Best Practices to Reduce Claims Cost
There are three things that every school district can do to help reduce the cost of its workers' compensation claims. If each district implemented these three practices, it would realize a reduction in the cost associated with its workplace injuries.
- 1. Use an Occupational Health Clinic as the primary treatment facility for injured workers. Select an occupational health clinic that is part of a network. Members of the SEG Self-Insurer Workers' Compensation Fund may contact Administrative Assistant Karen Carr at (800) 292-5421, ext. 620, for assistance in identifying a nearby Occupational Health Clinic that is in-network. Such facilities have agreed to accept a fee lower than that established by the state for the treatment of work-related injuries. This helps control the cost of medical claims.
- 2. Have an active Safety Committee. A working safety committee represented by all employee groups is a major component of any successful effort to manage workers' compenation costs. Safety Committees review accident reports for lessons to be learned on how to prevent future occurrences. They look for root causes and then recommend appropriate corrective actions such as engineering controls, safety policy changes or training needs. These committees meet periodically throughout the school year with the goal of making the workplace as safe as possible.
- 3. Offer a Return to Work program to employees who are able to work, with some restrictions. Studies have demonstrated that employees who return to work in modified-duty jobs are much more likley to return to their former positions than those who are not placed in modified-duty jobs. Also, when an employee returns to work in a modified duty capacity, the employer has no further claim exposure. Examples of modified-duty employment include hall monitor, bus monitor, or file clerk. There are specific steps that must be taken when making an offer of modified duty to an employee. Contact your CCMSI claims examiner for details on preparing, presenting and implementing modified-duty job offers.
Benefits of Return to Work
What is a Return to Work Program?
A Return to Work (RTW) program is an important component in a Workers' Compensation Management Program, second only to an Accident Prevention Program. Once an injury has occurred, the goal of a RTW program should be to return the injured employee to work as quickly as possible. To accomplish that, the employee's job may have to be reevaluated considering the following two alternatives:
Modified Work: The employee returns to his original job, but some restrictions are placed on the job by the treating physician. Restrictions may include reducing the amount of work time, and/or restricting certain activities such as bending or lifting. Modified Work is also referred to as Light Duty.
Temporary Alternate Work: The employee returns to work, but because the original job cannot be modified to conform with the physician's restrictions, he or she performs another job that accommodates the injured employee's abilities.
What are the Benefits of a RTW Program?
A RTW program is beneficial to both management and employees. Such a program:
· Allows an injured employee to continue to be productive and to contribute to the company.
· Maintains communications between injured employees and management.
· Reinforces the company's interest and concern for an injured employee.
· Improves communications between company, the employee and the treating physician.
· Discourages malingering.
· Reduces the disability associated with an injury and its related costs.
Another benefit of developing a RTW program is that it helps a company comply with the Americans with Disabilities Act. By following the steps listed below, specifically those in Job Descriptions, the essential components of each job will be identified and classified. This will help management identify jobs which potential employees with disabilities may be able to perform.
In order for a RTW program to be successful, it is imperative that management make a firm commitment to "drive home" the need of the program and its benefits to all employees. Once the program has been developed, management should develop a strategy for communicating its enthusiasm for the program throughout the company.
Job Descriptions
A written description should be developed for all present jobs as well as potential alternate jobs. The description should include a listing of the job's essential functions, the location where it is performed, length of shift, etc. Job functions such as lifting, carrying, bending, walking, standing, and other repetitive motions should be classified according to severity and recurrence.
Policies and Procedures
Top management should develop policies and procedures by which RTW programs will operate. A variety of issues must be addressed, including: Who administers the program, and how is that administrator selected? When can the program be used, and by whom? What sort of forms (job demands, doctor's release to work, standard letters) should be developed? How long should Temporary Alternate Work last? How long should Modified Work last?
Communication and Training
Once the program is developed, top management must develop a strategy for communicating with employees about the importance of the program and their role in it. This communication may take the form of training for management and supervisors, and group discussions or seminars with employees. Top management may also want to meet with treating physicians or other medical personnel to get their input and involvement.
Follow Up and Evaluation
Top management should establish a timetable for periodic follow-up and evaluation of the program. This will ensure the program's continued use, identify any incorrect procedures, and reveal concerns that may not have been addressed in the original program.