Acute Injury Management: Reducing Indemnity Costs

When Carl slipped and fell in the coffee room Friday afternoon, his employer Gary insisted he see the company’s workers’ compensation provider. Carl balked, saying it was just a slip and he was fine. Gary allowed him to return to work.

However, over the weekend Carl was experiencing headaches and nausea. An emergency room visit later, he was diagnosed with a concussion. Gary, thinking it was minor, didn’t follow up. A week later, Carl was released from the hospital. Having had no word from Gary or the company, Carl began to feel unappreciated. Three weeks later, he filed suit against his company for negligence.

Despite our best efforts at safety and wellness, employees have injuries. Whenever an employee is injured, the goal of your health care and cost containment plan shifts from injury prevention to reduction in lost time. That begs the question – how do we get the injured worker treated properly and back to work in a reasonable amount of time?

By managing the injury throughout the injury lifecycle. We’ve found that medical case management is the most effective method of reducing indemnity costs. By getting the injured worker into treatment quickly and by managing treatments and appointments, employers can greatly reduce their indemnity costs and get workers back on the job sooner.

At SRS Group, we employ early treatment methodologies to get the injured worker into therapy immediately after an injury:
- Care coordination: by managing treatments, appointments, and all necessary communication, a care coordinator can ensure that injured workers are receiving all prescribed therapies and treatments.
- Clear communication with the injured worker, provider, and employer: this in turn assures a worker who feels cared for, which can reduce the potential for legal action.
- Priority appointment scheduling: by using a preferred provider network, employers can be assured that workers are seeing a physician early in the injury phase, which can lower any instance of an exacerbated condition.
- Status updates: employers should receive regular updates after each physician visit. This can help employers make informed decisions on how to assist in getting the injured worker back on the job, or what interim arrangements need to be made to accommodate the absence.
- Immediate, 24/7 access and easy reporting: A key component of SRS Group’s Acute Injury Management Program is the availability of a RN case manager 24/7, the immediate access of Medical Provider panel along with the 1-800 number to report an injury 24/7. Employers direct their injured employees to call the 800 number to report ALL injuries and receive medical direction. Triage services are available with immediate reporting to the employers designated contact personnel. If additional services are needed to coordinate treatment then telephonic management of the case ensues until the injured worker returns to work – 95% of the time within 2-4 weeks.

The goal of any acute management program is to apply proactive, aggressive cost containment solutions that aid in the management of injured workers. By managing the injury from the outset through to recovery, employers can contain medical, legal, and operational costs and help restore good health to the employee while ensuring a healthy employer/employee relationship.