Certified Master of
 Workers' Compensation
- Best In Class Program -

Curriculum

Injury Management Core (required for Best In Class, RTW , & Insurance Advisor, Specialties)

Core Course 1: Step by Step to an Elite WC Program

The Step by Step Process to Create an Elite Workers’ Comp Program

Reducing workers’ compensation costs is an outcome, not a goal. The goal is to put a proper program into place, reducing claims and returning injured workers to work. Implementation of a workers’ compensation management program is most successful in four distinct steps completed in a specific sequence and timeframe.

This session will cover the step-by-step process for you to assess your program, identify gaps, and implement solutions that will lead to significant workers' compensation savings.

This session will cover:

- Identifying strengths and weaknesses of current injury management systems
- Creating a timetable for highest priority items
- Where to start first, and what to do next in work comp management reform
- Creating meaningful benchmarks and metrics to measure success
- Building a team and holding parties accountable throughout the project.

And more...

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Core Course 2: Communication Strategies

Highly Effective Workers’ Comp Communication Strategies: What To Say & How to Say It

Communication in workers' compensation is the single most important tactic to learn and master. Every single aspect of work comp management will be better or worse depending on the effectiveness of your communication.

This training session will learn to ...

- Follow a Proven Script with Injured Workers Before and After an Injury
- Leverage Your Claims Management Team to Create Multiple Touch Points
- Prove the Value of Communication to Senior Management and Clients
- Demonstrate Care Quickly and Inexpensively

And more…

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Core Course 3: Return to Work

The No Holds Barred Definitive Guide to Return to Work Best Practices

Return-to-work is a fundamental best practice in workers' compensation management. The effectiveness of your return to work program defines the success or failure of your injury management system.

This training will cover:

- Critical elements of a transitional duty policy to build a solid return to work foundation
- Key points to reducing lost work days
- Getting employees back to work that don't like their job
- The right way to deal with doctors that won't give work restrictions
- Identifying light duty jobs that are valuable to the company, even for high wage earning employees.
- Latest research and evidence supporting pain management and recovery

And more…

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Core Course 4: Injury Triage

How to Leverage Medical Expertise To Immediately Return 95% of Injured Employees to Work

The best in class standard for returning injured employees to work is 95% within 0-4 days. There are many factors that go into achieving this goal, however, leveraging medical expertise ranks high on the list of critical factors, and can be the difference between employees returning to work rapidly or potentially being out of work for an extended and often unnecessary period of time.

This session will cover:

- What is the first thing you do when an employee is injured?
- How to get your injured worker to the right level of medical treatment for every injury.
- How Injury Triage really works.
- How to set up the treating physician relationship and what medical information you need to obtain.
- When / if you talk to the injured worker, and what are you supposed to tell him?

And more…

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    Core Course: 5 Critical Metrics

    How to Measure Workers' Comp Success with 5 Critical Metrics

    5 Critical Metrics make management understand the value of workers’ compensation management. 5 Critical Metrics keep management committed over time. 5 Critical Metrics measure the success or failure of your workers’ compensation program.

    We will cover the calculation and application of 5 Critical Metrics to address:

    - Workers’ comp viewed as a cost of doing business
    - Getting management to understand the value of return to work
    - Convincing policyholders to embrace a worker recovery program
    - Lack of informed and effective employer involvement in WC claims issues
    - Stakeholder apathy
    - Managers and supervisors not taking seriously their duty to protect workers

    And more…

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      Core Course 6: Train Supervisors

      How to Train Supervisors to Become Workers’ Comp Advocates

      Supervisors are often the first to respond to an injury and are a critical component of successful workers' comp management. Those supervisors who are appropriately trained to become advocates are the catalyst to drive superior work comp claim outcomes.

      This session will cover:

      - Supervisor impact on claim outcome from Liberty Mutual Research Institute
      - Overcoming conflicting roles of supervisors
      - Specific tasks for supervisors to complete before and after injury
      - How to immediately set the proper tone for the claim
      - Bringing supervisors on board and rolling out training in your organization

      And more…


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        Core Course 7: Evidence-Based Medicine 

        How to Use Evidence-Based Medicine to Create Better Workers’ Comp Claim Outcomes

        A common fact often forgotten is workers’ compensation claims are medical injuries and medical expertise is needed to get the best claim results. The workload of the everyday adjuster is unrealistic to expect accurate and appropriate medical determinations. This session will go in-depth on how to leverage evidenced-based medicine guidelines to empower claims handlers and drive positive claim outcomes.

        This session will cover:

        - Integrating evidence-based medicine tools into your claims process
        - Avoiding excessive medical treatment and unregulated compound prescriptions
        - Getting appropriate treatment approved
        - Proper utilization of doctor questions to push for needed interventions
        - Proper utilization of IME questions to move the claim toward resolution
        - Inappropriate use of Utilization Review

        And more…

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          Claims Core (required for Fraud - Investigation - Litigation and Claims Management Specialties)  

          Claims Core 1: Bulletproof Investigation

          How to Execute A Bulletproof Workers’ Comp Claim Investigation

          Good decisions in workers' compensation are made with good information. There is no time more important to lock-down good information than immediately following a work-related injury.

          In this training, you will learn:

          - Steps to properly preserve the scene
          - The exact questions to ask following an injury
          - The one crucial piece that is likely missing from your injury form
          - How to identify pre-existing conditions
          - Why eye-witness testimony is not the best
          - How to leverage your investigation to win litigation

          ... and much more!  

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            Claims Core 2: Nurse Case Management  

            How to Use Nurse Case Management to Improve Outcomes and Lower Workers’ Comp Costs

            Nurse case management in workers' compensation can be a highly effective service to improve outcomes and lower costs....when used correctly. When used incorrectly the nurse case manager can add additional expense with little to no added value.

            In this training session you will learn:

            - Clearly defined criteria for when, and when not, to use nurse case management
            - How to coordinate your nurse case manager as part of your team
            - Best practices you should expect from your service provider
            - Red flags for when hours billed are too high
            - Concrete data showing nurse case manager results
            - Typical fee ranges and common billing options

            And more…

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              Claims Core 3: Causation

              How to Determine Workers’ Comp Injury Causation

              The existence of a workers' compensation claim relies on the determination of an injury being legitimately work related or not. While many details of causation can be both medically and legally complex, employers and claims handlers need to understand key concepts in order to make informed and fair decisions.

              This training session will cover:

              - Action steps when an employee has a condition that may or may not be work related
              - If / Then case examples of what to do in specific scenarios
              - Red flags to look for as evidence of workers' comp fraud
              - When to leverage medical expertise to make a defensible determination
              - Using evidence-based medicine to complete a causation analysis

              And more…  

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              Claims Core 4: Early Indicators

              How to Identify EARLY Indicators of Expensive and Problematic Workers’ Comp Claims

              5% of claims account for 80% of workers' comp costs, and according to the Journal of Occupational and Environmental Medicine, 60-80% of lost workdays are unnecessary. These statistics illustrate the fact that a small number of claims are costing a large amount of money, and much of this money, time, and frustration is wasted and unnecessary.

              This session will cover the tools, techniques, and tactics to identify potentially problematic and expensive claims EARLY in the claim cycle.

              This session will cover:

              -Quantifying wasted claim dollars on your loss run
              -Simple characteristics of typical problematic claimants
              -Formal screening tests which deliver results
              -Bringing the claims handling team on board with screening tactics
              -What to do when an early indicator claim is identified
              And more...  

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              Curriculum

              Best In Class Specialty Courses  

              Specialty Course 1: ADA

              How to Coordinate Return to Work with ADA Compliance

              The interpretation and application of the Americans With Disabilities Act (ADA) is often confusing and overwhelming. In this session you will learn from Senior Attorney Advisor of the EEOC, Aaron Konopasky, on interpretations of this law in workers’ compensation, and how to coordinate return to work best practices with ADA compliance.

              Learn answers to the following and more...

              - Is a reasonable accommodation having someone do part of their job? Example all lifting?
              - How does the identification of light duty jobs factor into ADA's interpretation of reasonable accommodations?
              - What if the employee doesn't want to return-to-work, but wants to be out of work?
              - What if an employee, during the interactive process, says no, he or she is not aware of a reasonable accommodation?
              - If we have a transitional duty program, are we in jeopardy of being sued by employees if we terminate them because we cannot provide a reasonable accommodation?

              And more...  

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              Specialty Course 2: Hire Employees

              How to Hire the Right Employees to Avoid Immediate Workers’ Comp Problems

              Proper management of workers' compensation costs begins before an employer hires their first employee. Having the proper systems in place to hire the right employees will ensure they can safely perform the job, as well as avoid such negative actions as fraud, malingering, drug abuse, and theft.

              In this training you will learn...

              - how to address the challenges of finding the right candidates
              - best practices of employee selection
              - pre-employment screening options
              - physical testing options to ensure employees can safely perform work tasks
              - legal considerations and the Americans with Disabilities Act
              - ROI examples of implementing hiring best practices

              And more...  

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              Specialty Course 3: Sabotage 

              How to Avoid the Biggest WC Mistakes & Loopholes

              You’ve implemented a corporate return to work program, but your projected workers’ compensation savings haven’t yet materialized. It is time to examine the impact of collateral income sources and other common mistakes and loopholes.

              This session will cover:

              - Drivers of human behavior
              - The biggest mistake 79% of companies make with Return to Work
              - Collateral income sources
              - Concurrent employment
              - Disability insurance
              - Unemployment insurance
              - Company policies
              - Social Security
              - Incarcerated Claimants

              And more 

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              Specialty Course 4: Litigation

              How to Avoid, Manage, and Win Workers’ Comp Litigation

              The BEST way to reduce litigation costs is — to avoid litigated claims altogether. However, when claims do become litigated, it is important to be prepared in advance. Learn the secrets to manage, avoid, and win workers’ comp litigation.

              This session will cover:

              - How to avoid the litigation model of resolution
              - Establishing trust between the company and injured workers from various ethnic backgrounds
              - How to avoid litigated claims that balloon into much larger and more expensive claims
              - Dealing with other attorneys that have no concept of the complexity of workers comp law.
              And more…

               
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              Specialty Course 5 : Cost Allocation

              How to Create and Implement a Workers’ Comp Cost Allocation System

              5 Critical Metrics make management understand the value of workers’ compensation management. 5 Critical Metrics keep management committed over time. 5 Critical Metrics measure the success or failure of your workers’ compensation program.
              We will cover the calculation and application of 5 Critical Metrics to address:


              - Workers’ comp viewed as a cost of doing business
              - Getting management to understand the value of return to work
              - Convincing policyholders to embrace a worker recovery program
              - Lack of informed and effective employer involvement in WC claims issues
              - Stakeholder apathy
              - Managers and supervisors not taking seriously their duty to protect workers
              And more…

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                Specialty Course 6: Account Instructions

                How to Script Winning Account Handling Instructions

                Account Handling Instructions describe how your claims are handled, and will be given to any and every adjuster who works your claims. Properly scripting these instructions affects every aspect of your claims handling and is a CRITICAL step in a winning workers' comp management program.

                In this training session we will cover:

                - Defining settlement authority
                - Defense attorney selection
                - Investigation reports
                - File reviews
                - Timing of reports
                - Reserving Practices
                - Compensability Determinations

                And more..  

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                Specialty Course 7: Audit

                How to Plan, Prepare, & Execute a Meaningful Work Comp Claim Audit

                You are likely sitting on a gold mine of data that can hold the secrets to dramatically reducing your workers' compensation costs and improving injured worker outcomes.  In this session you will learn from 22 years experience in planning, preparing, and executing meaningful workers' comp claim audits.

                This session will cover:

                - The biggest benefits to conducting a claim audit (hint: it's more than just the data)
                - Why most companies time their audits incorrectly, and how to do it right
                - The art of selecting which claims to audit
                - The 6 most important elements to review in each claim
                - Critical steps to take after completing the audit

                And more…  

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                  Specialty Course 8: Culture

                  How to Create a Winning Workers’ Comp Culture

                  Company culture is the foundation on which an organization is built. It dictates customs, best practices, expectations, and 'how things are done around here.' Efforts to improve a singular aspect of workers' compensation management can be sabotaged by ingrained behaviors of the way things have always been done.

                  In this training session you will learn:

                  - How to take an honest assessment of your current company culture
                  - Tool and techniques to discern which current practices are sabotaging your work comp efforts
                  - Steps to improve employee relationships and company loyalty
                  - How to make communication 'authentic & natural' vs 'cold & corporate'
                  - How to use workers' comp management as a lever to improve overall company culture

                  And more...  

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                    Specialty Course 9: Select Doctor

                    How to Select the Right Workers’ Comp Doctor

                    The treating physician is an extremely important person in diagnosis, treatment, and recovery for an injured worker, yet, all doctors are not created equal. In addition, finding the right workers' compensation doctor has only become more complicated with specialized medical networks, and the emergence of telemedicine.

                    In this training session we will cover:

                    - Essential characteristics of the best medical networks
                    - How to identify the best performing providers in network
                    - What to require of your PPO account executive
                    - When telemedicine should and should not be used
                    - What to do when the employer can and cannot direct care
                    - Red flags which indicate you immediately find a new provider

                    And more...  

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                      Specialty Course 10: Prescription Drugs

                      How to Control Prescription Drug Costs, Avoid Abuse, and Deliver Pain Relief

                      Prescription drugs are the fastest growing component of medical care, carry huge lifetime costs in the treatment of injured workers, and have a high propensity for addiction. When left unmanaged, employers/payers are vulnerable to abuse from both prescribers and patients which drastically increases costs and can cause devastation in the lives of injured workers’.

                      In this training session, you will learn:

                      - Proper utilization of your pharmacy benefit management company
                      - How to customize your drug formulary
                      - How to ensure unauthorized prescriptions are not being filled
                      - Proactive drug management techniques to avoid overuse, abuse, and addiction
                      - How to deliver the right prescription, at the right time, for the right cost to help the injured worker recover.
                      - How to seamlessly integrate pharmacy management best practices into your work comp management program

                      And more...  

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                        Specialty Course 11: Settlement

                        The Process to Successfully Settle More Workers’ Comp Claims

                        Successfully settling workers compensation claims can have a positive effect both on an employers workers' compensation program, as well as the life of the injured worker. However, often claims remain open unnecessarily for months or years because the stakeholders involved have been unable to create a win-win outcome for the injured worker and payer.

                        In this session you will learn the process and system to consistently achieve successful settlements in workers' comp claims.

                        In this training, you will learn to...

                        - Identify Claims EARLY to Consider and Plan for Settlement
                        - Build Out and Leverage an Effective Claim Settlement Team
                        - Create and Consistently Follow A Settlement Process
                        - Create a Win-Win Outcome for Each Injured Worker with a Customized Settlement Package

                        And more..  

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                          Specialty Course 12: Silos

                          How to Break Down Silos & Apply Behavioral Based Safety Principles to Reduce Workers’ Comp Costs.

                          Workers' compensation management starts well before an employee is hired, or incurs an injury on the job.  Safety principles and injury management best practices should be two sides of the same coin, however, these two disciplines are often silos and lack connectivity.

                          This session will cover:

                          - Behavior-based safety best practices for the work comp professional
                          - Implementing a safety approach that supports injury management
                          - How to set realistic safety goals
                          - Overcoming management and employee stumbling blocks
                          - Essential elements to break down safety and injury management silos

                          And more…  

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                            Specialty Course 13: Trust

                            How to Develop Trust, Empathy And Improved Communication Skills

                            There is no one topic more important to the success or failure of your workers' compensation management program than developing trust, empathy, and communication. Every professional and personal interaction can be improved by developing and sharpening these skills.

                            This session will cover:

                            - The root definitions of trust and empathy
                            - How to deepen trust and the value of taking these actions
                            - Expressing empathy when it doesn't come naturally
                            - How to recognize and correct when you are saying one thing, and the receiver is hearing another.

                            And more…

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                              Step by Step to an Elite WC Program

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                              Bulletproof Investigation

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