Workers Comp Medical Only Claims Review – Important Time = Now
Risk Managers, business owners, and anyone who handles Workers Comp claims should look to start a Workers Comp Medical Only claims review. Why is now the prime time to accomplish a mostly easy task? Let us also count the Lost Time claims that remain open for months on your claims loss run.
One of the most popular terms that I have coined over the years is one area of claims that may be ignored – but should not be for Workers Comp claims. Medical Only Claims festering and small lost time claims that fester for months can end up costing $$$.
Why Now?
That is a fair question on why now is the time for a medical only claims review.
I want to avoid talking about the pandemic as much as possible, but it had a huge hidden effect on about 30% of the claims that J&L reviewed or adjusted during the pandemic.
I noticed that during the pandemic a hesitancy to attend medical appointments. Removing an injured worker from weekly indemnity benefits became a complicated matter at best. Did the injured worker finish out their medical treatment? A medical only claims review may lessen the risk of a festering claim turning into an expensive one.
Most of the indemnity claims had the element of continuing benefits or a PPD rating, or some facet that required an eventual follow-up medical visit. A medical only claim that may not have completely resolved could be your company’s next big claim.
For example, in Pennsylvania, an injured employee has a three-year time limit to file for benefits, even Medical Only claims. Most states have shorter time limits.
A medical only claims review should also address closed claims. Did the injured worker not finish treatment, or decide to wait and see on their claim?
Medical Only Claims Review = Resolving and Reducing Risk
Two articles that I recently authored on when the pandemic officially ended for Workers Comp claims and WCRI’s report on an increase in medical claims show that injured workers are seeking treatment for new or possibly old claims – see the festering links earlier in this article.
To see how to accomplish this task, see this 10+ year old article known as the loss run review guide
If you have online access to your claims, then you are already two steps ahead. The idea here is to perform a medical only claims loss run review or more generally, a complete loss run review.
