As part of the Grand Bargain, we have in the workers’ compensation system a process known as the exclusive remedy. What has been traded for is a quick and easy way to address injuries received in the occupational space. Consequently, we have a system that takes us out of the court system to receive proper benefits for those injuries. Exclusive remedy is doctrine and in return, employees cannot sue their…
Introduction Within all claims operations, the claims manager and supervisor are responsible for balancing the examiners’ caseload to make sure that the examiners not only have the right caseloads but also have the right claims within that caseload. Properly done, the assignment process will allow the examiner to produce optimum results. The right balance is based on the experience of the examiner, the support level of the claims team (number…
Establishing a people-centric culture in the workers' compensation industry is not just an aspiration but a necessity. While we take an industry-wide initiative shift into advocating for workers' recovery, the success of this initiative comes from our internal organizational culture. By focusing on intentional connections, supporting employees, fostering effective communication, and preventing burnout, organizations can create an environment that celebrates wins, promotes productivity, and prioritizes the well-being of employees and…
Ashley Means was the recipient of a WorkCompCollege’s Faculty Grant to become a WRP student. She progressed quickly through the 64 courses and 51 hours of content, completing her first course on November 30, 2023. She passed the Final Exam on January 25, 2024. That is the definition of motivation, and on top of that a high achiever with an overall GPA of 90.66%! Ashley was a groundbreaker in two…
A significant issue facing workers’ compensation professionals is rising medical costs. We all deal with escalating expenses, and there are a number of vendors who have offered various solutions to limit this escalation. The question becomes what can that workers’ compensation professional do to mitigate the expenses? Understanding that there are multiple methodologies to mitigate rising healthcare costs, one of the first steps noted is prevention. Candidly, that is well…
Introduction The “Optimum” throughput of claims always results in the lowest total cost of claims. Instead of focusing on caseloads the industry should focus on the throughput of claims to measure productivity and staffing needs. Optimum throughput of clams is; When claims are immediately reported, where compensability is promptly determined, when prompt appropriate medical care is provided, when early return to work is achieved, where indemnity benefits are accurately and…
Employers have a direct positive impact on their claims results if they partner with the claims examiners. When employers treat the claims examiner as a professional partner, claims results are always better. When employers work well with the claims examiners the examiners are happier and more productive. Employer actions also have a direct impact on examiner retention. In an industry full of negativity, acknowledgements and thank you notes to examiners…
I’ve known the team at ODG by MCG since 2009 when I became involved with the adoption of their drug formulary by Texas. I had the privilege of being engaged with the regulators and many of the stakeholders as a method to change prescribing behaviors was debated, implemented, and then measured. After almost two years of regularly commuting from Georgia to Texas, based on that experience, I had the opportunity…
Lakewood Ranch, FL (February 7, 2024) – WorkCompCollege.com, a division of Workers’ Compensation Educational Services, LLC and an #Edutech Company, has announced a Bronze Associate Partnership with The Builders Group (TBG). This partnership closely corresponds to and helps fulfill TBG’s guiding principle … “If responsible people acted responsibly, everyone wins.” “TBG offers a unique workers’ comp solution to the construction industry through our group, self-insured fund,” says Stu Thompson, TBG’s…
Workplace injuries have the potential to drastically alter the lives of individuals affected by them. Beyond the physical pain, these injuries also impose significant emotional and financial burdens. While workers' compensation programs aim to provide support, the journey to recovery is often challenging. As claims professionals, we must empathize with their experiences and better understand their challenges. Then why do we not start ANY training, education, onboarding, designation, or introduction…
