Management of Complex Worker Compensation Cases Joanne Ebert RN, MBA With the increasing complexity of worker compensation cases, a case manager needs an arsenal of tools to enhance effectiveness and return the employee to work. Frequently, physical problems couples with behavioral health are becoming the norm. Joanne Ebert RN, MBA [...]
MEASURING & ACHIEVING EXCELLENCE: EXHAUSTIVE AUDIT OF OCCUPATIONAL HEALTH PROGRAMS In order to meet the changing demands of business, occupational health services continue to evolve, offering a wide span of options for businesses. Traditional single-nurse clinics continue to prevail, however the use of advanced practice clinicians have broadened the scope of [...]
Sex & Occupational Injuries and Illnesses By: Steven Babitsky, Esq. There is currently little hard information on the sex differences between men and women suffering workers' compensation injuries. A study in Disability Rehabilitation entitled Understanding the Role of Sex Differences in Work Injuries concluded that: Work-injured women were significantly [...]
Medicare Set-Aside UPDATE By: Steven Babitsky, Esq. One of the hottest and most challenging issue facing employers, insurers, self-insurers and workers' compensation professionals is the settlement of claims and the issue of Medicare set-asides. The Medicare set-aside is a method that can be used in a workers' compensation settlement to [...]
The US Court of Appeals (7th Cir) recently held that an honest suspicion of FMLA abuse was sufficient to fire an employee. The court dealt with the following facts: In 2006, Carrier Corporation set out to remedy an excessive employee absenteeism problem which had developed at its Indianapolis manufacturing plant. [...]
Reducing Medical Costs in Workers' Compensation Cases In litigated Workers' Compensation cases, medical expenses can rise rapidly, and frequently exceed 50% of the total cost of the entire claim. What steps can employers, insurers, self-insurers and other workers' compensation professionals take to reduce these rising medical expenses. A Workers' Compensation [...]
Cost-effectiveness and the expanded coverage under the Affordable Care Act is driving the rapid expansion and use of work-site clinics to treat injured workers. A recent study by the research firm Mercer found that more than 500 large companies have these clinics already in place. Approximately 27% of large and [...]
Workers who suffer a significant head/brain injury will often require substantial and costly medical and rehabilitation treatment that can keep them out of work for lengthy periods of time. The Washington State Industrial Fund reported on 797 cases of work outcomes after traumatic brain injury. Of these cases: 9% had [...]
Psychological risk factors play a substantial role and present significant obstacles in the delayed recovery of injured workers. Modifiable risk factors such as fear-avoidance beliefs, catastrophic thinking, perceived disability and perceived injustice all have been found to play a role in the delayed recovery of injured workers. The workers' compensation [...]
The Insurance Journal reports that cost containment is the number one priority of employers (3/19/12 issue). Nearly half of the employers surveyed recently reported a Workers' Compensation premium increase. The latest statistics show approximately $60 billion in benefits paid almost equally divided between medical costs and payments directly to injured [...]