Substance abuse is common, and the costs of substance abuse are high for employers. Of the 20 million adults classified as having problems with substance dependence or abuse in 2013, about 12 million (60%) were employed full time, according to the U.S. Department of Health and Human Services.
In addition to higher absenteeism and lower job productivity and performance, substance abuse leads to greater healthcare expenses for injuries and illnesses. Furthermore, safety and other risks for employers can increase workers’ compensation and disability claims.
After a serious on-the-job injury, workers can face a long and painful road to recovery. As an essential part of the recovery process they are often prescribed narcotics to help manage their pain. While appropriate narcotic use can be extremely beneficial, abuse can lead to problems not just for the injured employee but also for you as the employer.
The first obvious concern brought on by narcotics abuse is the mental and physical effect that it has on an individual. While this is reason enough to make sure narcotics are used correctly, you as the employer should also be concerned about the increased claims costs that can be generated by abuse.
Drug prices are on the rise and, depending on the injury and course of treatment, they can be a substantial addition to the cost of a claim. In fact, it is estimated that narcotics account for as much as one-third of all workers’ compensation medication costs, according to the National Council on Compensation Insurance. Not only do costs increase when narcotics are overprescribed, in both time and quantity, but it can also extend claim length as both doctors and employers typically recommend that workers stay home while taking narcotics.
Currently, legal actions brought by workers who have attributed their misuse of narcotics to improper care have primarily targeted physicians and pharmacies. However, there is growing concern that these workers may be able to sue their employers for negligence. Specifically, some worry that the access employers and workers’ compensation carriers have to records that may show a history of misuse or abuse of narcotics could create a duty to warn involved parties of the potential for misuse. For that reason, employers should be involved with the recovery process and ensure regular communication with the carrier and physician.
Narcotics use plays an essential part in many treatment plans, meaning it isn’t something that can simply be eliminated. Instead, it is important that you set up safeguards that will monitor how narcotics are being used by those recovering from workplace injuries.
One of the best ways to monitor narcotics use is to establish a relationship with a pharmacy benefits manager (PBM) who is experienced in handling workers’ comp issues. PBMs act as your intermediary, monitoring progress and communicating with physicians.
PBMs can analyze individual claims at their onset to identify what type of injury has occurred. Using a pre-established system, they should be able to determine if, and to what extent, narcotics will be needed during treatment. At this time they can also review the patient’s history to make sure there is no past indication that would suggest the injured may pose a risk for narcotics abuse.
From the first time workers fills prescriptions to the end of their treatment, PBMs should continue to provide ongoing monitoring of the claims process for narcotics use. By doing so, they will be able to enact administrative controls that will prevent misuse or abuse and help workers regain their health and return to work quickly.
For more information, contact us.
Rebecca advises employers on leave policies, accommodations, discrimination and early intervention with workers’ compensation claims. While in private practice, she focused on defending workers’ compensation claims and handling Medicare-related issues arising from those claims. Rebecca received her
Rebecca advises employers on leave policies, accommodations, discrimination and early intervention with workers’ compensation claims. While in private practice, she focused on defending workers’ compensation claims and handling Medicare-related issues arising from those claims. Rebecca received her Bachelor of Business Administration degree with a major in human resource management from the University of Wisconsin-Eau Claire and received her law degree from Marquette University Law School.
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