Is everything possible being done to protect your company from the costly impacts of Workers Compensation claims? As an employer, you know that injuries will happen. However, this doesn’t mean you shouldn’t try to prevent them by knowing the dynamics and some of the solutions recommended by the experts.
Minor Injury, Major Claim. It’s the small injuries that often result in big claims. Some statistics show that 80% of workplace injuries are inconsequential, meaning they just require first aid or a trip to a physician. Eight percent of such claims are sprains and strains to the neck, back and various joints. However, these types of injuries account for an estimated 80%-90% of the system’s costs. Major claims are likely to follow if the frequency of such seemingly inconsequential injuries isn’t addressed.
Falsified/Exaggerated Claims. Claims that didn’t actually occur or that occurred outside the workplace are only representative of a small fraction of claims. However, employers can implement tip lines, video surveillance, drug screenings both before employment and after accidents, and so forth to reduce false claims:
The larger problem is from exaggerated injuries. Employers can take these steps to address exaggerated claims:
- Get injured employees immediate and appropriate treatment.
- Even if duties need to be temporarily modified, get injured employees back to work as quick as possible.
- Ensure supervisors communicate with injured employees and convey their concern and support.
- Do as much as possible to reduce the disruption employees may face post-injury.
- Assess and address behavioral issues that could be driving an injured employee’s disability.
Observing Patterns. Experts have recognized that there are patterns of reoccurring claims within groups, such as among certain industries or particular groups of employees. For example, more injuries may be seen in equipment operators that don’t receive proper eye screenings. Overweight employees tend to have more injuries than those of an average weight. The healing of injuries may be longer and more difficult among diabetic employees. Overexertion, meaning doing too much; too fast; and/or too frequently, is one of the primary causes of sprain and strain injuries. This often comes from an employee demanding more of their body than it’s capable of doing. The challenge is that this is a human behavior. Studies have shown that the majority of workplace injuries are from unsafe acts, not unsafe conditions. In other words, even in the absence of workplace hazards, injuries will happen. Additionally, there are also patterns of reoccurring fraudulent and exaggerated claims, such as an employee that seems to repeatedly have accidents.
Claim Reduction. Begin at the hiring process, ensuring that potential employees are capable of doing the physical and mental demands you’ve listed in the applicable job description. It’s important to understand that injury prevention must be embraced at the leadership level to be effective. Statistics show employees are most likely to have injuries when they feel their management doesn’t care. You might also consider:
- Excellent workplace safety programs.
- Efficient communication programs that allow you, injured employees, and insurance adjusters to easily communicate.
- A post-injury protocol, specifying the immediate reporting of an injury to appropriate personnel.
- Routing injured employees to seek medical care from a provider specializing in occupational injuries.
- Staying in touch with both the injured employee and their medical provider, making sure that you communicate your concern and care to the employee as they recover and accommodate any physical restriction recommended by the provider upon their return.
Cost Mitigation. Employers can take several routes to reduce the financial impact of claims. Transitional duty programs that enable an injured employee to continue some capacity of working as they recover would be one example. Research shows that around 40% of employers don’t currently have a transitional duty program. Another example would be referencing treatment guidelines to determine typical recovery times for various injuries. This information can be used to approximate how long it should take an injured employee to be treated and recover. Employers may consider having an on-site clinic for employees to go for both acute injuries and everyday health issues. Partnering with a physical therapy network may be a consideration. Research has shown that companies affiliated with physical therapy networks see injured employees returning to full-duty work 30% faster.
Wellness, Don’t Be Afraid. Lastly, some employers are apprehensive about implementing wellness programs because they’re concerned that participation itself may cause injuries. However, the risk of such is far outweighed by the many benefits of a wellness program, including claim-related benefits like healing faster and being able to resume work sooner. Remember, the success of any program comes from it being accepted from the top down.
Content provided by Transformer Marketing.
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This article was taken from: PropertyCasualty360.com
“Everything is not “coming up roses” for a Fontana, Calif. man who is facing workers’ compensation fraud and perjury charges.
Fifty-four-year-old Jose Cortez formerly earned a living as a gardener until Oct. 2010, when a large tree branch fell and landed on him during his shift for L. Barrios & Associates Landscaping. Cortez was then transported to a local hospital and sent home with “minor work restrictions.”
Although Cortez claimed the injuries sustained that day prevented him from completing his customary work duties, at least one person was not convinced. The following year, a tip aroused enough suspicion to initiate video surveillance of Cortez. During the course of the probe, insurance investigators observed Cortez carrying on as if it were business as usual. In fact, investigators documented at least six separate occasions when they saw him performing his normal duties as a gardener without any obvious signs of discomfort.
In Sept. 2012, investigators from the San Bernardino County District Attorney’s Office Workers’ Compensation Insurance Fraud Unit conducted a thorough criminal investigation, collecting surveillance footage allegedly incriminating Cortez, who was still collecting insurance benefits at the time.
“Mr. Cortez had previously stated that he was unable to perform the full range of his duties,” said Deputy District Attorney Scott Byrd, who is assigned to the case. “However, our investigation revealed that he had misrepresented the extent of his injuries and received more compensation than [to which] he was entitled.”
On Jan. 21, the prosecution filed criminal charges against Cortez, resulting in a felony arrest warrant being issued. Cortez was taken into custody outside his residence without incident by District Attorney Investigators. He was then transported and booked at the San Bernardino County Sheriff’s West Valley Detention Center. On Jan. 22, Cortez entered a plea of “not guilty” in San Bernardino Superior Court.
If convicted as charged, Cortez could enter a system far different from workers’ compensation—namely prison, where he could serve as many as eight years.
“This type of fraud is harmful because it causes premiums that businesses have to pay to go higher,” Byrd says. “It drains business profits, which in turn costs honest workers money in raises or other benefits that they may have been eligible to receive.”
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For more information about Workers Compensation or to obtain a new policy, simply contact Scurich Insurance Services located in Watsonville, California today at 800-320-3666 and we will be happy to help you.
Scurich Insurance Services did not originally write this content
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Overtime is highly popular among employees who want to squeeze those few extra dollars out of the week for a job well done. It’s far less popular among employers worried about longer work weeks stretching a skimpy budget even thinner. In many industries, overtime has become a way of life. However, eager employees and employers aren’t the only ones interested in the type of work being performed “after hours.” Workers Comp insurance companies and the IRS have developed their own standards for overtime pay — and these rules could mean trouble for companies that violate them.
Here’s an example of a company that decided to ignore the regulations set by Comp insurers and the IRS. The owner of a New Hampshire trucking business decided that instead of confusing himself and everyone else about overtime pay for some of his workers, he would “reward” them by paying the difference in cash under the table. To make a long story short, the owner got slapped with a slew of federal conspiracy charges from the IRS and the Transportation Department — not to mention an angry Workers Comp insurance company.
The bottom line: Creative schemes to cut Comp costs are never an acceptable alternative. Businesses buy this coverage to protect both themselves and their worker in the event of a workplace illness or injury, regardless of whether it occurred during the regular work week or while working overtime.
Make a call to any of our insurance professionals at Scurich Insurance and learn what your first step is in designing and maintaining an affordable Workers Compensation program that can offer the protection you need without incurring legal penalties. To learn more about this and similar topics, follow us on Twitter.
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If you have a post-injury response program for your business, you probably know that it both slashes Workers Comp costs drastically and helps get employees back on the job — quickly.
The more injuries your workers suffer on the job, and the longer they’re off, the more you’ll pay for Comp coverage (not to mention their lost productivity). However, according to a recent insurance trade press report, an effective program that focuses on containing costs after work injuries can cut these expenses in half.
The report recommends that a post-injury program should include a promise that an injured employee will receive the best medical care available and will return to the job only after they’re cleared to do so. What’s more, says the report, the program must be applied consistently, deal with every injury, and list “who reports injuries, who an injury is reported to, who transports the employee to medical providers, and how medical restrictions are obtained.” The plan should be in a format that’s easy for managers, supervisors, and employees to understand.
A post-injury program might also include creating a transitional-duty job to help an injured employee ease back into the swing of things. There are many other steps involved in creating and carrying out a successful plan.
To learn how you can avoid becoming another Workers Comp horror story, contact our insurance professionals at Scurich Insurance Services today. To learn more about Scurich Insurance Services, follow us on Twitter.
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The American melting pot is fast becoming a smorgasbord of distinctive cultures. During the past 10 years, more than half (51%) of new entrants into the U.S. workforce have been minorities. The next 10 years will see a dramatic increase in minority workers, many of whom might lack English proficiency and familiarity with basic workplace safety precautions. To help you meet the safety needs of an increasingly diverse workforce — especially where language barriers are an issue — we’d recommend these guidelines:
- Speak slowly, explain fully, and repeat important points several times.
- Choose simple words and avoid technical jargon (whenever possible).
- Use a translator with groups of employees who have only minimal English skills.
- Team up non-English-speaking employees with English-speaking employees.
- Provide handouts in the language(s) that trainees speak and read.
- Make sure that workers are able to understand written materials. Don’t assume that they can read forms, signs, written directions, etc.
- Stress the importance of following safety regulations and policies.
- Show employees how to use safety protections and explain why they’re important.
- Demonstrate while you speak and use pictures, diagrams, props, etc., to supplement your words.
- Follow up on the job to make sure that employees properly apply what they’ve learned in training.
All of the helpful and friendly agents at Scurich Insurance Service care that your business has the best California Worker’s Compensation Policy available. Contact any of our agents at Scurich Insurance, located in Watsonville, to have your questions answered regarding your Worker’s Compensation Policy!
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Is everything possible being done to protect your company from the costly impacts of Workers Compensation claims? As an employer, you know that injuries will happen. However, this doesn’t mean you shouldn’t try to prevent them by knowing the dynamics and some of the solutions recommended by the experts.