Presentation on theme: "Workers Comp Overview & Accident Investigations. Overview What is risk management? Predators Red Flags Client Selection Employee Orientation Accident."— Presentation transcript:
Workers Comp Overview & Accident Investigations
Overview What is risk management? Predators Red Flags Client Selection Employee Orientation Accident investigations
The Need for Risk Management Staffing firms assume risk at the time a hiring decision is made and a job order is filled Typically 2nd greatest expense Cost containment becoming more critical
Goal of Risk Management Minimize exposure to loss Reduce expenses related to loss #1 cost containment strategy Create advantage to sell at a more competitive price
Potential Predators Applicants/Employees Customers Staffing Company
Fraudulent/Suspect Claims – Who files them? Drug related individuals…………………………….70% Criminals/Ex-cons…………………...60% People earning close to minimum wage………………..………………….90%
Summary of Possible Red Flags in Prescreen/Intake Phase Unwilling to: –complete our intake materials –comply with substance abuse policy –release background history Inquiries concerning: –drugs tested for –how far back criminal history will be checked –workers comp benefits Lethargic, inattentive, indifferent Gaps in work history Many jobs in a short period of time (job hopping) No work history No references Incomplete application
Client Selection Staffing services must consider the following: –View client as individual risk with opportunity for profit or loss –Ensure good assessment and understanding of the risks assumed –Decision is more than filling job orders –Decision extends your insurance coverage to client work sites
Client Selection Key areas of Client Qualification –Interview (communication and documentation) –Facility tour –Summary –Follow up
Employee Orientation General orientation –Staffing companys concerns –Policies and procedures General safety orientation –OSHA compliance –Industry hot topics Client Site-Specific safety orientation –OSHA compliance –Task- and job-specific training
Accident Investigations What do I do now?
We had an injurynow what? An accident may be: –A workplace injury –An incident involving property damage –A near miss situation where no one was injured, but corrective action is needed to prevent future injuries
Purpose of an Investigation Investigations should focus on: –Determining the actual cause of the incident Dangerous conditions Dangerous practices Improper training –Determining the validity of the claim –Making recommendations for prevention
How soon should this be done? Timeliness is critical for the following reasons: –Evidence may be changed or destroyed by normal work activity. –Witnesses will be more likely to give accurate accounts shortly after the incident. –Serious cases involve OSHA notificationFed OSHA guidelines require notification in 8 hours when a fatality occurs at the worksite or if 3 or more employees are hospitalized from a workplace injury incident.
The OSHA Regulation (a) Basic requirement. Within eight (8) hours after the death of any employee from a work-related incident or the in-patient hospitalization of three or more employees as a result of a work-related incident, you must orally report the fatality/multiple hospitalization by telephone or in person to the Area Office of the Occupational Safety and Health Administration (OSHA), U.S. Department of Labor, that is nearest to the site of the incident. You may also use the OSHA toll-free central telephone number, OSHA ( ).
Timeliness in reporting the claim to Corporate is also critical. The Corporate Claims Department will need to report the claim to the insurance carrier in a timely manner to avoid penalties. Getting the claims manager at Corporate and the claims professionals of the Insurance Carrier involved in the process gives us the full advantage of their experience and expertise before the claim gets out of control.
Corrective Actions We should always conclude the investigation with recommendations for preventive measures to stop similar incidents from happening in the future. Share these recommendations with employees and clients in an effort to provide a better workplace for our employees.
Accident Investigation Flow Chart
How does investigation tie in to Modified Duty? The investigation does not stop at the incident scene, it may extend to the treating facility. –Determine work restrictions –Communicate with employee and treating facility –Be prepared with assignments –Monitor the work –Do you remember the two primary characteristics of a good modified duty assignment?
In Summary: The goal of Risk Management is to minimize your exposure to loss. Predators come in many different forms. Use risk management techniques to screen them out. Red flags dont necessarily equal red lights – just require further investigation. Client selection is a process – dont just accept any job orders. Train employees during orientation on accident procedures.
In Summary: An investigation should be done for all incidents that involve personal injury or property damage. Near miss incidents are an opportunity for a quick investigation and recommendations to prevent an injury in the future. Timeliness is critical. Call Corporate for assistance anytime you have a question. Special casesa fatality or hospitalization of 3 or more workers is an OSHA reportable event.