Download presentation
Presentation is loading. Please wait.
1
Risk Management Series Employer Work Comp 101
2
Risk Management Inc. © All Rights Reserved
Workers’ Comp 101 1 2 3 Pre-claim Management Education Documentation Process Post Claim Action Plan Accident happens Investigation Management Return to Work Expectations Follow up Execution Risk Management Inc. © All Rights Reserved
3
Risk Management Inc. © All Rights Reserved
Pre-claim Management 1 To reduce costs you must have a pre-claim strategy Education Documentation Culture Employee Supervisor Coordinator Medical Postings Safety Training HR Paperwork Safety Perception Survey Safety Opportunities Incentives Risk Management Inc. © All Rights Reserved
4
Pre-claim Management 1 EDUCATION
Workers’ Compensation takes a lot of coordination and that requires education Employee Rights and Responsibilities Supervisor Training Work Comp 101 RTW CWCO Program Process (comP4®) Loss Organization Training Physicians Questionnaire Risk Management Inc. © All Rights Reserved
5
Pre-claim Management 1 Documentation
In the world of Workers’ Compensation documentation is often the difference between a $5,000 claim and a $50,000 claim HR Paperwork HIPPA ≠ WC Post Offer Health Questionnaire Job Descriptions Work History Safety Training New Hire Ongoing Trend(Claims IQ® influences Safety IQ® Postings Are required State Postings up to date So you post Safety IQ® Do you post Claims IQ® What about OSHA Risk Management Inc. © All Rights Reserved Risk Management Inc. © All Rights Reserved
6
Pre-claim Management 1 Culture
They don’t care how much you know until they know how much you care? Incentives OSHA does not like incentives based on claims Supervisor They are the conduit of your organization’s safety culture Employee The buck stops here Gamification A creative solution used to vest employees in your safety culture Risk Management Inc. © All Rights Reserved Risk Management Inc. © All Rights Reserved
7
Post -claim Management
2 Take AIM to reduce claims costs! A I M Accident Investigation Management Medical Documentation Care and concern Incident analysis 3 Days 7 Days 21 Days Risk Management Inc. © All Rights Reserved
8
Post -claim Management
2 70% of the claims management process falls on the Employer 70% Employer Culture Supervisor soft skills Incident analysis Action plan Employee communication 30% Carrier/TPA State forms Coordination and payment of benefits Employee communication Risk Management Inc. © All Rights Reserved Risk Management Inc. © All Rights Reserved
9
Post -claim Management
2 Accident Happens You don’t wait for the tornado to hit to run your tornado drills! State Law Emergency Treatment OSHA Medical Get the facts Drug test Documentation Must evidence Assist but don’t harass If you don’t someone else will Care and concern “A claim that starts out on the right track typically stays on the right track.” Risk Management Inc. © All Rights Reserved
10
Post -claim Management
2 Investigation The Incident Analysis is a tool to prevent future claims! Employee Statement Supervisor Statement Witness Statement Manager Report Root Cause Analysis Direct Cause The Five Whys Root Cause Action Plan Risk Management Inc. © All Rights Reserved
11
Post -claim Management
2 Management 21 7 3 Action is the key to claims mitigation! Risk Management Inc. © All Rights Reserved
12
Risk Management Inc. © All Rights Reserved
Return to Work 3 Return to Work is a process not a program Expectations Communication Execution Employee Supervisor Claims Coordinator Insurer/TPA Initial Transitional Duty Medical Appts Employee Employer Medical Provider Insurer/TPA Risk Management Inc. © All Rights Reserved
13
Return to Work 3 LENGTH OF TIME OUT OF WORK CHANCES FOR EVER RETURNING TO WORK 6 months 50% One Year 25% 2 Years <2% You need to lay out the expectations for the injured employee quickly It will build credibility It will greatly increase the odds that the employee will return to work. To have a successful return to work program we need to lay out the expectations to the employee quickly. Employee’s have a lot of people giving them advice on what to do when they are injured. Studies have shown that the longer an employee is out of work the less likely they are to return back to work. Risk Management Inc. © All Rights Reserved
14
Risk Management Inc. © All Rights Reserved
Return to Work 3 If you don’t set the expectations someone else will! Risk Management Inc. © All Rights Reserved
15
Risk Management Inc. © All Rights Reserved
Return to Work 3 Communication creates relationships Create Expectation 1st week Make sure E’ee knows plan Create RTW plan Communicate weekly Ongoing Monitor workers activities E’ee RTW E’ee transitions to regular job E’ee is full duty Risk Management Inc. © All Rights Reserved
16
Risk Management Inc. © All Rights Reserved
Return to Work 3 You have done all the hard work, now all you have to do is execute!!! Risk Management Inc. © All Rights Reserved
17
Next Steps Compass Risk Management Score Compass Certified Consultant
Compass Risk Management System Pre-hire Post-offer Prevention Post-claim
Similar presentations
