Improving Communication with Your Adjuster Can Save You Big Money

 

Communication Can Be Significant Problem
 
Self-insured employers unintentionally, but routinely, sabotage the results they get on their workers’ compensation claims from their third party administrator (TPA) adjusters.  Of course self-insured employers do not set out to get sub-par results from the adjusters.  And, it should be understood that most TPA adjusters want to provide quality claims handling.
 
The reasons for less than expected claim handling results vary greatly from one adjuster to another, but there are some common threads in the employer—TPA relationship that create poor claims handling. A significant portion of the claim handling problems lies in the communications between the self-insured employer and the TPA adjuster. Often an employer will assume the adjuster knows what to do (and the adjuster does), but then the employer will be dissatisfied with the claims handling results because the adjuster handled the workers’ compensation claim differently from what the employer expected. 
 
 
Improve Communications With These Recommendations:
 
·         Talk to your adjuster regularly to understand what is being done, and what needs to be done, on the larger work comp claims they are handling for you
 
·         Be ready to offer input, but don’t try to micromanage the claim handling
 
·         Provide all necessary supporting documentation as quickly as possible including Employer’s First Report of Injury, payroll records, pre-employment physicals and health questionnaires, personnel file, etc. 
 
·         Don’t surprise the adjuster with critical information that you have, or become aware of, by not providing it to the adjuster timely.
 
·         If you become aware of any new information on the claim, share it immediately with the adjuster.  If you do not, the adjuster will more than likely spend time acquiring the information you already have
 
·         Let the adjuster(s) know how you prefer to communicate – whether you prefer emails over phone calls, or phone calls rather than e-mails
 
·         Strive for timely response to all e-mails and to timely return all missed phone calls
 
·         Let your adjusters know you expect a team approach to the claims handling and show respect for the work the adjuster does to create mutual respect
 
·         Be consistent in your communications of your claims handling philosophy in regards to claims handling.  Don’t take a hard nose, defend at all cost approach to one claim and on the next nearly identical claim, overpay the claim to get rid of it.
 
·         Be consistent in your claims handling philosophy or the adjuster will quickly decide you ‘don’t know what you want’
 
·         Never let your personal like or dislike of a particular employee influence your guidance to the adjuster on a claim
 
·         Discuss with your adjuster how much a particular claim is worth and what you will be willing to pay to settle the claim.  If you withhold what you are really willing to pay on the claim, then at time of the mediation or hearing, up the ante significantly, the adjuster is going to wonder why you had both the defense attorney and him/herself spend needless hours working on the claim that could have been settled much earlier
 
·         Don’t change your evaluation of a claim unless new, pertinent information that was not previously known comes to light
 
·         With an eye toward improving your relationship with the adjuster(s) ask your adjuster(s) what can be done to improve the communications between your company and them.  Then, be willing to listen to constructive criticism and act on what is said. If you are not self-critical and not willing to acknowledge the adjuster’s input, then asking them how to improve communications will not benefit either of you
 
·         If you see an adjuster making the same mistake over and over, communicate with the adjuster about the problem, ask the adjuster how the problem can be corrected, agreed on how the issue will be handled in the future, and then follow up to be sure the adjuster makes the necessary correction(s)
 
 
Be aware that every adjuster works differently, and every adjuster is under organizational pressure to accomplish as much as possible on many other claims.  Show your willingness to work with and to assist the adjuster in getting the work comp claim resolved.  Treat the adjuster will respect and communicate your desires to get the best possible claims handling.
 
 
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact:RShafer@ReduceYourWorkersComp.com
 
Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com
 
©2012 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 about workers comp issues.

5 Safety Communication Techniques for a Diverse Workforce

 

Communicating safety issues effectively to a diverse workforce is a challenge. As a risk management consultant for many years, I’ve gathered solid information and experience on the best way to communicate safety and workers’ compensation messages to a large and diverse workforce, including organizations with thousands of employees with diverse backgrounds and many different job descriptions.

 

Before beginning, identify your target audience and the safety message you want to give.  The most important thing an employer must do before implementing any safety communication program is meet with employees and supervisors to discover their ideas on what needs to be communicated and how best to do it.

 

 

Five Safety Communication Techniques

 

First:

Identify the specific message you want to communicate. Is the message about getting employees to work more safely around certain equipment? Or is it to provide information on steps to take if they are injured?

 

Second: Identify the skill set and grade level of your audience. A message to upper management on how to improve commitment to a safety program would be presented differently than instructions to first-line employees on how to report an accident. A general rule of thumb for thinking about language levels is to keep in mind that the Wall Street Journal is written at a first-year college level, while the Reader’s Digest is written at a sixth grade reading level.

 

Third:  Consider job functions and how best to get your message across. Some employees might spend most of their work day in an office or one specific area of a plant. Others may spend it working in different areas of the plant or facility. Still others may spend their day driving from location to location. It’s a good idea to tailor your safety message to the types of safety issues more likely to affect those employees and areas of work.

 

Fourth: Identify the languages your employees speak. Don’t assume they will be just English and/or Spanish. There may be other immigrant groups, such as Russian or Vietnamese speaking workers. In addition, there are differences within languages, such as Cuban Spanish and Puerto Rican Spanish. Ask management to survey their workers’ languages and provide all safety messages as appropriate.

 

Fifth: Consider the work environment. If you have a congenial workforce, don’t use a heavy-handed communication style. Save it for a workforce where there may be a lot of discontent and resentment.

 

 

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

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

 

©2012 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 about workers comp issues.

Employer Silence is Root of Many Workers Comp Problems

 

46% of Workers Incorrectly Think Claims Being Contested
 
Workers Compensation Research Institute (WCRI) has published a most welcome study into the reasons that workers get compensation lawyers. The most disturbing reason, cited by 46% of workers surveyed, was that they thought their claims had been contested, even though the paperwork had just begun and no decisions had yet been made.
 
People working with claims, any kind of claims, understand that there is an initial lag, ranging from days to months, before an administrative agency becomes active on a claim. An insurance company usually, but certainly not always, is quicker to respond, but “quick” might mean weeks, and a family suddenly without a weekly check and little or no savings will be on the verge of panic.
 
 
Lawyer Should Not Be One Communicating with Worker
 
If they consult a lawyer, they will quickly learn that the resolution is inevitably going to take time. But why must they hear that from a lawyer? Every risk manager or human resources chief could tell them that a lot faster (and cheaper!)
 
But there is something else your personnel can tell a worker who has just filed a comp claim – how to receive information and, if necessary, some form of income continuation. (A lawyer could tell them the same, but many don’t and it isn’t nearly as comforting as hearing it from the employer.)
 
The study mentioned another fact. When an employer is small enough to know everyone in the workplace (say 200 employees or so) comp problems grow more slowly than when the employee has no one in charge who knows them. (Julius Caesar was famed as a military leader because he could address all centurions in his army by their names- over 500. If he could do it, with a bit of effort you can do it with 200.)
 
 
It is Your Responsibility
 
Finally, there is the old problem of “falling between two stools”, meaning that there is always help at hand, but everyone assumes that someone else will provide it. Rather than rely on a disastrous assumption, just reach out and communicate. An employer that stays in continuous touch during the month or two following a reported injury will be the first to learn of a problem, and the first to propose a solution. And somewhere, a lawyer won’t get that first phone call.
 
If a worker (and the spouse!) is aware that the employer will nudge a silent bureaucracy with a call, the comp problems will start small and grow smaller.
 
 
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  
 
Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.  
 
©2012 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 about workers comp issues.

Employers Hold The Key to Controlling Workers Comp Claims Costs

 

Employers Are Most Important Piece in Communication
 
Many employers limit their participation in their own work comp claims hoping that the carrier will do nearly all of the work. It seems, to many employers, that it goes with the premium. However, as any trial attorney appreciates, whoever volunteers to become the communications center will control the progress of the claim.
 
Communications in comp claims are quite complex. It is wrongly imagined that the parties (employer and worker) are not allowed to communicate with each other during a claim. This is entirely false and the law requires that each MUST stay in touch with the other. In addition, one or both must often communicate with the carrier, the Work Comp Board, medical providers, health insurance and group disability carriers as well as a variety of agencies.
 
The flow of data among all these will quickly bring a claim to a halt unless properly coordinated. Delay costs money in comp and it’s only the employer who pays.
 
 
Take Control of Costs Through Communication
 
The cheapest and fastest way an employer can prevent unnecessary delay and confusion is to make sure that all other parties are copied on any piece of information the employer receives, from whatever source. Group medical plans are especially concerned that they may be paying unintentionally for a comp claim. Employers will often receive requests for information during a claim. Resist the temptation to refer the requests to someone else or stonewall the situation. By coordinating the requests with other parties you will maintain control and limit misunderstandings, a leading cause of soaring expense and lost time.
 
 
Right to Confidentiality is Waived
 
It is a misconception that medical information is automatically protected by a “right to privacy”. Whenever a claim for disability is made the “right to confidentiality” is waived. (“Right to privacy” does not apply to medical records, although the term is often misapplied to what is “right to confidentiality”)
 
Every year seems to bring new players into the field of employee benefits with ever more exchanges required. Stonewalling will work, for a while, but the bill to be paid in the end will be much higher.
 
 

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

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com Contact mstack@reduceyourworkerscomp.com


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com
MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

Employee Communication is Vital to Workers Comp Success

One factor that correlates strongly with the employer’s ability to control workers compensation cost is the ability to communicate effectively with employees.  The importance of quality communications with the employee cannot be overstated. The level and quality of communications will often make a difference in the final outcome of the workers comp claim.
 

 
Communications can be formal and informal. Formal communications include published policies, brochures and posters advising the employee of the work coverage benefits, and written documents / procedures outlining the roles and responsibilities of the employee and other personnel when a workers comp claim occurs. Also, a log where a summary is recorded of each verbal communication with the employee would be classified as formal. (WCxKit)
 
 
The informal level of communication would include both telephone conversations and face-to-face discussions with the employee. Informal communications would also include any voice mail or get well cards sent to the employee.
 
 
Through proper communication with the employees, the employer provides and receives information from the employee.  If the communications become a one-way street with the employee or employer providing all the information, the communications are not effective.  The balance between receiving and providing information should remain roughly equal.
 
 
Communications with the employee should start before there is a workers comp claim. This would be done:

 

By establishing the employee’s responsibility to report an injury accident immediately,
By having safety training sessions,
By establishing procedures the employee is to follow if there is an accident, and,
By communicating the importance of the modified duty program.
 
 
This proactive communication before an accident will pave the way for smoother handling of each claim, if and when one does occur.
 
 
After the injury it is equally important to communicate with the employee.  Contacting the employee immediately after the first medical treatment conveys to the employee a level of caring and concern about their wellbeing.  The employer should remain in contact with the employee throughout the recovery process.  The best way to do this is via a weekly scheduled phone call or having the employee call in after each medical visit.  The information discussed on these calls allows the employer to more easily respond to the injured employee's concerns.  
 
Most employees do not obtain an attorney out of greed or a desire to get something more than they deserve.  Most employees obtain attorneys because the level of communications between the employer and the employee is inadequate, or the level of communications between the adjuster and the employee is inadequate.  When there is an adequate conveyance of information between the employer and the employee, the employee does not see a “need” to get an attorney.
 
 
By keeping the employee thoroughly informed it conveys to the employee that he/she is important to the employer.  This will lead to an increased desire to understand company policies and how the employee can comply with these policies. (WCxKit)
 
 
There are various additional ways an employer can keep good communications with the injured employee throughout the claims process.  To learn more about how you can improve your communications with the employees, please contact us for your copy of 2012 Manage Your Workers Compensation Program, Reduce Cost 20-50%

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

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. Contact Mstack@ReduceYourWorkersComp.com. 

 

Our WORKERS COMP BOOK:  www.WCManual.com
 
 
WORK COMP CALCULATOR:  www.LowerWC.com/calculator.php

 
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
 
 
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact  Info@ReduceYourWorkersComp.com.

How Employers SHOULD Communicate in NY Workers Comp

Employers and employees are the most important persons in a comp claim. The law does not treat them very differently, although it gives a few advantages to the employee. However what makes a very big difference is how they communicate during a claim.

 

 

Communication is vital to the success of any claim or other legal action, but in workers comp two very different methods have evolved: one for the worker, but a very different one for the employer. [WCx]

 

 


A worker in a serious comp claim
 generally has a lawyer to coordinate the communications. Indeed, the worker is strongly advised not to communicate with anyone but the employer. The employer, in turn, will encourage regular communications from the worker, especially before a hearing. Also, a worker will generally have direct communications shortly after a hearing to provide information, documents, etc.

 

 


It might be expected that the employer
 has a similar relationship with the lawyer or representative appearing at hearings on the employers’ comp claims, but it is rarely so, even though close communication and participation inevitably reduces expense and hearings. In NY, more so than nearly every other state, the employer is typically invisible in the proceedings.

 

 


Comp insurance agents were recently asked
 what employers said about actual claims, and when they said it. The answers exposed a glaring deficiency. The employers complained long and hard about the FINAL results of a claim, but almost never spoke to a carrier, lawyer or agent while the claim was in progress. Communication was inevitably too little and far too late.

 

 


Employers should be aware
 that a person complaining is a person saying things that can no longer be effective. So the first thing an employer should do is to be the first person to speak, never the last.

 

 


A second piece of advice for employers is to speak
, with caution, to as many people as possible, not just a single claims examiner. Many people have to be informed ASAP in order for a claim to be handled effectively, and the law expects the employer to be involved. In addition to a carrier, the Board, the doctor, the worker, and many others must be informed simultaneously, not in sequence. Communication by forwarding through one person to another ceases with the first break in the chain and, at best, is only as quick as the slowest link.

 

 


Communication takes a bit of work
, but it costs a lot less than paying three to four times as much on a moderate size claim. And it can save a lot more than that. [WCx]

 

 


A final benefit to all that communication 
is that whoever volunteers to do it becomes the “center of communication”, which has priceless advantages. Whatever extra efforts are involved save far more time, and money, in the overall reduction of “claim friction”.

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

 
WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com

MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.
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