Pre- and Post-Offer Employment Testing Saves Organizations Money

Organizations can ensure they have the right worker for the right job by taking some simple and relatively inexpensive steps.

Finding qualified people to fill jobs these days can be challenging. The unemployment rate is such that many employers take the attitude that beggars can’t be choosers, and getting butts into seats — any butts — is the only goal. They think the idea of spending any time and money on testing applicants is a waste. But is any hire preferable to a bad hire?

 

Organizations can ensure they have the right worker for the right job by taking some simple and relatively inexpensive steps to make sure their hires are free of undesirable characteristics — such as dishonesty, theft, and substance abuse; and are physically qualified to do the job.

 

 

Costs of a Bad Hire

 

What if you knew that at least 25 percent of job applicants would have 2x the number of injuries as other employees, and would increase your indirect workers’ compensation costs as well; in lost productivity, lost time, and retraining new workers? Does it make sense to look the other way when an applicant walks in the door?

 

Most companies have had a bad hire at least once; an applicant who seemed terrific, but turned out to be just the opposite. When one of these ‘bad hires’ gets injured — which they tend to do more often than ‘good hires’ —  the costs can be astronomical. These costs include both direct and indirect costs, such as fewer sales, more legal issues, and increased negative morale among employees and clients.

 

A survey of thousands of companies by Careerbuilder found that 69 percent had been affected by a bad hire in the previous year.  Of those:

 

  • 41 percent said the cost exceeded $25,000
  • 24 percent — nearly one-quarter, said they paid more than $50,000

 

These companies were in a rush to fill positions and faced the lack of a talent pool. Unfortunately, the amount they spent on the bad hires was substantial compared to the expense of weeding out the bad seeds before the first interview was even conducted. These companies could have saved money and time by taking some simple first steps.

 

 

Pre-hire Testing

 

If you posed the question to a job applicant, ‘how often did you steal from a previous employer because you didn’t think you were being paid enough?’ do you think the person who has done this would admit to it?

 

Surprisingly, he would! He has convinced themselves that what he has done is no big deal and, therefore, will readily admit to acting in ways that could indicate a skewed value system.

 

Mark Walker, VP of Business Development at Integrity First states, “The question of why someone would answer truthfully is very important, and the answer is because they suffer from a state of mind we refer to as cognitive dissonance. The individual has rationalized their bad behavior as being acceptable.”

 

Integrity testing, as it’s known, measures four specific behaviors:

 

  1. Substance abuse
  2. Hostility
  3. Dishonesty
  4. Theft

 

Research shows that 25 percent of people faced with integrity testing will admit to conduct that runs contrary to that of a good hire. If hired, they are more likely to incur workers’ compensation claims and have higher absenteeism and turnover, poor performances and grievances.

 

The time to do this testing is at the very beginning, before any time or money is spent interviewing the candidate. It gives the employer the ability to evaluate someone on their values and determine if it’s someone they want in the company. Weeding out these bad actors right from the start is key to saving an organization thousands of dollars and major headaches.

 

Studies show that of the remaining 75 percent of applicants, nearly all — 99 percent — will pass background and drug tests. They are less risky hires for the company

 

 

Finding Enough Applicants

 

One concern voiced by employers is whether they can afford to weed out 25 percent of job applicants when there are so few to start. But breaking down the math shows this to the employer’s advantage.

 

Walker states that an employer should ask these two questions:

 

  • How many jobs do you plan to fill this year?
  • How many applications do you typically receive on a monthly or annual basis?

 

Despite the low unemployment rate, most companies get more applications than they need. If, for example, the company plans to hire 1,300 in a given year and receives 2,000 applications, that still leaves 1,500 applicants who pass the integrity testing. Those remaining are less risky, more viable job applicants. They will have fewer and less costly workers’ compensation claims than bad actors.

 

As stated by Walker, “The question of lack of available candidates is very common, but I have not yet had a client where the number of applications was less than the number of positions that needed to be filled.”

 

 

Post-Offer Testing

 

Using post-offer testing to determine if a candidate is physically ready for the position and can handle the essential functions of the job is an important step.

 

Most injuries occur early on in a worker’s tenure, within the first year. And these injuries are often the result of the person’s inability to perform the essential functions of the job. Larry Feeler, CEO of WorkSTEPS, states, “What we’re trying to do with physical testing is just like having individuals try out for a sport, we want to make sure that each person can demonstrate they are physically capable of performing at their position.”

 

A job offer can be made conditionally; that is, conditioned upon her completing and passing other tests, including essential function testing. By leveraging best-in-class service providers, this is simple to do. The employer has the person replicate exactly what she will be doing day in and day out.

 

The tricky part of essential function testing is to determine exactly what it is the job requires for the essential elements. How much physical force must be used? How much pushing, pulling, climbing — ladders, stairs, truck door openings, etc.? Accurate, comprehensive job descriptions are imperative to conduct effective functional testing.

 

Feeler states, “There’s no question that the most important thing is to identify an essential vs. non-essential job task. Once job task assessments are made, then you need to test them for accuracy.”

 

Many employers have poor job descriptions and a poor understanding of essential and non-essential functions. It is valuable to work with a service provider to help streamline the process to create a database of thorough and accurate job descriptions.

 

One additional benefit of essential function testing is that it establishes the person’s baseline health and provides a comparison in the event an injury does occur. For example, the initial testing may identify a 10 percent shoulder impairment. If the person subsequently sustains a shoulder injury and is deemed to have a 12 percent impairment, the employer is responsible only for the 2 percent difference rather than the entire 12 percent impairment.

 

 

Summary

 

Despite the scarcity of qualified job applicants, no company wants to hire its next workers’ compensation injury, or its next thief. Employers can find suitable job candidates who will make excellent employees by taking the necessary steps before bringing them on board.

 

 

 

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 the founder & lead trainer of Amaxx Workers’ Comp Training Center.

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://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.

SSDI, Reverse Offsets, and Prescription Drugs in WC Settlements

Looking beyond typical tactics can save money, promote settlement, and increase the ability to resolve workers’ compensation claims.

Cost mitigation is a significant key to a successful workers’ compensation program.  While it takes time and effort to implement, adding key components to your program can save money, promote settlement, and increase the ability to resolve cumbersome workers’ compensation claims.

 

 

SSDI Permanent Total Disability Review

 

Many workers’ compensation defense attorneys and members of the claim management team over-reserve and often settle cases with permanent total disability (PTD) exposure.  This is often found in cases where the injured employee is older or suffered a significant work injury where they would qualify for Social Security Disability Insurance (SSDI).  Studies have indicated these claims create barriers to settlement and cause unnecessary problems for claim handlers.  Now is the time to change how these claims are reviewed:

 

  • Understand the statutory language for someone to qualify for PTD benefits. This includes an understanding of case law, and the understanding that only in a few jurisdictions does the receipt of SSDI benefits create a statutory rebuttable presumption of being permanently and totally disabled;

 

  • Prevent unnecessary PTD exposure by reviewing cases in terms of the employee’s reasonable functional ability, transferable job skills, compliance with a vocational rehabilitation plan, and job search efforts; and

 

  • Reduce the indemnity costs of a claim through effective return to work efforts.

 

 

Clinical Review of Prescription Medications

 

All claim management teams should scrutinize medical spending on workers’ compensation claims.  This includes being proactive when it comes to the use of prescription medications and the dangers of opioid-based drug misuse and abuse.  Proactive features to include in any program should consist of the following:

 

  • The effective use of physician-to-physician engagement to ensure treatments and medications are reasonable, necessary, and related to the work injury. It is also important to apply evidence-based medication principles when it comes to treatment involving the use of common pain killers for more than 30 days; and

 

  • Use of clinical reviews when combined with future medical care cost projections that include seeking a physician to sign off on amended future care being recommended by the injured employee’s treating doctor.

 

 

Effective Use of Rated Ages

 

People often think of obtaining a rated age when it comes to preparing a Medicare Set-aside.  There are many other important applications to the use of this tool, including mitigation exposures and settling workers’ compensation cases.

 

  • Provides for an opportunity to more realistically calculate an injured employee’s life expectancy with any pre-existing or non-work related conditions; and

 

  • Provides a claim handler or defense attorney with an independent analysis of the injured employee’s need for future medical care and treatment – even outside the context of a Medicare Set-aside.

 

It is important to have this document available when negotiating a settlement.  It only adds to the credibility of your settlement offers.

 

 

Use Reverse Offset Provisions When Applicable

 

A handful of states still allow for the use of reverse offsets when it comes to injured employees receiving wage loss benefits, and SSDI benefits.  Without the application of these provisions, people will receive less in SSDI benefits, which gives them an incentive to continue to collect workers’ compensation.  Use of the SSDI reverse offset provisions allow the insurance carrier to do the following:

 

  • Find lost dollars that have not been offset against the workers’ compensation claim; and

 

  • Provide parties with a turnkey analysis to produce hard dollar savings without taking up claim handler time and energy.

 

The following jurisdictions have reverse offset provisions available: Colorado, Florida, Louisiana, Minnesota, Montana, New Jersey, North Dakota, Oregon, Washington, and Wisconsin.

 

  

Conclusions

 

There are my tools interested stakeholders have available at their disposal to mitigate workers’ compensation program costs.  These tools can be used on all types of cases, but are especially useful when it comes to pushing claims involving severe or catastrophic injuries toward settlement.

 

 

 

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: http://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.

 

7 Ways Organizations Can Mitigate Opioid-Related Problems

Most employers admit their organizations have been impacted by opioid use; however, few say they feel well prepared to deal with the issue.

Drug overdoses are the leading cause of death in many jurisdictions. Most employers admit their organizations have been impacted by opioid use; however, few say they feel well prepared to deal with the issue.

 

While it may seem there is little employers can do to prevent opioid-related problems – or deaths, nothing could be further from the truth. Workers spend a large percentage of their days at work, meaning employers may be in the best position to address the issue of opioids.

 

 

7 Ways Organizations Can Mitigate Opioid-Related Problems

 

Among the steps companies can take to prevent opioid use disorder, addiction, and overdose are:

 

  • Employee education.
    • Despite the persistent media coverage of the ‘opioid epidemic,’ most people don’t think they are at risk. But anyone can become dependent on opioids. Opioids can be useful post-surgery or for acute pain on a limited basis. But many people don’t realize when they have been prescribed an opioid or the dangers of longer-term use. They are also unaware of whether they have risk factors that make them more likely to develop opioid use disorder, such as a genetic predisposition or negative social influences. Educating employees on all things opioids can arm them to know what to ask or discuss with their providers and whether they are even being prescribed an opioid. Also, they will be better informed about whether they are developing opioid use disorder or dependency. Employees should understand the many alternatives to opioids for pain management.

 

  • Effective drug-free workplace policies.
    • While compassion toward employees who are struggling with drug issues is important, it’s also imperative to have clear boundaries about drug use in the workplace. Addiction is covered by the Americans with Disabilities Act. However, using drugs is not; nor is violating an employer’s workplace drug abuse policy. Organizations should have clearly spelled-out policies that detail if and when over-the-counter and prescription drug use is allowed. Companies that have ‘safety-sensitive’ workers, such as those who operate heavy machinery, should mandate that these employees notify HR if they are taking medications that could impair their ability to perform their jobs.

 

  • Manager/supervisor training.
    • Employees who are becoming dependent on opioids may show initial signs of impairment. Supervisors and managers should be trained on how to spot potential red flags and what to do in such situations. They need to understand what they should or should not say to the employee and the specific steps to take. Uninformed supervisors run the risk of violating the employee’s privacy on the one hand, or failing to protect the organization from safety hazards, on the other.

 

  • Return to Work
    • Injured workers may need to attend medical appointments or make phone calls to supportive services as they return to work. Employers can work with these employees and their providers to make sure they have access to available resources as they recover from opioid-related challenges.

 

  • Supportive culture.
    • One of the most important things employers can do to help employees – and themselves – is to create an overall culture of health and well-being, and free from the stigma that so often accompanies substance abuse issues. Employees struggling with potential opioid problems will feel more open to seek help early, rather than trying to hide their issues until they are out of control. Health fairs, employee committees on health and wellness, and outside speakers brought in to discuss substance abuse issues can go a long way to making workers feel it is OK to discuss their problems before they become worse.

 

  • Provide adequate benefits.
    • Preventive and treatment services available to employees can greatly mitigate opioid-related problems. Healthcare plans that cover pain management alternatives to opioids, such as massage, cognitive behavioral therapy, or different medications, can eliminate the problem by steering workers to other solutions from the get-go. Employee assistance programs can help workers who may be heading down a bad path get back on track. In addition to having EAPs, employers need to inform workers of their existence and what they offer.

 

  • Work with providers and Pharmacy Benefit Managers.
    • Medical providers who are committed to reducing opioid use among workers are extremely valuable to the effort. Employers can also work with providers who are not entirely on board with the efforts to decrease unnecessary opioid use. Working with pharmacy benefit managers can ensure that only a limited supply of an opioid is approved.

 

Conclusion

While the rate of new opioid prescriptions among injured workers has decreased in recent years, there are still far too many workers who are or have been prescribed these medications. Opioid use disorder, dependency, addiction, and death are still prevalent in society and the workplace. Organizations that understand this and adopt strategies to address it will help their employees and themselves.

 

 

 

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: http://blog.reduceyourworkerscomp.com/

 

©2020 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 Power of Making Connections In Your Organization

Very simple things can make a significant impact on an organization. Unfortunately, when there is no process or structure in place to capture relevant organization connections, there is missed opportunity and inefficiency. What is intended to be a good thing for an organization (Separate Process Areas for a Targeted Propose) has a tendency to evolve into siloed environments that cause organizations to have “Blurred Vision”.

 

As silos become more established, they have a tendency to move towards working independently and become less focused on other relevant areas that hold connected information. It is only natural; people within a particular process area get focused on their piece of the organizational puzzle and become less familiar and less concerned with other important pieces of the puzzle.

 

Actual “Silos” (vertical structures on farms) typically stand right beside each other. Although silos may be close to each other logistically, if you step into or are on the other side of a silo, you are unable to see the other silo that is literally right next to you.

 

This type of environment is not uncommon in organizations. Organizational process areas can reside next to each other, people within the process areas can walk by each other daily, sit beside each other in company meetings/functions, interact socially, but miss identifying simple and relevant organizational connections.

 

The Risk Leader has a responsibility to look cross-functionally at their organization. Cross-functional Vision is a “Risk”. It needs to be identified as such and processes and/or controls need to be put in place to permeate the silos and make important connections that otherwise do not get made.

 

 

Cross-Functional Vision

 

Most organizations have cross-functional vision issues. As the silo’d environments start evolving, the organizational lenses are not adjusted to see similar needs and opportunities that reside in different process areas.

 

Silos are in organizations for a reason and provide needed value. The objective is not to eliminate silos. Silos are where collaboration takes shape, direction and focus becomes targeted and stakeholders can build trust and a sense of belonging. The unique expertise the silo holds provides market intelligence and technical know-how to be experts in a dimension of the organization.

 

Putting process and focus into cross-functional vision promotes protection against the negative ramifications that silo’d environments bring. In addition to not seeing/making natural connections, the negative ramifications of silos include redundancies and lack of transparency that can lead to excessive organizational noise and process areas that hold on to risks that can be harmful to an organization.

 

Each silo’d area holds a piece of the bigger organizational puzzle. When there is no foresight to see cross-functionally, simple but powerful solutions do not get recognized and the broader puzzle does not get put together.  Not correcting this vision issue is wasteful and costly to organizations.

 

 

Correcting the Vision

 

We live in a world where laser eye surgery is commonplace to correct nearsightedness and farsightedness. It is technology that allows for 95% of cases to be successful in the first attempt. Like technology that has evolved for our personal vision, there is organizational laser surgery available that is not complex, is pain-free and can bring a significant ROI.

 

The work (organizational surgery) is to insert some consistency and repeatable processes into business process areas/silos so that commonalities can be recognized. This consistency is a way for process areas to identify both risks and opportunities and make important connections where they exist.

 

An essential part of the best practice is for an organization to establish a basic “Risk Register” that each process area contributes to by identifying and reporting their specific risk. As this risk gets housed in a central location through a standardize process, simple but powerful connections can start to be made.

 

Organizations will see immediate value by having structure to identifying risks, structure to organizing and prioritizing the risk and structure to reporting the risk so that the data can be aggregated up. As this process occurs and information aggregates up, it allows the organization to correct its cross-functional vision issues and for more global options and solutions to surface.

 

An additional and simple part of the organizational surgery is putting a consistent and repeatable process to quantify risk that is identified. Cross-functional vision gets blurred when there is no structure to putting a “Value” to risks that each process area holds. This is corrected by surgically applying a “Rating Process” that works cross-functionally so that apples to apples comparisons can be made with an organization’s limited time and resources. This surgical fix will correct the vision within silos and among/across silos.

 

By inserting a register that includes consistency to collecting data (risk) and a rating process with effective reporting from silo’d process areas, organizations will have significantly corrected their cross-functional vision issues.

 

The value of having this organizational “Corrective Vision Surgery” is that they will start seeing and making connections and organizational corrections that otherwise would not get made.

 

 

 

Author Mark Bennett, Founder of Risk Innovation Group (RIG), is dedicated to helping large employers face the complexities of risk through innovative Enterprise Risk Management (ERM) practices. ERM programs don’t just help large employers manage business risks more effectively; a well-developed ERM program can protect and create value as well as improve business performance and generate a strong competitive advantage.  Contact: m.bennett@riskinnovationgroup.com

4-Step Strategy to Successfully Settle Workers’ Comp Claims

Getting to a settlement can and should be a win-win for both payers and the injured worker. While most injured workers recover and return to work as expected, some stay in the system far longer than anticipated. Aside from catastrophic injuries, closing these ‘legacy’ claims can be extremely challenging.

 

It may seem impossible to move claims that have been on the books for months or years. But the expense to the payer and the inability of the injured worker to move on with his life are not in the best interests of anyone. Instead, stakeholders can reach settlements on these claims by partnering with the right experts and following best practices.

 

 

Understanding the Barriers

 

Empathizing with the injured worker is one of, if not the most important elements to settling claims. Claims managers, faced with a plethora of cases day in and day out, may lose sight of what’s actually going on in the mind of the employee. What they and other stakeholders need to understand is the driving force that keeps some injured workers in the system long-term; fear.

 

  • Fear of running out of money
  • Fear of having to navigate the healthcare system alone
  • Fear of having no support, from a claims adjuster, nurse case manager, attorney and anyone else who’s been involved with the claim

 

While in the system, the worker’s medical bills are automatically paid, they have a steady stream of money through indemnity payments, and they don’t have to haggle with providers over money. Once they leave the system, that all goes away. Stakeholders can have much more success settling claims by looking at the situation from the injured worker’s point of view.

 

Settling long-term claims is complex, as there are many moving parts. An adjuster trying to settle a claim on their own could be overwhelmed, as they would need an in-depth understanding of these and many other issues. That’s why a team approach is imperative to reach more settlements with injured workers.

 

 

The Team

 

The circumstances of the claim and the injured worker will help determine who should be included on the settlement team. The team should consist of:

 

  • Claims Adjuster. The claims adjuster is the backbone of the claims handling team who leverages the expertise of various settlement team members to both ease their workload and settle claims more effectively.

 

  • Employer. The employer owns the relationship with the injured worker and is an integral part of maintaining communication, rapport, and a connection to the workplace. The working employer-employee relationship will also provide insight into the desires, hopes, and dreams of the injured worker to help create a win-win settlement plan.

 

  • Settlement advisor. Structured settlements can offer significant benefits over lump sums. They are tax-free, periodic payments that are placed with a highly-rated life insurance company. Research has shown that recipients of lump sums often go through the money much faster than expected. Structured settlements help ensure there will be money throughout the person’s lifetime, and even beyond. These also offer flexibility in terms of how they are paid and how much.

 

  • MSA vendor. The Medicare Secondary Payer Act requires that Medicare not pay for coverage that should be the responsibility of a primary payer, which includes workers’ compensation. In addition to workers who already receive Medicare benefits, other workers may also need an MSA. The government has established certain thresholds that determine whether a person who is not currently on Medicare may qualify within a certain timeframe.

 

The MSA vendor can help

 

    • Determine if an MSA is necessary
    • Develop the MSA in a way that it can be effectively used for settlement
    • Seek approval from the Centers for Medicare and Medicaid Services

 

  • Professional administrator. Professional administration is a post-settlement support system for the injured worker. It fills the void left by the disappearance of all other stakeholders once the case has settled. Professional administrators can help manage the funds, ensure compliance with MSA requirements, and may offer network discounts for medical providers, treatments and medications.

 

  • A defense attorney who has been involved in the claim can be a valuable part of the team, as this person may be able to provide information and documentation, and communicate with the injured worker.

 

  • Medical advisor. In addition to determining whether prescribed medications and treatments are appropriate for the injured worker’s condition, this person can also ensure that any diagnoses are correct. They may also be able to identify brand-name medications that could instead be generics, and determine if prescribed opioids are necessary and, if so, for how long.

 

 

4-Step Process

 

Once the team is established, it can begin the process of getting to settlements with injured workers. Four best practices have been shown to be highly effective.

 

  1. Identify claims for settlement early.

 

Determine the trigger points of claims that are ripe for settlement. Among them are those in which the injured worker is:

 

  • Physically stable and has consistent medical treatments and prescriptions. An injured worker with upcoming surgery would not be a good candidate for settlement, as the costs may be extremely variable.
  • Extremely frustrated, with denials for treatment and/or independent medical exams
  • Fearful about running out of money, losing his support system, and dealing with Medicare and the MSA reporting requirements

 

 

  1. Engage the team.

 

Typically, the settlement advisor is the point person to move things forward. This person can reach out to the other team members to gain their input on whether the injured worker is appropriate for settlement talks. The advisor can provide and/or obtain information from vendors and other team members such as:

 

  • Medical history
  • Attorney representation
  • Prescription drug cost projections from Professional Administrator
  • Clinical/pharmacy review of the treatment plan
  • Pre-MSA triage talks from MSA Vendor

 

 

  1. Conduct roundtable discussions with the team to leverage settlement best practices.

 

Building trusted relationships and working together can help the team brainstorm on the various issues involved and determine how best to approach the injured worker, either directly or through his attorney. This stage involves soft tactics as well as technical tactics.

 

Soft tactics include discussing the worker’s fears, concerns and desires. Technical tactics include such things as gathering documents and information for settlement projections or a MSA, and pricing out future medical treatment and prescription costs. These conversations should also include a look at the post-settlement life of the injured worker and ongoing support, especially through a professional administrator.

 

 

  1. Negotiate the lowest reasonable settlement amount.

 

Once the team has discussed a plan, as well as a settlement amount, conversations with the injured worker can begin.  The discussions should include all the options and fees involved, such as the approximate $1,000 fee for a professional administrator.

 

The discussions leading up to the negotiations should be such that all are in agreement that the plan will adequately provide for the injured worker’s life, and is realistic to the payer. Therefore, emotion can be removed from the case.

 

 

Summary

 

Injured workers who are unnecessarily still in the workers’ compensation system will agree to settlements if they can see that the amount of money and ongoing support are appropriate. Gaining an understanding of the injured worker’s thinking and working with the right experts can help payers move claims to settlement.

 

 

 

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: http://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 The Super Bowl Taught Us About Workers’ Comp Claims

Even though the Kansas city chiefs were down by 10 points late in the second half of last night’s Super Bowl 54 to the San Francisco 49 years, you just kind of felt that something was coming.

 

Hello, my name is Michael stack and I’m the CEO of Amaxx and today I want to talk with you about that Chief’s victory, how it gave us a great roadmap and preview of how to actually handle and understand how a work comp claim is going to go. That predictor, that feeling that something either going to go really well or possibly go really poorly and it’s those ones that are going to possibly go really poorly that we need to pay attention to because those are the ones that caused those really poor outcomes for the injured workers and cost us a bundle, a bundle of money and frustration. So, we want to avoid those as much as possible.

 

 

Intervene EARLY In a Workers’ Comp Claim

 

So we need to get in front of them and we need to intervene early. And we know the earlier we intervene, the better we’re going to do. So, I want to give you two really quick tips here on how to get in front of this. If you followed any of the NFL playoffs this year, you know that the Chiefs were down by at least 10 points in every single one of their games, so when they were down again in the Superbowl, it wasn’t a big deal. You knew that they could overcome it. The fans knew that they can overcome it in the stadium and us watching it on TV knew that they could like the overcome it. It’s such a great indicator, such a great preview, such a great lesson for us to learn the work comp industry. They were extraordinarily resilient. They’d done it in the past and they’re going to probably do it again in the future.

 

 

How Well Have Injured Workers’ Handled Setbacks In The Past?

 

How well have your injured workers handled setbacks in the past? They had a big project. They had a big deadline. They had a big challenge, was another coworker or the supervisor or any number of billion things that could be a big issue or setbacks at work in our normal everyday lives in an office or construction site. Any type of work setting, how have they handled setbacks in the past? It is a major, major, major indicator of how they’re going to handle them in the future. If you don’t know this personally and you’re managing a claim about your injured worker, ask somebody who does because again, it’s going to give you tremendous insight into how they’re going to handle their claim and their setback and if they’ve handled everything poorly in the past as work comp professionals, we’re going to need to leverage some other tools, whether that’s case management or field case management or we’re going to leverage some other outside interventions to get in front of these problems.

 

We’re going to spend a little bit of time and energy upfront to avoid a major pain and a major cost on the backend resiliency. How have they done that? Learn that from last night, the Chiefs victory in the Super Bowl, it’s a major indicator.

 

 

Orebro Pain Screening Questionnaire

 

Now this one we didn’t learn in the Super Bowl, but it’s a great work comp technique. Anyway, so the Orebro brain screening questionnaire, it’s also called the short form 12 if you Google this, it’s free to use. It’s in the public domain. It doesn’t cost you a thing. This is a more formal way to do this. Now, this has been tested over many, many years and up to 95% accuracy. The Orebro pain screening questionnaire can tell you, how well they’re going to handle and injury. Are they going to do well? Are they going to not going to do well and again, leverage those interventions for the ones that need that extra support.

 

It’s going to cost avoid so much money and so much pain and frustration and really drive that better outcome for the injured worker. This test is administered two to four weeks typically into the claim and this can be done by a case manager. It could be done by a third-party vendor, it could even be done by the adjuster that administers this task. Look it up, leverage it.

 

 

Create Better Outcomes & Dramatically Reduce Workers’ Comp Costs

 

Neither one of these costs of thing. It’s just about being intentional about having that feeling, that indicates that something’s going to go, and then getting on top of it and being a professional in handling it so that you can create that better outcome and dramatically reduce your workers’ compensation costs, particularly for following these systems.

 

Again, my name is Michael stack. I’m CEO of AMAX, and remember your work today, sitting at your desk, particularly following these systems, 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: http://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.

Reduce Work Comp Costs Through a Safety Professional

Interested stakeholders are always seeking to reduce workers’ compensation program costs with a focus on injury prevention.  Safety measures are critically necessary to ensure work-related accidents do not occur.  If and when accidents do occur, you must have post-injury procedures in place to quickly address that accident, provide medical care to the employee if necessary, and return the employee to work in a modified or full-time duty position as soon as possible.  This includes designing a program that will enable you to manage both safety and workers’ compensation costs.

 

 

Effective Tools to Reduce Program Costs

 

The same tools you used to build your safety program can also be used in managing your workers’ compensation program.  Since a strong safety program is in place, once all employees are trained in as to signage, workplace safety, toolbox safety, handrail safety, etc., a post-injury response training program can also be developed.  Since communication is such a large part of safety, effective methods can be also be developed.

 

  • Use templates that are adaptable to develop a workers’ compensation policy such as an employee brochure, post-injury response documents, letters to medical people and claims handlers, a communication strategy; and

 

  • Assess how your workers’ compensation management program mirrors your safety program to acquaint yourself with the myriad factors impacting your program costs. This should include using a workers’ compensation tool that is driven by metrics to allow interested stakeholders to understand where injuries occur and how they can be prevented.

 

 

What to Do Next

 

Stakeholders in workers’ compensation programs should be open to receiving recommendations.  This should be in the form of a prioritized list developed from the assessment.  A plan of action is also necessary and should include a calendar plan with identified action items, and cost estimates.  It may also include the involvement of a company finance officer to ensure the plan receives adequate resources to do the job management gave you based on your company’s “safety experience.”

 

Issues companies should consider include:

 

  • Instituting a strong post-injury response procedure;

 

 

  • Reviewing your claims handling practices to ensure claims handlers are responsive and plugged into your situation;

 

  • Bringing injured employees back to work; and

 

  • Launching a communications program for the employee population (this includes writing a workers’ comp policy, a brochure detailing the policy and post-injury response procedures, and a get-well component for keeping the lines open without-on-comp employees

 

Considerations for returning employees to work include:

 

  • Designing modified duty positions as part of your transitional duty program for employees out of work for a short period of time.; and

 

  • Convening file reviews to develop remedial action plans for those employees who are out of work for long periods of time. File reviews would typically take place at the insurer’s worksite.  Participants should include the claim handler and a qualified vocational consultant.  Discuss each case and decide the next steps for bringing the case to resolution.

 

 

Conclusions

 

Effective workers’ compensation programs need to focus on all interested stakeholders.  This includes an evaluation that keeps the employer profitable, but at the same time, focuses on employee safety.  Key metrics need to be analyzed and used when preparing an effective plan.

 

 

 

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 the founder & lead trainer of Amaxx Workers’ Comp Training Center.

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://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.

Diversity in Workers’ Comp Claims Management

The ever-changing American workforce presents many challenges for claim management teams as they seek to hire, train, and retain claim handlers.  One of these challenges includes dealing with a workforce that was not born in the United States, is a newly arrived immigrant, or someone who has little to no knowledge of the English language.  Claim management teams should embrace this challenge and use it as an opportunity to expand their workforce as they seek to establish and expand their diversity and inclusion efforts.

 

 

Share Experiences Among Staff

 

We all come from different backgrounds, whether it be socioeconomic, race, or religion.  These factors make each individual unique – we all have a story to share.  This requires everyone on the claim management team to approach problems with an open mind and being willing to accept the viewpoint of someone else.  Other ways to address these issues and expand the knowledge includes taking time at staff meetings to share experiences, and provide suggestions on how to approach an issue on a workers’ compensation claim.

 

 

Se Habla Español?  Si!

 

The United States does not have an official language.  The result is millions of Americans either do not speak English, or have limited use of the language.  This creates a challenge for the claims management team as they address matters involving non-English speaking employees who have suffered a work injury.  Suggestions to meet this challenge include:

 

  • Create job openings for multi-lingual staff. This can include having positions that require the applicant to be fluent in common second languages such as Spanish, Somali, Chinese (Cantonese, Mandarin, other varieties), French and French Creole, Tagalog, and Vietnamese; and

 

  • Subscribe to telephonic “language lines” that allow claim handlers to access someone fluent in other second languages; and

 

  • Prepare documents in other common languages that explain the workers’ compensation process.

 

External steps can also be undertaken.  This can include locating organizations that work with diverse cultures and coordinate career fair opportunities with these new partners.  An effort should also be made to focus on outreach to businesses owned by minority groups.

 

 

Do Not Forget About Employees Living in Rural Areas

 

Employees living outside metropolitan areas face many challenges.  This includes frequent travel to receive medical care and treatment, and limited options in terms of specialists who perform surgery or treat catastrophic injuries.  Investments by a claim management team in technology-based tools can pay dividends.  This includes the following:

 

  • Telephone medicine;

 

 

  • Prepaying travel and reasonable meal expenses for those required to travel more than 150 miles.

 

 

Understanding Your Jurisdiction’s Demographics

 

Members of the claim management team should also make an effort to understand the demographics of the jurisdictions they cover.  Developing this understanding can become difficult as many claim handlers work files in multiple states.  One way to help everyone to understand the unique characteristics of a workforce is to invite a state demographer to a staff training event and have them share statistics on state diversity, and future trends.  This information will allow everyone on a team to brainstorm on ways to address the characteristics of the current workforce, and what changes need to be made moving forward.

 

The demographics of a claim team are also important.  Ways to address a group and meet their diverse interests could include:

 

  • Cross-train staff to capitalize on interests, strengths, and education;

 

  • Create a two-way performance review, which would allow claim handlers and their supervisors to better understand each other;

 

  • Balance business needs with staff strengths, individual lifestyles and being outcome-focused; and

 

  • Dive deeper into succession planning and opportunities for mentoring and career path growth.

 

 

Conclusions

 

The changing workplace is placing new demands on claim management teams.  This should be viewed as an opportunity to demand diversity and inclusions efforts internally, and in the larger community.  The result will be a better claim management team that is conscious of employees coming from different backgrounds and address their situation in a better manner.

 

 

 

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: http://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.

Injection Therapy in Workers’ Compensation

The use of injection therapy in workers’ compensation is a growing trend that is being used for a variety of injuries.  This includes primarily injuries to joints such as knees, elbows, and hips.  It also has practical applications for other injuries involving claims to the back and neck.  Members of the claim management team should be aware of emerging trends to better manage claims.

 

 

Understanding Common Injection Therapies

 

Therapy injections are injected directly into a joint or tissue with a local antithetic.  This procedure is primarily performed primarily in a clinical setting.  It can be performed by a doctor, or other mid-level practitioner such as physician assistant, nurse practitioner, and other approved clinical officer.

 

Common injections include:

 

  • Corticosteroids such as general steroids, or cortisone, which is a mixture of medications used to reduce inflammation in tissue. They are rather inexpensive and generally cost about $50 to $200 per injection; or

 

  • Viscosupplmentation injections such as Hyaluronic Acid, which is found in human cartilage. These injections serve as a lubricant or shock absorber and are frequently used to reduce pain in patients suffering from arthritis and osteoarthrosis.  They are performed in a series of injections, usually sets of three, and on a weekly basis.  These injections are more expensive, and generally cost around $1,200 to $1,500 for the series.

 

 

Work Comp Injuries Involving Injection Therapies

 

There are a variety of instances where the use of injection therapy to cure and relieve the effects of a work injury has a common application.  You will find this therapy being recommended in instances that involve:

 

  • Knee or other joint arthritis;

 

  • Lateral epicondylitis (tennis elbow);

 

  • AC joint osteoarthritis;

 

  • Carpal tunnel syndrome or de Quervain’s Syndrome;

 

  • Hip impingement syndrome;

 

  • Trigger finger; or

 

  • Plantar fasciitis.

 

They are also commonly used in back injuries involving spinal stenosis, or disc herniations.  The most common uses for therapeutic injections in workers’ compensation claims involve:

 

  • Meniscus tears: The meniscus serves as the padding or “cushion” in the knee.  Changes occur through an acute injury (twisting or pivoting motions) or degenerative changes caused by repeated movements over a period of time.  In some instances, injections to the knee are not recommended given its location inside the joint.  However, it can provide effective conservative care that prolongs the need for surgery and minimizes pain and swelling; and

 

  • Rotator cuff tears: Inflammation in the shoulder’s bursa and rotator cuff tendons are common sources of problems in workers’ compensation claims.  Movement of the shoulder only adds to issues.  Injections that are combined with physical therapy should be a standard protocol as surgical intervention can be costly, in terms of medical expenses and times lost from work.

 

 

Tips for Effective Claim Management

 

The claim handler needs to be aware of how injection therapy is used, and when it is reasonable and necessary.  Proactive members should be aware of the following before admitting injuries outlined above, or authorizing this form of treatment:

 

  • Ask detailed questions regarding the mechanism of injury. When in doubt, consult with a medical director, or defense attorney who has an understanding of these type of claims;

 

  • Review all relevant medical records associated with the claim. The injured employee should have unsuccessfully completed other treatment modalities before undergoing therapeutic injections.  Any medical provider recommending therapeutic injections must provide a reasonable justification for the procedure(s);

 

  • Requests for therapeutic injections in “off label” situations can present a number of issues. This is something that should be escalated to a claim manager or roundtable discussion; and

 

  • Understand therapeutic injections can be an effective form of conservative care when performed in the correct manner. They can often be used in conjunction with physical therapy to providing lasting, long-term relief.  It can also be used to avoid the need for more expensive and invasive procedures such as surgery.

 

 

Conclusions

 

Therapeutic injections can serve as effective medical care and treatment for a variety of work injuries.  It is important for claim handlers to understand the mechanism of injury, prior medical care, and medical justification before approving this treatment modality.  Failure to do so can result in unnecessary litigation, and prolonged medical care and disability.

 

 

 

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: http://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.

Safety in the Trucking Industry

Safety is the number one priority of the risk manager at a trucking company fleet. The cost of accidents involving big trucks is substantially more than the cost of accidents in almost any other business. Truck accidents have both the potential for significant property losses, and accidents pose an increased level of risk to drivers, especially in large trucks. Workers’ compensation costs for trucking companies is higher than most businesses.

 

Whether the trucking company is a common carrier, private carrier, inter-modal carrier, hauler of hazardous cargo, moving van company, dump truck company, or logging company, the most efficient way to influence the cost of workers’ compensation is an established safety program. Here are safety program recommendations trucking companies can consider.

 

 

  1. Written Accident Prevention Plan

 

Your safety program must be more than telling the drivers to “drive safely.” Your accident prevention plan must be a written, comprehensive manual provided to every driver. Drivers must be tested on their knowledge of your company’s safety requirements.

 

The written safety plan outlines — Required pre-hire training a driver must have:

 

  • Safety training a driver will be required to complete while employed;

 

  • Frequency and location of safety meetings;

 

  • Red flags. Those safety violations causing driver discipline or termination;

 

  • Company policy on hours of operation;

 

  • Steps to check the safety of the equipment;

 

  • Employer drug testing policy;

 

 

  • Post-accident retraining policy; and

 

  • Safe driver recognition program.

 

None of these points may be omitted!

 

 

  1. Driver Training

 

With the shortage of qualified truck drivers, especially long-haul drivers, you must establish a policy on whether or not the company hires only experienced drivers, will train your driver recruits or will utilize a truck driving school for driver training. Regardless of the experience, the following must be a consideration:

 

  • All drivers must be skill tested to verify they can operate the trucks in a safe and careful manner; and

 

  • A trainer/instructor rides with each new hire until the trainer is satisfied the new driver operates the truck in accordance with all established safety guidelines.

 

 

  1. Safety Meetings

 

Required safety meetings should be held at least monthly to review a safety topic. The agenda can vary and include:

 

  • Accident prevention;

 

  • Equipment safety; and

 

  • Fatigue management.

 

Hold the safety meetings at your terminal(s) to ensure maximum participation. Record each safety meeting for those drives unable to attend the safety meetings.

 

 

  1. Red Flags

 

Make the avoidance of risky behavior a condition of employment at your company. Place on probation drivers cited for speeding or other moving violations. Terminate drivers receiving multiple traffic violations. Monitor other driving behaviors such as leaving the designated route, complaints from the general public, unusual acceleration/deceleration, and failure to maintain proper logs.

 

 

  1. Fatigue Control

 

Drivers paid by the mile are often tempted to push the limits of their physical endurance. Strict policies need to be in place to ensure the drivers meet the minimum Department of Transportation (DOT) requirements for rest. Consider the following limitations:

 

  • Number of hours driven by drivers; and

 

  • Number of miles driven, especially at night.

 

Consider paid mandatory driving breaks to reduce the temptation to game the system and fight fatigue.

 

 

  1. Equipment Checks

 

Require every driver to check the truck before beginning a trip. Inspections include tires, brakes, hydraulics, lights, and wipers are a must.  Equipment and parts not operating correctly must be replaced before the trip begins.

 

 

  1. Drug Testing

 

Drug testing is an essential requirement for a trucking company. Administer both a pre-employment drug test as well as random drug testing. Schedule random drug testing often enough to so the potential for getting caught deters drug use.  Strict enforcement of this policy will also create a culture of compliance and assist when defending workers’ compensation and other claims.

 

 

  1. Accident Investigation

 

Investigate every accident to determine its cause. While driver inattention is the primary cause of accidents, other factors can play a role, including weather, equipment condition, and actions of other vehicle operators. By identifying what caused the accident, post-accident retraining will better benefit the driver.

 

 

  1. Post-Accident Retraining

 

Provide additional safe driving training to any driver involved in a traffic accident to reduce the potential for future accidents. The drivers involved in accidents can also be given competency testing to verify their knowledge of how to operate safely.

 

 

  1. Safe Driver Recognition

 

Recognize drivers who compile safe driving and reward them. Drivers who operate their equipment for a year without an accident or traffic citation may receive a plague and/or an additional cent per mile, or other tangible recognition.

 

 

Conclusions

 

It is important to keep truckers moving in a safe and efficient manner.  Implementing a safety policy and sticking to it can create a culture of compliance, and reduce workers’ compensation costs.  It will also promote a better work environment and pay dividends in other forms.

 

 

 

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 the founder & lead trainer of Amaxx Workers’ Comp Training Center.

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://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.

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