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Five Ideas to Reduce Workers Compensation Exposure When Downsizing

These are dreaded words heard ‘round the locker room or break room table.’  They may start out as nothing, maybe a little one-liner about “some layoffs coming down the road” or maybe another guy said he saw Keith talking to Bob about “Immediate downsizing.”

 

Whether these are true or untrue, as a risk manager or someone involved in the claims process, be ready for the onslaught of the consequences of layoffs or downsizing.  Not everyone will file a claim for workers comp, but bet the disgruntled employees will, along with a few unexpected employees to now report an injury of some sort in the past. (WCxKit)

 

 

How are these issues controlled and handled proactively? We discuss a few options below, and remember these may or may not apply in your jurisdiction.

 

Always consult counsel before implementing any of these ideas.

 

  1. Go back to documentation

Keith just received his letter that his job was terminated and his last day of work will be in 10 days.  Keith is nervous, because he has limited job skills, bills to pay. He lives in a small town and there are not a lot of jobs out there.  Plus he does not have the greatest relationship with his supervisor, and he feels this is a personal assault coming directly from that supervisor who just does not like him.

 

What does Keith do? Well he decides to say he injured himself a month or so ago but was afraid to report it, because he heard that layoffs were coming. And he did not want to be one of the guys picked to be laid off.

 

 

This is a very common scenario. And this is where attention to documentation comes in to play.  By now, everyone on the work floor should know that if any injury happens, whether they want treatment or not, the worker is to come to the risk manager’s office to complete some paperwork.  And those who decide not to do this face the consequences associated with not reporting it.

 

 

The first question to Keith after he tells you he hurt himself a month ago should be “Why did you not tell me?  You knew the procedure, right?  Did you tell anyone?  Did anyone witness your injury? Did you see your doctor?  Why are you telling me this now?”

 

 

These are the first handful of questions to ask.  Then call in his claim to the carrier/TPA immediately.  And let them deal with it.  If you still want to lay him off while his claim is under investigation, that is fine.  If you want to wait until a decision has been made, that is fine as well.   But documentation is key, and it always will be.  You have to constantly tell the workers the responsibility to come tell you when something does not feel right, and an injury may have occurred.  And if the employees do not do this then they face the consequences that can affect the claim’s compensability.  Make it a reminder phrase every week.

 

 

  1. Perform an exit interview

If a worker resigns from a position, or is laid off, chat with them a bit.  Chances are the worker will come to you anyway to ask why it was them anyway. So now is a good time to see if the employee  pulls out any angles to try and keep getting some income coming .  Flat out ask if the worker is hurt, or had a workers comp claim, or is experiencing pain for example.

 

Common knowledge will reveal that this is a way to increase your own claims, since if it is not mentioned then why stir the pot?  Actually, if employees are going to come forward and try being deceptive, better to confront it now versus 6 months from now.  A claim will result regardless. Granted, most people will say “No” and move on, but there is always that handful of people that will  try to claim an injury.   Call the claim in to the adjuster, and let them handle it.  That way you have performed your duty, and your responsibilities of reporting it are over and done.

 


  1. Have a medical exam performed by an occupational medicine doc or a local clinic doctor to be safe

In order to be ultra-aggressive, get a doc to do an exit-exam.  This will weed out all the fakers.  It is not going to be free, but weigh the costs.  If this is something to do to prove a point, then do it.  Take  time finding a doc that is also legit, and willing to do this.  In the grand scheme of things I guess it is not fantastic to be laying off people due to expenses, and then have to spend $4,000 to have a doc say these workers are fine and show no signs of disability. This is about protecting your company from the unknown future of compensation claims, some of which can become incredibly costly no matter how insignificant they seem.  So it is an option if that is preferred. Just make sure to have a credentialed doctor performing the exams in a private, professional setting (does this go without saying?), and that it is all HIPPA compliant.

 


  1. Ask the employees to sign a release waiving liability (if legal in your jurisdiction)

Probably the most common is just the legal paper stating that the worker is not claiming any disability at this time.  Depending on the jurisdiction, try inserting the word “future disability’ as well.  But my advice is to thoroughly check with the employment counsel, as well as the workers comp counsel on permission.  Or better yet have counsel draft the letter. Again it may cost something up front as far as expenses go, but it is all about protection down the road.

 


  1. With a witness present, ask if the worker was or is  hurt, or experiencing symptoms, and has been to the doctor for this. Ask is this is related to work or not.

This is similar to the doctor, but not as expensive.  Have another HR person present for the exit interview, and ask the person about any disability relating to work.  This will prevent the worker from coming back saying there were some problems swept under the rug and ignored. Check again with counsel on what can be and cannot be done, and then go from there. (WCxKit)

 

 

Summary:

With any type of employee reductions in the workforce, there are going to be some bitter feelings and resentment when reducing your number of workers.  This article is about protecting your company, and protecting the future of potential comp claims.  Any way to reduce exposure is always one worth researching, and implementing, sooner rather than later.

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.comContact: RShafer@ReduceYourWorkersComp.com.

 

 

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Powerful Work Comp Claim Strategy Because You DO NOT Know Everything

You don’t know everything about workers’ compensation. You do not know everything about workers’ compensation. And neither do I. Hello. My name is Michael Stack, CEO of Amaxx. If you’re going to accept that statement, that no one really knows everything there is to know about workers’ compensation, then you can do very well with a concept that I’m going to be teaching today, which is the weekly claims roundtable.

 

 

Leverage Shared Knowledge to Drive Positive Outcomes

 

Workers’ comp could be very simple, but it could also be very complicated, particularly as you get into individual claims handling. The biopsychosocial factors, the additional risk factors, the environmental factors. All these complicated things that go into making us up as individuals, as humans, throw in an injury, throw in a whole bunch of different stakeholders, and you can have a very hairy and complicated claim and trying to figure out the exact best thing to do with that particular individual can often be a daunting task.

 

Let me tell you about this weekly claims roundtable. It is an extraordinarily effective system to partner with your claims handling team, to be able to tackle these very complicated claims and come up with a plan to properly handle them to create the best outcome at the lowest possible cost.

 

 

Weekly Claims Roundtable Agenda

 

Let me give you a real quick agenda and tell you exactly how this can work so that you can implement this strategy within your organization. Three things that you’re going to cover, and this is the basic agenda:

 

  • Basic claim information
  • Claim status
  • Action plan

 

This is your three-part agenda for your weekly claims roundtable. Discussion in each claim should last between five and 15 minutes, tapping into the expertise, tapping into the experience, tapping into the prospective of your claims handling team, which could include your employer, it certainly could include your insurance broker, your insurance adjuster, your claims handling account representative from that organization, it could be a medical advisor, it could be an attorney, it could be other relevant stakeholders as it makes sense. But that’s the basic … That’s the core group of individuals that are going to be meeting on a weekly basis to go over these claims, five to 15 minutes. Come prepared to knock these things out and talk about this action plan.

 

 

Share Ideas & Perspectives to Create Plan For Best Claim Outcome

 

Let’s review this agenda very quickly. Basics. What’s the basic claim information? What’s the name? What is the date of the injury? What type of injury? Where does this claim kind of currently stand? What is the status? Is this individual back to work? Are they not back to work? How many days have they missed? How many days have they been on modified duty? Do they have a surgery coming up? Are they going through physical therapy? Are they seeing a specialist? Whatever that current status is of where this claim currently stands. Then, finally, talking about the action plan. Based on where this thing currently stands, based on what’s going on in the claim, let’s discuss as a group, share ideas, share perspectives, share experiences, share knowledge to create the best possible action plan to create the best possible outcome.

 

Implement this weekly claims round table in your organization. Start small. Start with a handful of claims. Start with your most difficult claims and build from there. Because, remember, your work today in workers’ compensation, it can have a dramatic effect on your company’s bottom line. But it will have a dramatic impact on someone’s life. So, be great.

 

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their 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/

 

©2018 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.

Top 5 Take Away Points from 2017 National Workers’ Comp & Disability Conference – Part 3

 

Top 5 Take Away Points from 2017 National Workers’ Comp & Disability Conference – Part 1

Top 5 Take Away Points from 2017 National Workers’ Comp & Disability Conference – Part 2

Top 5 Take Away Points from 2017 National Workers’ Comp & Disability Conference – Part 3

 

 

Hey, there. Michael Stack here, CEO of AMAXX. We’re about a month out from the conclusion of the National Work Comp and Disability Conference, held again this year in Las Vegas, back at Mandalay Bay.

 

 

Take Away #5: Blending Oversight and Empowerment to Maximize TPA Results.

 

Now, my fifth takeaway comes from a blending of a couple of different presentations at the conference. It comes from the Teddy Award winning presentations, and the risk management that described their programs in order to win those awards, as well as another presentation given by Caryl Russo from Barnabas Health and Carrie Burhenne from the PMA Companies entitled Blending Oversight and Empowerment to Maximize TPA Results.

 

“Don’t Go At It Alone”

 

The takeaway here is very simple. It’s the sentiment of, “Don’t go at it alone.” Don’t go at it alone. Workers’ compensation at its core is very simple, but as you lay around various stakeholders, claims handlers, vendors, biopsychosocial elements, state law reforms, it becomes extremely complex. The idea of don’t go at it alone is the fact that you will not be successful unless you bring on these partners. You develop this claims handling partnership with your TPA or a carrier. You develop these working relationships with your medical providers, with your adjusters, with your risk managers, with your attorneys, and all other stakeholders involved in the idea of creating these better outcomes for your injured workers, thus driving down your workers’ compensation cost.

 

If the Teddy Award winning companies and risk managers references this idea, if Caryl Russo from Barnabas Health who also won a Teddy Award a couple years ago is referencing this idea of not going at it alone, and that’s displayed and implemented in this idea, which Caryl does very well, of weekly meetings. If all of these companies are doing this tactic, working together, developing these partnerships, having this played out in strategy in the form of a weekly meeting, and in this weekly meeting you’re talking about what has happened in the past, what is currently going on in the claim, and what’s the plan going forward. It’s no more complicated than that.

 

Study & Follow Tactics of Best WC Programs

 

Jim Rowan says, “If you want to be happy, study happiness. If you want to be wealthy, study wealth.” If you want to have a successful work comp program, study successful work comp programs, and if all the successful work comp programs are doing this tactic, that’s a tactic you should be doing as well. If you’re not at the point where you’re ready to look at every single claim every single week, that’s fine. That’s not where you start. If you’ve never done this tactic, take one of your claims, take two, take three, take five of your most expensive open claims and look at them on a weekly basis. Bring in your stakeholders. Bring in your medical providers. Bring in your nurse case managers. Bring in the parties that are relevant to those specific claims. Talk about what’s happened in the past, talk about where you are now, and discuss the plan, and share ideas, share perspectives, share expertise in order to create that better outcome.

 

Takeaway number five is, “Don’t go at it alone, and be very intentional about developing those work comp management partner relationships.”

 

 

Education Without Implementation is Entertainment

 

That covers my top five takeaways for the National Work Comp and Disability Conference this past year. It was another tremendous conference with very valuable content and contacts, but as I referenced at the beginning of this session today, it’s not the content or the contacts that you receive at the conference itself, it’s what you do with that content, it’s what you do with those contacts, those business cards that you receive, that makes the most difference. If we’re not going to take the information and implement it, if we’re not going to be following up with those contacts and developing those relationships, and taking advantage of those opportunities, then the time that we just spent in Las Vegas is simply entertainment, and there’s a lot better ways, there’s a lot better shows to go see in Las Vegas than going to listen about workers’ compensation.

 

I encourage you to go back to your notes, develop your own top five takeaways, develop the one or two points that you’re going to implement right away. If you don’t have your own notes, borrow mine, and start to realize and implement to see those results.

 

Thanks again for your attention. My name is Michael Stack, CEO of AMAXX, and remember your work today in workers’ 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 - AmaxxAuthor 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/

 

©2018 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.

Top 5 Take Away Points from 2017 National Workers’ Comp & Disability Conference – Part 1

 

Top 5 Take Away Points from 2017 National Workers’ Comp & Disability Conference – Part 1

Top 5 Take Away Points from 2017 National Workers’ Comp & Disability Conference – Part 2

Top 5 Take Away Points from 2017 National Workers’ Comp & Disability Conference – Part 3

 

 

Hey there, Michael Stack here, CEO of Amaxx. We’re about a month out from the conclusion of the National Work Comp and Disability conference held again this year in Las Vegas, back at Mandalay Bay. It’s a great accommodation and I think they have right city to host this great conference every year. Now, I attended more sessions than I normally do. I was very interested in many of the topics that were presented. The general theme of the conference itself was really focusing on much of what, frankly, I teach and believe in, which is really the outcomes for the injured workers that drive down workers’ compensation costs, creating a true win-win scenario. I want to talk to you about my top five takeaways from the sessions that I attended.

 

 

 

What Have You Done With the Content & Contacts From Conference?

 

Before I get into the takeaways though I do have a question for you, particularly, if you attended the conference. I want you to answer this question honestly. What have you done with the content that you learned or the contacts that you received within this past 30 days since the conclusion of the conference? Did you take notes from the sessions? Have you read them over? Have you created your own top five takeaway list? Have you looked through those business cards that you received? Have you followed up with those individuals? Do you even remember the conversations even happening of what you were supposed to do?

 

What I find more often than not is that we run around crazy at these conferences. There are a couple of days our feet are hurting, we’re exhausted, we’re going to events, we’re attending sessions, we’re trying to get meetings scheduled in between, but when we come back to the office, we just kind of drop the ball and forget we even attended at all. So if there’s things that are left outstanding, if there’s things that you haven’t covered over the past 30 days that you meant to, I encourage you to take a look at them and take action with the next one to two weeks so that you can get the most value from attending that conference in the time that you spent.

 

If you didn’t come up with your own top five takeaways to implement because maybe you didn’t take as many notes as you would have liked or attended as many sessions as you’ve liked, I encourage you to use mine. Borrow the ideas that I’m going to be presenting today and implement those into your program even if it’s just one idea because you’re going to realize a lot more value from the time that you spent at the conference itself. Okay, so that’s my question. If you didn’t attend the conference then I encourage you to just leverage the information that I’m going to be talking about today.

 

 

 

Take Away #1: Alliance of Woman in Workers’ Compensation

 

Let’s talk about takeaway number one, which comes from the Alliance of Women in Workers’ Compensation Leadership Forum which was held the day before the official conference started. Now, the presentation was given by Margaret Spence. Margaret did a tremendous job at that presentation and at that leadership forum. To be frank, it had a fairly big impact on my own life in this past 30 days. Let’s talk about some of the things that she discussed and while this presentation was obviously directed towards women. Obviously, I’m not a woman, so I can’t fully appreciate and empathize with the experience of a professional woman in today’s environment or in the years past.

But I will tell you that the stories that she was describing, some of the challenges that women face, that she described both in the past and, currently, today in 2018 was a bit disheartening. It was a bit disheartening to hear that that still exists in our world, particularly, as I’m raising two young daughters. From my perspective, one of the underlying themes as it was given from the female perspective was to acknowledge and appreciate the struggles that women have come through and still face today, But having the courage and the confidence to break through it. One thing I’ll add from the male perspective and the perspective I think is very similar.

 

From the male perspective to appreciate and acknowledge the struggles that women have faced in the past and often continue to face today, but having the confidence and the courage to break through that, because while some of those prejudices may still exist in our world today, they should not exist in your world. If you take an honest and genuine look at yourself, and you see that those prejudices still exists in your world then you need to take the steps to correct it.

 

 

4 Questions to Take Charge of Your Own Destiny

 

So putting the issues of gender aside because I felt that Margaret’s message was very important for women, but it was also very important for men. It’s very important for African Americans, for Hispanics, for Mexicans, for Japanese, for Chinese, for Indians, for every race and creed. Her message was about having the confidence and the courage to take charge of your own destiny, regardless of the environment that you’re in. She walked us through an exercise which I’m going to relay to you now. I’ll tell you the answers that I came up with during that session, during that leadership forum, had a very important impact on my goal planning and business planning for my company, for 2018. Here’s a little exercise that Margaret walked us through. The first thing that she asked was what do you want. What do you want? She asked you to answer that question honestly and genuinely.

 

Second question to answer is why. Why do you want it? What do you want and why do you want it? Third question is what has held you back. What is holding you back from achieving this goal, from achieving this desired outcome? Number four is what do you fear. What do you want, why do you want it, what is holding you back, and what do you fear? If you can honestly answer those questions, it will help you develop that confidence, help you develop that vision, help you develop that courage to create this life that you both deserve and desire.

 

 

 

Take Away #2: Intersection of Medicine & Disability – A Doctors View

 

Let’s move on to takeaway number two. This comes from a presentation given by Dr. Marcos Iglesias, who’s the Chief Medical Officer at Broadspire.

 

The session was entitled The Intersection of Medicine and Disability, A Doctor’s View. Now, frankly, I felt that this was a strongest session and most valuable session that I attended at the National Work Comp and Disability conference. I could have taken probably all five of my top takeaways from this one session alone. Dr. Iglesias did give a very candid and simple explanation of the doctor’s viewpoint, of the clinical perspective. One of the things that we forget about so often in workers’ compensation is that every single claim is a medical injury. Every single claim needs some form of medical intervention to have that individual person recover to maximum medical improvement.

 

 

60-80% of Lost Work Days are Unnecessary

 

The better that we can understand that clinic perspective, that doctors perspective; the better that we can develop that working partnership is the better outcomes we’ll be able to provide for the injured workers. Thus, driving down our workers’ compensation cost. Let me go through some of the highlights that I took out from that session. Dr. Iglesias described that 60% to 80% of lost days in workers compensation of lost workdays are unnecessary, this idea of needless disability. There’s a number of psychosocial reasons for that but it’s important for us as non-medical professionals to understand and appreciate really the value of this one statistic as we’re looking at our own individual work comp management programs.

 

He talked about this idea of the injured worker often being in-charge of determining disability. He described that patient-doctor interaction. He also described some of the little tricks which I thought this was fairly interesting. If you Google doctor’s notes, you can get a very specific doctor’s note that looks very real, that has a phone number that you can call in order for the employer to verify your injury, verify the time needed out of work. The injured worker is often determining their own disability in many cases not coming directly from the doctor. He went into a much greater detail and I’m oversimplifying that point, but I think it’s important piece to understand how much of an impact the injured worker has on determining their own disability and the tools that that injured worker has at their disposal.

 

 

Redirect Conversation from Pain to Function

 

Next piece here then was redirecting the conversation from talking about pain to discussing function. Now, this was an impactful takeaway point for me because one of the things that I always recommend on the reports of injury is having a pain scale so that when you’re reporting that industry, you have that understanding of the current level of pain, and then you could re-look back at that later. Dr. Iglesias described this discussion of pain as being unproductive, that the more you focus on pain, the worse that pain becomes. Instead of talking about pain, talking about function, what can you do today, impacting these biopsychosocial elements that contribute to these unnecessary lost workdays.

 

So, takeaway here is redirecting pain to function. Next piece here then from this presentation was reframing this physician relationship, reframing the expectations of the physician relationship. So often we asked too much of our physicians. We asked, “Well, Joe got injured. Can he be back to work today or not?” The answer that Dr. Iglesias described was often from the physician’s perspective, “I don’t really know. I don’t really know the limitations that he needs. I don’t really know his job demands. I don’t really know the tolerance that Joe has for pain.” So when you reframe this doctor’s relationship, as Dr. Iglesias described it, he described to talk about things that can actually be measurable, the limitations, the capacity, and the actual restrictions themselves of the injured worker.

 

So rather than, “Can Joe be back to work today or not,” talk about what are the limitations of Joe, what is the capacity of Joe, and what are the restrictions of Joe, then it’s up to the employer to decide if Joe can be back to work or not, not the treating physician. That’s the discussion and that’s a framing that needs to be had with those treating physician relationships that you proactively develop. Last takeaway from this one session which I thought was a great clarifying question because not all the time do you have these great and interactive treating physician relationships, not all the time are your physicians on board, so if you’re working with a new physician or the relationship hasn’t developed quite so well going back to this point that injured workers are often the ones that are determining their own disability.

 

 

“If Your Patient Asked to Go Back to Work, Would You Allow It”

 

Asking this question that if your patient asked to go back to work, would you allow it. So, asking the treating physician the clarifying question that if your patient, if Joe asked you then, “Can I go back to work,” would that treating physician allow it? If the answer is yes then you know that there’s really no medical reason that Joe needs to be out of work. If the answer is, “No, I wouldn’t allow it,” then you need to further clarify what those medical reasons are. I thought it was a tremendous clarifying question to speak directly to this point of needless disability.

 

 

Top 5 Take Aways from 2017 National Workers’ Comp & Disability Conference

 

…to be continued

 

 

 

Michael Stack - AmaxxAuthor 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/

 

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

5 More Things The New Workers Comp Manager Needs to Know

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

 

  1. Sometimes it is time to babysit.

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

 

 

  1. Know the adjuster(s).

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

 

 

  1. Know your insurance broker.

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

 

  1. Know the return to work program.

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

 

  1. Review the claim files.

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

 

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

 

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

 

 

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

 

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

 

5 Things the New Workers Comp Manager Needs to Know

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

 

 

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

 

 

  1. The Safety Manager is your new best friend. 

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

 

 

  1. Learn how to read the loss run. 

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

 

 

 

  1. Know your insurer.

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

 

 

 

  1. Know the cost of workers compensation.

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

 

 

  1. Timing is everything.

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

 

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

 

 

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

 

 

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

 

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

 

Work Together As A Team If Forced To Do More With Less

These are the times that employers are operating lean and mean. Economic woes and dwindling profit margins have led to cutbacks in staff across the board. So, how to you handle the increased strain on your workers?

 

 

Pull Your Team Together To Get On Same Page

 

The first thing to do is to conduct a meeting with everyone. Call it a town hall meeting, an all-hands-on-deck meeting, or call it a meeting for free pizza in the lunchroom. Whatever you choose to call it, meet with everyone at once. One of the worst things to have is the rumor mill running wide open about what is going on and who is going to get whacked. In the world of work comp, those with plans of securing income via work comp wage loss will already be plotting their “accident” and how they are going to milk a claim for all it is worth once they receive their layoff papers. Include all levels of management, and all workers. This may not be able to be done in-house all at once, but you can do a webinar, recorded video, or hold the meeting at different times to address different workers. The plan is to make sure everyone knows what is going on so everyone hears the same story from the same person.

 

The next thing to do is seek department input. Have workers present concerns to their managers for them to take it up the ladder. Is one department being hit with layoffs worse than another one? If so, how are they going to cover work tasks? What are the concerns on the front lines? Do they have any ideas about covering shifts? Does anyone want to work other positions or be trained to do other tasks to help out other departments?

 

 

 

Make Your Employees Feel Heard

 

The key is to make everyone feel like their concerns are being heard, and ask them what they can do to help out another department. This is going to cut down those barriers between management and front-line workers. Effective communication between departments and between workers and management can be effective in reducing subjective work comp claims across the board.

 

Next up is implementation and transparency. You have to make workers feel trust. They need to know their concerns were heard, addressed, and suggested changes were implemented. Some of these suggestions may have come from very unlikely sources, but you never know if you have a genius of a janitor until you ask for their input. Not everyone’s idea is going to be implemented, but you should trust the judgment of those that do the job day in and day out. It is important to make sure their ideas are heard since they have more experience working those jobs than you do. Don’t assume that you know what is best. Try a few of their ideas and see what happens.

 

 

Additional Ideas To Help Weather The Storm of Change

 

So far we have communicating, seeking input, implementing change, and giving off an aura of transparency. The last items to think about are the 3 C’s. These are:

 

Commitment–You have to commit to the new plans that are being made. Cutbacks are necessary evils at times that have to be done. Commit to new plans once they are made and stay consistent.

 

Control— Executives or managers you have to be in control, and be accountable. At the same time, you may have to give up some of your control over certain tasks or departments. Remember to lean in to the shifts of control. Try not to move everything around all at once. If your workers feel that you are not in control of what is going on, they are going to take matters in to their own hands. This could lead to increased injuries.

 

Change—In business, you cannot be afraid to change. Make the change a new opportunity for some workers. The goal is to try and not shock anyone. I’m sure they are going to be freaked out enough as it is, wondering if they are next on the chopping block. Communicate to them what is going on, and how they can step up to the plate and help. Everyone handles change differently, so at times you may have to take a step back and review what is going on. Take your time, and make the new changes last by slowly doing one thing at a time.

 

Effective communication is always key when dealing with cutbacks. A sure way to see increased claim losses and more work comp problems are to not communicate what is going on to your front-line workers. Communicate, solicit feedback, and implement the changes needed. Hopefully your team will weather the storm with as little trouble as possible.

 

 

Author Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

 

©2013 Amaxx Risk Solutions, Inc. 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 about workers comp issues.

Get the Most from the 2013 National Workers’ Compensation and Disability Conference

 The 2013 National Workers’ Compensation and Disability Conference® and Expo

November 20th – 22nd at Mandalay Bay in Las Vegas will again be monumental for our industry. The conference continues to innovate to meet your needs

 

The 22nd annual conference offers regional breakout sessions and the expo hosts more than 260 exhibitors.

 

Among the highlights will be:

 

  • Best Practices for Injury Prevention

 

  • Strategies to Resolve Legacy Claims

 

  • Actions to Curb Opioid Abuse

 

  •  A brand new track focusing on an essential topic for industry professionals — Disability Management Solutions  – covering comorbidities, wellness and more

 

  • Critical issues in trend-setting states that often affect decisions in other regions

 

  • Emphasis on technology, innovation research & analytics to help workers’ comp and disability management professionals produce optimal outcomes

 

  • A hypothetical risk situation dissected in Risk Scenarios Live challenging you to identify key turning points of the claim

 

  • The Opening Keynote: Fighting Myths to Achieve Excellence in Workers’ Compensation by William Zachry, Vice President, Risk Management, Safeway, Inc.

 

  • Luncheon & Entertainment: When It Comes to Achieving Excellence — You Can’t Just Give It a Shot! Bruce Wilkinson, a safety and health expert turned professional speaker, delivers a fast-paced, humorous program to show you how to unlock the secrets of a positive attitude and can-do leadership style

 

  • Front and Center Again: Bloggers Speak Out on the State of Workers’ Compensation: David DePaolo, WorkCompCentral.com, Joseph Paduda,  ManagedCareMatters, Rebecca Shafer, ReduceYourWorkersComp.com & Robert Wilson, WorkersCompensation.com. They’re back!  If you missed them last year, you’ll want to catch these high-profile workers’ comp bloggers as they present their opinions o nsome fo the most pressing issues of the day.  It’s sure to be full of information, fun – and surprises!

 

  • The Legal Perspective of the Latest Workers’ Comp Reforms where Stuart D. Colburn, Esq., of Downs Stanford moderates a panel including Brad Bleakney, Esq., Bleakney & Troiani, author Thomas A. Robinson, J.D. and Rebecca A. Shafer, J.D., President of Amaxx Risk Solutions, Inc.

 

  • You can choose one of the following five tracks:

◦       Better Claims Management

◦       Disability Management

◦       Regional Issues

◦       Medical Management

◦       Legal/Regulatory Issues

 

 

Why Attend this Conference

 

The workers’ compensation industry is always evolving – new players, new laws and new equipment. Everyone in this industry should attend to learn new techniques, meet new vendors and discover the latest service enhancements.

 

The National Workers’ Compensation and Disability Conference® & Expo is the industry’s leading training event, attracting thousands of workers’ comp and disability management professionals from across the nation each year.

 

With proven guidance from industry experts, ample time to network with your peers and much more, there is truly no better place to find solutions to your workers’ comp and disability management challenges.

 

Continuing Education Credit:

The conference is routinely approved for AAOHN, CDMSC, CCMC, CRCC, CWCP and HRCI credits – so you know you’re getting quality education. It is   already approved for 7.75 of the recertification credits you need to maintain your PHR, SPHR or GPHR certification.

 

 

How to Get the Most Out of the National Conference:

 

  1. Attend the Opening Session. Don’t miss this because William Zachry, Vice President of Risk Management for the nation’s second largest grocery chain, has seen the workers’ comp and disability industry from all angles. Zachry will discuss well-known myths driving behavior and holding back the industry from achieving the best possible outcomes. In this energized presentation, he’ll explain what the myths are, how to separate them from the truth and how practitioners can achieve excellence.

 

 

  1. Focus on specific goals. For example, sessions about your region or attracting business. Attend all the sessions in the track that will bring the most value to your program. Use the 2013 Mobile App to plan which sessions you want to attend.

 

 

  1. Read the brochures when you return home to learn about service providers.

 

 

  1. Pass out your business card and network, network, network. Meeting knowledgeable people gives you a resource when you encounter a problem.   The conference offers ample opportunities for networking including a networking Reception and Closing Social as well as numerous meals and refreshment breaks. 

 

 

  1. Learn what you don’t know. Being exposed to new ideas presents an opportunity to learn things you don’t even know you are missing!

 

 

  1. Chat with people who do the same things that you do and see where you differ. At this conference, everybody’s badge includes their title and organization. It’s easy to identify other attendees who have similar roles in different organizations.

 

 

  1. Ask about key cost drivers. Attendees come from organizations of varying industries. Find people who work in workers’ compensation departments you know next to nothing about and ask them whether they are satisfied with their workers’ comp vendors. Ask them what drives their costs.

 

 

  1. Roam through the exhibit hall speaking to vendors and learning about the types of services that are available to reduce workers’ comp costs. NWCDC is the nation’s largest Expo of this kind. THIS will be the best education you will ever get!

 

 

  1. Wear comfortable attire. Bring comfortable shoes. The first day, people are a bit more dressed up than the following days. The last day is more casual because people are traveling back home. Definitely dress professionally because some of the people you meet with become lifelong contacts, so making a good impression is important, but you can be comfortable, too. For an ounce of prevention, bring moleskin to protect the areas of your feet most likely to get blisters.

 

 

  1. Attend both the exhibit hall and the educational sessions. 

 

 

  1. Start early, leave late and remember … although your feet may hurt, this is a once-a-year event!

 

 

  1. Before the exhibit hall opens, join the group breakfast to network with new friends. You will find people are very friendly and helpful.

 

 

  1. Keep your Show Guide for future reference. You may want to have this handy on your desk for the time you want to try a new service or ask a question about a new service. Or, if you are putting out a request for proposals, this will be your ultimate list of those companies to bid on your project.

 

 

See you there!

 

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact:RShafer@ReduceYourWorkersComp.com.

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

©2013 Amaxx Risk Solutions, Inc. 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 about workers comp issues.

Employer Steps to Eliminate Workers Compensation Fraud

Employers need to stay on top of fraud by proper investigation. Many examples of all kinds of clever schemes, plans, ideas and criminal behavior have been featured in our blog. 

 

Employers need to be aware of the lengths a dishonest worker may go to fraudulently obtain benefits. Therefore, employees need to be aware of the company’s intention to vigorously pursue all suspicious workers’ compensation claims. It costs a lot less to find, investigate and stop fraud and abuse then to let a healthy employee illegally collect benefits. If you think a claim is fraudulent, then you need to tell your insurance adjuster immediately.

 

When to Investigate a Claim

  •          To verify the extent of an employee’s disability
  •          If the injury is not consistent with nature of business
  •          To substantiate the ability of an employee to return to work or perform transitional duty
  •          To verify whether the employee is engaged in outside employment
  •          To prove insurance fraud
  •          To reduce (or increase) the amount of a settlement
  •          To deter future fraudulent activity

 

Work closely with your third party administrator to request an investigation. Investigations are not a one-size-fits-all arrangement. Different characteristics of a claim may require different types of investigation. Fraud will not be found in every investigation. However, never investigating will be more costly than investigating every claim.

 

Types of Investigation

 

General Investigation

This is an in-depth undertaking, compiling concrete evidence to determine the cause of the accident. To do this you would obtain:

  •          witness statements
  •          documents supporting the accident
  •          photographs

 

Activity Check

This is a brief surveillance where an investigator makes inquiries to friends and neighbors about the claimant’s daily activities. This may include documenting activities by videotape.

 

Sub-Rosa Investigation

This is a more comprehensive investigation documenting the employee’s activity level by obtaining a cross-section of the person’s activities on film. Use this investigation judiciously. Hire only qualified, bonded investigation firms. Monitor the investigation closely.

Virtual Investigation

This is where a professional conducts an on-line search of social media and other public sites to uncover an employee’s activities that are inconsistent with their claimed physical and medical restrictions. This may include photos of the employee participating in hobbies, sports or other activities, such as working at other jobs.

 

A Case Study

A California parks worker was apprehended as the result of an investigation conducted by the California Department of Insurance.  California charged the worker with presenting a false or fraudulent insurance claim and making false or fraudulent statements to his employer and to his treating physicians.

 

Over a five-year period, the man reportedly told his doctors:

  •          He was unemployed
  •          His injury continued to worsen
  •          He could not walk or walked with great difficulty, pain and limping, even after surgery to repair the injury
  •          He made similar statements under oath during a deposition taken when he filed for workers’ compensation.

 

What an investigation found

  • Undercover surveillance video captured the individual walking normally and bearing weight on his left ankle with no indications of pain
  • He was videotaped performing work-related activities at an auto-repair shop
  • He made inconsistent statements and material misrepresentations regarding the severity of his industrial injury and his employment status during appointments with physicians treating and/or evaluating him
  • These inconsistencies were in his sworn deposition testimony taken to file a false workers’ comp insurance claim with the employer’s third-party administrator.

 

The cost to the employer of his falsely receiving workers’ compensation benefits: $170,000

            $38,200 in indemnity benefits
            $23,300 in temporary total disability benefits
            $14,800 in permanent disability benefits
            $38,500 in medical treatment
            $  3,600 in vocational rehabilitation benefits
            $50,400 in legal expenses, defense costs and surveillance/investigation

 

What was the injury?

He “rolled” his left ankle while painting lines at a tennis court in a city-owned park.

Is anyone asking why it took FIVE YEARS to bring this worker to justice?

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact:RShafer@ReduceYourWorkersComp.com

 
Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com

 

©2013 Amaxx Risk Solutions, Inc. 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 about workers comp issues.

5 Safety Communication Techniques for a Diverse Workforce

 

Communicating safety issues effectively to a diverse workforce is a challenge. As a risk management consultant for many years, I’ve gathered solid information and experience on the best way to communicate safety and workers’ compensation messages to a large and diverse workforce, including organizations with thousands of employees with diverse backgrounds and many different job descriptions.

 

Before beginning, identify your target audience and the safety message you want to give.  The most important thing an employer must do before implementing any safety communication program is meet with employees and supervisors to discover their ideas on what needs to be communicated and how best to do it.

 

 

Five Safety Communication Techniques

 

First:

Identify the specific message you want to communicate. Is the message about getting employees to work more safely around certain equipment? Or is it to provide information on steps to take if they are injured?

 

Second: Identify the skill set and grade level of your audience. A message to upper management on how to improve commitment to a safety program would be presented differently than instructions to first-line employees on how to report an accident. A general rule of thumb for thinking about language levels is to keep in mind that the Wall Street Journal is written at a first-year college level, while the Reader’s Digest is written at a sixth grade reading level.

 

Third:  Consider job functions and how best to get your message across. Some employees might spend most of their work day in an office or one specific area of a plant. Others may spend it working in different areas of the plant or facility. Still others may spend their day driving from location to location. It’s a good idea to tailor your safety message to the types of safety issues more likely to affect those employees and areas of work.

 

Fourth: Identify the languages your employees speak. Don’t assume they will be just English and/or Spanish. There may be other immigrant groups, such as Russian or Vietnamese speaking workers. In addition, there are differences within languages, such as Cuban Spanish and Puerto Rican Spanish. Ask management to survey their workers’ languages and provide all safety messages as appropriate.

 

Fifth: Consider the work environment. If you have a congenial workforce, don’t use a heavy-handed communication style. Save it for a workforce where there may be a lot of discontent and resentment.

 

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact:RShafer@ReduceYourWorkersComp.com.

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

 

©2012 Amaxx Risk Solutions, Inc. 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 about workers comp issues.

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