Improving Communication with Your Adjuster Can Save You Big Money

 

Communication Can Be Significant Problem
 
Self-insured employers unintentionally, but routinely, sabotage the results they get on their workers’ compensation claims from their third party administrator (TPA) adjusters.  Of course self-insured employers do not set out to get sub-par results from the adjusters.  And, it should be understood that most TPA adjusters want to provide quality claims handling.
 
The reasons for less than expected claim handling results vary greatly from one adjuster to another, but there are some common threads in the employer—TPA relationship that create poor claims handling. A significant portion of the claim handling problems lies in the communications between the self-insured employer and the TPA adjuster. Often an employer will assume the adjuster knows what to do (and the adjuster does), but then the employer will be dissatisfied with the claims handling results because the adjuster handled the workers’ compensation claim differently from what the employer expected. 
 
 
Improve Communications With These Recommendations:
 
·         Talk to your adjuster regularly to understand what is being done, and what needs to be done, on the larger work comp claims they are handling for you
 
·         Be ready to offer input, but don’t try to micromanage the claim handling
 
·         Provide all necessary supporting documentation as quickly as possible including Employer’s First Report of Injury, payroll records, pre-employment physicals and health questionnaires, personnel file, etc. 
 
·         Don’t surprise the adjuster with critical information that you have, or become aware of, by not providing it to the adjuster timely.
 
·         If you become aware of any new information on the claim, share it immediately with the adjuster.  If you do not, the adjuster will more than likely spend time acquiring the information you already have
 
·         Let the adjuster(s) know how you prefer to communicate – whether you prefer emails over phone calls, or phone calls rather than e-mails
 
·         Strive for timely response to all e-mails and to timely return all missed phone calls
 
·         Let your adjusters know you expect a team approach to the claims handling and show respect for the work the adjuster does to create mutual respect
 
·         Be consistent in your communications of your claims handling philosophy in regards to claims handling.  Don’t take a hard nose, defend at all cost approach to one claim and on the next nearly identical claim, overpay the claim to get rid of it.
 
·         Be consistent in your claims handling philosophy or the adjuster will quickly decide you ‘don’t know what you want’
 
·         Never let your personal like or dislike of a particular employee influence your guidance to the adjuster on a claim
 
·         Discuss with your adjuster how much a particular claim is worth and what you will be willing to pay to settle the claim.  If you withhold what you are really willing to pay on the claim, then at time of the mediation or hearing, up the ante significantly, the adjuster is going to wonder why you had both the defense attorney and him/herself spend needless hours working on the claim that could have been settled much earlier
 
·         Don’t change your evaluation of a claim unless new, pertinent information that was not previously known comes to light
 
·         With an eye toward improving your relationship with the adjuster(s) ask your adjuster(s) what can be done to improve the communications between your company and them.  Then, be willing to listen to constructive criticism and act on what is said. If you are not self-critical and not willing to acknowledge the adjuster’s input, then asking them how to improve communications will not benefit either of you
 
·         If you see an adjuster making the same mistake over and over, communicate with the adjuster about the problem, ask the adjuster how the problem can be corrected, agreed on how the issue will be handled in the future, and then follow up to be sure the adjuster makes the necessary correction(s)
 
 
Be aware that every adjuster works differently, and every adjuster is under organizational pressure to accomplish as much as possible on many other claims.  Show your willingness to work with and to assist the adjuster in getting the work comp claim resolved.  Treat the adjuster will respect and communicate your desires to get the best possible claims handling.
 
 
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact:RShafer@ReduceYourWorkersComp.com
 
Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com
 
©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.  

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional about workers comp issues.

5 Safety Communication Techniques for a Diverse Workforce

 

Communicating safety issues effectively to a diverse workforce is a challenge. As a risk management consultant for many years, I’ve gathered solid information and experience on the best way to communicate safety and workers’ compensation messages to a large and diverse workforce, including organizations with thousands of employees with diverse backgrounds and many different job descriptions.

 

Before beginning, identify your target audience and the safety message you want to give.  The most important thing an employer must do before implementing any safety communication program is meet with employees and supervisors to discover their ideas on what needs to be communicated and how best to do it.

 

 

Five Safety Communication Techniques

 

First:

Identify the specific message you want to communicate. Is the message about getting employees to work more safely around certain equipment? Or is it to provide information on steps to take if they are injured?

 

Second: Identify the skill set and grade level of your audience. A message to upper management on how to improve commitment to a safety program would be presented differently than instructions to first-line employees on how to report an accident. A general rule of thumb for thinking about language levels is to keep in mind that the Wall Street Journal is written at a first-year college level, while the Reader’s Digest is written at a sixth grade reading level.

 

Third:  Consider job functions and how best to get your message across. Some employees might spend most of their work day in an office or one specific area of a plant. Others may spend it working in different areas of the plant or facility. Still others may spend their day driving from location to location. It’s a good idea to tailor your safety message to the types of safety issues more likely to affect those employees and areas of work.

 

Fourth: Identify the languages your employees speak. Don’t assume they will be just English and/or Spanish. There may be other immigrant groups, such as Russian or Vietnamese speaking workers. In addition, there are differences within languages, such as Cuban Spanish and Puerto Rican Spanish. Ask management to survey their workers’ languages and provide all safety messages as appropriate.

 

Fifth: Consider the work environment. If you have a congenial workforce, don’t use a heavy-handed communication style. Save it for a workforce where there may be a lot of discontent and resentment.

 

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact:RShafer@ReduceYourWorkersComp.com.

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 


Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional about workers comp issues.

Employer Silence is Root of Many Workers Comp Problems

 

46% of Workers Incorrectly Think Claims Being Contested
 
Workers Compensation Research Institute (WCRI) has published a most welcome study into the reasons that workers get compensation lawyers. The most disturbing reason, cited by 46% of workers surveyed, was that they thought their claims had been contested, even though the paperwork had just begun and no decisions had yet been made.
 
People working with claims, any kind of claims, understand that there is an initial lag, ranging from days to months, before an administrative agency becomes active on a claim. An insurance company usually, but certainly not always, is quicker to respond, but “quick” might mean weeks, and a family suddenly without a weekly check and little or no savings will be on the verge of panic.
 
 
Lawyer Should Not Be One Communicating with Worker
 
If they consult a lawyer, they will quickly learn that the resolution is inevitably going to take time. But why must they hear that from a lawyer? Every risk manager or human resources chief could tell them that a lot faster (and cheaper!)
 
But there is something else your personnel can tell a worker who has just filed a comp claim – how to receive information and, if necessary, some form of income continuation. (A lawyer could tell them the same, but many don’t and it isn’t nearly as comforting as hearing it from the employer.)
 
The study mentioned another fact. When an employer is small enough to know everyone in the workplace (say 200 employees or so) comp problems grow more slowly than when the employee has no one in charge who knows them. (Julius Caesar was famed as a military leader because he could address all centurions in his army by their names- over 500. If he could do it, with a bit of effort you can do it with 200.)
 
 
It is Your Responsibility
 
Finally, there is the old problem of “falling between two stools”, meaning that there is always help at hand, but everyone assumes that someone else will provide it. Rather than rely on a disastrous assumption, just reach out and communicate. An employer that stays in continuous touch during the month or two following a reported injury will be the first to learn of a problem, and the first to propose a solution. And somewhere, a lawyer won’t get that first phone call.
 
If a worker (and the spouse!) is aware that the employer will nudge a silent bureaucracy with a call, the comp problems will start small and grow smaller.
 
 
Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100. medsearch7@optonline.net  
 
Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.  
 
©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.
 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional about workers comp issues.

Post Injury Procedures: Communication is Key

 

Post injury procedures keep the circle of control between employees, the employer and the doctor. Companies need to have a tight post injury response procedure to keep down workers’ compensation costs. It is important to have a procedure in place to address an injury immediately after and for the first twenty-four to forty-eight hours after the injury. This is because there must be communication between the employee, the doctor and the employer. Nothing can be left to chance.

 

There should be a contained process so that communication with the employee and the doctor moves in a continuous loop. Without this continuity, the employee and the doctor may become fragmented, breaking off from the employer, with the employee remaining out of work as a result. A tightly controlled post-injury response procedure keeps control of the communication process among the three parties: employee, employer and physician. If communication between these parties is in place, it is much more likely that the employee will return to work in a prudent but timely manner.

 

Do you need help developing your post injury processes? We have consulting and training services available to help you at http://reduceyourworkerscomp.com/services/workers-compensation-consulting/#axzz2DKMATXF3. Or, to have a reference guide on hand to consult, see our book at http://reduceyourworkerscomp.com/workers-comp-cost-reduction-guide-book/#axzz2DKMATXF3.

 

Author Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com Contact mstack@reduceyourworkerscomp.com.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 


Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional about workers comp issues.

Employers Hold The Key to Controlling Workers Comp Claims Costs

 

Employers Are Most Important Piece in Communication
 
Many employers limit their participation in their own work comp claims hoping that the carrier will do nearly all of the work. It seems, to many employers, that it goes with the premium. However, as any trial attorney appreciates, whoever volunteers to become the communications center will control the progress of the claim.
 
Communications in comp claims are quite complex. It is wrongly imagined that the parties (employer and worker) are not allowed to communicate with each other during a claim. This is entirely false and the law requires that each MUST stay in touch with the other. In addition, one or both must often communicate with the carrier, the Work Comp Board, medical providers, health insurance and group disability carriers as well as a variety of agencies.
 
The flow of data among all these will quickly bring a claim to a halt unless properly coordinated. Delay costs money in comp and it’s only the employer who pays.
 
 
Take Control of Costs Through Communication
 
The cheapest and fastest way an employer can prevent unnecessary delay and confusion is to make sure that all other parties are copied on any piece of information the employer receives, from whatever source. Group medical plans are especially concerned that they may be paying unintentionally for a comp claim. Employers will often receive requests for information during a claim. Resist the temptation to refer the requests to someone else or stonewall the situation. By coordinating the requests with other parties you will maintain control and limit misunderstandings, a leading cause of soaring expense and lost time.
 
 
Right to Confidentiality is Waived
 
It is a misconception that medical information is automatically protected by a “right to privacy”. Whenever a claim for disability is made the “right to confidentiality” is waived. (“Right to privacy” does not apply to medical records, although the term is often misapplied to what is “right to confidentiality”)
 
Every year seems to bring new players into the field of employee benefits with ever more exchanges required. Stonewalling will work, for a while, but the bill to be paid in the end will be much higher.
 
 

Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100. medsearch7@optonline.net

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com Contact mstack@reduceyourworkerscomp.com


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com
MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

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.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

Employee Communication is Vital to Workers Comp Success

One factor that correlates strongly with the employer’s ability to control workers compensation cost is the ability to communicate effectively with employees.  The importance of quality communications with the employee cannot be overstated. The level and quality of communications will often make a difference in the final outcome of the workers comp claim.
 

 
Communications can be formal and informal. Formal communications include published policies, brochures and posters advising the employee of the work coverage benefits, and written documents / procedures outlining the roles and responsibilities of the employee and other personnel when a workers comp claim occurs. Also, a log where a summary is recorded of each verbal communication with the employee would be classified as formal. (WCxKit)
 
 
The informal level of communication would include both telephone conversations and face-to-face discussions with the employee. Informal communications would also include any voice mail or get well cards sent to the employee.
 
 
Through proper communication with the employees, the employer provides and receives information from the employee.  If the communications become a one-way street with the employee or employer providing all the information, the communications are not effective.  The balance between receiving and providing information should remain roughly equal.
 
 
Communications with the employee should start before there is a workers comp claim. This would be done:

 

By establishing the employee’s responsibility to report an injury accident immediately,
By having safety training sessions,
By establishing procedures the employee is to follow if there is an accident, and,
By communicating the importance of the modified duty program.
 
 
This proactive communication before an accident will pave the way for smoother handling of each claim, if and when one does occur.
 
 
After the injury it is equally important to communicate with the employee.  Contacting the employee immediately after the first medical treatment conveys to the employee a level of caring and concern about their wellbeing.  The employer should remain in contact with the employee throughout the recovery process.  The best way to do this is via a weekly scheduled phone call or having the employee call in after each medical visit.  The information discussed on these calls allows the employer to more easily respond to the injured employee's concerns.  
 
Most employees do not obtain an attorney out of greed or a desire to get something more than they deserve.  Most employees obtain attorneys because the level of communications between the employer and the employee is inadequate, or the level of communications between the adjuster and the employee is inadequate.  When there is an adequate conveyance of information between the employer and the employee, the employee does not see a “need” to get an attorney.
 
 
By keeping the employee thoroughly informed it conveys to the employee that he/she is important to the employer.  This will lead to an increased desire to understand company policies and how the employee can comply with these policies. (WCxKit)
 
 
There are various additional ways an employer can keep good communications with the injured employee throughout the claims process.  To learn more about how you can improve your communications with the employees, please contact us for your copy of 2012 Manage Your Workers Compensation Program, Reduce Cost 20-50%

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com. Contact: RShafer@ReduceYourWorkersComp.com.
 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. Contact Mstack@ReduceYourWorkersComp.com. 

 

Our WORKERS COMP BOOK:  www.WCManual.com
 
 
WORK COMP CALCULATOR:  www.LowerWC.com/calculator.php

 
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.
 
 
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact  Info@ReduceYourWorkersComp.com.

Highest Court Decision on NY Workers Comp Favors Employers

A decision issued this week, on 5/1/12, “Zamora v Neurologic Assn.”, has removed a presumption that people no longer working after an accident were presumptively disabled by the accident. This gave the employer the burden of convincing the Board that entirely different factors were at work.

 

 

To put it plainly, the employers had so little chance of success that carriers, lawyers, judges and commissioners paid little attention to agruments that a worker no longer was attached to work and had voluntarily retired. By the late 1980s, the situation had come to the point where “retirement injuries”, i.e., small incidents, were filed as comp claims and used as the basis, years later, for reopening the claim and receiving substantial tax-free supplements to retirement and Social Security payments.[WCx]

 

 

The decision, in which benefits were halted, will not be the last word quite yet. It was a narrow split decision and both labor and industry will presumably lobby for slight, but significant, changes in the law.

 

 

However, an employer with a well structured program for assistance in Return To Work, not just for workers comp but for disability in general, will benefit the most. Many of the recent decisions involve workers searching for jobs without any assistance from the employer. But an offer of a job, or assistance in finding one, can no longer be ignored by a worker without risk of consequences.[WCx]

 

 

Although the role of the employer is not central in the “Zamora” decision, that does not mean that it is not necessary for higher probability of success. Return to work begins, shortly after disability starts, with communication from the employer. The “Zamora” decision involved “presumptions”, but active participation by the employer quickly turns the discussion to facts rather than speculation.

 

See More on New York’s Workers’ Compensation Laws and Regulations in our Lowerwc.com resource center.

 

 

Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100. medsearch7@optonline.net

WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com
MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

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.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.
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10 Easy Ways to Cut Workers Comp Cost

Regular readers of our website know we are about saving employers money through reducing the cost of workers compensation. In this day of sound bites and short summaries, we offer easy ways to reduce the cost of workers compensation.
 

 
1. Report All Injuries Immediately
One of the biggest mistakes an employer can make is to delay the reporting of a workers compensation claim. The employee, whether suffering a major or minor injury, is going to understand very quickly that the employer is unconcerned about his well being when the injury is ignored. Also, the sooner the claims adjuster is aware of the injury, the sooner the adjuster can start the claims handling process moving the claim forward. The sooner the employee is treated, the sooner the healing process can start, and the sooner the employee will be able to return to work. (WCxKit)
 
 
 
2. Document the Details of All Injuries
The memory of the injured employee, the supervisor, and any co-workers who witnessed the accident begins to fade with the passing of time. To have the most accurate record of the claim, all witnesses and the employee's supervisor must be promptly interviewed. Write down what is said. If there are any tools, equipment or machinery involved in the accident, inspect it and document any failure of the tools, equipment or machinery. Do not dispose of anything involved in the injury until the claims adjuster has had an opportunity to inspect it or to have it inspected by an expert.
 
 
3. Keep in Contact with the Employee
Following an injury the employee is going to be concerned about: 1) obtaining the needed future medical care 2) how they are going to replace the lost income 3) losing the job if they are unable to work 4) the prospect of possibly being disabled and unable to ever return to the job.
 
 
While the adjuster can explain the workers compensation claim benefits, the adjuster does not replace the employer in the claimant's mind. The claimant is feeling vulnerable after an injury.  Contact from the employer helps to reassure the claimant that the employer cares about their well being and returning them to work.
 
 
4. Keep in Contact with the Medical Provider
This is one area where most employers fall short. Even if the employer has kept in contact with the employee, the employer still needs to be in contact with the medical provider. Often the medical provider will be very cautious with the injured employee and will keep them off work the maximum time needed for full recovery if their only input is from the employee. For example, if the employee is asked by the doctor what is the maximum weight of lifting at work, the employee may honestly say 100 pounds, but that may happen only once per month. If the employer has advised the medical provider to modify the employee's position to not lift over 20 pounds, the employee will be returned to work much sooner.
 
 
5. Have an Established Return to Work Program
The easiest way to accommodate an injured employee's work restrictions is to have an established modified duty return to work program in place. If all employees know before an accident they are considered a valuable part of the company with an established return to work program, they will be more compliant with both the employer and the medical provider about working a light duty job until they are able to return to work full duty.
 
 
6. Have an Established Safety Program
This is a no-brainer. The accident that never happens does not incur any claim cost. Set up a safety program to identify those aspects of the work that potentially can cause an injury. Analyze what can be done to reduce or eliminate the risk of injury, and then do it. Establish the proper methods of doing the day-to-day task so that the potential for injuries is removed. Be sure the employees have everything they need to do their job in a safe manner. Arrange for on-going safety inspections to identify and correct any hazard.
 
 
7.Train the Employees to Work Safely
It is not enough for the employer to know the potential hazards of the job. The employees must know too. The employees must be trained to do the job correctly, including complying with all safety measures.   Whether it is the safe operation of machinery, or the proper lifting techniques, the employer can reduce workers comp cost by training the employees to work safely.
 
 
8. Reward Employees for Promoting Safety
When employees think safety is “management's thing”, they are not considering themselves in the safety quotient. Involve the employees in the safe operation of the company by providing small monetary rewards to employees of a department that avoid injuries over a given period of time. The cost of the 'reward' will be far cheaper than the cost of workers compensation claims and the resulting insurance premium increase.
 
 
9. Have Your Insurance Premium Audited
Underwriters make mistakes. They can have your business improperly classified. They may also have employees misclassified or they may have the payroll information wrong for one or more categories. If the workers compensation insurance premium has risen lately and you do not know why, arrange for an independent premium audit. As the premium auditor works for a percentage of the premium reduction, it makes good sense to have your premium audited every couple of years or when there has been an increase in premiums. (WCxKit)
 
 
10. Have Your Claim Files Audited
The last thing the insurance company is going to admit is that the workers comp claims were poorly handled. When work comp claims are poorly handled, they cost more. The carelessness or oversights in claims handling comes back to the employer in the form of higher insurance premiums. If the results on the claims are not expected, hire an independent claims file auditor to review the files for proper handling, proper reserving and proper settlement.
 

Author Rebecca Shafer
, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
 
 
Our WORKERS COMP BOOK:  www.WCManual.com

WORK COMP CALCULATOR:  www.LowerWC.com/calculator.php

 
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.
 
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.

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Make Sure Your Carrier Does Not Use Trapdoor Communications

Communication (a sharing of information) is essential to proper handling of workers comp claims. Workers comp has a complicated communication network which, moreover, operates with numerous time deadlines. Regulars in the field, especially attorneys and doctors, quickly learn to spot the pitfalls and work through, under, over and around them.

 
 
But what about your employees? Chances are, they trust and hope much, and imagine that the vast communication network on claims is forwarding the proper information to the right people. Perhaps the employer thinks the same. [WCx]
 
 
It might come as a shock to learn that some communication is far from being an effective exchange. It is, in fact, a one-way flow to the detriment of the unwary. This form of communication, which takes information from the worker, gives nothing back, and only stores what is detrimental to the claim, discarding nearly everything else, appeared about ten years ago.
 
 
A call is made to a carrier. When the caller is identified as a person with an interest in a claim the call is transferred to a person vaguely identified as a “claim resolution officer” or, perhaps, not identified at all. The caller is asked some of the usual questions but then is asked if there are any problems. If the caller asks any questions, they will go unanswered, with a variety of reasons given. In the end, the caller is referred to a different number, or told to write.
 
 
What has occurred is that the caller, without realizing it, has been involved in a recorded call, after which the call may, or may not be saved. A warning is given that the message may be recorded “to ensure proper handling”.
 
 
In fact, the person on the other end may have a law degree, but is not admitted yet as a lawyer. Normally, a lawyer who is admitted is required to advise callers that they are speaking to a lawyer. But a person not admitted does not have to mention that they have a law degree. The person taking the call has, in fact, received training in asking the proper questions, but providing no answers. Calls which are useful for the carrier are saved. Others are dropped.
 
 
If this sounds a bit over the top, it is. Fortunately, it appears to be rare.
 
 

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How can we be sure that this was, or is, going on? When lawyers began having such strange conversations with claims units, the professional tendency toward paranoia got the better of them and searches on the Internet were conducted. Several years ago, an on-line ad for new law grads “not yet admitted” to work as “claim resolution specialists” appeared, posted by a major company.
 
 
And any trial lawyer knows in a nano-second when they are speaking to a law grad.
 
 
The practice seems to have shrunk since then. Workers, as any lawyer can tell you, have rather acute senses when it comes to strangers asking even stranger questions. But the biggest brakes seem to have been the law grads themselves. Recent law grads have the zeal and optimism of newly ordained missionaries and do not adjust well to a job better suited to the most cynical private investigators. In addition, the grads were themselves not told precisely what would be involved. When the truth appeared, the job was seen to be a resume killer. [WCx]
 
 
Hopefully, the practice has ceased. But employers should take the trouble to ask the employees what sort of treatment they are getting from the carrier.
 
 
Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100. medsearch7@optonline.net
 

 


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com

MODIFIED DUTY CALCULATOR:  
www.LowerWC.com/transitional-duty-cost-calculator.php

 

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.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

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Save Time by Reading A Summary of the Linkedin Group Workers Compensation Roundtable

This week at Workers Compensation Roundtable we surpassed 2,000 members! Read more about it    here. Bob Wilson, congenial host of the group writes, “Two of the reasons for this group’s success are the high quality of it's membership, and the success of specialized subgroups to help manage the flow of information. We appreciate your interest and support, and hope you continue to participate while we "march on" to top the 3,000 member level and beyond.”
 
 
On the discussion Which States are considered the worst from an Underwriting/Insurance Carrier standpoint?, John Daniels, CIC, says he gets feedback on a consistent basis that California, New York and Illinois are the most challenging states. (WCxKit)
 
 
On this discussion, read comments such as Steven Dlott, who says, “While I am happy not to lay claim to first place in this contest, Ohio also does not allow the employer any opportunity to manage or direct medical treatment. Let's just say chiropractors do very well in Ohio.”
 
 
Read more to find out why member Christopher Brigham thinks the most “dysfunctional” states are California and New York.
 

 
 
Rosemary posted a discussion titled Canadian Government continues to support the export of asbestos to developing countries here and sites this article. She writes, “This concerns me greatly as it should concern all of us. Anyone who knows anything about asbestos needs to be speaking up to protect the people in third-world countries.”
 
 
Join us at Linkedin's Workers Compensation Roundtable right now and right here! Better yet, invite your friends so they too can become informed on hot topics in the Workers Compensation industry. (WCxKit)
 
Workers Compensation Roundtable is jointly managed by people dedicated to the concept that workers compensation is a manageable line on your expense ledger, and that informed professionals are empowered achievers. Workers' compensation is not simply a cost of doing business, it is a cost that can be controlled. Beginning with an assessment of cost drivers, benchmarking data, and integrating the solutions, employers can reduce workers' comp costs 20 to 50 percent. With proper information, professionals managing compensation claims can reduce costs and improve outcomes for all stakeholders in the process. This group is for employers, business owners, risk managers, HR managers, insurance executives, and brokers to discuss the obstacles and strategies to overcome them.
 
By Director: www.LowerWC.com
 
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.
 
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.

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