29
Fall 2014 Issue
Safety & Workers’ Compensation
]
Under Ohio’s Health Partnership
Program, Managed Care Organizations
(MCOs) are responsible for the medical
management of Ohio employers’ work-
related injuries and illnesses. Every
employer in Ohio must have an MCO,
which is paid for directly by the Ohio
Bureau of Workers’ Compensation.
(BWC) from the premiums you pay for
coverage, which means there are no
additional out-of-pocket expenses for
employers for this service.
Serving as the Ohio Restaurant
Association’s (ORA) MCO since 1997,
Strategic Partner CareWorks focuses
its primary role on helping injured
workers recover from injury and restore
healthy, productive lifestyles as quickly
and safely as possible. This long-term
partnership with the ORA provides
CareWorks with a deep understanding of
the restaurant industry, especially when
it comes to medically managing injured
workers’ claim and returning them to a
productive lifestyle.
In fact, ORA members have access
to some of the most experienced and
dedicated nurse case managers and
medical case specialists, who possess
years of experience handling claims
and successfully getting restaurant
employees back to work. In addition to
this, CareWorks works closing with the
association to provide members year-
round access to educational information
related to workers’ compensation claims
via regular newsletters, seminars and
on-site meetings.
EARLY INTERVENTION
Before MCOs were utilized to medically
manage Ohio workers’ compensation
claims, it took restaurants on average
more than 36 days to report a new
workplace injury. Today, it takes less
than eight days. The earlier a claim is
reported, the faster a case management
plan can be developed, which leads to
more effective treatment and timely,
safe return to work. How long is it taking
your organization to report an injury?
For more information about CareWorks,
contact Derek Stern at (888) 627-7586,
ext. 3554 or
You can also visit
CareWorks’ MCO Services Safeguard ORA Members
The company’s commitment to getting employees back on the job strengthens your bottom line
- Arthritis
- Loss of sight
- Poliomyelitis
- Cerebral palsy
- Multiple sclerosis
- Parkinson’s disease
- Cerebral vascular accident
- Tuberculosis
- Silicosis
- Psychoneurotic disability
- Hemophilia
- Amputation foot, leg, arm or hand
- Chronic osteomyelitis
- Ankylosis of joints
- Hyperinsulinism
- Muscular dystrophy
- Arteriosclerosis
- Thrombophlebitis
- Varicose veins
- Cardiovascular and pulmonary disease (firefighters)
- Coal miner’s pneumoconiosis
- Completion of Industrial Commission or similar rehab program
- Service-related disability
SUBROGATION
• A type of third-party recovery
- Motor vehicle accident
- Medical malpractice
- Exposure to toxins
- Machinery malfunctions
- Animal bites
INDEPENDENT MEDICAL EXAMS (IME)
• BWC Independent Medical Examination – used to determine whether
the injured worker is capable of returning to his/her former position
of employment, or if the allowed conditions have become permanent
• Employer-sponsored IME/IMR (Independent Medical Review) – used
to provide medical evidence in support of an employer’s objection to
the claim allowance or compensation; the employer pays the fee for
this exam/file review.
SURVEILLANCE
• The employer hires a private investigator if red flags exist that may
point to fraudulent activity.
• The employer contracts directly with the investigator.
• If fraud is identified, it can be reported by calling BWC at
1-800-OHIOBWC or logging on to
This article was provided for reprint to the Ohio Restaurant
Association (ORA) by ORA Strategic Partner CareWorks
Consultants. For more information about what to do if a claim
occurs, contact your CareWorks Consultants’ claims examiner
at (800) 837-3200.
