1. Injury Management Overview
Axiom Medical Consulting, LLC
I encourage questions? Ask at anytime.
With any discussion on skin disorders, there will be graphic pictures
Caring is the Best Medicine®
25511 Budde Rd., Suite 801, The Woodlands, TX
(281)

2. Mission Statement
We are committed to providing the highest quality and cost-effective medical management services available to promote a safe and healthful environment for your employees
- Dr. Michael J. DeLitta
President & CEO

3. Service
The high road to service is traveled with integrity, compassion and understanding. People don’t care how much we know until they know how much we care.

4. Partial Client List Air Liquide Baker Hughes, Inc. BJ Services BP
Cactus Drilling
Chevron
ConocoPhillips
Cudd Energy
Encana
Exterran
Flint Energy
FMC
GDF Suez
Energy NA
Grey Wolf
Precision
Drilling
Halliburton
Honeywell
Key Energy
Marathon Oil
Mirant Services, LLC
PHI
Schlumberger
TEPPCO
Team Industrial Services, Inc.
Universal Ensco, Inc.
Weatherford

5. Injury Case Management Topics
Who Are We
Injury Management Process
Two Case Examples
Stats on Immediate Intervention
Closing

6. Who We Are Full Service Medical Department Physicals – OSHA, DOT
Drug Testing - DOT, non-DOT
Wellness
Case Management

7. Axiom Different From a TPA
We are NOT a Third Party Administrator (TPA)
We do not process Workers’ Comp claims
We do not negotiate or pay work comp bills
Case Managers, not Case Trackers

8. How TPA Different From Axiom
We are 24/7 - We don’t close at 5
We understand OSHA and its importance to our clients
All Case Managers (CM) are medically licensed (minimum of RNs)
Our CMs carry a case load of less than 15 – 20 cases (compared to 100 – 200)

9. Medical Staff Our staff consists of: Board Certified Physicians (MD)
Occupational and Environmental Medicine
Internal Medicine
Family Practice
Medical Review Officers (MRO)
Qualified Medical Examiners (QME)
Masters in Public Health (MPH)
Board Certified Physician Assistants (PA-C)

10. Medical Staff Continued . . . Psychologists (Ph.D.)
Registered Nurses (RN) with Bachelor or Masters of Science - Nursing (BSN / MS)
Certified Case Managers (CCM)
Certified Disability Management Specialists (CDMS)

11. Medical Staff Continued . . .
Certified Occupational Health Nurses (COHN)
Certified Occupational Health Nurses-Specialist (COHN-S)
Certified Occupational Health Nurses-Specialist/Case Manager (COHN-S/CM)

12. Injury Management Process
If the injury is critical or life threatening call 911 and then contact Axiom
Never delay treatment in the event of an emergency
If the injury is not an emergency contact Axiom before you transport the employee to a medical facility – this is important and will be explained

13. Injury Management Process
Call comes into Call Center and received by our Intake Specialists
Basic info taken and case is assigned to Case Manager (CM)
CM calls injured employee within 5 – 10 minutes

14. Injury Management Process
CM discusses incident and injury with employee
CM gather critical medical info
Supervisor is removed from treatment decisions
Determines if employee requires evaluation at medical facility

15. Injury Management Process
If a medical facility is indicated, CM directs employee to appropriate medical facility and provides initial info on case to health care provider
Speak with medical facility before employee leaves
Assist in getting post-accident drug and alcohol test –per company policy

16. Injury Management Process
If a medical facility is not indicated, CM will provide 1st aid recommendations and monitor employee’s condition
50% of cases never require clinic visit
CMs do NOT diagnose, nor do they need to in order to provide 1st aid measures

17. Injury Management Process
Employee and person calling in case (i.e., HSE, supervisor) must be in agreement with CM’s 1st aid recommendations)
If not, employee will be sent to medical facility for evaluation

18. Injury Management Process
CM provides a direct number to employee and supervisor to call with any questions, problems or changes
First goes out within 2 hours after treatment is completed
First follow-up call is usually made within first 4 hours; then 24 hours

19. Injury Management Process
This may mean calls in the evenings or weekends
Keep mgmt and HSE updated via phone and during entire process
Follow employee until able to perform regular duties or until adjuster assigned – depends on client’s preference

20. Injury Management Process
Ongoing dialog with employee, supervisor and treating doctor
Transitional duties (light duty)
Will assist with return to work exam, FCE, etc. if indicated
Important to determine if employee can safely perform all aspects of their job

21. Medical Case Management Case #1
Tuesday
3:30 PM - Employee (EE) holding a bolt and was struck in the hand by a sledge hammer by co-worker
4:00 PM - EE taken to local hospital
4:30 PM - Axiom called to intervene Called ER and spoke with charge nurse EE in x-ray

22. Medical Case Management Case #1
Tuesday
5:45 PM - Spoke with ER doc
X-rays negative
Diagnosis - hematoma
Plan to give prescription if infection occurs
Told doc we would follow case & look for infection. Prescription not written
Return to work (RTW) - full duty

23. Medical Case Management Case #1
Wednesday
8:45 AM - Spoke with Supervisor (Supv) and EE. EE doing well. Regular duties. Reviewed importance of OTC NSAIDs and ice
Friday
Spoke with EE and Supv. EE still doing well. No sign of infection. Case closed

24. Medical Case Management Case #2
Friday
8:25 AM - Pipe rolled off truck bed and struck EE in thigh yesterday
EE was Spanish-speaking only
EE had continued swelling and discomfort today, but was able to work

25. Medical Case Management Case #2
Friday
Had Spanish-speaking Case Manager speak with EE
Determined injury was soft tissue only
After getting thorough medical history EE was instructed on ice, heat, NSAIDs
Gave direct number to EE

26. Medical Case Management Case #2
Saturday
EE off work, but called him at home
Reviewed treatment plan and discussed starting heat on Sunday
Spoke with EE on Monday at work
Significant improvement. Told to continue treatment plan
Closed case on Tuesday

27. Outcomes of Injuries Without Case Mgmt Non-Work Related . . . . . . 0
First-Aid
Recordable
Restricted
Lost Time
TOTAL
With Case Mgmt
Non-Work Related
First-Aid
Recordable
Restricted
Lost Time
TOTAL

28. Immediate Intervention
75% of cases - notified same day
14% of cases - the following day
11% of cases - notified 2 days or greater
40% of these were over 1 week
80% of those were placed on OSHA 300
All 6 lost times fell into this category

29. Immediate Intervention
If case received within 24 hrs of injury the average time to close was 7 days
If case received within 2 days of injury the average time to close was 14 days
If case received on 3rd day or greater following the injury the average time to close was 32 days

30. Benefits To Employees
Immediate access to Medical Professional 24/7 for injuries
Employee can call CM at any time should medical condition change or if question comes up
Axiom Case Manager is not a “Company Doctor”

31. Benefits To Employer
Immediate access to Medical Professional 24/7 for injuries
Supervisor removed from treatment / medical decisions
Communication
Lower Claims Frequency/Severity
Reduction in Incident Rate, Reduction in Costs, Reduction in Modifier

32. Closing
It’s important to report injuries immediately – no matter how minor
A delay of reporting and treating injury by 1 day increases recordability by 60%
24 / 7 /365 coverage - (this is crucial)
Have only one number to call
(877) ( AXIOM)