“Workers Comp”: The Surprising Truth About Why California Business Owners Are Often Paying More Than They Should Be!

If you’re a small business owner or HR manager in California, and you’ve recently found yourself in the midst of a “workers comp” claim… then this article written by one of the country’s leading experts will shed some light on the ways that you, or your company, can save time, money and hassle – and bring a speedy and safe return to work for your employee.

Read on to find out how you can save money:

Lets Begin The Article By Discussing The 3 Phases Of The Employment Lifecycle…

With regards to injury prevention and injury management, the employment “lifecycle” can be broken down into 3 phases with the following recipe.

There are several reasons for an unnecessary prolonged return to work process that occur in these 3 phases…

If you are actively hiring, you are in Phase 1 and 2.

Phase 3 is for those of you with existing difficulties getting your employee back to work.

PHASE 1 & 2

In Phase 1… The Interview & Agreement

Are you hiring your future problems? Which means, of course, you may have hired your current problem. Your new employee was not physically perfect at the time of hiring and you can’t ask how imperfect they are!

The Opportunity Missed!

An ounce of prevention worth the pound of cure!

 

In Phase 2… The Legal Window

Did you take advantage of your legal window of opportunity during the post offer phase (provided by the ADAAA) to identify pre-existing issues that may or may not affect the ability of the worker to perform the essential job functions you are hiring them to do?

We have seen employees report these pre-existing injuries/conditions as new injuries leaving you unprotected from those old nagging football injuries or carpal tunnel claims.

From Day 1 of Employment…

Your Ingredients!

 

In Phase 3 Of The Employment Relationship…

The unspoken truth is… Worker’s Compensation assumes that everything that is wrong with your employee is your fault. You are 100% liable and your worker’s compensation premium is a reflection of that for years to come.

We have heard the consensus many times over from the Small Business Owner, the HR Manager, the Safety and Risk Manager, the Supervisor, the Work Comp Insurance Broker and, even, from some well meaning Employment Law Attorneys, that your Work Comp Premium is simply a cost of doing business and that there is nothing you can do about it.

Simply not true!

The Stick of Dynamite!

In the unfortunate event that your company does have a work related injury, every problem with the injured worker is considered “yours”. You own all the liabilities and you pay for it in many tangible and intangible ways. We have seen the high school soccer injury, the gymnastics injury, the out of control diabetic gangrenous toes and previous work comp carpal tunnel claims become a part of YOUR claim.

The Road Frequently Traveled…

The consensus is that Worker’s Comp Insurances, or Third Party Administrators promise to take care of all aspects of the case to reach a well-managed and speedy return to work with a cost savings to you. Isn’t that what you pay that premium for; service?

However, do you really know how your claims are being managed? We have seen many examples and symptoms of the overloaded Work Comp System, delays in care, delays in return to work, elevated premiums, not to mention the obvious and insidious stress that occurs on the employer, the remaining staff, and the injured worker.

What they don’t say is… That the overworked representative’s caseload may be (even unknowingly) subcontracted to a middleman, which creates and benefits this unnecessary intermediary.

These middlemen organizations add a bureaucratic layer that, in fact, does not necessarily speed the case along. This equates to more days lost, more upset for the employee and employer, and more costly delays prior to case closure which all contribute to your elevated bottom line.

Really how this works is… The “Middleman” Representative says to the Work Comp Insurance Carrier Executive that they will take care of “case management”, streamline and limit the claim expenses on the insurance’s behalf.

This is, then, marketed as the cost savings mechanism for the Insurance’s overhead and as a savings passed to the employer. You may, indeed, see a small savings upfront and, of course, this is better than no savings at all.

Yet, all of this is upfront “savings” is peanuts to what you may be facing when your work comp premium experience modifier calculation is adjusted upward for years to come because you have had a claim.

Not to mention, there is not any discussion as to the potential adverse affect on the more important employer/employee relationship and the culture of productivity in your company.

In our experience, all that is truly done by this outsourcing is that it just distances the decision makers further away from your employee, instead of creating a true cost and valued added savings for you, your employee and your company.

We consider the key ingredient to success is, direct is always best.

If You're Ready To Save Money Now...Call us today on- (805) 654-8127Or email- worksolutions@advatagept.com

The Explosion!

So Now That You Have a Claim… and The Clean Up…

Worker’s Compensation assumes that workers never grow old and bodies don’t deteriorate.

Since Work Comp assumes that everything and anything that is wrong with the injured worker can prevent them from getting better, these conditions may now be attached to your claim. (Remember that high school football injury?)

What this means to you, as the company, is that you are expected to rehabilitate that employee back to normal, but what is normal?   What does that mean to your bottom line? This is where the unknown escalating costs actually occur.

The Road Back…

R. I. C. E. Rest, Ice, Compression, Elevation…

A.K.A… The Risk of Injury Compensation Elevation

Now, that you have entrusted your claim case management to your Work Comp Insurance Company, they are now between you and your employee.

Then, in the next layer down, the Middlemen are between the Work Comp decision makers and your employee AND between your employee and their medical providers.

These layers serve to complicate the process for the medical providers who are charged with the daunting task of getting your employee back to work under a system that was already mired in bureaucracy and limitations.

“A Physical Therapist Who Is Experienced And Trained In Industrial Rehabilitation”

It is a known fact that direct and indirect costs decrease when the employee is seen by a Physical Therapist who is experienced and trained in Industrial Rehabilitation.

Assuming that there has been a request for Physical Therapy, it is important that it has been timely authorized and started within the first 4 weeks of injury.

This is a statistic that represents the ticking timeline of the best odds that you will even see this person back to work.

It is, also, important that once the employee does see an Industrial based PT, the treatment is performed with the job tasks in mind, and continued when needed without lengthy waits for further authorization.

These specialized professionals should have the ability to balance what is right for both the employee and the employer and advocate for both. The Industrial Rehab Staff needs to be experienced in and empowered to make professional objective decisions regarding balancing care with these considerations.

Rather than just providing what is “minimally” authorized or, in contrast, proceeding with unnecessary visits when employees demonstrate capability of being ready to return to work.

In some cases, we have seen treatment continuing because the worker simply states, “I just don’t feel good enough to return to work”, but I digress and will write about this another time.

The Return Trip…
Is your employee’s destination known
and are they a“fully baked cake”?

Hopefully, your employee has been given appropriate rehabilitation. Now, how do you know if you are being given back a truly safe employee, not one that is at risk of re-injury and the following potential downward spiral?

Do you know if your MD is overloaded?

Whether it is from the bureaucratic work comp process/paperwork or, as we have frequently heard from injured workers, that “the MD only spends 2 minutes with me”, or “I see a different doctor every time I go”?

Therefore, I ask you, in this example… How can the doctor, make a true objective decision about a return to work status when there was a 2 year ongoing injury condition in which the worker has literally done “nothing but sit on my couch”?

It is sad, but, we hear similar stories more often than we would like. What is worse is that in this case it was for a minor ankle sprain that should have been back to work within weeks of the date of injury.

Do you accept light duty or have a graduated benchmarked return to work program that this employee could have been in fostering a quicker return to work or better preparedness?

Unfortunately, I have seen examples where some physicians do not know the law regarding the legal definition of disability.

There are, also, misunderstandings with the interplay between the work comp case and the interactive process where employment law sensitivity is needed, along with what the true scrutiny level is that is vital to objectively determine a worker’s functional status as it relates to their essential job functions. These misunderstandings and their implications all impact your case closure and interactive process.

Typically, the medical physician who is responsible for this worker does not know of any objective way to make an appropriate determination on the injured worker’s functional ability and, therefore, set reasonable modification and accommodation recommendations to return that person to their position.

But let’s say you, in fact, have a fully engaged occupational oriented MD and a stellar work comp representative and they want objective information about the employee’s physical status and how their injury impacts their ability to perform their job…

Where do they get that objective information from, and does that information balance both the company and employee’s concerns regarding performance of the essential job functions?

Do you, as the employer, have objective information regarding your employee’s physical capabilities coming your way that will set up a successful interactive process prior to an employee’s return to work?

In order for you to fulfil your responsibility of maintaining a safe workforce, are you relying on opinions, medical or otherwise to make the decision about whether or not there will be an undue hardship placed on your company upon the employees return?

The Interactive Process & Workplace Re-Entry…
Have your cake and eat it too! Is that possible?

Did the MD verify the significance of the injury, the impact on the employee’s job and with what information did they make this decision?

Was that information collected and the decision made with the standard of being job related and consistent with business necessity?

What are reasonable accommodations and which ones are valid?

Do you have to accept permanent light duty?

How do you objectively determine those questions, or can you?

 Take This Assessment To Identify Your
Company’s Risk…

If you don’t look, you may never see your bottom line improve and continue to be subject to potential legal and financial exposure from workers comp.

To find out more about how you can take this Free Assessment, give us a call on: (805) 654-8127

Or, send us an email and we’ll be in touch with more information: worksolutions@advantagept.com

About the Author:

Blayne Liparoto, PT, CPAVE, CWcHP, Owner, CEO

Blayne R. Liparoto, P.T., CPAVE, CWcHP, owner/director of the clinic and licensed provider of WorkSTEPS. Her B.S. In Physical Therapy was from Texas Woman’s University, in 1984. Following graduation she began her career in the field of physical therapy working with neurologic and orthopedic cases while consulting in spine and sports rehabilitation. Prior to relocating to California, Ms. Liparoto worked with Mr. Feeler (the developer and founder of WorkSTEPS) at Odessa Physical Therapy during the early stages of employment screening in industrial services. With clinical experience in out-patient hospitals and private practice, she offered an extensive background in orthopedic manual therapy and neurologic treatment of the spine and sports care, golf specific performance enhancement, obstetrical and gynecological diagnoses, chronic pelvic pain, exercise, chronic pain management, TMJ and pediatrics. In addition, she has been an educator of her peers in the principal techniques for examination and treatment of the orthopedic and sports patients, and Woman’s Health Issues.

 




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