On this episode of the WorkSAFE Podcast, we sit down with returning guest Lyndi Barthel, Manager of Medical Services and Case Management at MEM. She has more than 28 years of experience in managing the medical aspect of work comp claims and oversees a talented team of professionals.
Planning ahead for workplace incidents is an essential task for any business. Despite safety rules and risk reduction, getting injured on the job is still a possibility. Emotions run high in the immediate aftermath of an injury. Having a plan of care in place ahead of time for an injured worker is an invaluable resource.
Listen to this episode of the WorkSAFE Podcast, or read the show notes below.
The importance of directing medical care
Injuries aren’t just physical – they’re emotional. In the heat of the moment, it’s easy to choose the quickest and nearest kind of care. But this isn’t always the right solution. It may mean an unnecessary trip to the emergency room, or even downplaying an injury that needs more attention than it first received.
Having a plan of care in place has one major advantage for both employers and injured workers: better medical outcomes. Employers have the right to choose where employees get medical care in some states. In other states, they can only make recommendations. In either case, Barthel advises that employers have a conversation with injured workers about post-injury care.
“That gives that injured worker a feeling of confidence in the employer’s ability to manage that medical need in the best and most appropriate manner,” she explained. This chat assures employees of not just physical care, but emotional support and their value to the workplace.
A plan of care: Finding the right care providers
Before employers start making a plan of care, they should determine if they can direct care based on their state rules and regulations. Then, they should start by finding the right providers to add to their plan of care. This is done by looking at the different levels of care injured workers may need.
Lower level care
Many injured workers encounter injuries that don’t require calling 911. For example, back pain, lacerations, or shoulder injuries. A nurse triage program is a great option for early intervention, where experts provide guidance over the phone about where and how to seek the right care.
Outside of a nurse triage program, Barthel recommends selecting a clinic that has comprehensive services. For instance, after an incident, drug testing is often required. A clinic that offers both treatment and drug testing is a more useful addition to a plan of care than one that doesn’t.
Medium level care
If an injury requires more expertise, then the next step is finding a specialist. Most work comp providers, including MEM, participate in a comprehensive medical network. Using medical records and the injured worker’s needs as a guide, a representative then connects them with a care provider who can best meet their needs.
High level care
Some workplace incidents are more serious than others. For example, if an injured worker is unresponsive or too ill to speak, bleeds severely, or has broken or exposed bones. Injuries like these require immediate medical attention. In these situations, employers should never hesitate to call 911. A claims representative will help determine long-term care options, such as burn centers or rehabilitation facilities.
Second opinions
Part of a good plan of care is to ensure the injured worker gets the right and most specific care possible for their injury. However, in some cases, a second medical opinion may be needed or wanted. “We hope to avoid the need for second opinions,” she added. “But they do come up from time to time.” A claims representative will work with the policyholder to determine the best course of action.
Planning ahead for the best care
It’s easy for employees to write off small injuries, like strains or scratches. But even the smallest injuries can escalate into something more serious. Getting the right care as soon as possible helps reduce the risk of complications – and unnecessary costs.
“We know that the earliest opportunity to obtain expertise in most cases is the best thing you can do, and that way the injured worker knows how to manage the injury.”
- Establish if you can direct medical care. If you aren’t sure if you can direct care, Barthel recommends reaching out to your work comp carrier as soon as possible to establish this.
- Pick your providers. Start creating your plan of care. When an employee is injured, who do you want them to call? Where do you want them to go?
- Educate your employees. Ensure your team knows policies and process around reporting and injury and getting help.
“Here at MEM, we want you to prevent injuries. We want to come alongside with you and help you to do that,” Barthel finished. “But when an injury occurs, we also want to come alongside with you and help you to know what to do in that moment.”