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Federal Government Heavily Involved in Workers Comp For Years


Federal Government and Workers Comp Insurance

I have posted often in the last few weeks in reference to how and why the Federal Government has been pushing to enter more regulations on Workers Compensation insurance including 24-hour healthcare coverage and a federal insurance office.

Graphic Of Insurance On Shield Federal Government Icon

I have not commented on how the Federal Government has affected almost all Workers Comp claims that have a settlement value of more than $25,000. A few years ago, the CMS (Centers for Medicaid and Medicare Services) issued a regulation that all Workers Compensation settlements of more than $25,000 have to be APPROVED by their offices. This caused an incredible logjam on getting cases finalized.

There are at least 10 major companies that have entrepreneured the business of assisting claims offices in getting the CMS to approve the Workers Compensation settlements. I have assisted no less than 15 investment companies in examining this market as a place to invest large amounts of cash. This is one of the hot ancillary service marketing areas in Workers Compensation today.

Calculator And Financial Bill Federal Government On Table

The rejection rate was supposedly calculated by the CMS at 28%. The CMS even issued a recent guide on how to get the Medicare Set Asides (MSA’s) approved by their offices. I do not fault the CMS for being more involved as quite often there is an interfacing of Social Security/Medicare benefits and Workers Comp settlements.

The main reason I posted on this situation is to let all my blog and newsletter readers that the FEDERAL GOVERNMENT IS ALREADY HEAVILY INVOLVED IN WORKERS COMP today. I have heard some of the Workers Comp pundits say that there is a long leap between the current Workers Comp system and a federalized one.

One does not have far to leap if one is already there.  CMS’s MSAs are the route into Workers Compensation currently taken by the Federal Government.

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James J Moore - Workers Comp Expert

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Management Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications


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