What to Ask the Adjuster When Managing Open Claims

If you are a new Workers' Comp Coordinator, you may following up on open, existing claims during your first week on the job. The claims are likely Lost Time Claims. You will want to develop a form asking questions similar to these: 1. Employees' name and accident date of loss 2. What is employee's current work status 3. Are there any written reports 4. What is the current medical treatment 5. How was the employee transported to medical treatment and did anyone accompany the employee 6. Did the employee come back to work immediately, the day of the injury 7. Were medical restrictions provided during the initial medical visit and if not, why not 8. Was transitional duty assigned and if not why not 9. What is the estimated return to work date and what is the medical duration in the guidelines. If not, how was the estimated return to work date established. 10. What additional efforts have been made to get employee back to work. 11. What contacts with employee have occurred including weekly meetings and nurse field case manager visits. 12. What is the next step in their Plan of Action (POA). These are just a few of the questions you'll want to ask the adjuster. Schedule another call about each employee at the time of the first call. This is not intended to be a complete or exhaustive list, but it should be enough to give you an idea of the flow of the call. Try the WC Cost Calculator to show the REAL COST of work comp. Look at WC 101 for the basics about workers comp. Workers' Comp Kit^® is a web-based online Assessment, Benchmarking and Cost Containment system for employers. It provides all the materials needed to reduce your costs significantly in 85% less time than if you designed a program from scratch. Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs. ©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact I[email protected]�