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WCIRB Delayed Medical Treatment Study Backs Up Six Keys Study

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WCIRB Delayed Medical Treatment Study Proves What We Knew All Along

The WCIRB Delayed Medical Treatment Study can be found here.  The WCIRB (California Workers Comp Rating Bureau) recently published a study on delayed medical treatment due to the recent COVID-19 pandemic.

picture of COVID-19 WCIRB Medical Treatment Delay Study
Public Use License – Maximilian Schönherr

I was hoping the study replicated or at least came close to the numbers that I had published in the late 1990s and early 2000s that showed if an injured worker experiences medical treatment delays, employers pay dearly.

Six Keys And Delayed Medical Treatment

Check out the Six Keys To Workers Comp Savings here.   The Six Keys were developed over time as first a workers comp adjuster and then a consultant.    I sampled 7,000 public entity claims files in 1998.  I performed the same study again in 2008 to confirm my findings.

The Six Keys are:

  1. Timely First Reports
  2. Medical Network
  3. Return To Work Program
  4. How the Employer Treats the Employee
  5. Management Adoption of Keys
  6. Understand your final policy bill or premium audit

My signature presentation subject comes from the first four from the above list.  Those four not being put into place costs an employer 400% more on their claims.  Looking at it from a cost reduction viewpoint, the total cost saving experienced by providing timely medical treatment equals 75%.

I hoped very intensely that my numbers matched the WCIRB study and report.   Some of my numbers had varied from WCIRB’s numbers over the years.  WCIRB seemed to back up my numbers in this study.

One exasperating area for the claims department is the Twilight Zone Phone Call.   Doing #1 and #2 on the list quickly means not introducing the claim to a claims department with a filing delay mistake.  The phone call often causes the adjuster to set the reserves to a much higher level than normal.

In other words, the employer already blew this claim, so the reserves need to be more to cover the increased payments incurred during the lifetime of the claim.    Yes, reserves are set that way most of the time.

How The WCIRB Delayed Medical Treatment Study Relates To the Six Keys

Let us look at the WCIRB Study.  By the way, you should download a copy of the study.  It is worth the read.  See the first link in this article to read and download the WCIRB article.   Yes, it is worth your time.

The chart that made me feel good about my old (yet still accurate numbers are included in the WCIRB charts below.   You may need to click on the chart thumbnail below to see it more clearly.   The charts are from pages 9 through 11 from the study.

wcirb medical treatment delay study chart
Please click on the chart to see full size
wcirb delayed medical treatment study graph
(c) WCIRB – all rights reserved

 

The charts show that overall when medical treatment is delayed the medical and indemnity costs increase sharply.  These charts are comparing delays due to COVID-19.  “Delays are delays” – the numbers bear me out.

Both charts parallel the same time when workers comp adjusters set the final reserves for the life of the claim.   Many more charts in the study come to the same conclusion – delayed medical treatment cost employers dearly.

Post-COVID-19 Recommendations

Long after the COVID situation resolves, the numbers on delayed treatment will stay the same.  If timely injury reports and medical treatment is provided, the savings are approximately 75% on the overall costs.

The numbers between the WCIRB delayed medical treatment study and the numbers I have seen on file for over 30 years may not match exactly, but they are close enough to cause concern for employers nationwide.

 

 

 

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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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