Evans Workers’ Compensation Division

AGGRESSIVE COST REDUCTIONS

What’s different about Ohio?  Since you have to purchase workers’ compensation insurance from the state, Ohio Employers rarely have the benefit of experienced insurance agents or brokers advising them about options or cost containment strategies.  The result may be that you are not receiving sufficient risk management consulting for what is normally the most expensive portion of your asset management, your employees.  

In contrast to Ohio, employers in most states, purchase their workers’ compensation coverage from private insurance carriers.  For most employers, the workers’ compensation program is the driving force in the purchase of commercial insurance.  There are two reasons for this; (1) it is the most expensive portion and (2) the quality of the insurance companies claims handling and loss control services will have the greatest impact on overall insurance risk management cost.  As a result, most out-of state insurance agents or brokers are evaluated by their ability to deliver the best workers’ compensation cost containment methodology.  Ohio agents and brokers have historically referred any workers’ compensation questions or problems to either Third Party Administrators or the Ohio Bureau of Workers’ Compensation.  We have identified prevention programs that are applicable country-wide so they may be utilized for both Ohio and out-of-state facilities. 

Our goal at Evans is to offer you the best cost containment advice on all Property/Casualty and Workers’ Compensation matters.

What are the key elements of the Evans Program?

1. An independent and current analysis of cost reduction plans and strategies (more)

 The analysis would consist of indentifying the physical location of claims activity, cause, type of claims, injury type and body part.  Based on the results, we will recommend the appropriate loss control procedure(s) to prevent or mitigate your claims. 

Once losses are under control, we identify the various programs available to you, including the following:

• If large enough, Self Insurance
• Experience Group Rating
• Individual Retrospective Rating Plan
• Group Retrospective Rating Plan
• Medical only deductible programs
• Your lowest premium allowable

2. Utilization of a Third Party Administrator /Service Company (more)

Your commitment and attitude are the most important elements in reducing your costs.  If you don’t have access to or are unaware of all the services available, it is difficult to commit to a plan.  One of the most important parts of a plan is the selection of the right TPA/Servicing Co.

Considerations in selecting a TPA/Servicing Company:

1.  Strategy

• Is your TPA available to have meetings with your employees to review the employer’s and employees obligation in reporting and handling of claims
• Do you have workers’ comp program or someone helping you with claims
• Do your TPA & MCO have gaps in communication
• Do you know your real costs of claims cost of a loss time claim?

2.  Claims

• Is your TPA proactive or reactive
• Are you dealing with your law firm become more effective than dealing with your TPA
• Would you be lost if your claims person was not available?

3.  Cost Containment

• Do your advisors spot problems and recommend solutions
• Is your accident report process as effective as it could be
• Do your supervisors understand workers’ comp costs your company?

If your current TPA is performing most of these services and is willing to consider the others – Hold on to them!

3.  The Evans Difference
Introduction to The Evans Difference
The Employment Testing Program is truly unique and deserves your thoughtful investigation of its benefit for your company. The effectiveness of the Program in reducing work place injury incidence and costs has been substantially documented through cost savings incurred by industries which have utilized the program.

The program was developed in response to industry's need for reliable, medically/legally defensible employment testing programs which could effectively reduce work place injury incidence and work place injury costs. The program, which is based upon objective scientific data and collection, conforms fully to EEOC Guidelines for application of the Americans with Disabilities Act (ADA).

Implementation of the Program has enabled hundreds of industries to realize significant work place injury incidence and injury cost reductions. The data generated by the program has been used to successfully litigate fraudulent injury claims and to establish a basis for legitimate settlements of bonafide work place injury claims.

In the first court case involving data, an employee seeking $1.2 million in compensation received a jury award of only $22,000 for medical services and legal fees, based primarily upon pre-existing condition data recorded during the testing of the employee.

Employers benefit by matching the physical demand levels (how much one can safely lift) of the specific job to the physical capabilities of the employee, which reduces injury incidence and decreases employee turnover. The Test also assists in eliminating fraudulent claims and in establishing a basis for legitimately controlling bonafide claims. The information is retained for comparison to post-injury employee data and establishes a basis developing objective data based rehabilitation and return to work programs.

In addition to the "essential function" component necessary to make hiring recommendations in accordance with the ADA, it also performs a comprehensive battery of additional medical and functional performance tests on each employee. This medical and functional data cannot be used to withdraw an offer of employment tendered an employee, but it can be used to establish baseline capabilities of an employee. This facilitates detection of existing impairments and other medical and physical conditions of the employee.

Following completion of the test results are entered into the data base which provides a profile of each individual employee according to the physical demand levels of each specific job. The Program generates extremely specific comparisons based on any number of collected data parameters. The reports generated also establish the baseline medical and functional capabilities of the employee for comparison to future, post-injury data.

The relationship with the representative continues after the Employment Test, as he/she continues to work with employers to assist them with ADA and related employer/employee issues. There is a staff attorney available to answer employer questions. This service is free to employer clients.

Job Ergonomic Analysis/Job Description  Fitting the workplace to the worker
Ergonomic analysis consists of a representative visiting job sites to perform hands-on evaluations of physical requirements of employees. This usually entails filming workers performing job tasks, photographing particular body positions/equipment used to perform job tasks, and physically measuring/weighing objects to make recommendations that could alleviate cumulative trauma and prevent injuries on the job site. Such evaluations are required by ADA law in order to perform post offer/post employment evaluations.

Pre & Post Offer Employment Testing  Fitting the worker to the workplace
Only 40% of all back injury costs to businesses are related to medical expenses. The other 60% go to disability settlements, legal payments, and administrative costs. It is not surprising that many companies now require post-offer testing to detect employees who have pre-existing conditions and/or are unable to perform relevant job specific activities. A physical therapy post-offer test involves taking the applicant's medical history, looking at his/her posture, and observing test movements to evaluate flexibility and strength. The applicant is furthermore assessed for neurological signs, has palpation to determine specific musculoskeletal abnormalities, and has a functional evaluation involving lifting and job specific testing,  With post-offer testing of this nature, it is possible to collect over 30 pieces of objective information related to the applicant's status prior to his employment.

Fit for Duty/Return to Work Addressing the aging work force
In addition to post-offer testing, companies who have saved the most dollars in preventive care programs have utilized post-employment/fit for duty tests.  This service allows objective data to be collected t:

1. Determine an employee’s ability to continue to perform his job tasks safely.
2. Indentify cumulative trauma syndromes or disease processes which increase in incidence with aging.
3. Establishes baseline data to qualify legitimate injuries and disqualify game players post-injury

Two recent incidences supporting the effectiveness of post-employment/fit for duty testing involved long term employees who had deteriorated in their ability to perform routine job tasks.  Both tests revealed early stage neurological symptoms that were diagnosed after the provider recommendation for further studies.  Should those individuals have been injured while working, the company involved would have been liable for that person’s disability for the duration of the disease.  In addition, job specific testing reveals that may employees actually work with discomfort while performing job tasks in a dangerous manner.  Such testing allows instruction in proper body mechanics, lifting techniques and simple exercises that can be done on the job to prevent degenerative problems.  Post-employment/fit for duty testing allows the employer to work with long term employees to insure their safety at the work site while considering the effects of the aging process.

Functional Rehabilitation & Work Hardening  Preparing the injured worker for return to work
As an extension of physical therapy the provider may offer conditioning and job related rehabilitation exercises aimed at preventing reinjury. Many patients have had months of inactivity with secondary deconditioning and are quite susceptible to reinjury. As a result, progressive cardiovascular exercises are implemented to improve aerobic conditioning. Also, work simulated exercise programs are implemented to reinforce the person's self-confidence, educate them to proper work related lifting techniques, and strengthen the muscles necessary for a permanent return to work. It has actually been documented that negligence regarding injury is negated significantly for employers who work with healthcare facilities that provide job simulation to ensure a safe return to work.

Functional Capacity Evaluation  Determining if the worker is prepared to return to work

The FCE is a medical test to measure an employees function post-injury. Our FCE is designed to document existing impairment, prove consistency, and create realistic objective treatment goals and return to work recommendations. The FCE is also automated and includes criteria to evaluate symptom magnification, inappropriate illness behavior, and validity of performance. (This information is invaluable to objectively move the patient through the system in a fair and timely manner.)

The employer is interested in a (FCE) at the time of injury to determine severity and legitimacy. One (FCE) is administered during rehabilitation to determine progress. And a post rehabilitation test to determine the employee’s ability to return to their job.

Functional Capacity testing is essential to objectively streamline the rehabilitation process and save employers considerable time and money. FCEs should be performed on all work related injuries.

F.A.Q.s
1. Can the employer withdraw an offer of employment if an employee is belligerent, obnoxious, or angry during testing?
Absolutely, since the employee is attending the facility as a representative of the company, they would be expected to conduct themselves in a manner conducive to company policy/expectations. Any insubordination or misconduct would be reported directly to the company via the job specific computer generated report. The final decision regarding continued employment rests with the employer.

2. If I test all people in one job classification and choose not to test a group in another job classification, is that  discriminatory?
No. Example: It is perfectly acceptable to test all mechanics in a facility and not any of the secretaries or vice versa.

3. How many employment tests have been performed utilizing the program protocol?
The ongoing database currently has over 1,000,000 and is being added to daily (January 2010).

4. What makes this program different from other testing programs?
A comprehensive database including 40 physical and medical measurements, which is to our knowledge the largest ongoing database of this type in the United States. The proven success of this program without causing injuries benefits everyone from a liability standpoint. Another component unique to the program is that it is a turn key program with all the training and supplemental materials that walk the representative not only through the testing process, but if they desire, the entire industrial rehabilitation process.

5. What if a person in sales takes the test and he/she has no lifting or aerobic requirement as an essential function of the job?
The position is first "altered" to a light position and no essential job functions are evaluated. As long as they are cooperative they cannot fail the test and the data is only used as a medical baseline if and when an injury occurs. The applicant will still be given safe lifting limits based on their maximum dynamic lift efforts.

6. Can the program help in supplying job descriptions for our company?
Yes. If data base has similar companies with similar positions such as county or city employees, these job descriptions can be readily available once a list of positions is received at the corporate office. However, there will be a charge to the company for the time involved to produce such descriptions on a per job basis.

7. Is it necessary to have job descriptions prior to testing?
No. It is necessary for the representative to have personal knowledge of the job in question or have performed a job analysis prior to testing in order to create accurate essential job specific tests. Even so, job descriptions are not mandatory.

8. If a company has job descriptions, must they be accurate?
Absolutely. ADA law relegates that it is better to not have job descriptions than to have job descriptions that are vague and don't describe the essential functions of the job.

9. Can I test one new hire for a specific position without testing everyone applying for that position?
No. If you test one new hire in a certain job, there must be a method in place to test the other employees in that same job in a "reasonable" time frame.

10. Can I test an existing employee without testing everyone in that job position?
If you have significant evidence that an existing employee is having difficulty performing the essential job functions, they can be tested at any time without having to test the other employees who work in that position.

11. If an employee fails every aspect of testing, including job specific testing, is he eligible for employment?
Absolutely not. If the employee fails only one part of the job specific testing, he may legally have the offer of employment withdrawn at the discretion of the employer.

12. How much time is required on each test for a licensed OT, PT or MD?
A) Basic test - none
B) Carpal tunnel test - 20 minutes
C) Comprehensive test - 15 minutes
13. What are the primary test components?
A) Physical Characteristics
B) Musculoskeletal Evaluation
C) Static GripTesting
D) Dynamic Testing
E) Specialty Testing (Isokinetic, Carpal Tunnel, etc.)
F) Job Specific Testing

Testimonials upon request

                       
FAQ of Evans Workers’ Compensation/Property Casualty Cost Containment Program

1. Q: How is Evans paid for their services?

A: It depends on how many services you want us to perform.  If it is only to serve as a consultant, the cost will be included in your property & casualty premium.

2. Q: Cost of out side services other than the BWC?

A: Initial Cost will be paid by you and will be a pass through.  No outside services will be considered unless they will result in future savings.

3. Q: What is the consulting only cost?

A: $2500.00 plus out sourcing costs

4. Q: Should I wait until my property & casualty expiration to explore the program?

A:  No, unless you have prepaid your annual premium