Your work comp management team is fantastic at ensuring early intervention for critically injured workers, but are they dropping the ball post-stabilization? Too often the fragmented nature of healthcare delivery falls short of meeting the long-term care needs of catastrophically injured workers.
injured workers and their caregivers often find themselves unable to cope with the consequences of injuries when they're discharged too soon or into the wrong environment. This is particularly true if they don't have the knowledge to navigate the challenges of a permanently changed life. This can quickly lead patients down a costly and calamitous path to the ‘vortex of failure.’
How Can Your Work Comp Management Team Prevent Such Catastrophic Consequences?
- Challenge the System
Specialized care and rehabilitative service is where the traditional care model often misses the boat. Medically-stable, catastrophically injured patients may fare better in a skilled nursing or residential rehab facility before going home.
- Understand the Step-Down Process for Catastrophic Claims is Different
This is not a sprained wrist or rotator cuff injury, catastrophic claims managers need to answer these critical questions before recommending the next step-down:
- What additional services will the injured worker need to function independently?
- How will the injured worker re-adapt to life in their ‘normal’ home/community setting?
- Do they have a close family member/caregiver that can help them cope with the after-effects of the injury?
- Can the employee return to work?
- Get the Injured Worker’s Family Involved
Ensure the long-term knowledge, skills and compassion necessary to support the injured worker are in place.
See the bigger picture. Help your work comp management team prevent creeping catastrophic claims with the help of Minnesota Comp Advisor today.
In a recent review, The Travelers Companies reported opioid use among more than 500,000 injured workers treated since 2015 has dropped a staggering 30%. How is the insurer forging a new path to successful outcomes without opioids?
The Early Severity Predictor Model
The company’s Early Severity Predictor identifies the probability of an injured worker developing chronic pain, a key cause of opioid dependency. By sharing these results with the injured employee’s physician, other effective treatment alternatives can be sought, such as surgery followed by physical therapy (in lieu of opioids for pain). Such regimens limit exposure to opioids, offering a safer recovery and often producing better long-term medical outcomes.
In addition to the 30% reduction in opioid use, since January 2016 the company’s workers comp cases also saw:
• Surgeries fell by 25%.
• Injured employees receiving alternative treatments recovered and returned to work 10% faster than employees who did not.
The nation’s largest workcomp carrier, Travelers, handles around 250,000 workers comp claims annually. Since the implementation of its Early Severity Predictor model in 2015, in combination with its in-house pharmacy management program, the company has aided employers in reducing medical expenses on identified claims by as much as 50%.
Claims professionals train with on-staff pharmacists, assessing the merits of requests for pharmaceutical reimbursement, ferreting out the potential for overuse and preventing dangerous drug interactions.
Concerned about opioid use affecting the recovery of stellar employees? Opioid use, addiction and overdose cross all ages, genders, and income levels. Do your part in protecting injured workers in light of the nationwide epidemic of opioid overuse and abuse. Learn more from MinnesotaComp Advisor today.
Thinking about terminating an employee who has filed a workman's comp claim? Extreme caution is warranted in navigating these dangerous waters.
State Laws Protect Workers
Terminating an employee who has filed a workman's comp claim is not prohibited. Most states, however, impose stiff penalties for those incidences deemed wrongful termination: When an employee is fired because of their claim. This can include fines, jail time, or both.
Tips to Reduce the Risk of Retaliation & Wrongful Termination Claims
- Know Statutory Worker Protections
Most state statutes indicate it is unlawful to discipline/terminate an employee who has filed a claim, and is considered a crime.
- Stay True to Company (Handbook) Rules and Policies . . .
Including rules for progressive discipline and termination. Does your safety handbook note these specific termination grounds? Has the employee been counseled verbally/in writing?
- Consider How Similar Situations Have Been Handled
If termination is harsher than past punishments you have handed out for a similar offense, the firing could be seen as retaliation or discrimination.
- Carefully Reflect On Facts, Circumstances and Timing
If an employee was being investigated for misconduct four weeks ago, but suffered an injury 3 weeks later, documented disciplinary actions and witness testimony could support a later termination, as the length of the investigation may not be seen as related to the claim. If you took no disciplinary or investigative steps, however, establishing the termination as unrelated to the workman’s comp claim will be difficult to prove.
Workman's comp waters seem particularly shark infested as of late? The experts at Minnesota Comp Advisor can help you find your way to safety. Learn how we can help you avoid workers comp risks today.
As marijuana becomes increasingly available medically and recreationally across the nation, complications surrounding marijuana in the workplace will continue to grow. How can you keep employees safe while still upholding their civil liberties?
Five Ways to Keep Your Workplace Safe Despite Changing Marijuana Laws
- Begin with hiring and training practices.
Before hiring for a given position, consider whether off-duty use of marijuana could affect on-the-job performance and safety surrounding any duty, not just essential ones.
- Familiarize yourself with state and federal laws.
Some states don't require an employer to accommodate employee use of marijuana if it prevents them from fulfilling any of their job responsibilities. For ADA requests, however, HR and legal council may be necessary to determine accommodation of marijuana in the workplace.
- Focus on performance.
Make safety a part of the company culture, beginning with employment and safety manuals.
- Learn to recognize impairment.
Train managers on how to recognize impairment and company procedures should it be a factor, particularly at the time of a workplace accident.
- Consider drug testing.
Familiarize yourself with state/federal drug testing laws and policies, noting the difference between pre-employment and for-cause testing. In the event of an incident, testing could indicate the presence and level of drugs in an employee’s system. It can also be used to determine whether employees are impaired and unable to safely perform job duties.
If you choose to avoid drug testing, consider alternatives such as psychomotor testing, which measures reaction time and coordination and has proven to dramatically improve safety results.
Marijuana in the workplace presenting unexpected challenges? Minnesota Comp Advisor can help. Contact us today.
Pain management in the workers comp arena can be particularly challenging. In combination with the glut of pre-existing conditions suffered by many Americans, the complexity of managing injuries within the system can be frustrating for all parties, leading to poorer outcomes for all. How can you thwart the common pitfalls of treatment?
Look at the System from the Eyes of Injured Workers
Attributing negative pain management outcomes to a worker’s desire for financial gain is overly simplistic. Viewing the process from ‘the other side’ and opening communication lines can go a long way toward showing you care about your injured workers’ needs and fostering a speedy recovery.
Do You Understand What Workers Comp Patients Go Through?
- Delays in treatment despite severe pain are a known contributor to slow/poor recovery outcomes.
- Accident investigations to determine liability/wrongdoing.
- The constant need for approval/vetting of desired treatment protocols to gain relief/function.
- Fear of job loss and financial insufficiency.
- Reduction in the capacity to contribute at home and at work.
- Loss of personal control and self-efficiency that can lead to hopelessness, depression, and ‘illness behavior.’
- The need to constantly ‘prove’ pain, a subjective symptom, to show injuries as genuine for continued treatment.
- Isolation from coworkers, friends, and family.
Set Injured Workers Up for Success
Go the distance, encouraging return-to-work by instituting light duty protocols or necessary equipment/environmental adaptations. Use this as the foundation for your caring support, boosting the social support system of injured workers, and putting them on the path to lifestyle and financial normalcy.
Pain management and productivity in the work environment can go hand-in-hand. Discover new ways to succeed with Minnesota Comp Advisor today.
Chronic pain affects a staggering 100 million Americans. Its prevalence continues to rise, and with it, so does the incidence of those using prescription narcotics like opioids for pain. The workers comp industry is working hard – and succeeding – in curbing narcotic use in chronic pain cases (especially compared to the public center). However, this mode of treatment continues to be a wrench in the works of positive treatment outcomes.
When a workers comp claim involves narcotic use, claim costs rise $20,000 more, on average, than those without. Other increases include indirect costs, such as the probability of chronic work loss – where the incidence is six times greater when opioids are involved.
How Can You Help Buck the Trend?
The faster injuries are reported and addressed, the better the prognosis.
Drug utilization review should occur often, at specific points in the claim, with drug types and duration of use closely monitored, and alternatives to narcotics prescribed whenever appropriate.
With the help of third party administrators that take advantage of predictive analytics for monitoring claims expenses. These can help you identify claims patterns surrounding narcotic use so you can pinpoint problems and brainstorm collaborative solutions for improving patient outcomes.
Strive for Return-to-Work
Any time a worker is injured to the point they lose time from work, there is a risk they may not return-to-work. With narcotics usage, this risk is significantly higher. Boost success with frequent employer/employee contact and modified duty whenever possible.
Curb narcotic use with proven tactics, doing your part to help control the rising opioid epidemic. Contact MinnesotaCompAdvisor to learn more today.
Catastrophic workman's comp claims are especially challenging to manage. Care of injured workers is often fragmented, with multiple providers and no holistic, long-term plan of care. Without centralized management, optimal care and quality of life cannot be achieved, leaving health to deteriorate and costs to creep to alarming levels. Fortunately, there are ways to proactively and successfully manage catastrophic claims.
How Can You Pave the Way to Effective Catastrophic Claims Management?
Understand the scope of the problem.
Catastrophic workman's comp claims account for only 1% of claims – but 20-30% of total medical spending in the workcomp arena. Medically complex and costly, such injuries require sophisticated care, equipment, and rehabilitation. Such life-altering injuries require a high-touch, compassionate response and include:
- Brain/spinal injuries
- Vision loss
- Severe burns
- Multiple traumas or amputations
Strive for collaborative care.
Safeguarding patient well-being while controlling costs is possible. Whether in-house or through a third-party provider. Develop a collaborative, team approach to provide ongoing coordination of services from primary care to equipment, drug utilization, home care and support.
Notify your catastrophic claims team while the injured worker is still in the hospital to ensure a smoother progression from hospital to home care, especially in the event medical equipment such as a wheelchair is necessary.
Don’t overlook the big picture.
Uncover other ways to pave the way to more effective catastrophic workman's comp claims management in part 2 of this Minnesota Comp Advisor series.
Comprehensive evaluation(s) of long-term needs are key to a successful transition. An in-depth evaluation of injuries, comorbidities, home and family situations, and injured worker feedback can head-off unexpected and costly complications.
Looking for new solutions in the prevention of workplace injuries? Inventive ways to support your return-to-work program success? Or simply struggling to keep up with the endless glut of workcomp case law updates? We’ve got you covered!
Stop Feeling the Pain of Workplace Injuries
Come join us Wednesday, October 4th for our FREE SEMINAR to learn more about ways your organization can improve workman’s comp patient outcomes and better control costs. This seminar will be held at the Great Hall of Carleton College, One North College Street, in Northfield. Registration will begin at 10:30 am in Severance Hall, overlooking the scenic Cannon River and Highway 19. The presentation will run from 11 am until 2:30 pm, and a complimentary lunch is included.
Forge a Better Path to Recovery with Keen Insight from Presenters:
Director of Risk Management, Minnesota Comp Advisor
A multi-talented authority on the complex subject of risk management, with a proven track record in implementing successful risk management solutions.
Michael T. Courtney
Work Comp Attorney, Heacox, Hartman, Koshmrl, Cosgriff, Johnson, Lane & Feenstra P.A.
A specialist in workcomp employer defense.
ATC, CSCS, Workplace Health Coordinator, Northfield Hospital & Clinics
Whose expertise in helping employers and employees get the most out of their working environments supports a higher quality of life at work and at home.
Work Comp Attorney & Partner, Heacox, Hartman, Koshmrl, Cosgriff, Johnson, Lane & Feenstra P.A.
Offering insight from her perspective as a defense attorney from the employer, insurer, and third party administrator arenas.
To reserve your spot for this FREE SEMINAR on workplace injuries presented by Minnesota Comp Advisor, call 612-236-1771 or email email@example.com today.
The workers comp arena is outperforming traditional healthcare settings in reducing the number of opioid prescriptions dispensed.
According to U.S. Center for Disease Control (CDC) data, despite attempts to increase awareness of opioid dangers, prescriptions continue to rise. The average days’ supply has climbed 33% from 13-days in 2006 to nearly 18-days in 2014 – three times as high as 1999 numbers. In workers’ comp cases, however, a study released in June by the Cambridge, Massachusetts-based Workers Compensation Research Institute shows frequency and strength of opioid prescriptions decreasing year-over-year.
It's believed the extra hoops workers comp prescribers must jump through in order to dispense opioid prescriptions are contributing to the decline. Claims management programs and workcomp formularies calling for utilization reviews are a major motivator, as is the reduction in claims costs. Downers Grove, Illinois-based Coventry, found an 8.5% drop in opioid use coincided with a 9.9% decrease in cost-per-claim when comparing current data to 2015 figures.
Opioid crisis taking a toll on your company? Discover ways you can help in addressing this national epidemic with the expert guidance of Minnesota Comp Advisor today.
The CDC is now working on analyzing the collected data to better understand how it can further spur change in the opioid epidemic. It's now known that the benefits of opioids in chronic pain management were overestimated while risks were marginalized. It's also known that opioids have been increasingly prescribed for a glut of problems, for longer time periods and at progressively higher doses. CDC report co-author Dr. Debbie Dowell admitted necessary practice changes often take years to implement despite evidence of safer/more effective options.
Work comp costs out of control? Take your toughest questions to the area experts in workmen’s comp at Minnesota Comp Advisor.
Please make sure to check our events page for upcoming events that will educate you on how to control your worker's compensation insurance premiums and experience modification factor.
Also please check out these recent articles for a more in-depth understanding of the topic:
Work Comp Management is Growing Increasingly Complex
Understanding the Time Limitations for Catastrophic Work Comp Claims
Test Your Knowledge on Worker's Compensation Insurance Coverage
Creeping Work Comp Claims - Identify and Manage Them Part One
Creeping Work Comp Claims - Identify and Manage Them Part Two
The Benefits of Pre-Employment Assessments
Make sure to check back on our blog every Monday and Wednesday for articles and information that actually provides tips and strategies to control your work comp rates.