Employer's School - Take Control Part 4

Saturday, July 3, 2004 | 0

The following is the fourth in a lengthy series of articles that, when pieced together, comprise the "Employer's School" developed by Brent Heurter, Founder and Chief Solutions Officer of ClearComp. The article series presents an "employer's school" on workers' compensation, how to examine your work injury strategy and ensure a "best practices" environment designed to lower your workers' compensation expenses. This article continues the "school." Earlier articles can be accessed by clicking on a title in the right side bar.

7. Show Genuine Care for Your Injured Employees
Your employees must feel that you're on their side.

Your employees need to know that they will be provided the best in quality care, and that you are on their side in getting them well again so that they can return to work. If they suffer an on-the-job injury, they want to know-more than ever-that you are there for them.

It is in your company's best financial interests to show your concern. Poor handling of claims can lead your employees to believe that you are indifferent or that they don't matter to you. That leads to anger. And anger leads to lawsuits!

Consider this: only 3% of claims start out as fraudulent, but more than 30% have some element of fraud by the conclusion of the claim. Poor treatment by the employer is the usual cause for an employee to seek legal help. It makes sense that your injured employee has access to a representative of your company. Otherwise, it may be an attorney who takes the call.

Ask Yourself:Top companies assign an employee advocate to guide and navigate injured employees through the workers' compensation maze. Statistics consistently show that employees who are guided through their process are less likely to engage a lawyer and litigate.

You can expect a 400% return on investment when you engage your own care coordinator or injury care coordinator. This coordinator should be available to help with:

* Transportation
* Temporary loans or advances
* Paperwork
* Family / work-life issues
* Doctor and rehab appointments

Your employee advocate should be there for your injured employees from the moment the injury is reported. He or she should follow the employee through the entire treatment and rehabilitation process. Here is what the employee advocate does for the injured party:

* Acts as a point of contact during the claim, assisting with paperwork, and ensuring that forms are filled out properly and filed on time. Paperwork can be overwhelming for the employee-and errors and oversights can be costly for the employer.
* Arranges transportation for work and for medical, rehab, and other appointments.
* Assists with prescriptions and helps employees understand their medication and comply with treatment. This leads to faster recovery and lower claims.
* Ensures that accident investigations are complete.
* Assists employee through problems. This area is especially important, since the assistance can make the difference between a happy employee and a disgruntled employee-who sues!
* Monitors the performance of the insurance company's claims and settlement practices. Since many insurance carriers have downsized their claims staff, mistakes are made and it is wise to have someone tracking claims. * Keeps all claims processes moving.

8. Have a Tightly Managed System in Place for Managing Minor Accidents
Do not allow a minor injury to become a major claim.

Many employers are under the false impression that they cannot pay for their own first aid claims. They can and they should. In many cases, this prevents a minor injury from becoming a major claim.

Most employers do not realize the crippling effect small claims have on the cost of workers' comp. The system penalizes frequency of claims rather than severity of claims. Small claims can cost an employer from 300% to as much as 700% of the actual claims cost. Every opportunity you have to pay a first-aid claim or to make the decision on whether a claim meets the first-aid criteria represents huge savings for you.

Have your clinic bill you directly for first aid claims; do not submit first aid claims to the carrier. In the California Code of Regulations, Title 8, Section 9780, "first aid" is defined as any one-time treatment, even if provided by a physician or registered professional personnel, and any follow-up visit for the purpose of observation of minor scratches, cuts, burns, splinters, etc., which do not ordinarily require medical care. It is not necessary to report such first aid claims to your workers' compensation carrier.

But be forewarned: there is a wrong way and a right way to handle first aid. You can be charged with a felony if you handle these cases incorrectly.

Ask Yourself:If your company is large enough, a good bill-review service, in which a nurse reviews all claims to determine whether any can be considered first aid, can save you up to 40% on medical bills.

If you don't have the resources to establish an in-house process for handling and paying first-aid claims, you can outsource the service. It would be worth the investment. First-aid claims can be monitored and paid by you at a reasonable cost instead of the exorbitant rate you would pay if you go through the workers' compensation system.

You will catch borderline claims, and save anywhere from 25% to 40% right off the top.

9. Always Provide Transitional Duty
The key to any effective workers' compensation system is to get injured workers back on the job as soon as they are ready.

When you get your employees back to work, you can realize as much as a 72.9% reduction in your claims costs.

Employers may require employees to return to part-time or temporary positions rather than provide benefits for paid time off under short-term disability, long-term disability, or workers' compensation. Thus, it is critical to have meaningful work assignments available for your returning-to-work employees.

Since short-term disability and workers' compensation call for you to provide compensation to employees who are off from work for certain injuries, your company should be developing policies that encourage, require, and facilitate employees to return to work.

Paid time off is expensive. While your policies need to be designed to comply with the Americans with Disabilities Act (ADA) and the Family and Medical Leave Act (FMLA), those employees who are fit for certain types of duties or for a certain number of hours each week may be required to return to work to maintain their status as employees. This will reduce the abuse by employees of state and federal law.

If an employee does not return to work when considered fit enough to do so, that provides the employer the mechanism to classify the employee as having abandoned the job.

Ask Yourself:The keys to a successful transitional duty program are consistency and proper oversight. If you have clear and systematically applied policies regarding return to work, you can guard your company against discrimination claims.

Better yet, don't return injured employees to work, make certain they stay at work. This is a culture you can create within your organization that will permeate outside of your company to your doctors, your employees, their families, and your WC insurance carrier.

10. Implement World-Class Hiring Procedures
At the very root of any workers' comp cost control effort is a focus on improving hiring practices.

By hiring smart today, you'll eliminate the need to manage tough later. It's far better to conduct a thorough background check of a potential employee before hiring than to discover-too late-that you have a "professional victim" on your staff.

According to industry expert Thomas Lundberg (winner of Workers' Compensation Honor Awards) "a high percentage of workers' comp claims are filed within the first three months of a workers employment." In addition, a Canadian study found that 43% of all accidents involve workers in their first year on the job.

Ask Yourself:How can you avoid budget-busting claims from your new employees? Consider your firm's hiring practices. Are you certain that every prospective employee has ...

* A fully verified work history?
* A complete, detailed check of references?
* A criminal background check?
* A physical examination?
* A drug test?

If you want to hire the best possible candidates in a manner that is fast, efficient, effective, and affordable, you need to use first-class screening and assessment tools. Make sure your system is robust enough to completely automate most of the following functions:

* Internet based job postings and marketing
* Recruiting
* Full tracking and routing of resumes, automatically, through the entire process
* Electronic gates through which only the prospects with the right skills and experiences can pass through
* Automation of all background checks, drug screenings, skill assessments, workers' comp checks, even personality profiles, all performed in precise accordance with state laws and regulations

Article series by Brent Heurter.
Brent Heurter is the Founder and Chief Solutions Officer of ClearComp, a workers' compensation alternative for companies that desire to control and reduce their workers' compensation costs. Brent can be reached at 888-CLEAR-89 or email brent@clearcomp.com.

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The views and opinions expressed by the author are not necessarily those of workcompcentral.com, its editors or management.