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Return To Work Tammy Roberts, BA, CCM, CDMS, QRP.

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Presentation on theme: "Return To Work Tammy Roberts, BA, CCM, CDMS, QRP."— Presentation transcript:

1 Return To Work Tammy Roberts, BA, CCM, CDMS, QRP

2 The Dilemma

3 Current Trends NCCIs latest review indicates Overall claim frequency has increased for the first time since 1997 (3 percent) Workers compensation medical costs per claim average more than $6,000 and soar to nearly $25,000 for lost-time claims Prescription drug use is a medical expense that makes up 19 percent of all workers compensation medical costs

4 Impact Of Co-Morbid, Chronic Conditions Out of the approximate 300 million Americans, 133 have one or more chronic conditions 27 percent of the increase in healthcare costs is due to obesity

5 The Opportunity A well-coordinated education and early activation approach involving primary care physicians, employers and workers compensation systems, and targeting workers beliefs, perceptions and expectations, would likely be most effective Izabela Schultz, et al, Spine Vol. 27, No. 23 pp. 2720-2725, 2002

6 SAW / RTW Motivation Two factors of SAW / RTW motivation 1.Lose versus 2.Gain

7 Why? Reduce claims costs up to 70 percent Injured workers return to workforce 50 percent sooner Reduce likelihood of malingering and fraudulent claims Reduce litigation costs

8 Newtons Law Of Motion Things in motion stay in motion Things at rest stay at rest, unless acted upon by an outside force

9 Why? Workers compensation costs are reduced when temporary total disability benefits cease or are adjusted when an injured worker returns to work Decreased loss ratios and experience modifiers help control premium costs

10 Why? Productivity is maintained and human resources are used to the maximum extent Wage costs for substitute employees are saved

11 When? The earlier, the better Return-to-work policy should be in place prior to a work-related injury and clearly communicated to the employees Employees should understand the purpose and benefits of the return-to-work program

12 When? Employees should have an understanding of how work-related injuries impact the company Employees should be trained on the policy upon hire or implementation with reinforcement throughout the year

13 When? Employees should acknowledge an understanding of their responsibilities Job descriptions and modified job descriptions should be available prior to a work-related injury

14 How? What parts of the job can the employee perform What is not getting done Pacing, task-sharing options Skill and knowledge building opportunity

15 Who? Who is involved in the process? Employer Employee Medical providers BrickStreet claims adjuster BrickStreet return-to- work specialist BrickStreet nurse case manager Field case manager Modified duty off-site provider BrickStreet underwriter

16 What? Return-to-work policy Job description Modified job description

17 What? Correspondence to employee and provider Job function evaluation Physicians statement of capabilities

18 Questions? Thank You!

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