Gene Sardon III MLR 601 Section 26 Reducing Workers Compensation Claims According to an essay pu lis!

ed online y CC"

Incorporated# t!e $irst step in reducing %orkers& compensation costs in'ol'es ensuring t!at your company !as e$$ecti'e sa$ety and accident pre'ention programs in place to reduce t!e amount and se'erity o$ %orkplace illnesses and in(uries) In addition to t!ose programs# t!ere are policies and procedures t!at s!ould e implemented to !elp

super'isors and "uman Resources pro$essionals in !andling %orkers& compensation claims in t!e most e*pedient manner possi le) "a'ing an acti'e sa$ety program !as a num er o$ ene$its) Some are o 'ious) +t!ers are not) A sa$ety program gi'es employees a sense t!at t!eir employer cares a out t!em) Issuing personal protecti'e e,uipment s!ould e part

o$ t!e sa$ety program as s!ould periodic inspection and replacement o$ %orn or damaged sa$ety e,uipment) Rotating %ork sc!edules or (o duties can reduce repetiti'e-stress ene$it is t!at doing so

in(ury pro lems) An additional

keeps %orkers more interested in t!eir %ork and more $ocused

Sardon 2 on t!e (o in(uries) A mandatory sa$ety training program also lets your employees kno% t!at any %ork related in(ury is and ad $or t!em t!ey are doing %!ic! also tends to reduce

ad $or t!e company) All employees s!ould participate in

sa$ety acti'ities including t!ose %orkers in administrati'e positions or per$orming o$$ice %ork) Ideally# t!e message employers %ant to deli'er is t!at e'eryone !as a 'ested interest in minimi.ing t!ese costs) W!en employees reali.e t!at %orkers/ compensation costs tie directly to %!at t!eir employer can pro'ide in t!e $orm o$ compensation and $ringe ene$its# t!ey start to understand t!e importance and t!e ad'antage o$ !elping reduce t!ose costs) Anot!er common error employers make is assuming t!at t!e less said to employees a out %orkers& compensation rig!ts and ene$its# t!e etter) In reality# an employee&s

ignorance a out policies and procedures a out %ork related in(uries may actually cost employers and t!eir insurance carriers $ar more money in t!e long term) It !as een pro'en

statistically t!at %!en an employee delays reporting a %orkrelated in(ury# t!e costs $or treatment tend to increase) I$ permanent disa ility results $rom inade,uate or delayed medical attention# t!e %orker may e entitled to a permanent ene$its

disa ility settlement# in addition to t!e temporary

Sardon 3 !e or s!e recei'ed %!ile treating t!e ailment) 0!e claim may also !a'e to e litigated# and re$usal y t!e employer to

pro'ide appropriate and timely medical care is not likely to e 'ie%ed sympat!etically y a (udge and (ury) In addition

to legal $ees and time spent preparing $or trial and at trial# it is also possi le or e'en pro a le t!at t!e employer %ill e re,uired to pay muc! !ig!er insurance

premiums i$ delayed claims result in litigation) Some employers are reluctant to contact employees %!ile t!ey are on medical lea'e as a result o$ %ork-related in(uries) Many employers !a'e no policies in place t!at in'ol'e getting employees ack to %ork as soon as it is asis or %it!

medically appropriate# e'en on a part-time limited (o responsi ilities)

Instead# employers s!ould 1mployers

acti'ely track t!e status o$ in(ured %orkers)

s!ould contact t!ese indi'iduals at least once a %eek) 2uring your %eekly contact# t!e employee&s manager or a representati'e o$ t!e !uman resources department s!ould ask3 i$ t!e employee is satis$ied %it! t!e medical care t!ey are recei'ing i$ t!eir medical manner i$ t!ey are recei'ing t!eir disa ility in a timely manner ene$its c!ecks ills are eing paid in a timely

Sardon 4 i$ t!ey elie'e t!at t!eir in(ury is impro'ing e a le to return to %ork

!o% soon t!ey t!ink t!ey %ill

%!at t!e company can do to !elp t!em Letting in(ured employees kno% t!at t!ey are important

and t!at you %ant and need t!em to return to %ork as soon as possi le !as tangi le ene$its $or t!e employer as %ell as e

t!e in(ured employee) 0!e return-to-%ork process needs to managed to minimi.e t!e time a%ay $rom %ork) 1mployers s!ould care$ully track t!e return-to-%ork process) Ideally# t!e process %ould in'ol'e some $orm o$ transitional return-

to-%ork program in %!ic! in(ured employees are encouraged to return to alternati'e or lig!t duty %ork as soon as possi le) 1ac! o$ t!ese steps reduces costs to t!e employer and !elps get t!e in(ured employee rat!er t!an later) Regardless o$ !o% many employees a company !as# t!e employer s!ould pro'ide regular and mandatory training seminars to ot! current and ne% managers a out tools and ack to %ork sooner

tec!ni,ues $or promoting %orkplace sa$ety# in addition to t!e critical procedures immediately $ollo%ing an in(ury) untrained manager mig!t not understand !is or !er responsi ility to complete an accident report) "e or s!e An

mig!t $orget to inter'ie% %itnesses) 0!e manager mig!t

Sardon 5 $orget to take p!otograp!s o$ t!e place %!ere t!e accident occurred# or mig!t not kno% %!at to include in t!e report# suc! as $acts# and %!at to e*clude $rom t!e accident report suc! as speculation a out t!e cause or causes o$ t!e incident) Wit!out in-!ouse training# super'isors and

managers %ill not kno% t!e proper procedures $or t!e acceptance and $iling o$ %orkers& compensation claims# or t!e need to ensure t!at in(ured %orkers seek immediate medical treatment) A compre!ensi'e sa$ety training program

%ould also $ocus on t!e pre'ention o$ managerial conduct t!at could later e construed as !ostile to %orkers or

unconcerned a out %orkplace sa$ety issues) 4ot! o$ t!ese common pro lems in t!e %orkplace make it more likely t!at accidents %ill occur# and t!at t!e %orker %ill sue# and t!at t!e %orker %ill necessary) W!en an employee e*periences an in(ury on t!e (o # t!e manager or !uman resources s!ould complete an accident report %it! as muc! detail as possi le) 0!is tends to reduce %orkers compensation claims) s!ould e taken o$ t!e scene) W!ene'er possi le# p!otograp!s 5otential %itnesses s!ould e e a%ay $rom %ork longer t!an %as a solutely

inter'ie%ed indi'idually and in pri'ate a out %!at t!ey sa% and %!at t!ey !eard) Wit!in 26 !ours# t!e $irst in(ury report or accident report s!ould e sent to t!e insurance

Sardon 6 company to ensure prompt !andling and to reduce t!e likeli!ood o$ $raudulent claims) All %orkers& compensation

insurance carriers !a'e a $raud in'estigation and pre'ention department) As claims managers are %orking on a claim# t!ey are constantly comparing t!e in$ormation t!ey recei'e $rom t!e employer and t!e employee and considering %!et!er or not $raud is an element o$ t!e claim) W!en additional

in'estigati'e %ork is re,uired# t!e insurance carrier !as t!e e*pertise and t!e contacts to do so e$$ecti'ely and discreetly meaning t!at t!e company&s managers or !uman resources department do not need to ecome amateur pri'ate

in'estigators intent on $erreting out insurance $raud 7"R Issues and Ans%ers8) According to 2ana S!illing in !er ook 90!e Complete

Guide to "uman Resources and t!e La%#: i$ you as an employer suspect $raud# immediately in$orm your insurance carrier) +t!er important points to consider include3 Re'ie% your policy $or accuracy o$ t!e claim) Make certain t!at you !a'e properly descri ed your usiness to your %orkers& compensation carrier) ;o classi$ication is t!e main $actor determining t!e

cost o$ your premiums) Some employers misclassi$y t!e %ork per$ormed !oping to reduce %orkers& compensation insurance premiums) W!at can !appen in t!is scenario is t!at t!e

Sardon 7 insurance carrier in'estigates t!e incident in %!ic! t!e %orker %as in(ured# determines t!at t!e employer $alsi$ied t!e claim and denies t!e %orkers& compensation claim on t!is asis) Reali.e t!at sometimes it pays to in'estigate %!at you suspect is a $raudulent claim) 2o not pay employees not to $ile %orkers& compensation claims) +ccasionally# an employer %ill decide not to report a claim to t!eir insurance carrier and opt instead to pay t!e medical e*penses t!emsel'es) 1mployers do so !oping to a'oid an increase in t!eir insurance premiums) <n$ortunately# %!at sometimes !appens is t!at %!at appears to t!e employer as a minor in(ury ends up eing somet!ing

$ar more signi$icant and more costly) I$ t!is !appens# and depending on t!e contractual language in t!e employer&s %orkers& compensation policy t!e insurance carrier may !a'e t!e rig!t to deny t!e claim placing t!e $ull $inancial urden o$ t!e in(ury on t!e employer) In'estigating near-misses and incidents t!at don/t in'ol'e loss and implementing actions to pre'ent t!em in t!e $uture is important to cost sa'ings) Create a c!ange in e!a'ior to pre'ent t!em $rom

occurring to pre'ent $uture in(uries and reduce %orker&s compensation costs

Sardon 8 1mployers %!o plan a!ead and immediately pro'ide transitional %ork assignments $or in(ured %orkers can reduce t!e num er o$ in(uries t!at result in lost time claims = and reduce t!eir claim costs and premiums in t!e process) Most %orkers/ compensation la%suits $iled y employees

are t!e result o$ employees $eeling as t!oug! t!ey are eing treated un$airly or eing under-in$ormed) >or e responsi'e and !elp$ul

t!is reason# employers s!ould

$ollo%ing an accident or in(ury at %ork) 2oing so can !elp a'oid litigation) ?ot only is t!is t!e et!ical t!ing to do# it also costs $ar less t!an !a'ing to de$end a company against a %orkers& compensation la%suit) I$ lost time in(uries !a'e already taken place# employers need to do more to reduce in(uries and illness) +ptions include !iring a consultant# asking t!e %orkers& compensation insurance carrier $or ideas and recommendations# or 'oluntarily asking +S"A to inspect t!e %orkplace and make recommendations a out c!anges t!at s!ould e made in order to reduce %ork

related illness or in(ury 7@@1-@@68) According to an essay pu lis!ed online y t!e Canadian

Women&s "ealt! ?et%ork %e site# %ork-related so$t tissue

Sardon 9 in(uries are a leading cause o$ %orkers& compensation claims) can 0!ey are di$$icult to diagnose and to treat) y t!ese risk $actors# o$ten %orking in 0!ey

e caused

com ination3 repetition3 especially $or $ine mo'ementsA $orce3 li$ting# pulling# pus!ing# 'i ration# contact pressureA a%k%ard and static ody positionsA

%ork organi.ation B speci$ically !o% !ard# !o% long and !o% $ast people are re,uired to %ork

t!e e,uipment t!ey !a'e or do not !a'e in t!e %ay o$ la or sa'ing de'ices 5re'ention is t!e est %ay to tackle any occupational

!ealt! and sa$ety pro lem) 1mployers s!ould create a !ealt!y and sa$e %ork $or e'eryone in t!e %orkplace) Company management is in t!e est position to make necessary c!anges 0!ere$ore# open and

to pre'ent in(uries# not %orkers) !onest dialogue

et%een %orkers and management %ill tend to

pre'ent in(uries and in turn reduce %orkers compensation costs and ot!er costs incurred is in(ured) y employers %!en an employee

0!ese !idden costs include decreased

producti'ity among t!e remaining %orkers# and t!e cost o$ !iring and training a temporary replacement until t!e

Sardon 10 in(ured %orker is a le to return to %ork) Anot!er cost

in'ol'es t!e loss o$ e$$iciency %!en a trainee replaces a trained employee as %ell as an o'erall drop in morale t!at can and o$ten does result in a lo%er producti'ity 75re'enting Work-related In(uries3 So$t 0issue In(uries8) Summary3 Common causes o$ industrial in(ury include poor ergonomics# p!ysically mo'ing !ea'y o (ects# slip and $all accidents caused y unsa$e %orking conditions suc! as

spills t!at are not contained or passage%ays t!at are not kept clear o$ o structions) Inade,uate training on t!e use o$ 'e!icle and e,uitment# inade,uate sa$ety training and !air or clot!ing t!at ecomes entangled in mo'ing e,uipment)

Many employers& sa$ety training programs $ocus on %!at do to a$ter an accident or in(ury occurs) 0!e $ocus s!ould

e s!i$ted to%ard pre'enting t!e damage $rom !appening in t!e $irst place) 5rimary inter'ention# in e$$ect accident pre'ention s!ould e t!e goal o$ e'ery employer)

<n$ortunately# employees o$ten do not report in(uries or c!ronic paint to t!eir doctors until t!e symptoms are serious# t!e damage is done# and t!e pro lem is so serious t!at it cannot e ignored) As a result# employees o$ten e re$erred to as secondary inter'ention)

undergo %!at mig!t

0!e goal o$ t!is $orm o$ treatment and inter'ention is to

Sardon 11 pre'ent t!e pro lem $rom %orsening or de ilitating) ecoming c!ronic and

Sardon 12 Works Cited C"R Issues and Ans%ers)C CC" 4usiness and Corporate Compliance) 2D Mar 2006) E Mar 200F G!ttp)HH!r)cc!)comH!!rli Hissuesans%ersHReducing-lost-%orktime-and-costs-due-to-%orkers-compensation-claims)aspI dateJMarc!-2D-2006K) C5re'enting Work-related In(uries3 So$t 0issue In(uries )C 0!e Canadian Women/s "ealt! ?et%ork) 02 >e F Mar 200F G!ttp3HH%%%)c%!n)caHresourcesH$a,Hso$t0issue)!tmlK) S!illing# 2ana) 0!e Complete Guide to "uman Resources and t!e La%) 1st) 5aramus3 5rentice "all# 1DDL) 200F) Canadian Women/s "ealt! ?et%ork)