Injection Therapy in Workers’ Compensation

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

 

 

Understanding Common Injection Therapies

 

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

 

Common injections include:

 

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

 

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

 

 

Work Comp Injuries Involving Injection Therapies

 

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

 

  • Knee or other joint arthritis;

 

  • Lateral epicondylitis (tennis elbow);

 

  • AC joint osteoarthritis;

 

  • Carpal tunnel syndrome or de Quervain’s Syndrome;

 

  • Hip impingement syndrome;

 

  • Trigger finger; or

 

  • Plantar fasciitis.

 

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

 

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

 

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

 

 

Tips for Effective Claim Management

 

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

 

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

 

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

 

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

 

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

 

 

Conclusions

 

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

 

 

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

 

©2019 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

Safety in the Trucking Industry

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

 

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

 

 

  1. Written Accident Prevention Plan

 

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

 

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

 

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

 

  • Frequency and location of safety meetings;

 

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

 

  • Company policy on hours of operation;

 

  • Steps to check the safety of the equipment;

 

  • Employer drug testing policy;

 

 

  • Post-accident retraining policy; and

 

  • Safe driver recognition program.

 

None of these points may be omitted!

 

 

  1. Driver Training

 

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

 

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

 

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

 

 

  1. Safety Meetings

 

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

 

  • Accident prevention;

 

  • Equipment safety; and

 

  • Fatigue management.

 

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

 

 

  1. Red Flags

 

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

 

 

  1. Fatigue Control

 

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

 

  • Number of hours driven by drivers; and

 

  • Number of miles driven, especially at night.

 

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

 

 

  1. Equipment Checks

 

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

 

 

  1. Drug Testing

 

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

 

 

  1. Accident Investigation

 

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

 

 

  1. Post-Accident Retraining

 

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

 

 

  1. Safe Driver Recognition

 

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

 

 

Conclusions

 

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

 

 

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

 

©2019 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

Reducing Work Comp Costs in Manufacturing

Manufacturing job are often thought of as dangerous places to work.  That is not the case if the factory has a proper safety program in place.  The creation of a safety program for a factory is not much more difficult than creating a safety program for any other type of business.  Now is the time to review your workplace if your business is engaged in manufacturing to make it safer for your employees.

 

 

Keys to Safety Success in Manufacturing

 

The success of any safety program relies on the emphasis safety is given within the company.  A company culture of safety that originates with the senior management of the company, with the safety culture being promoted all the way down through the ranks of the company, will have a major impact on the safety record of a factory.

 

The safety guidelines for factories are similar to the safety guidelines in many other industries. Key factory safety guidelines include:

 

  • All employees will wear all required safety gear, safety glasses, and safety clothing for their job/position while at their workstation.

 

  • All employees working around moving machinery are prohibited from wearing loose clothing or loose jewelry.

 

  • All employees working around moving machinery must have long hair tied back where it cannot fall forward or be caught in the machinery.

 

  • All tools will be in use or will be stored at their proper location at all times, no tools are to be left in any location where they are not being used or being stored.

 

  • All equipment, tools, and machinery are to be kept clean and in full working condition, with any defects being immediately reported to maintenance.

 

  • The instruction manuals for all machinery must be readily available for review.

 

  • All equipment and machinery are to be shut down when not in use.

 

  • All presses and machinery will require two-hand operation to keep fingers and hands away from moving part.

 

  • All machinery is to have the manufacturer’s installed safety guards.

 

 

 

Manufacturing Safety Pitfalls – Machinery Modifications

 

Machinery should never be modified by an employee.  This includes management or those not specifically trained in the technical aspects of the machinery.  All work areas are to be kept properly lit when anyone is working.  Other issues to consider should include:

 

  • All work areas are to be kept properly ventilated.

 

  • All areas of the factory are being kept clean and organized.

 

  • Anyone working in the factory under the influence of drugs or alcohol will be immediately terminated.

 

The safety officer for the factory should require every job to have a job hazards analysis with each employee performing that job being trained in recognizing the hazards to which they can be exposed and being trained on how they can safely eliminate or reduce those hazards. Each job should have a safety checklist with the employee being able to obtain a 100% grade on test questions about the requirements of their safety checklist.

 

 

Identification and Correcting Safety Issues

 

All employees conducting work that requires specific OSHA training must be required to complete the OSHA training before they can start work in the factory.  The factory safety officer should perform frequent factory inspections to identify any hazards the employees might have missed.  Any identified hazards should be immediately addressed and corrected.  The safety officer should also hold regularly scheduled safety training classes as well as requiring safety classes for all new hires before they can do any work in the factory.

 

Fire drills and other emergency evacuation drills should be conducted to ensure all employees know how to quickly and safely leave the building. As a part of all emergency drills, the employees need to know whether to shut down their machinery or to leave it running when they evacuate the building. As a part of the fire and emergency evacuation drills, all employees need to know where the fire extinguishers, fire hoses, and other emergency equipment is located, and how to use the equipment in an emergency.

 

 

Conclusions

 

The establishment of a strong safety program within the employer’s factory will result in a significant reduction in the number of workers compensation claims and their resulting cost.  Interested stakeholders need to be proactive on this issue and never shy away for making a change for the better in terms of safety.  When safety becomes a part of the culture, the reduction in work injuries will become notifiable.

 

 

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

 

©2019 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

What to Say After an Employee is Injured at Work

It turns out that “sticks and stones may break my bones, but words will never hurt me” is not exactly true. We know that words are powerful. Words are impactful. Words have a dramatic impact in the way that we feel and also a dramatic impact on the outcome of worker’s compensation claims and some of the highest value words, some of the most impactful words, are those words that we say immediately following an injury.

 

Hello, my name is Michael stack and I’m the CEO of Amaxx and today I’m going to walk you through a very simple dialogue. It’s a very simple script to follow. Immediately following that injury, we call this the first day phone call or the first day visit at the hospital, which is even better if you go to visit that injured worker and you’ll know when you go into that room, or when you pick up that phone.

 

Simple Dialog to Follow for Injury Follow Up

You’re going to walk into that hospital room, you’ll know exactly what to say and you’ll know if you follow this little dialogue, it’s going to put that claim on the path to success. I want to give you three little categories to follow and walk through here.

  • The first category falls under empathy or care. So first thing you want to do is express empathy or care. And you’re going to say, Hey John, we’re sorry he got hurt. We’re sorry this happened to you. How are you doing? How are you doing? Are you doing okay? Is everything okay with you? We’re really sorry. How you doing? Very simple, easy way to open up that conversation.
    • Number two, ask, is there anything I can do to help? So is there anything I can do to help you done? You know, do you need me to call your family? Did you leave any clothes at the at that works that I can pick up for you or you need a coordinate? Anything for you, anything I can do to help you? Sorry, you got hurt. How are you doing anything I can do to help after you follow this little technical piece? And of course you’re gonna listen to the answer to that very, I think obvious, but not so obvious in the way that people execute this. Listen to the answer. Have a little dialogue.
  • Next piece, I want you to get to go to this, this category, what I call technical. So then you’re going to go into some of the technical category and you’re going to say, how’s your medical, how’s your medical treatment going so far? How are these doctors, how the nurses treating you? Everything goes all, okay as far from a medical perspective. Any questions about that?
    • Number two, are you, do you know where you get your prescriptions? Do you know where to get all that information? You know, here’s your health ticket card that has your prescription number, this is how it’s all going to go. Do you know how to get some of this squared away? Some of that technical piece.
    • And then the third part of this is you have any questions you know about our work comp program. You know, do, do you understand the wage replacement? Do you understand, you know, our transitional duty policy, kind of how all that functions as far as our return to work and getting you back to go to full duty, all that stuff. Any questions about that? I can answer for you. John to make sure that you fully understand what’s happening. So you express the empathy, you go into the technical pieces. And then the last piece here is we want you back to work. We want you back to work. You know, John, we’re really sorry this happened.
  • As long as we go through all these questions and I want to let you know we’re excited to have you back. You know, we’re looking forward to helping you get this thing all squared away for you. Very simple dialogue, but also extraordinarily impactful. Follow that little three-step sequence and express the empathy, express the care, go into the technical pieces, and then we want you back. And if you do that, you will be setting your claim up for success.

 

Again, my name is Michael stack. I’m the CEO of Amaxx. And remember your work today in workers’ 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!

 

 

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

 

©2019 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

Create a Safety Action Plan

Engaged employers need to keep a continual eye on safety within the workplace.  According to the National Safety Council, 85 percent of all accidents could be prevented or reduced by having an effective safety program. To reach a high level of safety effectiveness a safety action plan is required. By creating a safety action plan, you remove the potential hazards and take the necessary actions to eliminate the hazards.

 

 

Taking the First Step: Hazard Identification

 

Safety concerns and hazards can be found in all types of workplaces.  The safety manager will recognize many, but even safety professionals do not recognize all hazards. The loss runs produced by your insurer or third-party administrator is an excellent source to identify hazards that you might not think about and overlook.  All company personnel should be encouraged to report any hazards they identify that have not been addressed by the safety manager. There are various types of hazards including:

 

  • Physical hazards: Machinery without guards, tow motors without back up sound warnings, inventory stacked haphazardly or too high, tools or equipment left where an employee could trip, etc.

 

  • Ergonomic hazards: Equipment or machinery placed incorrectly whether too high, too low, out of comfortable reach; processes that require the employee to twist back and forth; or that cause constant repetitive motions by the employee.

 

  • Chemical hazards: Improper ventilation, vapors from chemical processes, improper use of combustible materials.

 

  • Biological hazards: In the medical field, the improper disposal of needles and medical waste.

 

 

Taking Responsibility for Safety Issues

 

Every employer should treat safety as their responsibility and engage all employees in the process.

 

  • The employer should go a step further and hold the department supervisor or manager responsible for identifying the hazards within their work area.
  • The department manager should be given the authority to take the necessary actions to eliminate the hazards within the area of responsibility.

 

The next step in a safe workplace needs to be taken by management in eliminating the identified issues.  The department manager must follow through and create an action plan to deal with the hazard. Some hazards can be fixed rather easily. For example, an action plan for the haphazard stacked inventory – unstack the inventory and stack it correctly. Other hazards will take planning and resources.  This includes issues such as worn-out conveyor belt that poses a snag hazard for the employees. The hazard needs to be reviewed with the safety manager, and a plan to remove the hazard needs to become an immediate priority.

 

 

Implementing Safety In your Workplace

 

Whatever the nature of the hazard, once it is identified, timely, and appropriate action to remove the hazard is required. When a course of action can be implemented immediately, it should be. When the course of action has several steps, the implementation should be scheduled with a completion date set for each step to be implemented. The implementation and completion of the necessary course of action will reduce the risk of injury to the employees and reduce the company’s exposure to financial loss.

 

Removal or remediation of safety hazards require the following:

 

  • Use of financial resources;

 

  • Management taking necessary action to provide resources; and

 

  • Employees themselves will place a higher priority on safety.

 

Every action regarding workplace safety also required follow-up, refinement, and improvement.  When a hazard is identified within one location within the company, the safety manager should check to see if the same hazard exists at other locations within the company. When the hazard exists at multiple locations, the hazard should be identified to all employees. The action plan and implementation of the action to remove the hazard should be completed.

 

The process of implementing a safety plan requires the creation of a list of potential hazards. This can be very helpful in the elimination of future hazards. The list of hazards can become the foundation of a safety inspection checklist:

 

  • Review of housekeeping policies to ensure slips and slippery surfaces receive immediate attention;

 

  • Proper instruction on handling large objects and heavier items that need to be moved;

 

  • Proper storage of all materials, especially chemicals and corrosive substances; and

 

  • Instruction of self-aid/first-aid and reporting workplace injuries.

 

 

Conclusions

 

A safety action plan is not a one-time occurrence, but an on-going process to prevent new hazards from developing and to prevent old hazards from returning. By having a safety action plan, you can reduce both your physical losses and your cost of workers’ compensation.

 

 

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

 

©2019 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

3 Ways TPAs Use Analytics to Drive Better Claim Outcomes

Third-party administrators are often considered an integral part of the claims management process. Some would even call them claims process workhorses. Once a workers’ compensation claim begins, TPAs have a litany of things to do to help get the worker back on the job and the claim closed.

 

While such a service may seem invaluable, there is much more a TPA can do. Savvier TPAs become long-term consultative partners. By using advanced analytic tools in combination with a deep understanding of an employer’s unique situation, TPAs can help drive better outcomes for injured workers and their employers/payers. As stated by Mark DeLew, VP of Consultative Analytics at Broadspire, “a key role of the account executive is to understand the client’s objectives and then translate those with our analytic tools into Key Performance Indicators KPIs.”

 

What these TPAs do specifically, is help organizations come to realize:

 

  • Determine an Organization’s Objectives and Identify Opportunities to Improve
  • Define the Organization’s Goals and Priorities.
  • Manage Project with a Systems-Based Approach

 

 

  1. Determine an Organization’s Current State and Identify Opportunities to Improve

 

Getting an accurate picture of where a company currently stands involves a team effort. The TPA needs experts from many different facets of the claims management process to truly understand what is happening in the organization. Nurse case managers, adjusters, quality assurance personnel, utilization review specialists, intake setup personnel, data conversion experts, and others are needed for this step.

 

The TPA account executive needs first to understand the organization’s current state and identify opportunities for improvement.

 

  • What is the overall health of the program?
  • Are return-to-work rates trending up or down?
  • What is the litigation rate?
  • What is the loss rate?
  • What percentage of claims are closed, and within what timeframes?

 

Drilling down to identify these key cost drivers is the start of realizing what is actually happening in the company.  DeLew noted this analysis needs to be done “in collaboration with the cross-functional team of claims adjusters, team managers, nurses, and clients and to understand the root cause why.”

 

Once these are known and the reasons for them, the TPA can work with the organization to find areas for opportunities and the right solutions.

 

For each significant trend, the root cause must be determined. Interviewing those on the cross-functional team is a crucial part of the process to help come up with actionable items.

 

DeLew gave an example of a client who found its incurred claims costs were trending higher but did not know why. Broadspire introduced a virtual peer, a benchmark based on other similar companies within the same industry. Using a predictive model that took into account various factors, they drilled down for such things as age, body part, cause, and nature of the injury, and compared them with those of the virtual peer. They found that in this particular company, age was a big driver of increased costs.

 

Broadspire then went back to the cross-functional team to come up with potential solutions to the increased rate of older workers having workplace injuries.

 

 

  1. Define the Organization’s Goals and Priorities.

 

Tools such as the virtual peer can help determine where a company is headed. Advanced analytics can be used to create a cost-benefit analysis to help an organization better understand what is likely to happen. Savings are then projected based on loss experience.

 

One potential area of focus is Return to Work. Looking at the average RTW date vs. the release date for injured workers can help to see the real cost of not getting injured workers back to work quickly.

 

The figures can also be presented by showing different regions of the country where the lag times, and hence, the costs may be greater or smaller. The result might be to discuss improving RTW rates in a specific area. Showing those in charge the costs of not getting an injured worker back is more likely to prompt buy-in from managers and others. Joel Raedeke, Senior VP of Consultative Analytics at Broadspire states, “this metric is one that we like because it clearly shows costly behavior and gives concrete data to drive action.”

 

Litigation is another area where advanced analytics from a TPA can help drive better outcomes. ‘Dollarizing,’ the litigation can help a company see its costs related to how quickly claims are litigated, as well as the impact of particular defense firms. “Statistics on how quickly claims are being litigated can help identify prevention opportunities. Then comparing the impact of defense firms on outcomes helps to mitigate costs even further,” said DeLew.

 

Using infographics and timelines can illustrate where the company is going. For example, let’s say a company wants to reduce its loss pick by 6 percent and decrease its open inventory by 22 percent. A year-long timeline can be set up. It may start, for example, with the TPA account executive aggressively pursuing claim closure with the cross-functional team, and setting meetings with the actuary to understand cost drivers. The ensuing months would then contain a variety of other steps to show how to achieve the goals. “Infographics and timelines allow us to visualize with a client stepping into that future state and the steps needed to achieve their goals,” said Raedeke.

 

 

  1. Manage Project with a Systems-Based Approach

 

Emails and spreadsheets are the status quo for the industry, but not necessarily the best way. Trying to manage multiple projects with multiple people involved can be tedious and inefficient.

 

Account management can instead be done in a way that gives full visibility and track-ability in real-time. A system based approach eliminates the necessity to wait until the weekly meeting to get an update on what everyone involved is doing. “Better operating tools allow an account executive to efficiently manage a large team and achieve the goals of large projects,” said Raedeke.

 

 

Conclusion

 

Best in class TPAs that can an organization determine their current state of workers’ comp management, set realistic goals for improvement, and use a systems-based approach to project management using better operating tools and sophisticated analytics can help organizations vastly improve their outcomes and decrease their costs.

 

 

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

 

©2019 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

 

Using Medical Disability Guidelines to Estimate Return to Work

Members of the claim management team face many challenges in handling their files in workers’ compensation claims.  When an employee misses work, the team needs to make efforts to return that person to work, and also have a good idea when this will occur.

 

Medical disability guidelines can assist an employer and the claim management team in planning for the future return of an injured employee. Medical disability guidelines are an essential planning tool because they provide an employer with a time frame as to how long an employee, on average, will be away from work. Large self-insured employers, TPAs, insurance companies as well as captives and associations that handle claims all use online medical duration guidelines.

 

 

Understanding Medical Disability Guidelines

 

Medical disability guidelines are simply that – a guideline.  They do not offer the medical provider or employer a precise number, but rather a range of time the guideline’s user can anticipate the employee will be off work depending on the difficulty of work. Other important issues to consider include:

 

  • The range of time is based on a compilation of extensive data about numerous injuries;

 

  • The collection of data is sorted by the nature and the extent of injury;

 

  • The greater extent of data, the more accurate a disability duration prediction is; and

 

  • The field of occupational medicine continues to grow and expand, providing a constantly evolving and growing accumulation of data.

 

It should be noted that medical disability guidelines are designed to provide physicians, employers, and employees with ranges and guidance, not precise answers. Guidelines often have a minimum recovery time, a maximum recovery time, and an optimum/average recovery time. The specific employee’s willingness and inclination to return to work can be measured in three ways:

 

  • Restrictions;

 

  • Limitations; and

 

  • Willingness to tolerate the symptoms brought on by the injury.

 

 

Working with Medical Providers on Return-to-Work

 

The medical provider will set restrictions on what the employee should perform. While the employee may be capable of doing the activity, to do so could pose a risk to the employee and possibly others. An example of this is an employee with an injured arm might be capable of driving a dump truck, but there is a risk the injury could impair the employee’s ability to do so, posing a risk to both himself and others.

 

The medical provider will also take into consideration of limitations of the employee.  These limitations include:

 

 

  • When the employee should be able to reach their optimal performance level.

 

For example, an employee with an injured back will not have the physical capability to lift heavy objects. Limitations are normally in place for what would be considered the average time a person will be off work.

 

 

 

Dealing with An Employee’s Work Restrictions

 

Restrictions placed on an injured employee should closely conform to the minimum column of the medical disability guidelines while the limitations will often correlate with the optimum recovery time in the guidelines. The maximum amount of time an employee should be off work is reflected by the concept of tolerance.  The greatest variance in the medical disability guidelines arises from the willingness of the employee to tolerate the symptoms of the injury. The medical provider may look at the medical disability guidelines and establish what is the normal recovery time for an injured person who has a particular nature and extent of injury. Individual factors such as fatigue and pain can impact an employees’ disability duration.

 

Personal factors can also play a role in the recovery and disability duration including:

 

  • Comorbidities (diabetes, obesity, etc.), which can distort the disability duration; and

 

  • The employee’s motivation to return to work will influence their tolerance level. These motivational factors can include income (satisfied with the tax-free income of workers’ compensation), job dissatisfaction, self-esteem, health insurance provided by the employer, etc.

 

These are not medical reasons for disability but impact the employee’s willingness to tolerate injury symptoms, and therefore whether or not the employee disability duration falls within the medical disability guidelines. The maximum time frame is often placed at the 90th percentile, where 90% of the people with the type of injury involved have returned to work.

 

Conclusions

 

The medical disability guidelines are evidence-based disability durations. They are multidisciplinary in scope with their findings continuously updated to reflect an improvement in medical care and medical practice. They are best used to answer the question, “how long will the injured employee be off work.”

 

 

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

 

©2019 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

Understanding Work Comp in the Healthcare Industry

Hospitals Nursing Homes Workers CompInterested stakeholders in the healthcare industry face many unique challenges in terms of finding affordable workers’ compensation insurance coverage.  This is especially the case when it comes to those who operate hospitals, clinics, and nursing homes.  These challenges include rising premiums based on the nature and extent of work injuries and accompanying restrictions on activity that serve as a barrier when it comes to getting an injured employee back to work.

 

 

Understanding Nursing Homes and Work Comp

 

Nursing homes can be found in every state.  Many are privately owned and managed, but regional and national nursing home companies are gradually increasing their share of the market.  The workforce of the nursing home will consist of:

 

  • Registered nurses (RN);

 

  • Licensed practical nurses (LPN);

 

  • Nurses’ aides;

 

  • Administrative staff;

 

  • Food service; and

 

  • Housekeeping

 

The primary workforce issue is often the training and turn-over among the nurses’ aides.

 

 

Dealing with Work Injuries at Nursing Homes

 

Safety is normally emphasized in nursing homes to protect both the patients and the staff.  Nursing homes are built to protect the patients and staff, which tends to lower the risk of injury.

Physical hazards and causes of injury to nursing home employees include:

 

  • Lifting and moving of patients, the most common cause of work-related injuries;

 

  • Musculoskeletal injuries; and

 

  • Needle sticks and dealing with infectious diseases communicated via bodily fluids.

 

Medical care for workers’ compensation injuries in this line of work is readily available because most states require a duty nurse to be on duty at all times.  Minor work-related injuries, including cuts, bruises and abrasions, can be treated by the on-staff nurse or by other nurses on duty.  For more severe injuries, medical facilities are often located nearby.

 

Reducing Indemnity Benefits in Healthcare Settings

 

The cost of indemnity benefits for workers’ compensation injuries at nursing homes averages approximately the same as work comp benefits for all industries. Occupational diseases and associated disability benefits occur infrequently among nursing home employees.

 

Some categories related to nursing homes that would have the same or similar work comp issues include:

 

  • Hospitals including acute care hospitals;

 

  • Home health services;

 

  • Retirement centers;

 

  • Boarding homes; and

 

  • Assisted living facilities.

 

While many of the jobs in this industry require the ability to lift patients (heavy lifting), accommodation may be possible. Equipment such as mechanical lifts and friction-reducing devices decrease both the frequency and severity of the injury and make temporary accommodation easier to accomplish.  A union contract may serve as a barrier to return-to-work issues in some instances.  It is important to keep these issues in mind when negotiating a labor contract and to seek cooperation from union representatives on these issues.

 

Notwithstanding this matter, there are ways to get injured healthcare employees back to work in a timely and efficient matter.  Possible temporary transitional work includes:

 

  • Office Workers: Look for ways to accommodate prolonged sitting and standing as needed, or to elevate a broken limb.  Lifting beyond physician assigned abilities could be done by another employee.

 

  • RN, LPN & Nurses’ Aides: Utilize other employees to do the “heavy” lifting of patients or equipment. Provide equipment to make patient transport non-strenuous.

 

  • Food Service: Identify tasks within the cafeteria or snack bar within physician assigned abilities such as light cleaning or working the cash register.

 

  • Other Employees: Consider placement at an Information Booth to help visitors with directions or assistance.

 

  • Light Janitorial: Employees can use a broom and long handle dustpan to clean up spills and litter.

 

Conclusions

 

Engaged stakeholders in the healthcare and nursing home industry need to be creative in managing workers’ compensation claims and reducing program costs.  This required them to seek creative solutions to manage medical care based on the severity of the work injury, and look to get an employee back on the job within their restrictions.  This may require compromise, but will promote savings in the long run.

 

 

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

 

©2019 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

Injury Prevention With Ergonomics Creates Money

ergonomics in workers compensationTom Cruise famously shouted, “Show me the money,” in the movie Jerry McGuire, as he was attempting to get his client to the very top of his career.  In the same regard, interested stakeholders and employers seeking to save money in their workers’ compensation programs are usually saying, “Show me what it saved the other guys and what it will save me.”

 

If the employer believes there is a safe workplace and a good loss run, then it can be a hard sell.  Notwithstanding good results, everyone should always seek to do better when it comes to their programs.  This includes improving safety and improving ergonomics in the workplace.

 

Injuries do happen.  Here are some examples of companies benefiting from the installation of an ergonomic/safety program.  Stakeholders should be asking themselves if there is room for improvement in their offices and workspaces.

 

 

Large Scale Construction Company

 

A company began to notice large spikes in musculoskeletal disorders among its employees.  To combat this problem, they hired and implemented a pilot program at one of the company’s larger construction sites that consisted mainly of a customized stretching and strengthening program for the workers based on the specific jobs they were performing at that site.

 

RESULT: After implementing the program, employees logged over 104,000 hours at that pilot jobsite without any reported work-related musculoskeletal disorders.  That is 2,600 – 40-hour workweeks. The employer went from having a significant outbreak of a specific type of injury, to almost wiping it out.

 

 

Local Graphics Company

 

An employer was concerned about rising workers’ compensation costs instituted a comprehensive ergonomics program using employee-led management teams to identify ergonomic risk factors for workplace injuries and establish training and controls to reduce the risk drivers.

 

RESULT:  Within four years, this employer experienced positive results and savings:

 

  • 25% reduction in the number of work-related injuries;

 

  • 39% decrease in the number of back injuries; and

 

  • Overall result in lost work time days by 25%.

 

The key here is that the employer used an “employee-led” approach.  By using their employees as resources, they were able to know what was taking place at their workstations day after day.  These employees had legitimate concerns, which resulted in solutions that worked.

 

 

Nationwide Manufacturing Company

 

This employer experienced an increase in injury rates at its upper-Midwest production facility in the early 1990s, as the worker population and seniority rates changed.  A comprehensive approach to injury prevention was developed, focusing on:

 

  • Ergonomic training;

 

  • Ergonomic retrofitting; and

 

  • On-site stocking of frequently used ergonomic items such as hand tools, floor mats, footrests, and anti-vibration gloves.

 

RESULT:  The employer reported a significant reduction in lost time and/or restricted workdays as a result of the program. The key is taking a step back, identifying the risk factors, finding out what options are available to reduce the risk, and implementing them.  The more you are working at full capacity, the better the production, the stronger the profit margin.

 

 

Food Processing Company

 

This employer noted an increase in musculoskeletal disorders identified at a specific location.  To combat these numbers, the employer instituted an on-site medical management program to reduce the number and severity and these injuries.  The medical management team consists of an on-site physical therapist to assist with job placement and job analyses, as well as follow up on the doctor prescribed treatment of work-related injuries. The occupational health nurses, physicians, and therapists met together at least annually as a group to discuss the successes of the program as well as to recognize any areas of improvement.

 

RESULT:  This program was successful because it produced a better job placement program.  The following improvements were made:

 

  • Job modification process became personalized to the injured employee;

 

  • Communication between various interested parties such as therapist, doctor, team member, and management team were streamlined, which resulted in faster recovery times; and

 

  • In some cases, it led to the prevention of work-related injuries/illnesses.

 

 

Conclusions

 

There are no more excuses for not implementing a safety team or program after reviewing these examples.  Each of these stories is a great example of identifying a problem, establishing a plan to correct it, and tracking the successes of your implementations.  Your broker/carrier/TPA has resources to get you started in the right direction.   The sooner the program is implemented, the sooner to begin saving on claims.

 

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

 

©2019 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

 

Ask One Question to Set Return to Work Expectations

Study Reference: The Relationship Between Work-Disability Duration and Claimant’s Expected Time to Return to Work as Recorded by Workers’ Compensation Claims Managers https://www.ncbi.nlm.nih.gov/pubmed/27460477

 

Hey there, Michael Stack here, CEO of Amaxx and Happy New Year to you as we start this fresh decade in January of 2020. Now, one of the cool things about this time of year as you’ve likely done some planning or some goal setting or setting some expectations for what you want to happen in this year and in this decade to come and maybe reflecting on what went well in the past year or the past decade that we just left behind.

 

As we started on this new year, I want to give you one quick tip and far as worker’s compensation return to work, a piece that you could integrate into your return to work program and just have that much more accurate expectations. If we think about James Allen’s book As a Man Thinketh, he says that basically what we think about has the greatest odds of actually happening and that is very true in workers’ compensation as well.

 

 

When Do You Think You’ll Return To Work?

 

There was a study in 2016 that looked at the correlation between the expected return to work times and then what actually happens and you’ll see a link to that study below here and I want to have you ask this question, when do you think you’ll return to work?

 

When do you think you’ll return to work? And the answers will be very accurate as far as the correlation. That’s what this study proved, and I’ve got to run through these numbers here quickly. It was 43% that expected they would be back to work. I’m sorry this is wrong. In less than seven days were accurate. So, 43% had the expectation. They said, yeah, I’ll be back to work in less than seven days. And they were accurate with their assessment. 22% said, yeah, I think I’m going to be back to work in greater than seven days. And they were accurate with their assessment. These are not ‘johnny on the spot’ as far as, okay, 95% of the time. But there’s a significant correlation and that’s the point of getting that understanding of what their expectation is and this one was the most accurate.

 

 

Expectations Predict Reality

 

This one was for people that expected that they would be out of work in greater than a hundred days or 181 days. There were actually returned room to work in seven days or less, so greater than 180 days. My expectation is I’m going to be out of work probably at least six months, you know, I can’t see myself getting back to work before then. Virtually none of them were back to work right away.

 

The point is, ask that question upfront, ask that question. When do you think you’ll be back to work? And you will get a pretty good indication as far as how to tailor your claims management strategies to that expectation to either help them along and confirm that, hey, you think you’re going to be back, let’s make sure you’re back. If you think you’re going to be out a lot longer, maybe we’re going to need some extra services on this such as nurse case management, etc, to help that claim move further along.

 

Happy new year to you. I’m excited for this year for you ahead to implement these best practices and see some of those tremendous results, because remember, your work today in workers’ 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.

 

 

 

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

 

Contact: mstack@reduceyourworkerscomp.com.

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

 

©2019 Amaxx LLC. All rights reserved under International Copyright Law.

 

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

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