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Choosing the right doctor is the prescription for keeping Workers Comp costs down

Insurance Forums Staff

When an employee gets injured at work, very often they’ll report in to their supervisor, who usually says, “Go see a doctor.”

So where does the employee go? If they have a family doctor they probably go camp out in their waiting room, hoping that there’s an opening. If not, the injured employee might wind up in the black hole that is a large hospital Emergency Room.

The employee’s injury is going to require that they have their dominant arm in a sling for two weeks before they can return to their regular job. Which means that family or ER physician just signed an out of work order for two weeks and your client just bought two weeks of lost wage payments through their workers’ comp insurance.

This example illustrates the importance of making sure your business owner clients establish a relationship with a physician well-versed in occupational medicine when sending their employees to a doctor following an injury. Don’t leave it at the discretion of the employee. In most states, employers have the ability to direct injured employees to a doctor of the employer’s choice. The rules about this can vary by state, so it’s critical that you discuss the exact process with your employer clients.

Find them the right doc

Once it is determined that the business owner client has the right to direct care, you can help them find the right doctor. Start by searching for a doctor in your area who is board certified in Occupational Medicine. If you can’t find one, search your area for physicians that market services for Workers’ Compensation.

Once you find a doctor, then it becomes a matter of training your clients to consistently direct their injured employees to this physician. It won’t be easy to do at first, because most employers will simply tell the injured party to “go see their doctor,” which usually means a GP (General Practitioner). And although well-intentioned, this doctor will more than likely tell the injured worker to stay out of work and get some rest until he feels better, while perhaps even prescribing some opioids (which opens up a while different can of worms). The doctor won’t even consider a recovery-at-work scenario because in all likelihood he has absolutely no idea what his patient’s job entails and the employer makes no effort to communicate with the doctor about the recovery at work options they have available.

Unfortunately, that’s not what you or your client wants. The idea is to get them back to work as quickly as is safely possible. So it is imperative to establish an effective return-to-work program which will get the employee back to work faster, perhaps on limited duty, which is going to stop the payout of a claim and have a positive impact on the all-important experience modification factor.

The goal of having your client develop a solid relationship with a Workers’ Comp specialist medical provider is to ensure that the doctor knows the client’s business and the physical demands that the employees are under. They should also have a good knowledge of the transitional work that the company has available. When a doctor knows that the company will accept an employee back to work on transitional duty, they are far more likely to send them back to work rather than send them home to sit on the couch and watch infomercials for attorneys specializing in accident victims.

Emergency Room a last resort

Another priority for your employer clients is try to steer them away from sending their injured workers to the ER, unless the situation absolutely warrants it, such as after hours or when an ambulance is needed due to the severity of the injury. An unnecessary ER visit will likely incur long waits for the injured party. Emergency Rooms are also more expensive and because of the nature of ERs, all follow-up appointments will have to be with another primary care physician.

A better alternative is an urgent care center, which generally has longer hours than a traditional office, the technology needed to diagnose typical workplace injuries, and very often physicians versed in workplace injuries. I would suggest you start looking in your immediate area for such a facility and steer your employer clients towards it. But when searching, do some due diligence first:

1. Make sure the waiting room doesn’t have a television set to daytime TV and the potential to watch an endless stream of attorney ads.

2. Make sure they have the equipment capable of handling common workplace injuries, such as x-ray machines to diagnose breaks and fractures, and slit lamps to detect foreign objects lodged in the eye. Because the fewer tests they have to send out, the quicker the process can proceed.

3. The urgent care facility also needs to have staff that understands the value of a recovery-at-work program versus recovering at home, which means the doctor must understand the basic functions of what the patient did at his job. You need to make certain that the doctor understands that people who recover at work get better faster.

4. If at all possible the physician should agree to visit the workplace, to see what is done, who is doing it, and what the potential perils are.

Extra effort pays dividends

Making sure your employer clientshave a relationship with an occupational medical provider in your area is imperative. Physicians have a blank check from the workers’ compensation insurance company every time they see an injured employee. When you work with a medical provider who understands workers’ compensation and occupational medicine, those checks are smaller AND the injured employee enjoys a more effective recovery. Every dollar the insurance company spends for a workers’ compensation claim will serve to increase your client’s experience mod. Strong medical providers are a proven piece of reducing an employer’s tax on workplace injuries.

The savings your extra effort to create this relationship with physicians schooled in occupational medicine will strengthen your client relationship and foster loyalty that could prove invaluable when renewal time rolls around.

Kevin Ring is the Lead Analyst for the Institute of WorkComp Professionals, which trains insurance agents to help employers reduce Workers’ Compensation expenses. A licensed property and casualty insurance agent, he is the co-developer of a new Workers’ Comp software suite that will help insurance professionals working with employers. He can be contacted at 828-274-0959 or [email protected].



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