Know what is available in your toolbox for managing claims

When an employee alleges an injury, there are many directions that the claim can go. When a claim does head in a potentially negative direction, there are resources and strategies available to help identify issues early on to get the claim back on a positive track.

Smart Business spoke with Lynnae MaGinn, client services representative at CompManagement, about the resources employers have at their disposal.

What tools can help contain claim costs?

There are three main cost containment solutions for workers’ compensation claims: transitional duty, salary continuation and vocational rehabilitation.

Transitional duty keeps an employee with restrictions at work allowing for a safe return to full duty while avoiding any compensation benefits being applied to the claim.

Salary continuation allows an employee to receive full pay while off work, but allows an employer a reduction in compensation benefits paid to reduce annual premiums.

Vocational rehabilitation assists an injured worker in returning to employment either with the current employer or a new one.

Many of the costs involved are absorbed by the Ohio Bureau of Workers’ Compensation’s (BWC) surplus fund. It provides a potential reduction or elimination of compensation benefits paid, and safe return to work for the injured worker and resolution of the claim.

What medical reviews are available?

Independent Medical Exam: a physical examination is conducted by an independent physician or specialist to help determine the extent of disability, work capabilities, causal relationships and ease any suspicions regarding the description of the accident. Failure of the injured worker to attend may result in claim suspension by BWC.

Independent Medical Review: a review of existing medical records to determine claim allowance, appropriateness of treatment and clarify contrasting medical opinions.

Functional Capacity Evaluation: an evaluation of injured workers’ level of function that measures and predicts task performance and is performed when workers are medically stable, but cannot return to their former position.

Drug Utilization Review: a review of prescription medications by the BWC’s pharmacy department based on one of 10 allowed reasons for the request by BWC.

What can be done if there are credibility concerns regarding the injured worker?

Background checks, such as Insurance Services Office (ISO) checks, can help to identify prior claims filed. Additionally, online ‘footprint’ searches can help guide the monitoring of social media sites. Employers could also consider professional surveillance for a designated period of time looking for questionable actions and demonstrations of physical capabilities.

An employer may want to consider legal representation on certain claim-related or credibility issues. Before getting started, analyze the cost/benefit by determining the cost impact of the claim, condition or benefit at dispute and compare that to the cost of the defense intervention being considered.

How can companies reduce claim costs?

For state-funded employers, the most effective ways to reduce claims costs are handicap reimbursements and settlements.

Handicap reimbursement is a re-insuring fund that allows employers to request a reduction in the cost of the claim being charged to their premium experience. Reduction can be awarded if the claimant has one of the 26 recognized pre-existing conditions, and if that condition is related to the allowed claim conditions, it contributed to increased costs or delayed recovery.

The handicap percentage that is awarded by the BWC is applied to medical costs, reserves and any reducible compensation charged to the claim. Those reduced costs are then used in the experience calculation for the employer, and their rates and premium are reduced accordingly.

Claim settlements can help reduce claims costs and realize premium savings. If a claimant and the employer agree on a settlement amount and the BWC approves it, it is paid by BWC and charged to the employer’s premium experience as an indemnity charge. The claim remains on the premium experience, but no future reserves or payments will be assessed and it ceases all future claim activity.

Insights Workers’ Compensation is brought to you by CompManagement

Know the importance of dialogue and strategies

Once an injury occurs, it is crucial to effectively manage medical treatment and return-to-work options.
“There are various resources available and knowing the crucial components of communication, treatment negotiation and return-to-work strategies should be understood,” says Todd Keserich, assistant vice president, client services at CompManagement.

Smart Business spoke with Keserich about strategies to assist injured workers back to work.

What are the first steps to take when an injury occurs?

Once an injury occurs, there are three important steps to take. Those include authorizing timely, medically appropriate treatment to resolve the physical injury; facilitating a return-to-work date as soon as functionally possible; and managing any barriers and costs to treatment.

What resources are available to an employer to manage a claim?

State-funded employers across Ohio are required to have a Managed Care Organization (MCO). MCO’s are responsible for the medical management of a claim. The case management of a claim includes an assessment and plan of care that includes a goal for return to work. The case manager will review the treatment plan provided by the physician, facilitate authorized services, monitor the progress of treatment, reassess return-to-work barriers if they should occur and review and monitor prescriptions issued. When making treatment decisions, MCO’s are required by the Ohio Bureau of Workers’ Compensation to conduct a process called utilization review. This consists of reviewing the Official Disability Guidelines, looking at what treatment has been approved and completed thus far, reviewing the progress of any current treatment, and examining diagnostic testing reports, as well as looking at the mechanism of injury, age of the injured worker and any comorbidities.

What is important to communicate?

It is important to work collaboratively with the medical provider to help establish the medical necessity of health care services and procedures according to evidence-based criteria or guidelines so that an injured worker may safely return to work. If an injured worker has limitations returning to work, transitional work and on-site therapy or vocational rehabilitation may be utilized.

Transitional work includes therapy that primarily focuses on using the injured worker’s functional work tasks to progress the worker to a target job. On-site therapy includes physical or occupational therapy services provided to the injured worker while on-site at work. Vocational rehabilitation is an individualized and voluntary program for eligible injured workers needing assistance in safely returning to work. Vocational rehabilitation emphasizes restoring or maximizing the injured worker’s abilities and minimizing long, debilitating absences from work. It focuses on returning the injured worker to the original employer, but if that is not possible, rehabilitation services can help the injured worker identify skills and abilities to secure a new job with another employer.

What outcomes should be expected if communicating effectively?

There are three main outcomes that should be expected if the communication is effective when actively managing claims:

  • Safe and timely return to work — This occurs when the process of assessing all information and communicating with all involved parties is effective.
  • Right care at the right time for the right reason — Reduces the overcrowded hospital emergency room departments and makes sure that treatment is timely to keep the injured worker from losing days away from the workplace.
  • Advocacy — Engages injured workers, explains the claim process, helps them through the process after a work-related injury occurs, calms their fears and answers their questions.

Why is advocacy so important today?

Advocacy is important because claims can be complex, the severity of claims is on the rise and more lost-time claims are occurring. There also is an increase in continuous trauma, an inappropriate use of opioids to treat conditions, comorbidity factors and psychosocial issues.

Insights Workers’ Compensation is brought to you by CompManagement

Steps to take before an injury occurs in the workplace

It is always important to have policies in place that address procedures to be followed in the event of a workplace injury. However, the best solution is to focus resources on how to prevent that worker from becoming injured in the first place.

“A focus on preventative measures and the various resources available to create a safer workplace is truly important,” says Bruce Preston, manager of client services at CompManagement. “Getting the right people in the door is a very good first step, along with proper training and creating an environment that emphasizes safety.”

Smart Business spoke with Preston about the resources available to improve your overall safety.

What are the first steps to prevent injuries?

It is important to provide a safe environment both physically and organizationally. Create a safety committee that can do a hazard analysis to identify potential injury risks. From there, safety requirements may be developed. Once the safety requirements are in place, enforce safety best practices.

Also review your hiring practices. The best outcome is to hire and retain people who are physically capable of doing the work expected. Complete a job analysis for all positions to identify the actual physical expectations of the job. This should be utilized during pre-employment testing.

What resources are available to employers?

Most full-service, third-party administrators will offer safety services that include accident prevention, safety training and safety management program development. Additional services are also available from the Ohio Bureau of Workers’ Compensation (BWC) division of Safety and Hygiene (DSH). BWC offers three main services: consulting services, educational training and outreach, as well as library services. BWC industrial safety, construction safety, industrial hygiene and ergonomic specialists can visit an employer’s workplace or consult by telephone and/or email to assist in the development of effective injury and illness prevention services. BWC also offers OSHA and Public Employer Risk Reduction (PERRP) services. Under the OSHA onsite consultation program, services include free on-site safety inspections and consultation, safety program assistance and training. PERRP provides a variety of specialized workplace safety and health services for Ohio’s state, county and local government agencies, and public schools and colleges.

For training and outreach, BWC offers classroom and online courses. BWC also sponsors dozens of safety councils across the state that provide their local communities with quality safety programs. The best part is that the BWC DSH services are free to all Ohio employers.

How can changes be made cost effectively?

The BWC offers a variety of safety grants to employers for safety equipment, wellness and to foster a drug-free workplace. Safety Intervention grants are available to employers that wish to purchase equipment to substantially reduce or eliminate injuries and illnesses associated with a particular task or operation. Employers wanting to improve the health and wellness of their workers can benefit from the Workplace Wellness Grant Program. It provides funding to assist employers in establishing training and programs to reduce health risk factors specific to their employees. Grants are also available to assist employers that are implementing the Drug Free Safety Program at either the basic or advanced level. In addition, new grants have recently been developed to focus on firefighter exposure to environmental elements and employers working with persons with developmental disabilities.

How can this be sustained?

Create a culture of safety. Management must be committed to the culture and be involved with the safety committee to allow the committee to secure funding or support to address safety hazards. Their involvement also helps committees make more realistic decisions and recommendations. Also consider inviting non-committee front-line workers to participate in a meeting and discuss hazards that they encounter daily. Encourage employees to report hazards and unsafe work practices to a committee member, act on employee recommendations, keep the committee visible, and promote all activities and accomplishments.

Insights Workers’ Compensation is brought to you by CompManagement

Monetizing workers’ compensation managed care services in Ohio

Ohio employers now have the opportunity to select a managed care organization (MCO) to coordinate the medical aspects of workers’ compensation claims.

During MCO Open Enrollment, materials are published that attempt to compare MCOs’ effectiveness and service. Ultimately, employers must select an MCO based on what is most important to them. The MCO’s responsiveness, level of engagement, ability to control expenses and lost workdays, and help injured employees recover and return to work should drive the decision.

Smart Business spoke with Quinn Guist, president of CompManagement Health Systems, to learn more about factors to consider when choosing an MCO.

What aspects of an MCO’s services help control costs?

It can be difficult to assess MCOs in terms of financial impact. When we think about controlling costs for Ohio workers’ compensation, we typically think of premium discount and rebate programs administered by third party administrators that provide financial relief. We may also think of disputing a questionable claim to prevent unnecessary costs and preserve lower premium rates. These factors have clear implications for an employer’s premium, but the MCO’s ability to coordinate medical treatment, resolve workers’ compensation claims and help employees get back to work can have a tremendous impact on your organization’s costs and should not be overlooked.

What cost drivers may go unrecognized?

Qualifying for a premium discount or rebate depends on claim costs relative to an employer’s size. Claim costs are mainly driven by lost workdays. The MCO’s primary focus is to facilitate a prompt, safe return to work, limiting lost workdays and helping injured employees recover.
Severe injuries may result in substantial time off work. Lost time incurred on a claim drastically accelerates costs, and directly impacts the employer’s premium rates and options for discounts or rebates. In cases like these, the MCO’s role is crucial to the financial future of the employer.

Consistently engaging the injured employee and physicians to keep them focused on the return-to-work goal is critical. Every claim is different and there is no magical formula that guarantees painless results, but an employer should feel informed and confident that their injured employees are receiving the most appropriate and effective treatment.

What does a high-performing MCO look like?

One sign that an MCO is performing at a high level is in its response to treatment requests. Most treatment requests are appropriate for the injury and approved by the MCO. Occasionally, a request will seek to treat issues unrelated to the claim and may be denied. But even with appropriate requests, there are often opportunities to coordinate with the treating provider to encourage more beneficial treatment and/or shorter durations to keep the recovery process moving quickly. This requires a thoughtful MCO that finds opportunities to shorten periods of disability and minimize the burden of the claim on both the employer and the injured employee.

MCOs can also play a key role in matching a physician’s assessment of their patient’s physical ability with the employer’s flexibility to accommodate work restrictions. Throughout this process, there are therapy and rehabilitation resources available to help employers and employees continue to close the gap on working full duty, and the MCO is the access point for these services.

Another sign of increasing importance is the MCO’s involvement in reviewing medications prescribed in claims. While the Ohio Bureau of Workers’ Compensation utilizes a pharmacy benefits manager to oversee the prescription drugs in claims, it also allows MCOs to refer cases to be reviewed for excessive or inappropriate medications. It is well known that the costs of prescription medications can be exorbitant and it is not uncommon for an individual to be unable to work solely because of the side effects of some of these drugs. Examining medications for appropriateness and identifying alternatives have become crucial steps in medical management and important services employers should expect from their MCO.

Insights Workers’ Compensation is brought to you by CompManagement Health Systems

How a better relationship with your MCO contributes to financial success

Every state-funded employer in Ohio utilizes the services of a managed care organization (MCO), whose central purpose is to manage the medical aspects of workers’ compensation claims.

“What that actually means in practical application can seem mysterious,” says Lance Watkins, vice president of client services at CompManagement Health Systems. “By clearing up confusion about the MCO’s impact, employers may find new opportunities to leverage their MCO to help control costs, and also more confidently evaluate the effectiveness of their services.

Smart Business spoke with Watkins about what MCOs can do for companies.

Why is an MCO important?

The resolution of any claim — in a way that limits its future impact on your rates, premium and discount options — depends on injured employees recovering quickly and safely. Your MCO works closely with employees and their physicians to facilitate timely and appropriate medical treatment. MCO case managers keep all parties focused on the return-to-work goal. Your connection to your MCO ensures that lost work days are kept to a minimum.

How does an MCO help reduce lost time?

Depending on the type of injury and your company’s ability to adapt job requirements, your MCO may be able to help develop modified duty options that can drive a quicker return to work and lower claim costs.

Employees are sometimes taken off work due to the potential side effects of a prescribed drug. MCOs can discuss over-the-counter or alternative options to lower medical costs and allow employees a wider range of activities without medication-related impairment concerns.

A physician may prescribe treatment programs that could require an employee to be off of work. Additionally, physicians commonly take patients off work until they can be re-evaluated after physical therapy. Thinking creatively, your MCO can consult with you, the doctor and the physical therapist on options to support recovery with less downtime. Work activities could be incorporated in a physical therapy program.

While every injury and patient is different, it is important to keep the treating physician informed of the extent of lost time anticipated for each specific injury. Official Disability Guidelines provide this data based on the history of similar diagnoses.

How do MCOs directly impact businesses?

  • Initiating new claims — Thoroughly documenting and quickly submitting new injury reports to your MCO reduces ambiguity and expedites allowance decisions by the Ohio Bureau of Workers’ Compensation. An accurate and efficient injury reporting process speeds medical treatment and resolution.
  • Reviewing and paying medical bills — When opportunities to pay for medical services at lower reimbursement rates arise, your MCO may be able to reduce the costs applied to your premium rates.
  • Exploring vocational rehabilitation options — ‘Voc rehab’ can support employees as they prepare to return to work. It can also help employers defer significant claim costs and limit the impact on premium costs. All parties must agree on the utilization of voc rehab services, and partnering with your MCO in this process is essential.
  • Facilitating treatment requests — A physician or attorney may appeal an MCO’s decision to deny a specific treatment request, typically leading to delays, a series of hearings with the Industrial Commission, and significant time, energy and emotion invested by all involved. Your MCO can sometimes help avoid these delays by engaging the treating physician, exploring alternative treatment options to keep the claim moving toward resolution, and helping the employee return to work sooner.

An MCO’s focus on safe, efficient recovery will help ensure not only the health and productivity of your employees, but also your workplace. Employers often focus on premium rates and options for discount and rebate programs, which is appropriate. But these options depend largely on controlling your claim costs. Working closely with your MCO to limit lost work days and control medical expenses will help you secure premium advantages in coming years.

Insights Workers’ Compensation is brought to you by CompManagement Health Systems

Don’t become part of the statistic — reduce new hire injuries

Today, many employers struggle to maintain sufficient staff and are always on the lookout to find qualified people. This shortage may cause employers to do the minimum for safety orientation requirements, which often results in a new hire injury.

“Employees are expected to follow the safety standards set both by the Occupational Safety and Health Administration (OSHA) and those set by their company,” says Doug Newman, senior risk services analyst at CompManagement. “Before employees can follow these standards, they must be aware of them. This requires access to information on standards and the hazards they cover.”

Smart Business spoke with Newman about the importance of new employee training and what should be included.

Why conduct safety training?

No matter the size or nature of your business, the general duty clause of the Occupational Safety and Health Act states that each employer shall furnish to each of their employees a place of employment that is free from recognized hazards that are causing or are likely to cause death or serious harm to the employees. It is also an opportunity to influence new employees on the safety culture and safety expectations within the company.

Three key reasons to conduct new employee safety orientation can be found in statistics collected from OSHA, which reports that: 40 percent of workers who are injured have been on the job less than a year; one of every eight workplace injuries occurs to employees on their first day; and new hires are five times as likely to be injured on the job as experienced workers.

When should safety orientation training be conducted?

Safety orientation training should be conducted when the employee is first hired; when the employee is given a new job assignment or transfer; and when introducing new substances, equipment, processes or when a previously unrecognized hazard is identified. An orientation session should be held prior to the time an employee undertakes any work.

A general training session for all employees should be held at the beginning of the year or season, and regular five- to 10-minute safety meetings should be held throughout the year or season. At these meetings, managers and employees should be encouraged to report any potential safety hazards and any accidents or near accidents from the previous week should be discussed. This will keep safety awareness at a high level and help to prevent recurring accidents.

What topics should be covered?

Creating an employee orientation checklist is a good way to ensure all orientation items are completed. The training also needs to be conducted in a manner and language the employee understands.

Recommended topics include:

  • Company safety and health rules and policies — explain all safety and health company policies and ensure they have been acknowledged, signed and dated.
  • Safety training — provide general safety training and training specific to the employee’s position.
  • Emergency procedures — go over emergency procedures and show eye wash stations, first aid kits, fire blankets, exits, fire alarm pull boxes, etc.
  • Illness/injury reporting — review injury, illness and near miss reporting procedures. The policy must be acknowledged, signed and dated.
  • Applicable OSHA programs — review all applicable OSHA compliance programs.
  • Safety team — discuss the purpose of the safety team and introduce the new employees to its members.
  • Contacts — review emergency contacts with new employees.
  • Safety responsibilities — review employee safety expectations and responsibilities.

How should temporary workers be trained?

Host employers and staffing agencies have joint responsibilities to maintain a safe work environment for temporary workers. Host employers should provide temporary workers with safety training that is identical or equivalent to that provided to the host employer’s own employees performing the same or similar work. OSHA may cite both the host employer and staffing agency if violations are found in the training.

Insights Workers’ Compensation is brought to you by CompManagement

Tips on how to prevent, respond to and recover from workplace violence

Workplace violence affects more than 2 million American workers annually and is currently the fourth leading cause of fatal occupational injuries in the U.S.

“Workplace violence has become a growing concern for employers and employees across the country,” says Cassy Taylor, senior risk services analyst at CompManagement. “Employers face not only the physical and emotional suffering of their employees, but also bear potential costs related to workers’ compensation losses, temporary staffing, overtime, higher turnover, and hidden costs such as lack of productivity and lower morale.”

Smart Business spoke with Taylor about how employers can prevent, respond to and recover from workplace violence incidents.

What is workplace violence and who is the most vulnerable?

Workplace violence is any act or threat of physical violence, harassment, intimidation or other threatening disruptive behavior that occurs at the work site.

Those at an increased risk include those who exchange money with the public, deliver goods and services, work alone or in small groups, work late at night or early morning, work in high crime areas or have extensive contact with the public. Other vulnerable occupations include home health care and social work, hospital staff, probation officers and community workers, such as utility workers, phone/cable installers, mail carriers, retail workers and taxi drivers.

What types of workplace violence exist?

There are four types of workplace violence:

  • Criminal intent — violent acts by criminals who have no connection with the workplace.
  • Customer/client/partner — violence against employees providing services to the public.
  • Co-worker — current or former employees.
  • Personal relations — a family member or someone with a personal relationship who does not work at the facility.

What are the key elements of a workplace violence protection plan?

The primary elements of a program include planning, policies, training, physical security and evaluation.

Consider establishing a threat assessment team that will assess current conditions, establish and implement policies, develop an employee assistance and training program, conduct practice drills, survey employees to help identify how they feel about their safety while at work, prepare a crisis response plan, and regularly test and improve the program.

How can employers protect employees?

The best step to take is to implement a zero tolerance policy toward workplace violence and create a prevention program. Ensure that all employees know your policy and that all incidents of violence will be investigated.

To protect employees:

  • Provide a safety education program so employees know what conduct is not acceptable.
  • Secure the workplace: video surveillance, extra lighting, alarm systems, minimize access by outsiders through use of identification badges/electronic keys, train employees on situational awareness, and incorporate scenarios of potential violence for your workplace in emergency drills.
  • Instruct employees not to go where they feel unsafe, introduce a buddy system, or provide an escort or police assistance in potentially dangerous situations.

What should be done after an incident of workplace violence?

Always ensure that the appropriate medical evaluation and treatment occurs first, and that the incident is reported to the police. Also be sure to:

  • Require that employees report and log all incidents and threats of workplace violence.
  • Discuss the circumstances of the incident with staff.
  • Encourage employees to share information about ways to avoid similar situations in the future.
  • Offer stress debriefing sessions and post-traumatic counseling services to help workers recover from a violent incident.
  • Investigate all violent incidents and threats, monitor incidents by type of circumstances and institute corrective action.

Insights Workers’ Compensation is brought to you by CompManagement

Address safety in your workplace with a safety committee

The best injury is the one that never happens, but how is this achieved in a work environment? Regardless of the task at hand, safety is everyone’s responsibility from a top-down approach.

“Safety is a team effort and one of the most effective ways to start addressing safety in the workplace is by developing a safety committee,” says Doug Newman, senior risk services consultant at CompManagement.

Smart Business spoke with Newman about some of the key components of a safety committee.

What should companies consider before setting up a safety committee?

Prior to creating a safety committee, gathering management commitment is imperative. The involvement of management in the committee allows committees to secure funding or support to address safety hazards, and their involvement helps committees make more realistic decisions and recommendations.

It is also important for committee members to see that their suggestions have an effect on workplace safety. If the decisions of the committee are deemed too costly or are never used, enthusiasm within the committee may decrease. Management involvement also shows employees that safety is important to management, which can have a positive effect on their own safety values.

How large should a safety committee be and how should it be structured?

Your safety committee team should consist of 10 to 12 members. Take volunteers first and make sure all key areas are represented. Clearly define the purpose and objectives of the team and determine the length of the committee members’ terms, which should be more than six months.

Determine the roles of the team members — team leader, note taker, timekeeper, facilitator, members — then set goals to effectively review safety practices, make recommendations and implement measures upon management approval.

What should the duties and key elements of the safety committee be?

Safety committees should be involved in developing safe work practices, writing safety programs, facilitating safety training with the organization, conducting inspections of the workplace and investigating any reported accidents. An effective safety committee needs to hold meetings on a regular basis; publish meeting agendas in advance; keep minutes of each meeting that include the issues discussed, proposed action to be taken, and the member that is responsible for follow-up; make the meeting minutes available to all employees; document the committee’s accomplishments; and develop a way to recognize any individuals or groups within the company that make significant contributions to the safety program.

What safety policies and procedures should safety committees develop?

It is recommended that employers have:

  • Safety policies — review on an annual basis.
  • Written compliance programs — the type of business will determine Occupational Safety & Health Administration (OSHA) required programs.
  • Preventative maintenance programs — regular equipment inspection and documentation.
  • Standard operating procedures — guidelines should be provided to employees.
  • Written incident and accident reporting procedures — include near misses.
  • Medical provider relationships and a return to work program — develop relationships and maintain communication.

How can companies keep safety committee members and employees engaged?

Safety committees may struggle to maintain member enthusiasm. Consider inviting noncommittee front-line workers to participate in a meeting and discuss hazards that they encounter daily. This will allow the committee to rotate their focus on a variety of topics. To get everyone engaged at your workplace, tell employees how they can be of assistance to the committee, encourage employees to report hazards and unsafe work practices to a committee member, act on employee recommendations, keep the committee visible and promote all activities and accomplishments.

Insights Workers’ Compensation is brought to you by CompManagement

What Ohio employers need to know now that medical marijuana is legal

This past September, Gov. John Kasich signed Ohio House Bill 523, which continued the nationwide trend of states legalizing medical marijuana. The new law allows people with one of 20 qualifying conditions to use marijuana with a doctor’s recommendation.

“Employers may still establish and enforce drug-free workplaces that prohibit and test for any drug that is illegal under federal law, and employees under the influence of marijuana are still not covered by workers’ compensation,” says Stephanie McCloud, government/industry relations counsel at CompManagement.

Smart Business spoke with McCloud about this new law and what employers should do now.

When does the law actually become operable?

The state officially began establishing the Medical Marijuana Control Program, which will serve as the infrastructure to regulate the industry, on Sept. 8, 2016. Patients with one of the 20 qualifying medical conditions will not actually gain access from within the state to medical marijuana until the program is established, which is expected to be no more than two years after the effective date.

Who will regulate the law?

The Ohio Department of Commerce will regulate the licensure of medical marijuana cultivators and processors, as well as the laboratories that test medical marijuana. The State of Ohio Board of Pharmacy will license retail dispensaries and register patients and their caregivers. The State Medical Board of Ohio will regulate physicians’ requirements and procedures for applying for and maintaining certificates to recommend medical marijuana. It will also maintain the list of conditions for which medical marijuana can be recommended.

What are the impacts of the new law related to workers’ compensation?

Impacts are limited to Ohio’s workers’ compensation system and the Ohio Bureau of Workers’ Compensation’s (BWC) Drug-Free Safety Program is not affected. The law does not require BWC to pay for patient access to marijuana nor is an employee found to be under the influence of marijuana covered by workers’ compensation.

Is medical marijuana reimbursable under workers’ compensation if recommended for an injured worker?

Although the law does not address reimbursement for medical marijuana that may be recommended for injured workers, there are already rules and statutes that limit what medications are reimbursable by BWC. Drugs covered by BWC are limited to those that are approved by the Food and Drug Administration. Marijuana has not been approved and remains a Schedule I illegal drug under federal law. In addition, prescriptions funded by BWC must be dispensed by a registered pharmacist from an enrolled provider. Under the new law, medical marijuana will be dispensed from retail marijuana dispensaries, not from enrolled pharmacies.

Is an injury compensable if the injured worker is found to be using marijuana for medical purposes?

The law does specify that marijuana is covered under ‘rebuttable presumption,’ which means that an employee whose injury was the result of being under the influence of marijuana is not eligible for workers’ compensation. This is the case regardless of whether the marijuana use is recommended by a physician.

What should employers do now?

There are certain sections of the new law that reference the use of medical marijuana in violation of an employer’s drug-free workplace policy, zero-tolerance policy or other formal program or policy. If employers do not have a drug-free workplace policy in place, now is the time to do so. If an employer does have an existing policy, now is also a good time to review it and update as necessary.

This article is informational only and should not be construed as legal advice.

Insights Workers’ Compensation is brought to you by CompManagement

The basics of OSHA/PERRP reporting

Under the Occupational Safety & Health Administration’s (OSHA) record keeping regulation, certain covered private employers — entities run by private individuals or groups — are required to prepare and maintain records of serious occupational injuries and illnesses using the OSHA 300 Log. In Ohio, public employers — cities, counties, public schools, villages, etc. — are also required by the Ohio Public Employer Risk Reduction Program (PERRP) to maintain the same records on the PERRP 300P log.

“The information is intended to help employers evaluate the safety of their workplace as well as help implement protection for their workers in order to reduce and/or eliminate hazards,” says Cassy Taylor, senior risk services analyst at CompManagement.

Smart Business spoke with Taylor about some of the fundamentals of maintaining these records and the approaching deadlines for posting.

Who is responsible for keeping injury and illness records?

Private employers with 10 or more employees at any point during the year, with the exception of certain low-risk industries, are required to keep an OSHA 300 log. The list of certain low-risk industries may be viewed on OSHA’s website. Private employers with 10 or fewer employees for the entire year are required to keep records if directed to do so by OSHA. All public employers are required to keep a PERRP 300P log. There are no exemptions for public employers.

What is a recordable injury or illness?

Employers must record each fatality, injury or illness that is work-related; if it is a new case or meets one or more of the criteria contained in the OSHA/PERRP record keeping instructions that include death, days away from work, restricted work or transfer to another job, medical treatment beyond first aid, loss of consciousness or diagnosis of a significant injury/illness by a physician or other practicing licensed health care professional.

What cases are considered work-related?

An event or exposure in the work environment that either caused or contributed to the resulting condition, or an event or exposure in the work environment significantly aggravated by a pre-existing injury or illness.

Are there any exceptions?

Yes, there are a few exceptions to the record keeping rule that include being present as a member of the general public; voluntary participation in wellness program, medical, fitness or recreational activity; eating, drinking or preparing food or drink for personal consumption; symptoms arising in work environment that are solely due to a non-work-related event or exposure; personal tasks outside assigned working hours; personal grooming, self- medication for non-work-related condition, or intentionally self-inflicted; a motor vehicle accident in a parking lot/access road during a commute; common cold or flu; and mental illness, unless the employee voluntarily provides a medical opinion from a physician or licensed health care professional having appropriate qualifications and experience that affirms work-relatedness.

How long do records need to be kept on file and is there a deadline to post?

OSHA 300 and PERRP 300P logs cover one calendar year and must be kept on file for five years. The information on the OSHA 300 and PERRP 300P logs must be transferred to the OSHA 300A and PERRP 300AP summary forms for posting. Private employers must post the 300A for all employees to see from Feb. 1 to April 30 of each year; there is no need to submit the log to OSHA unless asked to do so. Public employers must post the 300P for all employees to see from Feb. 1 to April 30 of each year as well as submit the report to the Ohio Bureau of Workers’ Compensation by Feb. 1.

Are all recordable injuries or illnesses also workers’ compensation claims?

No. For example, if the injured party only received treatment from an in-house physician, a workers’ compensation claim may not need to be filed. If the treatment was beyond first aid, it must be recorded on the 300 or 300P log.

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