Wellness and Workers’ Compensation

 In an effort to reduce workers’ compensation claims and costs, a large employer and an insurer in separate efforts are looking to wellness programs.  These programs (with disease management programs) are typically implemented to reduce health care costs, reduce employee absences and increase productivity.  However, concerns about increased liability for work-related injuries may have discouraged employers from suggesting wellness programs to injured workers.

A large multi-state manufacturing company is working with its group health insurer, FMLA administrator, third party administrator and disability insurer to link workers comp and wellness.  “They are developing a plan to direct employees with complex workers comp claims to disease management programs originally established for the company’s group health side.”

They are currently undergoing a compliance review to make sure that laws in the various states “will allow it to address employee health issues, such as obesity that exacerbates a work-related back injury, without making the company liable for the obesity as part of the workers comp claim.”  While these concerns have kept companies and insurers from creating similar strategies, this employer believes it can benefit by reducing complex occupational claims.

“In a separate effort, Denver-based Pinnacol Assurance hopes to involve 30,000 of its clients’ employees by year-end in a study that began in May.  The study aims to determine whether Pinnacol can reduce claim frequency and severity while improving worker productivity with wellness offerings.”  One unusual aspect of this study is that Pinnacol “is introducing wellness practices to small employers that may not even provide their workers with a health insurance plan.”

“The two efforts may provide models to help other employers . . . reduce workers comp costs by addressing claimants’ underlying health care issues.”

From Business Insurance, August 23, 2010 issue, pp. 1 and 21.