Workers Comp Cost Containment Fundamentals Archives

Orchestrate A Culture of Quickly Reporting Workplace Injuries

September 27, 2018 by Michael B. Stack

An important role of the claims management team is to coordinate with employers and defense interests to make sure quickly reporting workplace injuries is a top priority of your organization. It is easier for claims to be evaluated and decisions regarding primary liability to be made in an effective and efficient manner when injuries are quickly reported. There are many steps claims management teams can make to develop important work injury compliance steps, which includes the use of evolving technology.

Emphasis the Importance of Reporting Workplace Injuries

There are several steps that employers can make to ensure workers’ compensation claims are reported in a timely manner. This starts with developing a culture of understanding on the part of the employees. This goes beyond making sure the proper posters are displayed in the workplace:

Make all new employees aware of workers’ compensation information at the time of hire. This includes providing documentation to new hires about the name of the company’s workers’ compensation insurer and other contact information;

Provide documentation on how work injuries should be reported and the information needed to make a report of injury; and

Ensure that the employer has a contact person to make sure the First Report of Injury is filed timely with the workers’ compensation insurer. In some instances, employers and their staff are unsure how the process generally works. Making sure these persons understand the process is important.

All workers’ compensation insurance carriers and third-party administrators can provide information to their insured on these processes.

Ensure of Culture of Compliance from the Top

The best workers’ compensation programs at the employer level have a culture of compliance and consistency. This means that senior-level leaders within an employer need to emphasize safety and ensure that reports are being dealt with ethically and honestly. All employees need to be treated with respect and dignity. Other steps can include:

Preparation, issuance, and posting of quarterly safety reports. State industrial commissions typically require the posting of job site injury information. This should be viewed as the baseline requirements – do not be afraid to go beyond those requirements; and

Highlight improvements to safety within the workplace. This ensures that all employees understand the important role they play in the process.

Eliminate ‘Accident-Free’ Incentives

Employers often attempt to drive a culture of safety through creative programs that provide cash incentives for ‘accident-free’ days. These types of programs are a mistake because studies demonstrate they have an adverse effect where employees feel they cannot report a workplace injury. In reconsidering these original programs, employers should focus more on a metric that encourages the timely report of work injuries.

Provide Effect Reporting Tools

Technology has created many opportunities for employers to ensure all workers’ compensation claims are reported by employees in a timely manner. It also allows employees to provide greater detail, including documentary evidence that allows for quicker and more accurate decisions concerning primary liability.

One example of matching technology with efficient and effective work injury reporting is app-based technology. The development of this technology is cheap, and it is easy to implement. With a vast majority of employees having smartphones, it is something nearly anyone can upload and use. Features that can be used on these apps include:

Completion of the First Report of Injury and uploading to the employer, insurer and other interested stakeholders;

Easy communication with the injured worker and the claims management staff. Communications include information regarding primary liability determinations, request for documents and prior authorization requests; and

Payment status and direct deposit of indemnity benefits. This allows for injured workers to receive payments immediately, and avoids the uncertainties of mailing a check.

Conclusions

The workers’ compensation process starts with the reporting of workplace injuries. This is a process that causes confusion, delay, and frustration in the process. Proactive members of the claims management team can work with their insured to improve the reporting process through reforms to internal processes. It can also include the development and implementation of app-based technology to make the process efficient and user-friendly for all employees.

Michael Stack - Amaxx Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center.

Contact: mstack@reduceyourworkerscomp.com.

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

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

Filed Under: Report A Claim

Health Navigation – Finding a Path to Better Health and Lower Costs

September 20, 2018 by Curtis Smith

If you or a loved one has ever been hurt or sick, you know well that healthcare and insurance systems are complicated; the challenges can seem endless and overwhelming.

Health navigation helps individuals and companies through these challenges. It includes clinical services, of course, but it’s much more than that. Knowing what services are needed, where to get them, and in what timeframe are critical elements to getting on the right path to recovery.

Fundamental Premise of Health Navigation

People can’t always tell at the onset how serious an injury or illness is. So, sometimes they go to an ER when they could have gone to a doctor’s office, or they go to a doctor’s office when they could have cared for themselves. Other times people underestimate or don’t recognize symptoms, and look back wishing they had realized how serious something really was – this regret can make them more likely to overreact the next time they are confronted with a health concern.

The fundamental premise of health navigation is getting people the care they need when and where they need it, which removes burdensome guesswork. A best-in-class health navigation provider should:

Have clinicians which navigate people to the right level of care at the right time, in the right place.
Have systems to help people determine the severity of each case and the best course of action for treatment.
Provide the needed care or guide patients in self-care whenever possible.
Make a referral when further care is required

People know overtreatments and over prescribing exist, but they don’t know how to tell when it is happening to them. What’s the best practice?

Evidence-Based Medicine

Evidence-based medicine is the best practice; it represents the science of proven medical effectiveness. Protocols, algorithms, and guidelines need to be built on evidence-based medicine. As a result, unnecessary treatments and prescriptions are avoided while required treatments are obtained right away.

People want to believe that all providers follow best practices, but still unnecessary care persists, including surgeries, prescriptions, therapy, and other interventions that contribute to high costs for everyone.

The healthcare and insurance systems have evolved to include many conflicts of interest, financial biases, and administrative costs. Effective navigation requires guiding patients to the right destination rather than following the momentum and pressures of a complex claims-driven system. Working with a provider who operates transparently and without conflicts of interest offers the key difference of advocating for patients rather than treating them.

Access to Care

It can take weeks to get an appointment. Lack of access to care drives frustration and drives people to go to more expensive options such as urgent care centers and ERs.

Clinics can and should be convenient and accessible, mobile units should go to patients, virtual health services should be available on-demand 24/7, and a telephonic triage service should be preloaded with clinics that accept walk-ins and new patients. In addition, staff should know the in-network providers in their patient’s communities, establish relationships, and have the tools necessary to gain appointments.

Serious illness and injury involves a lot of emotion, which affects people’s decision making. It feels awkward to tell a provider you want a second opinion or other options. It is not easy to know if a provider is in-network or out-of-network, and it is near impossible to find out in advance what services cost.

Decision Support

Navigation requires decision support – not just information, but recommendations. People need reassuring, they want to know the risks, and they appreciate assistance.

Health navigation gets people through the system to achieve better clinical outcomes and lower costs. That’s good for individuals, and it’s also good for their employers, who bear much of the cost of caring for their employees and their families, and who want their employees to be healthy and productive.

Author Curtis H. Smith, Executive Vice President, joined Medcor in 1995. He helped develop Medcor’s injury triage system and holds several US and foreign patents on injury assessments methods. Smith has taught and practiced in EMS as paramedic and dispatcher. He currently supports Medcor’s business development and marketing teams. http://medcor.com. Contact: csmith@medcor.com

Filed Under: Work Injury Response

3 Reasons and 5 Ways to Speed Up Workers’ Comp Claim Lag Time

August 9, 2018 by Michael B. Stack

Determining lag time is one of the easiest things to measure in workers’ compensation. Yet many organizations put little if any effort into it. More than likely they don’t see the value in tracking that particular metric.

But those that do report better outcomes for their injured workers and significant dollars saved for their bottom lines. There’s substantial research to back them up.

Why Workers’ Comp Claim Lag Time Matters

Lag time refers to the time period from the moment of injury until it is reported to the insurance carrier. For example, if an injury occurs on Oct. 1 and the insurer receives notice of the claim on Oct. 3, the claim will have a report lag of two days.

Tracking a company’s lag time is fairly simple, since every claims handler or adjuster has the information. The goal is to have shorter lag time, as several studies reveal tremendous cost differences.

Kemper Insurance Study

Kemper Insurance did a study and found that a claim reported within 30 days is 48 percent higher on average than a claim reported within 10 days of an injury.

The Hartford Insurance Study

The Hartford looked at 53,000 permanent partial and temporary claims and found the cost of a claim increases with each passing week before the incident is reported. Compared to an injury reported within week:

Within 2 weeks the claim was 18 percent more expensive
Within 3 weeks the claim cost 29 percent more
Within 4 weeks there was a 31 percent cost difference
Within 5 weeks, the claim was on average 45 percent more expensive

NCCI Study

NCCI’s study found “the closure ratio — the ratio of the number of claims closed within 18 months of the report date to the total number of claims — is inversely related to the median claim cost … the highest closure ratios are for claims reported in Weeks 1 and 2. Claims reported after Week 2 are less likely to be closed at 18 months…”

The study also found that median claims costs were lowest for claims reported after the day of the accident but within two weeks. It noted that claims reported on the actual day of the accident can be costly, as these are often the most serious injuries and require emergency care.

Additionally, longer lag times were associated with:

Greater attorney involvement —12.8 percent after more than 1 week, increasing to 148 percent more than 5 weeks after injury.
More use of lump-sum payments
Lower paid-to-incurred ratio at 18 months
Lower closure rate at 18 months.

The data indicates that claims with a lag time of more than two weeks are more complex, take longer to close, and have longer disability durations.

Why Workers’ Comp Claim Lag Time Is Important

There are many possible reasons that increased lag times result in increased costs. Experts speculate some include:

An injured worker may visit a primary care physician rather than an occupational physician who understands return-to-work and other elements of the workers’ compensation system.
The worker may feel he and his injury are being ignored, that the company doesn’t care about him. That could drive him to seek an attorney.
Quicker reporting means faster medical treatment which results in faster RTW rates.

Tracking lag time helps you and others at your organization better understand how well your program is working. You can use it, along with the available research to show the cost savings you are achieving by having shorter lag times.

Organizations with multiple divisions can compare the lag times for each to show which are doing a better job of getting injuries reported quicker.

Improving Workers’ Comp Claim Lag Time

Getting injuries reported to the carrier as quickly as possible takes a concerted effort and should be embraced by everyone in the organization. The employee needs to report the injury immediately and the supervisor must complete the necessary paperwork to get the report to the carrier as soon as possible. Senior managers should consider the issue a priority as well.

Getting the buy-in of all involved takes some education, so everyone understands the value in shorter lag times and the process required. Injured workers should be made aware that reporting an injury sooner means they will get medical attention and care they need immediately. Supervisors and managers need also to understand the financial impact of shorter lag times.

There are several ways to ensure better lag times:

An employee brochure. This should explain the workers’ compensation process and be provided to all personnel.
One-pager. A short notice that explains the process for reporting an injury should be available to all employees. It can be posted in areas where workers congregate, placed in company vehicles, and even provided on the back of a lanyard.
Employee training and retraining. In addition to providing written material, new hires should undergo training on proper incident reporting. This should be repeated as retraining annually.
Supervisor education. All supervisors and managers should be well versed on the process required once an employee reports an injury. This can even be part of their performance reviews.
Make it easy. A complicated reporting process is more likely to incur longer lag times. There should be a single contact within the organization to report injuries when a supervisor or manager is unavailable, such as a single phone number.

Summary

Improving and tracking lag time are fairly simple processes and can have a tremendous impact on the company’s bottom line. The sooner an injury is reported, the sooner the worker will receive medical care and return to work, and the better off the organization will be.

Contact: mstack@reduceyourworkerscomp.com.

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

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

Filed Under: Report A Claim

The Process to Workers’ Comp Reform Is Just Like Riding A Bike

July 30, 2018 by Michael B. Stack

Hey there, Michael Stack, CEO of Amaxx. It was a pretty exciting weekend for my family, a landmark weekend if you will. I was worked with, and taught our five year-old daughter, Emma, the third of our four children, to ride a bike. Now if you think about this process and this challenge of learning to ride a bike, it’s one of the first accomplishments in a child’s life that they have to do all on their own. They have to feel that balance. They have to figure it out. They have to work through that challenge to overcome what feels like a major obstacle.

Overcome Resistance to Workers’ Comp Reform

Kind of sounds a lot like the process organizations go through when they’re looking to reform their work comp program. You start at the bottom. Your work comp programs feels like it’s a total disaster. Things are off the track. Fraud is out of control. Litigation rates are extraordinarily high. To get to the end of the rainbow, well where it’s a well oiled machine working like clockwork, and you’re creating these great outcomes for your injured workers, and drastically reducing your work comp costs.

What I want to talk with you today is a two step process that works to teach a child to ride a bike and works in our work comp adult organizations looking to overcome this major obstacle. The first step that I want you to have as you’re approaching this very difficult and very challenging obstacle of reforming your work comp program is to have a can do attitude. Have a can do attitude. Very, very rarely will you get the 100% buy-in from your senior managers, because have you met Sue? Have you met Jim? Have you met John? Whoever it is that’s that senior manager that’s very difficult, that isn’t onboard with this idea of reforming your work comp program, they’re never going to give you that 100% buy-in unless they can see the proof.

Step #1: Can-Do Attitude

So while you can’t have that 100% buy-in, what can you get approval for? What small piece can you start to get that buy in to start to build that momentum? Have that can do attitude not for what’s not approved, but for what that small thing is that can be approved. Maybe it’s just getting an employee brochure started, and getting that deployed within your organization.

Step #2: Feel Success

Because when you do that, now you can go on to step two which is to feel success. Feel what success feels like. Prove to your organization that you can be successful in this. The first very first, and most important, step in teaching a child to ride a bike is to have them feel that balance for themselves. The very first, and most important, step in teaching a child to ride is bike is to have them feel for themselves that they can balance, even if it’s just for a foot, or two or for three feet, because now they can start to build on that momentum and they believe in their ability in order to get it.

Build Momentum To Workers’ Comp Mastery

That same theory applies here. You need to build that momentum to feel for yourself, as an organization, that this system can work for you. Sure, it’s worked for hundreds or thousands or organizations, but can it work for you? You need to prove that to yourself and feel that success. So when you get that employee brochure deployed, you can now start to set those expectations for your employees. You can start to change some of the mindsets. You can start to have this system, the very first part of it, start to work, and feel the success of improving the outcome for the injured worker, and starting to lower your work comp cost. When you feel that first momentum, when you have that can do attitude, you take that first step. Now you’re ready to take the next step, and you continue to build on that momentum, and you continue to take those steps all the way down to get to the end of the rainbow. Get on Michael Stack CEO Amaxx, and remember your work today, in worker’s compensation, can have a dramatic impact on your company’s bottom line. But it will have a dramatic impact on someone’s life, so be great!

Contact: mstack@reduceyourworkerscomp.com.

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

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

Filed Under: Workers Comp Cost Containment Fundamentals

4 More Ways to Spring Clean Your Workers’ Comp Program

May 17, 2018 by Michael B. Stack

Spring is here and it’s time to clean out the junk in your garage and trim the bushes. As we go through our annual spring cleaning ritual at home, it’s also time to take a look at tuning up your workers’ compensation practices.

See 5 Ways to Spring Clean Your Workers’ Comp Program

Here are 4 additional ways to spring clean your workers’ comp program:

Cooperate Fully with the Claims Adjusters

Stay in contact with all your injured employees who have not returned to work. In addition, make the commitment to stay in contact with the claims adjuster(s) handling your work comp claims.

You work comp claims coordinator should be exchanging information with the adjuster(s) on all claims on a regular basis. You may know important information that will assist the adjuster in bringing the claim to a speedy conclusion.
Or, the adjuster can coordinate with the nurse case manager on the information you provided about the employee’s medical concerns.

Update the Medical Treatment Panel

If you have not revisited your posting on required medical providers (or recommended medical providers in the states where the employee selects the medical provider), now is an excellent time to do so. Set up a conference call and consult with the work comp adjuster(s) and the nurse case manager(s) on your work comp claims.

Do any of the doctors on your medical treatment panel list seem to keep employees off work longer than others?
Do any of the doctors seem to have to operate on employees more than other doctors?
Do any of the doctors on your medical treatment panel fail to provide timely medical reports to the adjuster(s) or nurse case manager(s). .
Are there any doctors the adjuster(s) or nurse case manager(s) would recommend to be added to your medical treatment panel?

Use the Expert Panel if your TPA has one. If your TPA doesn’t have one, consider changing your TPA.

Fight Fraud Religiously

An excellent spring renewal is to fight fraud. In addition to your anti-fraud posters, start a fraud hotline for other employees to report fraud anonymously to a tip-line.

Offer a reward for anyone who reports a work comp fraud that results in a criminal conviction.
Make sure all your employees know about your Return To Work Program that will prevent them from being off work any longer than is necessary.
Always report any suspicious claim to the Special Investigations Unit of the insurer.

Improve Your Medical Management Program

Make the commitment to maximize your medical management program. Review all your programs to control medical cost.

Consider ways you can improve your use of nurse case managers, utilization reviews, pharmacy benefit managers, medical fee bill reviews, durable medical equipment, independent medical examinations and peer reviews.
Seriously consider Injury Triage for all injuries. Employees love it and it will reduce your claims volume significantly.

Contact: mstack@reduceyourworkerscomp.com.

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

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

Filed Under: Workers Comp Cost Containment Fundamentals

5 Ways to Spring Clean Your Workers’ Comp Program

May 16, 2018 by Michael B. Stack

Improve Safety

A safe workplace is the best way to reduce workers compensation cost. Now is an excellent time to renew your commitment to safety.

review your safety program for ways to improve your safety training,
update the job hazard analysis of every job position within the company,
review the qualifications of the members of your safety committee
schedule the work-site evaluations and safety inspections for the year
update the safety manual to cover new equipment, new machinery or new job positions
review your safety posters, safety brochures and other employee safety communications

Report All Claims Timely

If a review of your loss run reflects that you have claims that were not reported the same day as the accident, a great spring cleaning task is to review your claim reporting procedures to be sure all claims are reported timely (the day of the accident). All department managers or location supervisors should be trained to report all injuries to the company’s claims coordinator or directly to the claims office immediately after they have arranged transportation to the medical provider. Timely reporting allows the work comp claims adjuster to investigate properly, establish compensability and better control the course of the workers’ compensation claim.

Keep in Touch with All Injured Employees

Make the commitment to show your injured employees that your company has a human side and does care about their well-being. For every injured employee who has not returned to work, mark on your calendar when you want to contact them. A contact schedule that you can modify as needed would be to:

contact the injured employee the day of the accident (First Day Phone Call)
contact the employee 2 days after the accident to make sure they understand the WC procedures and process, and answer any questions they have. Make yourself available. (Follow-up Phone Call)
invite the employee to attend all workplace functions even if they are not working in the workplace temporarily.
have the employee attend a Weekly Meeting until the employee is back to work. Use Weekly Meeting Guidelines to structure these meetings and make notes.

Stay Current on All Work Comp Claims

Closely related to staying in touch with the injured employee is staying current on ALL of your work comp claims. Make the commitment to do so.

During these contacts with the employee ask the employee the status of their medical treatment and when the doctor may be able to let them to return to work either full duty or on modified duty.
Stress to the employee that the work they do for your company is important and that you need them, not some new hire, doing their job. If you have employees you haven’t communicated with, now is the time to reconnect with them.
We worked with a large bread company and when the risk manager started his job there were 45 employees out of work. We directed him to invite each to lunch and ask them when they could come back to work. Twenty said they could come back to work “now” but that no one had asked them to return to work up until that lunch. A good lesson about why to stay on top of all of your claims.

Do not rely solely on the employees for information about their work comp claims, call the adjuster on a regular basis to discuss treatment status, return to work status and any permanent partial disability which will require modification of the employees job position. Hold bi-weekly or weekly roundtables with the adjuster to discuss a rotating selection of claims.

Improve Your Return To Work Program

If your idea of light duty return to work is to have the employee count paper clips, now is the time to commit to improve your Return To Work Program. A good place to start would be to review our website and all the information we provide to employers on managing your Return To Work Program.

Your commitment to RTW should include:

On every lost time claim to take the time to contact the medical provider and ask that the employee be allowed to return to work on light duty.
Make sure to provide the medical provider with a complete job description so the medical provider can place the appropriate restrictions on the employees workability.
You should have > 95% returning to work within 1-4 days after the injury.

Summary:

Spring is a time for renewal. If you follow through with your commitments, your workers’ compensation program will bloom and prosper.

Contact: mstack@reduceyourworkerscomp.com.

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

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

Filed Under: Workers Comp Cost Containment Fundamentals

How Star Wars Nailed the First Step in Workers’ Comp Management

May 7, 2018 by Michael B. Stack

Hey there, Michael Stack here, CEO of Amaxx. So this past weekend my wife was gone for the weekend. She was visiting one of her good friends from college, from Lehigh University, who’s actually was the maid of honor in our wedding up in Saratoga, New York. So whenever she’s gone, I like to take the opportunity to watch some movies that maybe she wouldn’t really like quite so much. So I was able to watch The Godfather and then I also watched Star Wars The Last Jedi, the latest Star Wars movie that I hadn’t seen yet.

“Don’t Worry, We’re With The Resistance”

In that movie, in The Last Jedi, there’s one scene which encapsulates and demonstrates so well a critical, critical, element of worker’s compensation management. Actually when I work with a company, one of the first things that I often recommend that they do. So here was the scene, there’s two characters Finn and Rose, and they go on an adventure of course to save the galaxy. On their adventure, they encounter a little boy, and they need his help. The little boy of course is scared. One thing they say to him, is they say, “Don’t worry, we’re with The Resistance.” And they show the little badge and they show The Resistance icon. In that little statement, in that little exchange, they demonstrated a number of very important things.

Identify, Branding, Meaning

One was identity. They demonstrated their identity. Number two, was the branding. They had the logo in order to identify themselves and demonstrate that visually. Number three, most importantly, was the meaning behind it. Identity, branding, and meaning. In one little exchange they were able to get the trust and understanding of that little boy and demonstrate what it is that they’re there to do. In an instant.

ACME IPAR Program

If you take this concept and you look at your work comp management program, your injured worker is scared, they don’t know what to expect, they don’t know what is coming next. If you can demonstrate to them and create some branding, create this name around it. An example I love to use, is the Acme, if the Acme is your company, the Acme IPAR, the Acme Injury Prevention and Recovery program. You create an identity and a branding campaign around that, so that you can know and demonstrate in an instant the meaning of what is going to happen next to that injured worker.

If you can put some thought into that, if can brainstorm around that, if you can create this identity, create this brand, and attach it to that meaning of what to expect next, you will win the worker’s compensation battle. Again, I’m Michael Stack, CEO of Amaxx. Remember your work today in worker’s compensation can have a dramatic impact in your company’s bottle line. But it will have a dramatic impact on someone’s life, so be great.

Contact: mstack@reduceyourworkerscomp.com.

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

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

Filed Under: Work Injury Response

11 Ways Supervisors Can Enhance Your Workers’ Compensation Program

March 15, 2018 by Michael B. Stack

Supervisors are critically important to the effectiveness of your injury management program. They are often the first person on the scene of a workplace accident and may know the injured worker better than anyone else in the organization. They set the tone for how well the injured worker responds and engages in the recovery process.

Employees in charge of other workers who view their role in the workers’ compensation process as just an annoyance do a disservice to injured workers and the organization. Employers should take steps to ensure supervisors appreciate the value of the workers’ compensation program and have a thorough understanding of how they can positively contribute to it.

Injury Response

While some organizations have detailed step-by-step plans in place for handling workplace injuries, many don’t; or even if they do, most employees are typically not well versed in the protocol. That’s why it is imperative to continually train supervisors on all the various aspects of the workers’ compensation system and how they fit into it.

For example, if one of your workers went to his supervisor after sustaining an injury, how would the supervisor respond? Would he know, or have a list of steps to follow, a medical provider to treat the worker, if needed? Would he know to address the worker’s medical needs first?

Here are some of the initial procedures supervisors should have down pat:

Get injured worker medical attention. First and foremost, make sure the worker gets medical attention if needed. If so,

Where to go
How to get the worker there; i.e., should he drive himself, and, if not, who should drive him
What, if anything to take with him

Communicate appropriately. Extensive research has been done on the impact of a supervisor’s language and tone toward an injured worker. Questioning the truthfulness of the worker, for example, can have a dramatic impact on outcomes. Negativity threatens the worker and research has shown the odds are there will be twice as many days out of work than if there is a positive response from the supervisor.

Whom to contact. Is there a department/person/number the organization has for reporting injuries? For example, is there a nurse triage system in place?

Initiate an investigation. While it may not involve a formal inquiry, the supervisor should speak with anyone with possible insight into the accident, such as the injured worker and any witnesses. Having such conversations as soon as possible after an incident is best for getting the most information when it is fresh in people’s minds.

Take good notes. Any information from the injured worker, witnesses or anyone else who may know about the injury should be written down with as many details as possible. Documentation should include at least the basics — who, what, when, where, why and how.

After the Fact

Following-up on a workplace accident — or near miss — is also important, as that can go a long way in preventing recurrences. Some actions supervisors can take at this point include

Determine if any obvious risks contributed to the accident/injury. Walking through the area and talking with other employees who work there can provide insights into potential problems.

Take corrective action. Any hazards that are obvious should be eliminated as soon as possible, if not immediately. This may require notifying and working with a safety person or other managers. Supervisors should know and be given authority to make simple corrections that can prevent future accidents.

Communicate the risks and any changes to staff.

The Recovery/Return Phase

If a workers’ compensation claim has been filed and the employee is not working, the supervisor’s role should be one of support. The injured worker needs to know he is a valued employee and the organization wants him back at work. If the supervisor has a positive relationship with the worker, she can take the following steps:

Initial contact. The supervisor should make the first-day phone call to the injured worker — ask how he is doing, how he feels, and find out what he needs. This is also the time to let the injured worker know what to expect; how/when medical treatment will be provided, who will contact him and for what reason(s), how and when he will receive money, and other aspects of the claims process.

Ongoing communication. The first-day phone call is extremely important, but the contact should not end there. The supervisor should stay in touch with the injured worker on a continuing basis, through conversations and by sending get-well cards. In addition to finding out how the worker is progressing, these conversations can provide insight into the worker’s mood and whether he is engaged in his recovery. The supervisor should also relay the latest workplace happenings, so the worker feels kept in the loop.

RTW/Transitional duty. Supervisors should be trained on the benefits of returning an injured employee to work as soon as possible, that it is not only best for the organization from a financial standpoint, but usually is best for aiding the worker’s recovery. If the employee cannot return to full duty or his usual work tasks, there should be some type of modified or transitional duty available. The supervisor should be an integral part of this — finding/designing opportunities and guide the injured worker through the process, such as getting the medical restriction information from the treating physician.

Conclusion

Well-run workers’ compensation programs protect employees and save money for their organizations. The supervisor is in the best position to make sure a worker who does get injured has a smooth experience. Therefore, it is vital to make sure they are well trained in all aspects of the program.

Contact: mstack@reduceyourworkerscomp.com.

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

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

Filed Under: Workers Comp Cost Containment Fundamentals

Fourteen Steps Employers Can Take to Manage Workers Compensation Claims

March 1, 2018 by Rebecca Shafer, J.D.

Too many employers allow their involvement in the workers’ comp claim to end when they send the employee to the doctor. That is a huge mistake and will result in a steady increase in the amount of workers comp insurance premiums. The employer needs to have an established post injury process. It should include:

Report the claim to the insurer, third-party administrator or self-insured claims office immediately. The supervisor or your workers’ comp claims coordinator should be reporting the claim to the claims office while the employee is still en route to the medical provider.

Complete the Employer’s First Report of Injury and any other state required paperwork on the claim. If the injury is severe and the employee will be unable to return to work within the waiting period, provide the claims office with necessary wage information for the calculation of indemnity benefits.

Advise the claims office of the claimant’s prior history of workers comp claims. The adjuster’s approach to the claim varies significantly between the employee who never had a previous workers comp claim and the employee who has had 15 workers comp claims in the last ten years.

Review your transitional duty program and find a job the employee can do within the treating physician’s restrictions.

Be sure the employee’s supervisor (and co-workers if needed) is available to discuss the accident and injury with the claims adjuster and to assist the adjuster with the claims investigation as required.

Don’t alienate the employee – show empathy to the employee. When employees feel the company does not care about them and their injury and the company owes them, the claim will get ugly when employees think it is time to stick it to the employer.

Maintain an open dialogue – call the employee at home to show your concern and to offer assistance in processing the workers’ comp claim with the insurance company. Address any employee problems or issues right away. Also, call the employee on a regular basis until s/he is back at work.

If you are contacted by an attorney representing the employee, notify the claims adjuster immediately.

Immediately dispute any invalid or fraudulent claim.

If the employee has a questionable claim or a subjective claim for neck or back injuries, and immediately goes to the television advertising workers comp attorney, or a plaintiff’s attorney-oriented doctor known for excessive disability ratings, advise the employee immediately that you intend to fight the claim as the attorney and/or doctor has a history of inflated claims.

Monitor the state filings by the adjuster and any other claim related paperwork.

Monitor the Workers Compensation Board decisions – that means, reading them carefully, not just filing them away. Be ready to protest any finding or order you feel is unfair to you as the employer as all decisions have time limits for disputing the decision, with some time limits as short as 15 days. The board will learn YOU are an employer who takes part actively.

Monitor the medical progress reports to be sure the treatment is appropriate – for example – no physical therapy for the low back when the injury is a cut finger.

Always advise the adjuster when the employee returns work – the same day.

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

Contact: RShafer@ReduceYourWorkersComp.com.

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

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

Filed Under: Workers Comp Cost Containment Fundamentals

The Real Value of Injury Triage

February 28, 2018 by Craig Deneau

Injury triage has become more common over the last several years. Although the market is still in the process of adopting the service as a best practice, there are fewer risk managers that start off a conversation regarding triage by asking: “What’s that?” Indeed, injury triage is no longer a service only utilized by early-adopting, forward-thinking risk professionals. The service has proven its value in enough settings and employer types that adoption of the service will continue on to virtually all employers who have exposure to work-related injuries.

Looking at Triage Simply to Reduce Claims Could Miss Bulk of Savings

So, what is the reason why more employers, insurers, and carriers are beginning to use the service? The easy answer is that injury triage reduces the number of claims that are produced. By reducing claim volume, one can easily assume that overall claim costs for an employer or insurer will also decrease. This seems logical, right? While that may be true, looking at triage simply as a means to reduce claim frequency might be missing the bulk of the savings and efficiencies gained from use of injury triage.

Rather, a strong argument can be made that the real value is delivered through the use of the service from what might be referred to as “second-tier savings.” These are ancillary savings that are often unique to an employer’s situation. Many times the real value of utilizing injury triage has much to do with the specific challenges faced by an employer. For example, an employer that operates on a 24-hour basis or during late-night hours might have a significant dilemma regarding Emergency Room visits. ER’s are typically the only place where medical treatment is available at night. This type of medical treatment is expensive and not conducive to the overall goals of a well-managed workers’ compensation program. The ability of injury triage to greatly reduce the frequency of ER visits would be far more significant to that employer than an employer who operates during normal business hours when there are other accessible healthcare options.

Evaluate Real Value by Examining All Savings

Another example of injury triage’s real value demonstrated through “second-tier savings” would be a contractor or similar business, that is highly sensitive to OSHA recordables. In many cases, these types of businesses must be able to prove that their OSHA recordable rate is below a certain level in order for them to be able to obtain new projects and earn new business. The ability of injury triage to reduce OSHA recordables by making sure that injured employees access the proper level of care can be more valuable than any other benefit. This would not necessarily be the case for employers who are not as sensitive to OSHA recordables; so the real value of injury triage for some contractors lies in ancillary benefits.

A strong Return on Investment can be shown simply by looking at injury triage as a means to reduce the number of claims that are produced in any given time period. However, evaluating the real value of injury triage should be done by examining all of the savings the service provides on an employer-specific basis.

Author Craig Deneau, Medcor, National Practice Leader-Triage Services. 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.

Filed Under: Work Injury Response

Orchestrate A Culture of Quickly Reporting Workplace Injuries

Health Navigation – Finding a Path to Better Health and Lower Costs

3 Reasons and 5 Ways to Speed Up Workers’ Comp Claim Lag Time

The Process to Workers’ Comp Reform Is Just Like Riding A Bike

4 More Ways to Spring Clean Your Workers’ Comp Program

5 Ways to Spring Clean Your Workers’ Comp Program

How Star Wars Nailed the First Step in Workers’ Comp Management

11 Ways Supervisors Can Enhance Your Workers’ Compensation Program

Fourteen Steps Employers Can Take to Manage Workers Compensation Claims

The Real Value of Injury Triage

Search Site

Subscribe to Our FREE Newsletter

Read Our Award-Winning Blog

Currently Trending in our Roundtable

Recent Blog Posts

Blog Resource Categories

From “Risk Management Monitor”

Share Us

Site & Blog Navigation

Subscribe to Free Weekly Newsletter

Professional Development Resource

Please don't print this Website