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September 2010

Are Death Benefits Payable In WC?

Term Of The Day-Death Benefits Death benefits are a very important part of  a claim where the employee expired due to an on-the-job-injury. Under Workers Compensation, benefits are paid to the spouses and dependents of a worker who dies as the result of a work related injury or illness. Dependents

Federalization Of Workers Comp Takes Another Step

Workers Comp Takes Another Step Toward Federalization  All Workers Comp takes another step towards being a federalized. Check out the Want Ad  for  the Federal Insurance Office Director Job.  According to the NY Times, a new job was posted that indicates the seriousness of establishing the Federal Insurance Office. The

Temporary Total Disability Benefits Important Facet Of WC Claim

Temporary Total Disability Benefits Are Very Important To The Injured Worker Temporary Total Disability is one of the most common terms. in Workers Compensation. The acronym is TTD.  This level of Workers  Comp disability reflects an injury that has rendered the employee completely unable to perform any job functions on

Two Workers Comp Bills Vetoed By California Governor Schwarzenegger

Two Workers Comp Bills Vetoed by Governor Schwarzenegger The Governator has two Workers Comp bills Vetoed,that opponents said would have had dire effects on the current Workers Comp system in California. Instead of explaining the bills, I included the veto memos from the Governor to the California Senate and State Assembly.

Is A Commutation of Benefits Beneficial?

Commutation – Workers Comp Term Bills, debts, and personal finances can all be affected by the scheduling of workers compensation payments. Often a lump sum payment is more beneficial or necessary than receiving many individual payments over time. A commutation is an order given by a judge in a workers

Is There Apportionment in Workers Compensation?

 Workers Comp Term-Apportionment The tem apportionment is the workers comp term of the day. If a worker has various injuries, some of which may be pre-existing or unrelated to a work injury, a panel of board members will be responsible for determining which of those injuries an employer may be

Discontinuation Notice Not Same As Denial

Term Of The Day – Discontinuation Notice A discontinuation notice is a very generic “old school” term for  suspending or altering a benefit payment. Temporary Total (TTD) suspension is the most common one. Every state has some type of prescribed form for removing or altering/lowering benefits.  The Workers Comp Commissions


Term Of The Day – Continuance A continuance is a postponement of a court hearing or law suit until a later date. During a workers compensation hearing, several continuances may be issued, which will delay proceedings and possibly your pay and benefits. ©J&L Risk Management Inc Copyright Notice

Product Liability Suit

Term Of The Day – Product Liability Suit A Product Liability Suit is a lawsuit brought on by an employee against a third party and not an employer. If there is the possibility that an injury was caused by equipment fault or failure, a product liability suit may be filed against

Workers Compensation Premium Auditors – Not Licensed Like Claim Adjusters?

Workers Compensation Premium Auditors Licensed Like Claim Adjusters? The Workers Compensation premium auditors should likely have licenses like claim adjusters. Workers Compensation premium auditors have never been licensed or actually regulated in most states. I have spoken often to the other premium audit companies for employers about starting an organization

Relapse Benefits

Term Of The Day – Relapse Benefits Relapse benefits are workers compensation benefits that are received when a worker experiences a relapse or recurrence of a previous injury for which workers compensation benefits were previously awarded. If you are unable to work due to a recurring injury, you may still be

Concurrent Employment

Concurrent Employment The Concurrent Employment benefits cause confusion in workers comp claim departments if the adjuster is not informed of other jobs worked by the injured employee. Being concurrently employed simply means that a worker is employed by more than one employer. Workers compensation pay and benefits are determined by

Disability Rating

Term of the Day – Disability Rating Industrial accidents are rated on a scale or schedule in order to provide a reference point for physicians, insurance companies, and employers. Upon being examined by a qualified physician or network doctor, a worker’s injury will be placed on a Disability Rating Scale to

Self Insurance – Forgotten Area For Medical Networks

Self Insurance And Medical Networks   Last week, I covered the advantages of Workers Comp self insurance over regular insurance. Today, I wanted to cover an area that is often ignored when setting up a self insurance program. That is the area of medical networks. Are you going to turn

Utilization Review

 Term Of The Day – Utilization Review In order to deem a medical treatment viable and necessary, insurance claims administrators will often perform a utilization review. Utilization reviews are conducted according to established rules and procedures, and normally involve the input of the disabled worker’s physician in order to determine the

Occupational Disease

Term Of The Day – Occupational Disease An occupational disease is a disease that is contracted by a worker during a period of employment. Common examples of occupational diseases include asbestosis, silicosis, and byssinosis. These diseases are often eligible as workers compensation claims, and workers must be thoroughly examined by

Qualified Medical Evaluator

Term Of The Day – Qualified Medical Evaluator If a workers compensation claimant disagrees with a diagnosis given by a network doctor, a qualified medical evaluator (QME) may be consulted to examine the injured worker. These examiners are chosen by qualified medical boards across the country, and are accredited from various

Self Insurance For Workers Compensation – Has Big Advantages

 Advantages Of Self Insurance – Going Out On Your Own In my last few posts, I did make Workers Comp self insurance seem to be more of a hassle than it is really worth. My main reason for posting the 11 concerns was to make companies examine their program more

Form 18 North Carolina Industrial Commission

Term Of The Day – Form 18 This Form 18 is important to Workers Compensation.This is the first form to be filled out by employees who have been injured on the job. This is a report to employers on the nature and condition of the injury, and must be filed within

Outpatient Treatment Definition

Term Of The Day – Outpatient An outpatient is someone who has been hospitalized for 24 hours or less, but continues to visit a hospital or medical facility for treatment or diagnosis. Similarly, outpatient surgery is surgery that is performed on a patient without overnight hospital admittance. Different workers comp

Workers Comp Self Insurance – Five More Things To Consider

Workers Comp Self Insurance Concerns Below are Five Workers Comp Self Insurance concerns when reviewing your policies and audits. Earlier this week I posted on what companies should consider before pursuing self insurance as a means to reduce Workers Comp costs. We had a large enough response to the article

Correction to Previous Article On Our Website Traffic

Correction On Website Traffic A correction on our Website Traffic on previous article. After almost 600 posts we do occasionally make mistakes. We had earlier said that this blog was in the Top 7% For All Web Traffic. We had used a statistics package with input from a third party

Mediator in Workers Comp Resolves Disputes

Term Of The Day – Mediator Workers compensation cases often do not go to court, but are settled between employer and employee with the help of a mediator. A mediator is a generic legal entity whose job is to help resolve disputes without engaging in a full court trial. Workers

Workers Comp Self Insurance Conversion – Five Questions To Ask

Workers Comp Self Insurance Qualifiers Most of the Workers Comp self insurance qualifiers center around the employer’s ability to have enough money to pay claims. One of our most requested services is to see if self insurance is a valid option for a large company. If your company is considering

Statutory Duty Means Full Disclosure To All Involved Parties

Statutory Duty Levels the Playing Field The statutory duty of a business includes full and clear disclosure of insurance terms and conditions to both the client and the insurance company. Statutory laws are often beneficial to both employers and their employees, as they require detailed plans and schedules of payments

Actuary – Insurance Definition

Term Of The Day – Actuary An Actuary is an insurance agent that computes dividends, rates, and risks according to statistical evidence and records. Actuaries play an integral role in the calculation of workers compensation insurance rates. Their assessments are vital in determining how much you will be paid if

Subcontractors vs Employees From IRS

The IRS Subcontractors vs Employees The following is from the IRS website on Subcontractors compared to the employees. I have printed this in the past. The last IRS update to the page was less than a month ago. Independent Contractor (Self-Employed) or Employee? It is critical that you, the business owner,

Subcontractor vs Employee – Insider IRS Guide Great Explanations

 IRS Guide To Subcontractor vs Employee Determination I was going to reprint the IRS’s guide to Subcontractor vs Employee. Lately, we receive this type of question more than the Premium Audit Bill inquiries. I then came across The Training Manual used by the Internal Revenue Service for separating employees and

This Workers Comp Blog Makes Top 7% For Website Traffic

Workers Comp Blog Makes Top 7% For Website Traffic, the Workers Comp Blog makes top 7%. Yes – we printed our own press release. A recent analysis by an independent third-party website traffic analysis firm indicated that http://blogs.cutcompcosts.com was ranked in the Top 7% Of All Website Traffic. J&L Risk

Tort Is Rare In Workers Comp Due To Exclusive Remedy

Term Of The Day – Tort A tort is rare in Workers Compensation insurance. The word originates from Old French and Medieval Latin tortum, meaning twisted. In modern English, a tort is a civil wrong that is committed by a tortfeasor, or wrong-doer. Whether committed intentionally or through negligence, if

West Virginia Workers Comp Is Doing Well – For The Most Part

West Virginia WC Doing Much Better The insureds in West Virginia used to keep us busy questioning how their Workers Comp premiums had been calculated. We still have a few WV clients. Commissioner Cline and the West Virginia Insurance Commission are to be congratulated for their efforts.  As I said

Why Does State Have Second Injury Fund?

Term Of The Day – Second Injury Fund Administered by the individual state, the Second Injury Fund reimburses an employer for a portion of claims caused by an on the job injury to an employee with a pre-existing permanent partial disability. This reimbursement program encourages employers to hire employees with disabilities.

Ombudsman – Do All States Have One For WC?

Term Of The Day – Ombudsman An Ombudsman impartial individual who is responsible for investigating complaints in order to mediate a fair and equitable settlement between aggravated parties. It is originally a Swedish term. In some parts of the world it is a government official appointed to investigate complaints against the government



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