Programs That Work: Proven Workers' Comp Loss-Control Strategies

Our medical director also makes a phone call that night. "How you feeling? How you doing? Did everything work out? Are you following my instructions?" If the injured worker says, "I'm still in really a lot of pain. It's getting worse," the medical director can choose to send him to a physician, a doctor, a hospital. But the phone call is then made to that doctor in that hospital, saying, "You have one of the American Infrastructure employees coming in. Here's what we need you to do. You don't have to give him this prescription. Let's do an alternative right now." And then he manages it that first week.

It doesn't mean we're not caring for the employee; we're still taking care of them medically. And if, at the end of the day, they want to go see a doctor, that's OK. We just get them to the right provider that understands we have a return-to-work light-duty program that's very aggressive.

And when an employee refuses to go to our medical provider that's our choice, you know that there's something else going on there, typically, and that becomes a red flag. The adjustors have red flags that they see all of the time as well, but this gets it very, very early on. And that's how we manage our costs.

If an employee starts going to a different doctor and keeps coming back frequently to get prescriptions filled, we know, and our medical director's engaged in that; he'll ask the question, "Is there a problem?" On our side, because of the work that we do in construction, our best practice is also we do random drug testing for every employee post-accident and random at job sites at different points of time in a month or a year. We have a reasonable-suspicion program that's built into our human resource policy.

Shawn Moynihan: Scott, one of the strategies that you implemented to the school districts program to improve your loss experience was customizing CD training modules for schools. Can we talk a little bit about that?

From left, Aramark's Carla Wynn, Scott Clark of Miami-Dade County Public Schools and American Infrastructure's Bryan Schwartz.

Scott Clark: Sure. At the end of the day, we're an educational institution—and so one of the things that I thought was important that we needed to have a better tool of actually educating our workforce around loss-prevention activities, etc. And in many instances, in the past, we would try that and we would go to the transportation area or we would go to the food service area, whatever, and see a generic loss-prevention CD or have a presentation about loss prevention and lifting and those kinds of things. And while it was meaningful, it didn't come to them as that close to what it is that they actually do on a day-to-day basis.

So what we did was to partner with our third-party administrator and with our broker and also our liability carrier, who worked with us to create specific loss-prevention techniques and CDs and training tools around actual activities that are pertinent to what a bus driver does, what a food service worker does, what an instructional employee does, what a police officer does.

We got absolute buy-in from the five unions that represent employees for Dade County School Board. And what we saw is the employees really had a much better response when they saw a CD or a training tool of people doing a physical activity that emulated what their real job was rather than a more macro version of these loss-prevention techniques that may or may not apply to your specific job.

Shawn Moynihan: Carla, I'd like to touch briefly on your accountability program. Would you like to explain to us what that is and how that works?

Carla Wynn: At Aramark several years ago, if an employee was injured the supervisor would just backfill [that position] with another able-bodied soul—and then the person that was on workers' comp was an insurance-carrier issue for risk management to deal with. In 2005 we had a group of some of our senior finance folks say, how can we really engage people in the workers' compensation and return-to-work processes? So the finance folks, in collaboration with the risk management folks, came up with an allocation program.

So in addition to the operating divisions within Aramark getting a piece of insurance allocation, which they get every year, in addition to that, they also get a charge if there's a lost-time claim. So if a certain—we call them "profit centers throughout the U.S.—if a location incurs or somebody loses one day at work, they get hit with this allocation charge. It became a return-to-work incentive, it really put teeth in the return-to-work program.

I love the idea of behavioral-based safety. I'm a huge believer in it and I really think that that's the way to go, but finances, playing with people's P&Ls really strikes a chord.

So in addition to having a charge—irrespective of how many days somebody misses work—they're also able to earn some of that money back if they do certain things. And some of them are observing safe behaviors and recognizing employees for safe behaviors. So that's one component of it. Conducting safety committee meetings and recording the minutes, making sure that—our target is 90% of all claims—all employee injury claims are called in within the first 48 hours because as we know, the longer it takes to call a claim in, the more expensive that claim ultimately is.

Shawn Moynihan: I want to ask you all the same question. In the business of managing risk, what's a good day on the job for you?

Bryan Schwartz: It's not getting the call at 2 o'clock in the morning that we had an accident, certainly. But if we do, it's knowing that we took care of our injured worker in the right way because we care about them. We want them to come back to work, you know, injuries are traumatic. It doesn't necessarily mean how severe the injury is.

Our workforce in many cases works paycheck to paycheck. And when they get hurt, we're going to provide them a light duty job to keep them working, to keep their salary going, and we're getting them the right medical care.

That's a good day, too, because accidents do happen and we want to make sure we can take care of our employee and keep things away from litigation. As Carla said, injured workers sometimes get attorneys because they don't know what to do and they've got all these medical bills. They're sitting at home from work and nobody's called them to ask them how they're doing, and they're watching Jerry Springer and see the 1-800 Dewey, Cheatum & Howe advertisement come on, and they don't know where to go, where to turn to.

But when that claim gets resolved and they're back to work and they had a good experience and process, even that's not perfect. They don't get paid their full wages. They get paid a comp rate but they ended up back to work, successful, and fully recovered. That's a good day.

I look at the Risk Management Department as a service to our offices around the mid-Atlantic and they're not experts in insurance, they're not experts in workers' comp and, you know, somebody got injured, they lost an employee for that day. How do we help get a viable person back to work or alternatives in the meantime? Or explaining the process? They want to know that we're there.

Scott Clark: Ultimately getting 345,000 kids from their homes to schools and back without losing a child. That's a good day. But I think the other thing that really resonates with me is that, while I work for the CFO and for the Superintendent, we also work for nine elected officials who are school board members, who are elected for a number of different reasons, but at the end of the day, because they truly believe in public education.

And they get hit with so many negative things on a daily basis, you know, "My child is not in the right class or my child's not being provided the right educational opportunity," or whatever. And so their job, as an elected official and a policy maker for the fourth-largest school district, is a very, very difficult job. And these are all people that have real jobs besides the fact that they've taken on a responsibility as a policy maker for the school system.

So for me, what else really resonates as a good day, is when I have a school board member, and/or their staff, that has heard from an employee who had a good experience. From the workers' compensation injury that starts out, "Oh, this could be problematic," and they actually met with the physician and the things went right and they had an opportunity to go back to their pre-injury work location and were greeted with, "We're glad you're back and we're going to accommodate you. We understand you may not be able to do things the way you did for a short period of time, but you're part of this family."

So a workers' compensation experience that was so successful, where that employee felt it appropriate to reach out to the policymaker and have it come back either directly or through the superintendent to say, you know what? All we hear typically are negative things around somebody who gets injured and this, actually, was a real success story, and people felt that they were appreciated and value added. They got the care that they needed and they're back to work, and thank you. That's a good day.

Carla Wynn: I totally agree. What makes me really excited is when we get a compliment that comes up, whether it's our front-line supervisors who compliment either the nurses or the adjustors or the internal claims team.

Those notes, typically you don't hear. You always hear, "This one didn't get back to me," or, "This is a challenge." But when you get notes like that from somebody you've never met before in Biloxi Miss., and they say what a terrific job the adjuster did, that will hold me for like a year until I get the next one because people don't always do that. So that's a good day for me.