You know that one of the keys to minimizing your workers’ compensation costs is getting employees back to work and closing out claims. So, what’s stopping you? A survey of claims administrators published by Rising Medical Solutions in 2016 identified the major factors that claims administrators identify as problematic.
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Here’s a look at some of those factors:
Obstacle Course
Among the most common obstacles claims administrators encountered in getting workers back on the job are:
Lack of options or accommodations for returning to work. When workers cannot return to their full duties, it’s important to have light-duty, part-time, work-from-home, and other options available. Without accommodations for workers who are still recovering, even the most motivated worker will have difficulty coming back. Your return-to-work program should provide options both for a phased return to work (for workers who are expected to make a full recovery) and permanent accommodation or reassignment (for workers who become permanently disabled). In addition, employers should understand that while standard labor laws and workers’ compensation regulations applied before a worker’s injury, the Americans with Disabilities Act—which has its own nondiscrimination and accommodation requirements—may apply afterward.
Late injury/claim reporting. When the employer does not file the worker’s claim in a timely manner, it creates a cascade of problems leading to increased costs and poor outcomes. Worker trust is damaged when claims are not filed quickly, which increases the chance that the injured employee will hire a lawyer. Incident investigations are more difficult when the claim is delayed. And one study by the Hartford Financial Service Group found that waiting just 7 days to file a claim could increase the cost of the injury by almost 20%.
Proactive/timely communication with stakeholders. In a report prepared by the California Commission on Health and Safety and Workers’ Compensation (CHSWC), the CHSWC discussed recommended best practices for treating physicians, employers, and claims administrators. The CHSWC recommended that treating physicians formulate and communicate clear work restrictions; that employers communicate promptly, openly, and respectfully with injured employees regarding the return-to-work process and methods to find appropriate alternative work; and that claims administrators facilitate nonadversarial communication between the injured worker, the employer, and the treating physician to achieve medically appropriate return-to-work.
Employee/employer relationship. The Workers’ Compensation Research Institute has identified trust to be the key predictor of a successful return to work. It evaluated “trust” by evaluating whether workers felt they would be fired after an injury. Workers who felt strongly that their jobs were in jeopardy were less likely to have successful return-to-work outcomes.
Litigation. Workers are more likely to seek legal representation when trust is absent and communication is poor—creating a low-odds scenario for successfully returning to work, regardless of how the litigation is resolved.
Tomorrow we’ll look at the number-one obstacle identified by claims administrators in successfully returning employees to work after an injury: “psychosocial factors.”