Articles | Cases

Work comp costs get healed through onsite treatment
By Janice Berthold

It all starts with a workplace injury. Somebody leaves oil on a floor, forgets to wear safety goggles, fails to remember to replace a safety guard on a saw, touches something that should absolutely, positively, never ever be touched. And once that happens a chain of events takes place, most of it bad.

We're all familiar with the process: the injured worker is taken to an overcrowded Occupational Clinic (often accompanied by one or more co-workers-who are no longer doing their jobs) where they can figure on spending a good portion of their working day. Then the OC doctor (if you ever get that high on the medical food chain), who just assisted a 10-year old with crayon stuck up their nostril, will try to diagnose an industrial accident. From there it becomes a labyrinth of missteps and wrong turns as everything gets sorted out by the supervisor, the claims people, insurance company and your HR department... and all the time the injury clock is ticking and your premiums are getting ready to escalate.

As a business owner, you feel the frustration. The increased costs, the ascending experience mod, the loss of productivity with anywhere from one to three employees not on the plant floor doing their job. Now think how frustrated you would be if you found out that 90% of all non-life-threatening workplace injuries could be quickly resolved with on-site first aid?

It's no secret that medical costs continue to rise at double-digit rates, and as a result, now comprise approximately 60 percent of the average claim. Indemnity costs are also problematic. Within this current state of flux, many organizations are looking to implement innovative strategies to overcome traditional hurdles, but what is new in workers' compensation?

Some companies are offering telephonic nurse triage services. But this type of service has only a 20%-40% success rate, plus the injured employee gets the feeling that the employer doesn't care about their situation, to the point they aren't even taking them to a medical provider.

However, recently a more positive trend has emerged. To put it quite simply, instead of taking the injured worker to a medical professional, the medical professional visits the scene of the injury and treats the worker. Known as "injury triage," a medical professional is able to assess an injury where the injury takes place. Why describe how an employee was injured to a doctor 10 or 20 miles away when you can actually show how it happened, perhaps even reenacting the injury to some degree? Such triage-treated injuries can include abrasions, lacerations, burns, eye irritation, neck or back pain, extremity injury and heat illness, to name a few. The triage worker will call in the troops should the injured party lose consciousness, have a possible spinal injury, serious burns, bone fractures or loss of limbs or extremities.

The workers' compensation industry is just beginning to catch on to this concept, leveraging injury triage to harvest benefits and savings as a result of prompt medical action onsite (the longer an employee has to wait for treatment the more likely the injury will get worse). Benefits include the rapid processing of claims and a drastic reduction in the loss of production when employees are away from their jobs. No longer does processing a claim happen at a glacial pace, where some injuries can take five to 10 days to be reported, for a myriad of reasons. A recent study by the Hartford Financial Group pointed out that prompt reporting of injuries leads to improved claims costs and outcomes. Triage nurses are trained to handle all of the facets of paperwork. This reduces the burden on supervisors and injured employees of filling out and submitting claim forms. In most cases the nurse sends an injury report to all concerned parties, including the employer contacts, treating physician, and the claims adjuster.

Feedback thus far from employers who have utilized injury triage has been promising. "We've already treated a few employees with hand laceration, ankle sprain and knee sprains," said Isaac Valle, Safety Coordinator for Jensen Corporate Holdings in San Jose, CA. "The service has been prompt and effective thus far and has helped us keep these three incidents as First Aid incidents with our employees feeling comfortable with the service."

Another key is that this process assures every injured employee will receive the appropriate level of medical care. You can train your supervisor, your VP, even your cafeteria worker on first aid tips and how to respond in a medical emergency, but do you really want to put the burden on those folks to make a medical decision? One that has potential liabilities should improper treatment be administered? No, you don't... and neither do they. Which is why the easiest course of action was either to call an EMT or transport the injured worker via car to the nearest hospital. And it has been reported that as a result of that decision, companies ended up using Occupational Clinic services in 20% to 30% percent of their incidents, resulting in an unnecessary level of care and expense. Another positive factor is that additional services can also be offered, including onsite drug-testing, tetanus shots, first aid training, forklift training, CPR training, and more.

Also important is the mindset of the injured workers. When they see that their employer has taken the action to have a medical professional onsite as quickly as possible to personally treat them, as opposed to a grueling wait in the OC, it establishes a culture of caring between employer and employee, that their safety and well-being are a top priority within the company, resulting in a reported 40-67% reduction in claims litigation.

These benefits have enabled workers' compensation programs to decrease overall costs, which significantly help employers, particularly in light of today's difficult economy and ever-increasing workers' compensation costs.

Janice Berthold is a Senior Vice President with Heffernan Insurance in San Francisco, California. She has over 25 years of commercial insurance experience, is a Certified WorkComp Advisor (CWCA) and holds the insurance designations of Chartered Property Casualty Underwriter.