© axiom medical consulting, llc. all rights reserved. © axiom medical consulting, llc. all rights...

© Axiom Medical Consulting, LLC. All rights reserved.© Axiom Medical Consulting, LLC. All rights reserved.

Injury Management Injury Management OverviewOverview

Axiom Medical Consulting, LLCAxiom Medical Consulting, LLCCaring is the Best MedicineCaring is the Best Medicine®®

25511 Budde Rd., Suite 801, The Woodlands, TX 7738025511 Budde Rd., Suite 801, The Woodlands, TX 77380(281) 419-7063 www.AxiomLLC.com(281) 419-7063 www.AxiomLLC.com


Mission StatementMission Statement

We are committed to providing the We are committed to providing the highest quality and cost-effective highest quality and cost-effective

medical management services medical management services available to promote a safe and available to promote a safe and healthful environment for your healthful environment for your

employeesemployees- Dr. Michael J. DeLitta- Dr. Michael J. DeLitta

President & CEOPresident & CEO


The high road to service is traveled The high road to service is traveled

with integrity, compassion and with integrity, compassion and

understanding. People don’t care understanding. People don’t care

how much we know until they how much we know until they

know how much we care.know how much we care.

Service Service


Partial Client ListPartial Client List

Air LiquideAir Liquide Baker Hughes, Baker Hughes,

Inc. Inc. BJ ServicesBJ Services BPBP Cactus DrillingCactus Drilling Chevron Chevron ConocoPhillipsConocoPhillips Cudd EnergyCudd Energy EncanaEncana

ExterranExterran Flint EnergyFlint Energy FMCFMC GDF Suez GDF Suez

Energy NAEnergy NA Grey WolfGrey Wolf Precision Precision

DrillingDrilling HalliburtonHalliburton HoneywellHoneywell

Key EnergyKey Energy Marathon OilMarathon Oil Mirant Services, LLCMirant Services, LLC PHIPHI SchlumbergerSchlumberger TEPPCOTEPPCO Team Industrial Team Industrial

Services, Inc.Services, Inc. Universal Ensco, Inc.Universal Ensco, Inc. WeatherfordWeatherford


Who Are WeWho Are We Injury Management ProcessInjury Management Process Two Case ExamplesTwo Case Examples Stats on Immediate InterventionStats on Immediate Intervention ClosingClosing

Injury Case Injury Case Management Management TopicsTopics


Full Service Medical DepartmentFull Service Medical Department

Who We AreWho We Are

Physicals – OSHA, DOTPhysicals – OSHA, DOT Drug Testing - DOT, non-DOTDrug Testing - DOT, non-DOT WellnessWellness Case Management Case Management


We are NOT a Third Party We are NOT a Third Party Administrator (TPA)Administrator (TPA)

Axiom Different From a Axiom Different From a TPATPA

We do not process Workers’ Comp We do not process Workers’ Comp claimsclaims

We do not negotiate or pay work We do not negotiate or pay work comp billscomp bills

Case Managers, not Case TrackersCase Managers, not Case Trackers


We are 24/7 - We don’t close at 5We are 24/7 - We don’t close at 5

How TPA Different From How TPA Different From AxiomAxiom

We understand OSHA and its We understand OSHA and its importance to our clientsimportance to our clients

All Case Managers (CM) are medically All Case Managers (CM) are medically licensed (minimum of RNs)licensed (minimum of RNs)

Our CMs carry a case load of less than Our CMs carry a case load of less than 15 – 20 cases (compared to 100 – 200)15 – 20 cases (compared to 100 – 200)


Our staff consists of:Our staff consists of:• Board Certified Physicians (MD) Board Certified Physicians (MD)

– Occupational and Environmental Medicine Occupational and Environmental Medicine – Internal Medicine Internal Medicine – Family Practice Family Practice – Medical Review Officers (MRO) Medical Review Officers (MRO) – Qualified Medical Examiners (QME) Qualified Medical Examiners (QME) – Masters in Public Health (MPH) Masters in Public Health (MPH)

• Board Certified Physician Assistants (PA-Board Certified Physician Assistants (PA-C)C)

Medical StaffMedical Staff


Continued . . . Continued . . . • Psychologists (Ph.D.) Psychologists (Ph.D.) • Registered Nurses (RN) with Bachelor Registered Nurses (RN) with Bachelor

or Masters ofor Masters of Science - Nursing (BSN / Science - Nursing (BSN / MS) MS)

• Certified Case Managers (CCM) Certified Case Managers (CCM) • Certified Disability Management Certified Disability Management

Specialists (CDMS) Specialists (CDMS)



Continued . . .Continued . . .• Certified Occupational Health Nurses Certified Occupational Health Nurses

(COHN) (COHN) • Certified Occupational Health Nurses-Certified Occupational Health Nurses-

Specialist (COHN-S) Specialist (COHN-S) • Certified Occupational Health Nurses-Certified Occupational Health Nurses-

Specialist/Case Manager (COHN-S/CM)Specialist/Case Manager (COHN-S/CM)



If the injury is critical or life threatening If the injury is critical or life threatening call 911 and then contact Axiomcall 911 and then contact Axiom

Injury Management Injury Management ProcessProcess

Never delay treatment in the event of Never delay treatment in the event of an emergencyan emergency

If the injury is not an emergency If the injury is not an emergency contact Axiom contact Axiom beforebefore you transport you transport the employee to a medical facility – the employee to a medical facility – this is important and will be explained this is important and will be explained


Call comes into Call Center and Call comes into Call Center and received by our Intake Specialistsreceived by our Intake Specialists


Basic info taken and case is Basic info taken and case is assigned to Case Manager assigned to Case Manager (CM)(CM)

CM calls injured employee CM calls injured employee within 5 – 10 minuteswithin 5 – 10 minutes


CM discusses incident and injury CM discusses incident and injury with employeewith employee


CM gather critical medical infoCM gather critical medical info Supervisor is removed from Supervisor is removed from

treatment decisionstreatment decisions Determines if employee requires Determines if employee requires

evaluation at medical facilityevaluation at medical facility


If a medical facility is indicated, CM If a medical facility is indicated, CM directs employee to directs employee to appropriateappropriate medical facility and provides initial medical facility and provides initial info on case to health care providerinfo on case to health care provider


Speak with medical facility before Speak with medical facility before employee leavesemployee leaves

Assist in getting post-accident drug Assist in getting post-accident drug and alcohol test –per company policyand alcohol test –per company policy


If a medical facility is not indicated, CM If a medical facility is not indicated, CM will provide 1will provide 1stst aid recommendations aid recommendations and monitor employee’s conditionand monitor employee’s condition


50% of cases never require clinic visit50% of cases never require clinic visit CMs do NOT diagnose, nor do they need CMs do NOT diagnose, nor do they need

to in order to provide 1to in order to provide 1stst aid measures aid measures


Employee and person calling in case (i.e., Employee and person calling in case (i.e., HSE, supervisor) must be in agreement HSE, supervisor) must be in agreement with CM’s 1with CM’s 1stst aid recommendations) aid recommendations)


If not, employee will be sent to If not, employee will be sent to medical facility for evaluationmedical facility for evaluation


CM provides a direct number to employee and CM provides a direct number to employee and supervisor to call with any questions, problems supervisor to call with any questions, problems or changesor changes


First e-mail goes out within 2 First e-mail goes out within 2 hours after treatment is completedhours after treatment is completed

First follow-up call is usually made First follow-up call is usually made within first 4 hours; then 24 hourswithin first 4 hours; then 24 hours


This may mean calls in the evenings This may mean calls in the evenings or weekendsor weekends


Keep mgmt and HSE updated via Keep mgmt and HSE updated via phone and e-mail during entire processphone and e-mail during entire process

Follow employee until able to perform Follow employee until able to perform regular duties or until adjuster regular duties or until adjuster assigned – depends on client’s assigned – depends on client’s preferencepreference


Ongoing dialog with employee, Ongoing dialog with employee, supervisor and treating doctorsupervisor and treating doctor

Transitional duties (light duty)Transitional duties (light duty) Will assist with return to work exam, Will assist with return to work exam,

FCE, etc. if indicatedFCE, etc. if indicated Important to determine if employee Important to determine if employee

can safely perform can safely perform allall aspects of aspects of their jobtheir job



TuesdayTuesday 3:30 PM - Employee (EE) holding a bolt and 3:30 PM - Employee (EE) holding a bolt and

was struck in the hand by a sledge hammer was struck in the hand by a sledge hammer by co-workerby co-worker

Medical Case Medical Case Management Management Case #1Case #1

4:00 PM - EE taken to local hospital4:00 PM - EE taken to local hospital 4:30 PM - Axiom called to 4:30 PM - Axiom called to

intervene Called ER and spoke with intervene Called ER and spoke with charge nurse EE in x-raycharge nurse EE in x-ray



TuesdayTuesday 5:45 PM - Spoke with ER doc5:45 PM - Spoke with ER doc

• X-rays negativeX-rays negative• Diagnosis - hematomaDiagnosis - hematoma• Plan to give prescription if infection Plan to give prescription if infection

occursoccurs• Told doc we would follow case & look for Told doc we would follow case & look for

infection. Prescription not writteninfection. Prescription not written• Return to work (RTW) - full dutyReturn to work (RTW) - full duty



WednesdayWednesday 8:45 AM - Spoke with Supervisor 8:45 AM - Spoke with Supervisor

(Supv) and EE. EE doing well. (Supv) and EE. EE doing well. Regular duties. Reviewed Regular duties. Reviewed importance of OTC NSAIDs and iceimportance of OTC NSAIDs and ice

FridayFriday Spoke with EE and Supv. EE still doing Spoke with EE and Supv. EE still doing

well. No sign of infection. Case closedwell. No sign of infection. Case closed



8:25 AM - Pipe rolled off truck bed 8:25 AM - Pipe rolled off truck bed and struck EE in thigh yesterdayand struck EE in thigh yesterday

EE was Spanish-speaking onlyEE was Spanish-speaking only EE had continued swelling and EE had continued swelling and

discomfort today, but was able to discomfort today, but was able to workwork

FridayFriday



FridayFriday Had Spanish-speaking Case Manager Had Spanish-speaking Case Manager

speak with EEspeak with EE Determined injury was soft tissue onlyDetermined injury was soft tissue only After getting thorough medical history After getting thorough medical history

EE was instructed on ice, heat, NSAIDsEE was instructed on ice, heat, NSAIDs Gave direct number to EEGave direct number to EE



SaturdaySaturday EE off work, but called him at homeEE off work, but called him at home Reviewed treatment plan and Reviewed treatment plan and

discussed starting heat on Sundaydiscussed starting heat on Sunday Spoke with EE on Monday at workSpoke with EE on Monday at work Significant improvement. Told to Significant improvement. Told to

continue treatment plancontinue treatment plan Closed case on TuesdayClosed case on Tuesday


Outcomes of InjuriesOutcomes of Injuries

Without Case Without Case MgmtMgmt• Non-Work Related Non-Work Related

. . . . . . 0. . . . . . 0• First-Aid . . . . 44First-Aid . . . . 44• Recordable . . 33Recordable . . 33• Restricted . . . 42Restricted . . . 42• Lost Time . . . 33Lost Time . . . 33• TOTAL . . . . .152TOTAL . . . . .152

With Case MgmtWith Case Mgmt• Non-Work Related Non-Work Related

. . . . . . 16. . . . . . 16• First-Aid . . . . . 85First-Aid . . . . . 85• Recordable . . . 16Recordable . . . 16• Restricted . . . . 29Restricted . . . . 29• Lost Time . . . . . 6Lost Time . . . . . 6• TOTAL . . . . . .152TOTAL . . . . . .152


Immediate InterventionImmediate Intervention

75% of cases - notified same day75% of cases - notified same day 14% of cases - the following day14% of cases - the following day 11% of cases - notified 2 days or greater11% of cases - notified 2 days or greater

• 40% of these were over 1 week40% of these were over 1 week

• 80% of those were placed on OSHA 30080% of those were placed on OSHA 300– All 6 lost times fell into this category All 6 lost times fell into this category


Immediate InterventionImmediate Intervention

If case received within 24 hrs of injury If case received within 24 hrs of injury the average time to close was 7 daysthe average time to close was 7 days

If case received within 2 days of injury If case received within 2 days of injury the average time to close was 14 daysthe average time to close was 14 days

If case received on 3rd day or greater If case received on 3rd day or greater following the injury the average time following the injury the average time to close was 32 daysto close was 32 days


Benefits To EmployeesBenefits To Employees

Immediate access to Medical Immediate access to Medical Professional 24/7 for injuriesProfessional 24/7 for injuries

Employee can call CM at any time Employee can call CM at any time should medical condition change should medical condition change or if question comes upor if question comes up

Axiom Case Manager is not a Axiom Case Manager is not a “Company Doctor”“Company Doctor”


Benefits To EmployerBenefits To Employer

Immediate access to Medical Immediate access to Medical Professional 24/7 for injuriesProfessional 24/7 for injuries

Supervisor removed from treatment / Supervisor removed from treatment / medical decisionsmedical decisions

CommunicationCommunication Lower Claims Frequency/SeverityLower Claims Frequency/Severity Reduction in Incident Rate, Reduction in Reduction in Incident Rate, Reduction in

Costs, Reduction in ModifierCosts, Reduction in Modifier


ClosingClosing

It’s important to report injuries It’s important to report injuries immediately – no matter how minorimmediately – no matter how minor

A delay of reporting and treating A delay of reporting and treating injury by 1 day increases injury by 1 day increases recordability by 60%recordability by 60%

24 / 7 /365 coverage - (this is crucial)24 / 7 /365 coverage - (this is crucial) Have only one number to callHave only one number to call

• (877) 502-9466 (877-50-AXIOM)(877) 502-9466 (877-50-AXIOM)

© axiom medical consulting, llc. all rights reserved. © axiom medical consulting, llc. all rights...

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