ comp program and cause interested clients to lose confidence in the process. Transparency and consistency are key. Now is the time for all claim handlers and their managers to better understand the various rules and requirements in jurisdictions they handle, apply these procedures correctly and make good faith determinations to avoid common pitfalls in the claims process.

Common Errors that Result in Workers’ Comp Penalties

Many rules govern workers’ compensation insurers and third-party administrators. It is important the claims management team understands these rules and make proper determinations.

Frivolous Denial of Liability: Denials of primary must state why a claim is being denied. This includes stating a factual and legal basis for not paying on a claim or deny specified treatment. This can also include a failure to fully investigate a workers’ compensation claim in a good faith manner or make inaccurate statements following the investigation.

Nonspecific Denial of Liability: Denials of primary liability must also be specific. The requirements to avoid this type of penalty vary, but generally, denials must be sufficiently specific to convey clearly, without further inquiry, the basis for the denial. Denials based on the premise that the injury did not “arise out of and in the course and scope of employment” must also include additional information supporting this position, so the injured employee knows why a matter is not being paid by the insurance carrier. Avoid excessive “legalese” when denying a matter.

Late Denial of Liability: Applicable laws generally require a determination to be made promptly. In many instances this is between 10-14 days. When a member of the claim management team receives a reported injury, it is important for them to determine the first day of disability and when the employer received notice of disability. Knowing this information can ensure the claims professional issues the denial promptly.

Late Filing of First Report of Injury (FROI): The employer plays an important role in completing the FROI. This is important as most state workers’ compensation laws require this form be completed and filed with the industrial commission in a timely manner. Claim handlers must ascertain when the employer receives notice of the injury or disability to determine when the FROI must be filed in a timely manner. An effective claim management team should help train employers on these issues to avoid delay and penalty.

Late First Payment of Benefits: There are also time requirements for the insurance carrier or administrator must make payment on admitted claims. Important information for the claim handler to know to avoid a penalty for late payments includes: the first day of disability, when the employer received notice of the injury or disability, if the employer is paying the ongoing employee wages, and requirements regarding the payment of wage loss benefits. Coordination and cooperation are

Other Prohibited Claims Practices

Workers’ compensation insurance carriers are also required to operate honestly and ethically. This includes not acting in bad faith.

Insurance carriers that operate fraudulently may be subject to discipline by a state commerce department. When underwriting workers’ compensation insurance policies, it is important carriers, and administrators follow through on contractual promises and provide what is covered under the policy. Failure to do so can result in a carrier not being able to sell insurance in a state or subject to other sanction.

In the same regard, an insurance carrier should avoid bad faith tactics. This includes not dealing fair with parties subject to an insurance contract. This duty is known as the “implied covenant of good faith and fair dealing.”

Conclusions

Members of claim management teams and their insurance carriers have a contractual and ethical obligation to serve their insureds. This is accomplished by following the rules established under a workers’ compensation statute that require good faith claims practices. Failure to do so adds to the costs of a workers’ compensation programs and can jeopardize a carrier’s ability to underwrite workers’ compensation policies.

Contact: mstack@reduceyourworkerscomp.com.

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

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

Filed Under: Claim Management

12 Questions and Metrics to Assess Work Comp MSA Cost Drivers

December 4, 2018 by Michael B. Stack

A thoughtful and critical review of your Medicare Secondary Payer (MSP) compliance program is a great exercise to perform annually. Consider these questions and metrics:

Questions & Metrics to Assess Work Comp MSA Cost Drivers:

What percentage of your Medicare Set-Aside (MSA) submissions are accepted?
Can you identify the biggest cost drivers in your MSAs?
What percentage of your CMS approved MSAs include opioids?
What percentage of your approved MSAs include any pharmaceuticals?
What is the average cost of prescription drugs on MSAs?
Do you understand why CMS approves/denies MSA proposals?
Are you overfunding/underfunding MSAs? How do you know?
Do you know what documentation you need for approval of changes in medical treatment or pharmaceuticals?

If you were not able to confidently answer the questions above it might be time to make some changes to your MSP compliance program. Some claims and risk managers put together a program, let it run and hope for the best. Instead, using data analytics and continuously tracking outcomes and other performance indicators can significantly improve the process of preparing and submitting MSAs to the Centers for Medicare and Medicaid Services (CMS) — especially, where pharmaceuticals are concerned.

MSP Through the Years

It’s been approximately 15 years since the government ramped up its efforts to ensure Medicare doesn’t pay for medical services that should be funded by some other entity, including the workers’ compensation system. At the time, organizations scrambled for ways to develop MSAs that would be approved by CMS.

The process for CMS approvals has evolved over the years. What was a fairly complicated system, to begin with, has turned into an extremely intricate series of steps that can befuddle even the most competent people in the industry – unless they have the benefit of highly advanced technological solutions combined with strong expertise.

For example, in addition to new regulations from CMS, state statutes and fee schedules are also constantly changing. Failing to keep tabs on them can make the process time consuming, costly and fraught with peril.

In the past 18 months, CMS has taken steps to intensify its efforts further. The agency has put millions of dollars into a new contractor and greatly updated its technology, making the process of identifying mistakes that much quicker and easier. It means anyone trying to stay in compliance with Medicare also needs to improve and upgrade their systems.

What the Metrics Can Tell Us

Most workers’ compensation payers would agree that pharmacy is the biggest cost driver for their MSAs. However, few know the answers to these key metrics:

What is your current pharmacy spend on MSAs?
What percentage of your CMS-approved MSAs include opioids?
What percentage of MSAs are approved with or without drugs?
What is the average cost of prescription drugs on your MSAs?

With medications comprising such a tremendous portion of MSA costs, it’s vital to have a clear understanding of the issue. This can only be accomplished by focusing on the metrics. By analyzing the data on opioids as well as other pharmaceuticals in terms of your MSAs that are approved, you can then begin to fully manage these costs.

Optimizing MSA Outcomes

Whether working with an MSA vendor or doing Medicare compliance on your own, several strategies are a must for success.

Identify metrics that drive the results you want to see, particularly where medications are concerned.
Measure your performance and modify processes, workflow, and technology to improve it. For example, look at the percentage of your MSAs with ongoing medical to see how much you have allocated for opioids. If the answer is anything more than zero, go back to the drawing board.
Examine current CMS performance and the most recent state statutes and fee schedules against CMS’s review methodology as defined in the most recent Workers’ Compensation MSA Reference Guide. If/when there are changes, update your system immediately. Once developed, this should be a simple verification, audit and sign-off process.
Analyze every CMS response against your internal best practices in MSA allocation, with a focus on pharmaceuticals and opioids. You want to know how you are performing against CMS in such areas as pricing, frequency and life expectancy.
Leverage Section 111 data to improve the CMS approval rate of MSAs.

To truly effect change in your Medicare compliance program requires examining certain metrics and taking steps to manage them best. For example:

What is the number of Medicare conditional payment searches and investigations initiated and the success rates for disputes and appeals, including dollars saved?
What type of clinical interventions have been initiated, what is their success rate and the average dollar amount saved because of them? This strategy can save many thousands of dollars per claim. Investigating each claim with an eye toward medical procedures anticipated and/or pharmaceuticals can yield surprising results. You may find, for example, a doctor is prescribing a medication the injured worker no longer takes or has never taken; so removing that drug from the future medical amount is an easy change.
What is the percentage of submissions to which CMS has countered with a higher dollar amount? A lower dollar amount? If there is a high percentage of either, you need to understand why there is a trend and how to counteract it.

You want the injured worker to have adequate funds for his lifetime needs related to the injury, but you don’t want to pay unnecessarily high costs. Often the projected expenses are way too high, or the therapy is not within evidence-based medical guidelines.

The best MSA developers can fully assess exposure before the proposal is submitted. They can spot inappropriate or unnecessary treatment and pharmaceuticals AND take steps to curb them such as physician peer-to-peer discussions, for example.

Conclusion

Paying too much for anything does not make sense. But, that’s exactly what happens far too often because many workers’ compensation payers don’t take advantage of advanced technologies in developing MSAs. Using metrics and data analytics and working with an MSA expert can help ensure injured workers get what they need and deserve without payers going overboard.

Contact: mstack@reduceyourworkerscomp.com.

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

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

Filed Under: Medicare Set Asides (MSAs)

ODG Announces Release of Job Profiler Powered by MyAbilities Into Its Industry-Leading Guidelines

December 3, 2018 by Senior Editor

AUSTIN, Texas, Nov. 28, 2018 /PRNewswire/ — ODG, an MCG Health company, (USA) has announced a partnership with MyAbilities Technologies to incorporate a unique new product option, the ODG Job Profiler, into its industry-leading medical treatment and return-to-work (RTW) guidelines.

The ODG Job Profiler is an innovative software platform powered by MyAbilities™ which will be made available as an add-on to the ODG by MCG User Interface. The ODG Job Profiler adds job demand data across every industry and occupation by providing a comprehensive database of physical, cognitive, and environmental demands specific to over 30,000 jobs spanning nearly every industry. This solution helps insurers, third-party administrators (TPAs), and employers identify and mitigate the risk of injury by creating a customized Physical Demands Analysis (PDA) for each job function, adjusting disability duration guidelines according to job demands.

Case managers, claims adjusters, site managers, and clinicians will be able to collaborate around job-specific lost-time goals and activity modifications, with the shared goal of expediting return-to-work while implementing proper measures to prevent workplace injuries.

“The ODG Job Profiler offers a valuable complement to our treatment, return-to-work, reserving, and risk-analytics tools, supporting a comprehensive, evidence-based solution set. Innovative and technology-enabled, it enhances efficient collaboration and communication between payer, employer, and provider around what matters most: function. The art and science of return-to-work have never been better,” said Phil LeFevre, Managing Director of ODG.

“We are convinced that all stakeholders will experience better injury prevention and management by using the ODG Job Profiler which is empowered by the congruence of advanced ergonomics, artificial intelligence, digital job-matching, and risk assessment technology. The ODG Job Profiler revolutionizes claim and human asset management by creating a new industry-standard paradigm,” said Reed Hanoun, CEO of MyAbilities.

About MyAbilities

MyAbilities is a technology company delivering workplace risk mitigation and injury management strategies using Artificial Intelligence (AI) and robust data analytics.

MyAbilities develops software solutions to help employers assess their jobs, identify risk and prevent injuries using proprietary AI, computer vision, analytics, ergonomic risk analysis, and injury prevention strategies. Post-injury, MyAbilities support claim administrators with an evidence-based claim and medical management software for the resolution of injuries and illnesses in workers’ compensation, and disability programs to reduce costs of claims and expedites return-to-work. More information is available at http://www.myabilities.com.

About ODG

ODG, an MCG Health company, (www.mcg.com/odg) provides unbiased, evidence-based guidelines that unite payers, providers, and employers in the effort to confidently and effectively return employees to health. The clinical guidelines and analytical tools within ODG are designed to improve and benchmark return-to-work performance, facilitate quality care while limiting inappropriate utilization, assess claim risk for interventional triage, and set reserves based on industry data.

About MCG Health

MCG, part of the Hearst Health network, helps healthcare organizations implement informed care strategies that proactively and efficiently move people toward health. MCG’s transparent assessment of the latest research and scholarly articles, along with our own data analysis, gives patients, providers, and payers the vetted information they need to feel confident in every care decision, in every moment. For more information visit www.mcg.com or follow our Twitter handle at @MCG_Health.

For media inquiries, please contact:

Name: Daphne Worrall
Title: Marketing Manager, ODG by MCG
Tel: 406-622-5516
Email: daphne.worrall@mcg.com

Name: Sarah Reid
Director of Operations MyAbilities Technologies
Email: sarah@myabilities.com

Related Links

Visit the ODG website

SOURCE ODG

Fix and Flip Your Work Comp Management Program

November 28, 2018 by Michael B. Stack

In the popular TV show Property Ladder, real estate junkies seek to find homes in need of repair, fix them and then flip it for a profit. Like the show, members of the claims management team should be on the constant look-out for parts of their program that need to be improved to increase client satisfaction and ensure it is being run ethically and honestly for the ultimate stakeholder – the employee! This takes a lot of hard work, but the ultimate result can improve the satisfaction of clients and improve the experience for persons who have sustained a work injury.

Finding a Home to Renovate – Effective Injury Response

Like a broken home, the employee who suffers a work injury is in need of help and tender loving care. A fast and effective response to every work injury, no matter how minor, can pay dividends in the future.

All workplaces need to have a plan in place to deal with work injuries. This includes the accessibility of first aid kits and other medical equipment. Factors to consider include having a plan for all types of injuries and emergencies, making employees aware of the plan and proper implementation. Do not forget that even if your company is not required to have one, the inclusion of a safety chair and emergency response team can assist in a program renovation. This team can be used for the following tasks:

Maintenance and use of various fire extinguishers;

Knowledge and ability to perform cardiopulmonary resuscitation (CPR);

Understanding on how to contain and dispose of bloodborne pathogens;

Proper chemical handling, storage and containment procedures; and

Dealing with and responding to incidents involving hazardous materials and workplace fumes.

Other items to consider should include teaching employees basic first aid and other features such as lifesaving equipment that can include a portable defibrillator.

Fixing Up the Property – Workplace Ergonomics and Safety

A great way to ensure a safe workplace should include a review of workplace ergonomics. This can include features such as assessing risks in the workplace on an ongoing basis, correcting the problems and encourage physical health. Suggestions can include:

Onsight or easily accessible health clinics that include vaccinations, immunizations, and wellness information;

Encouragement to use a gym or health club – be sure to include discounts on medical insurance for frequent users. Onsite stretching activities, yoga, and mindfulness can also promote a safe work environment; and

Training on preventing and dealing with workplace violence and “active shooter” situations.

Flippin’ the House for Profit – Ongoing Employee Satisfaction

Like a completely remodeled home, a workers’ compensation program that is in pristine shape will add value and create its own demand. This will improve company morale and improve return to work rates following an injury. Interested stakeholders should look for opportunities to add value through a workers’ compensation program’s “curb appeal.” This can be accomplished by promoting medical and behavioral health consultations to assist employees manage their lives in and outside the workplace – and enhance one’s work/life balance.

Addressing the needs of employees mental health needs is important in today’s fast-paced society. This is especially the case when employees work during a clinic’s hours of operation. By making these services available to employees on-site or at a convenient location, people are more willing to receive the care they may need.

Addressing the mental health needs of all employees are important both before and after a work injury. Studies suggest that people who receive mental health counseling following a work injury have a lower chance of re-injury or malingering. This translates into lower workers’ compensation insurance premiums.

Conclusions

Members of the claims management team should seek to climb the property ladder to add value and reduce costs to a workers’ compensation program. This includes simple steps that can be taken to renovate a program, make it better and increase its value. When a program is strong, it also adds value to the clients it serves.

Contact: mstack@reduceyourworkerscomp.com.

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

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

Filed Under: Work Injury Response

Digital Job Profile Technology and Your Workforce

November 27, 2018 by Jacob Lazarovic, M.D.

Companies are using advanced technologies to manufacture their products, create intellectual property, and deliver their varied services. But are they making use of new technologies to optimally manage their own workforce? In the majority of cases, the answer is No.

Most of the tools and processes being used to assess job demands, hire capable workers, prevent injuries, manage recovery, and return to work, have not kept up with available software and methodologies. These new advancements can substantially enhance the health, safety, and productivity of a company’s greatest resource – its employees.

Let’s review some of these options with which employers and brokers should become familiar.

Technology for Physical Demands & Ergonomic Risks

Do employers really understand the physical demands of each of their company’s jobs, as well as the ergonomic risks that each job may present? Traditional job descriptions do the former poorly, and the latter not at all. With the use of today’s technology, a company risk manager can potentially access comprehensive, quantified digital job profiles for virtually every position in their organization, either “off the shelf” or customized with a few modifications. Additionally, they can use a smartphone to capture an employee performing his/her job and upload it into artificial intelligence-powered software that automatically produces a video digital job profile displaying the job in action with quantified physical demands.

Value of Digital Job Profile

Using today’s technologies, an employer can cost-effectively build a digital database of all their company’s jobs which can be used to create precise protocols for post-offer employment testing.

Benefits include:

flag high-demand jobs, ranking the body regions most susceptible to injury, leading to prompt ergonomic mitigation.
suggest training programs to build and maintain endurance, specifically tailored to the demands of each job.
facilitate return to work based on digitally matching the employee’s clinical status during, and at the end of rehabilitation, to his/her own job or other company jobs in the database, consistent with any physical restrictions or limitations.
decrease an employer’s risk exposure for ADA non-compliance.

The technology of this type is not confined to industrial applications but is also available for office workers. Office worker technology can provide computerized video-guidance allowing the employee to assess their workspaces (computer, monitor, keyboard, chair, etc.), generate instant ergonomic modifications, and if necessary, recommendations for the purchase of more suitable equipment. This feedback and information support productivity, comfort, and a reduced risk of work-related conditions.

Share Digital Job Profile with Stakeholders

Last, but not least, if and when an injury occurs, the digital job profile is electronically shareable with the employer’s insurer, TPA, or managed care organization (or for self-administration) and provides a roadmap for claim and medical managers to make informed compensability determinations and pursue evidence-based treatment and return-to-work strategies. But more about that in a future installment.

Employers, and brokers are well-advised to explore these novel approaches which modernize our approach to workforce management.

Jacob Lazarovic MD, Medical Advisor at Amaxx LLC, has considerable experience in managed care, including 18 years as chief medical officer at Broadspire , a leading TPA. His department produced clinical guidelines and criteria to support sound medical claim and case management practices; participated in analysis, reporting and benchmarking of outcomes and quality improvement initiatives; and operated a comprehensive in-house physician review (peer review) service. He has been published extensively in industry journals and has held several senior medical management positions at companies including HealthAmerica, Blue Cross/Blue Shield of Florida and Vivra Specialty Partners. In his current capacity as CMO at MyAbilities Technologies, he has developed evidence-based online clinical applications that support the company’s digital job profile software, and its claim and medical management tools geared to functionality-driven return to work and job-mat

Filed Under: Return to Work and Transitional Duty

Marijuana: A Medical Perspective — White Paper

November 26, 2018 by Marcos Iglesias

We have a drug problem.

Americans consume more opioids than anyone else in the world. We are also among the highest consumers of marijuana. As a nation, we continue to rely on passive treatments for chronic conditions, instead of active management.

Poll Found 93% Support Medical Marijuana

There is widespread acceptance of marijuana in the United States. A recent Quinnipiac University poll of US voters found that 63% of respondents believe that marijuana should be legalized and 93% support its use for adults with a medical prescription by a physician. The 2016 National Survey on Drug Use and Health estimates there are almost 38 million marijuana users in the United States. Thirty states and the District of Columbia currently have legalized marijuana in some form (most of these are so-called medical marijuana states). Eight states and the District of Columbia have legalized marijuana for recreational use.

Yet marijuana continues to be classified as Schedule I drugs under the Federal Controlled Substances Act and, therefore, illegal to manufacture, distribute, or dispense.

Medical Efficacy Factors of Marijuana Use

When it comes to the legality of medical efficacy of marijuana use, there are a number of factors at play. These include:

Pharmacology — how exactly do the relevant chemical compounds, THC and CBD, interact with the body? And, given the non-traditional routes of administration for marijuana (usually inhalation or ingestion), how can we anticipate or regulate what the response will be?
Adverse effects — we’ve all heard about the euphoria and impairment of memory, judgement, reaction, and other mainstream effects. But what about adverse physical effects? Or, the link to psychological disorders like depression, schizophrenia, or psychosis?
Efficacy — in some circles, marijuana is touted as a harmless cure with the ability to cure everything from cancer to chronic pain. The challenge with these claims is that there are few methodologically rigorous trials that can back the claims up. Is there something here for doctors to work with or should the claims be dismissed as nothing but rumors from idealistic hippies?
Workplace impact and safety — with additional increases in marijuana use, both recreational and otherwise, seeming inevitable, what is the link to workplace safety? And how can employers, insurers, and claims handlers respond?

Dr. Marcos Iglesias, senior vice president, and chief medical officer at Broadspire has prepared a comprehensive white paper and recorded webinar diving deep into medical considerations surrounding marijuana.

This objective whitepaper using evidence-based research can be found here.

Dr. Marcos Iglesias is senior vice president and chief medical officer of Crawford & Company’s global TPA, Broadspire. He has more than 25 years of experience in workers compensation, disability evaluation and treatment, and insurance leadership. In addition to being a physician, executive, national speaker and author, Iglesias is known for his compassion for patients, progressive and inspirational leadership, and integrated approach to injured worker care. Iglesias has a special interest in the prevention and mitigation of delayed recovery and disability. He is driven to help ill and injured workers live active, productive and fulfilling lives, which has led him to develop innovative, comprehensive disability management solutions that focus on returning workers to pre-injury function.