28
Fall 2014 Issue
Safety & Workers’ Compensation
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A Claim Has Been Filed so What Can You Expect?
It’s important to understand next steps once a claim is filed
MEDICAL ONLY CLAIMS:
• Usually a minor injury
• Claims with seven or fewer days of disability usually results in a
small reserve for a limited period of time
LOST TIME CLAIMS:
• Claims with eight or more calendar days of disability
• Reserves can occur in lost-time claims
OCCUPATIONAL DISEASE CLAIMS:
• Claims where an employee contracts a disease in the course of
employment; these claims often develop over time
COST-CONTROL TECHNIQUES
THAT CAN HELP EMPLOYERS SAVE MONEY ON A CLAIM:
• Safety
• Accident investigation
• Salary/wage continuation
• $15,000 medical-only
• Vocational rehabilitation
• Transitional work
• Lump sum settlements
• Handicap reimbursement.
• Subrogation
• BWC/employer-sponsored IME
• Surveillance
SAFETY
• Make safety a high priority for your company
• Create a safety plan that will help reduce the occurrence of claims
• Involve all employees in safety efforts
ACCIDENT INVESTIGATION
• Communicate with your claims examiner as soon as the injury occurs
• Thoroughly investigate the circumstances of the accident
• Document evidence in writing
• Utilize accident report and photographs
• Obtain witness statements
SALARY CONTINUATION
• Should be considered for any claim if eight or more calendar days of
work will be missed, even if a claim is not certified by the employer
TRANSITIONAL WORK
• Reduces cost of hiring and training replacement
• Helps prevent injured worker’s adjustment to disability lifestyle
• No break or loss in income
• Gradually returns employee to full-duty work.
• Lower costs contribute to overall premium reductions
• Works in conjunction with salary continuation
VOCATIONAL REHABILITATION
• Return to work focused
• Closely monitored, individualized programs
• Participation is voluntary for the injured worker
$15,000 MEDICAL-ONLY PROGRAM
• Call 1-800-OHIOBWC, press 0, option 2, to enroll
• The first $15,000 of medical bills are paid by the employer in claims
with seven or fewer lost days from work
• MCO cannot manage the claim, authorize treatment or pay medical bills
• If a claim changes to lost time, the Ohio Bureau of Workers’
Compensation (BWC) automatically removes the claim from the program
• Once the $15,000 limit is reached, the employer should notify the BWC
• Medical cost is not charged to experience
LUMP SUM SETTLEMENT (LSS)
• Employer, injured worker and the BWC must agree to the LSS
• BWC pays settlement
• Settlement will eliminate the reserve portion of the claim and
prevent future payments
• Claim will remain in employer’s experience for four years
HANDICAP REIMBURSEMENT
• Reduces overall cost charged against employer in claims with
certain pre-existing conditions:
- Epilepsy
- Diabetes
- Cardiac disease
The best way to control workers’ compensation costs is to maintain a healthy, cooperative relationship with your
employees where communication is open and encouraged.
There are several different types of claims that an employer may experience.
