According to Kim Sharkey, vice president at The Graham Company, no
business is exempt from the possibility of a workers’ compensation claim. “I
think every employer in every industry has
to worry about it,” she says. “Unless you’re
in a firm where most of the staff is sitting
behind a desk at a computer, but, even
then, you have to worry about such things
as carpal tunnel or other unexpected
injuries. So I think it impacts everybody’s
bottom line.”
Smart Business spoke with Sharkey
about managing workers’ compensation
claims and the accompanying costs.
What drives workers’ compensation costs
and how can they be controlled once a claim
arises?
As far as the claims costs themselves,
they’re driven by a lot of factors, including
medical costs, medical inflation, how well
claims are managed by insurers and if you
have a return-to-work program. When controlling costs on the back end, the biggest
thing is to identify a contact within the
organization that’s going to oversee the
claims management process. We typically
call them claims coordinators. Most of the
time they’re involved with human
resources type functions already, and they
take on this aspect as well. That person
works to establish a solid claims management program, part of which is developing
relationships with physicians and providers. We help our clients set up a panel of
physicians so that when a person gets
injured they’re sent to an occupational
health provider that knows our client’s
business. The goal is to work with those
providers to get the person back to work as
soon as possible. Returning to work stops
the ‘lost wage’ or indemnity component of
a workers’ compensation claim.
Is it common for an employer to have relationships with people in the medical field?
Absolutely. We stress that our clients not
only develop the panels and have them
posted for the employees, but that they
also get to know the providers with whom
they’re working. We want them to make
phone calls and visit the plants and locations so they can see the types of jobs the employees do. Medical providers need to
understand the client’s return-to-work program and modified duty, which enables the
employee to come back to work even if not
fully recovered, and make sure that the
physician sees what types of jobs are available with restrictions to get the employee
back in the work place immediately.
How much control does the employer have
over a workers’ compensation claim?
Ultimately, the relationships with the
medical providers are key, because they
control how long that employee stays off of
work. They treat, rehab and manage the
injury. Having the employer work with that
physician to make sure that any accommodation can be made to get the employee
back into the work place as soon as possible is the key to controlling that overall
cost of the claim.
What if the employee is unable to return to
work?
If there’s a situation where an injured
employee has permanent restrictions, then
there are a couple of things you can do. If
the employer can accommodate those permanent restrictions and keep the employee
working, that would be the first choice. If
returning to work would cause an undue hardship or the work place can’t accommodate the worker’s permanent restrictions, in Pennsylvania we have to find that
person a job elsewhere in order to get them
off of workers’ compensation benefits. If
another job is not available at the employer, then we sit down and talk about how
maybe a potential settlement would be the
best cost control measure. We try to help
our clients with a cost benefit analysis of
what happens if you can’t take the employee back, if we have to search for another
job elsewhere, or if we settle the claim.
How can an employer keep tabs on injured
employees?
The biggest key is that centralized coordinator. He or she is responsible for keeping in touch with employees and not just
relying on the insurance company or third-party administrator. Find out how they’re
doing. Let them know you’d like to have
them back as soon as you can and will
make a job available for them. You want to
make them feel part of the company and
you want to make them feel that they do
have a job to which they can return.
Staying on top of that goes a long way for
the ultimate cost of the claim. Stay in touch
with them and the physician and make
sure that they’re all working together to
achieve the best outcome.
Anything else an employer should know?
When accidents occur, it is critical to
have solid accident investigation procedures. Ultimately you want to find out why
the accident occurred, determine the root
cause and then put things in place to prevent that situation from ever happening
again. We do a lot of trending and analysis
for our clients, analyzing where the claims
are coming from and looking at the accident investigations to make sure that all
types of programs are put into place to prevent the same incidents from happening.
The bottom line is that employers do not
want employees to get injured and they
want to do whatever they can to create a
safe work place.
KIM SHARKEY is vice president of The Graham Company
in Philadelphia. Reach her at [email protected] or (215)
701-5278.
