Are your Texas workers’ compensation insurance costs growing every year? Then it’s time to take control by getting actively engaged and purposeful with your claims response. Here are five crucial steps:
- Start the cost containment clock as soon as an injury occurs. When an accident happens and one of your employees gets injured, what happens in the first 24 hours is critical for keeping costs down. The injured worker needs to get immediate and appropriate care, you need to investigate and gather all of the facts and any witness statements and you need to establish immediate and ongoing communication with the injured worker to help set expectations for the process, give the employee crucial guidance and ease frustrations and anxieties. Being proactive about these measures at the outset of the claim is critical to managing costs.
- Regularly review the original documented facts of the injury. With a claim that drags out for 12 to 18 months or longer, it’s important to stay refreshed on what was originally documented and make sure the claim doesn’t wander off course. Be aware of any increase in exposure as the injured employee continues treatment, especially for conditions unrelated to the original injury. It’s vital to work with the claims adjuster to set and keep the claim on the right trajectory. Pay special attention to complex, catastrophic claims such as amputations or brain and spinal injuries, which lead to the highest costs and highest risk.
- Be aggressive about controlling medical and drug costs. Medical and pharmacy costs represent the lion’s share of most workers’ compensation claims, so be aggressive about minimizing these costs. Foster relationships with your claims adjuster to make sure he or she is being as assertive as possible in using all available resources to minimize costs for medical care.
- Monitor the employee’s activity during recovery. While injured employees are recovering, maintain regular contact and perform activity checks. They should be adhering to their treating physician’s recommendations for optimal recovery and cost containment. Social media can be helpful to monitor the employees’ activity during recovery, since employees are often open about describing their daily activities. If you suspect fraudulent activity by an employee, consider targeted surveillance. As always, work directly with the claims adjuster in these matters.
- Get injured workers back on the job ASAP. The biggest cost driver in any claim is severity – the length of time an employee is off work – and every day the injured employee is off work costs you money. So, getting him or her back on the job should be the primary goal with every claim from the outset. That’s not just a crucial cost cutting strategy, it’s also a psychological boost for the injured worker. Getting them back into the work environment helps change their focus from being disabled to getting back to their normal routine. Whether it’s modified, transitional, part-time or alternative duties, get them back on the job ASAP. Coordinate with your claims adjuster so you adhere to state laws.
When you consider medical and pharmacy costs, time loss costs, lost productivity, possible legal costs and the many hidden costs, even one workers’ compensation claim can take a substantial bite out of your bottom line. So, fight back – be proactively engaged in the process and attack these costs head-on.