Discover strategies to bring down the cost of work comp claims.

1. PROVEN STRATEGIES TO CONTROL WORK COMP COSTS

2. HOUSEKEEPING
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3. Thanks to our sponsors!

4. INTRODUCTIONS
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Jodi Mathy
Senior Claims Consultant
jmathy@hni.com
262.641.5804
Andrea Tarrell
Marketing Director
atarrell@hni.com
262.641.5813

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6. KEY COMPONENTS
•SET THE SCENE FOR SAFETY
•DON’T HIRE YOUR NEXT CLAIM
•PROMPT REPORTING AND MEDICAL CARE
•RED FLAGS
•INJURY MANAGEMENT COORDINATOR
•COMMUNICATION
•MODIFIED WORK PROGRAM
•EXPERIENCE MODIFICATION RATE (MOD)
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7. SET THE SCENE FOR SAFETY

8. CULTURE OF SAFETY
•You must make safety a priority from the top down.
•Make sure that you have the proper policies and training in place.
•Educate employees about their rights as well as roles and responsibilities in the event of an injury.
•Find ways to incentivize a safe workplace.
•Review all accidents and injuries to identify the root cause and put proper controls in place.
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9. REENERGIZE YOUR SAFETY PROGRAM
•You can’t change your past experience but you can change your future!
•Review your safety program or start one! Work with your agent if you need assistance and resources to help you achieve this.
•Safety culture in your organization needs to become a top down priority!
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10. DON’T HIRE YOUR NEXT CLAIM
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11. THE RIGHT FIT
•Put in place post-offer enhanced physicals.
•These types of tests objectively measure whether a candidate can perform the essential functions of a position.
•This step requires updated job descriptions with specific physical requirements.
•Go beyond drug testing!
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12. START AT THE BEGINNING
•ADA compliant job analysis details essential job functions.
•Highly detailed measurement of lifting/carrying/push/pull, positional demands, etc.
•3rdparty objective documentation of tasks verified by management and labor (both groups accept the validity of the description).
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13. GET TO WORK
•PT develops EPT protocol based upon physical demands documentation and client input.
•Validity testing
–Client sends in an employee to go through the EPT to validate the specifics of the protocol
•Revisions made as necessary.
•EPT becomes part of the client’s Post Offer Physical process.
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14. BENEFITS OF EPT
•Provides a snapshot view of the workers ability to perform the critical physical demands of the position.
•Highly individualized and specific to the job.
•Useful on a post offer/pre-employment and post accident fitness for duty examination.
•Useful in Physical Therapy treatment to identify crucial physical task goals for case closure and RTW.
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15. PROMPT REPORTING AND MEDICAL CARE
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16. TIMELY REPORTING
•Allows claim representative to make contact to explain benefits.
•Allows for proper medical attention.
•Reduces overall costs.
•Reduces litigation.
•Allows early utilization of Fraud Investigation Unit.
•Allows timely investigation.
–when facts are known and fresh
–potential subrogation
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17. ACCIDENT INVESTIGATION
•Interview the injured worker as soon as possible, after medical care has been rendered.
•Interview any witnesses.
•Investigate the injury site and review the actions leading up to the injury.
–Prevent others from encountering the same hazard
•Gather the facts and look for possible causal factors.
•Review findings with your safety committee
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18. MEDICAL TREATMENT
•Who is making the call at your organization?
•Are you utilizing the jurisdictional controls available?
•Establish relationships with local occupational health facilities.
•Consider utilizing a 24/7 nurse triage service to help refer your employees to the appropriate level of care. There are multiple options out there for this type of service.
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19. RED FLAGS
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20. WHAT SHOULD I LOOK FOR?
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•The alleged injury occurred on Monday morning or on a Friday afternoonbut was not reported until the following Monday.
•The accident occurs just prior to or after a strike, job termination, layoff, end of a project or at the end of seasonal work.
•The accident was unwitnessedby any fellow employees.

21. MORE TO LOOK FOR…
•Claimant has a historyof prior claims.
•A substantial delayoccurred in reportingthe incident or in the filing of the First Report of Injury.
•There are different descriptionsof the accidentas set forth in the medical history and the Employer’s First Report of Injury.
•There are frequent difficulties in contactingthe claimant at homewhen he/she is allegedly disabled.
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22. OH THERE’S MORE!
•The lawyer and/or treating physicianare known for being involved in suspect claims.
•The claimant frequently changesphysicians or medical providers.
•The claimant has received a release for work which is followed by the claimant changingphysicians or medical provider.
•A third partyis involved in the incidentunder investigation. Be alert to the possibility of subrogation in any claim.
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23. INURY MANAGEMENT COORDINATOR
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24. WHO ARE THEY?
•The individual who you have empowered to be the point of contact for your injured employees and the adjusters.
•They maintain communication and help to relay red flags and other information to involved parties.
•They work to help place injured employees in modified work positions.
•Could be your safety manager, risk manager, HR manager or a separate role. 25

25. WHY IS THIS IMPORTANT?
•Your injured employees need direction.
•One point of contact keeps the confusion to a minimum.
•They become stewards of the company to help employees in their recovery.
•It shows your commitment to a culture of safety.
•Communicationis key!
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26. COMMUNICATION
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27. DON’T LOSE TOUCH
•The adjuster shouldn’t be the representative for your company.
•Your employee should know that you care about their recovery.
•Lack of communication often leads to confusion and ATTORNEYS!
•An injured employee is STILL an employee.
•Outline roles and responsibilities.
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28. PICK UP THAT PHONE
•Make periodic inquiries of the employees condition.
•Help them get answers to their benefit questions –be their advocate.
•Discuss use of FMLA and how their benefits may be impacted by their disability.
•If they need corrective action, handle it swiftly.
•Welcome them back to work modified if possible.
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29. MODIFIED WORK PROGRAM
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30. AND THE SURVEY SAYS
Why are these programs important?
•When an employee returns to work in a modified position that employee is more likely to have better healing and a higher likelihood to get back to 100% pre-injury activity
•By having a dedicated modified work program the company wants to show all employees that they are valued members of the team.
•It feels good to contribute to the team’s success.
•Not all restrictions can be accommodated but the company and the employee should have good open communication for when the time is right to return to work.
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31. “don’t let TIME get away from you!
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% increase
0%
25%
50%
75%
100%
6 months 12 months 24 Months
Time Away From Work
Chance of Returning to Any Work
Source: New York State Workers’ Compensation Board, 2011

32. BEST PRACTICES
•Create a written program that outlines the responsibilities of the employee and management
•Identify light duty positions across the organization to utilize when the need arises –Job Bank
•Establish guidelines and length of time the modified duty program is available
•Have an Employee Commitment Review Form (requires employee’s signature)
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33. EXPERIENCE MODIFICATION RATE (MOD)
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34. YOUR MOD
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35. CONTROL YOUR EXPERIENCE
•Review all reserves and payroll data prior to unit stat filing.
•Project what your future rating will be.
•Audit your published rating at time of release for errors.
•Take advantage of state specific rules that allow for mod corrections to be made in your favor.
•Medical-only claims receive a 70%discount when their primary actual dollars go into your mod calculation. 36

36. Workers compensation claims are costly and frustrating.
GIVE SOME OR ALL OF THESE STRAGEIES A CHANCE.

38. WHAT’S NEXT AT HNIU
NEWChiropractors & Work Comp: Aligning Treatment and Expectations to Handle Claims Effectively
10-11 a.m. December 18 | Webinar
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39. Thank You
hni.com