Outlining expectations for injured workers upfront can save comp dollars
That fairly typical scenario is unnecessary -- and expensive, according to an insurance broker executive. Instead of leaving the process to chance, he suggests providing injured workers with all the information they need to make the system work smoothly, as soon as the injury occurs.
"I've seen firsthand some very, very large corporations that don't do this and employees are lost," said Andrew Muller, senior account executive with Neace Lukens. "They get frustrated with the company, the carrier, the TPA. They hold a grudge, and you lose productivity."
In a recent LinkedIn post, Muller suggested handing an injured employee a premade injury packet upfront as a way to "drastically" reduce claims costs. "It creates a culture of safety and says, 'We're serious; we mean business when it comes to work-related claims,'" he said. "Creating that safety culture is the key ingredient to having a successful program."
The first item in the packet is a letter outlining the workers' comp process. "It can be from the director of human resources, the safety director, or the president of the company," he said. "It needs to state the expectations -- what the employee should expect to receive out of this process and what they are expected to do."
The letter need only be a page or two but should fully explain some key parts of the workers' comp process. For example, it should detail what percentage of the person's pay he is entitled to and the maximum payment allowed under state law.
"You need to clearly state, 'This is not a money-making process,'" he said. "I think that's a very important part because some employees don't realize that. If you tell them upfront, they may be more inclined to come back to work."
The packet should also include a prescription information sheet "to take and fill out at a pharmacy that will be part of a network to keep costs down," Muller said. "They'll understand, 'If I go to CVS, it's cheaper than if I go to the local pharmacy down the street.'"
The packet should also include an Authorization for Release of Medical Information. The letter should explain that this will help the physician determine the care and treatment of the injured employee and that the information is confidential.
Explaining alternative work options can facilitate faster return to work. The letter should state that the company will communicate with the injured worker's medical providers.
"It needs to be defined in the letter that 'you'll be expected to fulfill RTW requirements,'" he said. "If there's a noncompliance with the expectations, it could result in a suspension of benefits."
Muller also says the injured worker should be made aware that he is eligible for mileage. "A lot of people don't realize that but find out a month later and say, 'Why didn't someone tell me that,'" he said. "We not only tell them but give them a log to keep track of mileage -- anytime they go to the doctor, the therapist, anything related to the injury we say, 'Keep track of it to get reimbursed.'"
Additionally, the letter should include a section on monitoring of care. "You establish that getting the employee back to work and their health and safety is number one -- that's why we want to monitor the progression," Muller said. "We want their input on how to prevent these claims from happening. We want them to be involved."
Finally, the packet should include an injury report to be completed by the supervisor, the injured employee, and any witnesses, as well as an injury questionnaire. "You can gain great knowledge by understanding what the employee's thoughts are," he said.
Read more at the WorkersComp Forum homepage.
January 20, 2011
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