Worker safety: You’ve got a worker’s compensation claim – now what?

2014-04-28T07:30:00Z Worker safety: You’ve got a worker’s compensation claim – now what?RANDALL M. ADAMS Chippewa Valley
Business Report
Chippewa Herald

Control of worker’s compensation costs is getting a lot of attention these days. There are many possible cost drivers in worker’s compensation, starting with preventable injuries.

Injuries that do not happen cost nothing. According to the National Council on Compensation Insurance, Wisconsin ranks sixth worst in the U.S. for work comp cases filed per 100,000 workers. Those numbers indicate that many organizations do not meet minimum regulatory requirements (OSHA, EPA, etc.), such as housekeeping, machine guarding, hazard communication, personal protective equipment and employee training, for example.

This suggests that many employers need to evaluate what is driving their comp costs. Taking a proactive approach to injury prevention is the right thing to do for our employees and their families, for our communities and for our businesses. No one wants to see anyone get hurt under any circumstances.

However, the reality is that accidents, injuries and work-related illnesses can still happen despite our best efforts to prevent them. A machine part can fail, even though the proper maintenance has been done; a hydraulic hose may break; a well-trained employee can inadvertently do something wrong. Some unforeseen variable can occur that defeats all our safeguards, including well-designed safety programs.

When an on-the-job injury does occur, policies and procedures need to be in place to manage the entire “life-cycle” of the claim. Some employers tell the employee to come back to work when they are 100 percent. Some let the insurance company and health care provider handle all aspects of the case. Some involve themselves more proactively in case management and return-to-work programs. Long story short, an employer who avoids being involved in the management of these injuries is setting him/herself up for an increased loss.

Some fundamentals include well-written and equitably-applied safety policies that include job descriptions and pre-established alternate duty plans. In today’s business environment, a well-designed Stay-At-Work/Return-To-Work program is at the core of a successful work comp program.

Research has clearly shown that the earliest possible safe return to work, under any level of restrictions, is a key factor in promoting healing and in avoiding unnecessary and costly periods of disability. Research has also shown that an employee that is out of work on disability for six months has a near-zero chance of ever returning to gainful employment. That is stark, especially since we know that 60-70 percent of long-term disability cases are medically unnecessary and preventable.

Your employee expects you to take charge and do your part, just as you expect them to do their part. How you do that can set a positive tone right from the start, and it is best to start immediately.

If a fixable problem on-site caused the injury, fix it. Ensure that you or the supervisor communicate regularly with an injured employee who is unable to work; a bit of help with snow shoveling, lawn work or grocery shopping might provide a lot of relief to your employee (and buy a lot of loyalty in the bargain). If you have an EAP, get it involved sooner rather than later. Show that you care about them and their recovery.

The health care provider that your employee selects can also be recruited into this process. They often work in a vacuum, receiving very little information from the employer or insurer, depending instead on the injured employee for information. Add to this the fact that very few providers from any profession receive significant training or education regarding the WC system, and they can be woefully ignorant of the realities that you face as an employer. This is a poor recipe for effective management, but you can help by the simple expedient of communication.

Let the provider know that you are interested, that you can provide information about the job, work site and incident, and that you have a return-to-work program in place to help enhance their efforts (they are required to include return-to-work in their treatment plans). The health care provider will probably welcome your overtures. It might be a good idea to assign someone to become familiar with the work comp treatment guidelines that are required here in Wisconsin; this allows you to participate in the process more effectively.

Your insurer has a lot of resources as well. You will want to work with them to let them know your expectations, and what level of participation in case management you can provide. Communication will have to happen in all directions to keep a case moving. After all, you are the one closest to the employee.

Also, the less involved you are with an injured employee, the more likely it is that he or she will feel abandoned, neglected and unvalued. The end point of this situation is predictable, and potentially costly. The employee’s supervisor is the one who knows the department and its people, and will need to be given the tools and training to learn their roles.

And let’s not forget the object of all this attention: the injured employee. A basic element of engaging injured employees in the return to normal duties is to have ensured that they have been informed since time of hire of what their legal rights and responsibilities are, and of company policies, procedures and benefits. It is even more important to make sure that the entire workforce knows that they are valued, that they are receiving the right training and equipment, and that they will not be punished for reporting near-hits, incidents or injuries.

If we respect and treat each other as human beings, we might just find that a reduction in problem cases follows.

Dr. Randall Adams of Chippewa Falls is a consultant who is board-certified in occupational health, and holds a master of risk control degree from UW-Stout. He can be reached at, or at 715-944-5276.

Copyright 2015 Chippewa Herald. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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