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May 2010

Expense Constant Charge On All Workers Comp Policies?

Term of the Day- Expense Constant Charge The Expense Constant charge is a fee charged on every Workers Compensation policy, regardless of the policy size. It is a fixed, flat expense charge that is applied in addition to the premium developed for that policy, usually ranging between $100-$300. This arbitrary

Most Popular Prescription Drug Shows Alarming Trend

Most Popular Prescription Drug Was An Opioid? The most popular prescription drug was one that I have taken myself a few times over the years.  Statins were very popular at one time.  Stomach and digestion remedies dominated the requested prescriptions decades ago. I was just reading an article in Forbes Magazine.

Carpal Tunnel Syndrome Is Repetitive Injury Involving Wrists

Term Of The Day – Carpal Tunnel Syndrome Carpal Tunnel Syndrome is numbness, tingling,weakness, and other problems in your hand because of pressure on the median nerve in your wrist. Continuing with the medical term of the day, we’ll look at something that is similar to DeQuervain Tenosynovitis, but far

Kyphoplasty – New Treatment For Vertebral Fractures

Term of the Day- Kyphoplasty The Kyphoplasty procedure avoids surgery (a good thing).   Another prevalent injury seen in the workers comp field is spine fractures. Our most recent case of this resulted from a fall out of a semi-truck, but we have seen a wide array of painful vertebral

Maine Makes Solid Subcontractor Rules For Workers Compensation

Maine Solid Subcontractor Rules The state of Maine makes solid subcontractor rules for Workers Compensation.The State of Maine has come up with a novel plan to identify companies/individuals that are construction subcontractors and not employees. The twelve rules for an business entity to be considered a subcontractor are spelled out

DeQuervain’s Tenosynovitis vs Carpal Tunnel Syndrome

DeQuervain’s Tenosynovitis One thing we rarely cover in our blog is medical terms such as DeQuervain’s Tenosynovitis. . We’ve had a lot of questions surrounding different injuries and so for the next few posts, we are going to define some of the more common claims in the workers comp industry.

Is Debridement Of All Wounds Necessary To Prevent Infection?

Term Of The Day – Debridement The Debridement is the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue..Most of you are probably wondering how this can be considered a workers comp term, but it is a great example of the types

Allocated Expenses – Very Important and Confusing Definition

 Allocated Expenses-Workers Comp Term of The Day Allocated Expenses (also known as ALAE)  are expenses charged to a Workers Comp term file that are not indemnity or medical benefits. They are associated with the adjusting of the file. Expenses for defending claims such as attorney fees, private investigators, independent medical

Excess Loss Is Very Important on Experience Mod Sheets

Term Of The Day – Excess Loss The Workers Comp term of the day is excess loss.  It is the amount of a Workers Compensation claim that exceeds the Primary Loss – usually $5,000. The Excess Loss does not affect the EMR/E-Mod/X-Mod as much as the Primary Loss on a

Who Is Your Medical Only Claim Adjuster – Name Please

Your Medical Only Claim Adjuster Important Team Member The Medical Only claim adjuster is the person that are usually handling the more serious medical only claims.A large number of our clients have received our heavy recommendation to get to know their lost time claim adjuster(s). The adjuster(s) have a huge

Primary Loss – How Much Is It Recent NCCI WCIRB Rule Changes

Primary Loss – Term Of The Day The primary loss part of a claim is one of the most important terms involving the premiums your company pays for Workers Comp insurance. It is the part of any loss that weighs very heavily on your E-Mod or X-Mod. In almost all

Loss Run Request – What and When Will I Receive It ?

Term Of The Day – Loss Run The loss run is a listing of all Workers Comp claims that a carrier or TPA provides to its insured. They can be ad-hoc (on demand), monthly, or quarterly. The virtual loss run is when the employer can access their claims data by signing

Feedburner Feed – Updated – For Our RSS Readers

Feedburner Feed For RSS Readers Will Be Updated The Feedburner Feed always seems to operate in a shroud of mystery.   Blogger changed the rules on us.  That is OK, except as we know, when there are website tool changes the readers always seem to suffer the most.   We

CMS Confuses Me Once Again With Medicare Part D

Once Again The CMS Confuses Me Again the CMS confuses me.  In many of the LinkedIn and other discussion boards on Workers Compensation, the comments are flying. There is a supposed insider memo from the CMS that indicates how the drugs that are disapproved by Medicare Part D should not

Do We Have To Pay Premium Audit Bill Now – Not Exactly

Do We Need To Pay The Premium Audit Bill Immediately? All employers have concerns on whey they should need to pay premium audit bills as soon as they receive them from their insurance carrier. As I have mentioned often, employers call or email us with this question more than any

Pay Without Prejudice – Legal In Workers Compensation Claims?

Pay Without Prejudice OK In Some States The pay without prejudice period occurs when the Workers Comp adjuster decides (where legal) to begin paying indemnity and medical benefits without accepting an accident as compensable. Many jurisdictions have a specific form that is filed with the governing body to allow the

Indemnity Only Settlement – Good Idea In Some Cases

Indemnity Only Settlement – Now More Popular The Indemnity Only Settlement is when the Workers Comp adjusters settle the compensation payments part of the claim. The medical part of the claims is left open for the employee’s lifetime. With the CMS’s Medicare Set-asides (MSA) becoming so prevalent, Indemnity Only Settlements

Audit Workpapers – Are They Important To Employers?

Audit Workpapers Are Important To Employers In All Cases The Audit Workpapers are important to your Workers Comp premium reduction program.   Worksheets prepared by the Workers Comp premium auditor, can be either hand-written or computerized, showing how the auditor arrived at the payroll numbers that are used to determine the

Tulsa’s Workers Comp Doubles Payouts in Six Years Starting 2003

Tulsa’s Workers Comp Payment The City of Tulsa’s Workers Comp will be double Payouts in six years.  When something comes across my radar screen from my original home state, I always make sure that I read it over closely. According to the Tulsa World – Oklahoma’s second-largest city – Tulsa

Maryland Was The First State To –?

Term Of The Day – Maryland The State Of Maryland claims a first in Workers Comp.  This post is more of a question and answer – What state was the first to enact Workers Compensation laws? Maryland enacted the first set of Workers Comp laws in 1902. All states had

Lag Time In First Reports Very Costly To Employee and Employer

Lag Time Costs Employers Now And In The Future Lag Time is a very simple Workers Comp term. It is a measurement of how quickly the employer reports an injury to the insurance carrier or TPA. A longer lag time is money the employer is throwing down the drain. Many

Workers Compensation Bulletin – A Great Free Guide

North Carolina Workers Compensation Bulletin – Great Publication The great free guide for Workers Compensation bulletin is now available.   I have received a few emails recently and have seen posts on LinkedIn about what information should be shared with employees on the Workers Comp system. The following is a

Make Work Is Still A Hot Topic – Definition And Examples

Term Of The Day – Make Work A make work job is a job that has less final benefit than the job costs to support. Make-work is a rather controversial return to work issue for Workers Compensation. Certain states do not allow an employer to create a job just to reduce

UNIT STAT Date Is One To Mark On Your Calendar

UNIT STAT Date – Very Important Planning I had mentioned the UNIT STAT date and report in May 2008. It is worth mentioning again as it is one of the most important reports in all of Workers Comp insurance.   The name was shortened from Unit Statistical Date. The UNIT STAT

California Workers Comp Self Insured Mess

Self Insured Mess Of California The California Workers Comp self insured situation should be considered a total mess.  I was reading an article at www.wcexec.com on the recent collapse The Contractors Access Program of California (CAP), a self insured group of contractors, is scheduled to be seized by California’s Office of Self



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