John Cooper and Paul Miller bust the myths surrounding workers’ compensation claims and give you expert advice in how to lower the cost of your claims.

If there is one universal belief ingrained in both public and private sector employers, it’s that workers’ compensation claims are a cost of doing business. After all, accidents happen and there’s nothing you can do about them. You’re just supposed to sit back, close your eyes and pray that the ones that do happen aren’t all that bad.

This isn’t to say that people don’t have safety programs (they do) or aren’t trying to mitigate claims once they happen (they are). But claims keep racking up and after a while just seems like the future is just a matter of chance.

That’s just a myth. The reality is the future is a matter of choice. Most of your claims are both predictable and preventable and you can choose to eliminate them through data analysis and creative, proactive solutions. Here are a few more myths you can bust.

Myth 1: All expensive claims are random, bizarre accidents

Reality: Only 15% of large losses (greater than $50,000) are classic catastrophic events. The other 85% are long-tail, adverse development claims that start as minor injuries and typically take an average of 8 years to “bloom.” These claims tend to be either sprains/strains or slip and fall, both of which share a common solution. A quality ergonomics program. One that addresses workers’ movement and pain levels before the accident happens. Therapy after an injury is great, but addressing these issues beforehand is critical, because the best claim you’ve ever had is the one you never have.

A Call to Action | Issue 12

Myth 2: After a TPA performs a bill review, reduces costs down to fee schedule, and applies PPO discounts etc., there is no other way to save money on medical costs

Reality: Some medical bills in workers’ compensation are “up coded” with the wrong ICD-10 codes which artificially inflates the initial price of the bill. Using certified medical coding specialists who are also licensed medical doctors to double check your bill coding ensures that your bill review process starts from the correct place for the services your claimant received, potentially saving thousands of dollars in the process.

Myth 3: Small claims (especially medical only) are a given and not a big concern

Reality: These claims add up fast and most don’t belong in the comp system. They can be easily handled by first aid or your group health benefits program as a non-OSHA recordable event. Triaging these claims is the single most important step in your claims intake process and no one is better equipped to perform this task than a telehealth service. As an objective third party removed from the social environment of the workplace, telehealth services utilize registered nurses to determine care before making the knee jerk reaction to visit an emergency room and create a claim. In many cases they can provide the necessary care immediately and more affordably, typically cutting small medical-only bills in half, which can add up to millions over time for many employers.

The common thread here in busting work comp myths is that you need to identify where your biggest challenges are and then tackle them head on with meaningful solutions. The single biggest tool you have in the first step is your data. Fall in love with it. It gives you the roadmap of where to start. But then you must take real action. Posters, ergonomic coffee mugs or steel-toed boots simply won’t have the impact you are looking for. Take advantage of the many industries and specialists that exist purely to drive the frequency and severity of your comp claims down. Do that and you’ll bust the biggest myth of all: that workers’ compensation programs can’t be controlled.

Need support to reduce your compensation claims? Cardinus’ ergonomics program Healthy Working helps employees’ reduce their own injury risk while giving managers the information to support those with a greater need. Email info@cardinus.com or call (323) 337-9016.

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