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Virginia Has High Medical Costs Per Claim According to WCRI


High Medical Costs Per Claim In Virginia

A recent study by WCRI indicates that the state of Virginia has one of the higher medical costs per Workers Compensation lost time claim. WCRI’s recent study included 16 states. Virginia’s average medical cost per claim was 22% higher than the median state.

Graphic Of Silver And Golden Medicines And Money Medical Costs Per Concept
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The reason for the high medical costs may be attributed to the fact that Virginia does not have a fee schedule. I am not inferring that any state without a fee schedule will have a high level of medical costs. In October 2009, I compared other states that did not have a fee schedules and found them to be much more expensive than states with fee schedules. Tennessee reduced its medical costs significantly by adding in a Workers Comp medical fee schedule.

I thought I would research Virginia’s medical costs even further. According to the NCCI in April 2011, Virginia was 23% higher than any of the states in the same region. The comparison by NCCI included Kentucky, Maryland, DC, and North Carolina.

I would have to agree with the WCRI’s overall conclusion -over time trends in medical prices are lower in states with fee schedules. I hope that Virginia will in the future follow Tennessee’s lead and enact a fee schedule. The results will be positive.

There is an old and unfounded rumor that any state that enacts a fee schedule will cause a reduction in the availability of medical care for Workers Compensation claims. I have never seen this occur in any of my research.

Most Workers Compensation medical payments are higher than the comparable group health figures.   One of the main complaints that have now faded was workers compensation carriers and Third Party Administrators tend to pay slower than other lines of insurance.

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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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