Workers’ Comp Mastery – Training Courses

One of most fundamental definitions of insurance is 'the transfer of risk. ' While this definition is universally agreed upon, not one single structure of workers' compensation insurance is right for all companies to accomplish this task.

Many factors go into the selection of the right insurance structure. This training will cover the various factors to consider, as well as the financial benefits of making the right decision.

In this training you will learn to:

- Determine Which Insurance Structure is Right For You (or your clients)
- Accurately Pair Risk Tolerance with the Correct Insurance Structure
- Define the Advantages & Disadvantages of Captive Models
- Maximize the ROI of Workers' Comp Management Improvements

And more...

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11 Lessons

95% of workers' compensation management is the management of human behavior. This is true for claims, and management of the supervisors and divisions leaders in charge of implementation at the employer site. For decades great companies have understood and implemented best practices to maximize the effectiveness of their internal leaders.

This session will cover the strategies and tactics of motivating participation and engagement in workers' comp management best practices using the tool of a cost allocation system.

In this session you will learn to:

- Identify the True Drivers of Manager's (or clients) Behavior
- Use Corporate Structure to Modify Manager 'Buy-In' to WC
- Create A Meaningful Cost Allocation System
- Implement a Cost Allocation System in a Step-by-Step Fashion

And more...

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10 Lessons

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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10 Lessons

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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9 Lessons

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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11 Lessons

The experience modification factor is a snapshot assessment of risk for an insurance carrier. In guaranteed cost programs it is a primary factor in the pricing of workers' comp premiums, and this formula is key to understanding how injury management best practices result in lower costs. For high deductible and self-insured employers, the experience mod offers a simple benchmark which can be leveraged for greater program insight.

In this training you will learn...

- how to speak in simple language about the complex mod formula with clients or senior management
- what elements of workers' comp claim costs actuaries view as most important
- how changes in claim outcomes affect premium pricing
- the simple formula to calculate your minimum experience mod
- the impact of one claim on your experience rating

And more...

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13 Lessons

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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10 Lessons

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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10 Lessons

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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10 Lessons

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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11 Lessons

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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10 Lessons

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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10 Lessons

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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10 Lessons

5% of workers’ compensation claims account for 80% of total costs. For this small group of claims the stakes are highest in both financial dollars and impact on the injured worker’s life. Knowing how to approach these claims, what strategies to use, and when can make a dramatic difference in the claim outcome.

This training session will cover:

Critical injury response elements at the time of injury
The best ways to approach, and resolve, old dog claims
Specific claim examples of turning around a difficult scenario
Effectively using nurse case management
The little things that make a big impact
Coordinating appropriate medical treatment

And more…

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12 Lessons

The total cost of workers' compensation is calculated as Payroll x Class rate X Experience Mod x Adjustments = Premium + Losses (loss sensitive program). A strong system of injury prevention and management is the major determining factor of the variance in total workers’ compensation costs between similar employers, however, mistakes in employee classification mean the employer is paying more than necessary.

This training session will cover:

Examples of immediate financial impact of proper employee classification
Common class code errors and opportunities
How and where to find payroll deductions in your state
The process to verify the accuracy of class codes in your organization
The biggest mistake companies make
Preparing for the workers' comp premium audit

And more…

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10 Lessons

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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10 Lessons

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 cover:

- How employees learn about workers' compensation and set their expectations
- Important aspects about workers' comp employees need to know
- Creating a system of communication to create consistency
- Exactly what to say to an employee before and after an injury
- Leveraging your claims management team to create multiple touch points

And more…

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10 Lessons

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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10 Lessons

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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9 Lessons

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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9 Lessons

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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8 Lessons

A common statement regarding workers’ compensation is “I hope we have a good year”, or “we’ve been lucky/unlucky the last couple years.” The reality is hoping for good luck has very little to do with workers’ compensation success or failure.  Workers’ comp success is driven by a comprehensive systematic approach to injury management, however, it’s often 1 or 2 tactics that make all the difference.

This session will cover:

- 11 tactics to drive workers’ comp success
- How to identify which 1 or 2 tactics will work for you
- Where to start if you are at ground zero
- Getting into the end zone if you are at the 5-yard line

And more…

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9 Lessons

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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9 Lessons

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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8 Lessons

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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9 Lessons

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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9 Lessons

Bringing old dog, expensive claims to settlement can have a positive effect both on an employers workers' compensation program, as well as the life of the injured worker. In this session, you will learn the trade secrets to settling the most difficult and challenging workers' compensation claims.

This session will cover:

- Identifying and breaking down the biggest barriers to settlement
- The first step in approaching a "lost cause" case
- Coordinating risk manager, adjuster, plaintiff/defense attorney, and vendors
- The most powerful asset to bring a case to successful conclusion
- 3 case study examples: the challenges, the negotiation, and the resolution

And more…

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9 Lessons

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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9 Lessons

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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8 Lessons

Many employers are suspicious of working with unions, thinking that they support the filing of questionable workers’ comp claims. However, when done properly, working with labor unions can lead to significant decreases in workers’ comp costs. In this session learn the secrets that lead to one union representative we worked with to state “the result of your program was 20 more good years of work, we were facing job loss because of the stress workers’ comp had on the company.”

This training will cover:

- Identifying and placing individuals in jobs commensurate with their inflated union based wages
- Getting people back to work who really don’t like their job.
- Obtaining light duty releases from doctors that you can actually accommodate.
- Employee feeling of entitlement vs Return To Work
- Coming up with creative and valued transitional work duties

- And more…

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8 Lessons

Workers' compensation is a complex system with many stakeholders, and for those new (or even for many who have been around!), it can be overwhelming.
At the core, however, workers' compensation is very simple, to provide medical treatment and assistance to employees who are hurt at work, so they can return back to work.

- The WC Newcomers course will walk you through, step-by-step all of the critical aspects of workers' compensation you need to know to be up and running very quickly.
- At the completion of this course, you will have learned what it takes most people at least 10 years to learn about this industry.

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5 Lessons