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Phoned In FROI Response To My Last Article – Excoriated

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Phoned In FROI (First Report of Injury) Reader Response To My Last Article 

A reader phoned in FROI response left an unapproving voice mail this morning.   My last article covered the First Report of Injury coding becoming very important due to COVID-related claims. 

Doctor talking on Phoned In FROI while looking at clipboard
StockUnlimited

The reader said examples of the sections in the FROI should have been included in my last article.   

The old saying – “The customer is always right” rang true in this example.   We put the rush on this article to get it in our newsletter for today.  Gulp! – deadlines! 

The WCIRB (California Rating Bureau) sent out a press release that any Corona virus-related claims will not count in any California employer’s X-Mod.   

I had recommended employers use their carrier or TPAs online claims systems.  A phoned in FROI or a paper report may cause the carrier’s data inputters to code a COVID-related claim as not related to the coronavirus.   

Two First Report of Injury Examples 

I decided to show the readers two examples of what you must fill out that make a claim considered and coded as COVID-related.     Please note these are image thumbnails – click on them to see a larger image. 

Cutout of phoned in FROI section for California WC claim
(c) CA DWC
phoned in froi cutout for North Carolina
(c) NCIC

The two are cutouts of the paper reports of injury.  The first one is from California.  The second cutout is from our HQ state North Carolina. 

The California Form 5020 covers the injury or illness a little more thoroughly than the North Carolina Form 19.  I am not sure if either state has or will devise another form or attachment to identify COVID-related claims.  

Cannot Fill Them In – Even The Examples  

Our legal advisor said that I should not fill in each for examples of how to designate them as COVID-related.  That cuts down what I was going to cover in the article.   

My advice from the last article I wrote is to try to attach the physician’s statement to the FROI if possible.   Be explicit as possible when filling out the report or if you are doing a phoned in FROI. 

 

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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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