May 23, 2023

How Nurse Triage Could Lower Your Work Comp Insurance Costs

The average workers’ compensation claim costs $41,353, according to the National Safety Council. Frequent and severe claims can increase your experience modification factor (Ex-Mod) and drive up your workers’ compensation premiums. A nurse triage service can help you manage your claims and lower your workers’ compensation insurance costs. 

Expert Advice When You Need It 

How do you know if a worker’s injury is serious enough to warrant a trip to the emergency room? It’s a difficult dilemma. Quick access to an expert could solve the problem, and that’s exactly what a nurse triage service provides. 

A 24/7 telehealth nurse triage program puts your injured workers in immediate contact with an experienced healthcare provider. Instead of having to trust your gut instincts about the level of medical intervention needed, you can have a trained nurse assess the situation and provide guidance. 

Nurse Triage Can Reduce Claims and Lower Costs 

When a worker uses a nurse triage service, a few different outcomes are possible. Sometimes, the nurse may advise the worker to seek immediate care. Other times, the nurse may recommend first-aid that can be completed without going to an emergency room or a doctor’s office. This triage system can reduce workers’ compensation claims frequency and severity in several ways: 

  • Work Comp Claim vs. First Aid: Incidents that can be resolved with simple first aid may not need to be filed as work comp claims. 
  • Medical-Only Claim vs. Lost Time Claim: You can get immediate feedback on how soon a worker can safely return to work, and some incidents may be deemed medical-only claims, not requiring temporary total disability resulting from lost time from work. 
  • Temporary Total Disability vs. Temporary Partial Disability: Nurses can approve light duty work if required, keeping workers engaged and part of the team. If injured employees work light duty, they will continue earning part of their wage, only requiring temporary partial disability benefits from the claim, reducing claim severity. 
  • Serious Injury Intervention: If an incident seems serious, the nurse can refer the worker to the most appropriate medical practitioner, enabling appropriate treatment protocols to start faster. 

In every situation, the employer and the injured employee can proceed with confidence, knowing that a health care professional is helping to guide crucial decisions. 

Helping Workers Feel Cared For 

In addition to helping you feel more confident and in control of workplace safety, nurse triage services can help employees feel more supported at work. 

Imagine you’re a care provider, and you slipped and hit your head while at work. You think you’re OK, but you’re worried, and you’d like to see a doctor to be sure. Your boss is short staffed and doesn’t want you to take time off to go to the emergency room. You feel like your employer is prioritizing the facility’s needs over your well-being.  

According to Gallup, only 24% of workers strongly agree that their employer cares about their well-being, and workers who don’t think their employer cares about their well-being are more likely to report experiencing burnout and look for a new job. 

Injured workers who don’t think their employer has their best interest at heart may also be more inclined to retain a lawyer. A nurse triage program is one way of showing your team members that you care about them. 

Bolstering Your Documentation 

Whenever someone is hurt at your care facility, documentation is essential to record what exactly happened and why. If an employee is injured, documentation can also be important to determine if the cause of the medical condition is work related – particularly in cases where there is not a defined injury event and other non-work related causes could be contributing.   

A nurse triage service can be a source of this documentation. For example, imagine a care provider strains her back but she says it’s minor and she doesn’t need care. The supervisor accepts this. A couple of days later, the worker seeks emergency care for back pain after playing in a softball game. The supervisor suspects the pain is related to a separate injury but isn’t sure. The worker tells the doctor that the back pain is due to the work incident and that she wanted to get treatment immediately following the incident at work, but the supervisor refused to let her go. Now the care facility has a suspicious workers’ compensation claim plus allegations of negligence. 

If a nurse triage system had been used, the extent of the injury and the employee’s explanation would have been clearly documented. In addition, the employer’s response and immediate care given would have been documented. 

Take the Next Step 

Workers at assisted care facilities are vulnerable to injuries, so a proactive workers’ compensation program is essential. Tangram provides insurance for adult residential care facilities through the Personal Care & Assisted Living Insurance Center (PCALIC). We offer customized insurance packages with comprehensive risk management tools and resources to help you manage claims. Our programs include nurse triage services. Learn more.