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Home » Archives for August 2014

Archives for August 2014

Loss Development Factor – Do I Need One – How Do I Get One

August 28, 2014 By JL Risk Management Consultants

Loss Development Factor Critical For Self Insurance

Do I need Loss Development Factor? Loss Development Factors (LDF’s) are one of the under-the-radar parts of the Workers Compensation system.   This was a question received last week by a reader that found the blog on Google.

Picture of Loss Development Factor Business Infographic

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LDF’s can be thought of very generally as the Experience Modification Factor (E-Mods) for self insureds.   The Ultimate Claims Value (Ultimate Loss)  is a very important term that distinguished self insured analysis from a regular WC policy.

E-Mods (also referred to as X-Mods) are limited in scope to a maximum of almost five years in the past in certain situations.   LDF’s cover up to 10 years as the risk of being a self insured is your company or organization will be responsible for paying the full value of the claim.

There are many companies, including ours, that can calculate LDFs for you.  In fact, you can calculate it yourself if you have the right software.  The caveat, as any actuary or claims statistician will tell you is the concern about accurate inputs into the LDF formula.

Woman Employee Loss Development Factor Customer Paying

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The old saying about GIGO (garbage in- garbage out) applies here to the hilt.   Usually, there may be some type of statistical “smoothing”  such as lessening the impact of one or more outliers that can make the LDF become somewhat inaccurate.

The bottom line is – as a self insured- how do you budget for claims presently?  If you have a method that works, then you are ahead of the curve.   However, LDF’s will usually be the most accurate way to assess your present and future WC needs.

It may be good to obtain one to see if your projections agree with the calculated ultimate claims value.  Are you looking for 5+ years into the future?  If not, an LDF may assist you with long term budgeting.

©J&L Risk Management Inc Copyright Notice

Filed Under: LDF, Loss Development Factor Tagged With: Ultimate Loss, ultimate value

What Would Happen If Workers’ Compensation Ended Tomorrow?

August 27, 2014 By JL Risk Management Consultants

Workers’ Compensation Ended Tomorrow – Then What?

If Workers’ Compensation ended tomorrow, what would be the result?

Picture of Man Stealing the Results Workers' Compensation Ended Tomorrow

StockUnlimited

One of the more prolific bloggers such as myself recently published an article that was titled “Without Comp.”   I started thinking what would happen if Workers Comp was completely abolished for injured

workers.The most prevalent results would be:

  1. The loss of  the no-fault part of the system.  Ask Florida employers and citizens what that might be like for all of us.
  2. An outbreak of liability lawsuits that would clog the court systems for eons.  Employers would sue negligent employees.  Employers would be sued in civil court by their employees.  A very large legal mess would ensue.
  3. AFLAC stock would blow through the roof.  Disability policies would become similar to health insurance.  Every worker would have to sign up for one if affordable.
  4. The federal government would create the Affordable Disability Insurance Act with many exchanges.

    Man Sitting Wheel Chair Workers' Compensation Ended Holding Ball

    StockUnlimited

  5. Safety standards would have to become more strict to the point of interfering with business.
  6. A shift in insurance companies from WC adjusters to more liability adjusters.  The retraining burden would make insurance carrier unprofitable for a few years.
  7. The legal system would shift to pure liability concerning injured employees,
  8. The vendors would have to adapt quickly, but what would the market look like after the end of comp?
  9. State WC systems would subsist for a few years with the claims run-off of the old claims.
  10. Many claims would be filed with an accident date of today.  Claims filing fraud would be rampant.

And the list would go on and on…..

What do you think would be the results of WC ending tomorrow?  Could it really happen?

©J&L Risk Management Inc Copyright Notice

Filed Under: Florida, without comp Tagged With: abolished, civil court, Disability policies, prolific, rampant

California SB 863 Failure Result In 6.7% WCIRB Rate Increase?

August 26, 2014 By JL Risk Management Consultants

California SB 863

California SB 863 was supposed to be a cost-cutting measure for all parties involved in their WC system.  Last week, the WCIRB  (Workers Comp Insurance Rating Bureau) recommended a 6.7% increase due to a number of factors for policies effective January 1, 2015.  

Graphic Map of California sb 863 State

StockUnlimited

According to the WCIRB press release, there were numerous factors that led to the recommended rate increase:

  • Continued adverse medical loss development
  • Greater recognition of changing long-term medical paid loss development patterns
  • Continued high levels of indemnity claim frequency
  • Higher than anticipated loss adjustment expense inflation in part attributable to less than projected frictional costs savings resulting from Senate Bill No. 863 (2012)
  • Lower than forecast wage growth
  • Modest increase in the experience rating off-balance correction factor
Female Doctor California SB 863 On Duty

StockUnlimited

The Cost Driver Section in WCIRB’s rate filing report delved further into the reasons for the recommended increase.  SB 863 was supposed to save $200 million which never materialized due to the Independent Medical Review (IMR) process.  The WCIRB had to remove the $200 million in savings from their calculations. 

The WCIRB went on to say:

 

The WCIRB’s estimated frictional cost savings related to IMR were predicated on replacing higher cost medical treatment dispute resolution mechanisms such as medical liens and the qualified medical evaluator (QME) and expedited hearing processes with lower cost IMRs. 

 

However, Division of Workers’ Compensation (DWC) data on IMR suggests the volume of IMRs is two to four times higher than that contemplated in the initial cost estimates. Also, while at a reduced volume, medical treatment on a lien basis is still occurring. 

 

Finally, while qualified medical evaluations are generally not being conducted on medical necessity issues, many claims, partially in response to the Dubon decision, are having expedited hearings on utilization review issues. 

©J&L Risk Management Inc Copyright Notice

Filed Under: California, SB 863, WCIRB Tagged With: IMR, medical liens, medical loss, medical paid, wages

IRS Independent Contractor Determination Not Magic

August 20, 2014 By JL Risk Management Consultants

IRS Independent Contractor Determination

The IRS independent contractor determination can be very helpful to contracting companies.  

The IRS recently updated their info on the Employee vs. Independent Contractor determination decision by an employer. The complete breakdown of the common law rules the IRS independent contractor determination is listed in this article.  

Picture of IRS Independent Contractor Determination

Wikimedia Commons – ENERGY.GOV

Even though this list is comprehensive, the IRS indicates there is no one factor that determines if the worker is an independent contractor.   This information is not state-specific.   The info is more of a rule of thumb.  

Many of these rules can be seen in the Massachusetts case covered two days ago. 

Common Law Rules

Facts that provide evidence of the degree of control and independence fall into three categories:

  1. Behavioral: Does the company control or have the right to control what the worker does and how the worker does his or her job?

  2. Financial: Are the business aspects of the worker’s job controlled by the payer? (these include things like how worker is paid, whether expenses are reimbursed, who provides tools/supplies, etc.)

  3. Type of Relationship: Are there written contracts or employee type benefits (i.e. pension plan, insurance, vacation pay, etc.)? Will the relationship continue and is the work performed a key aspect of the business?

Businesses must weigh all these factors when determining whether a worker is an employee or independent contractor. Some factors may indicate that the worker is an employee, while other factors indicate that the worker is an independent contractor. There is no “magic” or set number of factors that “makes” the worker an employee or an independent contractor, and no one factor stands alone in making this determination. Also, factors which are relevant in one situation may not be relevant in another.

Lying Gavel IRS Independent Contractor In Front Of Judge

(c) stockunlimited

The keys are to look at the entire relationship, consider the degree or extent of the right to direct and control, and finally, to document each of the factors used in coming up with the determination.

1. Behavioral Control

Behavioral control refers to facts that show whether there is a right to direct or control how the worker does the work. A worker is an employee when the business has the right to direct and control the worker. The business does not have to actually direct or control the way the work is done – as long as the employer has the right to direct and control the work.

The behavioral control factors fall into the categories of:

  • Type of instructions given

  • Degree of instruction

  • Evaluation systems

  • Training

Types of Instructions Given

An employee is generally subject to the business’s instructions about when, where, and how to work. All of the following are examples of types of instructions about how to do work.

  • When and where to do the work.

  • What tools or equipment to use.

  • What workers to hire or to assist with the work.

  • Where to purchase supplies and services.

  • What work must be performed by a specified individual.

  • What order or sequence to follow when performing the work.

Degree of Instruction

Degree of Instruction means that the more detailed the instructions, the more control the business exercises over the worker. More detailed instructions indicate that the worker is an employee.  Less detailed instructions reflects less control, indicating that the worker is more likely an independent contractor.

Hand Illustrating IRS Independent Contractor Evaluation

(c) stockunlimited

Note: The amount of instruction needed varies among different jobs. Even if no instructions are given, sufficient behavioral control may exist if the employer has the right to control how the work results are achieved. A business may lack the knowledge to instruct some highly specialized professionals; in other cases, the task may require little or no instruction. The key consideration is whether the business has retained the right to control the details of a worker’s performance or instead has given up that right.

Evaluation System

If an evaluation system measures the details of how the work is performed, then these factors would point to an employee.

If the evaluation system measures just the end result, then this can point to either an independent contractor or an employee.

Training

If the business provides the worker with training on how to do the job, this indicates that the business wants the job done in a particular way.  This is strong evidence that the worker is an employee. Periodic or on-going training about procedures and methods is even stronger evidence of an employer-employee relationship. However, independent contractors ordinarily use their own methods.

 

2. Financial Control

Financial control refers to facts that show whether or not the business has the right to control the economic aspects of the worker’s job.

The financial control factors fall into the categories of:

  • Significant investment

  • Unreimbursed expenses

  • Opportunity for profit or loss

  • Services available to the market

  • Method of payment

Significant investment

Picture of Cupped Hand with Dollar Currency Symbol IRS Independent Contractor Concept

(c) stockunlimited

An independent contractor often has a significant investment in the equipment he or she uses in working for someone else.  However, in many occupations, such as construction, workers spend thousands of dollars on the tools and equipment they use and are still considered to be employees. There are no precise dollar limits that must be met in order to have a significant investment.  Furthermore, a significant investment is not necessary for independent contractor status as some types of work simply do not require large expenditures.

Unreimbursed expenses

Independent contractors are more likely to have unreimbursed expenses than are employees. Fixed ongoing costs that are incurred regardless of whether work is currently being performed are especially important. However, employees may also incur unreimbursed expenses in connection with the services that they perform for their business.

Opportunity for profit or loss

The opportunity to make a profit or loss is another important factor.  If a worker has a significant investment in the tools and equipment used and if the worker has unreimbursed expenses, the worker has a greater opportunity to lose money (i.e., their expenses will exceed their income from the work).  Having the possibility of incurring a loss indicates that the worker is an independent contractor.

Services available to the market

An independent contractor is generally free to seek out business opportunities. Independent contractors often advertise, maintain a visible business location, and are available to work in the relevant market.

Method of payment

An employee is generally guaranteed a regular wage amount for an hourly, weekly, or other period of time. This usually indicates that a worker is an employee, even when the wage or salary is supplemented by a commission. An independent contractor is usually paid by a flat fee for the job. However, it is common in some professions, such as law, to pay independent contractors hourly.

3. Type of Relationship

Picture of IRS independent contractor Businessmen Shaking Hands

(c) stockunlimited

Type of relationship refers to facts that show how the worker and business perceive their relationship to each other.

The factors, for the type of relationship between two parties, generally fall into the categories of:

  • Written contracts

  • Employee benefits

  • Permanency of the relationship

  • Services provided as key activity of the business

Written Contracts

Although a contract may state that the worker is an employee or an independent contractor, this is not sufficient to determine the worker’s status.  The IRS is not required to follow a contract stating that the worker is an independent contractor, responsible for paying his or her own self employment tax.  How the parties work together determines whether the worker is an employee or an independent contractor.

Employee Benefits

Employee benefits include things like insurance, pension plans, paid vacation, sick days, and disability insurance.  Businesses generally do not grant these benefits to independent contractors.  However, the lack of these types of benefits does not necessarily mean the worker is an independent contractor.

Permanency of the Relationship

If you hire a worker with the expectation that the relationship will continue indefinitely, rather than for a specific project or period, this is generally considered evidence that the intent was to create an employer-employee relationship.

Services Provided as Key Activity of the Business

If a worker provides services that are a key aspect of the business, it is more likely that the business will have the right to direct and control his or her activities.  For example, if a law firm hires an attorney, it is likely that it will present the attorney’s work as its own and would have the right to control or direct that work.  This would indicate an employer-employee relationship.

©J&L Risk Management Inc Copyright Notice

Filed Under: independent contractor, Internal Revenue Service, IRS Tagged With: Behavioral Control, Financial Control

Independent Contractor vs Employee Definition From IRS

August 20, 2014 By JL Risk Management Consultants

Independent Contractor vs Employee Definition

The independent contractor vs employee definition has been the bane of companies for many years.

 The Internal Revenue Service is always a great place to find information on independent contractors. Of course, the information is common law and your applicable states or states may vary from the following information. As with most independent contractor considerations – behavioral and financial control along with the relationship of the parties will usually determine how to denote a worker.

Home of the Independent Contractor vs Employee Definition Internal Revenue Service

Wikimedia commons – Joshua Doubek

For further consideration, another great rule of thumb list is from the Massachusetts article published yesterday. 

Topic 762 – Independent Contractor vs. Employee

For federal employment tax purposes, the usual common law rules are applicable to determine whether a worker is an independent contractor or an employee. Under the common law, you must examine the relationship between the worker and the business. All evidence of the degree of control and independence in this relationship should be considered. The facts that provide this evidence fall into three categories – Behavioral Control, Financial Control, and the Relationship of the Parties.

Behavioral Control covers facts that show whether the business has a right to direct and control what work is accomplished and how the work is done, through instructions, training, or other means.

 

Two Man Independent Contractor vs Employee Definition Hand Grasp

StockUnlimited

Financial Control covers facts that show whether the business has a right to direct or control the financial and business aspects of the worker’s job. This includes:

  • The extent to which the worker has unreimbursed business expenses
  • The extent of the worker’s investment in the facilities or tools used in performing services
  • The extent to which the worker makes his or her services available to the relevant market
  • How the business pays the worker, and
  • The extent to which the worker can realize a profit or incur a loss

Relationship of the Parties covers facts that show the type of relationship the parties had. This includes:

  • Written contracts describing the relationship the parties intended to create
  • Whether the business provides the worker with employee-type benefits, such as insurance, a pension plan, vacation pay, or sick pay
  • The permanency of the relationship, and
  • The extent to which services performed by the worker are a key aspect of the regular business of the company

©J&L Risk Management Inc Copyright Notice

Filed Under: independent contractor, IRS Tagged With: Behavioral Control, Financial Control, relationship parties

Massachusetts And Independent Contractor Determination

August 20, 2014 By JL Risk Management Consultants

Massachusetts And Independent Contractor

The Massachusetts has an interesting take on independent contractors.  One of the hottest topics that still generates interests over the years is the subcontractor vs. employee debate.

Map Of Massachusetts Graphic

StockUnlimited

Many states have publicized cracking down on “1099 employees.”Massachusetts has a landmark case that has been used for determining whether or not a workers is considered an independent contractor or employee.The list is comprehensive in nature, yet concise enough to be a listed here:

  1.  the extent of control exercised by the employer over the details of the work
  2.  whether the worker was engaged in a distinct occupation or business 
  3. whether, in the locality, the type of work usually proceeded under the direction of an employer or by an unsupervised specialist
  4.  the skill required for the occupation
  5. whether the employer or the worker supplied the tools and place of work
  6. the length of time of the working relationship
  7.  the method of payment
  8. whether the work was part of the regular business of the employer
  9. whether the parties believed that they were creating an employment relationship
  10. whether the alleged employer constituted a business 

The Massachusetts case referred to is MacTavish v. O’Connor Lumber Co., 6 Mass. Workers’ Comp. Rep. 174, 177 (1992).

The IRS website will be revisited tomorrow to see if there has been any updates to their website on independent contractors.

©J&L Risk Management Inc Copyright Notice

Filed Under: independent contractor, Massachusetts, subcontractor Tagged With: comprehensive, extent of control exercised, IRS website, MacTavish

Live CA WCIRB Webinar On State Of California’s Work Comp System

August 7, 2014 By JL Risk Management Consultants

CA WCIRB Webinar

The following is a great live CA WCIRB webinar that was typed in as it happened.

Please excuse any typos, weird language as I am typing this live as I hear it.   Thanks for the understanding.

Map Of Live CA WCIRB Webinar With California Quail

StockUnlimited

Check back often as this blog will keep updating, if things go as planned.I will try to input info that will not be in the written report provided by WCIRB.

There were a few technical difficulties (as in 99.9%of webinars) with the sound.   Everything is A-OK now.

The Agenda for today is:

  • Employer Costs
  • Cost Distributions
  • Cost Drivers
  • Senate Bill 863
  • Insurer Results

Employer Costs – 

Total Premium estimated for 2014 16.3 Billion, steady double digit increase since 2006

Most of the increased Employer Cost Factors are from increases in what premium carriers charge employers

Average charged payrolls are the same as the 1970’s(?)   – $2.97 per $100 of payroll

California has always had a higher charged rates when compared to the national average.

Graphic Of Human Head Live CA WCIRB Webinar With Dollar an Question Mark

StockUnlimited

Published rate (average) are extremely high for Transportation and Utilities  – almost $10 per $100.  That is normal for most states- Transportation is usually highest or almost the highest

Cost Distributions

Medical benefits – 37% of total comp payouts – very similar to most states.WCIRB actuaries say Permanent Disability benefits will increase sharply over the next few years.

The largest growth in medical payments – is medical payments made to employees

Cost Drivers

Accident rates are much lower than n the 1990’s with a high in 1991 of 5% of all employees filing a WC claim for indemnity – Frequency has fallen to under 2%- possibly due to CA becoming a service-oriented state

Indemnity claims frequency was highest in central California.   Los Angeles area is starting to increase in the 2012 data.

As compared to NCCI data, since 2012, CA has had a much higher rate of  claims reported.

As expected, California has much more Permanent Disability rate on indemnity claims = 47%   There are actually six states higher than CA.   South Carolina is a surprise state.

Indemnity claim severity has been flat for CA since 2005.

Medical costs increase on indemnity claims have increased by 500% since 1991.   The recent medical costs have leveled off for the most part.

CA is highest on the Incurred Medical Benefits per indemnity claim except for Delaware and Alaska.

Allocated Loss Adjustment Expenses (ALAE) have actually increased since SB 863 as WCIRB had projected a 6% reduction.  ALAE expenses actually grew 6 – 9% in 2013 – alarming.

Flag of Live CA WCIRB Webinar California

Wikimedia commons – Makaristos

Senate Bill 863 (SB 863)

Liens seem to be the only positive result so far when compared to the WCIRB’s  forecasts.   However, it is much too early to really have any full assessments of the involved factors.

Participant questions- Will the legal push-back on lien affect costs?  Yes, but unknown effect,

Any surprises from SB 863?   Basically, no reductions in SB 863 frictional costs which was the reason for enacting the bill.

Overall Outlook

CA has very high volatility on profitability, but still indicates some profitability.

Summary – I will cover this more in depth next week.   (Slide 37)

Final Participant Questions – Does/will the Affordable Health Care Act affect CA WC?   – Still studying the matter, supply and demand on health care access, workers may not try to shift a health claim to WC if they have health insurance instead of being uninsured – premature estimations

SB 863 question – Forecast on ALAE?   Alarming increases instead of projected decreases. There are many possible changes that may decrease frictional costs.

Any info on Physician Dispensed Medication?   WCIRB released report late last year on this subject.

Overall – a good webinar.  This live CA WCIRB webinar went well and covered a very difficult subject.

©J&L Risk Management Inc Copyright Notice

Filed Under: California, WCIRB Tagged With: Cost Distributions, cost drivers, Employer Costs, Senate bill 863

Recent Nebraska Supreme Court Cases Underwriter Adjuster Changes

August 6, 2014 By JL Risk Management Consultants

Nebraska Supreme Court Cases

Two days ago, I analyzed a recent court case where the Nebraska Supreme Court Cases made a ruling that can devastate a state’s Workers Comp system.

Graphic Of Nebraska Supreme Court Logo

StockUnlimited

The conundrum is two- fold for carriers and self-insureds and their Third Party Administrators (TPA’s):

  1. How do the insurance carriers make up the difference now that bad law that will likely be exploited is now “on the books?”
  2. Can insurance carriers properly adjust files now that there is a cloud of a bad decision on the definition of an accident?

The carriers’ underwriting departments could have in no way anticipated such a momentous decision that may open up the floodgates on past, present and future denials of claims that were based on the definition of an accident.

If you did not read the article from two days ago in this blog, it may behoove you to look at the article here.  The article has links to the decision.  Follow this link for the prior bad decision by the Nebraska Supreme Court.

Incurred But Not Reported (IBNR) can only offset so much of a new bucket of claims that may have to be paid or settled due to such a decision.  Changing the definition of an accident can alter the underpinnings of how claims are viewed in a state.

Man And Woman Arguing Nebraska Supreme Court Cases In Front Of Judge

StockUnlimited

Twenty years ago, the large carriers were going to pull out of writing in North Carolina due to an even worse Supreme Court decision.  The NC legislature stepped in to quell employers’ and carriers’ concern with legislation that corrected the decision.

Claims adjusters in Nebraska may now have to consider or reconsider claims where the definition of an accident was expanded from a single traumatic incident into an incident that stretched for months or years.

Employers may notice that claims where the definition of an accident comes into play, especially on denials, large increases in Total Incurred which increases an employer’s E-Mod (X-Mod) or LDF if self insured.   Adjusters usually react to bad case law on the books by heavily increasing the reserves on a portion of their files that involve an accident definition.

I may sometimes not agree with carriers or TPA’s.  However, in this case, when the road-map of underwriting and claims handling change overnight, what is a carrier’s underwriting and claims department going to do in such cases?

The bottom line is the employers in Nebraska could end up paying more premiums and the self insureds could end up with a much large WC budget when the unanticipated is now fact.  Even worse, the employers may soon  find fewer carriers writing WC in Nebraska.

©J&L Risk Management Inc Copyright Notice

Filed Under: E-Mod X-Mod, Incurred But Not Reported, Nebraska, North Carolina, Total Incurred, TPA Tagged With: conundrum, momentous, Nebraska Supreme Court, quell

Nebraska Supreme Court – Another Bad Decision

August 5, 2014 By JL Risk Management Consultants

Nebraska Supreme Court Makes Surprising Decision

The Nebraska Supreme Court as State Supreme Courts seem to do more often lately- affirmed the Workers Comp court’s decision in one of those cases that send a chill throughout the Workers Compensation community.

Front Nebraska Supreme Court Dusk

Wikimedia commons – Noclip at en.wikipedia

The full decision can be found here.   This is a .PDF file that requires a PDF reader that can be found for free here.  

Last year, the Nebraska Supreme court made a similar ruling concerning an employee that voluntarily leaves an employer for a higher paying job.
I was reading a very recent article on the case that surely seemed to be a proper denial by the insurance carrier.  A 30-year career dental hygienist had filed a claim against her most recent employer even though she had earlier sought medical treatment with a different employer and carrier that actually paid for her medical benefits.   The case is Potter v. McCulla. 

The most recent WC carrier sent the employee for an evaluation where the physician did not relate the injury to her current work.  The physician’s exact words were “pre-existing and progressive degenerative cervical disc condition.”    The current WC carrier denied benefits. 

The claimant then went to treat on her own and self-reduced her work hours to three days per week.  

overview of Nebraska Supreme Court state capitol

Wikimedia Commons – Capitolist


From the Nebraska Supreme Court decision: 
—

Potter left her employment with Garcia in June 2011 to accept a position as a dental hygienist with another clinic,  where she worked 3 days a week. She continued to feel pain in her neck, and in June 12, 2012, she sought treatment with Dr. Phillip Essay of the Spine and Pain Center of Nebraska. In July 2012, 

Essay imposed permanent work restrictions of working only 3 days per week. Essay opined that Potter had “degenerative spondylosis in her cervical spine” that was “aggravated by the repetitive work duties and postures required in her work as a dental hygienist,” although he acknowledged it was “impossible to state to any reasonable degree of medical certainty which of her positions as a dental hygienist caused what and/or when.”
—-
The claimant filed a petition with the Nebraska Workers Comp court.  The court awarded Ms. Potter benefits.  The carrier decided to appeal it directly to the Supreme Court and not the Nebraska Court of Appeals.  

The dentist,  defense attorney, and carrier should have known they were in trouble when the Nebraska Supreme court started referring to Oklahoma’s expanded definition of an accident.  There was enough precedent in Nebraska without looking outside the state.  

Female Judge Nebraska Supreme Court Holding Gavel

(c) stockunlimited

The Nebraska Supreme Court delved very heavily into the definition of an accident and ruled that the first time that the claimant had to leave work was the date of the accident.  

I will pick this back up tomorrow as the article is becoming too much material to cover in one article/post.  

The case is worth a quick read.  You can follow the links above to see it.  

©J&L Risk Management Inc Copyright Notice

Filed Under: Nebraska, Supreme Court Tagged With: degenerative, McCulla, Potter, voluntarily

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James J Moore
Raleigh, NC, United States

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:
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