Litigation Management

Get Creative

How can a risk manager implement creative strategies to prevent workers’ compensation claims and get a handle on insurance costs? It is a difficult challenge to address. Yet it is one that is critical for the future of our economy. There are two key areas that the risk manager must focus on: accident prevention and loss control.

Accident prevention focuses on strategies and techniques that occur to avoid or minimize the risk of loss. There are three key steps to accident prevention:

Employee screening — The first step in accident prevention is matching the employee’s physical capacity to the essential functions of the job. According to Louis Zuniga, president of Health Masters in El Paso, Texas, and an authorized WorkSTEPS Program provider, “Employers must ensure that they have the right employee performing functions that he/she is physically capable of performing. An office manager would not hire a data entry clerk who can’t type. The same goes for our labor force. By screening employees utilizing a program like WorkSTEPs, the employer fulfills the need for reliable, medically safe, legally defensible employment testing programs to assist in reduction of work place injury incidence and associated costs.” Employers must invest in functional capacity screening in order to match the required level of physical activity with the employee’s ability to perform.

Education and training — In a down economy two of the first things on the chopping block are safety and training. Without training employees become inefficient and may make mistakes resulting in rework. Doing something twice is never a good way to save money. Safety management protects the life force of the organization and keeps everyone working smart. According to Darren Woody, president of CF Jordan Construction LLC, a large general contractor, “Safety is the litmus test of how our projects are performing. If there are issues with safety, it will not be long before there are issues with quality, schedule and profitability.”

Continuous Improvement — When we accept the status quo, we accept failure. Keeping employees involved in preventing accidents, investing in corporate wellness, communicating the value of our employees and helping them stay motivated in the vision of the organization is the key to successful safety management and accident prevention. Recognizing that the wellness of the workforce is one of the biggest ways to save money and improve productivity will result in a bottom line profit improvement and lower turnover.

Loss Control

In the event a claim occurs, the next key strategy is loss control.
Catherine Benavidez of Injury Management Organization, a
health cost containment company in Dallas, provides the follow-
ing guidelines on how to control a workers’ compensation loss:

Compassion — Make sure that the employer has designated someone (supervisor) responsible for creating and maintaining a continuous personal connection with the employee. It is important that the employee have a clear and reasonable understanding of worker’s compensation as well as employer expectations.

Collaboration — The employer adjuster, employee and medical community must work together to achieve the best outcome. Employers should invest time in advance of a claim to develop a resource network for doctor referrals that will ensure the injured employee receives excellent medical care from a provider who understands work-related injuries and the employer’s culture and environment. Having the physician and staff tour the workplace in advance and work on identifying transitional duty opportunities can help minimize the length of lost time as a result of an accident.

Knowledge — Working with your broker and underwriter to ensure that your claims provider understands your business and is interested in developing a business relationship with you and your employees is critical.

Transitional Duty — Look for ways to accommodate meaningful, productive transitional duty assignments for employees injured on the job. Studies show that the ability to return to work keeps the employee engaged and increases the healing time while reducing costs of workers’ compensation.

Benavidez also recommends becoming familiar and selective about the health care network (HCN) provided by your carrier. Some of the benefits of an HCN include:

u Screened medical providers who are credentialed and contracted to effectively mange medical costs and lost days of work exposure.

u Expedited care using effective medical utilization techniques to limit exposure to unnecessary, expensive treatment.

u Greater employee access to communication and guidance. The employee will have access to telephonic case managers that assist in the coordination of care.

Employers must take an educated approach when selecting a workers’ compensation carrier that goes beyond the insurance purchase decision. By exploring the service provided by the carrier and the claims administrator the employer will ensure that their employees are treated fair and equally with better access to service. They will also ensure that they are receiving excellent service, which can result in better outcomes and savings.