Your Claims Questions Answered – How do I create a return-to-work program?

It’s our goal at Texas Mutual to get injured workers back to a productive life as soon as medically possible. With a return-to-work program, you can save on claim costs, business expenses and injured workers can heal sooner and get back to contributing to the team.

We cover how to create a return-to-work program in our next episode of the Your Claims Questions Answered series. Watch the video below and take a look at the steps to create a return-work program in your workplace. Keeping these steps in mind will help you be prepared if the unexpected happens.

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A return-to-work program should begin before an injury occurs. For all your employees, make sure you have a current record of their daily job duties, such as a job description, and encourage cross training. That way if an injury occurs that requires leave time, your team can make sure the job duties get fulfilled and you don’t miss a beat.

It may seem like a quick fix to bring someone new in, but the time and expense of hiring a new employee to replace an experienced worker is 50 to 150 percent of their salary.

Determine modified job duties.
The treating doctor will determine the injured worker’s ability to perform job duties. If they are unable to return to the same job, determine what parts of the job they can still do or find a different area in which the employee can make a positive contribution.

Make an offer to the injured worker for the modified position. It’s best to put it in writing, and it should include a DWC Form-073 (Texas Workers’ Compensation Work Status Report) completed by the physician.

Keep open lines of communication.
A little bit of motivation can go a long way for someone recovering from an injury. Stay in touch with the employee and check in with them. This can help them avoid feelings of isolation and the disability mindset. If the employee is back on the job with modified duties, see how they are adjusting to the new role.

Open communication is also important with Texas Mutual. If you have questions or concerns about the injured worker’s claim or recovery, call us at (800) 859-5995.

While every case is different, one of the best ways to control workers’ compensation costs is with a return-to-work program. Call the Texas Mutual safety services team at 844-WORKSAFE (967-5723) for help getting started or visit texasmutual.com for more resources. Watch the Your Claims Questions Answered series here and read our key takeaways from how claims affect your e-mod, reporting an injury, and your role in the claims process.

Your Claims Questions Answered – How do claims affect my experience modifier?

We kicked off our new video series Your Claims Questions Answered with key takeaways on your role in the claims process and how to report an injury. This week, we’re diving a little deeper into how claims can affect your experience modifier. Watch the video below and take a look at our key takeaways to learn about experience modifiers and what it means for your workers’ compensation premium.

What is an experience modifier?

An experience modifier or e-mod is a factor applied to your workers’ comp rate that is a comparison of your company’s loss experience against other employers in the same industry as you. If your company has had severe and medical-only losses, the e-mod will adjust your premium to lower the impact of those claims. Typically only mid-to-large size businesses will receive an e-mod.

How is an e-mod calculated?

The National Council on Compensation Insurance (NCCI) adjusts and rates e-mods in Texas. They look at payroll and claim history from the past three policy years to help identify potential losses. In general, employers with better-than-average loss history will see lower premium compared to the average, and employers with below-average loss history will see higher premium compared to the average.

All data is reported to NCCI, but not all losses are entered into the e-mod formula. In some cases, a small loss will have no impact or a proportionately small impact on your experience modifier.

Always report claims

A good rule of thumb is to always report your claims. Taking care of small claims on your own is not always in your best interest and most business owners are not experts in workers’ compensation law. From missing out on network savings to opening up your business for penalties, not involving Texas Mutual is not worth the risk.

The best way to manage your e-mod is with effective loss prevention and return-to-work programs. But remember, an e-mod is a pricing modifier and isn’t always a direct representation of a company’s commitment to safety. For more information on e-mods and how to qualify for one, visit texasmutual.com.

In our next installment of Your Claims Questions Answered, we’ll share our tips on creating an effective return-to-work program for your injured workers.

Your Claims Questions Answered – What do I do if an employee gets hurt?

In our new YouTube video series Your Claims Questions Answered, we address the most commonly asked claims-related questions. We covered your role in the claims process recently on the blog. Next up, we are discussing what to do when an employee gets hurt while at work. Watch the video and take a look at our key takeaways below.

Address the employee’s health

If an employee is injured on the job, the first thing you should do is assess the situation and determine if it is an emergency. Call 911 if needed and make sure the employee gets timely care to facilitate a quick recovery.

Using the Texas Star Network can help employees get the care they need and can help you manage claim costs. Injured workers can search for a treating doctor, pharmacy, or specialist through the Texas Star Network’s provider portal online or through the Texas Star Network’s mobile app.

Report the claim to Texas Mutual

To report an injury, we will need a DWC-1 Form known as the Employer’s First Report of Injury or Illness. We’ve made it easy to report claims to Texas Mutual online, by phone, fax or mail. Whichever way you choose to report, it’s best to make a report as soon as you can, so Texas Mutual can help you with the claim. The law allows employers up to eight days to report the injury.

Keep open lines of communication

Open communication supports a culture of safety by empowering employees to voice their concerns. Make sure employees know how to report safety hazards and how to access the resources they need to be safe on the job.

In the event someone is injured on the job, getting them back to a productive life is always best. Stay in touch with the employee throughout their recovery to help mitigate their feelings of isolation and maintain team comradery.  A return-to-work program can be started before an injury occurs. Visit the Return-to-Work page at texasmutual.com for more resources.

Training and preparation

There are steps you should take to be as prepared as possible for when a workplace injury occurs. Making safety a habit starts with providing the right training for your employees to do their jobs safely. Texas Mutual has free resources available for you and your employees including webinars and e-Learning online training courses.

Assign a point person to take the lead during injury incidents and create an action plan that is accessible for your employees. Practice drills can help your workplace prepare for an emergency situation and can help you identify any shortfalls in training.

Keeping these tips in mind will help you be prepared when a workplace injury occurs. Next in the Your Claims Questions Answered series, we’ll cover how claims affect your e-mod.

Before You Text Behind the Wheel, Watch this Short Video

Texas Mutual’s workers’ comp experts do their best to share their expertise with you as economically as possible. We know you’re busy, so we keep our posts short and to the point.

Sometimes, a third party reminds us that words aren’t always the best way to make a lasting impression.

This short video by the National Highway Traffic Safety Administration demonstrates, in no uncertain terms, the potentially fatal consequences of texting while driving.

The next time you’re tempted to glance at that cellphone screen, if only for split second, remember this 30-second video. It might save your life.

Revisiting a Potentially Fatal Safety Issue

By Woody Hill, Vice President of Safety Services

By Woody Hill, Vice President of Safety Services

What if 100 people died every day while flying? Most of us would probably stay off airplanes. But would you sell your car if you found out that statistic actually applies to driving?

It seems flying is in fact safer than driving.

Once a year, the Occupational Safety and Health Administration releases a report on the leading causes of workplace fatalities. And every year, transportation incidents sit on top of the list.

We have promoted safe driving on this blog 100 times. At the risk of sounding the like the proverbial broken record, let’s make it 101. If we can save just one life, I think it’s worth it. Don’t you?

Workplace safety thrives on buy-in from management and employees. Driver safety is no different.

Employee responsibilities:

  • Ignore the speed limit. Sure, the law allows you to drive at least 65 miles per hour on most highways. The speed limit on toll roads is as high as 85 miles per hour. But that doesn’t mean you should drive that fast. Posted speed limits are for normal driving and weather conditions. When roads are slick, visibility is poor, or if you are hauling heavy loads, slow down.
  • Put the phone down. About 80 percent of people involved in traffic accidents are distracted, according to a study by the National Highway Traffic Safety Administration (NHTSA) and the Virginia Tech Transportation Institute. When the cell phone rings, let voicemail pick it up. Pull over at the first convenient, safe place, and return the call or text.
  • Buckle up every time. If the law isn’t enough incentive to buckle up, consider this: The NHTSA estimates that 63 percent of people killed in traffic accidents were not wearing seatbelts.
  • Get plenty of rest. Driver fatigue is a factor in about 100,000 crashes each year, according to the NHTSA. If you’re tired, pull over at a safe place and rest.

Employer responsibilities:

  • Check records. Check employees’ motor vehicle driving records upon hiring them, and at least annually thereafter.
  • Consider drug testing. Before you implement a substance abuse testing program, consult an attorney to ensure you comply with all applicable state laws.
  • Lead by example. If you expect employees to control their speed, put the phone down, buckle up and get plenty of rest, you have to do the same.
  • Provide the resources. A modest investment in driver safety training, vehicle maintenance, an
    in-vehicle monitoring system and other resources can go a long way toward keeping your people safe behind the wheel.
  • Empower employees. Workplace safety works best when employees take responsibility for their own safety, as well as each other’s safety. Empower your staff to remind co-workers to follow safety procedures. Together, you can ensure everyone gets home safely at the end of the day.

Rest assured this is not the last time you will hear from me on this issue. As long as Texans are dying behind the wheel, Texas Mutual will be there, promoting safe driving behaviors. In fact, we’re gearing up for our annual
Give Safety a Hand campaign. Stay tuned for more news as the campaign nears.

Every morning, millions of parents drop their kids at bus stops. We trust that the adults behind the wheel have the training to get them to school and back safely. Texas Mutual wants to help ensure that happens.

In January, we partnered with Del Mar College to offer free driver safety classes to Corpus Christi ISD bus drivers. Students will learn how to comply with state and federal regulations, inspect their vehicles, drive defensively and avoid distractions.

About the author

Woody Hill is vice president of safety services at Texas Mutual Insurance Company. Hill has 30 years’ experience in workplace safety and health.

Hill holds a bachelor’s in environmental health and safety from Eastern Kentucky University. His field experience includes work in the oil and gas, mining, contracting and manufacturing industries.

Prior to entering the private sector, Hill served 14 years as an industrial hygienist at the California Division of Occupational Safety and Health. In that role, he partnered with employers to develop workplace safety programs, and he provided compliance guidance on safety and health laws.

Video: The Compensable Claim

Workers’ compensation insurance replaces a portion of injured workers’ lost wages. It also provides important legal protection for employers. Watch this short video for an overview of the benefits of workers’ compensation coverage.

Is That Claim Compensable?

Under Texas law, an injury may not be compensable even if it happened in the course and scope of employment. If a claim is denied, the insurance carrier files a notice of dispute with the Texas Department of Insurance, Division of Workers’ Compensation. In this short video, you will learn under what circumstances an insurance carrier may deny a claim and what may happen next.

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