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9 Painless Steps to Improve your Workers’ Compensation Program

Do your injured employees know what to do if they are injured on the job?

Do your supervisors know what information is needed if there is a workplace accident?

Do your supervisors know where they should send the document and/or report the injury?

Do your injured employees know where they should seek treatment for a workplace accident?

Do your supervisors know if they should obtain witness statements?

Does your company have internal accident investigation forms?

Do you know who to call for answers regarding an Ohio workers’ compensation claim?

If you can’t answer “yes” to all of these questions, here are some simple steps to streamline your workers’ compensation program:

  • Develop an Employee Claim Reporting Process
  • Establish a relationship with medical providers
  • Evaluate the need for Supervisor Training
  • Complete Accident Reports
  • Obtain Witness Statements and even Non-Witness Statements
  • Create and utilize your Safety Committee
  • Maintain regular communication with the Injured Employee
  • Document – document – document
  • Work with the experts, your Ohio Managed Care Organization (MCO)

Putting these procedures in place before the accident happens can really help when, and if, a workplace injury occurs. Remember to rely on the experts, your MCO, to help you through every stage of a claim.

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Why are my employees getting medical bills for their workers’ comp claims?

Have your employees ever received medical bills related to their Ohio workers’ compensation claim and wondered why they are being billed? Here’s the simple explanation, the physician’s billing office may not be aware that the charges are related to a workers’ compensation claim. To be certain, the actual statement will always tell the story. If it shows that the medical insurance was billed or there is a discount noted for not having insurance, that is a good indicator that the physician’s offices does not have the employee’s workers’ compensation information on file.

The best way to remedy this situation is to act quickly and follow these simple steps:

  1. Have the employee contact the physician’s office to clarify the injury was work related. Your employee will need to have their BWC claim number and Managed Care Organization’s (MCO) contact information when they speak to the providers’ office.
  2. You, as the employer of record, can contact your MCO right way to discuss the matter. Your MCO will be able to assist you and your injured employee to ensure the bill is properly addressed with the physician’s office.
  3. The employee can then follow up with the physician’s office to confirm their records have been properly updated to reflect their injury is a workers’ compensation claim.
  4. The employee or you can follow up with your MCO to verify the physician has billed the MCO and payment will be forthcoming.

Your employees should not receive any medical bills for their workplace injury. If, at any time during the life of the claim, they do get a bill, make sure you follow the steps outlined above. Immediate attention to medical billing statements will prevent any collection activity that could negatively impact credit scores. Remember to always work with the experts, your MCO, to ensure workers’ compensation medical bills are paid accurately and timely.

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Finalizing your Return to Work Toolkit

In our previous posts, we talked about building your Return-to-Work Toolkit. Now, we’re going to wrap up what is needed to complete your Return-to-Work options regarding your Ohio Workers’ Compensation program.

There are many different strategies for employers to use in an attempt to return an injured employee to work in a safe and timely manner.  As a quick review, here are the following Return-to-Work Strategies we have addressed:

  • Collaborating with your Managed Care Organization (MCO)
  • Communication
  • Creative Thinking
  • Utilizing the programs available
  • Creating a modified duty job position
  • Effectiveness of your job descriptions
  • Transitional Work

Vocational Rehabilitation

Vocational Rehabilitation is another tool to assist with getting injured employees back to work. This is a program designed for lost time claims only. There are many different services available through the vocational rehabilitation program, but before an injured worker can enter the program, they must be referred. The employer can make the referral, or the physician of record, third party administration, MCO or others can also make the referral. If referred to vocational rehabilitation and accepted, the injured employee must agree to participate.

Here are some key factors to look for when determining if vocational rehabilitation is a good option:

  • Claim must be a lost time claim
  • The injured worker must be off work at the time of the referral
  • The Injured worker is experiencing a significant impediment to maintaining employment due to the allowed condition
  • The injured worker has restrictions

The vocational rehabilitation program offers many different services, including, but not limited to:

  • Job development
  • Job retention
  • Job placement
  • Job search
  • Work hardening
  • On the job training
  • Transferable skills analysis

Remain at Work

In additional to return to work strategies, employers also have a Remain at Work program available to them for their Ohio Workers’ Compensation claims. The Remain-at-Work program is for injured workers who have medical only claims but are experiencing difficulties that could lead to lost time. If this is the case, contact your MCO right away to discuss the difficulties and collectively determine if the injured worker needs any specialized services.

Any injured worker with a medical only claim that is experiencing difficulties at work due to the allowed conditions, and the difficulties have been identified by either the injured worker, employer or physician, is eligible for the Remain-at-Work services.

Your MCO will document the difficulties the injured employee is having and then develop a Remain-at-Work plan. Services covered under the Remain-at-Work plan include but are not limited to:

  • Ergonomic study
  • Job analysis
  • Transitional work
  • Physical or occupational therapy offered on-site
  • Job modification
  • Tool and equipment
  • Remain-at-Work field case management
  • Gradual return to work
  • On the job training

It is important to remember that if your organization experiences a workplace accident, it is imperative to communication with your MCO early and often, discuss the different return to work options available to determine the best strategy.

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Electronic filing of OSHA logs means employers have 2 deadlines in 2017

The Occupational Safety and Health Administration (OSHA) requires that covered employers maintain records of occupational injuries and illnesses. A summary of those records must be posted by Feb. 1st each year. Earlier this year (May 12, 2016), OSHA published its final rule on a new requirement for employers to also submit OSHA records electronically through the OSHA website. The electronic 300A Summary report must be submitted for the 2016 calendar year by July 1, 2017.

This means covered employers now must meet two requirements/deadlines: Feb. 1 for the 300A paper summary and July 1 for the electronic version of the 300A summary.

Did you know?

  • Not all Bureau of Workers’ Compensation (BWC) workers’ comp claims are OSHA log recordable.
  • Not all emergency room visits are OSHA log recordable.
  • Non-compliance in recordkeeping and submission delays can cost your company thousands of dollars.
  • Employers are required to retain their current records plus records from the previous five years.

OSHA uses records of injuries and illnesses to determine the effectiveness of existing safety and health standards. Sheakley can help you understand the requirements of OSHA Recordkeeping, industries that are partially exempt from recordkeeping forms, and the fines associated with non-compliance.

Sheakley’s safety team has upcoming training sessions about OSHA Recordkeeping and more! To find out more and register, go to sheakley.com/safety-training.asp, choose the Monthly Safety Webinar option then scroll to find the session you’d like to attend.

Not all employers are required to file OSHA logs. Not sure if this applies to you? Sheakley can help – simply email safety@sheakley.com for guidance.

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DOL Overtime Rule Blocked in Federal Court

On November 22, Federal Judge Amos L Mazzant III allowed a preliminary injunction motion seeking to stop the revised regulations from taking effect nationwide on December 1, 2016. The Department of Labor’s (DOL’s) new federal overtime rule would have doubled the Fair Labor Standard Act’s (FLSA’s) salary threshold for exemption from overtime pay. In October, 21 states and various chambers of commerce and business groups filed separate suits in opposition of the changes, claiming the DOL surpassed its authority by raising the salary threshold too high. Judge Mazzant heard arguments from both sides, and issued the court’s ruling to stop the revised rules from taking effect.

For now, the rules are temporarily on hold until the judge decides to grant a permanent injunction or grant the states motion for summary judgement. This preliminary injunction is not yet permanent and simply preserves the existing 2004 overtime rule. It may be still implemented down the road. Many employers have already raised exempt employees’ salaries or reclassified employees who did not meet the minimum salary requirement. Employers have a choice to make as to whether they go forward with the changes already in the works, or to put them on hold pending the final outcome of the litigation.

Some congressional alternatives to the DOL rule are currently being reviewed with the halt of the previous changes.

  • The Regulatory Relief for Small Businesses, Schools, and Nonprofits Act proposes delaying the effective date of the overtime rule by six months, from December 1, 2016 to June 1, 2017.
  • The Overtime Reform and Enhancement Act was introduced to the House in July and has more limited aims. The overtime rule would be phased in over four years and eliminate the automatic triennial inflation-based increase of the exempt salary threshold. Instead of raising the exempt salary threshold to $47,476, this bill would raise the new threshold this December from $23,660 to $35,984. It then would raise the threshold to $39,814 on Dec. 1, 2017; $43,645 on Dec. 1, 2018; and $47,476 on Dec. 1, 2019.
  • The Overtime Reform and Review Act was introduced in September and would provide the same step increases as the Overtime Reform and Enhancement Act, but at a slower pace and with no increase in 2017: $35,984 on Dec. 1, 2016; $39,814 on Dec. 1, 2018; $43,645 on Dec. 1, 2019, and $47,476 on Dec. 1, 2020.

If the DOL’s overtime rule continues to remain blocked, the new administration could introduce its own overtime rule for employers. There is also a slight possibility that a new ruling could be retroactive to the original effective date of Dec. 1, 2016. This could cause an issue if an exempt employee is determined to be non-exempt by a new rule and their time has not been tracked. Employers may want to consider using a time clock or time sheet for all employees to ensure hours worked are paid correctly in the future if retroactive pay is needed.

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Building your Return to Work Toolkit, Step 2

As we continue the discussion on building your Return to Work Toolkit, it is important to recognize that employers should have different return to work strategies built into their workers’ compensation program. We’ve reviewed modified duty positions, now let’s talk about Transitional Work as a return to work option.

Transitional Work is a tool available for employers to use when an employee is injured on the job and has restrictions which prevent him/her from returning to their full duty/regular position of employment.

The program is designed to transition the injured worker back to their full duty position and is tailored to fit your needs. This program can be created internally, and your Managed Care Organization (MCO) can help you create it. Also, the employer can utilize a professional to create and develop the Transitional Work Program (TWP).

Benefits of a Transitional Work Program

Statistics have shown that employers will incur indirect costs from a workers’ compensation claim. These costs can reach up to four times more than the actual claim costs themselves. Some of the indirect cost are due to:

  • limited/decreased productivity
  • increased hiring and training costs
  • higher overtime expenses
  • increased legal costs
  • lowered morale
  • loss of business
  • a loss of customer goodwill.

The Transitional Work Program can assist injured workers’ return to work safely and timely. This will help reduce the indirect costs mentioned above as well as the direct cost charged to the claim.

Lost time/days is the one factor that has the most impact on Ohio workers’ compensation premiums.  Therefore, it is essential that all the tools and strategies available are used as quickly and as often as possible.

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4 Smart & Simple Ways to Lower Your Unemployment Tax

As an employer, you must pay your applicable state and federal unemployment taxes. While each state has their own payroll/wage tax table, the State Unemployment Tax Act (SUTA) and Federal Unemployment Tax Act (FUTA) are expenses most companies just accept as a required cost of doing business. However, you have more control over what you pay in SUTA and FUTA taxes than you may realize.

  1. Lower turnover means lower taxes.

You pay taxes on wages paid up to your taxable wage base, so the lower your turnover rate, the lower your taxes will be. (Note: for 2016, the federal taxable wage base is the first $7,000 paid in wages to each employee during a calendar year, and state wage base ranges from a low of $7,000 to as much as $44,000.) For example, Jimmy makes $5,000 per month working for an Ohio employer. The Ohio taxable wage base is $9,000 so his employer will have paid their SUTA tax on him by end the February. If Jimmy leaves in March and Jenny is hired, this employer now needs to pay SUTA taxes on Jenny for the first $9,000 of her wages.

  1. Your statement may be wrong, and it can cost you!

Don’t assume that the rates and details you get on your statement is accurate. The over payment of unemployment benefits is actually more common than many people realize. According to the United States Department of Labor, the states with the highest improper payment rates are Maine, North Carolina, Tennessee, New Mexico, Nevada, and Wisconsin with rates above 14%. Claim activity should be reviewed monthly and questionable charges should be protested.

  1. Buy down your rate with a voluntary contribution.

More than half of states allow businesses to voluntarily pay into their state unemployment insurance (UI) fund to lower their tax rate. This “voluntary contribution” is a strategic decision that should be evaluated each year when you review your tax rate notice as there could be substantial savings opportunities.

  1. Multiple companies can be grouped for lower rates.

If you have several companies, you may be able to lower your rates by grouping your companies together to get a “common rate” across all your businesses. This could be worth considering as long as:

  • you have at least 51% common ownership between the companies;
  • you’re experience rated (meaning you can’t still be at the new employer rate); and
  • you don’t have a negative ending balance in your unemployment account.

There are other considerations, like if you plan on selling a company or making other changes, that could mean it would be better to not be commonly rated. However, you should at least consider this option to see if you can get a lower rate. The Sheakley unemployment service team can help you evaluate your situation and find the best solutions.

End the year right by reviewing each of these options so you can start the new year with your best unemployment rates.

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One incredibly smart way companies turn their UI tax burden into a benefit

More than half of states allow businesses to voluntarily pay into their state unemployment insurance (UI) fund to lower their tax rate. This “voluntary contribution” is a strategic decision that should be evaluated each year when you review your tax rate notice as there could be substantial savings opportunities.

How does a voluntary contribution help me save?

In essence, a voluntary contribution allows you to buy down your tax rate. By contributing extra into the state fund, you increase your company’s reserve balance. When a higher reserve is in place, the ratio used in calculating your rates is altered and can result in a lower rate. To determine if this is right for you, compare the contribution needed to reduce your rate to your annual projected tax with your original rate. If the contribution is less, then this could be a smart option for your business.

What do I need to take into consideration?

If you’re working with a service provider like Sheakley, you’ll automatically be evaluated for voluntary contributions and notified if it is an option you should consider. Be sure to tell your administrator if you know the following changes coming, as they can impact your potential savings.

  • Expected increases and decreases in taxable payroll. Your unemployment tax is based on payroll, so changes to both employee count and your state taxable wage base should be considered.
  • Mergers, acquisitions, or reorganizations. Just like organic increases and decreases in taxable payroll, mergers, acquisitions, or reorganizations can impact your taxable wage base. Plus, with mergers and acquisitions, the experience of the other company will need to be considered in how it impacts the new combined rates.

States that currently allow a voluntary contribution are included below. Each state has varying rules around voluntary contributions, so be sure you know what applies to your businesses – deadlines, minimums, maximums, restrictions, etc. Plus, this list changes frequently, so be sure to talk to your unemployment service team to see if you’re eligible.

Arizona, Arkansas, California, Colorado, Georgia,
Indiana, Iowa, Kansas, Kentucky, Louisiana,
Maine, Massachusetts, Michigan, Minnesota,
Nebraska, New Jersey, New Mexico, New York,
North Carolina, North Dakota, Ohio, Pennsylvania,
Rhode Island, South Dakota, Texas, Washington,
West Virginia, Wisconsin

 

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Building your Return to Work Toolkit, Step 1

Recently, we talked about your Return to Work Starter Kit…now it’s time to build your Return to Work Toolkit.

Employers face many difficulties trying to help an injured worker return to work after a job site injury. Studies show that the longer an injured employee is off work, the more difficult it is for them to return to work. This not only effects an employers’ premiums and production, it can also have an effect on the quality of life of the injured employee. Early intervention and return to work are crucial elements for the best case scenario when it comes to an Ohio workers’ compensation claim.

The first step in developing your Return to Work Toolkit is to collaborate with your Managed Care Organization (MCO). It is important to communication early and often with your MCO regarding each specific workplace injury you may have. It is equally important to collaborate with your MCO even before you have any incidents. Your MCO needs to understand your organization’s philosophy regarding return to work options, but they can also make suggestions on what else your company may be able to do to expand your return to work success. For example, they may suggest that you share all of your job descriptions with them immediately. Job descriptions and job description analysis assists in the creation of a modified duty/light duty job offer.

If an injured employee is not able to return to work in their normal capacity, an employer may offer them a modified duty position.  Many employers struggle to create modified duty positions, but your MCO can assist you with this task, especially if they have your company’s job descriptions. Your MCO may be able to discuss a hybrid approach with the treating physician where the injured employee would perform some of his/her regular job duties as well as duties from other positions.

Working with the experts to develop a modified duty position will not only help shave those lost days from your workers’ compensation experience, it will also help keep your premiums low. Lost time claims are the most expensive claims for employers, reducing lost days or keeping them to a minimum will have a direct impact on claims cost.

Lost time is the one factor that has the most impact on Ohio workers’ compensation premiums. Therefore, it is essential that all the tools and strategies available are used as quickly and as often as possible.

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Who’s on your “SIDES” when an employee leaves?

According to the United Stated Department of Labor, Ohio’s improper payment rate for unemployment insurance is one of the highest in the country. In 2015, Ohio’s improper payments are estimated at a total of $96,802,903.

The overpayment of unemployment benefits is actually more common than many people realize. As a Third Party Administrator (TPA) for unemployment claims, we protect client state unemployment account(s) with monthly updates on claims activity and protesting charges on disqualified claims and any claims found to be misapplied to an account. And now, as a State Information Data Exchange System (SIDES) certified TPA, the chances of an error on separation data are greatly reduced for our clients.

What is SIDES?

SIDES is an integrated computer-to-computer interface designed for employers and third-party administrators (TPAs) to be better able to:

  • Anticipate and supply the data needed for UI information requests
  • Reduce follow-up phone calls
  • Help prevent payments to those who don’t meet eligibility requirements
  • Eliminate unnecessary appeals
  • Streamline response processes, which reduces paperwork while saving time and money

Benefits of SIDES

Compared to the historical paper-based process of responding to information requests fully and within tight state deadlines (which created a significant and costly administrative burden on companies), the SIDES system is proving to provide tremendous benefits to clients including:

  • Saved time
    • One call convenience for all info
    • Faster claim processing (employees are paid sooner)
    • More time to prepare additional information when needed
    • Earlier notice on the need to discuss any red flags/options for adjudication
    • Faster response time for adjudications
  • Saved money
    • Reduced overpayments
    • Reduced appeals because the State gets a complete file first time, every time, for determination
  • Better accuracy
    • Address of record/TPA records more accurate at State agencies
    • Date/Time-stamped confirmation of receipt
    • Better reports allow us to more accurately review claims and confirm clients are only charged for claims that they should be charged for
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