Cold winter nights and non-stop snow storms across the country should not delay claim management teams from preparing for springtime.  Now is the time to do some “spring cleaning” in your claims management program to make sure you are ready for summer.  Part of this process includes a complete review of your program to ensure efficiency and effectiveness.

Know the Goals of Your Clients

Everyone talks about “meeting the goals” of your clients.  Do you really know what those goals are?  The process starts with meeting with your clients to better understand what they are trying to fix, accomplish or avoid.  This will allow your team to concentrate their efforts on these areas to meet – and hopefully exceed their expectations.  Common themes can include:

• Complete Required Documents in a Timely Manner: Members of the claim management team are required to perform a number of functions in a timely manner.  This includes the prevention of unnecessary costs associated with administrative penalties, excessive litigation costs, and delayed return-to-work.

• Avoid Communication Breakdowns: Workers’ compensation claims are driven by information.  Not having correct and accurate information results in time lost by individual claim handlers.  Physical and psychological barriers need to be removed so all interested stakeholders can communicate in an effective manner.

• Full Regulatory Compliance: The workers’ compensation system is driven by the details.  This includes ever-changing requirements on when, how and where forms are to be filed.

Implementation of Claim Management Decisions

Proper execution of a client’s decisions is essential when running an effective claim management team.

• Empower all team members to make decisions: Surround yourself with people who exercise good judgment and make informed decisions.

• Keep the goals and objectives of the client, and keep them in mind at every decision. This includes using preferred service providers when necessary and a willingness to make recommendations.

• Be a zealous advocate for the claim – integrity is key! Treat all injured employees with respect and dignity.  This can be accomplished by returning calls in a timely manner and making all decisions in good faith.  Never cut corners or try and save a buck by issuing frivolous denials.

Coordinate Efforts on Risk Assessment

There are numerous ways claim management teams can be involved in the risk management process. Key areas to focus on include the following:

• Preparing effective job descriptions: There are a number of challenges employers face when engaging in the hiring process by the posting of an open position.  Potential barriers include the American with Disabilities Act and other affirmative action considerations.  A proper job description should be written in a comprehensive manner that includes the ability to accommodate all prospective employees.

• Interviewing process: This part of the hiring process is fraught with dangers that lurk in every question asked of a candidate.  During the interview process, it is important to focus on someone’s experience, training, and planning ability.  It is also essential to set the right tone when it comes to workplace safety.

• Global Settlement and Release of Employment Claims: Seeking a voluntary resignation and release of all employment claims is often a term of settlement employers request when settling a workers’ compensation claim.  While employees are a valuable asset, seeking their resignation of employment can be a tool to reduce future exposure and limit liability.  Consultation with an attorney who understands employment law issues is important when making these requests.

Review of Return-to-Work Policies and Procedures

Countless studies indicate that returning an employee back to work following an injury pays dividends.  It is important for employers and other interested stakeholders to be fully invested in these measures as part of their workers’ compensation programs.  This should not be limited to returning an employee to work with the date of injury employer.  Other considerations should include the Ticket To Work program and “work to loan” efforts.

Conclusions

Spring is in the air – now is the time to review one’s workers’ compensation program.  This includes a proactive claim management team meeting with their insureds and better understand their goals.  Suggestions can also be made when it comes to assessing risk and getting injured employees back to work in a timely manner.

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: 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.

It is important for members of the workers’ compensation claims management team to take a proactive step in reducing program costs.  This includes a variety of opportunities for all interested stakeholders to take ownership of cost reductions within a program.  The result means a more efficient program that allows the claims handler to focus on their job and serve not only their clients but the injured employee.

Educate all Stakeholders

Reducing workers’ compensation costs all started with educating all interested stakeholders and employer representatives.  This includes the following activities:

• Be aware of important state laws and regulations. Making everyone aware of important state laws and regulations that impact a workers’ compensation claim;

• Treat all employees with respect and dignity. Emphasize the importance of treating all employees with respect and dignity. It buys goodwill and helps move claims toward settlement; and

• Be resource for employers and their management team. Become a resource for employers and their management team. Developing a good rapport includes being someone others can count on for timely and accurate information.  This can consist of offering seminars and other educational opportunities.

Safety Priority #1

The best way to improve a workers’ compensation program and reduce costs is to prevent an injury from taking place.  Making safety a priority goes beyond setting common-sense policies and procedures within the workplace.  It must also include other actions that demonstrate a commitment to safety for all employees:

• Buy-in from management. Full participation in a safe workplace starts with buy-in from management. Practice what you preach and others with follow;

• Reflect the value of safety. Reflect the importance of safety in all workplace policies and procedures. When the expectation of safety is reflected in everything a company does, it is a lot easier for the employees to take notice and follow;

• Highlight safety procedures and accomplishments. Highlight safety procedures and achievements in visible locations throughout the workplace. It should also be something that is discussed at all team and companywide meetings.

Employees seek workplace cultures that are driven by success.  One element should include safety, which makes employees feel appreciated.

Take Immediate Action Post Injury

Employees judge employers on how they respond to workplace injuries.  Interested stakeholders should make every effort to respond to injuries promptly.  Important considerations go beyond calling 9-1-1 or handing out a band-aid.

• Plan consistent injury response procedure. Planning is often overlooked in the modern workplace. Every employer regardless of size should have a plan in place that covers anything from minor injuries to large-scale disasters;

• Establish a chain of command. Establish a chain of command for workplace injuries. All employees should know and understand whom they need to contact following an injury.  This will also include where to seek medical care and treatment; and

• Create emergency response teams. Create emergency response teams to assist an injured employee following an event. This can include having someone on staff that is familiar with first aid techniques that can include including cardiopulmonary resuscitation (CPR) and portable defoliators.

Responding to injuries also includes following up with the employee in the days and weeks after the incident.  Studies demonstrate that workplaces that have long-term injury response reduce the likelihood a claim will be placed into litigation and quicker return to work times.

Sniff out Fraud and Stop It!

Fraud in workers’ compensation goes beyond the malingering employee.  The true essence of fraud occurs when someone knowingly makes a false representation of a material fact to obtain workers’ compensation benefits.  It can also occur when an employer misrepresents the amount of payroll or classification of its employees.

Members of the claim management team need to understand fraud by the employee and employer are wrong.  All states have whistleblower laws that protect an individual who makes a good faith report of fraud.

Conclusions

The bottom line of any workers’ compensation program should be to reduce costs and pay benefits an employee is entitled to receive.  Diligent workers’ compensation programs seek opportunities to reduce costs ethically and promote efficiencies.

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: https://blog.reduceyourworkerscomp.com/

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

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

Hey, Michael Stack here with Amaxx. We’re getting down to crunch time. It’s six days to Christmas. It’s about the holiday pageants and the parties and leveraging the overnight and priority shipping, to get everything ready and prepared for the big day. Now in my family we have four young kids, aged two to six years old. It’s a lot of fun for us, very exciting time of course for them, and really enjoyable for us to really share in that experience with them. But of course it’s a lot of work and it’s very busy, so one of the things that we like to do to enjoy this time of year is to sit down and watch holiday movies.

Apple Removed “Swipe” on iPhone

We are through on the movie Christmas with the Kranks this weekend, nice Tim Allen family comedy Christmas movie. As we’re sitting on the couch my wife is sitting next to me and she takes out her phone and she swipes, she’s, “Oh man. Shoot.” She just updated her iPhone operating system. Of course with new operating system they eliminated the swipe, and she hadn’t yet learned that new habit. I’d updated mine a couple of weeks before and it took me probably maybe 30 or so swipes before I learned that new process that I didn’t have to do that anymore.

Return To Work Success Happens One Worker At A Time

It got me thinking about our work comp programs and the goals that we set for the new year in 2017. Let’s say you want to be one of the best in class providers and return to work, and you want to get 95% of your employees back to work within zero to four days as your goal. What’s important to remember is that that old habits, that old process, that old culture, same as when we’re learning to use our new phones, exists in a much larger scale at our organizations. That goal of 95% of your employees back to work in zero to four days starts with getting one employee back to work just one day sooner. It puts you on that path to achieve that significant goal.

Again, I’m Michael Stack with Amaxx. I want to thank you for your support of me and of the Work Comp Roundup blog throughout this past year of 2016. I look forward to continuing to provide you content to help you along with your progress in the new year.

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices.

Contact: mstack@reduceyourworkerscomp.com.

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

Live Stream WC Training: http://workerscompclub.com/livestreamtraining.com

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

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

Hello, Michael Stack here, Principal of Amaxx, Founder of COMPClub, and co-author of Your Ultimate Guide To Mastering Workers Comp Costs. The recent opt-out discussion at the WCRI Conference was nothing short of a title fight. Trey Gillespie, who’s the Senior Director of Workers Compensation at the Property Casualty Insurers Association of America, as well as Bill Minick, who’s the President of PartnerSource, faced off with very professional and strong arguments both for and against opt-out. What I want to do is give you a summary of that discussion, and talk about some of the best practices that can impact you and your organization.

Benefits of State Plan Are Regulated; Opt-Out Defined By Employer

When you talk about comparing opt-outs to the state system, the main area of comparison is in the injuries and benefits that are covered. We’re going to compare the state system of Oklahoma against their opt-out plan, which is called the Injury Benefit Plan. In the state system of Oklahoma, injuries and benefits, just like the 49 other states, are state regulated. In order to qualify for those benefits in that particular state, the injured worker needs to be injured in the course and scope of employment. Very basic workers’ compensation 101. It’s going to vary by jurisdiction significantly as far as the laws, but these basics are fundamental across the entire country.

Now let’s talk about the opt-out plan. It was defined in Oklahoma that the benefits need to be equal to or greater than the state. That’s the way it was originally presented, and that’s the way that that act originally passed. Here’s the rub, and here’s the reason why that plan, that injury benefit plan, the opt-out plan at Oklahoma, was recently determined to be unconstitutional; is because the employers define what is and is not an injury in their plan. I’ll paraphrase from the conclusion of the judge that deemed it unconstitutional. It was a Dillards workers’ compensation case, and this judgment came out in February of 2016. He said that while standards of the state act, certain standards like the average weekly wage, the death benefits, disability benefits, do apply to the Injury Benefit Plan, no other provision of the plan applies unless expressly incorporated. He said, “While certain aspects of the plan, like the average weekly wage, the death benefits, the disability benefits, do apply down here, no other provisions apply unless expressly incorporated.”

One of the aspects that Trey pointed out was that claims that are reported after 24 hours are typically excluded from those plans, so a claim that’s reported 3-4-5 days later, 7 days later, can be excluded from the plan and not covered under workers’ compensation. Only about 60 employers in the state of Oklahoma have actually opted in, so clearly by the general nature of the ability for companies, and certainly not all companies that have opted-out would do this, but the ability for them to unfairly treat injured workers, and the judge’s unconstitutional conclusion, obviously that employer plan in Oklahoma has a ways to go before it’s a responsible alternative to workers’ compensation.

Accountability & Communication

Let’s talk about some of the best practices that we can pull out of this presentation, and how it can impact your organization. Bill’s main point was in the opt-out plan, there’s significant accountability and communication…he said there’s significant accountability and communication…accountability and communication…accountability and communication. Hold on to that point because it’s a significant one for you and your organization. In the state plan, the accountability and communication requirements are very low, in the opt-out plan, they’re very high. Obviously this isn’t the right thing to do, but having the requirement that claims are reported within 24 hours creates a significant opportunity for improvements in workers’ compensation outcomes.

Let’s talk about how this can impact you and your company. Accountability and communication, regardless of the state you’re in, regardless of the jurisdiction you’re in, regardless of if you’ve opted out or not opted out, are fundamental techniques in workers’ comp cost containment. Fundamental techniques in creating a high integrity work comp management plan that not only creates better outcomes for your injured workers, but it significantly reduces your cost. Implementing accountability is as simple as creating an employee brochure, creating a culture of reporting claims within 24 hours, not because your claim is going to be denied, because it’s the right thing to do, and it’s a better outcome for the injured worker. They’re going to report those claims because it’s better for them, not because it’s better for you. They’re going to get treatment faster, get returned to work faster, reduce your costs, reduce their length of time with a disability.

Implementing a communication plan, again, of setting those expectations and then meeting those expectations. Hold weekly meetings with your injured workers. Talk to them about how you can creatively create a return to work plan to get them back functioning, being productive for themselves, and your company. It’s part of a high integrity work comp management program that not only creates better outcomes, but it significantly reduces your work comp costs.

Remember your success in workers compensation is defined by your integrity, so be great!

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

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

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

Series Offers How To’s And Strategy For One Individual to Master Organization’s Work Comp Costs

HINGHAM, Mass.—Jan 11, 2015— With regular company mergers, acquisitions, and changes in management, professionals in the workers’ compensation industry know that the only certainty is constant change.  Individuals looking to stabilize and grow their career in the workers’ compensation industry will get practical how-to’s and strategy to master workers’ compensation and positively impact their career.

The series will cover the detailed path of how one individual can drastically influence the cost of workers’ compensation at their organization to make themselves an invaluable asset. Lessons that have been field-tested by Amaxx, workers’ comp cost-control experts, for more than 25 years.

Topics include the specific tasks and systems that create the most impact on work comp costs, how to bring management and employees on board, as well as how to implement these systems to achieve incredible results.

“Besides risk managers and human resources professionals, the training is invaluable for adjusters, vendors, attorneys, brokers, carriers, and anyone else interested in controlling workers’ comp costs,” said Rebecca Shafer, head of Amaxx and America’s leading workers’ comp cost-reduction expert.

Amaxx also recently launched COMPClub, a workers’ comp training service and community that has already attracted 75 members nationally.  COMPClub includes Amaxx’s annually updated cost control guidebook, live workshops, monthly webinars, small-group mastermind calls, a newsletter, networking events and more.

Registration for the free training series, “Power of One: How Your Impact On Workers’ Compensation Will Change Your Career” is available at http://reduceyourworkerscomp.com/register. As supplemental material, those registered will also receive a free copy of “Your Ultimate Guide To Mastering Workers’ Comp Costs – Mini Book”.

Amaxx (http://reduceyourworkerscomp.com) helps employers in all industries reduce workers’ compensation costs through education, publishing and consulting.

New Service from Amaxx, Leader in Cost Control, Provides Unique Training Community

COMPClub, offering training, community and knowledge- for everyone who needs to help their organization or clients reduce workers’ compensation costs has been unveiled by Amaxx Work Comp Solutions, a training firm and publisher.

“This is a new way for risk managers, adjusters, vendors, attorneys, brokers, carriers, and employers with an interest in controlling workers’ compensation costs to increase their knowledge and apply it,” said Rebecca Shafer, a renowned workers’ comp expert who heads Amaxx. Shafer’s pioneering methods have been proven to slash workers’ comp costs by 20 percent to 50 percent.

 
COMPClub offers a full menu of benefits free with membership:

• Annual copy of COMPClub’s training manual – “Your Ultimate Guide to Mastering Workers’ Comp Costs,”—a $250 value.

• Live quarterly workshops. One-day workshops on key cost containment topics will be held in different regions of the US. These will give COMPClub members a deeper level of interaction with experts and each other in a hands-on, interactive classroom setting.

• Best Practices monthly webinars on topics such as return-to-work, post-injury response, and medical management. Led by Shafer or another top expert, the webinars will give attendees state-of-the art knowledge on best practices and creative solutions.

• Monthly small-group mastermind calls offer the opportunity for interactive learning. A group of up to 10 peers will share their challenges and successes implementing the training material in the spirit of collaboration where participation is encouraged and solutions are discovered.

• The monthly CompClub newsletter will summarize, highlight, and simplify the discussions on the topic of the month. Members will receive practical tips to implement into their organizations immediately.

• Members-only events networking events at the annual RIMS and National Workers’ Comp and Disability conference.

• A members-only LinkedIn group and CompClub members directory.

• Opportunity to private-label Amaxx products and publications at a discount.

• License to use Amaxx’s library of workers’ comp articles for internal publications.

Workers’ Comp Newcomers

For those that are new to workers’ compensation there is a special subgroup designed to get quickly to speed. This program focuses on workers’ comp 101 topics and is a safe place to answer all the questions newcomers are too afraid to ask.

Sign up Now for Risk-Free Trial and Receive 40% Off First Year Membership

COMPClub membership is $99 per month, with the first month FREE. People who pre-register will get 40% off first-year membership dues for a limited time.

“There’s no cost and no commitment sign up. Our risk-free trial allows users to try out the COMPClub experience,” said Amaxx president Michael Stack.

To find out more or sign up for COMPClub, visit www.workerscompclub.com.

There are many tools employers can use to solve their workers comp problems. The answer to the problem can be a traditional solution, but workers compensation is a moving target, so the employer is required to consider all options.

Consider the option of “The Indirect Approach”, which in recent years has been described as “thinking out of the box”.

The theory of the indirect approach was published in the 1920s. Don’t do the obvious and don’t do what has consistently failed. Otherwise, you are duplicating Einstein’s definition of insanity: doing something a hundred times and thinking you will get a different result on the hundred and first try.

Consider Workers Compensation’s Relationship With Other Laws

Workers compensation coexists with dozens of other laws with which an employer must comply, creating opportunities for the curious. Every new law, and there are thousands of new laws each year, necessarily interact with laws already in existence, but little is written about those countless possible interactions, many of which can solve a comp problem for an employer, as well as its employees.

Attorneys who represent workers quickly discover these interactions in benefits awarded from several sources on a comp claim. A single motor vehicle accident might have the work comp attorney juggling through a comp claim, a negligence suit, STD, LTD, social security and unemployment claims. Furthermore, these interactions are quite common. But to the employer, as well as to carriers, the comp claim seems to be isolated and only indirectly affected.

But the worker’s attorney, after a few years in the business, learns how to coordinate handling of multiple claims to produce more fees for fewer hours worked – but only with proper coordination.

Regulatory Laws Provide Additional Investigative Options For Employer To Reduce Claim Costs

For the employer, regulatory laws from both state and federal, provide additional opportunities to investigate work comp problems within the first week after a reported injury, without interacting at all with the comp system. The opportunities include medical exams, HIPAA releases, as well as numerous opportunities to open and maintain independent channels of communication with the worker and the medical providers.

Medical examinations of drivers of heavy vehicles, under the federal Department of Transportation (DOT) regulations are usually done every two years to keep a driving certificate active. What is not generally known is that the employer may schedule its own exam anytime the driver’s medical condition may have changed. This is what precisely arises whenever a comp claim is filed. The exam is under the sole control of the employer and outside parties, other than the driver, may not be informed.

Many other laws have similar provisions for exams. Surprisingly, these have the effect of reducing the number and severity of comp claims.

In many med exams, HIPAAs are necessary since prior conditions must always be considered. Here, too, is an opportunity for employers.

Largest Positive Effect Is Employers Engagement in Employee Communication

But the largest positive effect of the employer engaging with alternate Federal and State laws comes from the chance an employer has to communicate with a worker and the worker’s family. The communications can involve the possible causes of the injury, but can also involve early discussions about return to work. Involving the spouse in the discussions reduces disability duration, since spouses are rarely supportive of extended disability.

All these things are produced by an indirect approach handling of employee disability.

Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100. medsearch7@optonline.net

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

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