Tag Archives: injured worker

Interesting Approach

10/17/18   Julius Young

Recently I became aware of an interesting experiment by the SCIF, the State Compensation Insurance Fund.

Titled the “Injured Worker Incentive Program”, this SCIF program (see link below) promised certain monetary incentives to those who it deemed in compliance with certain benchmarks.

savings graph for article about Injured Worker Incentive ProgramsThis apparently was a small SCIF program, and inquiries by some of my colleagues have resulted in head scratching by various SCIF attorneys who claimed no knowledge of it. The program may not be getting off the ground at this time.

I’ve heard whispers that this program came to the attention of some at the DWC, but to my knowledge there’s been no public discussion of it.

The July 2018 explanatory letter from SCIF notes that “the sooner injured employees return to work, the sooner they feel better.” The letter explains that this program is established to encourage injured workers “to establish and maintain an active and healthy lifestyle”. As a result, “State Fund is prepared to assist you in your efforts by supplying some fitness equipment which you or your physician may think would be helpful.”

Other benefits of the program included:

• Potential eligibility for a $1,000 payment to those who return to work within 7 days of release by a doctor and who remain employed for 6 months;

• Payments of $500 for maintaining pre-injury weight or $1,000 for losing at least 5% of pre-injury weight;

• Potential monetary payments of $1,500 (compliance with treatment), $1,000 (staying within the MPN), and $1,250 (agreeing with the PTP findings to avoid use of the QME medical-legal evaluation process);

• Wellness program participation ($500)

These cash awards were noted to be considered taxable income and as a result 1099 forms would be issued by SCIF.

How should we assess this program?

One could argue that experimentation in workers’ compensation may be a good thing. And some of the program’s goals are laudable, i.e. getting people back to work and supporting healthy lifestyles and “wellness”. Extra monetary incentives for workers could possibly be a tool to drive behavior that arguably might lead to some better outcomes.

It’s an issue that the comp community should debate.


3 Factors That Most Impact Worker Outcomes

March 21, 2017 by

same old thinking - same old results graphicIt’s been two weeks since the WCRI Conference recently held in Boston. I’m Michael Stack with Amaxx and today I want to give you some highlights and recap from that recent conference, from the notes that I took and the perspective that I had on it. The second session was about worker outcomes and what impacts, based on studies and research to define the best outcome.

What are those factors that we can address? For me, this was the most interesting and impactful session for what I do, which is work with employers, insurance brokers and educating best in class programs. This session is one that I found extraordinarily valuable to get an understanding of, what are those things that impact the outcomes that we can address at the beginning a claim and make sure our success is that much more likely.

Single Biggest Factor That Impacts Claim Outcome

This is a study I’ve quoted a number of times. It was published by WCRI a few years back and they came out with a study and said, “The biggest single factor based on their research that impacts the outcome of that claim is trust.” The biggest single factor that outcome impacts the outcome of a claim, is the amount of trust between an employee and an employer. Hugely important point. Hugely important factor to understand. Now, we’ve seen that one before.

How Does Supervisor Respond to Injury?

Glen Pransky from Liberty Mutual gave a presentation about some of their research and their studies. I found it extraordinarily interesting and valuable. Here’s what they came up with. Two different things that impact their outcomes, one of the biggest factors, all things being equal, if how does the supervisor respond to the injured worker at the moment that claim is reported. I’m going to say that again. How does the supervisor respond to the injured worker at the moment that that claim is reported. Do they respond with blame and anger and frustration? Continue reading 3 Factors That Most Impact Worker Outcomes

10 Ways to Kick Start a Workers’ Comp Stewardship Program

By ReduceYourWorkersComp.com   February 28, 2017

Workers' Compensation Claims road sign
This way to reduced WC costs

If you’re trying to improve your workers’ comp program, ask for an annual stewardship meeting with your insurer/third-party administrator.

But if you really want to see game changing results, initiate a stewardship process. It’s a collaborative approach that takes some leg work and elbow grease, but can truly push your workers’ comp program to the next level.

In a typical stewardship meeting a representative for the employer and insurer or third party administrator discuss a pre-prepared report that shows your claims and program trends from the previous year and discuss goals for the next year. While it can be beneficial to get this snapshot of your workers’ comp program, there is much more that can be done.

Best outcomes for injured workers, optimized claims performance, and a reduction of your total cost of risk should be the goals. Savvier companies find more value and better outcomes through an intensive coordinated approach that starts long before the actual stewardship meeting.

Prep Work
Conversations with a multitude of people ahead of time can help you define what you want included in the report, the metrics you want analyzed and the parameters. Among those you may want to consult with are your carrier or TPA account manager, risk management information systems personnel and data analysts; claim and safety consultants; your insurance broker or agent; and others within your own organization.

Key steps in the process at this point include:

Set the date. Decide when you want the report completed.

2. Review past reports.
This can help you establish a baseline.

3. Formulate a concept for the report.

4. Discuss the format and content of the report;
set goals, objectives, metrics, deliverables, ideal takeaways, and the list of attendees.

5. Review preliminary data.
Easily available analytical reports can be your starting point until you determine what needs to be customized, depending on what you are trying to accomplish. Not all data is going to be relevant. Some examples of the types of data may include:
•  Frequency analysis: claim volume, litigation, examiner caseload and lag time.
•  Severity analysis: average/total incurred, average/total paid, loss stratification, lag analysis, litigation, subrogation/recovery.


Cycle Time Is King


By Dr. Laura Gardner, Vice President, Products, CLARA Analytics

Santa Clara,CA – Workers’ compensation is essentially a collection of interrelated actions taken by the employer, payer, provider and injured worker in the service of the injured worker’s recovery and return to work.

Putting the injured worker at the center of this activity is critical and discussed in the previous article in this series, Five Best Practices to Ensure the Injured Worker Comes FirstWorkers’ compensation cost control, cycle time, return to work, injured worker. But what is the best way to achieve our objective of getting injured workers rapidly back on track? What processes, tools and systems do we put in place? What problems should we focus on?

Critical to answering these questions is a framework that is based on years of handling service operations across a range of industries (airlines, retail banking, healthcare, etc.).

Any service process can be measured based on its performance along three dimensions:
•. Cycle time – time to complete one cycle of an operation (e.g.,   from opening to closing of a claim)
•. Cost – the cost to go through a cycle of the process
•. Quality – the error rate that occurs as you go through a cycle

It’s a truism in process improvement that you can improve only one or two of these factors at a time, at the expense of the others. While this is true if we push on cost or quality, pushing on cycle time improves all three metrics. This is an important finding that’s worth restating. If we endeavor solely to reduce cycle time, we can improve all three metrics — cost, quality and cycle time — without sacrifice. To explain why, let’s look at a few examples.
Continue reading Cycle Time Is King

Return-to-Work Programs


The only place success comes before work is in the dictionary” –
Vince Lombardi

At the 2015 WCI Conference this session addressed the issues faced from employees returning to work and to create a successful return-to-work program. .
benefits of return to work programs graphic
The speakers included Margaret Spence, President/CEO, Douglas Claims & Risk Consultants, Inc, and Rose Royo, Supervisor, Workers Compensation, Miami Dade County Public Schools.

Key idea to remember, work smarter not harder. Main focus when creating a return to work program is the employee. The injured worker is an employee not a claimant. Imperative to make sure the employee knows they are vital to you and that you are not just treating them as a claim. The employment situation creates the workers’ compensation situation. It is essential to have a happy medium when working with an employee and the return to work program. The goal is to keep the employee working you do not want to get wrapped up in everything else.

When you create a return to work program, it is helpful follow these guidelines:

• Create an injury management team-this starts with the highest employee in your organization

• Understand the organization’s why- injured employee should be at the center of the focus

• Define the process-make sure there are steps the employee needs to take in order to get back to work

• Embrace your purpose and value-Remember your employee is most important

• Make the business care-costs money to bring new employees into the company, focus on getting the injured worker back to work

• Find ways to engage-this program should be a collaborative effort between several departments

• Create an integrated disability team- build proactive policies

As an employer you cannot be afraid to ask the employees what can we do for you in order to get you back to your job and work at 100%. The saying goes a “happy worker is a happy worker!”

Return to work programs are not something you create in a year and never look at the program again.