Is Football Contributing to Work Comp Fraud?

Author in the Reduce Current Costs category

What better thing to do on a Sunday than have a BBQ at home, watch some football, and then maybe go and toss the ball around. Going in for that interception! Tackle!

Did you know that work comp fraud is rising, and faking that football injury as a Monday work related injury could cause your employee to go to jail and/or be fined?

California employers in the insurance industry, District Attorneys, and an anti-fraud campaign are all playing a very important role in protecting your premiums and trying to keep these crimes down. As an employer, it is so important to keep both eyes peeled when employee injuries come about immediately after a weekend.

Unfortunately, there are people out there looking for free ride and we encourage you, the employer, to pay special attention after a claim has been filed.

Did the employee report the injury right away? Can they remember all the details of the accident? Were there any  witnesses? Also watch for changes in their story, or if you find they are doing activities that are not consistent with their injury. Finding out that your “injured employee” finally finished that kitchen remodel is very suspicious. If your employees hurt themselves at work and want to get better, they will attend all the necessary appointments.  Missing appointments can sometimes be reason to suspect fraudulent activity.

All these activities do not mean they are being fraudulent, but as an employer you always need to be on your toes and protect yourself, and your business, against workers trying to make an extra buck on at your expense.

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Preventing and Rehabilitating Injuries in the Workplace

Author in the Reduce Current Costs category

If you are like most people, you suffer an injury from time to time. No matter if it is as severe as a herniated disc, or as miniscule as a paper cut, it is still an inconvenience. Some minor injuries, like a paper cut, can simply be avoided by being a little bit more careful and maybe doing our work a little bit slower. While the same rule applies to preventing major injuries, they also require a little bit more work on our part.

The best ‘treatment’ for injuries is prevention. Good agility, technical skills, and cardiovascular and musculoskeletal fitness are important in injury prevention. In order to achieve all of these things, a multiphasic training regimen (training regimen consisting of multiple phases) should be used. A good multiphasic training program should include warming up and cooling down, the use of safe and familiar equipment, muscle strengthening exercises, cardiovascular exercises, and the training of neurophysiological functions (balance, coordination and reaction time). These are all essential in preventing injuries and they become increasingly important as you get older.

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How Can You Control Workers’ Compensation Costs?

Author in the Reduce Current Costs category

Regardless of the industry you’re in, the best way to control the cost of workers’ compensation premiums is to avoid injury claims. A safe environment, effective safety training, and ongoing programs to promote safe work habits are keys to preventing employee injury.

Once new employees are properly trained to perform their jobs safely, it’s important to maintain safety awareness. In addition to posting safety reminders in common areas, consider holding workshops or hosting safety seminars to talk in depth about the specific issues affecting workers. Providing incentives for good safety records is also a good idea.

In most states, workers’ compensation is “no fault.” That means that on the job injuries are covered by workers’ compensation insurance, regardless of the cause of the accident. In other words, if employees are injured on the job due to their foolish or careless behavior, those accidents are covered by your workers’ compensation insurance. This is why it’s crucial to continually promote safety awareness and safe work habits.

Workers compensation costs businesses over a half trillion dollars. You don’t have to accept your current levels of workers compensation claims or claim costs. Contact Proof:Positive today for a free initial consultation.

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Talking With A Doctor – Be Prepared

Author in the Reduce Current Costs category

Visiting a doctor’s office can make your injured workers nervous, impatient, or even scared. They may end up having only a few minutes with their health care provider. Later, they might remember something they forgot to ask, or they may forget what the doctor or nurse said. Being prepared can help them get the information they need. Here are some tips you can give to your injured workers to help them make the most of their doctor visit:

  • Make a list of their concerns, any allergies, and all the medicines, herbs or vitamins they may be taking
  • Provide a detailed description of their symptoms – when they started, what makes them better or worse
  • Bring a notepad – and use it
  • Have a trusted friend or relative to go with them

Make sure that your employee understands their diagnosis, any treatments they may receive, and encourage them to have their provider write down instructions. If they still have trouble understanding the different aspects of their injury, provide them with resources so they can gain the knowledge.

With all the work your company or business has to do, these issues may seem tough to handle. Proof:Positive can handle these issues for you. Proof:Positive can help monitor each injured employee’s case along with providing them with the knowledge and understanding of their injuries. Our Health and Wellness Rooms provide a platform for each injured employee to ask questions and help educate them on their injury and recovery. Proof:Positive has experienced medical staff in each room that can help your injured workers learn how to prevent, and recover from, their injuries. Contact us to see how we can help alleviate the worry and management of your injured workers.

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Is Daytime TV Addictive?

Author in the Reduce Current Costs category

Are Oprah or Jerry Springer offering addictive content in their television shows? Is this one of the reasons lost-time workers’ compensation claims can get out of control?

OK, maybe it’s not Oprah’s fault. There are complex psycho-social factors at work when an individual is off work, nursing an injury, with a reduced income. Managing these factors can help keep the individual out of a costly slump (costly to the employee and costly to the employer).

Every day an injured employee is away from work, the likelihood that they will return to work decreases, which is why it is important to have an early return-to-work program (ERTW) in place – to ensure that employees can recover in a safe and supportive environment. By providing access to an ERTW program you take an active role in your employees’ recovery, which benefits both the employee and the employer.

Proof:Positive has successfully integrated Health and Wellness Rooms into employer operations, supporting injured employees and saving companies money by effectively reducing the cost of work comp claims and returning injured workers to work quickly and safely. Contact Proof:Positive to learn how we can help you leave day-time TV for your competitors.

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Instruments of Recuperation

Author in the Reduce Current Costs category

“Just reading the material made me realize I could lose weight without having to exercise that much,” one of my injured employees said to me the other day. Simple eating changes accompanied by drinking plenty of water every day can improve health, weight, and skin problems – no matter what your activity level. Being idle because of an injury does not mean that you need to have an idle mind. When attending Health and Wellness Rooms injured employees don’t sit and watch television or get lost in the system – they get moving. Whether it is a walk, stretching or wellness education, nobody is left behind with a tailor made schedule to fit all work modifications. We want your employees to be BETTER, faster!

What could be better than finding out that even though you have an injury you can maintain and/or even improve your habits? 

The simplicity of having your employees on a modified work status program, coming into the Health and Wellness Room to learn about the injury that they suffer from, and discovering alternative ways to maintain weight and health while incapacitated, is reason enough to be excited that this option is out there for any sized company. I’ve been told by some employees in our Los Angeles Health and Wellness Room that they look forward to coming in after the weekend because they are getting better from stretching, walking, and maintaining a routine. Not only that, but the forestallment of future injuries is money saved as well. Because we are an advocate for the employer, we are your ally in employee recovery.

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Costly Medical Errors – Surgery Is Not Always The Answer

Author in the Reduce Current Costs category

“Potentially preventable medical errors that occur during or after surgery may cost employers nearly $1.5 billion a year, according to new estimates by the Department of Health & Human Services’ (HHS) Agency for Healthcare Research and Quality (AHRQ).”

“In a study published in the July 28 issue of the journal Health Services Research, AHRQ’s William E. Encinosa, Ph.D. and Fred J. Hellinger, Ph.D., found that insurers paid an additional $28,218 (52 percent more) and an additional $19,480 (48 percent more) for surgery patients who experienced acute respiratory failure or post-operative infections, respectively, compared with patients who did not experience either error.”

The authors also found these additional costs for surgery patients who experienced the following medical errors compared with those who did not: More…

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Social Capital – Funding the Trust in Workers’ Compensation

Author in the Reduce Current Costs category

The workers’ compensation system is filled with complex relationships and competing agendas. It can be confusing or even exasperating for an employee who must navigate this system alone. Employees need an advocate they can rely on while in the workers’ compensation system.

The employer must be that advocate.

By investing in prevention and early return-to-work systems, an employer can create social capital – the trust or ‘good will’ needed to maintain relationships – even in difficult situations. The key is to select a talented employee health partner. Proof:Positive can help you make these systems your own, by involving employees during every step. Engaging employees in prevention and the return-to-work process builds trust and shuts down the avenues for over-treatment and litigation.

Ask yourself this question: Do we give a F.I.G. about our injured employees? Use this mnemonic device to assess your organization’s ability to maintain trust when an employee becomes injured and enters the workers’ compensation system.

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Knowledge is Contagious – Give Your Employees the Forum to Learn

Author in the Reduce Current Costs category

Many factors affect our health. Some are beyond our control, such as genetic makeup and age – but we can make changes to our lifestyle. By encouraging your employees to take steps toward healthy living, you can help reduce the risk of heart disease, cancer, stroke and other serious diseases. Obvious practices are to eat well, maintain a healthy weight, be physically active and see a doctor for regular screenings.  

Incorporating these practices into lifestyles and routines can be difficult for those people who don’t realize their significance. Wouldn’t it be nice to have a place where your employees can learn this information while on the job and also have it available to your injured employees?  A Health and Wellness Room can help employees learn about a healthy lifestyle, which in return produces a healthy and productive employee. Knowledge is contagious and when one employee shares his knowledge about health or safety, it spreads to others.

Proof:Positive can provide your employee with a wealth of knowledge that will spread throughout your business. Proof:Positive can decrease your workers compensation costs through preventative measures or by educating the injured. All this can be done while they remain on normal payroll so lost time is reduced. Let us help you create a workplace filled with informed employees who are motivated to perform their duties safely.

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Spinal Tap: Secrets That Back Surgeons Won’t Tell You

Author in the Reduce Current Costs category

Low back pain is a universal human phenomenon. It affects, not just all occupations, but all age groups. In a given year over 80% of us will experience a bout of back pain. For about 50% of us it will be a memorable event. Between 10% and 20% will find the experience overwhelming. When employees suffer this predicament, they need support from the workplace to avoid becoming entangled in the medico-legal systems surrounding workers’ compensation.

An abundance of providers and products take aim at an employee’s back pain. Braces, mattresses, pills, therapies and surgeries are routinely applied to the aching back. Some of these interventions are ineffective, but harmless. Some are ineffective and harmful. None have proven to significantly alter the course or duration of low back pain.

Surgical stabilization has proven less effective than rehabilitation therapy for low back pain, as well as sciatica. Yet, spending for spinal fusions has increased over 500% in the last 15 years. Employers need not be duped into subjecting employees to ineffective or harmful care.

By providing a supportive workplace, the injured employee will recover more quickly, with better outcomes. Professionally staffed Health and Wellness Rooms offer exactly this kind of support. By remaining active, but within their physical limits, employees can experience quicker recovery from back injuries and return to work faster than employees exposed to surgical interventions. It’s a win-win for the employer and the employee.

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