proven strategies to control work comp costs
DESCRIPTION
Discover strategies to bring down the cost of work comp claims.TRANSCRIPT
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PROVEN STRATEGIES TO CONTROL WORK COMP COSTS
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HOUSEKEEPING
• Slide deck will be posted on hni.com
• Q&A at the end, but feel free to ask questions throughout
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Thanks to our sponsors!
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INTRODUCTIONS
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Jodi MathySenior Claims [email protected]
Andrea TarrellMarketing Director [email protected]
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KEY COMPONENTS
• SET THE SCENE FOR SAFETY
• DON’T HIRE YOUR NEXT CLAIM
• PROMPT REPORTING AND MEDICAL CARE
• RED FLAGS
• INJURY MANAGEMENT COORDINATOR
• COMMUNICATION
• MODIFIED WORK PROGRAM
• EXPERIENCE MODIFICATION RATE (MOD)
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SET THE SCENE FOR SAFETY
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CULTURE OF SAFETY
• You must make safety a priority from the top down.
• Make sure that you have the proper policies and training in place.
• Educate employees about their rights as well as roles and responsibilities in the event of an injury.
• Find ways to incentivize a safe workplace.
• Review all accidents and injuries to identify the root cause and put proper controls in place.
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REENERGIZE YOUR SAFETY PROGRAM
• You can’t change your past experience but you can change your future!
• Review your safety program or start one! Work with your agent if you need assistance and resources to help you achieve this.
• Safety culture in your organization needs to become a top down priority!
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DON’T HIRE YOUR NEXT CLAIM
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THE RIGHT FIT
• Put in place post-offer enhanced physicals.
• These types of tests objectively measure whether a candidate can perform the essential functions of a position.
• This step requires updated job descriptions with specific physical requirements.
• Go beyond drug testing!
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START AT THE BEGINNING
• ADA compliant job analysis details essential job functions.
• Highly detailed measurement of lifting/carrying/push/pull, positional demands, etc.
• 3rd party objective documentation of tasks verified by management and labor (both groups accept the validity of the description).
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GET TO WORK
• PT develops EPT protocol based upon physical demands documentation and client input.
• Validity testing
– Client sends in an employee to go through the EPT to validate the specifics of the protocol
• Revisions made as necessary.
• EPT becomes part of the client’s Post Offer Physical process.
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BENEFITS OF EPT
• Provides a snapshot view of the workers ability to perform the critical physical demands of the position.
• Highly individualized and specific to the job.
• Useful on a post offer/pre-employment and post accident fitness for duty examination.
• Useful in Physical Therapy treatment to identify crucial physical task goals for case closure and RTW.
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PROMPT REPORTING AND MEDICAL CARE
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TIMELY REPORTING
• Allows claim representative to make contact to explain benefits.
• Allows for proper medical attention.
• Reduces overall costs.
• Reduces litigation.
• Allows early utilization of Fraud Investigation Unit.
• Allows timely investigation.
– when facts are known and fresh
– potential subrogation
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ACCIDENT INVESTIGATION
• Interview the injured worker as soon as possible, after medical care has been rendered.
• Interview any witnesses.
• Investigate the injury site and review the actions leading up to the injury.
– Prevent others from encountering the same hazard
• Gather the facts and look for possible causal factors.
• Review findings with your safety committee
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MEDICAL TREATMENT
• Who is making the call at your organization?
• Are you utilizing the jurisdictional controls available?
• Establish relationships with local occupational health facilities.
• Consider utilizing a 24/7 nurse triage service to help refer your employees to the appropriate level of care. There are multiple options out there for this type of service.
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RED FLAGS
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WHAT SHOULD I LOOK FOR?
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• The alleged injury occurred on Monday morning or on a Friday afternoon but was not reported until the following Monday.
• The accident occurs just prior to or after a strike, job termination, layoff, end of a project or at the end of seasonal work.
• The accident was unwitnessed by any fellow employees.
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MORE TO LOOK FOR…
• Claimant has a history of prior claims.
• A substantial delay occurred in reporting the incident or in the filing of the First Report of Injury.
• There are different descriptions of the accident as set forth in the medical history and the Employer’s First Report of Injury.
• There are frequent difficulties in contacting the claimant at home when he/she is allegedly disabled.
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OH THERE’S MORE!
• The lawyer and/or treating physician are known for being involved in suspect claims.
• The claimant frequently changes physicians or medical providers.
• The claimant has received a release for work which is followed by the claimant changing physicians or medical provider.
• A third party is involved in the incident under investigation. Be alert to the possibility of subrogation in any claim.
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INURY MANAGEMENT COORDINATOR
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WHO ARE THEY?
• The individual who you have empowered to be the point of contact for your injured employees and the adjusters.
• They maintain communication and help to relay red flags and other information to involved parties.
• They work to help place injured employees in modified work positions.
• Could be your safety manager, risk manager, HR manager or a separate role.
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WHY IS THIS IMPORTANT?
• Your injured employees need direction.
• One point of contact keeps the confusion to a minimum.
• They become stewards of the company to help employees in
their recovery.
• It shows your commitment to a culture of safety.
• Communication is key!
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COMMUNICATION
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DON’T LOSE TOUCH
• The adjuster shouldn’t be the representative for your company.
• Your employee should know that you care about their recovery.
• Lack of communication often leads to confusion and ATTORNEYS!
• An injured employee is STILL an employee.
• Outline roles and responsibilities.
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PICK UP THAT PHONE
• Make periodic inquiries of the employees condition.
• Help them get answers to their benefit questions – be their advocate.
• Discuss use of FMLA and how their benefits may be impacted by their disability.
• If they need corrective action, handle it swiftly.
• Welcome them back to work modified if possible.
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MODIFIED WORK PROGRAM
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AND THE SURVEY SAYS
Why are these programs important?
• When an employee returns to work in a modified position that employee is more likely to have better healing and a higher likelihood to get back to 100% pre-injury activity
• By having a dedicated modified work program the company wants to show all employees that they are valued members of the team.
• It feels good to contribute to the team’s success.
• Not all restrictions can be accommodated but the company and the employee should have good open communication for when the time is right to return to work.
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“don’t let TIME get away from you!
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% incre
ase
0%
25%
50%
75%
100%
6 months 12 months 24 Months
Time Away From Work
Ch
an
ce
of
Re
turn
ing
to
An
y W
ork
Source: New York State Workers’ Compensation Board, 2011
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BEST PRACTICES
• Create a written program that outlines the responsibilities of the employee and management
• Identify light duty positions across the organization to utilize when the need arises – Job Bank
• Establish guidelines and length of time the modified duty program is available
• Have an Employee Commitment Review Form (requires employee’s signature)
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EXPERIENCE MODIFICATION RATE (MOD)
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YOUR MOD
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CONTROL YOUR EXPERIENCE
• Review all reserves and payroll data prior to unit stat filing.
• Project what your future rating will be.
• Audit your published rating at time of release for errors.
• Take advantage of state specific rules that allow for mod corrections to be made in your favor.
• Medical-only claims receive a 70% discount when their primary actual dollars go into your mod calculation.
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Workers compensation claims are costly and frustrating.GIVE SOME OR ALL OF THESE STRAGEIES A CHANCE.
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WHAT’S NEXT AT HNI U
NEW Chiropractors & Work Comp: Aligning Treatment and Expectations to Handle Claims Effectively
10-11 a.m. December 18 | Webinar
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Thank You hni.com