Employers who stay involved and report to carriers about employees riding the system or working somewhere else while drawing benefits do help to clean up the mess.
Where to start? First, lets all admit that this approach has been tried many times over many years. Success depends on cooperation from the “injured” employee and the treating doctor. Anyone bent on scamming the systems will succeed. And doctors whose practice is built around “work injuries” will not look kindly on a nurse trying to manage the claim/treatment. Success starts with some simple basics. Immediate reporting of the injury, or suspected injury. Not tomorrow, and sure as heck, not 30 days from now. Immediate drug test with absolute denial of claim if the test is positive. No choice of doctor. Must go to a company or carrier designated doctor. This can be expanded to choice from a 3 doctor list posted in the workplace. Tennessee does this. No chiropractors, period. Those three steps will remove 80% of the questionable claims. Nonsubscriber experience in Texas proves it. There are fewer claims and the cost drops dramatically. A $10,000 workers comp claim can/will be in the range of $2,500-$3,000. With better care. The nurse case manager idea should be called “the nurse full employment idea”. I worked for a company that, in the year before we went nonsubscriber, incurred $1,350,000 in total workers comp costs in Texas. After going nonsubscriber, and mandating the three initial requirements, the next year total dropped to $135,000.
Employers who stay involved and report to carriers about employees riding the system or working somewhere else while drawing benefits do help to clean up the mess.
Where to start? First, lets all admit that this approach has been tried many times over many years. Success depends on cooperation from the “injured” employee and the treating doctor. Anyone bent on scamming the systems will succeed. And doctors whose practice is built around “work injuries” will not look kindly on a nurse trying to manage the claim/treatment. Success starts with some simple basics. Immediate reporting of the injury, or suspected injury. Not tomorrow, and sure as heck, not 30 days from now. Immediate drug test with absolute denial of claim if the test is positive. No choice of doctor. Must go to a company or carrier designated doctor. This can be expanded to choice from a 3 doctor list posted in the workplace. Tennessee does this. No chiropractors, period. Those three steps will remove 80% of the questionable claims. Nonsubscriber experience in Texas proves it. There are fewer claims and the cost drops dramatically. A $10,000 workers comp claim can/will be in the range of $2,500-$3,000. With better care. The nurse case manager idea should be called “the nurse full employment idea”. I worked for a company that, in the year before we went nonsubscriber, incurred $1,350,000 in total workers comp costs in Texas. After going nonsubscriber, and mandating the three initial requirements, the next year total dropped to $135,000.