Money Saving Workers' Compensation Tips, Matthew Davis GDI

Written by on 9/30/2010 2:46 PM . It has 0 Comments.

Focus On What You Can Control!

The rules, costs, and insurance companies are constantly changing as CA struggles to try and manage a broken system.  The only thing a company can do is to make sure they qualify for the best rates available, and manage their workers compensation modification factor!  Here is a brief outline of what GDI does for its clients.

Safety Issues

  • Investigate “near misses” to prevent future accidents. Seventy-five percent of accidents are preceded by a near miss.
  • Create a risk control service plan based on your workers’ compensation losses. Pay particular attention to frequency and severity of claims in crafting an appropriate plan.
  • Justify your risk control expenditures strategically to senior management so that you receive the budget you need. Be sure they understand the importance of your company’s safety program and the money it saves in the long run.
  • Based on your experience with prior claims, create a workers’ compensation cost allocation program. Budget money by examining what types of claims you’ve had the past several years and how much they have cost.
  • Benchmark your company’s workers’ compensation performance against other comparable companies in your industry. This will help you identify areas to improve upon.
  • Choose a practical flooring surface, not just one that looks nice. Often, the best looking floors can be the most dangerous and slippery when wet.
  • Listen to and follow emergency announcements. For example, on 9/11/2001, a tendency of many workers was to watch what was happening rather than swiftly evacuate.  
  • Customize work spaces to fit each employee through ergonomics. By ensuring that an employee’s work space is tailored for their needs, you create a safer environment less prone to bodily stress or injury.
  • Protect your employees by minimizing any job hazards. You should always be evaluating all aspects safety of your workplace to ensure the safest environment possible.
  • Create a policy on distracted driving. Vehicle fatalities account for a large percentage of work-related fatalities. Eating and drinking are the number-one cause for distraction, but there are many other sources of distraction, including cell phones and music devices. Go beyond simply following the laws in your state – a good policy can help prevent fatalities and limit liability for your company.
  • Along the same lines, prohibit texting while driving. Texting while driving makes an employee 23 times more likely to have an accident. Create a written policy for both distracted driving and texting while driving, and have all employees sign it.
  • Educate your employees on the safest way to lift objects. Squatting with bent knees minimizes the stress to the back, regardless of what is being lifted.


Return to Work Strategies

  • Job offers should be made in writing. They need to be very specific and thoroughly describe the offered job.
  • When the job is offered, a formal “job offer package” should be sent along with the job offer letter. Make sure it includes all the benefits the potential employee is eligible for, so there is no confusion later.
  • When developing a temporary assignment for someone returning to work, find useful tasks, but items that aren’t currently being done in other areas of the company. You don’t want to take work away from another employee when the injured employee returns.
  • Create a written job description and job analysis for all “transitional duty” jobs. These jobs should match physical capabilities with the work that needs to be done so that they are both useful and appropriate.
  • Hold employees working temporary assignments or transitional duty jobs to the same work rules as other employees. This prevents devaluation of the job from their perspective and sends the message that they are still contributing to the company.
  • Develop and maintain a close working relationship with medical providers. Make sure they understand your business, and then they can help you evaluate policies and situations based on their experience treating injuries.
  • For all employees assigned to temporary work, monitor their medical health regularly. Make sure they are physically doing okay, and if they are making progress find out if they can move forward to more demanding tasks.
  • Develop and maintain a close working relationship with claims adjusters. Make sure they know your return to work program and ask them for advice and suggestions to improve it.
  • Resist the temptation to turn temporary job assignments into indirect punishment. Understand that the work is therapy for the returning employee. Make sure to stay positive and keep the work meaningful.
  • Consider establishing a “transitional duty” rate of pay. It will be less than what the employee would earn working their normal job, but make sure it is consistent.
  • For return-to-work (RTW) program employees, stay in frequent touch from the RTW offer letter until they return to full working status. You should be accessible for them to be sure their return-to-work is progressing smoothly.
  • Develop a return-to-work plan for every injury that results in lost time. Communicate with the employee’s doctor so you understand when and how they can progress to various work tasks.


Claims Management

  • Contact your injured workers early and often. This will leave the impression that you really care about them and can help keep morale up (and encourage return to work).
  • Consider unconventional or “outside the box” treatment when necessary, if it will help them recover and return faster.
  • Determine whether the employee was actually working on the date that they claim to have been injured. Discrepancies or falsities happen often, particularly with late claims.
  • Exercise due diligence when investigating a claim. Beyond speaking to the direct supervisor and the injured employee, interview other witnesses or co-workers that could shed light on the situation.
  • If your state allows you to direct or encourage employees to use certain doctors, use doctors who really understand your business whenever possible. Develop relationships with certain doctors so that they can learn about your company and the types of injuries that are common. This will help ensure the best treatment for your employee and hopefully the best return to work scenario.
  • Integrate strategic wellness programs into your company to help reduce injuries. Understand how chronic conditions like obesity and diabetes can affect or cause other injuries. Managing such diseases properly can reduce workers’ compensation claims costs.
  • Explain workers’ compensation during new employee orientation. Make sure they understand that they will not be punished in any way for making a claim or reporting an injury. Explain the importance of promptly reporting any injury or incident.
  • Be prepared for a crisis. Explore all the possibilities and understand what could happen; prepare for the worst so that you can handle anything that happens.
  • After an incident or claim, be sure to investigate early and keep all the information organized. Make sure you gather all appropriate evidence and information, so that it can be verified later.
  • Make return-to-work a priority across your entire organization – every job should have a return-to-work provision and every employee should know about it. This should not just be the job of Human Resources or the claims adjuster.  
  • Keep up to date on laws that impact your workers’ compensation claims. Be sure to know your requirements and responsibilities as an employer and how to address any possible or suspected fraud. 
  • Keep tabs on and understand what your claims administrator is doing; you should always know what is happening with a claim. 


Medical Considerations

  • Don’t pay for surgeries or operations caused by arthritis (such as a knee replacement). Arthritis is not caused by trauma, and thus was not caused as a result of the job and should not be a workers’ compensation claim. The only exception is arthritis caused by repetitive trauma, but only if the employee does a lot of squatting or kneeling.
  • Make sure that your occupational medical practitioner does a thorough and proper examination when an employee first goes to see him/her, so that you are not surprised when the independent medical examiner (IME) tells you that you have a problem claimant. This includes performing Waddell’s tests when there is a lower back injury involved.
  • Fibromyalgia is not a diagnosis, it is a symptom. The word itself means “pain in the fibrous tissue” (the suffix “algia” always indicates a symptom).
  • A diagnosis should be supported by the way the accident happened. If the two don’t match up, then the diagnosis could be a result from something not work-related, so make sure you don’t pay for it!
  • Don’t pay for a loose knee replacement. Generally, trauma does not affect an existing replaced knee, so the condition is not work-related.
  • In general, do not let your occupational medicine doctors prescribe prednisone. It is usually not necessary, and you will pay much more than you likely need to.
  • Before a surgery takes place, make completely sure that it was caused by a work-related condition. Doctors often suggest surgery a bit more readily when they know it is a workers’ compensation claim.
  • Make sure that diagnoses are legitimate and universally accepted before you pay a claim. For instance, don’t list “pain” as your work-related diagnosis. Pain is a subjective finding – you cannot qualify it or quantify it. 
  • Don’t let the MRI dictate your case management. An MRI only proves that there is an injury, not whether it happened at your workplace.
  • For a quick and easy way to save money, find an MRI radiologist that you trust to provide legitimate findings and diagnoses to refer employees to.
  • Don’t pay a bill for a surgery or procedure without reading the operative report. Sometimes it can contain things that had nothing to do with the incident that should not be your financial responsibility.
  • Arthritis aggravation should never be a work-related diagnosis. Trauma does not aggravate arthritis.
  • Go visit or look your claimant in the eye every once in a while. You’ll be able to tell if he/she is taking the prescribed drugs or selling them (constricted pupils indicate narcotic use).


Legal Considerations

  • Know and understand the interplay between your state workers’ compensation laws, the American with Disabilities Act (ADA), and the Family and Medical Leave Act (FMLA).
  • Keep your legal counsel in the loop right from the beginning. The first 24 hours after an incident are crucial and your lawyer needs to be informed.
  • When hiring, provide detailed job descriptions that include the percentage of work that is physical. The description should also outline a general return-to-work policy.
  • Before any claims are filed, make sure you know your employees’ history and as much about them as possible. Document and file everything, as it may become relevant information if there is a claim.
  • After an incident, review the employee’s personnel file. This will help you understand the employee better and may offer clues or tendencies for potential fraud or a vendetta against a co-worker or manager.
  • After an incident, your legal team or representative should do an on-site inspection where the injury occurred. Be sure that they interview others who do a similar job as well as any witnesses.
  • If there are changes in the diagnosis, the accident needs to be reevaluated. It may not have happened as reported.
  • Keep an organized case chronology, documenting everything from initial claim to the close of a case. This includes previous history of the employee that may be relevant (past disputes with co-workers, claims history, problems at home, etc).
  • Make sure to provide the IME with everything you have, including your chronology.
  • Before a trial, make sure your witnesses are prepared. Someone from the company should be present at every hearing. It’s important to make sure that everyone is always on the same page.
  • Establish and enforce disciplinary measures for safety violations. There should be some type of corrective action for any employee who doesn’t abide by safety requirements.
  • Train your supervisors in-house. They may have previously been trained as supervisors in general, but they need to also be trained in your particular work environment.

 To learn more about how to take control of your workers compensation insurance costs vist this page here, or call me at 888-991-2929  Ask for Matt Davis!


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