Partnering with Medical Providers

Roberta S. Mike, WCLA, FCLA

Since the pandemic, employers and medical providers have become distant due to limited visits to facilities and staffing challenges/changes.

Yet, employers realize their involvement in their employee’s medical treatment after a work injury is valuable. Injured workers have a limited understanding of their treatment plan and protocols, which causes a significant oversight of communication.

The medical provider’s role is critical to the injured worker, as well as the importance of always clearly communicating the care plan. So, partnering closely with medical providers offers the best outcomes for both employees and employers.

To start looking at partnering more efficiently, employers and medical providers suggest the following:

• Establish a profile of contact information for the employer and their protocols, sharing all locations and contacts. • Create a good contact source to ensure access to all parties. • Provide written job descriptions to your medical partners, including photographs, if possible. • Be clear about what is available with medical facilities and never assume it’s a one-stop-shop. Know what they have, for example, diagnostic and physical therapy services. • Have medical providers share the availability of services, including hours and weekend access. • Schedule a meeting with all providers and outline expectations to ensure the partnership benefits all. • Ask for pricing of services, medication dispensing, and other services offered, including weekend access. • Inquire and consider offering transportation to injured workers’ appointments to ensure their attendance. • Consider utilizing telehealth/telemed on minor issues and/or follow-up appointments. • Educate employees on different mental and behavioral health issues and topics. • Meet the hospital representative in your area and inquire about other non-emergency services as well as any free seminars offered to your employees. • Discuss transitional duty positions and be clear on their availability. • Invite all medical providers to the facility and meet with lead managers, safety team members, and human resources personnel. • Inform medical providers of machinery and all operations for medication dispensing. • Educate employers and management on the use of regimented medications such as those used for high blood pressure and diabetes. • Build a rapport between all parties including pharmacy, physical therapy facilities, dentists, specialists, or any other medical personnel or providers you work with. • Inquire about free services with providers such as nutrition, controlling diabetes and high blood pressure, exercise, smoking cessation, etc. • Check out the vending machines and offer healthier suggestions. • Include claim professionals in these meetings so they’re aware of services and communications with all parties. • Respect everyone’s time during business time. • Minimize and simplify paperwork to include what is authorized and contact information to their carrier. • Ask the employee about their appointment(s) outcome and address any concerns immediately. • Always compliment great outcomes and care in any situation.

All of the above will impact the best outcome for everyone.

Roberta Mike is a senior field claims adjuster for Strategic Comp, a division of Great American Insurance Group and the past president of Atlanta Claims Association. She began her career forty years ago at Travelers Insurance Company in New York, and also worked for Fireman’s Fund Insurance Company in New York and Georgia, Ryder Claim Services, and Zurich North America, and Muller Water Products . Roberta served as president for Atlanta Association of Insurance Professional (AAIP) which is a local chapter of the National African American Insurance Association. She is a recipient 2017 Recipient Claims Person of the Year and Pioneer’s Award of 2018.

Ben Vinson, Chairman and Chief Appellate Judge

Happy Fall Y’all! I hope everyone had a great summer and now we can look forward to cooler weather and enjoying some outdoor activities. On behalf of the State Board of Workers’ Compensation, I am proud to report we are having a successful 2022 with a continued increase in all types of proceedings and board functions. The Board remains in good health and we finally saw the return of many of our traditional in-person events this year.

We were thankfully able to host our regional seminars and our annual conference in person… just like the old pre-pandemic days. The Public Education Committee of our Advisory Council organized an exciting program for the regionals that was filled with important information and perspective on several hot topics.

We were delighted to take the show on the road to five (5) cities across the state: Cartersville, Columbus, Athens, Savannah, and Alpharetta. I enjoyed visiting each city and speaking with industry representatives to discuss all types of issues. Fittingly, the theme of our annual conference was “Return of the Champions” to recognize the Braves and Dawgs championship seasons and our return to the field to move past the pandemic and gather together for a large, meaningful event. We appreciate all who participated by sponsoring, exhibiting, speaking, and attending.

In June, I joined the GWCA Spring conference at Jekyll Island and provided a legislative update. The Georgia General Assembly convened the 2022 Session on January 10 and adjourned Sine Die on April 4. As predicted, three issues emerged that directly affected the world of workers’ compensation: 1) a presumption for first responders with PTSD, 2) a measure to address the coverage gap with PEOs, and 3) a $50 increase in the max TTD rate. While the PTSD and PEO issues did not pass into law, the TTD bill passed overwhelmingly and was signed into law. Our Advisory Council, led by Bobby Potter, was engaged on each issue and proved quite helpful as the legislative process played out. Importantly, we had many good discussions with policymakers on these and other topics to preserve a stable and balanced workers’ compensation system for all stakeholders.

This summer, the Board reconsidered its guidelines for in-person hearings and revised them on June 27 to reflect the most recent information from the Center for Disease Control (CDC) and the Georgia Department of Public Health. The new guidelines lift many of the screening and other protocols while leaving in place a streamlined process to limit participation by parties that are sick. The guidelines are posted on our website and reflect the goal of our staff to remain on mission and operate the Board effectively and efficiently.

As a final note, I am glad to announce that the Board has a new office location in Savannah at 35 Barnard Street, Suite 301, Savannah, GA 31401. Have a great second half of 2022 and I look forward to seeing everyone at various events this fall.

Ben Vinson was appointed Chairman and Chief Appellate Judge of the State Board of Workers’ Compensation by Georgia’s Governor Brian Kemp in May 2021. He previously served as Director and Appellate Division Judge for the Board, appointed by former Governor Nathan Deal in July of 2017. In addition to hearing Workers’ Compensation cases on appeal, Chairman Vinson shares responsibility with Judges McKay and Bahl for governing the state agency, which includes regulatory, policy, and operational matters.