Controlling Comp Costs, A Broker Perspective - Part 2

Saturday, November 22, 2003 | 0

The first in this series of articles providing tips and advice to employers from the insurance brokerage perspective - the level of interaction that is most frequent and common to the employer experience with workers' compensation - reviewed various procedures the business owner and manager can use to help prevent work injuries. This part of the two article series reviews employee and supervisor training and communication in the prevention of work injuries as a part of your overall workers' compensation control program.

The broker's perspective is an interesting twist - the right broker can have a significant impact on the cost of your workers' compensation program beyond just shopping for the best deal. A broker that is doing his or her job will work with you to reduce injuries, assist in claim investigation, and be the front person in your interactions with the carrier.

Review Employee Communications And Safety Training
Safety starts with management sending a strong message of accountability and support. Following up with action lets employees know that safety is important to the company.

Effective workplace safety and workers' compensation programs start with good employee communications. Communication problems are a top reason for disputes following a workers' compensation claim. Lack of effective communication between the employee, doctor, claims examiner and employer can cause delays and frustrations that may lead to litigation.

Train Supervisors And Managers
Supervisors, foreman and team leaders need training to recognize and control hazards, teach and monitor their staff in safety procedures and work habits.

Invest in your supervisors and make sure they know that safety is a priority for your company.

Areas to cover in supervisor policies and training include:
- How the company's safety program works and their responsibility in it.
- What to do when an injury occurs, after-hours policies-remember the third shift-working off-site, emergencies and assigned responsibilities.
- How to arrange medical care for injured employees.
- How to report injuries quickly.
- You must give the injured employee an Employee Claim form (DWC-1) within one working day of your knowing an injury occurred. The employee fills out the top part, you fill out the rest and send it to the insurance company- the employee gets a copy of the completed form.
- How to respond to an injured employees' questions and concerns after an injury.
- How to investigate the accident promptly and correct any safety problem.
- How to file a supervisor's report of the injury-and send it to the insurance carrier.
- How to keep records of the accident, medical and disability reports.

Employee training
- Seasonal and temporary employees must be included in training; they're your responsibility.
- Are new employees thoroughly oriented to the workplace, shown how to do their job safely and how to report problems?
- Do all employees receive safety training when they move to a new job site or get new equipment, furniture or tools?
- Do they have a feedback system to make sure employees understand the training they receive?

Assess special training needs
Up to 30% of work injuries take place among employees who have been on the job for less than a year. Retraining in the first year of employment pays off in fewer injuries.

Workplace safety and health training must be conducted in a form readily understood by all employees. If you have a non-English speaking employees, the written and verbal instructions must be translated. Ask your insurance carrier for safety and workers' compensation materials in other languages.

You must also conduct specialized job-specific training.

Posting Notices, Giving Medical Care Instructions
Obligations to Inform Employees
You must post a notice in a conspicuous place, giving employees information on the company's workers' compensation coverage and where to get medical care for work injuries.

Failure to post this notice may be considered evidence of non-insurance. The notice also must include advice about the injured employee's right to receive medical care, to select or change the treating physician, and to receive temporary disability indemnity, permanent disability indemnity, vocational rehabilitation services and death benefits as appropriate. Labor code 3550.

Failure to post this notice will automatically permit the employee to be treated by his/her own physician for an injury occurring during the period in which the notice was not posted. Labor code 3550.

At the time of hire and again when an injury occurs, you must give basic information to employees about workers' compensation coverage and benefits. Samples of these pamphlets can be found at the end of this manual.

Every employer subject to workers' compensation must give each new employee a written notice of the above information either at the time the employee is hired or by the end of the first pay period. Labor code 3551.

If the employee makes the request, the employer must provide him/her with an appropriate form on which to indicate the name of the employee's personal physician. Labor code 3552.

If the employer does not offer two or more certified health care organizations (HCO) for treatment of occupational injuries, the employer must furnish each employee, upon request, with a form allowing him/her to designate a personal physician prior to the date of injury.

If two or more certified care organizations are offered, that form must be furnished at the Time of employment and at least annually thereafter, allowing the employee to designate the HCO or a personal physician.

Any such designated physician must be a licensed physician who has previously treated The employee and maintains that employee's medical history. The employer should retain the completed designation forms and a copy forwarded to the employer's compensation insurance carrier. Labor code 4600.3.

Most carriers, as well as, the California Division of Workers' Compensation have brochures that you can use for this purpose. The brochures cover where to go for medical care, how to report an injury, what will happen after the injury, and employee rights and benefits after an injury; and must be available in English, and in Spanish of you have Spanish-speaking workers.

Also at the time of hire, employees must be told of their right to pre[designate their own personal physician who would provide treatment if an injury occurs on the job. The employer may give employees a form for pre-designating medical care, or the employee may write a note that should be kept in the personnel file. A sample form is included near the end of this manual, just ahead of the aforementioned brochures.

Reporting Injuries
Some employees are afraid to report injury to their employer. This may be especially true for conditions such as carpal tunnel syndrome, tendonitis, and low back pain, in which symptoms develop slowly over a long period of time. Employees who are working in pain, trying to hide their symptoms, suffer reduced productivity and morale, and may end with more serious and costly injuries. Don't make it difficult for employees to report injuries to you. A potential injury caught early may avoid a workers' compensation claim altogether. California Labor Code 132(a) prohibits discrimination against an employee who is injured on the job or files a workers' compensation claim.

Medical Attention
Information on where to get emergency care must be posted in your workplace.

Have you checked to see how your employee was treated on a medical visit?
This may influence the whole course of treatment and recovery. You need to take control as to the quality of treatment you want your employees to receive.

Why is choice of doctor important?
The treating doctor will:
- Decide what kind of medical treatment is needed.
- Help identify the kinds of work the employee can do safely while recovering.
- Provide key information to help the injured worker return to work.
- Prepare medical reports that affect the benefits the employee is eligible to receive.

Have you evaluated your occupation health clinic?
Have you ever visited the clinic?
Do the assure early access to needed medical services?
Do they have a program to ensure quality of care?
Do they use nurse care managers to facilitate communication between you, the employee, doctor and insurance carrier?
Will they help you coordinate early and safe return to work?
Do they hesitate to refer out to a specialist?
And a hundred other questions...

The pre-designated physician
Usually the employer chooses the primary treating physician for the first 30 days after an injury is reported. However, if before an injury the employee had notified you in writing of a personal physician who previously directed the employee's medical treatment and has the employee's medical records, the pre-designated physician can treat that employee from the date of injury. This physician must be a medical doctor or osteopath. If the employee wants to be seen by some other kind of doctor, e.g., a chiropractor, the injured employee may ask to change doctors after the initial visit.

The most fundamental instrument you have in controlling your workers' compensation costs is medical treatment - insist that your employees receive the absolute best treatment available so that employee can return to work faster. Be an advocate for your employee - the employee is your most valuable asset. Make sure your insurance company understands that and your employee will be happy, less likely to seek the advise of an attorney (which will cause the case to go litigated) and you will be happier with lower workers' compensation premiums.

Brent Heurter is a partner and President of the insurance brokerage firm Pavlo, Weinberg & Associates. He can be reached by phone toll-free at (877) 591-2663, or by e-mail at bheurter@employerbenefits.com.