The 5 Building Blocks Of a Positive Corporate Culture: Part III

Strong company culture is not only a pleasant place to work, but it has also been associated with better financial success. Such companies also have fewer workplace injuries, better employee engagement when there are injuries, and quicker return-to-work rates.

 

With statistics showing most employees are either not engaged or actively disengaged in their work, it means organizations need to take steps to improve their company cultures. Vulnerability and Purpose are the final two building blocks of a positive corporate culture in our 3 part series.

 


See additional articles in 3 part culture series:


 

  • Vulnerability

 

Showing your vulnerability goes a long way in gaining trust from others. It puts you on the same level as the other person.

 

A dramatic example of the power of vulnerability came during an airline tragedy in 1989. United flight 232 was about an hour out of Denver en route to Chicago when the engine in the tail of the DC-10 blew, destroying the three hydraulic systems pilots use to move flight control surfaces and steer the plane.  While 111 people were killed, 185 survived — largely because of the efforts of a DC-10 instructor who happened to be on the plane flying home for the weekend.

 

Trained for catastrophic failures, Dennis Fitch told the flight crew “tell me what you want and I’ll help you.”  The pilot and two co-pilots put Fitch to work helping to bring down the plane. None of the flight crew worried about their status or that of Fitch; they were focused only on working collaboratively and trying any and every idea possible.

 

 

Response in Workers’ Comp is Typically Rigid

 

The workers’ compensation industry’s response to injured workers is typically very rigid. Physical restrictions are set and those handling the claim dictate what happens each step of the way. Think about how that could be different if there were collaboration and stakeholders made themselves vulnerable to the injured worker.

 

What if the employer, nurse case manager, or claims handler said to the injured worker, ‘tell me what you want and I’ll help you.’ Such a small shift in attitude demonstrates that you are a partner with the injured worker, rather than an adversary. Offering to pick up something from the office, or call a family member, or even getting a glass of water could be seen as helping.

 

Such collaboration could extend to return-to-work efforts. Instead of simply relying on the medical restrictions, you could say to the worker ‘tell me what you think you can do, and we’ll develop lite duty work.’ It’s a way of working with the injured worker, instead of being on opposite sides. It starts with vulnerability.

 

 

  • Purpose

 

All the other building blocks to a winning corporate culture come down to purpose; that is, what is the purpose or reason a company exists? What is the purpose of employees who go to the organization every day? Ideally, it is to work for something larger than just ourselves.

 

 

Majority of Workers Do Not Have Greater Purpose

 

The Gallop poll showing the engagement — or lack of — among employees in their work shows the majority of workers do not have a greater purpose in mind each day. It even showed that 18 percent of employees were actively disengaged and would go out of their way to do something that would negatively impact their companies. By using the previous four steps to create a caring, compassionate, strong culture, companies can change the attitudes of their employees.

 

As demonstrated in the study of preschoolers who were drawing, motivation must come from within. External rewards, such as additional money, are the least impactful.

 

The Nordstrom company has a great example of how an organization encourages purpose among its workers. The single rule told to employees is; Use good judgment at all time. That speaks not only to the company’s well known excellent customer service but also extends to how injured workers and their claims are managed. Managers, supervisors and injured workers all know what their purpose it.

 

 

Conclusion

 

Employees who are not only allowed but encouraged to work outside the rules and be creative are much more likely to feel a stronger sense of connection appreciation and connectedness to their organizations. Autonomy, mastery, belonging, vulnerability and purpose are the building blocks to create a winning corporate culture in which workers take pride, leading to fewer injuries and faster return-to-work.

 

 

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/

 

©2019 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

The 5 Building Blocks Of a Positive Corporate Culture: Part II

Strong company culture is not only a pleasant place to work, but it has also been associated with better financial success. Such companies also have fewer workplace injuries, better employee engagement when there are injuries, and quicker return-to-work rates.

 

With statistics showing most employees are either not engaged or actively disengaged in their work, it means organizations need to take steps to improve their company cultures. Mastery and Belonging are two of the five building blocks of a positive corporate culture.

 

With statistics showing most employees are either not engaged or actively disengaged in their work, it means organizations need to take steps to improve their company cultures. Vulnerability and Purpose are the final two building blocks of a positive corporate culture in our 3 part series.

 


See additional articles in 3 part culture series:


 

  • Mastery

 

Pride in doing something well is one of the highest factors that motivates human beings. The proof of this has been borne out by several studies, including one involving preschoolers in 1970.

Children who were found to spend much of their free time drawing were divided into three groups:

 

  1. Group one students were told they would receive a blue ribbon with their name on it if they continued to draw
  2. Group 2 students were not told in advance, but received an unexpected ribbon for continuing to draw
  3. Group 3 students were neither offered nor given any reward

 

The group that continued to draw the most every day was not the first group. The promise of a blue ribbon was not a good incentive for them. In fact, the frequency of their drawing decreased. The second and third group drew the most. The reason: their motivation to draw came from within, rather than externally.

 

The same is true for adults in companies. Those who are offered more compensation or other incentives often do worse than others because their own drive to accomplish whatever the goal is has been diminished. Building a winning corporate culture involves empowering people to do their best work because they want to.

 

The workers’ compensation system is often an enemy of a strong corporate culture. Rather than feeling empowered and in control, injured workers are typically forced to adhere to a multitude of rules and regulations and given little to no voice in their own situations. Organizations can change that attitude by including injured workers in discussions about their claims and medical care and helping them feel like they too are part of the solution.

 

One idea is to ask an injured worker what he believes he can do work-wise while he recovers. This takes some pressure off supervisors to find light duty work and helps the injured worker feel more motivated to do something he wants.

 

 

  • Belonging

 

All of us need a sense of belonging. Whether it is to a relationship or organization, we want to feel like we are part of something bigger. Companies with strong cultures know this and leverage many strategies to foster it.

 

The power of inclusion has been shown in Australian studies of patients treated for suicide attempts. Following their release from hospitals, some of the patients were sent a series of postcards expressing support.

 

The idea of the postcards was simply to increase social connectedness, to create a concrete expression that someone still cares about the patient. They included statements such as, “it’s been a short time since your visit and we hope things are going well for you. If you wish to drop us a note, we’d be happy to hear from you.”

 

The researchers found that the low-cost postcard intervention reduced the number of suicidal attempts per individual by nearly 50 percent, which they described as “clinically and statistically significant.”

 

Employees also respond well to gestures that show they are a part of the organization. Such actions let workers know they are noticed and valued by others in the company.

Employers don’t need to spend large amounts of money or other resources to foster a sense of belonging. What is key is the continuous reinforcement of these measures.

These can include:

 

  • A get well card sent to an injured worker as soon as possible.
  • A phone call or visit with the injured worker the day he is injured or the next day.
  • Weekly contact with the injured worker, to discuss his situation and needs.
  • A small bouquet of flowers sent weekly, rather than a large bouquet sent just one time.
  • A small, $5 gift card for Starbucks.

 

Reinforcing the sense of belonging is vital — for all employees but especially for injured workers who are inherently feeling left out. One risk manager decided to increase the connectedness of injured workers by taking each of them out to lunch while they recovered. Out of 12 employees, 10 were back at work within two weeks.

 

 

Conclusion

 

Feeling like we are a part of something greater than ourselves is something all humans desire. When the work environment promotes this, employees are more engaged and motivated to be the very best they can be for their organizations. Using the 5 strategies to improve a company’s culture can go a long way to making this happen.

 

 

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/

 

©2019 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

 

The 5 Building Blocks Of A Positive Corporate Culture: Part I

Why do employees go to work every day at a particular organization? Is it the paycheck? The people? The work itself? Or something else entirely — the environment, perhaps?

 

If it’s the company culture, you’re in business! It means your employees are more likely to stay for the long term, less likely to incur injuries, more willing to cooperate and engage in their healing if they are injured, and unlikely to stay out of work for very long. A strong, positive corporate culture is key to keeping workers happy — especially if and when they are injured.

 

Savvy organizations understand that and know the 5 strategies that must be carefully implemented to create a winning corporate culture.

 


See additional articles in 3 part culture series:


 

 

  1. Autonomy/Safe Culture

 

Micromanaging people and forcing them to adhere to strict sets of rules and regulations do not produce creative, out-of-the-box thinking that puts companies ahead of the competition.  What is needed is effective collaboration among workers. Synergy is the key.

 

Groups of workers can achieve amazing results when they feel safe to share their ideas and are focused more on working together rather than one-upping other workers. This has been proven in the popular, Marshmallow Design Challenge.

 

Design engineer Peter Skillman came up with the idea of looking at group interaction through an exercise replicated at many companies. It begins with four components:

 

  1. 20 sticks of uncooked spaghetti
  2. One yard of tape
  3. One yard of string
  4. One marshmallow

 

Teams of 4 each are given 18 minutes to create the tallest possible free-standing structure using only those ingredients. Skillman and others have undertaken the study with many groups; such as CEOs, lawyers, recent business school graduates, and kindergarteners. The winners are always, hands down, the kindergarteners. Their structures are on average 26 inches tall. Among the worst performers are recent MBAs, with a dismal average structure of just 10 inches.

 

 

5-Year Old are Better at Collaboration Than Business Students & CEOs

 

Why are 5-year-olds better at collaboration than other, older more experienced groups? As Skillman himself has said; “none of the kids spend any time trying to be CEO of Spaghetti, Inc.”

 

It is not that the kindergarteners have better skills than those in the other groups, it is that they interact more effectively. The business school students are engaged in managing their statuses within the group, figuring out where each fits into the picture. Instead of focusing on the task, they are spending their energy on the pecking order of the group. By contrast, the kindergarteners work together enthusiastically, trying new ideas, moving quickly, and helping one another toward the solution.

 

Navy SEALs work together in much the same way. Each is dependent on the success of the other. If one fails, they all fail — or even die.

 

Creating an atmosphere where workers feel free to truly share their input without fear of repercussions requires breaking down silos and encouraging each and every person in the organization to speak up. Employees who feel valued by a company are more apt to feel comfortable contributing to the greater good. Skillman suggests the following to help workers feel autonomous and safe:

 

  • Allow them to learn by doing and discovering problems that can’t be predicted in advance.
  • Simultaneous iteration enables a free flow of good ideas.
  • Multiple iterations usually beat a commitment to making the very first idea work; i.e., practice makes perfect
  • Encourage wild ideas.

 

Organizations can encourage autonomy by giving employees time on which to work on something not necessarily related to their normal jobs, but something they are interested in doing. This helps set expectations and can also lead to the creation of light duty work for workers who become injured.

 

 

Conclusion

 

Employees who are not only allowed but encouraged to work outside the rules and be creative are much more likely to feel a stronger sense of connection appreciation and connectedness to their organizations. In addition to autonomy; mastery, belonging, vulnerability and purpose are the building blocks to create a winning corporate culture in which workers take pride, leading to fewer injuries and faster returns-to-work. Parts II & III take a look at those strategies.

 

 

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/

 

©2019 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.

Evaluating Medical Evidence to Make Better Decisions

Evaluating Medical EvidenceMembers of the claim management team are called upon to evaluate the medical evidence and determine issues of reasonableness and necessity of medical care and treatment, along with determinations of causation and primary liability.  These decisions have a significant impact on an individual claim and effectiveness of a workers’ compensation program.

 

 

Evaluating the Evidence from a Physiological Standpoint

 

Imagine the next claim that lands on your desk involves a meat production worker.  The employee is a 62-year-old man who’s work activities require him to process meat on a bench that is no higher than his waist.  During this process, the employee will turn in one direction to place the finished product for further processing and sale, and turn in the other direction to place the undesirable portions of the product for disposal.  None of their work activities require the employee to lift objects above chest level or over his head.  The employee is now claiming a progression of symptoms that involve stiffness, which has now culminated in “frozen shoulder” syndrome.

 

Should the alleged injury be accepted?

 

While the cutting of meat and its processing are repetitive, not all claims of repetitive trauma are compensable.

 

 

Making the Right Assessment

 

Claim handlers deal with many barriers when reviewing matters and determining questions that have real consequences.  This includes rigid timelines that can result in sanction or penalty if not done right or within a timely manner.  Questions that must be considered include:

 

  • Did a work injury actually occur – even if it only aggravated or accelerated an underlying condition?

 

  • What role if any, did the work activity contribute to the injury, disability and/or need for medical care and treatment?

 

  • Even taking into consideration the employee’s age and possible prior injuries, did the work activity advance the underlying condition to the point of compensable injury?

 

 

In terms of the above scenario, the claim handler worked with a medical expert to review the claimed mechanism of injury, prior medical records and other information to allow for a primary denial.  It was noted that the contemporaneous medical records and work history did not support a work injury and the claimed mechanism was inconsistent with the subsequent medical diagnosis.  In sum, because the physiological body mechanics in question did not fit injury, the proactive claim handler was effective and proactive in denying the claim.

 

 

Application in Claims Handling Practice

 

It is important for members of the claim management team to review their files and determine if the medical evidence fits in not only workplace exposure/repetitive injury claims, but also specific incident injuries.  Examples of how this can be used in specific injuries include:

 

  • How the employee fell or what they were doing when they fell;

 

  • Angles of fracture and the type of fracture following a slip/fall; and

 

  • The nature and extent of an injury based on pre-existing conditions such as degenerative disc disease for back and neck claims, and claims involving joints such as knees, shoulders, and

 

The list of possibilities is really endless.

 

 

Conclusions

 

Members of the claim management team face many challenges in their position on a daily basis.  It is of utmost importance that claims handlers make proper decisions after having investigated a claim in a timely manner and making evidence-based decisions.  This includes taking the time to obtain information on how the injury took place, they can save time and money for their program and clients.

 

 

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/

 

©2019 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

10 Signs of a Negative Company Culture (that drive up workers comp costs)

Negative Company CultureWhat is meant by ‘corporate culture’ and why should we care, especially in the workers’ compensation realm?

 

According to research, corporate culture can have a significant impact on an organization’s finances. Also, companies with strong, positive cultures have employees who are more engaged — in their jobs, their companies, and their own recoveries if they become injured. It all adds up to better outcomes for injured workers and stronger bottom lines for organizations.  Understanding a few facts about corporate culture can make a tremendous impact on a company as a whole, and its injury management program in particular.

 

 

The Evidence

 

The relationship between organizational culture and corporate financial performance has been the subject of research for a number of years. One of the most dramatic studies came out of Harvard in the 1990s.

 

The researchers looked at the corporate cultures of companies and the potential impact on economic performance. Their analysis led them to compare 12 companies in particular that had positive cultures and 20 that did not. Over an 11 year period they found startling differences:

 

Positive cultures          Weak cultures

Revenue growth                                682%                                    166%

Employment growth                         282%                                    36%

Stock price growth                            901%                                    74%

Net income growth                            756%                                    1%

 

While it has not been definitively determined that corporate culture alone has a significant impact on a company’s financial success, it is at least clear that it doesn’t hurt. As one of the two researchers of the study later said, “For now, my point is simply that corporate culture can contribute meaningfully to financial results, and many people do not give this fact enough attention.”

 

 

About ‘Culture’

 

There are a variety of definitions for the term ‘corporate culture.’ While basketball courts and ping pong tables in the lunchroom may come to mind, they don’t define corporate culture. Essentially, it boils down to the beliefs and behaviors that affect the way employees and management interact. It is not something tangible, but more of an attitude and way of doing things that permeates an organization.

 

While it is not something that can be seen or touched, it can be developed and intentional. It starts with the values, vision, mission and the day-to-day communications within a company. A strong, positive environment empowers employees. It makes them feel they are part of a team with a specific purpose. It motivates them to do well and go beyond simple expectations.

 

Motivated employees are contagious. Their positivity affects others around them and spurs better outcomes from the entire organization. However, the reverse is also true; a negative, weak culture results in unmotivated workers and can lead to a deterioration in productivity.

 

 

Cultural No-Nos

 

The first step in building a positive corporate culture is to assess the organization’s current culture. There are several clear indications that point to a poor corporate culture.

 

  1. High turnover. The overall average staff turnover rate for all industries is 16.7 percent, according to a study in 2015. Industries such as insurance and utilities had slightly lower turnover rates, while hospitality had a higher rate. A rate that is high indicates employees are unhappy in the environment.
  2. High-stress There are both physical and emotional symptoms of stress, but employers may not be privy to that information if employees are not forthcoming about it. One way to determine if a company has high-stress levels is to look at documents such as sick leave and workers’ comp claims information. Observing workers may indicate if there is high stress, especially high tensions among employees. Employers can encourage activities shown to reduce work-related stress, such as:
  • Create an atmosphere that makes it easy for a worker to get exercise, such as discounted gym memberships or suggesting taking walks outside during breaks.
  • Remind workers to use their vacation time, to avoid burnout and prevent stress from overwork.
  • Make employees feel valued. Recognizing even small contributions from workers shows you care about them and can help reduce their stress levels.

 

  1. Lack of trust. While many supervisors and managers don’t consider this important, more than 90 percent of employees say it is vital to have a boss they can trust — or they will seek out new employment. Indications of a lack of trust include:
  • Workers are unwilling to go the extra mile and only do the bare minimum.
  • Complaining, finger-pointing and blaming with little effort to accept responsibility.
  • High levels of competition to the extent that others’ ideas are blocked and pertinent information for good decision making is withheld.
  • Policies and procedures are based on the idea that employees cannot be trusted.

 

  1. People don’t share ideas.
  2. Silo mentality, where employees do not collaborate
  3. Low participation in activities or wellness programs. Employees who don’t feel like part of a team are less likely to engage in events with their coworkers.
  4. Failing to report injuries. A quick check of the lag times between injuries and when they are reported will indicate whether workers feel safe or even understand they need to report workplace injuries.
  5. Punishing those who report injuries. Employees who are discouraged from reporting injuries do not trust their supervisors, managers, or their entire companies.
  6. Litigating most workers’ compensation claims. While some litigation does occur, greater than 50% of claims is a red flag.
  7. Failing to return to work anyone who is not at 100 percent. Company policies that keep workers out until they have fully recovered to their pre-injury status are harmful, to injured workers as well as the companies themselves. The longer someone is out of work, the less likely he will return. It causes disability mindset for the worker and increases costs unnecessarily and dramatically for employers.

 

 

Conclusion

 

Less than one-third of employees say they are ‘actively engaged’ in their work, according to a Gallop poll. These employees have fewer workplace injuries, are more active in their recoveries and return to work sooner. The remainder of workers say they are either ‘not engaged’ or ‘actively disengaged’ in work.

 

Getting more workers into the ‘actively engaged’ category starts by understanding the culture of an organization, then taking steps to improve it.

 

 

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/

 

©2019 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.

What Is Your Workers’ Comp Brand?

 

Louis Vuitton luggage, a Prada bag, a Tiffany bracelet, even an American Girl doll. These are all items which may have shown up as gifts or you may have asked for as gifts over the course of this past holiday season. And while the quality of those products is high, the quality of the product is not the reason you asked or received that gift.

 

 

Branding is Powerful Concept in Work Comp Management

 

Hello, I’m Michael Stack, CEO of Amaxx, and today I want to talk to you about the importance of branding, how powerful it is. Because the difference in quality between a Louis Vuitton piece of luggage and another maybe generic piece of luggage might not be that different, but the cost is dramatically different. And the reason is for the status that brand brings and the meaning that it brings to have that certain type of brand on that particular product.

 

 

Brainstorm Your Workers’ Comp Brand As One of First Steps

 

When we think about your work comp program … and let’s put this in that context … one of the first things that we do when we’re working with an organization is define that brand for what you stand for. I want to encourage you to take the step, and I want to give you an example of what this might look like.

 

What you’re going to do is you’re going to do some brainstorming. You’re going to get your team together, senior management, maybe a couple supervisors, your vendor teams, your claims handling team, some various people that are going to be working together with you on this project of reform as you’re starting to take the step.

 

And ideally what you’ll do is you’ll create some meaning behind this, and likely what we like to do is create an acronym. I want to give you an example. So say you work for the ACME company and you brainstorm and you talk about sort of the culture of what your organization means and what you stand for as a company, and you come up with the ACME IPAR program, the ACME Injury, Prevention and Recovery program.

 

 

Create Logo & Awareness of Your Work Comp Brand

 

You then create a logo around this. We create some branding around this. We create some awareness around this, and so when you’re introducing your work comp program to your company, you say, “This is what we do here at ACME. We have the ACME Injury Prevention and Recovery program, and when you’re hurt as an employee, we’re going to take care of you.”

 

A tremendous first step, carries a tremendous amount of meaning, particularly when you back that up and meet those expectations in the injury management of employees when they do get hurt.

 

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 - 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/

 

©2019 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.

Durable Medical Equipment Often Overlooked for Cost Containment

Durable Medical Equipment Often Overlooked for Cost ContainmentSelf-insured employers who are trying to control the cost of medical care within their workers’ compensation program will often use medical triage, nurse case managers and pharmacy benefit managers, but overlook durable medical equipment (DME).  Durable medical equipment is reusable medical gear or reusable medical products necessary for the injured employee to function at home or away from a medical facility.  Durable medical equipment must be prescribed by a doctor and most DME will have no benefit to a person who does not have an injury or occupational illness.  The need for durable medical equipment is closely related to the severity level of an injury — the higher the level of severity of an injury, the greater the probability that an injured employee will need DME.

 

 

Can Be Expensive, However Cheaper Than Hospital

 

Depending on the nature of the DME, it can be very expensive adding considerable medical cost to the workers’ compensation claim.  Examples of DME that can add substantially to the claim cost include:

 

  • Oxygen tents

 

  • Hospital beds

 

  • Motorized wheelchairs

 

  • Power operated vehicles

 

  • Lift chairs

 

  • Continuous positive airway pressure (CPAP) machine

 

  • Iron Lungs

 

  • Traction equipment

 

  • Prosthetic limbs

 

  • Transcutaneous electronic nerve stimulators (TENS units)

 

  • Air beds or fluid beds

 

 

While some DME can be expensive, it is always much cheaper for the injured employee to be at home using DME than it is for the injured employee to be in a hospital room, nursing home or other type of convalescent facility.  The cost of medical care supplied away from the home can range from 100% to 1000% higher than the cost of medical care at the injured employee’s home with DME.

 

In some liberal jurisdictions, the range of DME has been expanded to include such items as:

 

  • In-home spas

 

  • Whirlpools

 

  • Hot tubs

 

  • Orthopedic/specialty mattresses

 

  • Air conditioners

 

  • Dehumidifiers

 

  • Hearing aids

 

 

Prescription Written by Doctors Should be Verified

 

Prescriptions for these types of items are normally only written by doctors chosen by the employee’s attorney.  If the employer is confronted with a prescription for specialized DME of this type, an independent medical examination of the injured employee can be completed to verify the need for the specialized DME.  An alternative is to have a utilization review or a peer review of the prescription to verify the medical necessity. A different approach is to have the request for specialized DME reviewed by the workers’ compensation board or industrial commission for their concurrence or denial.

 

 

Claims Adjuster Should Arrange for Purchases

 

If it is determined the specialized DME is necessary, the claims adjuster or the nurse case manager should arrange the purchase of the specialize DME.  This will allow the adjuster or nurse case manager to obtain the necessary equipment, but restrict the purchase to what meets the doctor’s prescription, but does not exceed it.  For example – the doctor writes a prescription for a Tempurpedic mattress and the industrial commission rules it must be provided.  If the claimant is left to select and order the mattress, the claimant will select the $6,000 version, while if the adjuster is responsible for obtaining the mattress, the adjuster will select the $3,000 version that meets the requirements of the doctor’s prescription.

 

Some DME is not expensive and is commonly provided to injured employees.  Examples of less expensive DME includes:

 

  • Commode chairs

 

  • Walkers

 

  • Canes

 

  • Crutches

 

  • Nebulizers

 

  • Non-motorized wheelchairs

 

 

Hold Durable Medical Equipment Costs Accountable

 

If the state medical fee schedule includes DME (some state fee schedules do include DME while others do not), and if there is no question in regards to the medical necessity of the DME, it should be submitted to the medical fee bill review service for control of the cost of the DME.

 

In the states where the state fee schedule does not address DME, the self-insured employer should make arrangements with a company that specializes in DME to provide all necessary DME.  A pre-arranged pricing agreement for the DME items listed above will reduce the cost of DME.

 

 

 

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.

Six Tips to Get the Most From Your Insurer

Six Tips to Get the Most From Your InsurerMany insurers are great providers, however, it is naïve to think every insurer has your best interests in mind. Sometimes you need to remind them, and be very specific about your needs.

 

Here are six tips to get the most from your insurer:

 

 

  1. Get Regular Reports

 

It is essential for companies to request brief, narrative reports from their insurers for all open claims at regular intervals of 30, 60 or 90 days. The frequency of reporting requirements is, of course, dependent on claims volume and availability of internal company staff.

 

A company with 1,000 lost-time claims annually may want less frequent or less-detailed reports every 90 days, for example, but, a company with only 100 lost-time claims annually may want full narrative reports every 30 days.

 

The adjuster should provide sufficient detail in describing “action items” planned for each 30-day period that indicates steps to be taken to resolve the claim.

 

Many companies requested information solely about reserve practices in the past, however, the focus of reporting requirements should be on claims resolution strategies.

 

 

  1. Ask About Recovery Potential – Get it in Writing

 

Additional items often incorporated in your Account Servicing Instructions (ASI) include requirements that “all claims should be evaluated for state second injury fund and subrogation potential.” The company should receive a report identifying recovery potential within 90 days after the claim is received by the carrier. The carrier files liens in all actions brought by its employees against third parties and these liens should not be waived or compromised without the company’s prior written consent.

 

 

  1. Benefit Checks Should Come to You First

 

In those states where permissible, benefits checks should be delivered to the company to distribute to employees. In lieu of this, copies of all checks should be forwarded to the company. Direct deposit can be a convenient way to distribute checks, but you will lose the ability to interact with your injured workers come payday.

 

All claims should be paid “without prejudice” in those states where possible, and the carrier should file for extensions of this status whenever possible.

 

 

  1. Ask Your Carrier to Reference the CIB

 

Companies should also request their carriers reference the Central Index Bureau, an insurance industry-maintained database, on all claims to determine if a prior claim was filed.

 

 

  1. Be Sure your Carrier and Insured Are On the Same Page with Denials

 

When the company requests a claim be discontinued, the carrier should be flexible enough to agree to take necessary steps to terminate benefits in a timely manner so long as the company’s position is legally supportable. The carrier should take an aggressive posture in denying insupportable claims. Conversely, the insured should be consulted before any claim is denied to avoid human resource and morale problems.

 

 

  1. Your Insurer Should Notify You In Advance Regarding Hearings

 

Furthermore, the company should be notified sufficiently in advance of all hearings and conciliations so its representative may attend the hearings. Also, the litigation manager should be consulted before appeals are filed and should retain the right to determine whether an appeal is warranted.

 

 

 

 

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.

Establishing and Changing Primary Care Doctors in Workers’ Comp

Establishing and Changing Primary Care Doctors in Workers’ CompA common method to control costs in workers’ compensation claims is the designation of a primary treating medical provider.  This is important for a number of reasons and is something claim handlers need to understand.  Failure to recognize its significance can result in excessive costs in the claim management process.

 

 

Threshold Issues to Consider for Primary Care Doctors in Work Comp

 

Determinations regarding the establishment of a primary care doctor are usually defined by statute or administrative rule under a jurisdiction’s workers’ compensation law.  In many instances and employee establishes their primary doctor based upon the number of times or frequency an injured employee receives medical care and treatment following an injury.

 

 

Time to Consider a Change in Healthcare Providers?

 

A health care provider is typically considered the “primary doctor” once they direct and coordinates the course of medical care provided to the employee. Employees are usually allowed to only have one primary health care provider at a time.  Once an employee establishes a primary treating physician, their ability to change that provider are limited.  Circumstances that permit change without initiating a legal process include the following:

 

  • Death or retirement of a physician, doctor or other health care provider;

 

  • Termination or suspension of a provider’s health care practice; or

 

  • Referral from the primary provider to another provider.

 

Failure of an employee to receive advance approval of a change in health care provider can have a significant impact on a workers’ compensation claim.  One common consequence of this action is the ability of the workers’ compensation insurer to avoid legal liability for medical care and treatment received by the employee even if the medical care is reasonable, necessary and causally related to the work injury.

 

 

Other Factors to Consider When a Request for Change Occurs

 

If a change is not approved by a workers’ compensation insurer, employee’s generally have the ability to initiate a legal process to change their primary health care provider.  While factors to consider in this process vary, they generally include the following issues:

 

 

  • Whether the requested change is an attempt to block reasonable treatment or avoid acting on the provider’s opinion concerning the employee’s ability to return to work: A change is sometimes requested when an injured employee is hesitant about proposed medical care and treatment.  Failure to follow the proposed treatment plan can also delay recovery.

 

  • Development of a litigation strategy rather than to pursue appropriate diagnosis and treatment: This can occur in instances where an employee is malingering or exhibits unsafe habits such as seeking opioid-based prescription medications.

 

  • The provider lacks expertise to treat the employee for the injury: Medicine is complex.  Sometimes a medical provider may lack the necessary training or experience to properly care for an injured employee.  There are also health care providers known to enable an employee by seeking excessive care or unnecessary procedures.

 

  • Other factors to consider: It is important to evaluate a request for change in a health care provider in terms of travel costs to see a particular health care provider and other unnecessary expenses.  Members of the claim management team should be skeptical of a request for change when it is certain the employee does not require additional care.

 

Members of the claim management team also need to consider the best interests of all parties.  What these means is often vague and uncertain.  This requires the application of the “smell test” to determine if such change is really necessary.

 

 

Conclusions

 

Claim handlers need to be vigilant of excessive medical costs as long as it continues to drive workers’ compensation program costs.  One area of focus should be a determination on the employee’s primary medical provider following a work injury and what circumstances truly necessitate a change.

 

 

 

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.

6 Ways Nurse Case Managers Add Value to Workers’ Compensation Claims

6 Ways Nurse Case Managers Add Value to Workers’ Compensation Claims Nurse case managers can be invaluable to an injury management program. They can have a tremendous impact by helping organizations attain better outcomes for their injured workers and saving significant dollars.

 

But far too often industry stakeholders misunderstand how and when to use them. Like many aspects of claims management, Nurse Case Managers are a tool that should be employed judiciously and with forethought to garner the most value.

 

 

Expectations

 

NCMs are not miracle workers. However, when incorporated into the right types of claims they can be instrumental in getting the injured worker healed and back to work in a timely fashion, resulting in the types of savings reported above.

 

Here are the many ways NCMs help with a claim:

 

  1. Patient advocacy. This is where NCMs shine. Injured workers are often confused and scared, especially if the injury is severe. Unlike being injured at home and going to see whatever physician they choose, the rules for injured workers are different. They are often told what doctor to see and when. They may also be concerned about how they will get money if they are out of work for any length of time. And they may fear losing their job. A NCM can guide the injured worker through the process, allaying his fears and answering his questions. They can

 

  • Explain the process and restrictions
  • Discuss likely recommendations from doctors
  • Provide options for various specialists, regardless of the rules for physician choice in a jurisdiction. Where the injured worker has the option to visit any physician, the NCM can recommend physical therapists, orthopedists, or others. In employer-directed care states, the NCM can discuss various in-network providers known to her.
  • Review meds. The NCM can explain the medications that are prescribed and look at possible interactions with other pharmaceuticals the injured worker may be taking.

 

  1. Reduce litigation rates. One of the benefits of NCMs is the trusting relationship they develop with the injured worker. Research shows injured workers who work closely with a NCM are much less likely to sue their employers.

 

  1. Increase engagement and ensure compliance. Injured workers can be notoriously unfaithful to the treatment plans — forget to take their medications, miss PT or other provider appointments, failing to do assigned exercises that aid recovery. Again, having a trusting relationship with a NCM who is clearly advocating for the injured worker is likely to result in better adherence to a treatment regimen.

 

  1. Communicate. Because he is closely involved with the injured worker, the NCM is the best person to act as the liaison to all stakeholders.

 

  • With the employer. The NCM can keep the employer updated on the injured worker’s progress. He can discuss restrictions and ways the employer can accommodate the worker. He can also discuss the capabilities the injured worker has during the recovery process to help identify light-duty work.
  • With the treating physician. Especially in states where workers have a choice of providers, the NCM can explain the workers’ compensation system and the emphasis on return to work.
  • With the claims adjuster. The person handling the claim may be unaware that the injured worker has been released to return to work, for example, requiring a change in the benefits.

 

  1. ID then need for peer review. Sometimes claims go off the rails because the treating physician is not following evidence-based medicine guidelines, or doesn’t understand the goal of return to work. A medical provider who is not an occupational physician may continually say the injured worker should not go back to work in any capacity. The NCM can detect such incidents and get a medical provider from the insurer or third-party administrator to review the case and possibly talk with the treating provider.

 

  1. Coordinate interventions. Psychosocial issues may be present that could derail the claim unless they are addressed. The NCM may be the first person able to detect these and seek cognitive behavioral therapy or other intervention. A pain management program may be warranted, which the NCM can coordinate.

 

Conclusion

 

NCMs are one of the most effective ways to achieve best win-wins for injured workers and employers. But it’s important for stakeholders to know how and where they can add value. For example, they should not be used on every claim.

 

 

 

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.

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