Six Secrets

#1 ASAP First Reports

• Fax, email, or report the injury online ASAP.  Treat the First Report like a hot potato.  
• If an employee is out of work, follow-up within two business days to see if your injury report has made it to the adjuster.   A well placed email to the adjuster will take care of this task and document that you had followed up.  
• Note any questions or concerns by attaching a note to the first report of injury.  The more concise the information is will help the adjuster to address your concerns as the employers. 

The adjuster cannot begin their work without a first report of injury.  (FROI).   Without the FROI the insurance carrier or Third Party Administrator (TPA) cannot set up a file.  The age of electronic reporting leaves very little room for reasons why the FROI was not filed immediately. 

#2 Dr. Network

• This is the most critical part of any WC claim without question.
• WC courts consider physicians the only impartial parties/witnesses in a claim.
• A physician panel needs to be in place .
• Treating physician controls medical cost, length of time out of work, and any permanent disability

Many states (41) allow for some type of medical control at the beginning of the claim.  If you do not have a physician network including second level physicians such as orthopedists, you are throwing premiums down the drain.  

#3 Return to Work Program 

• The medical providers that are seeing the WC employees should know if you have a RTW program in place
• Employees should know a return to work (RTW) program is in place.

No matter how well you have performed your job to file the FROI and send the injured employee into your prescribed Dr.’s network,  ignoring this very important point can make a small claim into a Permanent Total benefits claim.    All physicians in the Dr’s network should know that you have a return to work program.   

If for some reason, you do not have a RTW program, you need to establish one ASAP.  This is the one area that claims explode into large dollar claims in a split-second. 

#4 Employee Treatment 

• Reduces fraud
• Helps Return To Work program
• An out of work employee is still your employee
• Keeps employee in the loop

When an employee is injured, they are still considered your employee until a RTW or a claim resolution.   The show of concern by the employer has always enhanced a successful RTW.  There are many studies that show this link. 

#5 Understanding Your Premium Audit 

For non self-insureds, your yearly workers comp premium audit can be a daunting task.   The link in the prior sentence covers some of the methods to make the task less stressful.   There are many articles on handling premium audits in this website.  Searching the articles by using the search box at the top right of any page is recommended.  

Many employers just write a check and consider the premium audit as a tax of doing business.   No insurance carrier or agent will ever dissuade you from reviewing the premium audit bill and then questioning any of the figures on it.   The more active you are in the process shows a concern that will only result in saving you premium dollars. 

#6 Adoption By Management 

All five of the previous suggestions are just like the dusty manual that sits in the corner that no one uses.  If a company’s or governmental entity’s  management does not see Workers Comp as a budget-killing expense that should be acted upon in some manner, what is on the page is just fluff and nothing more.   

The recent concerns with the Affordable Care Act (Obamacare) has put Workers Comp on the back burner.   One has to remember that the back burner can still burn things if not tended to very well.   

An encouraging sign is that some employers have now or in the past paid attention to WC.  They are reaping the benefits.  Why not give these Six Secrets a try?    We are here to help if you need us.   Please do give these Six Secrets a shot.