By Rebecca Shafer


One of the main  goals in managing workers' compensation costs is returning your injured worker to work as soon as medically advisable. For this you need to review your special handling instructions, or SHIs to make sure the proper wording and instructions are in place for the adjusters. Knowing the SHIs allows you to design transitional duties or work-arounds for your employees and get them back on the job.

As you can imagine,  documenting the process thoroughly is critical. Once you have an injury management program in place, write an e-mail (you can also attach a Word document) to the account executive at your third-party administrator.

Nine Steps To Remember When Making Your Request:

1. Your e-mail  asks for the most recent version of the account instructions.
2. You copy  the claims VP at your broker.
3. You remind  your recipient you have an aggressive return-to-work program.
4. Acknowledge   your company can accommodate nearly all medical restrictions.
5. Mention you have a medical director reviewing all independent medical evaluations and examinations. This establishes the professionalism and thoroughness of your company.
6. Note  your medical director reviews claims to add details and ask the third-party administrator for additional verbiage corrections or changes.
7. Collaborate with  the third party administrator on the wording for any changes.
8. Summarize  by asking again for their suggestions and the copy of current account instructions.
9. Don't  forget to say thank you and tell them you look forward to their participation on your cost containment team.

We all know  the time from the moment of injury to final resolution can be lengthy. A competent business manages the process in an organized manner by monitoring all claims to ensure adjusters start working the claim as soon as it is reported.

Clearly define  the role of your adjuster and injury coordinator to ensure a delineation between the roles.  The injury coordinator provides input into overall "big picture" strategy on claims.  Adjusters determine compensability pursuant to state law on individual claims.

Guidelines for Managing Ongoing Workers' Comp Claims

1. Adjusters must contact  the employee, the employer, and the doctor immediately after the work-related incident occurs.
2. Adjusters must ensure  the employee receives medical treatment and medication.
3. Adjusters must notify  injury coordinator if the employee misses medical appointments.
4. If the injury  is questionable, adjusters must investigate the incident and immediately discuss this with the injury coordinator.
5. Adjusters should assist  in determining which transitional jobs best accommodate the physical limitations of injured employees.
6. Visit a claims' handling  office at least once a year to view claims handling and to develop a rapport with the adjuster. Sit "chair-side" for an afternoon - you'll be amazed at how much you learn.  (workersxzcompxzkit)
7. Invite the adjuster  to visit your facility to meet you, to learn job categories and physical demands of the jobs, and to observe or discuss transitional duty jobs. Include lunch.

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Rebecca Shafer, J.D., designs and develops workers' compensation cost-containment programs, and is the developer or Workers' Comp Kit®, an online automated tool kit with an assessment, benchmarking and improvement plan.  www.ReduceYourWorkersComp.com. Reprinted with permission.
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