Canadian Association of Movers November 2004 Annual Conference
Topic overview • Workplace statistics trends affecting the Moving & Storage Industry • Understanding the Workers’ Compensation Maze • 4 Steps to control your W/C costs
Billions in Losses • Annually-5 billionin W/C costs • Average $82,500 / working minute • 3 workers die every day • Yr 2000-882 workers were killed • Yr 2000-800,000 workers were injured on the job • On average-injury occurs every 9 sec • Each yr 400,000 workers-serious-can’t work
Workplace Statistics Moving & Storage Industry 1999-2003
National-Moving & Storage IndustryLost Time claims OVERVIEW • Nature-Type of injury • Part of body injured • Event-type of accident resulting in the injury
Lost Time M&S-Nature Data from the Association of Workers’ Compensation Board (AWCBC) National Work Injury Statistics Program)
Pushing/ pulling Bending/ twisting Overexertion Lost Time M&S-Event Data from the Association of Workers’ Compensation Board (AWCBC) National Work Injury Statistics Program)
Lost Time M&S-Part Data from the Association of Workers’ Compensation Board (AWCBC) National Work Injury Statistics Program)
Sub Category-Legs Data from the Association of Workers’ Compensation Board (AWCBC) National Work Injury Statistics Program)
What does the data show us? • Trend-stable to slight decrease in lost time frequency • Increase in severity • Duration of claims • Length in recovery Time • Permanent Impairment
What areas do we need to focus on? • Hazard Analysis • Hazard Assessment • Workers’ Compensation • In house claims management Pre-injury Controls Tomorrow Post-injury Controls
Workers’ Compensation Funding Premiums Rate Groups Benefits for Employers, Workers Assessing the need for Claims Management
Workers’ Compensation • The most expensive Insurance Recent survey in 2001 asked employers if Workers’ Compensation is affecting the financial viability-profit margin 70% indicated that they were somewhat to vary concerned
Workers’ Compensation Premiums
Workers’ Compensation Benefits for Employer • Protection from lawsuits • What about sub-contractors? • Non-fault Insurance • What about third party?
Workers Compensation • Incentives • Experience Rating Surcharges & Rebates • Audits (target areas)
Workers Compensation • Provides coverage for workers • Who is covered? • FULL TIME • PART TIME • SEASONAL • CASUAL • PAID STUDENTS • LEARNERS • SUB-CONTRACTORS? • OWNERS?
Benefits for Workers • Benefits for wage loss and health care • 75-90% Gross • Permanent Impairment Benefits • Re-training cost
Survivor Benefits • Retirement Benefits • 12 months loss of earnings -5%(retirement fund)-paid at age 65
Preventing premium increases • Hazard Analysis • Hazard Assessment • Workers’ Compensation • In house claims management Pre-injury Controls Post-injury Controls
Assessing whether you need a Claims Management program • Is your W/C costs higher than they should be? • What is your average claim cost? • What is your average lost-time duration days?
Controls W/C Costs 4 Steps to Claims Management • Determining your situation-industry standards • Set Objectives • Reporting Procedures • In-House Claims Management Training • written procedures post-injury • Claims management checklist…
Step 1. Determining your situation • Most employers sense their W/C cost may be higher than they should be • measures to evaluate • Traditional small or large employee base • Prescriptive
Step 2. Set W/C Objectives • Where you are vs. Where you want to go • Consider: • Evaluate W/C total net costs / yr. ≥ $500-$1000/yr /full-time worker its to high • Number of lost-time cases (1 to 2 yrs) closed within 10 days (from date of accident). If %≤ 90% W/C costs are too high
Educate staff and supervisors on claims management practices 10-20% Reduction. Key staff members should be familiar with injury management goals and procedures (Reporting Procedures)
Step 3. Reporting Procedures • What is the number one cause of lost-time injuries?
Communication • Between the worker to the lead hand or supervisor to office to the Workers’ Compensation office
Accident Reporting Procedures True or False One of the biggest challenges facing employers on gathering claim related information is the lack of knowledge about the Workers’ Compensation process
Accident Reporting Procedures-Checklist • Written procedures-Why? • Absentee program • Why is it needed-nature of industry-cyclic • What is it-proactive-notification of injury from Board • How does it work-checklist • Roll calls • First-aid, medical attention…
Accident Reporting Procedures-Checklist • When is modified work offered?(medical note one week off) • How and what is offered?
Accident Reporting Procedures-considerations • Does the Board have a copy of modified-work program • Completing the Employer’s Report of Accidental Injury (F7) how are your concerns reported…Benefit of doubt…accident investigation • Lost-time vs non-lost-time filing • Reporting procedures for workers included in hiring process
Most Effective Tool Step 4. In-House Claims Management • What is it? Systematic response post-injury that guides employers through the maze of Workers’ Compensation policies • A management tool-control claim costs • Provides a system of Checks and Balances • Holding the Board Accountable for decisions and duration of claim entitlements.
In house Claims Management • Why is it important? • Over 360,000 claims adjudicated per year • Well-defined C/M program can mean the difference between a claim costing $10,000 vs. $100,000
Claims Management Who should be trained? • Your Workers’ Compensation liaison person, staff… • Challenges • Payroll • Operations…
Claims Management What should they be trained on? • The Fundamentals of the Claims Adjudication Process Specific to Moving & Storage
Fundamentals • Types of claim entitlement issue…M&S • Specific & Gradual onsets • Immediates / compatibility
Fundamentals • Reporting Injuries to the Board-form 7 • reoccurrence , aggravation… • Loss of earnings • Pre-existing-financial relief • Re-employment obligations
Return-to-work Process • Modified Work • When and how to offer modified duties • Normal healing time • Independent Medical Evaluation, Physical Demand Analysis & Functional Capacity Analysis • Permanent Impairments-Maximum Medical Recovery, Non-Economic Loss Award • Re-training
Claims Management-Checklists • Warning signs of Workers’ Compensation Fraud-initial contact with worker • Initial Entitlement-Is the claim allowable/ Reoccurrence… • Return-to-work monitoring checklist-benchmarks-recovery-graduate to regular duties…
For every $1 spent-company can save $5 in Workers’ Compensation costs How does this happen? Control the outcome of disability by controlling the process How does Claims Management Save you Money
Case Study-Claims Management • Facts: • 39 years old • Hired May 1 2004-Driver • Gross $40,000 / yr (with OT) $750/week • DOA May 17, 2004 • Low back strain • Standard back precautions • Medical treatment-Cat Scan, MRI… • Ongoing modified work-helper • MMR October 1, 2004-P.I. • W/C calls- A/E Accommodation? Control the outcome of disability by controlling the process
Case Study-Claims Management • What Next?
Case Study-Claims Management • 2 options • Accommodate • Vocational Rehab-training
Case Study-Claims Management • Accommodate Tools available to you • Functional capacity evaluation-measures what worker can / can’t do… • Therefore-making the job fit restrictions…. Total cost $5000
Case Study-Claims Management 2. Vocational Rehab-training costs VR assessment $2,250.00 Re-training (1 yrs) Wage loss 1yr x$637.50/wk $33,150.00 Tuition / books $1,500.00 Mileage .34/ km $270.00 Wage diff $2.50/hr x35yr $130,000.00 TOTAL $167,170.00
Questions? Thank you