This Is Part 1 in a 3 Part Mini Series.

The Tipping Point in Workers Compensation

1. Paul Revere, Workers Compensation, and the Tipping Point
2. Make Your Work Comp Message Stick Like Gorilla Glue
3. How Work Comp Can Be Just Like Prison

“One if by land and two if by sea,” April 18th 1775, Paul Revere was sent on a midnight ride to notify John Hancock and Samuel Adams that the British were coming. He was also tasked with notifying the countryside to be prepared for battle in one of the first stages of the revolutionary war. We all know that story, we all know the name Paul Revere, but there was a lesser known name, William Dawes. He was sent with that same task but why is Paul Revere famous in American history and William Dodd is a relative unknown?

I’m Michael Stack with Amaxx and I just finished reading for the second time The Tipping Point by Malcolm Gladwell. I read it a number of years ago but I just read it again. I really thought it would be fun to do a little mini series about some of the lessons and the stories that Mr. Gladwell teaches in there about starting change, about starting an epidemic, which is what you’re often trying to do in a work comp management program and in implementation particularly in organization that has a significant difference in how things maybe have been done.

Law of the Few, Stickiness, and Power of Context

There’s 3 three elements that he talks about in there and I did a short mini-series, one on each. The first one is the law of the few. The second one is the stickiness factor, and finally the power of context. The law of the few comes into play when you’re trying to get buy-in. You’re trying to get buy-in from your organization that this is how we’re going to do things moving forward. How do you get that message across? How do you get people to buy into your program?

Certain Individuals Are Exceptional People

Three different types of people that he talks about in the book. The first is the connectors, second is the mavens and finally the sales people.  It’s a very popular book and many people have probably read it, but I want to have you not forget about these people, these innate skills. I’ll run through them quickly. The connectors are the people that know everybody, that have a lot of friends, have a lot of acquaintances, know everyone at the organization. The mavens are the researchers. These are the educators; these are the people that really read the policy in detail. When you’re looking to buy a new equipment you know you’ve got to to talk to Sue because you know she’s the only one that has really read everything in detail, researched it, looked it up. You have that level of trust in her because you know that’s an innate skill in her. The sales people are those people that are super smooth. You know that they have the charisma, they have that personality that people follow what they do, because that’s built into their personality.

Leverage The Exceptional People To Obtain Buy-In

When you’re trying to get buy-in the first step is to get your CEO involved as well as these people that have these innate skills. It’s critical to have people buy into your organization. Do not forget about the connectors. Do not forget about the mavens, the people that maybe will have researched all the doctors in your program, have researched all the vendors, have read through your entire policy, something that no one else probably did. Make sure you bring Sue on board. Make you bring your sales people on board. Make sure you bring your connectors on board. When you’re working with senior management, rolling out this program, do not forget about the law of the few and it can make a difference at your organization.

I’m Michael Stack with Amaxx. This is The Tipping Point mini series. 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.

Fear, silence, and uncertainty do more to drive workers’ compensation costs than is generally appreciated – and these factors are fairly simple to control through employer involvement. Attorneys in the field quickly learn that an unpaid medical bill is certain to drive a worker to a lawyer, but there are many other fears which will also do the same thing. Job security is perhaps the second greatest fear, but much else can cause dangerous anxiety. Your workers will quickly find themselves worrying about problems which don’t exist and can’t exist, but these problems will be very real unless someone communicates with them.

Employer Needs to Maintain Communication

The employer does not have to be a counselor or advocate to control such stress, it just needs a credible reason to maintain direct communication. Other laws, OSHA, DOT, FMLA, contain provisions for employer directed medical examinations which are separate from workers’ compensation. These demonstrate the employer’s concern and can be performed days after an injury is reported.

If an employee’s disability extends for more than a few days, a phone call at reasonable intervals to inquire about any difficulties in obtaining proper medical care or simply in purchasing food service as an excellent way to maintain contact.

The employer should be aware that many workers live alone and even one week at home can be a difficult experience. Also, the employee will be communicating with a new and often mysterious group of individuals that are inevitably part of the claim process – claims examiners, medical office personnel, state boards, and lawyers. Each of these will be speaking to them in unfamiliar technical terms.

The employer, who has been through previous workers’ compensation claims, can serve as an interpreter. The employer can also answer many related questions, especially with regard to short-term disability if the claim should be contested.

Employee’s Spouse Is Your Greatest Ally

The employer will also be able to answer most of the concerns of the spouse. Disability is a family problem and the spouse is your best ally. Spouses do NOT generally favor extended disability and will do more to make a return to work effort succeed than an entire team of vocational rehab experts. Never cut off communication with such a valuable friend.

In short, silence is the worst enemy of an effective disability management program.

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

©2016 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

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

THE SPIRIT OF RELATIONSHIPS

AN AGREEMENT FOR RESPONSIBLE COMMUNICATION  AT WORK

These guidelines are designed to help us maintain our courage and to remain open and vulnerable to those to whom we are listening. By providing a forum of trust based in support and sincere respect with co-workers, we will feel free and more comfortable to express and explore our feelings, insecurities, desires, hopes, and dreams.

1. I promise I will not only hear you, but will listen. I will try to let you finish your whole thought and not interrupt. The sharing of our thoughts is what respectfully engages us.

2. I understand you may say things, which are upsetting to me; however, I will accept what you say as your truth. I will not emotionally or physically withdraw as a sign of rejection.

3. Although being open and vulnerable to you may be difficult and possibly threatening to me; I will try to make it safe for you to express your most intimate feelings regarding your positions during our dialogue.

4. I know l am responsible for how I feel and which actions I choose. If you feel I am blaming you for my current feelings and actions during this forum, please tell me. I will listen to you, and stop!

5. Because there is complete understanding when the truth is shared, I will always tell you the (my) truth as honestly, compassionately, and respectfully as l can. I concede that my truth is based upon my knowledge and experiential loci.

6. Because I want us to convey meaning and commitment, I will not use my mind or body to manipulate, control, or defend what you communicate. I will strive to remain free to observe you, your presentation and behavior without projecting guilt, judgment or physical harm. In this way, we both open our intellectual discourse to explore the other’s values and conclusions thus broadening mutual understanding.

7. Because our minds are unique, we will interpret work values and beliefs somewhat differently. Therefore, I agree that we can disagree. My relationship with you is not based upon seeing eye-to-eye on all issues, rather upon mutual respect and honor of the other’s point of view. Between our truths lies compromise we can initiate action upon that and can create a path thru revisions to affect the best strengths of the plan. This concept fundamentally implies that the evolution of ideas and solutions is fluid and non-static.

8. If a barrier arises between us, l want you to know I will deal with working through it, until we have a resolution we can both accept and carry forth. We are committed to equality of governess, and I want to remain open to all perspectives, exposed to new ideas, and ideologically available to take positive action for the benefit of all.

9. Because I want you to trust me, and I want to feel equal with you, nothing you share with me will be intentionally distorted or used to provoke or diminish you, your ideas or actions later. I acknowledge, trust and respect our philosophical boundaries. I will refrain from using the spoken word and media to, as is commonly used, bear less than truthful witness and manipulate your position in order to gain strategic advantage.

10. I offer you my personage and help unconditionally for the philosophical purposes to advance and heal this organization. By this I mean I will support and be here for the intrinsic value of this wide reaching process and will work with you to achieve prosperity, community action and respect as well equal opportunity for all citizens.

We commit to these ideals.

Signatures of participants in this agreement:

Author: Christopher Maywald, D.C., Maywald Chiropractic & Sports Therapy, specializes in comprehensive chiropractic sports medicine care helping patients quickly reach their health objectives and enhance their overall quality of life. Dr. Maywald has a B.S. in Human Biology and a Doctorate of Chiropractic from Logan College of Chiropractic. He is a frequent author and speaker and has been featured in Time Magazine, on ABC TV’s Chronicle and in Patriot Ledger Sports. Contact: christoph.maywald@comcast.net, Website: http://www.maywaldchiropractic.com/

The dictionary defines rapport as:  a friendly relationship based on mutual liking, trust and a sense that they understand and share each other’s concerns.  One of the biggest mistakes employers make in handling their workers’ compensation claims is the failure to have rapport with the injured employee.

When an injury occurs to an employee, once the immediate medical treatment is obtained, the primary concern of the employee is how the injury will impact his/her job, his/her future income and his/her ability to take care of their family obligations.  The wise employer will have the workers’ compensation coordinator or employee’s direct supervisor in touch with the employee the same day as the accident to address the employee’s concerns about the future.

Employee Needs Feedback and Positive Reinforcement

Following an accident, the employee needs both feedback from the employer and positive reinforcement that he/she will be taken care of by the employer. The work comp coordinator or supervisor should contact the employee to:

• inquiry with the employee about what the medical provider had to say,
• offer to arrange future medical care or diagnostic testing, if needed
• advise the claim has been reported to the insurer and the adjuster will be in touch within the next 24 hours
• reassure the employee that their job will be waiting for them when they are able to return to work
• advise the employee that the employer will do what is necessary to provide the employee with modified duty/light duty work when the medical provider states it is okay to do so
• determine when the employee’s next medical appointment is
• ask the employee to call in following the next medical appointment to update his/her status
• ask the employee what the employer could do to prevent future accidents like the one the employee just had
• ask the employee if they have any questions or concerns about what will occur with their workers’ compensation claim
• by contacting the employee, preferably the same day, following an accident, and answering all of the employee’s questions, the employer shows the employee the employer is concerned about the employee’s wellbeing.  When the employee is not contacted following the accident, the employee will feel ignored by the employer.

No Contact Leads to Worry and Often Legal Involvement

This will often lead to the employee hiring an attorney to answer the questions about the work comp claim the employer could have easily answered.  The attorney will quickly express how the insurance company and the employer are out to take advantage of the employee, and, of course the attorney can protect the employee from all of his/her concerns for a percentage of the claim.  Often the attorney will even tell the employee that they will net more money after the attorney’s fee, than they would without the attorney’s assistance.  The worried employee will often be quick to latch on to these promises, if they have do not have rapport with the employer and the employer’s reassurance that the employee will be taken care of.

The best way an employer can prevent an injured employee from obtaining an attorney and the unnecessary additional claim cost that drives the employer’s premiums higher, is to maintain contact with the employee after the accident. Not only is contact immediately after the accident needed, contact with the employee following each medical visit will work wonders in maintaining rapport and trust with the employee.  By maintaining an active interest in the claim and the employee’s wellbeing, the claim will move forward in a positive manner.

Build Positive Momentum Through Return to Work Program

The return to work program, even if well established at your company, needs to be discussed and explained to the injured employee in terms of keeping his/her job available.  The return to work program should be explained to the employee in terms of minimizing the income lost the employee will have due to receiving the lower disability benefit rather than the regular paycheck.

By maintaining contact with the injured employee, the employer will maintain rapport throughout the claim process.  The positive atmosphere created by the rapport between the employee and the employer will lead to a more satisfying outcome of the claim for both the employee and the employer.

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.

WCRI Study – Avoid Litigation

WCRI did a study back in 2014, and it was all about avoiding litigation. It studied the factors that went into why employees will hire an attorney.  And there were three main findings:

• The first one was a fear of getting fired, they were concerned about being fired just because they were injured on the job.
• The second one was they thought that their supervisor thought that they were faking it, they thought their supervisor thought it was an illegitimate injury.
• And number 3 was claim denial, either the claim was actually denied, or their perception was that the claim was denied, even though it was accepted.

Poor Communication Main Factor In Litigation

Here is what stood out to me the most about each of these factors.  Each of these factors is due to poor communication. And the number that stood out the most was in this fired number.

• Of all the injured workers that they surveyed, 33% responded that they had a fear of being fired. I’m going to say that one more time, of all the employees that were surveyed, 33% responded that they had a fear of being fired just because they were injured on the job. An extremely huge red flag about poor communication with these employees.
• The rest of that study just to round that out, was that 48% of employees that actually hired an attorney responded that they had that fear.

Face-Face Weekly Meetings

So, how do we improve upon this, how do we improve upon these number, how do we improve upon this lack of communication? We talked about the importance and the value of those face-face connections this holiday season.  That same theory applies with your injured workers, with your employees.  Having face-face weekly meetings with employees that are injured is an extremely powerful and valuable technique to really make those connections to communicate, to be able to eliminate these fears of being fired, be able to increase your communication and understanding of what’s going on with this claim. If you have some medical information that is really the reason why the claim is denied, you can really make that connection.

Demonstrate Care

So, here is what you are going to be talking about in these meetings.  You are going to be demonstrating care, you are going to be demonstrating care just by having the meeting at your job site.  If the employee is continuing to show up at the job site, their fear of being fired should virtually go away.

Medical Information

You are also going to be getting medical information, you are going to be talking with them about how the medical is going, how the PT is going, maybe how their relationship with their nurse case manager is going.  You are getting that medical information to make sure that injury is continuing to heal, progress, and recover.

Transitional Duty

The next thing you are going to be talking about is their transitional duty job, how is that continuing to improve.  You want to make sure that job is progressive.  Based on this medical, if they can only start out with at 10 lb weight limitation, maybe the medical is improving, you increase that to 15, you increase it to 20, you increase it to 30 lbs, so that transitional duty job continues to progress.

Employee Attitude

And the final thing you are going to be reviewing in these meetings is the attitude of the employee.  Are they cooperative, are they combative, is there frustration, is there fear, is there anger, or are they happy with how things are going.

Hugely valuable time to make that face-face connection, to deepen those relationships, to eliminate these factors that go into why an employee would hire an attorney.  Remember, in workers’ comp, your success is based on your integrity.  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.

©2015 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.

Problem:

Employees with a poor work ethics or performance records can be an extra cost and burden on the workers compensation system when they have an on job injury. This type of employee usually lacks natural tendency, parental training, public educational influence, possible religious guidance, self-motivation, habit forming skills, as well as other personal abilities for self-improve.

Unmotivated employees can exaggerate their injury, become non-compliant in medical treatment, malinger, add non related medical pathologies, as well as outright lie and even commit fraud.

Today’s social entitlement attitude, weak criminal-judicial system, as well as the societal overlooking or acceptances of such practices seem to make any relief from this problem almost insurmountable.

It is a tough job to change personal behavior.  However, there are opportunities and suggested programs that can work.

Planning:

Begin with a plan. This will be a motivational program (just like those created by the great Tony Robbins); therefore the action plan must be doable, simple, yet comprehensive enough to accomplish the goals of improvement and change.  Much of the weak work ethic is driven by personal habit, mental attitude, and personality.  Occasionally a physical condition may influence the poor behavior.

Every human being is different and will respond to various motivational stimuli.   Therefore, the program must allow for various changes in approach and implementation.  For example: John may just accept a verbal suggestion to incorporate a change in his behavior.  On the other hand, Pete may need a reward or discipline before incorporating the change of behavior.

Gather Facts and Data:

Take time to study each problem employee on an individual basis as they are working. This should be done in such a manner so as not to arouse the employee’s angst or suspicion.

Watch their attitudes as they perform their job function.  Observe their interface with fellow employees.  Listen to how they discuss home environments.  Watch body language for negativity.   This may require the assistance of professional counselors.  It will be necessary to have an existing profile on the employee before beginning the implementation phase.

Implementation:

Once the employee profile is developed, obtain professional counselor ideas or suggestions as to how best approach and start working with the individual.  Be friendly. Advise the employee that the program is meant for their sole benefit. Give all suggestions and instructions in clear manner.  Be sure the employee understands what is expected.  Reinforce by adding that the expected results will also improve personal life activity as well.

Keep sessions short and limit times for instruction or training.  Even if professional counselling is used do not allow it to overburden or overwhelm the employee.  Interface on a friendly manner with the employee as much and as often as necessary.  Reassurance is as necessary as the program itself.

Follow Through:

Congratulate every positive progress point the employee reaches.  Give rewards, privileges, extra appreciation comments, or any other provision that will help boost the employee’s morale. This assures continued improvement and should limit any backsliding.

Consider the merits of doing these things publically.  This could have a positive impact on fellow employees and raise their esteem for the treating employee. It might also bond the unit together as a team.  Further the other employees will get to see that the employer cares about them as well.

Since this is a comprehensive issue with complex potential it is recommended professional behavioral experts be utilized in the development for this behavioral modification.

Conclusion:

Poor work ethics and performance issues can adversely impact workers compensation programs and add excessive cost.  They also impact day to day operation, limit production, cause employee morale issues and may develop hostile workplace environments.

These issues delve into employee personal traits.  They are a challenge for employers to develop delicate improvement programs.  However, successful programs can lead to better employer employee relationships.  Increased production and fewer workers’ compensation claims could also be a fringe benefit.

Author Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. He is an expert in employer communication systems and helps employers reduce their workers comp costs by 20% to 50%. He resides in the Boston area and works as a Qualified Loss Management Program provider working with high experience modification factor companies in the Massachusetts State Risk Pool.  He is co-author of the #1 selling book on cost containment, Your Ultimate Guide To Mastering Workers Comp Costs www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

©2015 Amaxx LLC. All rights reserved under International Copyright Law.

SALES TO PAY FOR ACCIDENTS CALCULATOR:  http://reduceyourworkerscomp.com/sales-to-pay-for-accidents-calculator/

MODIFIED DUTY CALCULATOR:   http://reduceyourworkerscomp.com/transitional-duty-cost-calculators/

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

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

Question: When your employees have fears and uncertainties about Who do they call?

Answer: Most often a lawyer.

Question: When they have fears and uncertainties about the lawyer, who do they call?

Answer: Most often – another lawyer.

Why all the uncertainty? Actually, workers ­­­comp, like most other systems, has large gaps in disseminating important information to the least informed group – the workers, the very group that the system was created to help.

In the overly optimistic beginning of work comp it was assumed that lawyers would be unnecessary to assist workers. That didn’t last too long and neither did most of the other predictions. All of which quickly led to pretty much all the players looking for answers.

Golden Opportunity For Employers To Provide Information

Workers, employers, doctors – all without exception are looking for answers. In truth, reform in work comp isn’t needed nearly as much as access to accurate information. Which is a golden opportunity for employers to occupy a woefully vacant niche role in the process. The advantages are boundless and there is little or no opposition.

There is nothing to prevent an employer from being able to settle employee fears. But it does take a bit of effort. Not too much, but a bit. And the effort helps the employer as well. Quality knowledge, once acquired, helps every situation.

See A Workers Comp Hearing First Hand

How can the employer gain such knowledge? In addition to books and seminars , comp hearings and computer screens can provide invaluable information. Dropping in to the hearing points for comp claims, preferably when employees don’t have a hearing, is a painless introduction to the system. Is the experience better – or worse – than a morning at the motor vehicle bureau? (Much worse, which is why employers should see it first hand.)

After that, the employer should learn to locate and read the state comp board’s computer site (nearly every state has them). It will take some time, but nearly every question can be answered. If it can’t be found on the site find its phone number and call. The general counsel’s office will be most helpful. They would much rather answer questions before, not after, problems appear.

How do your employees fit in to this? Well, what you are doing is to blaze a trail for them to follow. They will be stressed out, whether or not they have had prior claims, and your assistance will be greatly appreciated. But your assistance will sound hollow unless you have attempted to recreate a live-fire claim experience.

Employees Need A Little Encouragement

Comp lawyers, such as your correspondent, get phone calls all the time, praying for a simple answer and some encouragement. Usually, we are glad to talk. But there is no reason the employer can’t speak also.

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

©2015 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

SALES TO PAY FOR ACCIDENTS CALCULATOR:  http://reduceyourworkerscomp.com/sales-to-pay-for-accidents-calculator/

MODIFIED DUTY CALCULATOR:   http://reduceyourworkerscomp.com/transitional-duty-cost-calculators/

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

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

Alcohol abuse in the workplace has long been a contention for denial of workers compensation benefits.  However, while most jurisdictions have either legislated or set precedence for these declinations, it is still the employer’s burden to prove the injury was solely caused by alcohol intoxication.  In addition,the employer must have a low to zero tolerance in their job site alcohol policies, and the employer must furnish proof for enforcement of the alcohol program.

Unlike other substance abuse items, alcohol puts one toxic component (ethanol), in the body.  This tends to limit damage for underlying pathologies.  Still, over time alcohol can have pronounced effects on health, life style, and job performance.  Slowness of comprehension and speech, malnutrition, poor job performance, loss of personal hygiene and appearance are to be observed.  Frequent confrontations with fellow and supervisory personnel are often a sign that the employee’s behavior is not normal.  There may be physical deterioration such as weight loss, slower physical responses and judgment issues.   The most commonly known damage occurs in the liver.

Policy

Set guidelines that are legal, clear, comprehensive and enforceable.  Obtain professional assistance in developing the plan.  Include methods of dealing with enforcements, punishments, and confrontation.  It is also a wise idea to have a rehabilitation program as an alternative to termination. A good employee is worth salvaging. Be sure every employee is made aware of the program and obtain their written confirmations.

Front Line Notice

It must be noted that many persons with alcohol abuse issues may easily subdue the outward signs of alcoholism.  This makes it difficult for the employer to realize a problem exists.  It behooves the immediate supervisor in close contact with the employee to observe and document any changes in the employee’s behavior, attitude, or other outward appearances noted above.

One sign that the employee may be drinking on the job is a change in personality after arriving on the job.  Dullness to euphoria or vice-versa is often a sure sign. Frequent visits to the restroom or locker room with changes of personality after return are another sign.  Containers with alcohol can be easily hidden under clothing.  Thermos or other liquid holding containers may even be in plain sight.

Approach

Great care needs to be taken in confronting the employee for an alcohol situation.  Any case controverted by the employer needs proper preparation for defense.

Begin by careful and complete documenting of events, situations and observances by supervisory persons.  Make note of fellow employee complaints (these should come from the employee and not solicited by the supervisor).  However, once the offending employee is challenged it may be necessary to obtain statements form these employees to act as witnesses.

Obtaining a medical physical examination must be considered.  The doctor will also serve as an expert witness to confirm the alcohol problem.

Be certain that the confrontations and claim denials are done in accordance with the alcohol policy.

Rehabilitation

When the employee is valued enough to merit retention, supply a rehabilitation effort to correct the alcoholic abuses.  Such programs could be relatively inexpensive and done in accordance with local government sponsored rehabilitation programs for substance abuses.  Monitoring the progress is often all that the employer need do.

Work with the employee to re-establish a working relationship with fellow employees.  This will also show the fellow employees that the employer has employee best interests at heart.

Summary

Injuries on the job caused by the employee’s alcohol abuse can be successfully defended for declination of benefits.  However, the employer has a heavy burden of proof to have a successful ruling by a workers compensation judge or referee.  Policies for alcohol abuse must be properly established and enforced.  Strong investigation and evidence gathering is mandatory for a successful denial of benefits and medical care.

If the employee is valued, vocational and/or medical rehabilitation  might be a contingent for allowing a compensation claim to be absolved.

Author Michael Stack, Principal of Amaxx Risk Solutions, Inc. He is an expert in employer communication systems and helps employers reduce their workers comp costs by 20% to 50%. He resides in the Boston area and works as a Qualified Loss Management Program provider working with high experience modification factor companies in the Massachusetts State Risk Pool.  As the senior editor of Amaxx’s publishing division, Michael is on the cutting edge of innovation and thought leadership in workers compensation cost containment. http://reduceyourworkerscomp.com/about/.  Contact: mstack@reduceyourworkerscomp.com.

©2015 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

SALES TO PAY FOR ACCIDENTS CALCULATOR:  http://reduceyourworkerscomp.com/sales-to-pay-for-accidents-calculator/

MODIFIED DUTY CALCULATOR:   http://reduceyourworkerscomp.com/transitional-duty-cost-calculators/

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

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

There are classes of comp claims that start as ordinary reports of injury but quickly turn into claims nightmares. Among these is the younger worker claim in which an otherwise healthy person develops an inexplicably complicated claim. An explanation that needs to be considered is “trouble at home leads to trouble at work”.

Younger workers often have not yet gained the life experience to deal with routine problems, especially if they are on their own for the first time. A marriage, rather than being a stabilizing factor, often produces confusion. Your correspondent learned early in his career as a comp lawyer that comp claims are often seen as a good way to get rid of a bad marriage. And not just for younger workers. Mid-life claims often have a similar motivation.

An Employees Private Life Can Be As Much Of A Problem  As The Injury

Anyone can make a situation worse than it is; improvements take skill, especially with claims. The comp investigation process, governed by the carrier, not the employer, is too remote and impersonal to provide the hands-on approach required where an employee’s private life is as much a problem as the injury. This is where sensitive involvement by an employer can prevent a person from using a claim to derail not only a job but a private life.

The employer needn’t intrude – or wait until it earns a degree in counseling. Chatting goes a long way. If there are serious personal problems present they will quickly manifest themselves – no matter what the topic of conversation. Your correspondent, as a lawyer handling workers’ claims, learned the value of seemingly idle conversation with clients. Eventually, the true sources of frustration would surface and the relationship would quickly improve.

Communication Is A Powerful Tool & Neglected Art

Conversation is a powerful tool and is a neglected art. Scowling interrogation produces results – but not the kind you want. Communication skills look effortless but are acquired through a lot of practice. Is it worth the effort? Well, what better way to avoid a $100,000+ claim? Litigation is no substitute.

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

©2015 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

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MODIFIED DUTY CALCULATOR:   http://reduceyourworkerscomp.com/transitional-duty-cost-calculators/

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

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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.

Workers in the claims profession and also on the employer side will often only think of claims as costs of wage loss and medical exposure.  It is true that those costs are the ones on the surface.  The injured worker has created a monetary exposure of their loss of wages covered by work comp payments, and also their medical expenses.

But we like to remind employers of the hidden costs.  To create the picture of hidden exposures we like to use an iceberg floating in the ocean.  On the surface, you see the iceberg.  But hidden underwater, the extent of the iceberg can stretch to great depths.  It is the hidden hazards that can create as much havoc as the iceberg you see above the water surface.  You need to think of the costs and expenses that you can and cannot see.

Time spent dealing with the claim

A worker at the employer has to deal with the paperwork end of the claim.  This can take their time away from other tasks they have to deal with on a daily basis.  Time spent on paperwork filing the claim.  Time spent getting medical updates and discussing the claim with the adjuster.  Time spent getting wage histories, reviewing state forms, completing OSHA reports, and so on.  While it may seem like nothing, if you look at the time spent over the course of the year dealing with claims paperwork, emails, conference calls, etc., the production time lost can be quite significant.

Loss of production on the job floor

The worker that was injured had a job they were hired to complete.  If you remove them from work, someone has to cover their shift.  Another worker has to complete their job and maybe the job of the injured worker.  Do you keep the injured worker as an active employee or do you terminate their employment and look for someone else to replace them?  Who has to cover their shifts?  Does this lead to increased injury exposure by stretching your current workforce too thin?  Does production suffer due to injuries and a lack of depth of workers?

Morale of other workers

Other workers hear gossip about the injury, what is happening, what the injured worker is dealing with, and so on.  Time around the water cooler or lunch room can be spent talking about work injuries and the ramifications involved with filing a claim.  Workers can see this as an “Us vs Them” mentality (this is why communication is so important) where the workers feel as if they have to fight for what they are entitled to should a work injury occur.  Distrust between floor level workers and management can develop, and it can hinder the overall atmosphere at an employer creating a negative connotation.

Creating light duty jobs can be seen as favoritism for certain workers

Those employees that are longer term workers will recall a time when they were not allowed to come back to work until they were fully released from care.  Now the environment can be one of creating light duty work to bring workers back while on restrictions.  Maybe not all workers are allowed to come back to work depending on their job (we don’t recommend this).  However they see worker X brought back right away, being paid their normal wage for completing a “cake job” while other workers in other departments are not allowed to come back at all.  This situation will create a labor issue, perhaps more so in a union environment, and it can now lead to wage grievances and meetings between management and workers about this issue.  This is time consuming and usually does not lead to a positive proactive result.

Time Is Valuable, Use It Effectively

So as you consider your claims at your workplace, think of the hidden costs and expenses that are associated with these claims.  The biggest trend you will see will be that of time spent on the claim on the back end.  Yes the adjuster has the task of handling the claim to resolution, but the employer is also actively engaged in the process. Most employers are not large enough to have a dedicated claim liaison where their only job is to deal with the insurance carrier or following the claim to its end.

Time is a valuable asset.  Production is valuable.  Work floor morale is valuable.  Everything has a cost and an expense tied to it.  Safety is everyone’s job at any employer.  If you are avoiding claims, you are performing at your peak of production.  Every claim you have, even minor in nature, can rob your workers of their ability to be focused on the job they were hired to do.

Author Michael Stack, Principal of Amaxx Risk Solutions, Inc. He is an expert in employer communication systems and helps employers reduce their workers comp costs by 20% to 50%. He resides in the Boston area and works as a Qualified Loss Management Program provider working with high experience modification factor companies in the Massachusetts State Risk Pool.  As the senior editor of Amaxx’s publishing division, Michael is on the cutting edge of innovation and thought leadership in workers compensation cost containment. http://reduceyourworkerscomp.com/about/.  Contact: mstack@reduceyourworkerscomp.com.

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

SALES TO PAY FOR ACCIDENTS CALCULATOR:  http://reduceyourworkerscomp.com/sales-to-pay-for-accidents-calculator/

MODIFIED DUTY CALCULATOR:   http://reduceyourworkerscomp.com/transitional-duty-cost-calculators/

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

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