There’s a question I like to ask prospective clients when we start talking about workers’ compensation:

“Would you share with me what it looks like when an employee gets hurt on the job?” 

It’s a simple question. But the answer tells me a lot.

I’m not really asking where you send the employee for medical care or who fills out the claim form. I’m trying to understand what happens next.

Who gets involved? How quickly?

Does the supervisor know what to do?

Does someone stay in contact with the injured employee?

Do you know what the doctor said about restrictions?

Does the employee go home until he or she is “100%”?

Does anyone actively manage the claim after it gets turned over to the insurance company?

And, maybe most importantly, when does that employee come back to work?

Because an injury isn’t just a workers’ compensation claim. It can become an operational problem surprisingly quickly.

The Claim Cost Is Only Part of the Cost

Suppose an employee hurts his back and misses six weeks of work.

The insurance company may pay the medical bills and a portion of the employee’s lost wages. But who pays for everything else?

You do.

Someone else has to cover the injured employee’s work. That might mean overtime. It might mean bringing in a temporary worker. It might mean other employees becoming less productive because they’re trying to absorb additional responsibilities.

Supervisors spend time dealing with the injury instead of running the operation.

Deadlines can slip. Production can slow.

And the longer that employee remains disconnected from the workplace, the harder it can become to get him or her back.

Those costs don’t necessarily appear on a workers’ compensation loss run.

But they’re real.

Then There’s Your Experience Mod

This is where today’s injury can become tomorrow’s insurance cost.

Workers’ compensation claims are part of the calculation that ultimately determines your experience modification factor, or e-mod.

That means a poorly managed claim doesn’t necessarily stop costing you when the claim closes.

Its impact can follow you into future workers’ compensation premiums.

I’ve seen employers spend enormous amounts of time negotiating insurance rates while paying far less attention to the thing they have considerably more control over: the claims that ultimately help drive those rates.

That’s backwards.

The best workers’ compensation strategy doesn’t start 90 days before renewal.

It starts the day somebody gets hurt. NCCI lays out carrier perspectives here.

Return to Work Is One of the Most Important Tools You Have

One of the first things I want to know about a prospective client’s workers’ compensation program is whether they have a functioning return-to-work process.

Not a policy sitting in a safety manual.

A process that actually works.

If the doctor says an employee can return with restrictions — no lifting over 10 pounds, limited standing, no repetitive motion, whatever those restrictions might be — what happens?

Too often, the answer is:

“We don’t have anything for them to do.”

That’s worth challenging.

Modified duty doesn’t have to look exactly like the employee’s normal job. There may be administrative work, training, inventory, inspections, documentation, organization, quality-control tasks or dozens of other productive things that need to get done.

The goal isn’t to invent meaningless work.

The goal is to ask, “What can this employee safely and productively do while recovering?”

There is a big difference between those two approaches.

Don’t Outsource the Entire Claim to the Insurance Company

Your insurance carrier has an important role. So does the adjuster. So does the medical provider.

But none of them run your business.

None of them understand the employee’s job as well as you do. None of them feel the productivity loss the way you do. And none of them will ultimately experience the impact of your workers’ compensation costs quite the way you will.

That’s why I don’t think employers should simply report a claim and wait to see what happens.

Someone needs to be driving the process.

That means communication with the employee. Communication with the medical provider where appropriate. Understanding restrictions. Looking for modified-duty opportunities. Reviewing reserves. Watching claim development. And pushing for resolution when a claim seems to be drifting.

Good claims management is active, not passive.

So I Keep Coming Back to the Same Question

What does it look like when one of your employees gets hurt?

If the answer is clear — supervisors know what to do, the employee receives appropriate care quickly, communication starts immediately, restrictions are understood, modified duty is considered and someone actively manages the claim — you’re probably doing a lot of things right.

If the answer is some version of:

“We turn it in to the insurance company and they handle it.”

Then there’s probably an opportunity.

Not necessarily to buy different insurance.

To manage the risk differently.

That’s an important distinction.

Because workers’ compensation isn’t just about finding a competitive premium once a year.

It’s about what you do the other 364 days that ultimately determines how much the program costs you.

Ready to dig in to your experience mod?  Book a time here.