From Birds to Cats: WorkCompEdge, One Step at a Time

(Part 2 of the Series "Getting Started with WorkCompEdge")

In last week’s blog I talked about tackling work comp issues “bird by bird,” so it seems only natural that this week we should move, in some fashion, to a discussion of cats, as in, “there’s more than one way to skin a cat.” This common idiom certainly applies to the many ways you could decide which work comp issues - and WorkCompEdge modules, if you're a member - your company should focus on first.

Print a copy of the Getting Started with WorkCompEdge survey and consult with other staff before you complete it online. Don’t worry if you’re not very sure of how to answer all the questions - it's meant to be an intuitive guide to identifying the work comp issues you should focus on first.

As we discussed in the last blog, the WorkCompEdge proposal report in ModMaster provides an excellent first step - and analytical method - for determining where to start making improvements to your company’s or client’s work comp picture. But we also think there's merit in a more intuitive approach, so that brings me to

Step 2 - Answer some key questions about your company's operations in our Getting Started with WorkCompEdge survey.

This survey, located at www.specificsoftware.com/wce/survey.htm, consists of 19 questions to help a company assess its work comp strengths and weaknesses. Each “question” is really a statement with which you can strongly agree, somewhat agree, somewhat disagree, strongly disagree, or indicate neutrality. All questions have a ranking of importance which we’ve predetermined, but your positive or negative answers will, of course, further impact that ranking. Leaving a question blank is the same as a neutral response.

OK, now for the tricky part. Depending on the size and structure of your company, it may be difficult for one person to immediately answer all 19 of these questions. We have two suggestions:

1. Print a copy of the survey and consult with staff including the controller, insurance or risk manager, safety team leader, human resource personnel, and CEO to get these questions answered before you complete the survey online.
   
   
2. Don’t worry if you’re not very sure of how to answer all the questions. This is meant to be a more intuitive approach than the WorkCompEdge proposal report, so just give your gut response and move on.

When you submit the survey (using the button at the bottom of the survey page), results will be shown as a prioritized list of the WorkCompEdge modules. Whether or not you’re a WorkCompEdge member, you’re welcome to use the survey as a guide to determining the work comp issues that most need attention in your company. Give it a try - you'll be the cat's meow!

http://www.WorkCompEdge.com
http://www.SpecificSoftware.com

Bird by Bird – WorkCompEdge, One Step at a Time

(Part 1 of the Series "Getting Started with WorkCompEdge")

Although I originally joined Specific Software as the programmer for ModMaster, nowadays I write words more often than I write code here at work. After I write and edit usage instructions, marketing pieces, educational information, web pages and endless emails - I then do the unthinkable, to some: I go home and write for fun. In all its forms – novel, memoir, poetry, etc. – I’m addicted to the written word.

How does this relate to you and work comp, you might ask? Well, one of my favorite books about writing is Bird by Bird: Some Instructions on Writing and Life by Anne Lamott. Believe it or not, some of the lessons in this book easily transfer to the process of improving your work comp picture. Bird by Bird got its title from an episode that Lamott relates in the book: when her brother was 10, he had to write a report on birds. He’d put it off and put if off, and now it was due the very next day. Lamott writes,

…he was at the kitchen table close to tears, surrounded by binder paper and pencils and unopened books on birds, immobilized by the hugeness of the task ahead. Then my father sat down beside him, put his arm around my brother's shoulder, and said, "Bird by bird, buddy. Just take it bird by bird."

Bird by bird. Doesn't any big project - whether it's writing a whole book, building a high-rise condo or planning to host the Olympics - loom large and unwieldly until you start breaking it into pieces? I hope that making changes to improve your work comp picture doesn't feel quite as overwhelming as those tasks, but let's face it: as the sheer number of modules (15) on the WorkCompEdge site attests, there are a lot of places you could start. How do you decide where?

Whether you're an employer or an insurance professional, here’s what you need to do:

Bird 1 - Start by learning what the mod can tell you

You probably already know that the mod is a number somewhere around 1.0, more or less, and that less is better. You hopefully know that the higher your mod is, the more you are going to pay in workers comp premium. If you’re in an industry like construction, you know that you may not be eligible to win contracts unless your mod is at least 1.0. But an analysis of your mod, which your insurance agent can do in our ModMaster software, will show you information such as:

• Your controllable mod – the amount of mod points you could save if you had no losses – and the corresponding money you could be saving on premium


• How much money you could be saving in premium for every point you trim from the mod


• How the number and severity of your losses compare to standards for your industry


• How your losses are trending, and therefore what you may anticipate for your future mod(s)

The WorkCompEdge Proposal report from ModMaster will show you or your client the top 5 or 6 areas of concern to prioritize when evaluating work comp improvement opportunities.

These factors and more are presented in the new, handy-dandy WorkCompEdge Proposal report in ModMaster, which then goes on to do some analytical behind-the-scenes crunching of that data to present the top 5 or 6 areas of concern that you should consider first. For example, if your analysis shows that loss severity is an issue, then this report is going to recommend you look at the Clock Is Ticking, Expedite Return-to-Work and Before and After an Injury modules first. If you have a frequency issue, it’s going to steer you towards the safety modules. If your mod is already great – either at or very near the minimum possible mod – then it’s going to steer you toward optimizing your costs through modules like Avoid Low Bid Mentality, Wellness, and others.

Here’s a sample of the WorkCompEdge proposal report in ModMaster. If you’re an agent, be sure to run it for your clients. If you’re an employer, be sure to ask for it from your agent. It’s a great way to decide – based on analytical data - which “bird” deserves your attention first.

http://www.WorkCompEdge.com
http://www.SpecificSoftware.com

Small Medical-Only Claims - To Pay or Not to Pay?

Editor's note: today we welcome commercial insurance broker and consultant Maureen Gallagher as a regular contributor to the WorkCompEdge blog and wiki. Maureen, a partner with Neace Lukens and founder of Insurance Partners Academy, will be bringing commentary, success stories and in-depth analysis on current workers compensation affairs to us on a monthly basis. Read Maureen's bio and this press release to learn more.

Will paying small medical-only bills rather than reporting them to the carrier save you money - or cost you? The answer's not simple!

The most common question an insurance agent gets from employers is whether or not they should pay (or continue to pay) small medical bills on workers compensation claims rather than submitting them to the insurance carriers for payment. The answer to this question is not simple. It can depend on several factors including:

1. Whether or not the state has approved the Experience Rating Adjustment (ERA) in their experience modification formula.

2. Whether or not the employer has expertise in paying according to the state fee or reasonable and customary schedule and/or has access to discounted medical networks as insurance carriers do.

3. Whether or not a small deductible to handle small medical claims might be more appropriate and assist in complying with state rules.

4. Understanding the state rules and penalties where the employer is located.

5. Whether or not the state of operation has a favorable alternative option for handling small medical claims.

6. How organized and detailed the employer is.

For this blog, we're going to focus on one concern related to the ERA, but a full article addressing more about ERA as well as these other factors is available to WorkCompEdge members here on our wiki in pdf format.

An Analysis of Reporting vs. Not Reporting in ERA States

Many of you do business in states which have approved the Experience Rating Adjustment (ERA) to the experience mod formula. Medical-only claims, also known as injury code 6 claims, are reduced by 70% in states where ERA is approved before they are utilized in the experience rating process. Also, the expected loss rate and discount ratio, used to compute expected losses and expected primary losses, have been changed to reflect that medical-only claims will be reduced by 70%.

Many feel the incentive to not report medical-only claims has been eliminated in states where ERA is approved. In the interest of showing that, I performed several “what if” scenarios on employers either reporting to the carrier or paying medical-only claims on their own in ERA states and its impact on the Experience Modification and the employer’s overall costs. The studies are conclusive that the employer did not save money by paying medical-only claims itself in an ERA state, particularly if the employer does not know how to apply the state fee schedule and/or has no access to discounted networks like those developed by insurance carriers. Here is an example.

No State Fee Schedule or Discounted Insurance Carrier Network Applied
	Premium	Experience Modification	Adjusted Premium
Cost (premium) where all claims were reported	$40,790.00	1.275	52,007.25
Cost (premium) where employer did not report medical-only claims	$40,790.00	1.18	48,132.20
Premium Savings due to reduction in experience modification for not reporting medical-only claims.			3,875.00
Premium savings over three years due to the reduction in the experience modification for not reporting medical-only claims			11,625.15
Medical Claims cost paid by the employer			13,981.00
Additional cost to employer due to not reporting medical-only claims			2,355.85

Conclusion

If you're a WorkCompEdge member, I hope you'll refer to the full article on our wiki for much more depth.

The variances among states dictate that there is no one, simple answer to the employer’s quandary of whether to pay small medical-only claims or turn them in to the insurance carriers for payment. An employer must weigh the advantages and disadvantages of paying small medical claims after obtaining a complete understanding of their state’s rules and laws, evaluating their staff’s ability to effectively manage their own medical bills and reviewing the insurance alternatives available that take paying small medical claims into consideration.

http://www.WorkCompEdge.com
http://www.SpecificSoftware.com

Thoughts about Claims Management - and the Electoral College

Barack Obama was yesterday’s winner by notable margins in both the electoral and popular votes, but those two sets of numbers (currently 349 to 163 in electoral votes and 52% to 46% in the popular vote, with a couple of states still not reported) still tell different stories. Every presidential election we are reminded that it’s the electoral vote that really counts. It is, as history and pundits remind us, possible to win the popular vote and lose the electoral vote. Now, hold on to your comments, as I'm not trying to make any political statement here, and I know we've all had our fill of polls and graphs lately. I mention these numbers as an example of the cliché: it’s all in how you slice and dice the data.

I recently met with top level claims representatives from a major insurance company to discuss some issues related to their management of several injured employee cases. These are good people striving to do a good job. They do difficult work in a challenging system.

When it comes to claims management, insurance companies and employers are looking at the data in different ways.

However, during the meeting, it suddenly occurred to me why employers – and the agents who serve them - are often at odds with insurance companies over the way injury claims are handled. We’re looking at the data in different ways. Simply put, insurance companies frequently have different goals, objectives, and measurements than employers. I was at the meeting to discuss 9 individual injured employees. They came to the meeting to explain the workings of a system that handles 20,000 injuries a year.

Insurance companies’ key measurement for workers’ compensation injuries is something called the pure loss ratio. This is the percentage of the premium dollar that goes to pay for injury costs. For example, their goal might be to spend no more than 60% of premium dollars on injury costs. Add expenses to that percentage and what remains is their profit, not counting investment income.

From the insurance company’s perspective, if they meet their goal, then their processes are working. They see the work comp world from an aggregate view, while we’re looking at specific injured employees.

Some might suggest that if insurance companies are not effectively dealing with the specific, they will not meet their overall objectives. However, there are times, as is now the case, when they are saved by legislative reforms which drive down injury costs regardless of their processes. When doctors and lawyers get reigned in by the legislature, everybody looks smart. But as the saying goes, just because you are standing on third base, that does not mean you hit a triple.

The employer’s primary objective is for the injured employee to get the best medical treatment and to get back to health and productivity as soon as possible. The insurance company’s primary objective is to meet a number. If they attain their aggregate goal, then they are not as open to improving their processes.

Thus, it is up to the employer to make sure the employee gets what is needed and is not just a set of dates and numbers “sliced and diced” in the insurance company’s claims system. The incentives are not aligned such that the employer can abdicate this critical responsibility to insurance companies.

http://www.SpecificSoftware.com
http://www.WorkCompEdge.com

Scary Work Comp Stories for Halloween

Trick or treat, WorkCompEdge blog readers. In the spirit of Halloween, this week we offer some scary stories contributed by our staff. Some are true and some are imagined, but all illustrate concepts of which employers should beware. Can you tell which is which?

Of course, we think the scariest thing of all is an employer who doesn't use WorkCompEdge!

Category 1: Do we really want this employee returning to work?

The employee who tried to siphon liquid chemicals with his mouth.

The skull and crossbones must not have been enough. Now there has to be a label that says "use an approved siphoning device."

The employee who instigated an assault that led to work comp claims for himself and another employee.

Talk about needing an improvement in corporate culture.

Category 2: They said that?

Employer: "What's wrong with putting our gear machine operators in code 8810?"

8810 is the common code for office and clerical workers. A manufacturer classifying all employees in this category would probably be charged with, let's see, falsifying business records and committing a fraudulent practice.

Employer, in incredulous tone: "That's the sixth work comp claim this employee has made?"

Needless to say, they hadn't been doing much with claims management.

Employer, on buying work comp insurance: "I went with the low bid."

Cliches are usually true. You get what you pay for.

Employer, on buying work comp insurance the next year: "I don't know why my premiums went up so much this year."

It's called experience rating. Your agent should be helping you understand it.

Agent to employer: "The mod? I really can't explain it, but I know it's better if it's low."

Time for a new agent!

Of course, we think the scariest thing of all is an employer who doesn't use WorkCompEdge! But in all seriousness, whether you're a member or not, take our Getting Started with WorkCompEdge quiz. It's nineteen questions that will help you assess the areas in which your company may be getting tricked - and what WorkCompEdge modules you should treat yourself to first.

http://www.WorkCompEdge.com
http://www.SpecificSoftware.com

Benchmarking Your Safety Culture

Safety is about more than programs, and measuring your safety culture is the first step in improving it. If you have trouble viewing the video above, try this link.

I recently attended a safety conference sponsored by Occupational Health & Safety Magazine in the Washington, D.C., area. One of the more powerful presentations was conducted by Bob Krzywicki, North America Operations Leader with DuPont Safety Resources.

Most of the safety-oriented presentations I’ve attended over the years have focused on a traditional safety engineering approach, such as “find a hazard and remove the hazard.” Mr. Krzywicki, however, had a different approach. He challenged the audience to think about safety performance as a corporate culture issue. He said, “Safety excellence is a cultural transformation that requires felt leadership.” Felt leadership, as implemented at DuPont, establishes safety as a core business value, starts at the top of the organization, and is felt at every level of the organization through employee involvement and accountability. Read more about DuPont’s felt leadership in this article.

In addition, Mr. Kryzwicki said a safety leadership culture can be measured and improved.

He outlined three components of safety culture used at DuPont: leadership, structure, and processes and actions.

Each component includes four elements which he calls the “12 Gifts.”

Leadership elements include:

• Management Commitment


• Policies & Principles


• Goals, Objectives, & Plans


• Procedures & Performance Standards

Structure elements include:

• Line Management Accountability& Responsibility
  
• Safety Personnel
  
• Integrated Organization
  
• Structure Motivation & Awareness

Process and Actions elements include:

• Effective Communication


• Training & Development


• Incident Investigation


• Audits & Observations

Kryzwicki asked the audience to take a leap of faith and measure their safety culture and leadership performance with perception surveys of managers, supervisors, professionals, and hourly workers. DuPont studies show the better the safety culture score, the lower the number and severity of injuries.

Those of you who are very familiar at all with the content of WorkCompEdge will know that I delighted to hear of DuPont’s experience and certainly think it’s worth emulating. Although WorkCompEdge doesn’t express safety culture in quite the same components and elements structure that DuPont uses, we definitely subscribe to the same message: safety is about more than programs, and measuring your safety culture is the first step in improving it. WorkCompEdge members can start that process today using the survey included in the module Build True Safety Culture - It's More Than the Incentive of the Month.

I am confident in DuPont’s findings and encourage employers to perform similar assessments of their own safety culture and performance now, before you attempt to polish any rough edges in the culture you may suspect exists. Although it may take some intestinal fortitude to digest the perceptions you uncover, particularly among certain segments of your employees, you need to establish a baseline of your current safety culture at all levels of your organization. Benchmarking is a critical first step to determining where you are so you can decide where you need to go.

http://www.WorkCompEdge.com
http://www.SpecificSoftware.com

How Will the GFM Affect Workers Comp - and You?

If you don’t recognize the acronym “GFM,” never fear: I couldn’t resist throwing a new one out into cyberspace. AcronymFinder.com says GFM can stand for, among other things, “gaming FM (radio)”, “general field marshal,” and “global financial market,” but around the office we’re using it as a convenient way to refer to the current “global financial meltdown.” As a pilot and former rocket scientist, I find acronyms tend to lighten the subject at hand… terms such as MAD (Mutually Assured Destruction), BMDS (ballistic missile defense system), or one of my personal favorites CFIT (controlled flight into terrain) don’t seem quite as threatening if you only use the initials. So, GFM is a “lighter” way to refer to a situation that’s very serious indeed.

During this GFM, it's important to remember that historically, employees who are stressed about job security or have personal financial difficulties tend to file more workers compensation claims.

The past few weeks have been incredibly dramatic and sobering: I feel like my brain has been rewired and I'll never see the world in the same way again. Many of our staff here are thankfully young enough that we have some time for our retirement funds to recover, but most of us also have concerns at a level we’ve never had before regarding the cost of children’s college educations, major purchases and investments of any type, etc. We’re hearing from our personal and business contacts that we’re not alone. So, I thought I would survey the WorkCompEdge team and share with you how we view the impact of the GFM on workers comp - for both employers and insurance agencies. Here are some thoughts from our team:

Employers

Employers should be alert for a possible increase in workers compensation claims. Historically, employees who are stressed about job security or have personal financial difficulties tend to file more workers compensation claims. To avert such a possible increase, we have these recommendations for employers:

• Be especially vigilant at this time about nurturing supervisors’ relationships with their employees, even when there may be negative news to report. Effective, proactive communication with employees is never more critical than now, when fear and rumors can undermine a company’s culture.
  
• Pay close attention to any claims that are filed: show care and concern for the injured employee. An injured employee is often under a lot of stress, but those stresses may have extra weight in this economy and therefore lead the employee into a downward, self-defeating spiral.
  
• Even if your business is off, don’t relax your return-to-work policy. For both the financial benefit to your company and the injured employee’s recovery, it’s paramount that you get employees back on the job in some capacity. A claim that is partially due to emotional stress or depression will be greatly exacerbated by sitting at home.
  
• Finally, this is a great time to reinvigorate or launch an employee wellness program. Get your workers walking at break time; hire a massage therapist for a special on-site chair massage day; make healthy snacks and decaf beverages available in your breakroom to ward off junk food binges some research suggests may be related to stress.

WorkCompEdge modules that are particularly applicable to the above points include:

• Before and After an Injury - The Crucial Role of the Supervisor's Actions and Attitudes


• Expedite Return-to-Work - It's Critical to Health, Morale, and Your Bottom Line


• Build True Safety Culture - It's More Than the Incentive of the Month


• A New Paradigm - Promoting the Health of Your Workers
  

Agencies

Your employer clients may be hurting financially, but this may mean they’ll be open to new ideas that will make a difference. The coming months will likely be an excellent time to move away from "low bid" philosophies and demonstrate how WorkCompEdge can be an effective tool to lower costs. Use the “Learn the lessons” module to show the employer the potential savings that come with lower losses and a lower experience mod. Then, sit down with the employer and use the WorkCompEdge ModMaster report or the online survey to help map out a strategy for implementing WorkCompEdge.

It looks like we’re going to be dealing with a recession for a while. Ask yourself, “What do my employers clients need most in recessionary times?” We think that one answer is lower fixed costs and a healthy productive workforce – exactly what WorkCompEdge can deliver - but we’re very interested in hearing what you think. Through our products WorkCompEdge and ModMaster, how can we help you help them?

For All Our Readers

Whether you’re an employer, agency, or other insurance professional, it may be time to understand that the best investment you can make is in your own company and in yourself. We want to know how we can help you do that. What challenges do you think the GFM will bring to workers comp in the coming months?

Please, let us hear from you – on the blog comments or by email to me, Tim or our blog editor, Kory.

http://www.WorkCompEdge.com
http://www.SpecificSoftware.com