Jurisdictional Issues
There are as many names as there are states for the legal entity overseeing the workers' compensation system. Whether the name is "Industrial Commission," "Workers' Compensation Court," "Bureau of Workers' compensation" or some other name, they each have their own way of doing things in their state, with no two states being alike. It is imperative the workers' compensation adjuster knows both the procedures at the local level and the procedures on the state level for closing a claim.
Some states require the filing of numerous forms throughout the course of the open claim and at the conclusion of the claim. You do not want a settlement of the workers' compensation claim to be ruled invalid because the proper forms were not submitted at the required times either during the course of handling the claim or at the time of the claim settlement.
The adjuster needs to state the jurisdictional issues and/or legal steps necessary in their Action Plan. Your company's workers' compensation coordinator needs to review and understand the jurisdictional procedures before approving any monetary settlement of the claim.
Local Influences
In order to make an appropriate evaluation of the workers' compensation claim, the adjuster must be familiar with the nuances of the local workers' compensation board. Does the local practice include a negotiated value for the disability? Does the local board increase the disability rating by a percentage amount or some other identifiable factor? Is the local work comp board plaintiff oriented? What is the reputation of the treating physician(s)? What is the reputation of the employee's attorney for settling claims or pushing them as far as they can in the legal system? (workersxzcompxzkit)
All these factors come into play when the adjuster is calculating the value of the disability rating. The Risk Management Department's workers' compensation coordinator who will approve the settlement amount needs to know the answers to these questions in order to verify the accuracy of the adjuster's disability settlement calculations
Author Rebecca Shafer, J.D. President, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, healthcare, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: RShafer@ReduceYourWorkersComp.com or 860-553-6604.
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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers' comp issues.
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