Early Intervention in Claims Cuts Workers Comp Costs

Working in and around the construction equipment industry for many years has allowed me to form relationships with service providers with above-average industry knowledge and service levels. One such firm is Alper Services LLC, a full-service insurance broker that offers unique insurance cost-reduction strategies, particularly in the area of workers compensation. The company’s programs include Early Intervention, Reserve Reduction, AuditRate (a premium refund service) and a variety of risk management and loss prevention services. I make it a point of introducing Alper Services to companies with whom I consult, and I hope you enjoy this first in a series of articles by them. - Garry Bartecki

Workers compensation laws in most states promise injured workers medical treatment and lost wages without proving any negligence by their employer, but that doesn’t mean you’re powerless to control claim costs. Services with proven return on investment are available that can keep the busy summer season's injuries from increasing workers comp premiums

Prepare a Treatment Plan

Intervention at the moment an injury occurs is critical to controlling a claim. Too often, employees seek costly treatment in the local emergency room because they don’t know where else to go.

Larger projects may warrant on-site clinical management services – usually a trailer housing a nurse or paramedic equipped to treat worksite-specific injuries. Smaller jobsites should have access to Telephonic Nurse Triage, where nurses are specifically trained to assess injuries via telephone to determine if simple first aid is appropriate or if more substantial medical attention is warranted.

Telephonic Nurse Triage reduces unnecessary treatment by 20%. And for injuries where outside medical attention is warranted, the triage nurse helps ensure treatment is obtained promptly by reputable physicians.

Dedicated to Claims Control

Claims that start out relatively benign can quickly skyrocket if not properly monitored. The old 80-20 rule applies: 20% of your total claims will be responsible for 80% of your workers comp claim costs.

When outside medical treatment is needed, a case management program such as Early Intervention is a valuable resource to control workers comp costs by getting injured employees back to work as quickly as possible. For 30 days after a claim is reported, an Early Intervention (EI) nurse case manager is dedicated to overseeing it.

Your workers comp insurance adjuster will not react as quickly as the EI nurse. On average, it takes an adjuster six weeks to assign a nurse to a claim, by which time the employee may have had lots of unnecessary treatment, is unmotivated to come back to work and may have hired an attorney.

The EI nurse acts as a liaison between the employer and employee. The nurse’s first contact is with the employer to gather information — not just the standard accident details, but also any information about the employee’s past performance or personal life which may directly or indirectly hinder their ability to return to work. The next contact is with the injured employee.

The nurse helps communicate an employer’s concern about the injury, as well as the desire to get the employee back to the jobsite as quickly as possible. As simple as it sounds, employees are more motivated to get back to work and less likely to hire a lawyer when their employer shows a little compassion for their injuries. That’s where the nurse can help.

More importantly, the EI nurse regularly monitors the appropriate course of treatment and an employee’s compliance with recommended treatment guidelines.

Back to Work Sooner Than Later

Getting the employee back to work within 30 days is the primary goal of Early Intervention. An injured worker who is off work for 12 weeks or more is 50% less likely to ever go back to work.

The nurse helps the employer identify available light-duty positions— easy enough to comply with the injured worker’s medical restrictions, but not so easy that the employee wants to make a career out of it. The nurse then ensures that the treating doctor is aware that light-duty positions are available. The employee should never be the doctor's sole source of information about job duties, because all too often an employee may misrepresent (intentionally or not) the physical demands of the job.

Incorporating Early Intervention into your workers comp program is a proven return on investment. By returning injured employees back to work sooner, you eliminate payment of temporary disability wages. More importantly, Early Intervention will reduce medical costs on injuries by 30% to 40% compared to national disability guidelines.

Bobette Puckett is a comprehensive iInsurance architect and the executive vice president of Alper Services. A veteran industry leader, she designs creative solutions through innovative programs and services that help clients manage risk and increase profitability. She can be reached at (312) 867-7351 or BPuckett@AlperServices.com.