Month: September 2023

MN work comp law change regarding notice of non-emergency surgery

Posted on by Sara Goese

It’s now even more important for employers to notify their claims adjuster immediately if an employee requests a non-emergency surgery.

Minnesota workers’ compensation law changed recently to allow an employee to notify their employer directly of a request for non-emergency surgery. Once notice has been given, the employer or insurer has seven days to give a response to the request. In a previous version of the law, such requests had to be directed to the insurer by the health care provider.

Legal options available to employers and insurers for response include approving or denying the surgery, requesting additional information or a second opinion, or requesting an independent medical examination (IME).

 

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Hiring practices: Thorough processes can prevent injuries and problem claims

Posted on by Sara Goese

Following a thorough hiring process is one important way you can prevent problem workers’ compensation claims, along with other challenges.

“I always talk to employers about the importance of hiring and retaining the right people,” said Loss Prevention Specialist Dana Mickelson. “Usually if you have problem employees and they stick around long enough, they then are typically the ones with work comp claims that become more expensive.”

Choosing the right employee for a role is rarely easy, but there are steps you can include in your process to help you more confidently make hiring decisions.

Consider safety in your application and job description

Use the application to start the process off on the right foot.

We recommend employers have an official application process that includes a form applicants must complete that follows local, state and federal laws. Each job posting should include a current job description noting the physical requirements of the position.

“Consider having an ergonomist or physical therapist review the position and job description,” said Loss Prevention Specialist Nick Johnson. “This ensures you’re documenting, in detail, the correct physical requirements for the job.”

Being competitive in the market can also help you attract the best applicants for the role.

“Some companies have recently improved their pay and benefits to be competitive in the market, which in turn helps them to hire and retain their best employees,” Mickelson said. “That includes not only medical and retirement fund benefits, but also flexible schedules, among other perks for employees.”

Ask the right interview questions

Once you’ve narrowed down the pool of applicants, it’s best to hold several rounds of interviews, and have multiple people interview each candidate, to gather a more complete view of the candidate.

When preparing interview questions, we recommend including open-ended questions related to workplace safety.

“Let that person give their thoughts on the role and safety, rather than feeding them the answer you want, or making it easy for them to give you the answer you expect,” Johnson said.

How you ask questions is important, but so are the questions themselves.

State and federal laws are strict about what an employer can ask regarding a person’s physical limitations or workers’ compensation claim history, but don’t avoid these topics altogether. Employers can glean helpful information by asking other, related questions.

For example, asking an applicant about their past workers’ compensation claims is prohibited, however, employers can ask them about their previous workplace safety training and if they feel ongoing safety checks are important.

Similarly, an employer may not be able to ask a candidate about any disabilities, but they can use the job description to demonstrate the requirements of the role, and to ask whether the candidate can perform the tasks listed.

“I suggest employers use a detailed job description as part of the hiring process,” Mickelson said. “During the hiring process, you can review the essential functions of the job and have the applicant or new employee sign a statement confirming they can perform those functions.”

Mickelson said that having a confirmation of the employee’s capabilities documented may be helpful in the event of a work injury.

Follow a thorough vetting protocol

Once you’ve picked a candidate to move forward with, it’s in your best interest to do a background check and call references.

Below, we offer a list of recommended steps to take for every applicant you want to hire. Keep in mind that some of these steps may not be permissible until a conditional offer of employment has been made. Be sure to consult your employment law attorney.

  • Call references.
  • Conduct a nationwide criminal background check. Be sure to check state and local laws for any “Ban the Box” type regulations and compliance with the Fair Credit Reporting Act.
  • Consider a pre-employment physical examination for physically demanding jobs in accordance with state and federal laws.
  • Verify their educational credentials and professional licenses.
  • Verify legal eligibility to work in the U.S.
  • Use E-Verify as a tool.
  • For jobs that require driving, check motor vehicle records.
  • For safety-sensitive jobs, conduct drug and alcohol testing in accordance with state laws.

“The applicant may interview well, and you can’t always pick up on red flags during the interview process, but the background check and references may prevent onboarding the wrong candidate,” Mickelson said. “Many employers don’t check references because they feel that they don’t learn anything, but it’s important to at least verify employment history.”

Keep safety top of mind while training a new hire

Once you’ve hired your new employee, include safety training as part of their onboarding and then follow up afterward to reinforce the training.

SFM loss prevention experts recommend checking in three, six and nine weeks after a new hire is onboarded to answer any questions they may have and to emphasize the safety training they heard early on in their new role. It’s also important to maintain safety training records and have the employee sign acknowledgement forms regarding safety policies and practices.

“The three-, six-, and nine-week check-ins are critical to identify any additional safety training needs,” Johnson said.

Also ensure a robust safety orientation is provided to everyone, regardless of language. If a new hire does not speak English and that is your company’s primary language, make sure to assign a bilingual supervisor to stay in contact with them and to provide them the same standard of safety training.

This is not intended to serve as legal advice for individual fact-specific legal cases or as a legal basis for employment practices.

Pre-task planning: Prepare and be aware for successful injury prevention

Posted on by Sara Goese

By Nick Johnson, CSP, Loss Prevention Specialist

Imagine this scenario:

We are at the airport waiting for our departure flight. While waiting, we see our incoming plane land, taxi from the runway, and dock at the jet bridge with no issue. We watch as all the previous passengers disembark, and the plane is refueled. Soon, the gate attendant calls passengers to board. The process is running like a well-oiled machine with no delays, and it looks like it will be a smooth departure.

Once settled into our seats, we wait to depart, but minutes after the scheduled departure time, the pilot explains over the intercom that they found some “irregularities” during their pre-flight checklist. Since we just watched this plane land and taxi with no problem, it seems like it will be just a minor delay. After 10 more minutes pass, the pilot comes on the intercom again to express concern about the “irregularities,” and the maintenance team has been summoned.

Finally, the pilot comes back on and explains that the maintenance team reviewed the data and decided to fully assess the plane before clearing it for flight. Passengers are asked to disembark and go to another gate to board a different plane. There are audible groans throughout the plane, but who wants to be on a plane with a potential mechanical issue?

So how does this story relate to pre-task planning?

If the flight crew hadn’t performed a pre-flight check, we would have embarked on a flight with an increased risk for a tragic incident.

Experience doesn’t guarantee safety

Part of my role as a workplace safety professional is to speak with clients about pre-task planning. Employers often respond that their employees are well trained, or they perform this work “all the time.” I love to hear that! The problem is that even well-trained and competent employees can have incidents and be injured when placed in less-than-safe situations and environments.

Safety risks can change daily and it’s imperative that employees have opportunities to identify them so they can use their training to solve problems before they result in incidents.

Pre-task planning identifies potential hazards for a particular time frame, environment and/or work task. Taking time to ask questions before beginning work allows teams to focus on hazard recognition and put specific controls in place to prevent incidents from occurring.

A little preparation goes a long way

By prioritizing pre-task planning, employees can focus on hazard recognition so when working on a task, they can perform knowing they’ve put appropriate safety controls in place.

I encourage implementing pre-task planning at the start of the day and after lunch. It can be an excellent tool to prevent severe incidents and help reduce pesky (and potentially dangerous) one-off incidents.

Give it a try!

What questions should employers be asking to identify hazards? There is a wide range of topics to address relating to mental, physical, and environmental states, such as:

  • What is the task I am performing, and what’s the end goal?
  • What could go wrong with this task?
  • Is there a potential to fall, be struck by or caught between objects/equipment or to encounter energy sources (electrical, hydraulic, etc.)?
  • What other work is being performed in the area that might affect me?
  • How will I control my work area to ensure safety?
  • Do I have the proper equipment to perform this task safely?
  • What physical limitations do I feel would prevent me from performing this task safely today?
  • What is the appropriate personal protective equipment (PPE) for this task?
  • How will I mitigate the physical demands to prevent strains and sprains?
  • How knowledgeable am I about the task being performed?
  • What questions do I have about how to perform this task safely?
  • How focused am I on the task at hand?

While this is not a comprehensive list of questions, it should serve as a good starting point to customize your own approach. The idea is to give employees every opportunity to assess a situation in real time and use training received to problem-solve and prevent incidents.

Get to know an SFM employee: Meet a member of our in-house bill review team

Posted on by Sara Goese

Kirsten Peterson
Kirsten Peterson

Kirsten Peterson has been a Medical Support Representative at SFM for two years, and in the workers’ compensation industry for 15 years. Kirsten is part of SFM’s in-house bill review team. We asked Peterson to share a little bit about her background and her role.

How did you get into workers’ compensation?
I just kind of fell into it by getting a temp job at a small workers’ compensation third-party administrator. I later got a job with a large pharmacy benefits manager. That’s where I learned a lot about medication and authorization and different rules for different states regarding medication. I still use that knowledge to this day, which is really cool. It’s kind of funny how it comes full circle.

How did you end up at SFM?
When I moved back to Minnesota, I made a list of the insurance carriers that were local and who had the nicest adjusters and SFM was at the top.

How would you describe your role in a nutshell?
A lot of what we do is processing medical bills, but a lot of people don’t know that we also educate medical providers to make sure they are billing us correctly and that we’re also paying them correctly. We also work closely with different state agencies to make sure that we’re following state-specific guidelines and rules. When we’re reviewing medical bills, we’re looking to make sure the bill relates to our injury. Sometimes we’re even identifying additional body parts or red flags in the medical records and passing that information on to the adjuster. They appreciate having us as their second set of eyes.

How is SFM different from other organizations you’ve worked for?
There’s a big sense of family, which I really love. Everyone is super kind, super friendly, super nice, very, very helpful. I love how close knit everyone is and you make relationships with people as you get to know them. We have a big focus on collaboration and learning from one another and teaching one another. I love having the opportunity to teach people on my team. Everyone’s feedback is heard and is welcomed. I work for an amazing team. Everyone’s super supportive. My boss is amazing. I love it a lot.

What do you like about your job?
I love that it’s completely different every single day. We have our basic set of tasks, but how you approach a bill is different from bill to bill and even claim to claim. I love provider phone calls because they keep us on our toes. Sometimes it’s a simple phone call wanting to know if the bill was received, and sometimes it’s a lot more complex.

What’s most challenging about your job?
There’s a lot of different state rules and regulations, so as we branch out into new states – which is really awesome and exciting – there’re new things that we have to learn, so we have to do the research. We have to reach out to other departments of labor and industry and make sure that we’re doing things appropriately, so that’s where it can get a little bit challenging.

What words of wisdom do you have for employers?
Make sure injured workers know to give our billing information right away when they go to medical appointments. If they don’t have a claim number yet, that’s OK. At least give our mailing address. That’ll ensure a smooth billing process, and they won’t get any unexpected bills sent to them.

Tell us a little bit about yourself.
I’m from International Falls, Minnesota, and I picked my college for their hockey team. I don’t necessarily recommend that as a method to choose your education, but it was also a good school (University of North Dakota). I have a 12-year-old nephew who does it all. I like to go to his hockey games, football games, baseball games, and now he’s a cowboy, so we keep pretty busy attending all of his sporting events, or if I can’t make it, my mom takes a video for me so I can cheer from afar.

 

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Companion moving to electronic delivery

Posted on by Sara Goese

SFM’s Companion magazine will be delivered via email only starting with the January 2024 edition.

“As more and more communication moves to electronic channels in many of the workplaces we serve, we felt the time was right to make this change,” said Vice President and Chief Communications Officer Andy Gebhard. “Discontinuing our print edition will allow us to place more focus on our online resources, and operate in a more environmentally friendly way.”

SFM will continue to send out the emailed edition of the Companion as it has for the past several years. Going forward, recipients of the electronic version will see no immediate changes.

In addition to the Companion email newsletter, SFM policyholders have on-demand access to a wealth of articles, downloadable resources, and videos covering a variety of workers’ compensation-related topics at sfmic.com.

 

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