By Donna Motley, Vice President of Claims

As employer I am sure you are acutely aware of the demand for higher wages merely to employ “a warm body” – not always acquiring talents that were promised. I was at my dentist this past week and was told they are having an issue finding a receptionist; a person was hired but quit after one week. My dentist is a female; her husband periodically “helps out” in the office because they are short staffed. Jobs are available!

It seems the price of everything has universally increased. While the price of gasoline may fluctuate, I haven’t seen the same phenomenon happen at the grocery store! The local Meijer has installed a large number of “selfcheck- out” scanners, almost totally eliminating human cashiers.

A local Michigan utility has announced rates will be increased during “peak” hours; peak hours that happen to coincide with the hours I’m not at work! I can’t do my laundry during the day because I work from 8:00 A.M. to 5:00 P.M. So I assume I will have to pay “peak”!

Consequently, everyone is looking for ways to reduce costs. We can tell, in our office, when insureds decide “not” to file a claim for a work injury. A record of “no claims” would equal low premiums, right? Afterall, you now have to pay higher hourly wages to get someone to work, right? But, what are you really saving?

If an employer is paying for medical treatment for a work related injury, payment is 100% of the amount charged. Medical bills processed through our office are generally discounted between 40% and 60%. As an employer, are you receiving the medical documentation indicating diagnosis and treatment plan? As an employer, are you sure all the services being rendered are actually related to the alleged work injury? Our office tracks and follows treatment of an injured worker; we only pay for treatment related to the verified injury. We receive the medical records and follow the treatment plan, looking for signs of malingering, contributing comorbidities or aggravating outside activities. We have the ability to schedule necessary or requested testing (at a discounted rate), expeditiously. We have the ability to choose a specialty physician when we think it necessary. We have the ability to watch for abuse of prescription medication; as an employer, you may not even be aware if medications were prescribed. We also have the ability to schedule and track physical therapy appointments. Did you know that if a therapy patient stops showing measurable gains (improvement), treatment stops and payment is denied? How likely is an injured worker willing to schedule physical therapy “outside” of their work hours? WE schedule the employee’s therapy.

As an employer, you most likely would be confined by the restraints of HIPPA (Health Insurance Portability and Accountability Act) – we are not. Along those lines, we can also obtain “past” medical records that could have an impact on a “current” medical condition or injury. A large number of claims being received in our office are for recently hired employees – employees you don’t really know and of which you are not aware of their physical or medical histories. As a Workers’ Compensation carrier we can delineate between “chronic” and “acute”; “objective” vs. “subjective”. The mere allegation of “pain” does not constitute a work related injury or claim. Claims that do not fit the criteria of “arising out of and in the course of employment” are Disputed and not covered.

The Michigan Workers’ Disability Compensation Act is the guide. Our office has more than 100 years of experience in the Workers’ Compensation realm. Workers’ Compensation is all we do so we can devote all our attention to the claims that are submitted. The goal is a successful recovery of a valid injury and to save the employer time and money!