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TPA and Claims Administration

Undocumented Workers Eligible for Workers’ Comp Benefits

In November, 2013 the Iowa Supreme Court ruled in the case of Staff Management v. Jimenez that …

Undocumented Workers Eligible for Workers’ Comp BenefitsRead More

Never Give Up – The Mantra of an All Star Work Comp Adjuster

Too often adjusters will perform a background check, medical record sweep, or run an ISO sweep* …

Never Give Up – The Mantra of an All Star Work Comp AdjusterRead More

Poor Documentation Makes Claims Handling 100x More Difficult

File notes and goals are becoming extinct.   Realistically, the only way to move a file …

Poor Documentation Makes Claims Handling 100x More DifficultRead More

Your IME Doctor Selection Can Make or Break Your Case

A common error I notice in work comp files are adjusters choosing the wrong IME doctor. Sure …

Your IME Doctor Selection Can Make or Break Your CaseRead More

Make Sure Injury Is Work Related Before Approving Treatment

The wise workers’ compensation adjuster during the initial investigation of the claim ties down the …

Make Sure Injury Is Work Related Before Approving TreatmentRead More

Why Train New Hires When They Will Just Quit Anyway?

To date, I have yet to meet anyone that planned on being a claims adjuster. Think about that for a …

Why Train New Hires When They Will Just Quit Anyway?Read More

We Are Getting Worse at Dealing with Back Pain

I was reviewing an article that was of no surprise to me: Insurance companies are getting even …

We Are Getting Worse at Dealing with Back PainRead More

Is Your Workers Comp Claims Supervisor Being Held Accountable?

In a perfect world, everyone is held accountable for their actions. Not only in life outside of …

Is Your Workers Comp Claims Supervisor Being Held Accountable?Read More

Proper Compensability Investigation Stops Claim Before It Starts

Many rookie adjusters get ahead of themselves. This probably should not be seen as a surprise, …

Proper Compensability Investigation Stops Claim Before It StartsRead More

Self-Insured Employer Must Confirm TPA Has Customer Service Guide

Every self-insured employer should confirm their third party administrator (TPA) has a Customer …

Self-Insured Employer Must Confirm TPA Has Customer Service GuideRead More

Workers Compensation Claim Handling Standards

Self-insured employers have more leeway in establishing and controlling the quality of claim …

Workers Compensation Claim Handling StandardsRead More

Try Not To Be So Optimistic When Reserving A Work Comp Claim

Contrary to popular belief, sometimes adjusters are optimistic when reviewing their open cases. …

Try Not To Be So Optimistic When Reserving A Work Comp ClaimRead More

Understanding and Defending Occupational Disease Claims

Understanding and Defending Occupational Disease Claims Employers who are not in the mining …

Understanding and Defending Occupational Disease ClaimsRead More

How To Stop (or slow) Adjuster Turnover at Carrier/TPA

Back in the 1980s it seemed like adjusters settled down right when they were hired. Most spent …

How To Stop (or slow) Adjuster Turnover at Carrier/TPARead More

Walk A Mile In The Shoes Of Your Work Comp Claims Adjuster

  A work comp injury can change a person. It can change the way they think about their …

Walk A Mile In The Shoes Of Your Work Comp Claims AdjusterRead More

Spring Cleaning For Workers Comp Laws, Techniques, And Bad Habits

  This is a great time of year. The weather warms up, snow melts, golf courses open for …

Spring Cleaning For Workers Comp Laws, Techniques, And Bad HabitsRead More

How To Be An Effective Claims Supervisor – Part 2

This is the second part in our coverage of how to become a more effective claims supervisor. …

How To Be An Effective Claims Supervisor – Part 2Read More

Employee Injury Compensability Factors In Workers Compensation

Consider the following employee injury scenario:   An injured worker has low back …

Employee Injury Compensability Factors In Workers CompensationRead More

Claim Reserving Is Not For The Faint Of Heart

Claim reserving is complex, complicated, and difficult. Just when a claims professional thinks …

Claim Reserving Is Not For The Faint Of HeartRead More

Adjusting Claims: A Slow Death From Inside A Cubicle

“Adjusting claims, a slow death from inside a cubicle”, this was part of a quote from a friend of …

Adjusting Claims: A Slow Death From Inside A CubicleRead More

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