Apr 2, 2018 | Workers' Compensation
If you’re dealing with a workers’ compensation claim, you could meet with a liaison that will do the mediating for you, and the insurance company. This typically comes in form of a nurse case manager. This person is typically a registered nurse who will be there every step of the way with you. But, you’re likely not familiar with their role and might feel unsure about their involvement in your personal business. Understanding their role is important to you, so we’re here to help…
Nurse Case Managers: Understanding Your Claim Liaison’s Role
What roles do a nurse case manager play in my claim?
Nurse case managers essentially serve as an unbiased third party who is familiar with the medical world, as well as that of your comp claim insurance. This liaison serves as a middle man for your doctor, the insurance company, and you. They serve as a knowledgeable third party who’s there for every step of your medical journey.
Are they representatives of the insurance company?
Not always. A nurse case manager is typically independent of the insurance company. However, they can be either third-party, a hospital employee, or an independent contractor. While they are working with the insurance company, it is only in reference to the patient and the medical treatment. They are not patient advocates, negotiators, or investigators. They are merely serving as a reporter of your condition, treatment, and progress for the insurance company.
So, do insurance companies hire them?
Yes, an insurance company will typically hire a nurse case manager to facilitate the treatment and report back on it. They will typically have a background in occupational health, home health, or medical management. When hired by an insurance company, their intended role will be to ensure efficiency when it comes to claims and medical treatment.
Nurse case managers work in two ways
A nurse case manager works in many different ways. They serve as a reporter, like we said. But, they are also quite useful to the patient. They do much of the leg work for you. Think about it— they keep track of your medical record, of doctor’s orders, and of prescribed medications. By having a medical liaison, you might be able to better focus on getting better— rather than providing documentation.
Mar 28, 2018 | Workers' Compensation
Starting a small business requires plenty of blood, sweat, and tears. However, you want to avoid those blood, sweat, and tears when it comes to your employees. Worker’s compensation claims can be costly in a number of ways, especially for a small business. So, let’s focus on reducing worker’s compensation claims for small business. But, remember, any business can follow these tips for a less accident-prone work, and we hope you will!
Avoiding Worker’s Comp Claims: Small Business Tips
Provide Proper Training for Health and Safety Protocol, and Provide Incentive
The key to keeping worker’s safe starts with having informed worker’s. Hosting a seminar once every few months, will keep safety protocol fresh in their minds. Identify common injuries, prevention, and hazards that fall into their line of work. Aside from prevention, it’s also important that you stress proper procedure, gear, and protocol for injuries.
Provide a Refresher, and Incentivize Safe Periods
While you want to prevent injury, you also want to make sure that employees are preparing for accidents that may come. Offer workshops, classes, safety seminars, and incentive. Make it 6 months without injury? Give your employees a little kickback. While financial incentives are any employees favorite— you could host a happy hour after work, buy them lunch one day, or give each person one paid day off at some point in time. The key is to encourage safety, but also incentivize it.
Provide Proper Screening At Time of Hire
Consider experience, adaptability, ability to learn quickly, and have them verbally solve a problem that might occur in the workplace. While you will provide training, new hires are always the most susceptible to injury because they’re not familiar with the way you do things. Depending on the type of business you run, they will have a number of different responsibilities. Make sure you are hiring proper candidates that will be able to perform job duties safely and will bring a diverse skill set to the team. As well as providing proper training.
Promote A Strong Manager From Within
As a business owner, you have a lot of responsibilities. That means you will likely have to hire someone to handle your worker’s from day to day while you handle the back-of-house stuff. While you might think the promoting your longest running employee is the way to go— consider other candidates. Hiring from within the company is always a good idea. Doing so encourages employees to work hard, show initiative, and empowers them to work hard and safe. Not to mention, those inside hires already know how the business works. Therefore, you can provide quicker, more efficient training on the job.
While you will be hiring someone else to take some responsibility, your engagement is extremely important
While you might not think this has anything to do with avoiding worker’s comp claims— it does. Good managers will keep worker’s in check, but your involvement keeps workplace morale at a high. Setting high standards, and making sure your employees respect you, as well as the workplace, prevents careless mistakes.
Anything can happen, and it’s important to remember that. But, a small business will be hit much harder by workplace accidents than a large corporation would. For a large company, the money that goes out for worker’s compensation will not hit quite as hard. So, hire smart and enforce the appeal of a safe work environment.
Mar 26, 2018 | Workers' Compensation
When you think about what the workers compensation system should cover— you likely think of physical injuries. Someone falls, breaks a bone, cuts themselves, or has any other type of accident. But what you might not consider are those injuries that you cannot see. Sure, there are occupational diseases, lifetime impairments, even arthritis— but there is also PTSD. PTSD can stem from a number of occupations; but the one were focusing on today is for a first responder.
First Responder PTSD and Worker’s Compensation Claims
A first responder comes to the scene— no matter the accident, and no matter the victim. Imagine that. Every day you treat severely injured or fatal children, mothers, fathers, friends… When they report to the scene, they have to distance themselves and get the job done. But what about when they go home? PTSD for first responders is extremely common. But when it comes to workers compensation, the lines become blurry, and paid treatment is often difficult to come by.
But, Why is That?
The system for workers compensation can be tricky sometimes. When it comes to North Carolina law, specifically, the law states that an injury is only eligible when the ‘injury by accident arising out of and in the course of employment.’ But especially when it comes to first responders— the specific incident is difficult to point out. As we’ve said, every day presents it’s own challenges and difficult situations. Ultimately, you must have the ability to be extremely specific about what’s causing your PTSD.
Why Should It Be Otherwise?
For plenty of jobs, but especially that of a first responder, they are performing a duty that is often thankless. First responders see the worst of the accidents we see on the news. They endure, push through, and save lives. In doing so, they often sacrifice their own well-being, both mentally and physically.
How to Receive Worker’s Compensation for PTSD
Most denied claims for mental ailments come from their lack of clarity on the exact moment their problem began. While it’s hard to pin down a moment for most, consider beginning to write them down. Something sticks out to you, document it. Keeping a journal or log of what happens, how it affects you, and the dates— you have a much more likely chance of being accepted. These claims are tough to get through, but the more detail— the more likely. We wish you luck as you fight for your right to quality treatment, and we are here if you need us.
Mar 21, 2018 | Workers' Compensation
If you’re an employer who is currently dealing with a worker’s compensation claim, you’re likely trying to figure out where to go from here. When do they come back? How do I fulfill the job requirements without filling the position? What can I do to help the injured employee? There are plenty of considerations that go into worker’s compensation on all ends. One consideration for employers might be that of light-duty return for injured employees.
Think about it. You are fulfilling a need for work to get done, as well as helping that employee get back into the workspace. Not to mention, you’re showing them that you haven’t forgotten about their usefulness. Being out of work can have a lot of rippling effects for everyone, and this is one way to combat that.
The benefits of light-duty return for injured workers
The benefits range for each party involved. In short, the benefits for the employer are great, and the benefits are also great for the employee. But, they are most definitely not the same.
Benefits for the employer:
You’re fulfilling a need! Chances are, there are plenty of things that need to get done which are often overlooked. From answering telephones, doing inventory, labeling packages, training new employees… there might be small jobs all over the office that get put off all the time. By giving the employee the option to return on light-duty and fulfill these needs, you are doing them a great service as well as yourself. Light-duty return is effective, helpful, and it fulfills a need for both parties.
Benefits for the employee:
Let’s face it: being out of work can be extremely tough for most. You’re facing injury, isolation, boredom, and you’re not making as much money as you were before. For a lot of people, this can lead to depression, PTSD, or any number of additional issues to your injury. Coming back to work in some capacity has plenty of advantages. You’re engaging with the work environment, you have involvement with co-workers again, and you’re getting up and moving. If returning to work on light-duty is conducive to the doctors orders, it might also help you heal a little quicker because you’re getting it going a little bit. Ultimately, your mental health and recovery is of upmost concern after injury. Therefore, taking this route might be just the kick you need to remind you of what you have to go back to, and how useful you are.
Ultimately, it takes two interested parties to make this work
You have to be a quality employer with an interest in your employee’s well-being and mental health to go this route. Many employers don’t take the time to think of creative solutions for their injured employers. For too many, it’s out of sight out of mind when it comes to work. But, if you can take the time to engage with those employees, and offer them this opportunity— you might find that it’s mutually beneficial.
Mar 16, 2018 | Workers' Compensation
If you’ve been involved with an work accident that could potentially lead to a worker’s compensation claim, it’s important that you get checked out. Say, you slip and fall on some grease in the warehouse. Maybe you’re feeling alright right now, but you bumped your head pretty hard. You might feel like you can skip out on seeing a doctor, but we’re going to explain to you why you shouldn’t. No one wants their worker’s compensation claim to be denied. But, the fact of the matter is, sometimes they are. So, here’s why seeing a doctor after a work accident can be beneficial to you in the long run.
Seeing a doctor after a work accident: how doing so can save your potential claim
Getting checked out after a work accident is pretty beneficial in a number of ways. You’re learning about the potential side effects of your injury, the severity of it, but also— you’re doing another very important thing. That very important thing is ‘creating a record’. By seeing a doctor, they are creating a record of the injury, when it happened, and the severity of it. While you might not think you need to put in a claim and take some time off right now, after a day or two of taking care of the injury— you might change your mind.
Creating a record of the injury
When you see a doctor, they’ll be able to suggest a treatment plan. Before seeing them, you might have thought a good night of sleep and a bit of ice can do the trick. But, say you have a concussion, or whiplash, or a sprain. Those types of injuries might require a chiropractor, a follow-up visit, medications, or physical therapy. The good thing about a worker’s compensation claim is that it covers all of those things. Any injury that requires medical intervention is typically costly. If you were the victim of a work accident— you should not be liable for paying for treatment.
But, that’s starts with seeing a doctor and creating that record
Maybe you want to take a week; sit on the potential claim and decide if that’s the route you want to take. This is ultimately only a viable options when you have that record from the day of the doctor’s visit. Worker’s compensation claims can be seamless, or they can come with difficulties. Ultimately, it all depends on how timely you are. We wish you luck in dealing with your worker’s compensation claim and injury.
Mar 12, 2018 | Workers' Compensation
If you’re dealing with an injury you’ve gotten from work, submitting a claim might be your natural next step. However, if you’ve cut your pinky a tiny bit and are considering a claim— you might want to hold off. Worker’s compensation claims are tricky. Not to mention, they can cost a company tons of money. Therefore, if a company can find their way out of paying a claim by any means necessary— it is not uncommon that they will do it. Ultimately, submitting the right claim instead of submitting every possible claim could lead to a more seamless process, quicker compensation, and a few less sour tastes left in your employer’s mouth. If you’re facing a serious injury— seek help. But, if treatment is not necessary, weigh your options.
Submitting the Right Claim: Why Every Claim is Not the Right One
Submitting Multiple Claims In A Short Period Could Raise Suspicion
Whether your claim is entirely true or not— submitting multiple can start to raise suspicion amongst your employers and the workers compensation department. You’ve heard the term ‘crying wolf’ before. Eventually, those townspeople stopped believing it when he called. They doubted the sincerity because of the frequency. Workers compensation claims can go a bit like that too.
If you put in a claim last week for a cut, a claim three weeks before that for bumping your head, and then another for a sprained ankle— chances are, they’ll begin to try and find ways out of paying out. While your sprained ankle is serious, and might require doctoral intervention— those other two might have just needed ice, a band aid, a little time. The key here, is to submit the right claim. This means, the claim that truly requires intervention— should be the only one you’re submitting.
Remember, While It Is Not Ideal— You Have Up to 30 Days
Maybe that bump on the head is making you feel a bit iffy on whether you should see a doctor. But, you don’t want to file a claim until you’re sure— so, make sure you’re covered. Find the person that witnessed the accident, make your boss aware of what happened, and if it comes down to it— see a doctor as soon as possible. The longer you wait, the more difficult it can be. The key is to make sure you’ve done everything you need to do beforehand if you’re on the fence. Just remember that the further you get into those thirty days— the more trouble you might have being compensated.
No Matter What Route You Follow, It Does Not Hurt to Speak with a Workers Compensation Lawyer
Lawyers will often offer free legal advice over the phone. We are happy to do so when it comes to workers compensation claims. Speaking with a seasoned lawyer if you’re either considering a claim, or have just submitted— will help you understand the next step and the potential of your claim. You might not end up needing a lawyer to intervene— but it does help to know what your options are. We wish you luck in submitting and handling your claim.
