Nurse care management and a solid return-to-work program are two ways employers can proactively manage workers’ compensation costs.
Panelists at the 2017 Risk Management Summit in Las Vegas, Nev., emphasized the role an employer plays in maintaining good communication with injured workers to ensure their transition back to work.
Panelists spoke during the session, “Workers’ Compensation Programs That Really Work.”
Insurance Journal was a sponsor of the summit that was hosted by eServices, a division of Energi that provides a turnkey risk management, claims and marketing technology for companies.
Suzie Burdette, vice president of Managed Care at Wellcomp and a registered nurse, said that employer involvement in workers’ compensation programs directly impacts the success of these programs.
While some insurers may balk at hiring nurse case managers, Burdette urged employers to learn about the benefits. “Multiple studies have been done about effectiveness of nurse case management,” she said.
If expense is a factor, an employer may wish to consider other cost-effective options such as telephonic nurse case managers that can still yield similar benefits.
Burdette said employers are often asked to document why a nurse case manager needs to be assigned to a particular claim. Factors that may be weighed in deciding whether a claim warrants a nurse include the type of injury, co-morbidities, obesity concerns, employee motivation and an employee’s relationship with his or her employer, Burdette told attendees.
Nurse case management can also be helpful when a physician has prescribed narcotics. Burdette said the nurse can address the prescription with the doctor and discuss a wean and taper program. Nurses may also propose alternatives such as cognitive behavior therapy (CBT) to address psychosocial behaviors that might make an injured employee more reliant on narcotics.
Panelists said that employers can assist in the claims investigation and management of the claim file by communicating their knowledge and concerns relating to the employee to the claims adjuster. The employer can also provide the same information to the nurse case manager.
Employers should be directly involved with getting insured workers back on the job, said Nancy Segreve, a vocational consultant and owner of Occupational Resource Network. One of the easiest ways to do this is by communicating the business’ needs and goals to those working the claim and treating the injured employee.
Dina Snyder is president of Traditional Work Solutions, a company that aids employers with no light duty by having injured employees return to light duty capacity working at a non-profit until they are no longer restricted from their job duties.
Snyder stressed that employers need to stay involved for workers’ compensation to work and that employers should not be passive about their role.
“Employees may not know there is light duty available,” Snyder noted.
Segreve agreed. “Communicate with employees. Make sure they know about it,” she said.
In attempting to return an injured worker to transitional job duties, it helps if employers can supply detailed job descriptions to assist physicians, nurse case managers and vocational rehabilitation consultants.
Snyder emphasized that employers should share information even if they might not think it’s important. For example, an injured worker’s motivation to return to work can shift if he or she is about to be fired. It’s also important to keep the lines of communication open with injured workers because they can start to feel isolated, disengaged or embarrassed. For unrepresented employees, employers can send a card or call and just ask if they received their paycheck, Snyder added.
“Keep communicating with injured workers,” Snyder stressed.
Burdette said nurse triage programs can also benefit workers’ compensation claims. In a traditional program, a nurse reviews the initial injury report to evaluate factors that might make the claim go south. She said this can go hand-in-hand with an insurer’s predictive analytics program.
Employers may also offer a telephone hotline so those workers injured on the job can obtain guidance on whether they can self-treat or require medical attention. This type of program can aid in keeping treatment with appropriate, in-network providers.
Segreve emphasized the value of a return to work program, stating that it allows the employer and insurer the ability to avoid costly expenses for things like surveillance down the road.
Snyder considers return to work the most powerful mitigator for reducing costs associated with workers’ compensation claims.
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