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Workers Comp Basics From A Friend’s Great Book

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Workers Comp Basics – New Book Looks At The Forest Instead of the Trees

A long-time friend of mine Nancy Germond decided to grab the tiger by the tail and write a great book on Workers Comp Basics.   Check out the bottom of this article for the info in case you want to read more excerpts than in this article or to purchase.  I gave the book a big t.humbs-up review on Amazon.

pic of forest in fall workers comp basics
Wikimedia License – Németh Tibor

The book gives anyone new to the world of Workers Comp a quick intro or a refresher to anyone who has experience in WC.  Nancy was kind enough to forward a few passages for me to use in this article.

One of the areas covered in her book that I have not covered in my 2,000 articles is Loss Prevention Safety Committees.  (See Chapter 5).  Safety programs reduce Experience Mods and Loss Development Factors when the owners or managers are patient.  You have to give a safety program three years minimum to show the full effect of your efforts.

Let us see what Nancy has to say on  Workers Comp basics.

From the book – Workers’ Compensation In Two Hours

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The workers compensation process

When a claim is work-related, here is a breakdown of the steps in a normal workers compensation process.

  • Step One – The employee has a witnessed or otherwise routine workplace injury or reports an industrial illness, such as lung disease.
  • Step Two – Your adjuster investigates the claim, accepts the claim, and begins to manage and pay for the medical treatment, paying lost wages when needed.
  • Step Three – When the injury has some extent of lifetime disability or your employee becomes disabled, your employee and your insurer agree in front of an administrative law judge to the degree of disability and the appropriate compensation for that disability.
  • Step Four – Your employee and the court accept the final settlement offer.
  • Step Five – Your adjuster pursues any subrogation by at-fault parties to recoup payments made on your behalf. Subrogation is a right in your policy that allows the insurer to recover loss payments from the party that caused the loss. For example, the adjuster pursues the insurer of the driver who injures your employee when your employee is blameless.
  • Step Six – The adjuster closes the claim. In cases of permanent disability, the adjuster continues to pay “supportive care,” court-approved medical care needed for the employee to maintain his or her level of function.

In general, the safety net of workers compensation operates smoothly, administered slightly differently from state to state. States recognize most types of injury, with back sprains and strains one of the most common work injuries. They also recognize certain occupational diseases, such as asbestosis or certain occupation-related cancers. COVID-19 has added to the complexity of these decisions to accept or deny a workers compensation claim, known as “compensability determinations.”

A compensable claim is one that the insurer or the administrative law judge accepts as work-related and thus payable.

_______________________________

If you liked the passage from Nancy’s book, or have any additions, please let me know in the comments.

The Workers Comp Basics = the forest, not all the trees.

Go here to see more info on the book and recording (George Jack of Insurance Journal).

Workers’ Compensation in Two Hours: The Business Owner’s Guide to an Exceptional Workers’ Compensation Program 

by Nancy Germond, MA, SPHR, SHRM-SCP, ARM, AIC, ITP

If you want to get back to Workers Comp basics, try this one out.  It has 20+ 5-star recommendations.

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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 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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