Category: CompMed Insights

Most claims organizations treat attorney involvement as a symptom. The worker hired a lawyer, the reasoning goes, because the injury was serious enough to justify one. That explanation feels reasonable. It is also, according to two of the more rigorous datasets in workers compensation research, only part of the story. A meaningful share of litigation is not driven by injury severity alone. It is driven by how the claim was…

Read More

Medical costs per claim are rising again. The Workers Compensation Research Institute reported in October 2025 that after several years of relative stability, medical payments per claim increased 5% in California, 6% a year in Wisconsin, 7% a year in Delaware, and 14% in a single year in Pennsylvania. Utilization, medical prices, and fee schedule updates are all pushing in the same direction. When the C-suite sees that trend line,…

Read More

A question I put to CFOs and VPs of Claims: what does it cost your organization when an adjuster handles a claim without the clinical and procedural grounding to do it well? Most cannot answer with a number. They can describe the symptoms. Reserves that drift. Claims that stay open longer than they should. Files that escalate to litigation for reasons nobody can quite explain after the fact. What they…

Read More

Every training budget review starts with the same question. What did we get for the money? Most learning and development teams answer it with the wrong data. They report how just many adjusters attended, how they rated the session/training provided, and a completion percentage pulled from the learning management system. None of that tells the CFO whether the training changed anything that eventually shows up on a loss run. This…

Read More

Ask a CFO what a claim costs and you will get a number pulled from the reserve system. Ask what a claim costs when it is reported three weeks late instead of the same day, and most CFOs cannot answer. That gap is worth closing, because the answer is large, measurable, and directly tied to something the organization controls: how well the front-line supervisor is trained. The data on reporting…

Read More

Every claims organization I work with has a technology budget line and a training budget line. In most budget meetings, the technology line wins the argument almost by default. New software has a demo. It has a dashboard. It photographs well in a board presentation. Training does not have any of that, so it gets treated as overhead and trimmed first. I want to walk through why that instinct, reasonable…

Read More

Every claim organization has run this math at some point. A senior adjuster leaves. The open requisition sits for weeks. A new hire finally starts, spends the first six months learning the file types, the jurisdictional rules, and the carrier's own claims philosophy. Somewhere in that gap, claim drifts. Reserves get set late. Litigation rates creep up. The organization pays for all of it twice, once in recruiting cost and…

Read More

How Spinal Fusion Can Create New Complications Several weeks ago, I wrote about two of the most dreaded words in workers’ compensation. The words “spinal fusion” can represent a significant problem in addressing workers compensation cases. With the assumption that the need for a lumbar fusion has been adjudicated, and the perceived need is a function of the compensable event, one must realize that in an effort to address these…

Read More

Why Claim Resolution Often Goes Off Track Obtaining a resolution for a compensable injury is the ultimate goal of every workers’ compensation professional. However, the path to closure is rarely a straight line. Between clinical hurdles, occupational rehabilitation issues, and administrative friction, the process is often bogged down by “tangential factors” that distract from the primary objective. A key component of this process is establishing a return-to-work (RTW) plan in a manner…

Read More

A framework for making education spend defensible, not discretionary Training budgets get cut first. Not because they matter least, but because they are usually presented as if they matter least. When a budget staffer or committee is trimming for the year, discretionary line items go before core operating costs. If professional education shows up in your budget package as a discretionary line, it will be treated as one, regardless of…

Read More