By: Sedgwick TPA

For most employers, workers’ compensation is one of many items that require their attention daily. Most
workers’ compensation professionals will tell you that the best injury is one that never happens. The reality in Ohio, is that there are over 200,000 private and public employers and tens of thousands of new workers’ compensation claims filed annually.
 
Managing a workers’ compensation program can be simplified by implementing a few standardized processes that will make it easier for you to minimize lost days, control your costs and maintain productivity in your business.
 
Early Claim Intervention
Having a standardized injury reporting process and claim investigation mandate in place before an injury
happens means that you will have tools at your disposal to quickly analyze what happened; is the claim work related and are there any red flags that will lead you to contest the claim.
 
Your Managed Care Organization (MCO) can provide your company with guidance on any questions related to injury reporting and seeking Bureau of Workers Compensation (BWC) authorized provider medical treatment. 
 
Minimizing Claim Costs
Once a claim application is filed with the BWC, things begin to move quickly and your window of opportunity to minimize the impact of the claim is small. 
 
If you are not contesting the claim or its compensability, your focus should move to helping your injured workers get the necessary treatment they need to quickly return to full duty employment.
 
If you can accommodate a return to a transitional duty position while the treatment moves forward, making a transitional duty job offer will prevent the claim from flipping from “medical only” to “lost time”.  It will also keep your injured worker from getting accustomed to being off work because of the injury. If transitional work is not an option, then another path is to pay the injured worker their regular wages – also known as salary continuation - while they are off work. 
 
Cost Containment Options
When a claim is allowed the BWC attaches a reserve to estimate and cover future costs. There are several ways to minimize the impact a reserve has on your annual premium:

• Settlement – the most effective way to close a claim and prevent future costs from being applied is to negotiate a full and final settlement with the injured worker. The settlement amount is paid out of the claim by the BWC, the cost is added to the overall claim cost and the injured worker receives monies in lieu of future treatment and compensation. 
• Disability Relief – The BWC has a program in place to recognize pre-existing conditions that negatively impact the allowed conditions or the injured worker’s recovery from the allowed condition. The BWC will hold an informal conference to review the application and the medical that supports the request and then will determine an impact percentage that reduces the cost in the claim.
• Subrogation / No Fault Motor Vehicle Accident – When a third-party is the cause of a workplace injury there may be relief that can be pursued to offset the cost of the claim. The most common example is an employee’s claim that is the result of a non-at-fault vehicle accident involving a third party.

Navigating the workers’ compensation system can feel frustrating and at times complicated, but with your Managed Care Organization and Third Party Administrator partners you have access to subject matter experts that can make your job easier and keep your premiums down.

Learn more about the EA program

Sedgwick TPA can assist with cost containment options in your claims, as well as provide discounts through the Employers’ Association workers’ compensation program.  For a no-cost, no-obligation analysis, simply call or email Paul Feck at 614.906.053 or paul.feck@sedgwick.com. You may also submit an online application at sedgwick.com/ac3/ea.