Workers’ Comp Mastery – Training Courses

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

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:

- 30 day goals and action steps
- 60 day goals and action steps
- 90 day goals and actions steps

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