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Workers Comp Claims Spike – Easy Way To Handle?

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Workers Comp Claims Spike May Show Need For More Training

Does a Workers Comp Claims spike have an easy solution? In my last post,  the learning curve was what I thought would be the reason for an upcoming  workers comp claims spike or explosion in claims.  Rookies tend to make mistakes, whether in sports or at work.   I would also count workers that have not performed a job or job function as part of this group, even though they are not rookies. 

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New York, New Jersey and employers in many other states, especially construction and demolition, will likely see a spike in claims.  The easiest way to handle this inflow of claims from an employer’s  point of view is to have a few very simple strategies in place. 

 I am going to reiterate some of my Keys To Cutting Workers Comp Costs as these are easy to use in case of an accident: 

ASAP First Reports – this is very important during a claims spike as adjusters may be overloaded.  Get your reports in first. 

  • Fax, email, or report the injury online ASAP. 
  • If an employee is out of work, follow-up within two business days to see if your injury report has made it to the adjuster. 
  • Note any questions or concerns by attaching a note to the first report of injury. 
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Dr. Network – the most critical key

  • This is the most critical part of any WC claim without question.
  • WC courts consider physicians the only impartial parties/witnesses in a claim.
  • A physician panel needs to be in place .
  • Treating physician controls medical cost, length of time out of work, and any permanent disability

Return to Work Program – employers sometimes forget this area when overloaded with work and claims.

  • The medical providers that are seeing the WC employees should know if you have a RTW program in place 
  • Employees should know a return to work (RTW) program is in place. 

Employee Treatment – your workers are still your employees even after an injury

  • Reduces fraud
  • Helps Return To Work program
  • An out of work employee is still your employee
  • Keeps employee in the loop 

These four keys may seem very basic.  However, we find that most employers with high E-Mod/X-Mods/LDF’s are not following one of more of these keys.   Now is a good time to put them in place before the claims come rolling in quickly for your company. 

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James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt 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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