1. Sandy Cerimele Fralich, Senior
Account Executive
JWF Specialty Company
Working within the Indiana Worker’s
Compensation Community for more than 20
years, Sandy Fralich currently consults with public
and private employers in Indiana and Illinois to
establish self-insured claim administration for
claims involving worker’s compensation, disability,
property and casualty and FMLA. She previously
served 13 years with the Indiana Worker’s
Compensation Board dealing with dispute resolution, community education,
public policy, agency administration and legislative affairs.
“Thinking big in these times-where budgets are tightening and costs are rising-
is the first step in creating change, one that is sustainable over the long haul in
a changing economy.”
The Human Aspect of Worker’s Compensation
There is value in having an integrated approach in all aspects of human
resource and risk management. Truly understanding employers and
employees is key to setting up effective programs pre and post injury.
I honestly believe there is a mutual desire for injuries not to happen. But, when
injuries happen-a person is hurt and an employer is left without an employee,
which brings challenges for all. Quality care must be delivered promptly and
it must be at a reasonable cost and for a reasonable timeframe.
How do we do this in Indiana?
Indiana employers enjoy one of the lowest litigation rates in the country.
With everyone at the table, and generally not arguing, worker’s compensation
professionals foster great relationships that support employers in achieving
positive outcomes. All effective programs start(s) with the employer’s
commitment. My initial experience at the Worker’s Compensation board
formed my passion for what I do today. Years back, when I read letters from
injured workers looking for assistance, I understood how severely their lives
were impacted by occupational injuries. Fueled with curiosity about what
could be done to improve those sad situations, I began to also learn what
employers face in dealing with these same injuries. I understood rather
quickly that managing worker’s compensation programs is a complex task that
often presents very difficult challenges for employers. But, what also emerged
from that experience was a crystal clear view of one common element of all
efficiently run worker’s compensation programs - employer’s who walked the
walk in dedication to and understanding of the people on the job. Today,
I look for those employers as clients who want to take on these challenges
and provide creative solutions. I enjoy quantifying their successes in real
cost savings and in significant injury reduction, and I enjoy talking about
employees who are back to work after injuries that might otherwise have
been more debilitating. Celebrating these successes is important and
rewarding to everyone involved.
Advocacy and Guiding Philosophy
I am an advocate for influencing systems in companies that work properly.
I am an advocate for my clients who face challenges in keeping their doors
open and meeting critical responsibilities in challenging times. I am an
advocate not only for getting people to return-to-work, but also for treating
people well in the process. I am an advocate for new and exciting ideas that
keep people at work and uninjured - like implementing on-site biometrics
from athletic trainers, and integrating wellness into occupational side of
managing insurance programs. This advocacy was reinforced on my first
day on the job as newly promoted Executive Secretary of the Worker’s
Compensation Board nearly 20 years ago. My boss and mentor, Terry
Coriden, former Hearing Officer and Chairman of the Board for more than 30
years, handed me a jar of honey, and said, “You will get further with honey
than you ever will with vinegar.” I have kept that jar of honey in every desk I
have had since, because I believe the most effective way to problem solve is to
put yourself in someone else’s position. It softens your resolve to your own view
and allows you stay open minded. It has been most helpful in learning how to
impact a desired result in nearly every aspect of life, which is why it is equally
effective when listening to employees and employers in worker’s compensation
problem solving.
Spotlight: Employers Who Think Big Enjoy Big Results
While it is not news that injury prevention is essential, there are new ways
employers are tackling it. Biometric assessment and correction is the new wave
in injury prevention. This strategy allows employees to fix physical weaknesses
and prevent injuries. It is wellness in action in worker’s compensation. Wellness
programs were born out of alarming concern over rising health premiums. The
cornerstone of a wellness program is prevention. Healthy people need less
care, and therefore cost less to insure. The same analytics hold true in worker’s
compensation programs. Stronger bodies are more likely to avoid injury, and
stronger bodies suffer less severe injuries in general.
The program, which is gaining traction in Indiana by ATI Worksite Solutions,
involves hiring athletic trainers to visit employees on site. There, the trainers
view the physical demands and working environment in direct correlation
to the individual employee’s physical abilities. In addition, a bio-metric
evaluation is conducted for each employee that results in a personal
strength score. Athletic trainers then give each employee a road-map for
improvement. Armed with this road-map, and supported by their employers,
employees are able to work harder, stronger and smarter and they appreciate
their employers for the personal attention and investment in their well being.
The key result for employers is fewer claims and claims at lower overall incurred
cost, which lie directly in the prevention and severity reduction of soft tissue
injuries. A back or shoulder strain can range in direct costs from $400 to
$275,000 in Indiana, with costs varying only slightly from state to state in the
rest of the region. The severity of a given soft tissue claim appears to be directly
linked to the physical conditioning of the patient pre-injury. Stronger patients
have less severe injuries of shorter duration and respond to treatment willingly.
What becomes tricky is convincing employers to spend money to save money.
But those who have made the leap, report direct returns on that investment at
a much greater rate than they anticipated. Consider that at a median range
of roughly $140,000 for a soft tissue injury that requires surgery, preventing
just one injury will generally more than cover the costs of these programs up
front. Some employers even encourage healthy competition between workers
to improve their bio-metric numbers over an established period of time,
yielding morale boosts in a healthy employee culture.
Workers’ Comp Professional Insider
Insights, opinions and resources from our expert in the field.
Previously published as
“The Guest Guru” on

2. Own Your Program
Not all employers are willing to take big steps to act on big ideas. Many
still treat worker’s compensation as a business cost or an insurance program
and hand control over to carriers and others in a disinterested fashion. This
philosophy is fuel for fodder, leading to complaints about the system and about
people taking advantage of an entitlement. Though Worker’s Compensation
is a no fault system, employers in Indiana do have a tremendous say in how
their programs are run. Employers with cost effective worker’s compensation
prevention and management programs have mastered the task of holding all
of their partners accountable for the role they each play. Demanding quality
service, clear communication, and quantifiable results from medical providers,
claims professionals, legal experts, and other services providers is essential in
maximizing the outcomes for worker’s compensation programs in Indiana.
Big thinking employers examine trends, and actively participate in solutions
when issues arise, cutting through red tape and complacency.
Consider Alternative Risk
With insurance rates ticking up in a worker’s compensation hardening market,
employers who have already committed to strategies for keeping costs low
and dedication to their workforce high, will be in the best position to avoid
the pain of increases. The larger of these employers can also often consider
alternatives like self insurance and high deductible plans because they are
already doing the work necessary to achieve the instant savings in the bottom
line those programs yield. Employers who take this leap are no longer subject
to the impact of experience modification rating fluctuations in tail claims that
impact their costs in traditional premiums for many years. Thinking big in
these times where budgets are tightening and costs are rising is the first step in
creating change that is sustainable over the long haul in a changing economy,
and creates more opportunities for growth within each company’s primary
business objectives.
Top Ten Ways Employers Can Think Big to
Maximize Worker’s Compensation Programs
1. Modified Duty is Not an Option (no matter what). Employees
should return to work from initial appointments the same day
with restrictions in hand to be placed in transitional work.
2. Establish a treating physician up front and post that
information for your employees. Direct care even if an
employee indicates it might be of personal nature. This will
ensure proper communication from the beginning when a
claim adjuster has to take on the case.
3. Be a Master of Social Media. Employers are Tweeting employee
groups on health and wellness tips, and setting up Facebook
pages for safety prevention. Social media can also be used as
a claim investigation tool when injuries are in question.
4. Demand Feedback from your Claims Professionals. Loss runs
and trend reports can reveal budding problems in departments,
or for a class of employees, such as by occupation. Work
together in quarterly claim reviews to determine progress on
initiatives and identify other areas for improvement.
5. Involve your Employees in WC Program Development. Ask
employees to assist in: creating modified duty; developing a
work conditioning program; establishing an open network for
communication regarding WC issues.
6. Establish an Injury Prevention Program. Invest in conditioning
your workers to be stronger to avoid injuries and reduce the
severity of the ones that occur. Often avoiding just one injury
pays for the up front costs of this investment.
7. Job Rotation is Not an Option. Employers who do not take the
time to establish a mandatory rotation of jobs in a repetitive
environment are missing low hanging fruit in cost savings,
particularly in injury prevention. Think of all the work that
needs to be done and break it into tasks and then find a way
to share the tasks in a way that does not tax employees on an
individual basis.
8. Consider Alternative Risk. Indiana currently has fewer than
200 approved self insured employers on its state roster.
These employers have already learned that taking on risk up
front will yield cash flow advantages and provide long term
financial stability, especially when the market fluctuates. A
sweet spot for considering self insurance in Indiana is around
$250,000 in traditional worker’s compensation premium or
in combined deductible and premium expenses. Loss picture,
financial stability and employment class also have an impact.
9. Incorporate WC Medical Treatment into your On-site Medical
Clinics. Employers who already have on-site clinics are
treating either initial wc injuries, or follow up treatment,
or both at their on site clinics. If you choose to explore
this option, make sure the intake nurse is well versed in
WC triage, to ensure claimants are properly screened for
compensability.
10. Avoid Exclusivity in Partner Arrangements. Whenever possible
keep multiple medical service partners (physicians, case
managers, physical therapists), legal professionals in your
corner by establishing good working relationships with many
of them, or demand that your claims professionals do the
same if self insured. This healthy competition often assures the
best results at the lowest costs.
Contact Info
Sandy Cerimele Fralich
Senior Account Executive
sandy.fralich@oldnationalins.com
JWF Specialty Company
600 E. 96th St. Ste. 425
Indianapolis, IN 46240
(317) 706-9592
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About Us
With a mission of being the best alternative risk services company in their
territory by offering our customers flexibility, creativity and innovative
solutions in the handling and treatment of their exposures to risk of loss,
JWF Specialty Company focuses on specific critical success factors.
Philosophy
JWF Specialty Company’s philosophy regarding insurance is to provide
our clients with current, state of the art techniques to identify and carefully
handle their risk management needs. This allows JWF to address the specific
needs of our clients and provide them with a program tailored to their
individual requirements.
Products and Services:
-Alternative Risk Insurance
-Claims Administration
-Program Administration
-Public Entity Products