Author Archives: Synergy Coverage Solutions

What is Saliva-Based Drug Testing and Why is It Beneficial for Employers?

A saliva-based drug test is an alternative method to test for the use of illegal and controlled substances in the workplace.  A saliva-based test can be used for all aspects of a company’s drug testing program, including pre-employment, random, for-cause, and post-accident drug testing.  These products have more flexibility: they are less invasive, allow for onsite administration, and can detect up to 12 different substances at a cost that is significantly less ($11) than traditional drug testing performed at a doctor’s office ($60).

In workers’ compensation, saliva-based testing methods are particularly beneficial in post-accident scenarios.  After an injury, employers can quickly obtain the injured worker’s saliva to determine if the presence of illegal or unauthorized controlled substances may have contributed to the accident (which may affect the compensability of the employee’s workers’ compensation claim).

Another key benefit to saliva-based testing kits relates to their detection time.  Drugs can generally be detected in saliva for up to 24 hours.  Thus, they have the ability to demonstrate an employee’s impairment at the time of the accident (i.e. the employee’s drug usage was a proximate cause of the accident/injury).  A traditional urine-based drug screen performed at a doctor’s office can detect drug metabolites for several weeks in some cases; thus, a positive result cannot “prove” that an employee was under the influence at the time of the accident.  This is important in regards to the relevant workers’ compensation statutes regarding positive drug tests and claim compensability.  Additionally, the narrower detection window can assist your organization in complying with the anti-retaliation provision (effective 11/1/16) in OSHA’s Final Rule on Recordkeeping – Improve Tracking of Workplace Injuries and Illnesses.  This provision states that a post-accident drug test must be designed to elicit actual impairment at the time of the employee’s accident, for the same reasons described above.

It is important to note that the laws regulating the use of saliva-based drug testing kits for post-accident purposes may vary by state.  As an example, North Carolina only allows for the collection of an employee’s saliva; the analysis of each saliva sample must be performed by a certified laboratory.  Other states allow the use of a “quick-test” kit, which will detect the presence of drugs immediately upon collection of the saliva sample.

Interested in incorporating saliva-based drug tests in your organization? Contact your Synergy Loss Prevention Consultant or email us at info@synergyinsurance.net for more information.  Be sure to also ask about combining this novel drug testing approach with our Telemedicine option (Phone a Physician) for initial medical treatment.  Combining these two programs can save you over $130 on each injury, without having to leave your facility.  Now that’s Synergy!

Doctor Says Injury may be Work-Related, but Is It Really?

It is sometimes difficult to delineate the real cause of common injuries to the knee, back, or shoulders; it is important that we investigate deeply because they can easily turn into expensive workers’ compensation claims.

Quite often, doctors’ medical reports state that the injury might or could be work related but fail to consider the numerous other factors that contributed or may have been the cause of an injury; additional factors include everyday wear and tear, repetitive motion, and prior injuries. When a doctor so much as mentions the injury may be work-related, it is an uphill battle to argue otherwise.

However, in a recent ruling by the North Carolina Industrial Commission regarding a Synergy Coverage Solutions case, the Deputy Commissioner ruled in favor of the employer and denied the claimant’s request for benefits due to insufficient competent evidence of injury. In this situation, the claimant described a compensable trip and fall accident.  Evidence of the fall was confirmed and treatment to the left knee was provided and completed.  The employee later complained of right knee pain which required surgery; this condition was denied and went to a hearing.  Synergy Coverage Solutions was successful in proving that the claimant had changed her story multiple times regarding the mechanism of the fall and the timeline for the pain following the incident.  Additionally, the employee indicated that she had not treated for her knee previously, and Synergy Coverage Solutions was able to prove that this in fact was not true.  Finally, one of the physicians who initially related the injury to the fall, later testified upon questioning that the condition was ‘most likely a gradual process.’  Based on the inconsistencies in the claimant’s story and the testimony of the physicians, the deputy commissioner opined in Synergy and the employer’s favor.

For the employer, this is a significant ruling, as it shows the NC Industrial Commission taking notice of inconsistencies in the claimant’s account of their health and the incident.  Additionally, the Commission is paying attention to the actual injury and the likelihood of it being a result of a compensable incident.  Synergy knows that paying attention to all of these details can significantly reduce the cost of the claim, especially when the Industrial Commission takes a close look at the details presented.

Large Deductible Case Study

A school system, originally on a Guaranteed Cost policy, moved to a Large Deductible policy to obtain additional premium savings. In the first year of their Large Deductible policy, claim costs decreased by 62% and claim count decreased by 39%. This organization’s success can be attributed to strong management commitment to safety, implementation of crucial safety programs including Post-offer Medical Questionnaires, and a strongly enforced Early Return to Work program.

With a Large Deductible policy, our team at Synergy works in close conjunction with the employer to keep all parties informed and up-to-date on claims. This includes areas such as:

  • Regular claim reviews
  • Consultations on establishing reserves
  • Settlement of claims
  • Assignment of 3rd party vendors

Large deductible


Why choose our Large Deductible program?

  1. Cost Savings. Workers compensation premium is significantly discounted and employees remain fully insured.
  2. Flexible Products. Choose the premium and deductible level that best fits your organization. Deductibles range from $10K to $1M, with A rated carrier options available
  3. Quality Service. Aggressive claims management, combined with constant collaboration and communication with the employer, ensures satisfaction among all parties involved.

What is the Cost of a Bad Hiring Decision?

The cost of a workers’ compensation claim goes beyond medical and claim costs.  If a workplace injury occurs, your organization’s Experience Modification Rate (EMR) is negatively impacted, affecting your workers’ compensation premium for the next three years.

Cost of a claim graph

One way to control workers’ compensation costs is to hire appropriate candidates with the use of Post-offer Medical Questionnaires.

Learn more about Post-offer Medical Questionnaires in our webinar here.

Protect Your Organization from a Scabies Outbreak

It’s 2015, and while you may think of pirates when you hear about scabies, these mites are still around.  With an increasing number of organizations recently affected by scabies outbreaks, it is important to protect your employees and your clients.  Scabies can spread rapidly, especially in organizations such as nursing homes, extended care facilities, and hospitals.

A few quick facts:

  • Scabies can be spread through direct, prolonged, skin-to-skin contact or indirectly by sharing articles, such as towels, bedding, or clothing, with an infested person
  • Symptoms include intense itching, especially at night, and a pimple-like rash and may take as long as 4-6 weeks to appear
  • Treatment is typically a prescription cream or lotion

If an individual or client in your organization has been diagnosed with scabies:

  • Anyone who has had prolonged skin-to-skin contact with the infested individual should be evaluated by a physician and treated if necessary
  • Spraying or fumigating is unnecessary
  • Generally, infested individuals are safe to return to work the day after treatment has begun

Prevent “The Itch”

  • Avoid direct skin-to-skin contact with an infested person
  • Avoid skin contact with items used by an infested person (towels, clothing, bedding)
  • Household members and potentially exposed individuals should be treated at the same time as the infested person to prevent reexposure and reinfestation
  • Bedding and clothing worn or used during the 3 days before treatment should be machine washed using hot water and dried on the high heat setting (or dry cleaned).  Items that cannot be dry-cleaned or laundered can be disinfested by storing in a closed plastic bag for several days to a week (scabies mites do not survive more than 2-3 days away from human skin).

With Rising Medical Expenses, How is Synergy Managing Claims Costs?

Previously, indemnity costs surpassed medical costs in the workers’ compensation industry.  Today, medical costs continue to increase and have now surpassed indemnity costs.  How is Synergy Coverage Solutions working proactively to control medical costs?

  • Medical billing is handled in-house, giving us the ability to examine every medical bill, line by line, and only approve appropriate expenses (oftentimes, medical billing is outsourced and bills are paid without question).
  • Payment representatives are fully informed of individual claim details, offering a full perspective of the claim, rather than a segmented view.
  • Our network of medical providers deliver effective care at reduced prices and are informed of our Return to Work procedures.  When injured workers receive appropriate care, they are able to reach maximum medical improvement and return to work in a shorter time period.
  • Pharmacy network discounts are equal to wholesale costs.
  • Internal Nurse Analyst ensures injured workers are receiving effective care using the most cost-effective approach, proactively avoiding complications, and returning injured employees back to work as soon as medically appropriate.
  • Average medical costs are reduced by more than 50% of the original billed amount.

Synergy Coverage Solutions is dedicated to remaining at the forefront of the industry and providing valued services for our Policyholders.  To learn more about our innovative solutions, visit www.synergyinsurance.net.

How is Synergy Combating Increasing Medical Expenses?

With increasing medical expenses in the workers’ compensation industry, how is Synergy Coverage Solutions working proactively to control medical costs?

  • Medical billing is handled in-house, giving us the ability to examine every medical bill, line by line, and only approve appropriate expenses (oftentimes, medical billing is outsourced and bills are paid without question).
  • Payment representatives are fully informed of individual claim details, offering a full perspective of the claim, rather than a segmented view.
  • Our network of medical providers deliver effective care at reduced prices and are informed of our Return to Work procedures.  When injured workers receive appropriate care, they are able to reach maximum medical improvement and return to work in a shorter time period.
  • Pharmacy network discounts are equal to wholesale costs.
  • Our 24/7 Nurse hotline connects employers and the injured worker to qualified nurses who can direct appropriate care over the phone, reducing doctor visits, time away from work, and unnecessary medical expenses.
  • Internal Nurse Analyst ensures injured workers are receiving effective care using the most cost-effective approach, proactively avoiding complications, and returning injured employees back to work as soon as medically appropriate.
  • Average medical costs are reduced by more than 50% of the original billed amount.

Synergy’s medical cost containment programs are just one of the many benefits we are able to provide for our Policyholders.  We remain dedicated to staying at the forefront of the industry and delivering quality programs that add value to our workers’ compensation services.

Why Wait?

With every passing day that a claim goes unreported, total claims costs have the potential to increase, upwards of 20%.

Delays in claim reporting result in:

  • Missing or forgotten details from the incident
  • Difficulty in the claims investigation process
  • Delay in directing medical care, which can increase cost of treatment and compromise medical improvement
  • Increased attorney involvement
  • Reduced employee morale

What can employers do?

  • Report claims within 24 hours: Visit www.synergyinsurance.net/report-a-claim for quick & easy submission of the First Report of Injury, or call our claims reporting hotline at 1-877-327-5444
  • Train employees on proper claim reporting procedures
  • Inform employees of claim reporting procedures if an incident occurs outside of the facility
  • Designate a single contact to handle all workers’ compensation claims
  • Support injured workers by staying informed of their progress
  • Incorporate an Early Return to Work program and aim to return injured workers back to work as soon as possible

At Synergy Coverage Solutions, we are dedicated to providing quality services so your organization can return to maximum productivity.  Our latest enhancement, the online claim reporting web form, has been designed to be intuitive, streamlined, and easy-to-use, so your organization can get back to business.

Who Has Your Back?

When claims are effectively managed by the insurance company, employers can experience significant savings through a reduction of their Experience Modification Rate.  Below is an example of a case managed by Synergy Coverage Solutions which resulted in an estimated $100,000 savings in additional workers’ compensation costs.  How did just one claim make such an impact on the employer’s bottom line?

An employee had injured her back at work and filed a claim, which was deemed compensable.  It was initially determined, by the claimant’s general physician, that surgery would be required; the claimant received a 2nd opinion also recommending back surgery.  However, Synergy’s Claims Adjuster received two additional opinions, both stating surgery was not required.  The claimant later decided to undergo back surgery.  The claimant requested compensation for lost wages, medical treatment, and surgery costs with estimated total costs of over $200,000.  Who was responsible for coverage?

In this situation, Synergy denied coverage because surgery was not authorized.  The North Carolina Industrial Commission ruled in favor of the employer and Synergy.  The conclusions of law set forth by the North Carolina Deputy Commissioners were as follows:

  • Synergy Coverage Solutions and the Employer have the right to direct medical care
  • Synergy Coverage Solutions and the Employer are not responsible for unauthorized medical treatment.  The surgery was not authorized because it occurred one year later and two medical providers had advised against surgery.

Aggressive claims management and focus on cost containment improved the employer’s Experience Modification Rate.  The decrease of loss reserve directly reduced their Experience Modification to such an extent that the employer will experience a workers’ compensation premium calculation reduction of at least $100,000 over the next three years.  Synergy Coverage Solutions is focused on providing strong claims management as it allows our employers to experience significant workers’ compensation savings over the long term.

How Much Are Your Employees Costing You?

When it comes to lost productivity and workers’ compensation costs, how much can your employees cost you?  A study published by The American Journal of Health Promotion found employees of normal weight cost an average of $3,830 per year in medical costs, time away from work, short-term disability, and workers’ compensation claims.  Employees classified as morbidly obese (Body Mass Index of 40+) cost an average of $8,067.

A 2007 Duke University study found similar results – as BMI increased, the incident rate of workplace injuries increased, workers’ compensation costs increased, and obese claimants experienced longer recovery periods and a wider range of medical treatments, compared to employees of recommended weight (BMI of 18.6 – 24.9) with similar injuries.

What can employers do to control workers’ compensation costs and maximize productivity?

  • Make safety a priority in the workplace
  • Implement an Early Return to Work program, which can also help injured employees experience more successful medical outcomes
  • Utilize fit-for-duty assessments in your company’s hiring practices to minimize the risk of inappropriate hires that are not suitable for the physical duties of the job
  • Emphasize employee health and wellness in your company culture (i.e., health membership reimbursements, group fitness classes, wellness participation incentives, biometric screenings, health education & training)

Interested in learning more?  Contact your Loss Prevention Consultant or visit our website, www.synergyinsurance.net.