Familiarize Yourself with Basic State Procedures: Try to become more involved in deciding whether a claim is settled or litigated. If you operate in more than one state, be aware that state laws vary, particularly as they pertain to items such as commencement of the benefits period, retaliation, notice periods, attorney fees, and the availability of a subsequent injury trust fund.
Evaluate the Legal Knowledge of Cost Control Managers: Determine whether those persons presently responsible for cost control are trained on applicable provisions of state and federal law, including the ADA, FMLA, and the OSHAct.
Train Managers and Supervisors on Cost Containment: Instruct supervisors on proper techniques for compiling information and background evidence from the employee and other witnesses. Train them on proper safety procedure and first-aid, accident reporting, and physician referral procedures. Instruct supervisors to show personal concern for their employees while on leave.
Retain Aggressive Attorneys and Adjusters: When available, consider exercising your right to choose your own attorneys and adjusters. If your insurance policy does not allow this, consider renegotiating the policy, and insist on prompt communication with insurance representatives.
Know Your Insurance Policy Inside and Out: Understand the correlation between current experience and future premiums. Identify the parties responsible for attorneys' fees, and determine whether those fees are reflected in your experience ratings. Determine who pays for surveillance and medical exams, and whether you have input in selecting the attorney.
Handle Every Claim Individually and Aggressively: Consider possible courses of action for each file as you review it, including such options as surveillance, medical exams, termination of benefits and light duty. Move quickly when a course of action is determined.
Establish a Good Working Relationship with Company Physicians: Look for an honest and conservative doctor who, in addition to providing excellent medical care, understands your point of view. Cultivate a trusting relationship with that physician over time.
Identify and Deter Fraudulent Claims: Warn employees of the consequences of filing fraudulent claims, and aggressively investigate suspicious cases. When fraud is discovered, consider criminal prosecution and civil actions for damages, especially when evidence points to a conspiracy between unscrupulous lawyers and medical providers.
Obtain a Full, Universal Release of all Claims Before Settling: Retain full and final authority to approve any and all settlements. Make an effort to obtain a full release of all claims whenever a settlement of a workers' compensation claim is reached.
Coordinate Workers' Compensation Claims with Pending Litigation: When litigation is pending with the employee, a qualified person (usually labor counsel) should compare the facts contained in the workers' compensation file to the other litigation.
Do Not Overlook Subsequent Injury Trust Funds: The manager charged with responsibility for cost containment should become familiar with the procedures for obtaining reimbursement from the state subsequent injury trust fund, if applicable.
Bring Employees Back to Work as Soon as Possible: Consider implementing temporary light duty policies or "work hardening" programs designed to return employees to work as soon as possible. Designate a coordinator to work with injured employees while on leave, and to encourage them to return to duty as soon as possible.
Analyze the Advantages of Self-insurance: Under "self-funding" plans, the employer is directly liable for workers compensation benefits. In states that permit it, self-funding may provide significant cost-saving advantages, particularly when insurance premiums exceed the amounts paid to employees by the carrier.
Manage Workplace Injuries - Don't let Them Manage You: Audit your policies and procedures to ensure a proactive approach to cost containment. Computerize workers' compensation data to spot injury patterns. Emphasize early treatment and return to work. Refer your employees to trusted physicians. Follow up with and monitor injured workers by telephone.
Controlling workers' compensation costs is no longer merely a desirable goal. For many employers competing with other companies which have successfully lowered their costs, it is a necessity for business survival.