21
Workers Comp Overview & Accident Investigations RCS Presentation

Workers Comp Overview & Accident Investigations RCS Presentation

Embed Size (px)

Citation preview

Page 1: Workers Comp Overview & Accident Investigations RCS Presentation

Workers Comp Overview&

Accident Investigations

RCS Presentation

Page 2: Workers Comp Overview & Accident Investigations RCS Presentation

Overview

What is risk management?

Predators

Red Flags

Client Selection

Employee Orientation

Accident investigations

Page 3: Workers Comp Overview & Accident Investigations RCS Presentation

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

Page 4: Workers Comp Overview & Accident Investigations RCS Presentation

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

Page 5: Workers Comp Overview & Accident Investigations RCS Presentation

Potential Predators

Applicants/Employees

Customers

Staffing Company

Page 6: Workers Comp Overview & Accident Investigations RCS Presentation

Fraudulent/Suspect Claims –Who files them?

Drug related individuals…………………………….70%

Criminals/Ex-cons…………………...60%People earning close to minimum

wage………………..………………….90%

Page 7: Workers Comp Overview & Accident Investigations RCS Presentation

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

Page 8: Workers Comp Overview & Accident Investigations RCS Presentation

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

Page 9: Workers Comp Overview & Accident Investigations RCS Presentation

Client Selection

Key areas of Client Qualification

Interview (communicationand documentation)

Facility tour

Summary

Follow up

Page 10: Workers Comp Overview & Accident Investigations RCS Presentation

Employee Orientation

General orientation– Staffing company’s concerns– Policies and procedures

General safety orientation– OSHA compliance– Industry hot topics

Client Site-Specific safety orientation– OSHA compliance– Task- and job-specific training

Page 11: Workers Comp Overview & Accident Investigations RCS Presentation

Accident Investigations

What do I do now?

Page 12: Workers Comp Overview & Accident Investigations RCS Presentation

We had an injury—now 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

Page 13: Workers Comp Overview & Accident Investigations RCS Presentation

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

Page 14: Workers Comp Overview & Accident Investigations RCS Presentation

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 notification—Fed 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.

Page 15: Workers Comp Overview & Accident Investigations RCS Presentation

The OSHA Regulation

1904.39(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, 1-800-321-OSHA (1-800-321-6742).

Page 16: Workers Comp Overview & Accident Investigations RCS Presentation

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.

Page 17: Workers Comp Overview & Accident Investigations RCS Presentation

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.

Page 18: Workers Comp Overview & Accident Investigations RCS Presentation

Accident Investigation Flow Chart

Page 19: Workers Comp Overview & Accident Investigations RCS Presentation

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?

Page 20: Workers Comp Overview & Accident Investigations RCS Presentation

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 don’t necessarily equal red lights – just require further investigation.

Client selection is a process – don’t just accept any job orders.

Train employees during orientation on accident procedures.

Page 21: Workers Comp Overview & Accident Investigations RCS Presentation

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 cases—a fatality or hospitalization of 3 or more workers is an OSHA reportable event.