Reduce Work Comp costs with a proactive approach to treating injuries

hursday, January 31, 2013 from Secura Insurance

When injuries happen on the job, they can turn into expensive claims, ultimately driving an employer’s Work Comp insurance premiums higher. There are, however, ways to keep costs in check. The key is taking action before non-emergency work injuries become insurance claims.

Value-added features offered by select insurance companies, such as SECURA’s Nurse Hotline, connect employees hurt on the job with registered nurses via a 24-hour phone line. The goal of the service is to provide workers with immediate answers to the best way to treat their non-emergency injuries. These minor strains, sprains, and such respond well to simple treatments. That means no visit to the ER or a battery of expensive diagnostic tests.

The rewards of Nurse Hotline extend to both employers and employees.

Benefits to the employer

• Reduced claims. Many injuries reported to the hotline can be
  treated simply with self-care methods. That translates into no
  hospital visit and no claim.
• Reduced costs. When claims are reduced in both number and
  size, premiums typically follow. 
• Reduced lost time. When injuries are treated immediately, workers stay at work or return to work sooner.
• Expert guidance. Highly skilled medical professionals are providing answers. No more supervisor judgment
  calls or overtreating injuries.

Benefits to the employee

• Instant care. Injured employees get sound medical guidance immediately.
• No stress. A skilled independent medical professional advises employees on treatment.
• A true benefit. Employees will see such a hotline as an extension of the benefits package a company offers.

A proactive approach focusing on early assessment of work injuries can have a significant impact on reducing a company’s insurance claims. However, in order to reap the benefits, organizations must be partnered with insurance providers that offer them access to these value-added features, and employees must use them.

For more information about the benefits of Nurse Hotline, view a short video.

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Work Comp Claims Reporting Made Easy

Taking the proper steps in your organization to ensure prompt reporting of all workers compensation claims is essential to helping control your claim costs. As an employer, there are several things you can do to ensure documentation and reporting of a claim goes smoothly.

Reporting requirements
The Division of Workers' Compensation requires that "an employer or its insurer report the injury, other than an injury that requires immediate first aid and no further medical treatment or lost time from work, to them within 30 days after knowledge of the injury. Employers have to report all injuries to their insurance carrier within five days of the date of injury or within five days of the date on which the injury was reported to the employer by the employee, whichever is later."

Missouri Employers Mutual encourages our policyholders to report all injuries, even if it only required immediate first aid. Reporting minor injuries allows for two benefits. First, when a claim is reported to us, we report it to the Division of Workers’ Compensation which establishes the beginning of the statute of limitations on the claim. Second, if the minor injury ends up requiring further medical treatment or lost time becomes a factor, the claim is already in the system and can be assigned quickly to a claims representative for handling.

Train management and staff on claim documentationThe proper documentation makes all the difference in successfully reporting a claim. Train your supervisors and managers about what documentation is needed when an employee reports a work-related injury. Start the process with basic but crucial questions including, were there any witnesses? If so, have the witnesses document exactly what they saw or heard and have them sign their statement. It is also very important to have the injured employee recount, in their own words, exactly what occurred and have them sign the document.

Documentation makes it easy to gather incident information including the date and time the injury occurred, where and how it occurred, the severity of the injury, and body part(s) injured.

Review personnel files annuallyAlong with the incident details, you will also be required to report some personal information on the injured employee. The information is required, so it is very important to keep all of your personnel files up to date. When reviewing personnel files you should ask yourself, do you have the employee's legal name, date of birth, social security number and home address? If you do not require employees to update their information when they move, marry, etc., you may not have up-to-date records. The employee’s hire date is also important for reporting and should prompt you to verify if they have had a recent promotion that resulted in a job title or salary change. If your company does not have a formal process for keeping personnel records up-to-date, we suggest that you implement one.

Although a lot of information is needed for reporting a claim, the process doesn’t have to be complicated.  Put an injury reporting procedure in place that includes documentation of all work-related injuries (both major and minor), training supervisors and managers on the documentation and reporting requirements, and keeping your personnel files updated. For more information about reporting and managing injuries, check out the injury management tutorial on WorkSAFE Center and our prompt reporting video on YouTube.

Give one of our Agents a call 800-392-0423 or click here to email us.

Seven tips to prevent backing accidents in company vehicles

Thursday, July 19, 2012   

No matter what industry you work in, driving a company vehicle includes risk — from the possible cost of property damage to the potential for lawsuits. And those risks multiply when you need to back up a vehicle. Whether you’re an employer or a driver, it’s important to be trained in proper backing.

Follow these tips to prevent vehicle backing accidents: 

•  Know your blind spots. The larger the vehicle, the larger the blind spot. Ask an employee to stand directly behind a parked vehicle with a safety cone. Have him or her walk back from the vehicle, set down the cone when it becomes visible to the driver, and measure the distance of the blind spot. 

•  Walk around the entire vehicle, observing the proximity of structures, other cars, pedestrians, or overhanging wires. Map it out in your head before you get behind the wheel. 

•  Avoid backups when possible. In a parking lot, pull through to the space ahead of you; don’t leave room for someone to park in front of your vehicle. If possible, park in the street rather than a driveway. 

•  Don’t park in alleys where you can’t drive through. Backing out of an alley into a busy street is dangerous for everyone. If you must park in the alley, back in (if local regulations allow it). 

•  Use a spotter for difficult situations. Communicate with hand signals that the driver and spotter understand. This is important for situations where children are present, such as schools, play areas, and residential jobsites. Children are unpredictable and easily hidden in your blind spots. 

•  Get proper rest. Fatigue and lack of rest are major contributors to fleet accidents. Make sure drivers are well rested and alert when driving. 

•  Use technology with caution. Back-up alarms warn bystanders when a vehicle is in reverse. Back-up sonar warns a driver when an object is in the reverse path, and closed-circuit mini TV cameras give a clear view of the path. However, these tools can fail if the driver or surrounding pedestrians ignore or fail to use these devices properly.

Check out the rest of this article at Secura insurance blog at this link

The Cost of Hand and Wrist Injuries

May 22, 2012 11:08 AM, By Laura Walter via EHS Today

More than 2 million people visited U.S. emergency rooms for symptoms related to the hand and wrist in 2009. Now, researchers in the Netherlands have found that in addition to being pervasive, hand and wrist injuries also are one of the most costly injury types.

According to a new study appearing in the Journal of Bone and Joint Surgery, hand and wrist injuries represent the most expensive type of injury in the Netherlands, costing about $740 million U.S. dollars annually.

The study, "Economic Impact of Hand and Wrist Injuries: Health-Care Costs and Productivity Costs in a Population Study," examined the frequency, cost of treatment and lost productivity associated with hand and wrist injuries and compared them to other emergency department injuries.

Click here to read more

Understanding the Difference Between Work Comp Fraud and Abuse

Workers compensation fraud and abuse are each destructive and expensive. Determining the difference between work comp fraud and abuse can be difficult, but it is important. In Missouri, work comp fraud and abuse each carry different legal consequences. Read more to find out exactly what the difference is and some of the most common examples.

AbuseWorkers compensation claim abuse is defined as any practice that uses the work comp system in a way that is contrary to its intended purpose and/or the workers compensation statute. Abuse can involve the magnification of symptoms that fall short of a lie, or it could involve the exploitation of benefits. While work comp abuse is not a crime in Missouri, it can be cause for work comp benefits to be discontinued.

FraudWorkers compensation fraud requires a lie that is material to the attempt to receive or deny workers compensation benefits. The presence or absence of a material and provable lie is the deciding factor between fraud and abuse. Although the lie is key to proving fraud, additional elements must also be present including intent, materiality and a benefit.

Take a look at some of the most common types of workers compensation fraud and abuse.
The following examples are based on actual workers compensation claims.

Self-inflicted or intentional injury—Fraud A convenience store employee reported that he was assaulted and robbed while taking cash receipts to the bank. The police respond and the workers compensation carrier found the claim compensable and paid for medical treatment and total temporary disability benefits.

As the investigation proceeded, the employee admitted to stealing the cash deposit, and that his friend punched him in the face to make the assault appear more realistic.

The employee was later charged with stealing, filing a false police report and workers compensation fraud. He was ordered to pay restitution to the insurance company for the false claim and reimbursement of the stolen money. In the end, the employee lost his job and gained a felony criminal record, as well as, permanent damage to his vision.     

Job-related injury that never occurred—Fraud  
An employee was riding his four-wheeler and jumping over dunes during the weekend and sustained a serious knee injury. The employee waited until Monday morning and then reported that he hurt his knee just after starting work. Co-workers told the employer that he hurt it over the weekend. The employee was subsequently charged with workers compensation fraud.

Malingering or engaging in activities while allegedly disabled—Fraud or Abuse  
An employee injured his back during the course and scope of his employment. While collecting workers compensation benefits, the employee continued to engage in out-of-state rodeo and barrel jumping events. The employee was photographed on horseback in mid-air as he jumped over barrels with his number and name listed in the caption. This evidence enabled prosecutors to charge him with workers compensation fraud. He lost his job and gained a criminal fraud conviction.   

Workers compensation fraud and abuse are real problems and you can take control by preventing it in your workplace. Download some of fraud prevention materials:

Workers compensation fraud red flags handout

Workers compensation fraud red flags poster

Workers compensation fraud prevention poster (1) 

Workers compensation fraud prevention poster (2)

Workers compensation fraud prevention poster (3)

Employee fraud awareness quiz  

For more information about workers compensation claim fraud contact Construction Insurance TOGO at 1.800.392.0423