Workers’ compensation is a volume business for employers, defense attorneys, and the claim management team. Frequent “claim file roundtables” is one tool that can reduce workers’’ compensation claims and promote better claim handling skills. It can also lead to creative solutions by involving the interested defense stakeholders.
What is a Claim File Roundtable?
A claim file roundtable is a meeting that is held with the interested stakeholders in workers’ compensation claims to review files, keep everyone apprised of case developments and plan strategy. The participants for these conferences typically include the employer, claims management team, attorney, a medical advisor if available.
Employer Involvement
Employer involvement in file review conferences is critical. This should include the workers’ compensation coordinator or someone involved in risk management issues.
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Organizing a Claim File Roundtable
These conferences can be set for in-person meetings or via an online conference call service. The organizer of the individual file conference will set a date and time for the discussion. The selection of the files to be discussed will usually be set by the discussion coordinator, claim handler, a supervisor, or someone designated within the employer’s workers’ compensation program.
There are no set criteria on what files can be selected for review at these conferences. The claims chosen for discussion can be based on the obstacles the adjuster has encountered in moving the claim forward, important or unique medical such as delayed return to work. If more than one claim is included for discussion, each file will likely be discussed separately and independently of other claims.
Benefits of Claim Roundtables
There are numerous benefits to having file review conferences. It not only keeps all interested stakeholders aware of what is going on, but also forces everyone to be fully engaged. When this takes place, there is a better exchange of ideas and results.
- File Conferences Move Claims Forward. Members of the claim management team and employer representatives are responsible for countless activities that involve actions outside of their open claims. A file review conference allows everyone to keep abreast of developments on a file and better understand the issues. They can also lead to strategy on how to settle claims and deconstruct potential internal and external barriers to settlement.
- File Review Conferences Involve & Educate the Employer. Employers and their representatives are often on the front lines of workers’ compensation claims. They have the most relevant information to share about the injured party and the possibility for return to work. Regularly scheduled file review conferences also allow the employer to take a deeper look at what is going on in their business and understand the anatomy of individual claims, as well as see trends within their company or industry.
- File Review Conferences Allow Parties to Offer Different Perspectives. The interested stakeholders in workers’ compensation claims all come from different backgrounds. They also have different education and vocational histories. With these differing experiences, parties will view matters different. These differing opinions and views can promote an environment that helps solve problems
Conclusions
The use of file review conferences should involve all interested stakeholders of a workers’ compensation claim. These conferences can result in decreased costs to any workers’ compensation program when used effectively.
Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: [email protected].
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