Containing Your Workers' Comp Costs
The "We Care" program contains costs and manages risks by targeting three areas: employee interaction; medical management; and claims involvement. Another way of describing the components is: First Care, Right Care, and Always Care.
First Care - employee interactionThe goal here is to foster positive working relations with employees, demonstrating that the company's main concern is the workers' health and well being. Here's how to incorporate a caring attitude into routine incident investigations:
- Contact the employee within 24 hours or less of the incident.
- Show your concern through constant and frequent communication after the incident occurs.
- Schedule routine calls to the employee on a particular day of the week to monitor the progress of his or her recovery.
- Inform and routinely update supervisors of employee's health and work status. If the employee is working, make sure the supervisor understands the employee's work restrictions.
- Involve both the employee and supervisor in planning the employee's return to work, monitoring progress.
- Ease the employee's transition into work with reduced hours, increasing them steadily and gradually.
- Include the employee in evaluating any corrective changes resulting from their injury. Injured employees can become effective and active participants in the safety committee, ergonomics team, and first aid team.
Right Care - medical managementRight care is quality health care, beginning with first aid response and continuing through medical care and follow-up. A few ways to contain medical costs incurred by an injury are:
- Staff each shift with adequately trained first aid personnel. A well-trained first aid team can respond to a variety of injuries and illnesses.
- Triage emergencies to avoid unnecessary and expensive visits to the emergency room.
- Reduce the cost of ambulance runs (up to $500) by restricting use to unstable cases involving serious injury or illness.
- Use "Good Samaritan Transporters" to transport stable cases in company vehicles to the emergency room or occupational health clinic.
- Be smart about using your community medical resources. Tour local hospitals and freestanding clinics. Interview physicians, nurses, physical therapists, and health care managers. Ensure that emergency care covers all work shifts. Selected providers should tour your facility and be given extensive information about company operations.
You should have three basic expectations of your health care providers: 1) Initial medical response should be appropriate to the injury or illness; 2) Follow-up care should be coordinated by one provider; and 3) Adequate verbal and written communication must be provided to the employer within eight hours or less of a medical visit.
Always Care - claims involvementIt's important to choose an insurance provider who listens and meets your company's needs. To ensure a good working relationship, ask the insurer to arrange for the same case workers to be assigned to your company. Then give them facility tours and extensive information about your company's operations. Claims management should be an aggressive program, facilitated by your involvement with the provider. Here's how to achieve this goal:
- Establish case-specific communication with the insurer within 48 hours of an incident. If a case is going to be long-term, plan for it.
- Monitor the employee's progress, and if there is no improvement health-wise, an alert to the insurer should result in an Independent Medical Examination (IME). IMEs can function as second opinions.
- Maintain communication with the employee's physician, emphasizing the need for a doctor to provide an evaluation of the employee's work abilities so the employee can return to work as soon as possible.
- Institute a "return to work" program to reduce the costs of lost work time.
- A company representative should attend all workers' comp hearings and trials and be prepared to testify when necessary, providing photos, videos, and work samples to court.
- At least twice a month, review all open claims and care strategies with the comp business unit.
- Insist that medical bills and wages be paid promptly. Review loss runs monthly.
The three components of the "We Care" program - employee interaction, medical management, and claims involvement - are designed around caring for the employees' well being. A workers' compensation program centered around concern for employees will save you time and money.
Marcella R. Thompson, CSP, COHN-S, is Safety Engineer for Cherry Semiconductor Corporation, East Greenwich, RI. She is Administrator of the American Society of Safety Engineers' Management Division and this year's recipient of ASSE's "All Divisions Safety Professional of the Year."