We often forget workers comp claims are about MEDICAL INJURIES. Your medical director, medical department, or consultant is a key resource to help interpret medical jargon accompanying work-related injuries or illnesses. Medical personnel can help you to determine the extent of work-related injuries and design transitional duty jobs to get injured employees back to work. 

Several responsibilities of the medical director are:

1. Visit company facilities at least once per year.
2. Observe and document the physical requirements for all jobs to determine which of them have the potential to become transitional duty positions.
3. Assess the company's transitional duty program positions.
4. Telephone the treating medical providers BEFORE they prescribe time out of work for an injured employee to discuss the possibility of transitional duty assignments.
5. And many more... in Chapter 4 - Roles and Responsibilities.

Quality medical performance indicators in workers' comp encompass medical treatment, outcome, and cost factors similar to those in general health, but they also include non-medical functions. In workers comp, those non-medical elements can be primary drivers of cost, quality, and outcome. Karen Wolfe, BSN. MA, MBA President, CEO MedMetrics, LLC advises.  

We recommend a three prong approach to employer Best Practices in workers compensation cost control. While there are many best practices, these three are critical - and basic. Read on.

The purpose of the MSA is to have the carrier pay the actual cost of needed treatment, until the Medicare coverage kicks in to pay. But the number received for the MSA may not be the actual costs the carrier has an obligation to cover. Frequently, there are errors that may be included in the costs, and those errors can be costly. So how can that cost be decreased and also the MSA be approved by CMS?  How should these MSA cases be handled in general?

In Part III of this series, we look at the physical examination in light of the patient's history and expand on implementation of conservative primary care services that we can provide within our current scope of practice. The utilization of doctors of chiropractic to coordinate patient care should help reduce our nation's health care costs by preventing and managing chronic illness. By David C. Radford, DC David R. Seaman, DC James F. Winterstein, DC Robert C. Jones, DC.

Caution! The fastest growing area of workers compensation fraud is narcotics abuse. The fake workers comp claim for the purpose of feeding a drug addiction, or for the purpose of obtaining narcotics for resale, is a fast growing problem. Employers and claim adjusters should proceed with caution when an employee has been given a narcotic prescription. Pill mills often try to camouflage the activity as pain management clinics, but there are red flags. 

Fatalities from falls are the No. 1 cause of workplace death in construction. The National Roofing Contractors Association (NRCA) previously had voiced its opposition to OSHA's regulatory directive, believing it will hinder rather than improve workplace safety and make it more difficult for roofing contractors to operate their businesses. Read more.

"Despite the fact that safety gauges and devices were inoperable, the employers chose to proceed with the operation and risk the lives of their employees," said Brian Sturtecky, OSHA's area director in Jacksonville.

OSHA found employees exposed to falls from heights of 6 to 20 feet while performing exterior and interior framing work without fall protection or near an unguarded window, floor and stairwell openings, which resulted in a citation for one willful violation with a $28,000 fine. Read on. 

WorkSafeBC's Board of Directors reports it has approved amendments to Part 4 of the Occupational Health and Safety Regulation, regarding a third option to protect workers assigned to work alone in late night retail premises.The amendments become effective April 15, 2012. 

Don't gamble when it comes to Medicare/Medicaid Compliance!  

Gould & Lamb, LLC gather together some of the industry's most respected leaders and experts to provide attendees with 2 full days of compliance education and training, as well as an exciting look into the future of Medicare/Medicaid Compliance.

RIMS Conference and Exhibition is the largest industry conference. If you are new to workers compensation or experienced there are seminars to teach cost containment techniques.