Column: Workers' Comp

Double Duty

By: | August 4, 2014

Roberto Ceniceros is senior editor at Risk & Insurance® and chair of the National Workers' Compensation and Disability Conference® & Expo. He can be reached at [email protected] Read more of his columns and features.

A classic risk management refrain proclaims that the best claim is one that never happens. Another workers’ compensation maxim holds that 20 percent of claims drive 80 percent of costs.

Taken together, the two pieces of wisdom explain why, with good reason, we in workers’ comp spend so much time focusing on medical care management, yet also strive to prevent and mitigate claims early, before they require extensive medical management services.

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As an editor and co-chair for the National Workers’ Compensation and Disability Conference® & Expo, I have at times focused greater attention on medical management topics than on risk reduction and loss-control practices.

Doing so makes sense because medical expenses now account for more than half of a claim’s cost, on average. It’s also important to dig into the growing array of medical management services for injured workers to evaluate how claims payers effectively apply those services.

But a recent conversation with Tom Tobin, CEO and partner at Fit for Work LLC, pulled my attention back to the importance of reaching workers before soreness, minor aches and discomfort grow into claims needing greater medical care and management of medical services.

Tobin advocates engaging workers early, encouraging them to step forward when they first experience discomfort. Workers typically strive to be productive and focus on providing for their families, often ignoring early warning signs until they become recordable injuries and significant claims, Tobin said.

I have heard this is especially true about a company’s most productive workers. They are more likely to shrug off the early warning signs. There is also fear that reporting an injury might be negatively perceived.

A focus on medical management shouldn’t come at the expense of developing solid safety and risk management practices, like fostering a workplace culture that encourages employees to speak up when they first experience discomfort.

But physical therapists can periodically visit a workplace and develop relationships with workers, sending a powerful message that it is safe for employees to step forward when they first experience work-related aches, Tobin said.

The therapists can then develop stretch and flex routines, suggest work-performance modifications and provide other assistance that mitigates claims.

Acting to prevent injuries and mitigating their severity early on is a basic concept risk managers have advocated for decades.

But employers still struggle with soft tissue injury claims and their costs can mount, especially with a workforce that is growing older and heavier.

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Still, with medical care now driving such a large portion of a claim’s total cost, it’s also obvious that medical management services helping deliver the right care have an important role when applied in the right dose.

Clearly, a solid mitigation strategy requires both, addressing the challenging open cases with their ongoing medical expenses, and preventing new injuries or identifying them before they become part of the 20 percent.

A focus on medical management shouldn’t come at the expense of developing solid safety and risk management practices, like fostering a workplace culture that encourages employees to speak up when they first experience discomfort.

That is why, as an editor and conference producer, I’ll work to provide information that helps professionals tasked with reducing losses understand evolving claims management trends while also promoting practices that result in those claims never happening.

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The R&I Editorial Team can be reached at [email protected]