Avoid Critical Failure

There is a Reason!

  • “Why all the fuss about my employees’ job tasks?”
  • “Why can’t we just send injured workers to the nearest medical facility?”
  • “What’s the big deal about getting injured workers back to work immediately?”

So, let’s take a deeper look at the three important questions above.

Why all the fuss about my employees’ job tasks?

Every single worker covered by a workers’ comp policy is assigned a workers’ comp code based on his/her specific job tasks.  A roofer obviously has greater risk of incurring injury than a clerical worker who sits behind a desk.  Therefore, the premium rate for a roofer is much greater than that of the clerical worker.  If a company, knowingly or unknowingly, reports inaccurate class codes, then premium is not accurately assessed based on the amount of risk inherent in that job.

Companies may try to fraudulently lessen their workers’ comp premium by reporting workers under incorrect class codes with lower rates.  However, there is great danger in doing so:

  • If an injury does occur, there is not sufficient premium to cover the costs of the claim.  This escalates a company’s experience modifier (emod) tremendously and the company ends up “paying” for that mistake for years to come.  (Emods are assessed to the entire payroll; therefore, one injury affects rates for all employees.)
  • At times, insurance carriers conduct field audits or will quiz unknowing reception personnel about the tasks performed by various workers.  If workers are found to be misclassified, some auditors will assign entire companies’ payrolls to the class code with the highest risk (and highest cost) and place the burden on the company to “prove” who should be classified differently.  This is a very costly process.
  • Carriers may also cancel policies, or refuse to renew or quote a policy for a company who misclassifies workers.

That’s why CBR works diligently to accurately classify every worker.

Why can’t we just send injured workers to the nearest medical facility?

In a nutshell, it creates problems for the employee and it is extremely difficult for CBR to assist the injured employee.  (It also drives up your workers’ comp rates!)  CBR strives to ensure that employees receive appropriate care from physicians who are accustomed to dealing with work-related injuries.  Though there are no “perfect” clinics, hospitals or physicians, we work diligently to establish protocols with providers (Concentra Medical Centers, whenever possible) in whom we are confident that:

  • Employees will receive quality care, without hassles.
  • CBR receives the information we need in order to best serve the injured employee.
  • Physicians will provide specific details as to a worker’s ability to return to work, even if it is only modified duty.  (Hospitals and most physicians will not provide this information.  However, occupational medical centers will readily provide this important information.)
  • Protocols can be established so that the clinic knows the exact requirements (post-accident drug screens, who to contact if there are questions, who to send reports to, etc) when an employee comes in for treatment.
  • We can negotiate the best rates for treatment.

Here are some consequences that may occur when an employee does not report to the designated medical provider:

  • The chances are much greater that the claim will be denied.
  • The injured employee is likely to receive bills from the provider and may either be held responsible for them, or reported to collections for not doing so.  (This happens very consistently when injured workers fail to report to the designated provider.)
  • If the undesignated provider is not on the carrier’s “preferred list,” the costs of treatment may be extreme.
  • We cannot adequately assist the injured employee because providers will not release information to us.  (This is especially true of hospitals.)
  • Because the undesignated provider is likely not an occupational medical specialist, they are not pro-active in getting workers back to work.  (This dramatically affects the cost of the claim, and ultimately your rates.)
  • There are usually significant problems for the employee.

In order to care for your employees and to manage every claim efficiently, injured employees must report to the designated provider. Whenever possible, the designated provider is Concentra Medical Centers.  They have locations throughout the United States and we have established protocols in every market in which we have clients.  If you are unsure of your designated provider, please contact Norma Torres (CBR’s Injury Counselor) at 602-200-8500 x2045.

What’s the big deal about getting injured workers back to work immediately?

The most important reason to get injured workers back to work is that studies show that ill or injured workers heal more quickly if they are productive!  It is in the employee’s best interest to maintain or resume work (even if it is modified duty) as soon as a physician deems it appropriate.  (The longer an employee is off work, the less likely he/she is to return to work.)  In addition, an employee who is not working cannot support himself or his family financially.

From an employer’s perspective, it costs you lots of money when an injured worker remains off work.  Failure to return workers to modified duty will affect a company’s emod and rates more dramatically than anything else.

Click here for more information regarding a Return-to-Work Program and helpful ideas for modified duty.

There is a reason we stay abreast of your employees’ job tasks.  There is a reason we mandate that all injured employees report to the designated provider.  There is a reason we are aggressive in getting workers back to modified duty.  The reason is that we are committed to providing your employees with the best care possible, and we are committed to containing your costs when it comes to workers’ compensation.

If you have further questions or would like additional information on these topics, please contact Kym Varner (CBR’s Risk Manager) at 602-200-8500 x2012.