If someone gets hurt in your facility today do you know what your first step would be? Do you know where to send them? Do you know who the medical practitioner is that may attend to them? Does the employee know what to do when he or she gets hurt? The first few actions you take can be crucial to managing your workers compensation costs. And guess what? They need to happen well before anyone gets injured.
Workers compensation costs can quickly get out of hand when not actively managed. This management process should happen well in advance of any injury. There are several “lines of defense” when it comes to managing workers compensation. The first line of defense is building the right culture for a safe work environment and having solid safety processes in place. The second line of defense is having a solid new hire process in place. Do you thoroughly interview all your employees? Do you have a list of the physical requirements to perform the job and has the prospective employee been examined and tested to insure they can perform to these requirements? Is the physician aware of the requirements of the job? Do the employees go through an orientation process that includes workers compensation policies? The last line of defense and the one we will mainly focus on in this article is post-injury case management.
Once someone has been injured, the next steps you take can help decide the cost of the injury. This is where solid post-injury case management comes into play. Most employers rely on their carrier to manage their cases for them in their best interest, but I can assure you that rarely happens. And, even if you are not self-insured, each claim is going to potentially cost you additional dollars.
The first step in this third line of defense is creating a formal written program. The program should include reporting requirements. This not only includes outlining the reporting requirements for employees when they are injured, but also the requirements for reporting to your insurance carrier. The program should also address how the claim will be handled, who is responsible for the overall management of the plan, who calls the injury in to the insurance, how often are claims followed up, and whether someone accompanies the injured worker to their appointments. Next the program should address how the injury will be investigated. Who will you include in your investigations, how will they be conducted, are the results of the investigation communicated? The program should address the documentation requirements. Workers compensation may generate some confidential information. How will that be maintained, who will have access, how long will you keep it? Lastly the program should detail your return-to work policy. Will you accommodate all types of restricted duty? What types of work will you include in your return-to-work plan? This just touches on some of the items that need to be addressed and documented in a well thought out program.
The second step, and probably the most beneficial, is to establish a solid relationship with a medical provider regardless of your work environment. Your insurance may dictate who they want you to use, but you can push back if you are not getting the service you deserve. Invite them to your workplace to see what types of requirements your employees have to meet. Employers have had physicians walk through their workplaces and tell them that it is definitely not what the employees would lead him to believe the environment was like. Communicate your expectations for their service. Let them know about your return-to-work program and whether you accommodate all restrictions. Will they use over the counter medications or are they more apt to prescribe medicine? Building this relationship up front will go a long way in ensuring the most conservative treatment is given to help minimize cost and reduce OSHA recordables.
The third step is to train and educate employees how to handle an injury immediately after it happens. Encourage employees to report all incidents, no matter how minor, immediately. Employees responding to the injured employee need to be caring, compassionate and non-judgmental. Setting the right tone from the beginning with an injured employee will go a long way in ensuring they do not try to abuse the system. If he or she insists or requires medical attention, send him or her to the physician you have built the relationship with. If the request for medical attention seems unreasonable, ask him or her “If you did this at home, would you go to the doctor?” You may be surprised by the light that will go off when he thinks about that. Again, it has to be handled in a caring and compassionate way, but you have to also ensure the system is not being abused.
The last thing I will touch on is sending someone with the employee to the doctor, preferably their supervisor. You want to ensure that not only does the employee get there and back safely, but that everything gets properly communicated and the physician understands everything the employee was doing and is required to do in his job. As well, you want to ensure the requirements from the physician get communicated to the employer. You certainly do not want an employee to come back and say everything was fine, only to find out they should have had a five pound restriction and now he is much worse or vice versa.
Actively managing your workers compensation can be a lot of work, but it certainly will have its benefits.
Written by: Aaron Miller, CIH
Senior Project Manager
Astbury Environmental Engineering, Inc.