Mediation to Successfully Settle Workers’ Comp Claims

mediation to settle workers' comp casesMediation is frequently used in workers’ compensation cases to settle claims and avoid the uncertainties of litigation.  This is because it allows all interested stakeholders to be involved in the process and allows for outcomes not otherwise attainable in court.  When preparing for a mediation session, it is important for those involved to prepare and assist the neutral third party in better understanding the case.  One tool to accomplish this goal is to prepare a confidential mediation statement.  It not only helps the mediator but allows those involved to reflect and understand their claim.

 

 

Getting the Process Started – Agreeing to Mediate

 

Mediation can be a formal or informal process to settle a workers’ compensation case.  The structure involves a neutral third party who understands the process and controlling statute to help the parties evaluate their position and move a case toward settlement.  Selection of a neutral third-party requires cooperation between the defense and employee interests.

 

In very few instances is mediation “required” as part of the workers’ compensation claims process.  However, this should never prevent parties to a workers’ compensation case to use it as a means to settle a dispute.

 

 

We’re Going to Mediate – Now What?

 

Mediating a workers’ compensation case must be taken seriously.  It requires preparation and evaluation by all parties.  In many instances, the selected mediator will request the parties to prepare a mediation statement.  This is a letter prepared by the respective parties and should be kept confidential.  It should be factual, so the third-party assisting in the settlement can help.  It can also contain other important documents relevant to the case that outline a party’s position.

 

There is no one right way to draft a mediation statement.  Important elements to consider should include the following:

 

  • Defining the claim: When both parties outline the claim, it will allow the mediator to ensure both sides are beginning from the same starting point.  A classic example of this is a determination of the average weekly wage (AWW).  Because most indemnity benefits are based on this number, the value of a claim can hinge on the AWW.  It is also important to outline defenses to a claim.  This has a huge impact on the potential recovery and future exposures.

 

  • Procedural posture and prior negotiations: Providing this background information allows the neutral third-party to understand a case’s starting point and what the ultimate objectives of the parties include.  It will also allow the mediator to understand other important case dynamics.

 

  • Honest assessment cases strengths/weaknesses: This is especially important in instances where there is a denial of primary liability or the reasonableness/necessity of medical care and treatment.  Honestly going through the process allows all attorneys and members of the claims management team to understand the claim better and set realistic expectations.

 

  • Pertinent medical and vocational reports: These documents include IMEs, IVEs, FCEs and narrative reports from the employee’s treating doctor.  These reports and documents typically provide a good summary of the claim and help the mediator better understand the case.  It also allows the parties to understand the strengths and weaknesses of a claim.

 

 

Other Things to Consider

 

A mediation statement is also a great tool to inform the mediator about the case intangibles and dynamics.  It is important for a mediator to know information such as the special needs of a client and issues that are a “must-have” in any settlement.  This often includes a global settlement and voluntary resignation of the employee as part of the settlement.

 

 

Get Help Planning & Preparing for Mediation – For No Cost

 

With many aspects involved in a successful settlement, interested stakeholders can benefit greatly from professional settlement assistance. A settlement consultant comes at no cost and is a settlement expert with knowledge and access to various settlement tools to address the most challenging workers’ compensation claim issues. These experts can be brought into the process early on, so the settlement is set up appropriately.

 

Rather than just running quotes, the settlement consultant should act as the general contractor in identifying, bringing and managing the best experts to the table to address the issues preventing a positive outcome for all parties in the case.

 

 

Conclusions

 

The use of mediation in workers’ compensation is growing in popularity given its practical uses in settlement.  When preparing for mediation, it is important for all parties to prepare.  Part of this includes the use of a confidential meditation statement to provide a background to the neutral third-party and help the parties better evaluate their case.  It also serves as a means to make efficient use of time and reduce costs.

 

 

 

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.

Four Techniques to Effectively Communicate Safety in the Workplace

effectively communicate safetyEffectively communicating safety is a topic all interested stakeholders need to increase awareness. Not only is it required by law, but is reduces workers’ compensation program costs and promotes a better workplace.  When communicating safety, proactive employers and other interested stakeholders often struggle to find an effective means of communication with employees.

 

 

Effective Safety Communication Methods

 

There are many things employers can do to promote workplace safety and communicate important concepts to employees.  Simple suggestions that are effective include:

 

  1. Safety Equipment & Required Signs: A safety coordinator should review and determine what safety equipment is required in each area.   This should include a review and determination of the location signs may be needed, and where they are needed.  This consists of a review of the primary workspaces, individual offices, computer rooms, stairwells, bathrooms, other common areas, and parking garages and lots. Signage should be ordered and installed promptly. A periodic review should also take place.  This is something that can be done at the beginning of each month, and include an annual audit to ensure full compliance.

 

  1. Safety Awareness Posters: Every safety program should ensure all employees are aware of safety concerns in each area or location. These can be thought-provoking or humorous signs to highlight safety issues. Never hide safety awareness signage. Make sure they are placed in high traffic areas and rotated regularly.  A diverse workforce demands signs should be in all languages that are used in the workplace. These posters can be ordered from several vendors specializing in non-English signage.

 

  1. Safe Days Posters: Employers seeking to implement an effective safety program must communicate it to their entire workforce – and continue to do so on an ongoing, and regular basis. It is important to communicate to the whole workforce how well (or poorly) the safety program is working.  Steps should be taken, such as recognizing, and rewarding the efforts of employees for making the workplace a safe environment. Standard tools used to promote a culture of safety can include a chart highlighting the number of consecutive workdays without an injury for the facility, and also by department. Competition between departments can add increased consciousness of safety.

 

  1. Safety Recognition & Incentive Programs: Safety program incentives can be used to create employee interest in the safety program and motivate employees (and managers and supervisors) to act and work safely. But, if the incentives become the focus of the safety program and actual safety is not the focus, then the incentives become interference in obtaining a true safe working environment. Instead of the emphasis of the safety program being on the incentives, the attention should be on training the employee how to work safely. Educating the employee in the proper performance of their job will have a more significant impact on the overall safety record of the employer than an incentive program. If the employees do not know how to work safely, the incentive program will fail.

 

 

Other Safety Considerations

 

Engagement and follow-through by all interested stakeholders, including a company president or CEO.  If employees see active engagement and participation by everyone, the message will be reinforced.  Failure to do so will result in a failed mission, and the objective will never be completed.  Leaders need to lead by example.

 

It is also important to understand that safety is a continual process.  Once an effective program is in place, it requires frequent maintenance and review.  Improvements can always be made with involvement from all employees.

 

 

Conclusions

 

The best way to reduce work injuries is to prevent them from occurring.  The implementation of a safety program can accomplish this, along with an effective means of communication.  Now is the time to engage your workplace and promote a safe working environment.

 

 

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.

Bringing Understanding of MSA Complexities at WCI in Orlando

Understanding of MSA CompliexityMedicare Set-Asides are a pain-in-the-neck nightmare for many workers’ compensation stakeholders. They are expensive, complicated, and seemingly fraught with landmines. One misstep could cost a bundle for you and anyone else involved.

 

Concerns over MSAs result in a plethora of workers’ compensation claims left open – often years after they could have and should have been closed. Payers end up spending far more for ongoing medical than would have been allocated in an MSA, had the case been settled long ago.

 

But there is good news! MSAs don’t have to be ridiculously expensive or complex. Yes, they need to be carefully managed, and they need to be overseen by someone with a deep understanding of the intricacies of the Medicare Secondary Payer Act and the Centers for Medicare and Medicaid Services’ processes. Employers, payers, and others who have a basic insight into MSAs can approach claims settlement realistically, getting long-term claims off their books and helping injured workers to be in the best position to move forward with their lives.

 

A major employer and an MSA expert will take a deep dive into the issue during the 74th annual Workers’ Compensation Educational Conference (WCI), Aug. 11 – 14 at the Orlando World Center Marriott. Their focus will be on ways to measure and manage MSA costs. The session, Optimizing Settlement Outcomes by Measuring and Managing MSA Costs takes place Wed., Aug. 14, at 10:00 a.m. I’ll have the pleasure of moderating the session.

 

 

Measuring

 

The first step in assuring accurate future medical costs is to know what is in them. For example, do you know:

 

  • How many of your MSAs contain prescription drugs, the most commonly cited reason for high MSA costs?
  • How many contain prescription medications?
  • Your average CMS approved MSA amount?
  • Your trend lines year over year for your MSA program?

 

Attorney Dan Anders, the chief compliance officer for Tower MSA Partners, and Kris Sallee, claims manager-Eastern Region for American Airlines will provide metrics that will help you determine your MSA program success. Anders will show national standards, while Sallee will offer her company’s metrics to better understand how to measure your own program. Most importantly, the speakers will explain what the metrics mean and how they can be used to improve your MSA program.

 

 

Cost Management

 

Once the metrics are understood, it’s time to get down to the business of actually managing the costs of an MSA. The same types of best practices used for handling claims also come into play when developing MSAs, such as clinical interventions. For example, reducing unnecessary treatments and medications during the claims handling process will reduce the cost of the MSA.

 

Certain treatments, such as spinal cord stimulators and revision surgeries are most likely to increase MSA costs – and are often unnecessary. Likewise, certain medications may no longer be needed for the injured worker. Or there may be instances where a generic medication can be substituted for a brand name, either currently or in the near-term future when a patent for a particular medication expires.

 

The speakers will show attendees how to draft an MSA with an eye toward cost and frequency, as well as identifying opportunities to limit the MSA before sending it to CMS. Submitting the MSA can be tricky, and the panelists will address the necessary steps, especially the re-review process, when a dispute can be raised.

 

Finally, the speakers will allocate time for questions about all things MSA.

 

 

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.

DOL Strength Levels – Does Oversimplifying Job Demands Increase Exposure To Injury Risk?

DOL Strength Levels

This article originally appeared on MyAbilities.com

 

Article Summary: The DOL strength levels classify jobs into 5 separate categories defined by force/weight, and frequency of exertion. The classification system leads to a broad oversimplification of the demands of work, which in the worst case can lead to over and underestimates of physical demands of over 500%. A much more granular system is needed to better understand the different physical demands of work, and how that can be used in return to work, and injury prevention.

 

 

The Department of Labor’s strength definitions are widely used when determining the physical demands of a job, or the capacity of a worker when it comes to post-offer of employment testing,  return to work, disability management, and functional capacity evaluations. These strength definitions aim to look at the material handling component of jobs, and state what is required of the worker to be able to successfully perform that aspect of the work. Strength demands of work are broken into 5 categories – sedentary, light, medium, heavy, and very heavy. Each of these demand levels have a force and frequency component – stating what weight a person can lift, push, pull, or carry at a given frequency (Table 1).

 

DOL Chart

Table 1. Force/Weight, and frequency characteristics for the DOL levels of Sedentary through Very Heavy.

 

 

Most Common Jobs in America Are In Medium Category

 

According to the Bureau of Labor Statistics, the most common jobs in America are in the medium category – but this varies greatly by industry. Management and technical jobs have more of the light jobs, whereas construction, trades, and manufacturing jobs have more of the heavy jobs (Figure 1).

 

 

 

5 Levels of Classification Lack Granularity

 

While these five levels of classification of strength are useful in providing an initial look at the demands of work, there is not a lot of granularity when it comes to establishing how a worker is capable of performing these tasks.

 

 

NIOSH Lifting Equation – Vast Majority of DOL Levels For Strength Would Be Unacceptable

 

Ergonomists have a wide variety of tools for assessing the demands of work, and many are specific to individual physical demand types. One of these tools is the NIOSH lifting equation (Waters et al., 1991) – a tool that looks at the start and end height of a lift, the frequency and duration of lifting, the twisting required, and how far the worker has to reach to perform the lift. This equation returns a recommended weight limit (RWL) – the amount of weight that could be lifted that would keep the worker’s back safe during work. If you divide the actual weight being lifted by the RWL, you will get a value indicating the overall risk level of that given lift. If that value is greater than 1.0, this lift is above the RWL and puts the worker at a higher risk of injury.

 

Looking at the DOL levels, and a simple lift from about knee height to waist height, I simulated what the RWL would be for the ranges of frequencies and lifting weights from the DOL strength levels (Figure 2). (For those who would like to replicate these calculations, the start height was 30 cm, travel distance was 45 cm, horizontal reach was 40 cm, there was no asymmetry, or coupling factors modification. For frequencies, I used the less than 1 hour factors, and V<30. Each lift was assumed to be 2 s in duration, and the corresponding FM factor was found).

 

Job Demands Table

 

Figure 2. Lifting Index for the minimum, average, and maximum frequency possible (in % of time) for each DOL strength level. Values of greater than 1 (above the black line), would be considered “unacceptable”, as they increase the risk of injury in the lifter.

 

According to the Lifting Index, and the NIOSH lifting equation, the vast majority of DOL levels for strength would be unacceptable and cause an elevated risk of injury for workers. In fact, no simulated task for the heavy or very heavy categories would be a safe lift, and only 2 of the 15 simulated lifts in the medium category would be safe lifts. What is very interesting, is these large ranges spanning the frequencies identified in the DOL strength levels, can produce a lifting index of as low as 0.87, and as high as 4.41, all within the same strength bin (in this case, Medium). That is a 507% increased risk of injury in one strength category – primarily because of the high force levels, and huge variety of frequencies defined in this methodology.

 

The NIOSH lifting equation examines risk during lifting as a factor of the amount of spine compression that is occurring. NIOSH recommends lifts should not exceed 3400 N of spine compression during lifting. The peak spine compression of a lift is an interesting variable to examine, but it doesn’t necessarily factor in frequency – which can be an important variable in assessing risk. Even without frequency, you can see the DOL levels and their corresponding peak spine compression levels (predicted using Potvin 1997’s method) often exceed what’s known to be safe (Figure 3).

 

Spine Compression

 

 

Figure 3. Predicted spine compression level from different lifts, classified by the DOL levels of strength, compared to the NIOSH safe lifting limit of 3400 N.

 

DOL levels that feature 50 lbs or higher as the acceptable lift are in the high risk category. That means, these types of jobs are only appropriate for very strong individuals, if you want someone to work there with a low risk of injury. Even then, over the long term, these individuals are more likely to sustain a back injury in the workplace.

 

 

DOL Levels Do Not Include Other Physical Demands

 

What isn’t included in the DOL levels  are the other physical demands that could lead to an increased risk of injury in these types of work, e.g. lifting at, or above, shoulder height; lifting with a flexed spine; or a poor point of contact for gripping significantly impact the risk of injury.

 

The Demand Score includes the physical demands included with strength, but also factors in reaching, gripping, handling, data entry, and many more (26 different physical demands),  compares these demands against known ergonomic standards, and develops a score from 1 to 100, helping you better understand a job, and how it compares to other jobs within the same industry.

 

In summary – job descriptions and physical demands analyses are very nuanced and detailed things. Boiling them down into one of 5 categories over-simplifies the different factors in return to work and injury prevention, which can lead to either prolonged absences, or exposure to higher levels of injury risk than previously considered.

 

 

Author: Dr. Michael Sonne, VP Innovations and Research at MyAbilities. A leading occupational biomechanics researcher, with a history of developing technologies to automate ineffective processes in the ergonomics industry. In 2010, Mike developed the Rapid Office Strain Assessment – a method for conducting self-guided, office ergonomics assessments, resulting in a reduction of musculoskeletal injuries. Mike has developed global standards for muscle fatigue assessment in repetitive work, particularly in assembly lines. Mike is an adjunct professor at Brock University, and the University of Ontario Institute of Technology, and continues to publish in peer-reviewed journals.

 

 

References:

  • Waters, T. R., Putz-Anderson, V., Garg, A., & Fine, L. J. (1993). Revised NIOSH equation for the design and evaluation of manual lifting tasks. Ergonomics36(7), 749-776
  • Potvin, J. R. (1997). Use of NIOSH equation inputs to calculate lumbosacral compression forces. Ergonomics40(7), 691-707

 

 

The Work Comp Tool Box: Employing Creative Strategies to Settle Cases

Employing Creative Strategies to Settle CasesSettling workers’ compensation cases is an important part of being a proactive and effective member of the claims management team.  It also allows interested stakeholders to concentrate their efforts on other more burdensome cases.  Most importantly, it reduces unnecessary costs to a program’s bottom line. Working with an experienced workers’ compensation attorney can ensure you get the best agreement for both the employer and the injured worker.

 

 

What is the Claims Management Toolbox?

 

Having a “toolbox” at one’s disposal is important to being a great claims handler.  Like a toolbox a mechanic uses to practice their trade, claim handlers need one as well to fix, accomplish or avoid a number of issues.  Caution – use these tools with care and only when necessary.

 

 

Limited Compromise Settlements

 

All members of the claims management team will agree, the only good file is a closed file.  In some instances, this is not possible given the interests of the claimant or on advice of their attorney.  In cases that cannot completely settle, a claims handler should examine whether the claim presents an opportunity for a limited compromise settlement.

 

Under this type of settlement, indemnity benefits such as TTD, TPD, PPD and PTD are closed out.  The only benefits available to the employee include past and/or future medical benefits.

 

Limited Compromise Settlements have some advantages:

 

  • Reduces costly exposures that may be present on a claim. This is especially the case when an employee is not incurring much in terms of ongoing medical benefits, but is struggling with return to work issues; and

 

  • Studies indicate claimants in workers’ compensation claims tend to reduce the frequency of their medical care and treatment after closing out indemnity benefits. Limited compromise settlements that leave open future medical benefits can also be helpful in instances where the parties may want to consider a Medicare Set-aside, but the cost and/or future medicals that are reasonable is astronomical.

 

 

Effective use of Hold Harmless Agreements

 

A “hold harmless” agreement is another tool members of the claims management team can use to settle cases.  When using such agreements, the parties to a settlement are creating a contract where one party agrees to release another from all legal claims.  In the context of workers’ compensation claims, this is mainly used when it comes to the reimbursement of past or future medical expenses and liens.

 

Such agreements can be used in many instances to expatiate settlements.  This includes:

 

  • Delay in the receipt of medical bills related to a claim where the amount is either known, or reasonably expected to be known; and

 

  • One party to a claim has the ability to extinguish the interests or potential intervention rights of a known third-party.

 

Hold harmless agreements should be used with caution.  While such agreements “require” cooperation from the party receiving protection, it might not necessarily be the case if litigation occurs.  In fact, the indemnified party (the party receiving protection) may need to engage in litigation in order to secure cooperation.

 

Hold harmless agreements should also be avoided in instances where Medicare and Medicaid have an interest in a claim.  The statutory framework establishing these federal programs does not prevent the applicable government agency from enforcing their rights against any party to a workers’ compensation claim.  This rationale has been affirmed by a long line of case law interpretations.

 

 

Other Tools for Effective Claim Resolution

 

Settling workers’ compensation claims requires members of the claims management team to take affirmative steps to remove barriers to settlement by using their toolbox.

 

  • Develop strategies on their teams to identify cases ripe for settlement and take steps to close files. This sometimes includes picking up the telephone and making a settlement inquiry or offer. Once identified, these cases can be submitted to a competent structured settlement consultant who may be in the best position to determine the likelihood and course for settlement;

 

  • Using mediation and promoting the use of settlement conferences to move claims toward a timely resolution. Be prepared for these events.  One may also want to consider bringing a laptop computer and printer to these sessions.  This allows for the drafting of the settlement agreement on the spot and avoid delays in final execution; and

 

  • Implement effective medical management programs to lower prescription drug costs on all files.

 

 

Conclusions

 

The development of a claims “toolbox” is one step interested stakeholders can use to reduce workers’ compensation costs.  This is accomplished by promoting the closure of files, or at a minimum resolving some issues on a file to narrow the issues in dispute.

 

 

 

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: 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.

Sit Up and Take Note: The Truth about Ergonomics

Sit Up and Take Note: The Truth about Ergonomics

Article originally published on Medcor Health Blog

 

Does your back hurt? Are you experiencing neck pain? Do you find yourself complaining of hand, arm, knee, or muscle aches? If so, you may be suffering from a musculoskeletal disorder (MSD). Discomfort/pain, numbness, tingling, stiffness, burning, cramping, and swelling of bones, joints, muscles, tendons, and ligaments can be symptoms of MSDs. If work or leisure activities are causing discomfort – it is time to become more ergonomically aware.

 

MSDs are conditions of muscles (sprains/strains), tendons (inflammation), ligaments, joints (arthritis), and nerves that are often associated with exposures to ergonomic risk factors, including: awkward postures, repetition, force, contact stress, and vibration.1 Age, sex, obesity, and health conditions (i.e., diabetes, rheumatoid arthritis, and hypothyroidism) can also play a factor.

 

 

Truth: Being Aware Of Ergonomic Risk Factors Can Significantly Reduce Your Chance Of Developing MSDs

 

Being aware of ergonomic risk factors can significantly reduce your chance of developing MSDs which have costly and disabling effects for many Americans. An estimated 126.6 million Americans aged 18 and older suffer from MSDs – that is one in two adults.2 Costs related to MSDs involve treatment (medical visits, prescriptions), lost wages, and work-related injuries, estimated to exceed $200 billion annually.3

 

MSDs often result in chronic complaints, disability, issues with mobility and decreased quality of life and are the second largest contributor to disability worldwide. Frequently, MSDs result in work-related injuries impacting worker’s compensation costs, absenteeism, and productivity.

 

 

Truth: One-Third Of Million Nonfatal Workplace Injuries/Illnesses Result In Days Away From Work

 

The U.S. Bureau of Labor Statistics reported that approximately 2.8 million nonfatal workplace injuries/illnesses occurred in 2017, one third of those resulted in days away from work. MSDs represented 32% of those injuries.4

 

Employers and workers share in the responsibility to help reduce risk factors by understanding ergonomics, taking actions to decrease those risks, and promoting best work practices throughout the organization. Ergonomics involves everyone.

 

 

Truth: Ergonomics Help The Job Fit The Worker

 

Ergonomics includes engineering, administrative, and personal controls to help the job fit the worker, rather than trying to have the worker fit the job.5

 

Engineering controls include: workspace design, reducing the weight of loads or applying lift-assist devices, automating processes, and re-designing tools to promote neutral postures.6

 

Administrative controls focus on establishing work practices to reduce the risk of injury and encompass actions such as job rotation, managing over-time, providing adequate staffing, reviewing injury logs, performing accident investigations, promoting near-miss reporting, providing employee education on MSDs/risk factors, encouraging early reporting of work-related injuries/illnesses, implementing break and stretching schedules, discussing work load and job satisfaction with employees, and maintaining equipment and tools.7 Providing ergonomic friendly accessories, such as: adjustable table/chairs, lumbar supports, footrests, arm supports, document holders, sit/stand work stations can each promote the job fitting the worker.

 

 

Personal Controls

 

Lastly, personal controls include the appropriate use of personal protective equipment (PPE), being mindful of posturing, alternating between sitting and standing, reporting of work injuries at the first sign of discomfort, participating in ergonomic stretches/micro-breaks and safety committees.8 Everyone should be mindful of posturing (feet flat on the floor or footrest, back supported, elbows close to body, avoid slouching, keep neutral postures), avoid awkward positions (bending the neck, static postures, placing wrists at extreme angles, working above shoulder height, stooping/crouching), reduce unnecessary movements, limit carrying heavy loads, avoid excessive bending and twisting, avoid over reaching, and keep frequently used items within a safe reach zone.9

 

Implementing ergonomic awareness and promoting a culture of safety and overall total worker health will reduce the risk of work-related injuries, increase productivity and job satisfaction, decrease costs associated with worker’s compensation and health premiums. The truth is, awareness goes a long way in preventing injury.

 

This article is not meant to diagnose or treat any condition. Always consult your primary care provider for healthcare instructions.

 

 

Author Ashley Clay, MSPAS, PA-C, Medcor Provider. Medcor helps employers reduce the costs of workers’ compensation and general health care by providing injury triage services and operating worksite health and wellness clinics. Medcor’s services are available 24/7 nationwide for worksites of any size in any industry. Headquartered in McHenry, Illinois, the company operates 174 clinics and provides triage services to over 90,000 worksites across all 50 states and US territories. Medcor’s triage methods are covered by U.S. & foreign patents, including U.S. No. 7,668,733; 7,716,070; & 7,720,692; other patents pending. Medcor is privately held. Learn more at www.medcor.com.

 

  1. Occupational Safety and Health Administration, “Ergonomics: Overview,” accessed March 15, 2019, https://www.osha.gov/SLTC/ergonomics/index.html.
  2. Bone and Joint Initiative USA, “The Impact of Musculoskeletal Disorders on Americans—Opportunities for Action,” Executive Summary of The Burden of Musculoskeletal Diseases in the United States: Prevalence, Societal and Economic Cost, third edition.
  3. Ibid.
  4. United States Bureau of Labor Statistics, “2017 Survey of Occupational Injuries and Illnesses Charts Package,” https://www.bls.gov/iif/osch0062.pdf.
  5. Occupational Safety and Health Administration, “Ergonomics: Overview,” accessed March 15, 2019, https://www.osha.gov/SLTC/ergonomics/index.html.
  6. Occupational Safety and Health Administration, “Ergonomics: Solutions to Control Hazards,” accessed March 15, 2019, https://www.osha.gov/SLTC/ergonomics/controlhazards.html.
  7. Ibid.
  8. Ibid.
  9. Washington State Department of Labor and Industries, “Ergonomics Principles for Reducing Awkward Postures,” accessed March 15, 2019, http://www.lni.wa.gov/Safety/SprainsStrains/AwkwardPostures/ReducingAwkwardPostures.pdf.

Watch Chiropractic Care for Excessive Medical Bills

Chiropractic Care The use of chiropractic care is a recognized way to treat many workers’ compensation injuries.  This includes injuries to joints, the back, and neck.  If an injured employee is receiving medical care and treatment through a chiropractor, it is important to take note of several issues that will save money in a workers’ compensation program.  It is also essential to develop effective claim handling techniques to get the employee back to work promptly.

 

 

Areas of Concern with Chiropractors

 

By definition, chiropractors are considered “doctors” who are capable of providing medical care and treatment in workers’ compensation cases.  They are sometimes suspect as they do not have a formal medical education that an “MD” obtains through an accredited medical school.  The focus of their medical education is concentrated on the diagnosis, treatment, and prevention of disorders of the neuromusculoskeletal system.  There is also an emphasis on a holistic approach to health care that includes an understanding of the central nervous system plays.

 

 

Factors to Consider When Evaluating Chiropractic Care

 

There are various areas where members of the claim management team should focus their review of billing and provider issues related to chiropractors.  These areas should include the following:

 

  • Evidence of a reasonable treatment plan: This plan should be reasonable based on the nature and extent of the work injury.  It should include information on the duration of care and its frequency.

 

  • Documentation of the details of the treatment: A common complaint of chiropractors is their treatment notes outline the same complaints and care provided with every visit – it is almost as if the provider was using the “copy/paste” function on a word processor.

 

  • The degree and duration of relief resulting from the treatment: A review of what is stated in chiropractic medical records should always be reviewed for consistency.  This includes whether the care being provided is advancing the patient’s care and consistent with their deposition testimony, and findings at an independent medical examination.

 

  • The frequency of treatment: This element evaluates how often the injured employee is treating and how they are scheduling appointments.  Initial care with a chiropractor is typically set at certain intervals.  After a period of time, that care should diminish, or be on an as-needed basis.

 

  • The relationship of the treatment to the goal of returning the employee to suitable employment: A successful return to work should be the goal of any medical care and treatment provided to an injured employee.  This becomes paramount when dealing with chiropractic care as frequent, ongoing care can leave someone at their baseline with no improvement in pain relief or functional ability; and

 

  • Cost of Chiropractic care: This is an important factor to consider, especially when an injured employee is seeking approval for care after 10-12 weeks of care.

 

 

Issues to Review When More Care is “Required”

 

When it comes to chiropractic care, it is important to obtain detailed information from the injured employee on how they were referred to the chiropractor.  Closer scrutiny should take place when this is someone the employee has seen in the past or based on a family member referral.  A claim should be heavily scrutinized if the chiropractor shares a building with, or located in close proximity to a physical therapist also treating the injured employee.

 

Other issues to consider when challenging excessive care, or approving additional chiropractic care should include:

 

  • The injured employee’s opinion as to relief obtained;

 

  • The duration of relief from symptoms;

 

  • Whether symptoms return once care stops;

 

  • The use of other “alternative” medical care;

 

  • Whether the injured employee is psychologically dependent on chiropractic treatment;

 

  • Whether the frequency of treatment is warranted;

 

  • The cost/benefits analysis regarding treatment provided compared to the relief obtained;

 

  • The employee’s overall activities and the extent of the employee’s ability to work; and

 

  • The potential for aggravation of an underlying condition.

 

 

Conclusions

 

The goal when approving medical care and treatment should always concern the nature and extent of the injury and getting the employee back to their pre-injury condition.  This can be obtained through chiropractic care.  When handling a claim involving this treatment modality, it is important to be vigilant and ensure it is effective in providing lasting relief.

 

 

 

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.

Ensure Your Workers’ Comp Files Are Properly Documented

Workers Comp Files Are Properly DocumentedIt is important for members of the workers’ compensation claim management team to document their files properly.  If you do not have access to the electronic claims file, now is the time to ask. If not, it should be a condition of claim handling agreement with your third-party administrator (TPA) or insurer.

 

 

What is in a Properly Documented File?

 

Several items need to be in a properly documented claim file.  Important issues concerning coverage should be addressed at every step of the claim.  This should include:

 

  • The policy number;

 

  • The policy coverage period;

 

  • The states or jurisdictions covered by the policy;

 

  • Endorsements to the policy; and

 

  • Exclusions from the policy coverage.

 

If you have questions, be sure to ask – and demand prompt answers before the adjuster proceeds with the contacts and with the investigation.

 

 

Points of Contact Following a Work Injury

 

Prompt contact with all parties should be initiated immediately after the report of the claim.  Demand action is being taken on the same day a claim is received, or within 24 hours of the loss.  Points of contact should include, but not be limited to the following:

 

  • The employee;

 

  • The employer;

 

  • Any witnesses to the injury. All contact information for witnesses should be included as people change jobs over time; and

 

  • The medical provider(s), including ambulance services and law enforcement responding to a work injury.

 

The clock is ticking.  Steps taken during the initial phase of a claim are important.  Other important notes from a claim handler should be noted.  Important information to obtain should include:

 

  • Accident details as stated by the employee in the recorded statement, the employer’s version of the accident, and any witnesses’ version of the accident;

 

 

 

  • The current disability status of the employee, and projected return to work date;

 

 

  • Length of time the employee has worked for the employer;

 

  • The availability of modified duty for the employee not yet back to work;

 

  • Information on the nature of the injury, the treatment plan, diagnosis, and the prognosis;

 

  • Subjective information such as the employee’s attitude toward the employer, returning to work, and the quality of the medical treatment;

 

  • The explanation of benefits provided to the employee and the action plan information provided to the employee;

 

  • If there is an attorney representing the employee, if so, obtain the representation agreement.

 

 

Moving the Work Comp Claim Toward Settlement

 

Any time is the right time to move a workers’ compensation claim toward settlement.  Steps toward resolving the claim can also be taken after a work injury.  Part of this process includes obtaining documentation that is required to evaluate the claim and set reserves.  Documentation the claim handler needs can include:

 

 

  • Recorded statements of the employee, the employer, and any witnesses;

 

  • Medical authorizations. These will be needed to obtain a complete set of medical records regarding other conditions possibility contributing to the employee’s disability;

 

  • Wage records from the employer to calculating the average weekly wage;

 

  • Complete set of medical records. This may include past records, records related to the work injury, and for other records created in the future;

 

  • Other required state workers; compensation forms;

 

  • Police reports, EMS reports, OSHA reports, other governmental reports on an accident;

 

  • Independent medical evaluations (IME) or peer review;

 

  • Vocational and rehabilitation reports;

 

  • Subrogation documentation;

 

  • Second injury fund correspondence and/or documentation;

 

  • Correspondence to/from employee’s attorney;

 

  • Correspondence to/from defense counsel;

 

  • Workers’ Compensation Board/Industrial Commission correspondence and records; and

 

  • File notes on every telephone call, e-mail, or any other activity related to the file.

 

 

The claim file may also contain other important information on the claim handler’s efforts to resolve the claim, including:

 

  • Case evaluations and status reports regarding causation, legal defenses, and settlement;

 

  • Exposure analysis and case valuation;

 

  • A synopsis of any legal questions and the efforts to resolve those questions;

 

  • Information concerning the disability rating or the potential disability rating;

 

  • Legal analysis regarding a litigation strategy;

 

  • The “action plan” to bring the claim to a conclusion; and

 

  • A history of the settlement negotiations.

 

 

Conclusions

 

The claim handler’s file notes contain the main details of all file documentation received regarding a workers’ compensation claim.  It is important for employers to play an active role in every workers’ compensation claim and be engaged.  Failure to do so can prove to be costly and increase program costs.  The file documentation itself, whether maintained in the computer or by paper, must be complete and answer any questions you have about the file.

 

 

 

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: 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.

Workplace Safety for Non-English Speaking Employees

Workplace Safety for Non-English-Speaking EmployeesThe American workplace continues to evolve and workplace safety for non-English speaking employees is paramount. Stakeholders running an effective workers’ compensation program need to be aware of this issue and implement policy to ensure workplace safety.

 

 

The American Workforce – By the Numbers

 

America has always been a land of opportunity for people with many backgrounds.  In the past, immigration was mainly driven by European populations seeking a fresh start.  Times have changed.  This now includes shifting immigration patterns with people from Africa, Asia, and Latin American countries coming to the United States in search of a dream.

 

Unlike immigration in the past, newer immigrants are not dropping their native language for English.  This presents a challenge to employers as they seek to promote a workplace that reduces work injuries.  Now is the time to act.

 

 

Workplace Injuries and Hispanic Populations

 

The American Society of Safety Professionals has paid particular attention to workplace safety for non-English speaking Hispanic employees who may generally speak Spanish as their primary language.  Studies indicate the following characteristics:

 

  • Nearly 70% of Hispanic employees who died in the American workplace were born outside the United States;

 

  • Hispanic immigrants account for over 20% of the construction workforce in the United States. These are jobs that require employees to work at heights and use safety equipment to prevent falls. Impacted industries include roofing, ironworkers, and other physical labor positions.  A common denominator in these fatal incidents is workers not using proper equipment, work practices used in their native country (or by custom), or not being trained in the use of required equipment; and

 

  • Employees identified as Hispanic account for 15% of all fatal injuries – a rate of 3.7 per 100,000 full-time equivalent (FTE) employee, compared to a rate of 3.5 per 100,000 FTE for workers as a whole.

 

 

Avoiding Workplace Stigmas

 

All interested stakeholders in the workers’ compensation system should ensure employees, especially those who do not speak English as a primary language, are treated with respect and dignity.  This is an opportunity to put aside differences of opinion people have regarding immigration (legal and illegal) and make sure employers step up when it comes to making the workplace safe, and ensuring work injuries are reported in a timely manner.  In sum, one’s immigration status should never serve as a barrier to denying workers’ compensation benefits.  This is a policy decision best left to state legislatures, and not one’s personal preference.

 

 

Taking the Next Step – Creating a Positive Work Environment

 

The first step to ensure workplace safety for non-English speaking employees is making sure everyone is on the same page when it comes to employment practices, and safety education.  Steps interested stakeholders should consider can including:

 

  • Hiring safety individuals that speak multiple languages. If an employer has a significant number of Spanish speakers on staff, efforts should be made to have a safety professional who is fluent in that language;

 

  • Educate non-English-speaking employees on proper safety standards and procedures. This includes creating materials in other languages and reinforcing these best practices in the field; and

 

  • Involve all interested stakeholders in the safety process. This includes management, and organized labor.  It is important to lead by example!

 

Additional attention needs to be geared toward employees who generally work as day laborers.  These are people who typically work for someone for a short period of time – sometimes only a few hours on occasion.  People involved in the workers’ compensation system can also ensure these employees understand the system, know how to report a work injury, avoid common errors such as working for employers without insurance coverage, and engaging in safe work activities.

 

 

Conclusions

 

The changing American workforce places many demands on employers and employees.  One such change is to ensure workplace safety for non-English-speaking employees in the workplace.  Now is the time to get engage and ensure these workers understand the process, receive proper safety training, and have access to resources to promote a better work environment

 

 

 

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: 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.

Five Effective Ways to Communicate Safety Messages

communicate safety messagesCommunicating safety messages needs to be communicated consistently and continually.  It is something that needs to involve all interested stakeholders.  Taking the following steps can ensure the workplace remains safe for all employees, and provide a consistent response once an injury occurs.

 

 

Five Suggested Ways to Communicate Safety Messages

 

A safe workplace starts with an employer dedicated to safety.  There are countless opportunities to communicate safety messages and promote a safe work environment.  It starts with a commitment by all interested stakeholders to be involved in the process and not putting profit ahead of safety.

 

 

  1. Employee Safety Meetings (for all shifts): Taking this step reinforces the message that safety is important in the workplace.  Anyone from the president to mailroom clerk can talk about safety and promote a better work environment, but it is important for those who are perceived as leaders to do the talking – job titles do not matter.  These leaders should also practice what they preach to ensure follow-through.

 

  1. Posters and Bulletins: This can go beyond posters required by law.  Keeping safety reminders visible and in conspicuous places around the workplace reinforces important safety reminders.  Dedicated employers can also have posters produced in different languages if any employee does not commonly use English as a primary language.  Graphics can also reinforce the message of a safe workplace.

 

  1. Newsletters: Every company newsletter should include a blurb about safety.  It can highlight changes suggested by an employee on how the workplace became safer.  It can also update employees on changes to protocols and procedures.  Other common highlights can include information on how to report a work injury and where to receive medical care and treatment.

 

  1. Safety Suggestion Box: People are sometimes afraid to make suggestions on how to improve workplace safety.  Anonymous suggestion boxes can provide people the ability to make suggestions.  It is important to follow-up and highlights how these suggestions improved a defective condition and how remediation was made.

 

  1. “Toolbox” safety talks conducted informally by supervisors with their employees: Safety should be emphasized every workday.  Supervisor and managers can play an important role in explaining to their direct reports on how work injuries impact company and program efficiency.  Do not be afraid to go beyond the basics when it comes to safety.

 

 

Other Requirements: Beyond the Basics of Workplace Safety

 

Training records must be kept that refer to federal and state regulations related to workplace safety.  It is important to offer safety training in languages that match the workplace demographics.

 

Employers should also consider the implementation of a Safety Recognition Program.  Before developing a Safety Recognition Program, consider the following:

 

  1. You cannot “buy” safety, but you can expect safe behavior and recognize employees who deliver.

 

  1. Concentrate on results (i.e., fewer injuries) AND on behaviors (i.e., use of personal protective equipment, safety inspection scores).

 

  1. Establish clear, measurable goals for both results and behaviors.

 

  1. Employees should know that there will be serious consequences for not reporting accidents.

 

  1. Awards should have true value and be more than just cash (something tangible to remind the employee why they won the award and presented by senior management during an employee celebration (pizza party, for example).

 

  1. Senior management must completely support the Safety Recognition Program and be visible in the process.

 

  1. Consider rewarding individuals for safe behaviors and groups for safety results.

 

 

Conclusions

 

Now is the time to communicate safety messages and promote safety in your workplace.  This requires all parties to be fully engaged, and leadership in management to follow through on their commitments.  This includes effective communication and engaging employees on all aspects of a safe work environment.

 

 

 

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: 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.

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