Ohio Workers’ Compensation

What are some casual factors employers can use when reviewing their accident investigation reports?

When an occupational injury occurs, there are a lot of casual factors that employer’s can use to prevent the next accident from reccurring.

1. Tasks - Ergonomics, safe work procedures, safety devices.
   Example:  Employee’s are not following the proper work procedure and
   are finding ways to hurry to get their job done.
2. Material - Equipment  Failure, Machinery Guarding, any Hazard Substances
   Example:  No notification to management of any minor problems with the machines or tools
3. Environment - Weather Conditions, Noise Levels, Personal Protective Equipment
   Example: Winter weather such as ice and sleet causing slips and falls
4. Human Factor - This could be personal such as Level of Experience, Internal Training, and Stress
   Example:  Management not taking the time to give proper training 
5. Management - Management Support and Safety Policies
   Example: Not enough upper management support to enforce safety policies

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Just another way to control your Workers’ Comp cost - The $15,000 Medical Only Program:
 
- BWC sponsored program which helps keep costs from appearing on your rating experience
- Will help keep rates and premiums lower despite claim activity
- Makes the employer the manager of medical only claims
- The employer agrees to pay up to $15,000 in medical costs per claim
- The employer can pick and choose which claims they want to be a part of this program
- The employer can also withdraw a claim from the program at any time even if they have not paid the full $15,000 yet
- The employer must pay all invoices in a timely manner
- The employer also must keep a payment log as the BWC can audit these files

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Having a relationship with a provider prior to an accident occurring is a simple way to control costs and help ensure that your employee receives the necessary appropriate care.

Benefits of having a preferred provider:

• Provider will already know that you have transitional duty available and will be more likely to release an employee to restricted duty.
• Your employee will receive appropriate care and appropriate referrals.
• If your employee feels that they are being cared for, they may be less inclined to seek an attorney or respond to the marketing calls of providers that may not have your employee’s best interests first and certainly not your costs in mind.
• Having a preferred provider helps in unnecessary treatment being rendered and billed to your experience.

The provider is critical in management of the claim. By maintaining an open relationship with the provider, you increase your chances of returning an injured employee to full duty in an appropriate time frame.

Understanding the importance of the medical provider in managing a workers compensation claim can have a major impact in controlling the overall cost of the claim.

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The Occupational Safety and Health Administration (OSHA) requires employers to maintain records of occupational injuries and illnesses. 

Here are 10 important facts to remember:

1. Employers must maintain the Log of Work-Related Injuries and Illnesses (Form 300) and the Summary (Form 300A)
2. Records must be kept on a calendar year basis
3. If an employer has ten or fewer employees, you are NOT required to maintain the OSHA recordkeeping forms
4. Record injuries that result in death, loss of consciousness, days away from work, restricted work activity or job transfer, or medical treatment beyond first aid
5. The annual summary (300A Form) must be posted every year from February 1st to April 30th (the year following the year covered by the form)
6. An employer must retain the Log and Summary for 5 years following the year to which they pertain
7. Employees can request copies of the forms and employers must provide access or copies within the next business day
8. Work related deaths must be reported within 8 hours
9. Employers do not have to send in completed forms to OSHA unless requested to do so
10. Failure to maintain the Recordkeeping Logs and Post Log Summary will result in penalties of approximately $2,000.00  

The Bureau of Workers’ Compensation offers courses in OSHA Recordkeeping. 

For additional information, please visit www.ohiobwc.com or www.osha.gov.

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When a claim does occur go over all of your options with your partners (TPA/MCO). 
Here are some other items to keep in mind:

1. Wage continuation – contact your TPA to do a study to show cost benefits.
2. Modified Duty Off-Site (MDOS) – this can be coordinated with your TPA/MCO/Rehab provider. Offering a position at a non-profit within the injured workers’ restrictions is a good faith job offer.
3. Independent Medical Exams (IME) – consider getting your own company exam.  DID YOU KNOW:  BWC will no longer incorporate an additional allowance exam with extent of disability.  This is delaying the return to work process – you as the employer/TPA need to be aggressive.
4. Light duty/Transitional work – be flexible. 
   Work with your partners (TPA/MCO/Provider) on getting the injured worker back to some type of meaningful work.
5. Vocational rehabilitation – several different programs offered through the BWC surplus fund.  Research all of your options with your TPA/MCO. 
6. Functional capacity exam (FCE) – exam must be approved by the treating physician of record on a C9.  This exam will reveal the physical (function) as it relates to the injured workers’ job.  Work with your TPA/MCO to see if this is an option that should be considered. 

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It is hard to believe that 2007 is nearing the end.  Fall is right around the corner, the weather changing, leaves falling from the trees and yes, your yearly review of your claims experience that will make up your 2008 rates.  Unfortunately, there are few things that can be done to improve what has already happened but there are a few things to keep in mind. 

1. Settle claims – this various from claim to claim. Claims must be filed with the Bureau of Workers’ Compensation by 11-15 to impact the next year’s ratings.
2. Handicap reimbursement – impacts lost time claims that had wage continuation or TT paid out. A claim review should be completed to see if any of your lost time claims meet the BWC criteria (25 recognized conditions).
3. Review MIRA reserves – there is occasion where the BWC will set reserves in error. There should be a thorough review of your risk so that this does not occur.  If reserves are set in error – this can be corrected!

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