Building a plan for injury management 
By Carol Nardini, Sedgwick MCO

It is true that workers’ compensation claims in Ohio have been on the decline in recent years. The Bureau of Workers’ Compensation (BWC) has the 5^th lowest premiums in the country.  While this sounds assuring, accidents are always a possibility. Employers often struggle to contain costs associated with workers' compensation claims. Injuries sustained on the job can result in lost productivity, increased insurance premiums, not to mention legal fees. Constant review and implementation of cost containment strategies can help minimize the financial impact of these claims.

Governor DeWine has applauded employers for adopting safety-focused environments that lead to lower costs. One of the most effective strategies is to establish a comprehensive safety program with an emphasis on accident prevention. This includes providing regular training to employees on proper equipment usage and various safety protocols. The goal should be to maintain a clean and organized workspace and encourage open communication between management and employees regarding potential hazards. Your employees are on the front lines and can provide valuable information in accident prevention. The BWC’s department of Safety & Hygiene also offers many great services in this regard, and your Sedgwick team is also a tremendous resource.

When an injury does occur, it is important to have a plan in place for managers and supervisors to follow.  When the employer responds to a workplace injury with clarity and purpose, it demonstrates to your employees that their health is the priority and encourages open collaboration from the beginning of the claim process.   It is the employee’s decision to seek medical treatment with a medical provider of their choice, but having a trustworthy treatment option that you can suggest can simplify things for the injured employee. The next step is to promptly report the incident to your MCO and document all details related to the injury. This includes witness statements and medical records. This process can be time consuming, but it will pay off down the road. Specific dates and details not only help ensure that the employee receives proper medical attention but will also grant allowance of the claim and bills paid in a timely manner. A thorough investigation can prevent similar incidents from occurring in the future.

Your partnership with Sedgwick MCO & TPA as your experienced management teams will prove to be your best friends. These teams specialize in overseeing the administrative tasks associated with workers' compensation claims, return to work progress, accurate bill payments as well as claims investigation, hearing representation, and negotiating settlements. By working closely with Sedgwick experts, employers can feel confident that their claims are processed accurately and efficiently, minimizing the financial impact on the business.  A good rule of thumb to keep all parties appraised of claim developments is to utilize an email distribution list that includes your TPA and MCO claims teams.

A key piece to successful claims management is to establish a return-to-work program that includes modified duty or transitional work options. This program allows injured employees to return to work sooner, but in a limited capacity that protects their injury recovery process as approved by the employee’s physician. The BWC has Transitional Work Grants available for employers who wish to create formalized return-to-work options. A regular job description can be modified to fit the employee’s restrictions.  The BWC grant covers the cost of the developer that will come on site to write the various job analyses.  The BWC recently increased the grant levels available to qualifying employers, and Sedgwick can help guide you through this process.

Suffering an injury on the job can also be a challenging experience for employees. Not only do they have to deal with the physical pain and emotional trauma of the injury itself, but they may also face the added stress of being out of work for an extended period. Part of claims management involves educating your employee along the way since the process can be both confusing and frustrating. Gradually getting better in a limited capacity helps to maintain the employee's morale and motivation while not missing a paycheck.  Your MCO team will check in with your employee and their doctor regularly to monitor their recovery progress with transitional work options in mind. One of the most important things you can do is to check in with your employee on a regularly basis to see how they are doing and provide them with the support they need to feel confident in returning to work.

Building a thoughtful plan for post-injury management and early return-to-work is valuable step toward a comprehensive workers’ compensation program.  Your Sedgwick team is available to partner with you for a thorough asset that your organization and employees will benefit from.