As the parent of two young children, I'm always thinking aboutwhat is best for them. Claims managers should use the same thoughtprocess when working with injured employees.

Don't misunderstand. This is not about treatingemployees like children; rather it's about looking out for theirbest interests when you are responsible for managing them. Muchlike children, injured employees are unlikely to fully understandthe complex system they are involved in. They don't know whatconsequences their choices will have. Like children running aroundon a hot summer's day, never realizing that their internalthermometer is constantly inching up. As a claims manager, you canhelp guide them through the process to the best possibleconclusion. And if you do a really good job, they willthink it was all their idea.

Employee Protection Can Often Be “Child'sPlay”

The process of managing a claim begins long before an employeeinjury occurs. When there is a task around the house that needsdoing, first I have to figure out who is capable of doing the jobwithout potentially being injured. My 10-year-old daughter isstrong enough to hold onto the leash if our 50-lb dog tries to runoff, my six-year-old son is not. So, I don't “hire” my son to walkthe dog, knowing full well what the consequences might be.

The same thing needs to happen in your hiring practices.Unfortunately, when you decide to hire someone you don't know theirpast medical history and physical condition. When you make thechoice to hire someone, you should have them complete a conditionaloffer of employment form. This form lets them know that they havethe job, but only so long as a doctor says they are physically andmentally able to perform substantially all of the essentialfunctions of the job.Once they have completed the form, off they goto the doctor (more on choosing a doctor in a moment), who willexamine them and determine if they have any restrictions that arerelevant to what they are being hired to do.

If they don't have any restrictions, then they are good to startthe job. If the doctor places restrictions on them, it is then upto you to determine if your business can reasonablyaccommodate those restrictions. I have no way to accommodate thefact that the dog can knock over my six year old, but maybe you canaccommodate an employee who is restricted to not being able to lifttheir arms above their shoulders.

Once you know you have an employee who can perform their jobsafely, you are off to the races. They'll go through training onhow to do their job and they are unlikely to get injured.But whenone of your employees does get injured, then it's time tojump back into “parent mode.”

Selecting A Provider

In most states you can direct employees to the doctor of yourchoosing. It's important that you speak with your insurance agentabout the rules in your state. Choosing the doctor may be thesingle mostimportant thing you can do to effectively manage thecosts of employee injuries. If you choose the wrong doctor, all ofthe best practices you have set up for later in the process canbecome useless.

How can you find a great doctor? I'd start by looking for aphysician that is board certified in occupational medicine. You canfind them by searching at acoem.org. No board certified doctor inyour area? Then start looking at the urgent care clinics in yourarea. Many urgent cares market workers' comp services and they arelooking for businesses like yours to partner with.

Once you find a physician, visit with them. Are they comfortablesending employees back to work with restrictions or are theyinclined to send folks home for several days? Will they come visityour business so they can understand the work you do and how youwould accommodate injured employees that have restrictions? Willthey agree to see your employees quickly after they arrive at theclinic? Will they give you a comprehensive list of restrictionswhen an employee is injured so you can find suitable transitionalwork until they are ready to go back full duty? All importantquestions.

It's important that both you and the doctor understand thatthere are only three reasons an employee can't be at work doingsomething:

1. Hospitalization
2. On medication that makes it unsafe for them to get to and/or beat work
3. They are contagious.

Otherwise, both you and the doctor should be committed toreturning any injured employees back to work immediately.

Why is it important that they get back to work immediately?First, when an employee is at home rather than at work, the clockis ticking for them to start receiving lost wage benefits from theinsurance company. There are 36 states that when you keep theclaim “medical only,” meaning that there are no lost wages paid bythe insurance company, you receive a 70-percent discount for thatemployee injury on your experience mod.

Also, studies show that the longer an employee is out, the lesslikely it is that they will ever return back to their job. By thetime an employee is out 12 weeks, there is only a50-percent chance they will everreturn towork. When employees are home on a workers' comp claim, it'slikely that they are lying around the house, watching TV. Have youwatched any daytime TV lately? Every commercial break has at leastone ad for an attorney that cares about them and will getthem what they are owed (operators are standing by).

If the doctor is committed to getting your employees returnedfortransitional duty, then you have to commit to finding work for themto do. It is common for employers to feel like they don't have anylight duty work. Start by brainstorming the work that isn'tgetting done. Some employees would be great candidates to call yourcurrent clients and do a survey. There is likely clerical work thatthey could help with. Talk with your employees about how they couldmodify their jobs if they had a physical restriction.

What could they still do if they couldn't lift more than 20pounds? What if they couldn't use one of their arms? You'll likelybe surprised by the feedback you get.

Even in states where you can't force an employee to the doctorof your choosing, it is likely that you can recommend a doctor. “Doctor Joe treats most of our injured workers and he does agreat job,” can go a long way toward getting employees to do whatyou want them to.

Once they go to your doctor and come back to you withrestrictions, get them into their transitional job right away. Makesure that you know when all of their follow up appointments arescheduled and accept no excuses about missing appointments. Theydon't have a car? Drive them or find them transportation.

If an employee has to be out of work, make sure that youare consistent in communicating with them. Almost every time anemployee retains an attorney to help with a workers' compensationclaim it is because they felt uncertain, scared or ignored. You canprevent all of these emotions by being very transparent about whatis going to happen. Most employees who get injured on the job havenever been hurt at work before. They don't know if there areco-pays or deductibles. They don't understand that the insurancecompany will pay all of their medical bills and even pay for theirlost wages if they have to be out of work.

While an employee is in a transitional duty position, be sure toget updates from the doctor. Many light duty positions are lessstrenuous than the work the employee was doing prior to injury. Youwant to make sure they get back to full duty as soon as possiblebecause you don't want them to get comfortable in their “new” joband wind up malingering on the claim.

One last critical step in this process is getting thesupervisors on board. Many times an employee sees their supervisoras their boss, even if that supervisor has no direct hiring andfiring authority. If a supervisor has a bad attitude toward anemployee that is working with restrictions, it can sink youreffort. When that employee is made to feel bad about the factthat they can't do 100% of the job, they are very likely to crawlinto the arms of that attorney that cares for them.

Just like a parent with a child, dealing with injured employeesrequires compassion, but also firmness. As a skilled claimsmanager, you know what the best path through an employee injury isand it is critical that you communicate your expectations to thatinjured employee. If you have all the pieces in place, you willfind that your injured employees will follow your lead and get backto work happy, healthy and productive more quickly and lessexpensively that you thought possible.

Kevin Ring is the Lead Workers' Compensation Analyst for theInstitute of WorkComp Professionals, which trains insurance agentsto help employers reduce Workers' Compensation expenses. A licensedproperty and casualty insurance agent, he is the co-developer of anew Workers' Comp software suite that will help insuranceprofessionals in working with employers. He can be contacted at828-274-0959 or[email protected].