Transcript Return To Work - Cloudfront.net

Return To Work
Tammy Roberts, BA, CCM, CDMS, QRP
The Dilemma
Current Trends
NCCI’s latest review indicates
•
Overall claim frequency has increased for the first
time since 1997 (3 percent)
•
Workers’ compensation medical costs per claim
average more than $6,000 and soar to nearly
$25,000 for lost-time claims
•
Prescription drug use is a medical expense that
makes up 19 percent of all workers’ compensation
medical costs
Impact Of Co-Morbid,
Chronic Conditions
Out of the approximate 300 million Americans,
133 have one or more chronic conditions
27 percent of the increase in healthcare costs
is due to obesity
The Opportunity
“A well-coordinated education and early
activation approach involving primary care
physicians, employers and workers’
compensation systems, and targeting
workers’ beliefs, perceptions and
expectations, would likely be most effective”
Izabela Schultz, et al, Spine Vol. 27, No. 23 pp. 2720-2725, 2002
SAW / RTW Motivation
Two factors of SAW / RTW motivation
1. Lose
versus
2. Gain
Why?
Reduce claims costs up to 70 percent
Injured workers return to workforce 50 percent
sooner
Reduce likelihood of malingering and
fraudulent claims
Reduce litigation costs
Newton’s Law Of Motion
Things in motion stay in motion
Things at rest stay at rest, unless acted upon
by an outside force
Why?
Workers’ compensation costs are reduced
when temporary total disability benefits
cease or are adjusted when an injured
worker returns to work
Decreased loss ratios and experience
modifiers help control premium costs
Why?
Productivity is maintained and human
resources are used to the maximum extent
Wage costs for substitute employees are saved
When?
The earlier, the better
Return-to-work policy should be in place prior
to a work-related injury and clearly
communicated to the employees
Employees should understand the purpose
and benefits of the return-to-work program
When?
Employees should have an understanding of
how work-related injuries impact the
company
Employees should be trained on the policy
upon hire or implementation with
reinforcement throughout the year
When?
Employees should acknowledge an
understanding of their responsibilities
Job descriptions and modified job descriptions
should be available prior to a work-related
injury
How?
What parts of the job can the employee perform
What is not getting done
Pacing, task-sharing options
Skill and knowledge building opportunity
Who?
Who is involved in the
process?
•
Employer
•
Employee
•
Medical providers
•
BrickStreet claims
adjuster
•
BrickStreet return-towork specialist
•
BrickStreet nurse
case manager
•
Field case manager
•
Modified duty off-site
provider
•
BrickStreet
underwriter
What?
Return-to-work policy
Job description
Modified job description
What?
Correspondence to employee and provider
Job function evaluation
Physician’s statement of capabilities
Questions?
Thank You!