THE NEWSLETTER June GEORGIA EDUCATION WORKERS COMPENSATION TRUST Workers by mattarmstrong

VIEWS: 73 PAGES: 3

									                                         THE NEWSLETTER
                                                  ------------------------------/       /------------------------------
                                                                                                                                    June 2006




   GEORGIA EDUCATION WORKERS’
      COMPENSATION TRUST

Workers’ Comp: What Every School System Should Know
                                           By Greg S. Dorsey, CPCU, AIC
                                                                                                                              TRUSTEES
Dorsey is Assistant Vice President of Georgia Education Workers’ Compensation Trust’s third-party administrator, Affinity
Service Group. This article is the first in a three-part series that will be featured in the GEWCT Newsletter.                   Ric Hall

                                                                                                                             Laurence Stockton
If you or your employer has three or more employees, the State of Georgia requires that
                                                                                                                              Tommy Rogers
you carry workers’ compensation coverage. It is important for you to know you can
control your losses with the help of your insurance carrier and should investigate all                                         Phil Robbins
options. There are certain strategies and tools that every school system in the State of                                       Robert Aaron
Georgia should know.
                                                                                                                               Ronnie Clark
What is a Medical Panel Card and how does it function?                                                                         Larry Harmon

An employer is required under the Georgia Workers’ Compensation law to provide medical
care to employees who are injured on the job. This law also provides for the employer to                                    AFFINITY STAFF
have control over which provider will be used for treatment. In order to have some control,                                    Bonnie Corey
the employer is required to post a panel of physicians. The medical panel card provides a
listing of physicians that employees can receive treatment from after an on-the-job injury.                                    Greg Dorsey
Without the posted medical panel card, the employer has no control over the medical, and                                        Stan Deese
the employee is then free to select any physician to render medical treatment at the
expense of the employer.                                                                                                        Brian Wood

                                                                                                                             Charles Sizemore
The employer may comply with the posting requirement in one of three ways:
                                                                                                                              Doug Froemke
        • Provide a contract with a workers’ compensation Managed Care Organization
            (MCO)                                                                                                              Wayne Hurst
        • Create and post a conformed panel of physicians (must have 12 physicians)
                                                                                                                               Kasey Sewell
        • Post a traditional medical panel card
The traditional medical panel card is by far the most popular and most utilized.                                               Denny Pickett

                                                                                                                               Josh Conrey
The MCO must be certified by the State Board of Workers’ Compensation and must
include a broad range of services and providers. The MCO, in turn, would contract with an                                    Teresa Diamond
insurer or self-insurer to offer medical providers. The Conformed Panel of Physicians,                                          Mindy Lee
which is rarely ever used, requires ten physicians, one orthopedic surgeon, one minority
physician, one general surgeon and one chiropractor.                                                                          Terri Cormany

                                                                                                                               Nina Marshall
Most employers in the state of Georgia choose the traditional medical panel card to meet
their posting requirements. The traditional panel of physicians is a pink, legal-size listing                                Darchelle Stokes

of physicians that is posted in the workplace to notify employees of the medical providers                                      Pat Brown
with whom they are authorized to treat for an on-the-job injury. This list must contain at
                                                                                                                              Elaine Whiting
least six physicians to include: one minority physician, and at least one orthopedic surgeon.
                                                                                                                                Sherry Key

                                                                                    1
Additionally, a valid panel cannot have more than two industrial clinics. In the event an injured worker treats with
a physician that is not on this panel of physicians, the responsibility for the payment of treatment will be the sole
responsibility of the employee. By having the medical card properly posted the employer has control over which
physician will be authorized to provide treatment at their expense.

Once the panel of physicians is properly posted, employers must also take all reasonable measures to ensure that
employees understand the function of the panel and their right to select physicians in the event of an on-the–job
injury. It is recommended that employers obtain a signed statement or memo that the employee has seen the
medical panel, understands the medical panel and understands what to do in the event of an on-the-job injury.
This type of documentation provides strong evidence in the event the employee alleges no knowledge of the panel
of physicians. In an emergency situation, injured workers may get temporary medical care from any doctor until
the emergency is over, then they must get treatment from a doctor on the posted medical panel card.

An injured worker is allowed one change of physician without the approval of the employer/insurer. In order for
the employer to be responsible for payment the physician must be chosen from the list of physicians on the
medical panel card. Any other change must be agreed upon by the employer/insurer or from an order from the
Workers’ Compensation Board.

Selecting Physicians for the Medical Panel Card

        •   Choose physicians that are conveniently located to the work site.
        •   The physicians should understand the workers’ compensation system.
        •   The physicians should understand modified duty.
        •   Employers should meet the physicians on their panel to facilitate communication.
        •   Employers should choose a physician that will listen to the employee’s medical concerns
            following an injury.
        •   Employers should contact the panel physicians once a year to be certain that they are still
            accepting workers’ compensation patients.
        •   If the employer has a drug-free workplace, the physicians should be advised so that all
            applicable tests are administered following an on-the-job injury.

Regardless of which method an employer chooses to meet their statutory requirement: MCO, Confirmed Panel or
the Traditional Medical Panel of Physicians, the single most important thing an employer can do, prior to an on-
the-job injury, is to have a properly posted list of physicians. The medical cost associated with lost-time claims
continues to rise and makes up approximately 53% of all dollars paid out. Managing and controlling the medical
costs through the appropriate use of a physician list is vital to the employer in controlling claim costs.

The workers’ compensation system can be cumbersome, but if the panel of physicians is posted properly the
system will run much smoother for you. The medical panel card affects most issues that arise in the workers’
compensation system directly or indirectly. For example, length of disability, permanent disability ratings,
duration of prescription medication, return to work at modified duty, and Subsequent Injury Trust Fund Issues are
all impacted greatly by the physician.

Once the claim has occurred, quality medical care, along with open and consistent communication, is required for
mitigating the claim’s costs. Effective control of medical treatment is essential for the proper management of any
workers’ compensation claim. When an injury occurs, it is important to discuss the details with the doctor,
monitor the doctor’s recommendations, make sure your employees are following recommendations and
prescription needs. Taking these steps will help school systems enjoy reduced claims costs and ultimately
reduced insurance premiums.

Affinity Service Group can help with any of your workers’ compensation questions. If you need additional
information on the Medical Panel Card, please call our office toll free at (800) 233-2436.



                                                         2
   FACILITY INSPECTIONS ARE A GREAT ACCIDENT PREVENTION TOOL
                                                By Doug Froemke, Safety & Marketing


Every GEWCT member receives a minimum of two courtesy facility inspections each year. These inspections are
designed by intent to be a helpful service that will identify hazards and make recommendations to correct the
hazards. We emphasize this because occasionally a supervisor or responsible person has trouble accepting
anyone coming into their area and pointing out deficiencies and hazards that need to be corrected. We do not
punish or fine. Our ultimate goal is to help you eliminate hazards and reduce the risk of employee injury. Since
slips, trips and falls are the number one accident reported to our office, we make extra effort to seek out those
things that can cause school employees to fall. Special care is given to school entrances. The following are
some of the things we check:

         •   Parking areas need to be free of debris and potholes. Corrective action is simple. Clean up
             debris and repair potholes.
         •   Yellow caution paint on the curb edge step up from the pavement to the sidewalk catches the
             eye. The paint is a simple and economical way to help employees make the step up without
             tripping and falling.
         •   Uneven surfaces on the walkway leading to the entrance door can cause employees and
             school visitors to slip and fall. Concrete can break up, crack or buck up. It is well worth the
             effort to repair uneven surfaces to prevent an accident.
         •   Doorway mats do a great job preventing falls especially when employees transition from an
             outside rainy wet walk onto an inside tile floor. But if a mat becomes worn or curled up at the
             edges, it can become a trip hazard. Mats should be replaced once they become unsafe due
             to age and traffic wear.

Over and above the two yearly courtesy facility inspections provided, we have found that GEWCT members who
perform additional self-driven inspections at each facility entrance, improve their ability to reduce the hazards that
can cause employees to slip, trip and fall. The whole entrance inspection process can be accomplished in 3 to 5
minutes. Since this is such a big bang for the buck, it is well worth the effort, especially since accidents are
prevented. No doubt about it, correcting building entrance hazards goes a long way to reducing slips, trips, and
falls.
                                              --------------------/ /--------------------



                                      Value Added Services
                                                        By: Charles Sizemore


Members, new and old, sometimes confuse what “value added services” really are or how they may have a positive affect on
workers’ compensation premiums. GEWCT members receive value added services at no additional fees or charges. Many
school systems pay additional fees above their premiums for these types of services but GEWCT members receive these
value added services for FREE. Value added services include but are not limited to:
                  •   Courtesy facility safety inspections
                  •   Assistance in establishing employee safety committees
                  •   Safety training for all employees.
                  •   Periodic seminars for clerical/administrative personnel regarding workers’ compensation
                  •   On staff nurse
                  •   Assistance in formulating panels of physicians.
When School boards recognize that these services can help maintain a safe workforce and/or safe work environment, loss
frequency and severity of losses has the potential to drop thus creating a financial savings in the form of reduced premiums
(for example: promulgation of experience modification factor should trend down after an adequate time period of loss reduction
thereby reducing cost when a lower factor is utilized to calculate premiums).

If your system is not already taking advantage of GEWCT “value added services” and would like to, please contact Doug Froemke at
404-550-3789.
                                           --------------------/ /--------------------

WELCOME TO OUR NEWEST GEWCT MEMBER: FANNIN                                                    COUNTY BOE.

                                                                  3

								
To top