Best Practices for claims departments to maximize the effectiveness of an audit With commentary and insight from Rick Sabetta and Barry Bloom As a Claims Supervisor I reacted very poorly to my first workers compensation claims audit. I went through the familiar stages that one does when first audited: Anger (at how anyone could question my decisions or results) Denial (that someone in my claims unit had made mistakes) Negotiations (over…
by Bill Zachry, SCIF Board Member and Barry Bloom, Managing Partner, The bdb Group “As the claims manager goes, so goes the office.” The most important job in a workers’ compensation claim office is the claims manager. Most companies strive for consistency and accuracy with regard to benefit provision. They work hard to achieve these results while trying to maintain a low cost of claims administration. To accomplish these results, they establish policies…
Management Engagement: The approach and attitude that senior management takes regarding injury prevention, safety, employee welfare, interaction with injured workers, and treatment of claims partners are primary determinants of successfully managing the workers' compensation program. Hiring the Right Employee: Hiring qualified and engaged employees is essential for reducing the risk of workplace injuries and subsequent workers' compensation claims. In today’s employment market this can be a particular challenge. Safety and…
The actor Leslie Howard, who played Ashley Wilks in the Gone with the Wind movie, was killed during World War II when the airplane on which he was a passenger was shot down. After the war it was discovered that the English had broken the Enigma code and they knew that his plane was going to be targeted by the Luftwaffe. The British Military did not warn the plane or…
Some might say “second injury funds (SIFs)” are dinosaurs. However, structured effectively SIFs can enrich a state’s efforts to maximize their workforce. They have been a crucial element in states’ workers’ compensation for over a century. As early as 1916 states established programs to encourage employers to hire employees who had permanent disabilities by limiting the employer’s risk to costs related to subsequent injuries compensable under that state’s workers’ compensation…
I would like to thank all of you who have diligently read our “Simple Ideas” papers during the past year. I admit that a few of the papers we sent out were actually not “simple”. These papers are either focused on improving outcomes for the injured workers while reducing costs for the employers, or are designed to help bring you up to speed on the latest technology which will impact…
In my June 27, 2023 article, Trauma-Informed Practices and Workers’ Comp…, I mentioned motivational interviewing (MI) as another health-related intervention that can also improve outcomes for workers and employers in the workers’ compensation system. In other words, another tool to prevent or mitigate unnecessary work disability. MI is a counseling approach that can support a shift in the culture of our industry. Claim professionals can use MI to activate customers,…
1:00PM Eastern, Wednesday, January 24, 2024 Our last webinar, taking a high level look at what Artificial Intelligence is and how it may affect the workers' comp industry, was hugely popular. Now we take a deeper dive into how AI will change our workplace, and what that means for you and those you work with. Our guests represent both private and public sector entities, and will offer frank insight into…
Lakewood Ranch, FL - WorkCompCollege.com, a division of Workers’ Compensation Educational Services, LLC, continued to build on the September 18, 2023 launch of their State-Specific Training Program through the end of the year. There are now 15 jurisdictions with content provided by experienced experts in each state to explain the regulatory framework and “real world nuance” of the work comp claims process. A single student login may provide access to…
Voice of the Provider is a collaboration between Brooks Rehabilitation and WorkCompCollege.com and the name defines its purpose. Many stakeholders in work comp do not understand or appreciate all of the various clinical providers that help an injured employee return to and stay at work. Whether recovery from the injury / illness is easy or hard, there are clinicians along the way that utilize their education, expertise and experience to help.…
