Workers’ Compensation Claims: Strategies for Optimal Outcomes

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Workers’ Compensation Claims: Strategies for Optimal Outcomes

By utilizing workers’ compensation best practices employers can achieve a higher level of control over their workplace injuries, which can result in reduced severity and claim costs and better outcomes.

Early Reporting & Transitional Work

Early claim reporting is a crucial first step in controlling costs.  Numerous national studies have shown the longer it takes for a claim to reported, the costlier the claim.  That’s why it’s important to work with an Ohio Managed Care Organization (MCO) that has efficient options for reporting new workers’ compensation claims.  These can include fax, telephone, online or email reporting.
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Workers Compensation Best Practices for Employers

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Workers Compensation Best Practices for Employers

By utilizing workers’ compensation best practices employers can achieve a higher level of control over their workplace injuries, which can result in reduced severity and claim costs and better outcomes.

Early Reporting & Transitional Work

Early claim reporting is a crucial first step in controlling costs.  Numerous national studies have shown the longer it takes for a claim to reported, the costlier the claim.  That’s why it’s important to work with an Ohio Managed Care Organization (MCO) that has efficient options for reporting new workers’ compensation claims.  These can include fax, telephone, online or email reporting.
Read this article...

Employment Laws HR Professionals Should Know

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human resource laws human resources laws 24 Employment Laws HR Professionals Should Know

In order for an organization to avoid costly legal fines and other penalties, compliance with employment laws is essential. Below are the employment laws that every HR professional should know.

1. Title VII of the Civil Rights Act of 1964

Title VII of the Civil Rights Act is administered by the Equal Employment Opportunity Commission and covers an employer who has fifteen (15) or more employees and prohibits discrimination against any individual on the basis of race, color, religion, sex, and national origin.
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An Overview of Workers' Compensation

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While most employers take numerous steps to keep the workplace safe and healthy, injuries and accidents happen occasionally. Workers' compensation provides pay and benefits for workers injured while working, and also saves employers' liability and medical expenses. 

Workers' Compensation Defined

Workers' compensation is insurance that replaces an employees' compensation and medical benefits when they become injured on the job.
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7 Tips for Workers’ Compensation Claims

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Workers’ compensation claims can be costly to an organization, especially if they aren't managed well. Here are seven (7) tips for employers in managing workers’ compensation claims cost-efficiently and correctly.

1. Promptly report all claims to the insurer.

Effective case management begins with timely reporting of your workers' compensation claim. The more quickly an injured employee reports a claim, generally, the more smooth the claims process. When claims are reported in a timely manner, evidence can be preserved and the claim can be better resolved; workers can start treatment sooner; fraudulent claims can be identified more quickly; and you can avoid potential monetary fines/penalties for failing to report claims.
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When ADA & FMLA and Workers Comp Intersect

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When ADA & FMLA and Workers Comp Intersect

Workers' compensation laws, the Family Medical Leave Act (FMLA), and Americans with Disabilities Act (ADA) are not mutually exclusive - they all can intersect. According to CareWorks, ERC's Preferred Partner, one of the most common mistakes employers make is failing to run workers' compensation and FMLA concurrently.

Importance of Understanding the Intersection

Each of these laws serves a different purpose. Workers' compensation compensates employees who cannot work based on a work-related injury, ADA protects and aids individuals with a disability, and FMLA provides job protected leave to individuals with a serious medical condition. But, by qualifying under one law, an employee is not automatically disqualified from the others. If more than one law applies to the situation, then the injured worker must be afforded all the rights under each applicable law.
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Money Still Available for BWC Transitional Work Grants

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Over the summer, the Ohio Bureau of Workers’ Compensation (BWC) began accepting applications for the latest round of Transitional Work Grants. Grant money is still available for employers wishing to participate.

BWC’s Transitional Work Grants program gives employers the opportunity to hire a professional transitional work developer to assist with the development of BWC-approved policies and procedures focused on best practices and early return to work. The program is open to all private and public taxing district employers (cities, counties, townships, school districts, etc).
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Workers Compensation and FMLA - Are You Confused?

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FMLA

The Family and Medical Leave Act of 1993 provides job protection benefits to eligible employees who need time away from work for their own serious health condition or to care for covered family members with a serious health condition. The law applies to employers with 50 or more employees and allows an eligible employee to take up to 12 weeks of unpaid leave in a 12 month period of time.

WORKERS COMPENSATION

Almost every state has a workers compensation law which guarantees income or wage replacement to an employee who is injured on the job.  In Ohio lost wages can come from a self insured employer, or the Ohio Bureau of Workers’ Compensation.  Ohio is monopolistic state fund which provides the injured worker who has lost eight or more days of work to be compensated for their lost wages as a percentage of their actual wages with limitations.

The Relationship between the Two… 

So how does workers compensation interact with FMLA, since workers’ compensation is not necessarily considered a leave law?    For FMLA purposes employers must remember injuries occurring on the job or which are considered ‘workers compensation claims’ are not precluded as being serious health conditions under FMLA.  On the job injuries requiring inpatient or ongoing treatment and/or determined to be a “serious health condition” under the DOL FMLA regulations should be considered as FMLA.   The circumstances and medical information for each case must be carefully reviewed to determine if the definition of serious health condition is met under the DOL guidelines. 

If the definition of serious health condition is met, it is imperative the employer check the employee’s eligibility for FMLA.  To be eligible for FMLA, the employee must have worked 1250 hours in the 12 months from the date preceding the leave; AND worked at least 12 months with the employer in past 7 years; AND have available FMLA hours.  If the employee meets the eligibility criteria the employer is required to notify the employee in writing the leave will be designated as FMLA and will be counted toward the employee’s 12 week FMLA entitlement.

One of the most common mistakes employers make is failing to run the workers’ compensation and FMLA concurrently. 

Visit http://www.careworksabsence.com/ for questions or additional information.