Counsel of Care

Counsel of Care

Worker’s compensation coverage presents unique concerns to every company, and it can be tricky to navigate complex requirements for addressing individualized needs while remaining in compliance with established regulations. At Building Indiana, we make it our mission to provide ideas to our readers that might help companies grow, so we’ve reached out to experts from around the state and asked them for their number one piece of worker’s compensation advice for Indiana businesses.

The results turned out quite diverse, representing a gamut of ways that worker’s comp can be considered and managed. Check out what the experts have said, and use their knowledge to build upon your particular coverage:

 

Ron Knickrehm

Ron Knickrehm

Ron Knickrehm, PT, CEAS III, IU Health Occupational Services

In 2011, the Centers for Disease Control and Prevention (CDC) reports employers spent $50 billion on the direct costs for workers’ compensation related to Musculoskeletal Disorders (MSDs). In my opinion, much of the financial and human costs of MSDs are unnecessary and could be prevented through ergonomic intervention.

MSDs are the leading cause of pain, suffering and disability in the workplace with ailments ranging from carpal tunnel syndrome and tendonitis to neck and lower back issues caused or exacerbated by physical risk factors including repetition, force, vibration or awkward posture. These are risk factors that could be avoided with preventive measures.

As a Certified Ergonomics Assessment Specialist, I recommend companies be proactive by investing in a risk analysis and job site analysis to identify areas of potential risk and quantify essential functions of each job. It is my job to observe employees and, when needed, provide instruction to improve their safety – from training in body mechanics and lift techniques to office ergonomics and work station design principles, depending on the job. This can be done in any work setting, whether it’s a manufacturing or assembly job to a desk job, to pinpoint the factors that cause stress on a body and how to reduce it.

Job site analysis is essential in developing accurate functional job descriptions, modified duty programs, process design improvements, and essential function screenings, which allow you to hire individuals who are capable of performing the physical demands of the job.

From a workplace injury prevention standpoint, companies need to step back and look at the process as a whole. They have to know where they are before they can figure out where they want to go.

Conducting an ergonomics assessment is a win-win for both the employer and the employees. When a company is willing to invest in creating a safety culture it not only makes the processes more efficient, but it shows employees they are being taken care of. That in turn boosts morale and productivity, while diminishing the exorbitant costs of workers’ compensation claims. It’s all about prevention.

 

Sarah Taylor

Sarah Taylor

Sarah Taylor, RN, Case Manager, Community Healthcare System’s Occupational Health

Prompt attention and reporting of work-related injuries to the Workers’ Comp insurance company is important for many reasons. Early reporting helps to facilitate early treatment for patients. When a worker is injured and sent to Occupational Health, early treatment or diagnostic testing may be ordered by the physician. The case manager must then contact the insurance company for authorization.

If the claim is not reported as soon as possible, treatment for the patient may be delayed. It can take up to 24 hours for some insurance companies to process a claim once it is reported, and for it to be assigned a claim number and an adjuster. Claims that are not reported promptly delay the ability of case managers to obtain approval for MRI, physical therapy, and referrals to specialists.

When a patient receives prompt treatment- such as physical therapy, companies experience a reduction in lost time, lost revenue, and lost production from that employee. Some insurance companies use specific facilities for treatment/testing; and those facilities will not schedule a patient without a claim number and verbal or written authorization. Delayed reporting- even by one day, causes a delay in treatment, a delay in getting back to full duty, and loss for the company.

In addition, insurance companies charge more for delayed injury reports. It can cost the employer up to 30% more for late reports. Many insurance companies offer online reporting, as well as filing a claim by phone, or faxing over the incident report.

Lastly, always follow-up on the claim if it is faxed or reported online so that you can obtain the claim number quickly, and ensure prompt treatment of your injured employee.

 

Larry Meyers

Larry Meyers

Larry Meyers, Managing Partner – Property Casualty, Meyers Glaros Group

For many businesses, their exposure for Workers Compensation losses is limited to their business location or at most the state in which their business is located.  That is not the case for some businesses in which job sites can be in many different locations in states other than the state where their plant or office is located.  Coverage for these exposures can become complicated for a variety of reasons.

Let’s discuss those businesses that acquire their Workers Compensation protection via the Assigned Risk Pool in the State of Indiana.  Coverage under this plan is limited to exposures for the State of Indiana only.  If you have exposures in other states you must address those separately and purchase policies from those state pools (assuming there is a reason you are in the pool that would preclude you from obtaining a Workers Compensation policy from the open market) where you have the exposure.

If you have a “standard” Workers Compensation policy through the open market there is a good chance you have “other states” coverage which allows your Workers Compensation policy to comply with the benefits that are statutory in some of the other states.  It is important to note that this extension of coverage comes with some qualifications.  The first requirement is that you don’t currently have on-going operations in that state and secondly you do not plan to have on-going operations in that state during the policy period.

To further complicate matters, there exists several “monopolistic states” in which you may have to obtain coverage for your Workers Compensation exposure from the appropriate state sponsored insurance plan.  Each of these states has their own rules and regulations that dictate the terms in which coverage must be purchased through them.

Suffice it to say you need to keep your insurance agent informed as to any new projects or job sites involving locations out of your home state.

 

Charles Mok

Charles Mok

Charles Mok, Jr., DO, Medical Director, Occupational Medicine / Employee Health, Franciscan WorkingWell

Back injuries, sprains/strains, lacerations. . . . .these are the most common workplace injuries.  Generally, treatment of these conditions is straightforward and managed without days away from work.  Any qualified provider should be able to treat and manage such injuries.

What about the “questionable” injuries?  Here are some recent examples:

  • An employee recently presented complaining of low back pain. This employee stated the injury occurred on Monday, but did not have symptoms until Saturday.
  • On another occasion, an employee presented complaining of a rash due to “latex” gloves used on the job. Oddly enough, there was no rash on either hand in the areas covered by the gloves.

Had either case sought care through an Emergency Department, the company would be dealing with a recordable injury that was likely not work-related.

Fortunately, these companies had established a relationship with the Working Well program prior to the employee incidents.  The physician treating these patients was aware of the company’s work environment and the employee’s job description/responsibilities.  In the latter case, the physician was aware that the company uses only latex-free gloves.  Hence, latex allergy was not a reasonable consideration.  Obviously, there is more to the evaluation process, but this is a reasonable beginning.

Establishing a relationship with an Occupational Medicine provider is probably the “best medical advice” I can give.

  • A strong understanding of the work environment and individual needs of a company facilitates the “simple” cases and assists in navigating more challenging situation.
  • Large or small, every company would benefit from building ties with an Occupational Medicine facility.

 

Robert Wysocki

Robert Wysocki

Robert Wysocki, M.D., Hand, Wrist & Elbow Orthopedic Surgeon, Midwest Orthopaedics at Rush

Carpal tunnel syndrome (CTS) is the most common “pinched nerve” in the arm, actively affecting a million Americans at any given time. The condition leads to numbness, tingling, and often pain in the palm of the hand.

In the workplace, CTS is a critical condition to target in regards to cost, as it comprises only 15% of all upper extremity claims by number, but can comprise well over 50% of the cost of upper extremity occupational disease.  This is due not to the expense of surgical treatment per se, as carpal tunnel is one of the most inexpensive upper extremity surgical procedures, but primarily due to high amounts of work lost and permanent inability to return to work compared to other conditions.

Workers most at risk for occupational CTS include those with high frequency use of vibratory tools, frequent strong repetitive gripping, or frequent extreme wrist posturing.  The evidence is much weaker for any work-relatedness with clerical work or simply repetitive motion.

The number one reason for a failure to return to work after carpal tunnel release surgery is a persistence of symptoms, and the top reason for persistent symptoms is more severe symptoms going into surgical release. Thus, early recognition and intervention is critical in providing the best chance for full recovery and return to work.

High-risk workers should be considered for rotating amongst stations that would be lower risk to lessen the overall exposure.  Anti-vibration gloves can play a role for those using vibratory tools.

 

Kassandra Mason

Kassandra Mason

Kassandra Mason, HR Manager, Vibra Hospital of Northwestern Indiana

Don’t make the mistake of not involving the employee in the workman’s compensation process.  To avoid any errors, have the employee fill out their own accident report, documenting the description of injury and any actions/steps that were taken.

It is important to communicate the worker’s compensation process, whom the employee can contact with questions, and how to report an injury.  It is important to communicate and stay in touch with the employee while they are on workman’s compensation.  It is also essential to stay in touch with their health care provider regarding the status of their condition.

Additionally, keep in touch with the claim representative or care manager, work together to manage the claim and reach a proper resolution of all issues.

Have realistic expectations

Stay professional and keep emotions out of the Workman’s Compensation process. Be involved and anticipate what is to come in order to stay in control of the situation.

Important Dates

Stay on top of all important dates, to ensure all the paperwork is submitted and deadlines are met.

Training

Make sure that supervisors are trained on what your companies’ Workman’s Compensation process is.  A supervisor needs to know how to deal with employee injury and what the correct steps are.