When an employee gets injured on the job, it’s not always clear who is responsible. There can be many parties involved in a claim, the employee, the insured, a manufacturer, a subcontractor and even a sub-subcontractor. An effective...
There are some circumstances during the workers’ compensation claim handling process when you may want to perform drug testing on the injured employee. It’s not something we do for every WC claim but has certainly been beneficial when...
There are various times during the lifecycle of a workers’ compensation claim when it should be transferred from a medical only examiner to a lost time/indemnity adjuster. Knowing these signs will assist in the claim handling process...
Slip and fall claims are not always clear-cut. Sometimes they can become complicated depending upon how and where they occurred. It’s important for the adjuster to gather all the facts during the claim handling process to determine...
Improving communication with an injured worker can make a big difference for the employee when trying to reach Maximum Medical Improvement (MMI) or return to work full-time. When an injured worker returns to work they often report...
When an adjuster has a lot on their plate - multiple claims, a myriad of activity - their action plan tends to be short-sighted, and "will-dos" tend to multiply.
Beware of your TPA’s “Escalation Delay”
Almost every claims operation tracks “lag-time” - days to report and days to open a claim. You may not be aware of a hidden added lag we can call “Escalation Delay.” Many TPAs will hold a...
In part one of our blog post series “The Consequences of Intentionally Manipulating Workers’ Compensation Premiums” we focused on an example of an employer intentionally manipulating the system, and how it backfired. In part two we...
Determining what prescriptions should or should not be approved can be a challenge for adjusters. With increasing prices, prescription medications comprise a significant share of workers’ compensation costs.
In part one of our blog post series “The Consequences of Intentionally Manipulating Workers’ Comp Premiums” we focused on an example of an employer intentionally manipulating the system, and how it backfired.
