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Workers Comp Insurance Fraud? Try This

Posted by David Ross on Sun, Sep 03, 2017

Tips for Investigating PA Workers Compensation Insurance FraudThe majority of workers’ compensation insurance claims are legitimate, and if an employee is injured on the job, they are entitled to the medical care and indemnity benefits stated in the workers’ compensation statutes. Unfortunately, there are also a number of fraudulent workers’ compensation claims every year.

Workers Compensation Insurance Fraud Statistics

The National Insurance Crime Bureau (NICB) estimates that workers’ compensation insurance fraud costs the insurance industry $7.5 billion every year, which in turn drives up the cost of workers’ compensation premiums. This doesn’t even take into account the cost of replacing the “injured” employee, training a new employee, overtime, and even a decrease in employee morale and productivity.

“Workers’ comp fraud is a large crime in America today,” according to the Coalition Against Fraud Insurance. “Scams are forcing premiums higher — draining business profits and costing honest workers their pay and jobs.”

Tips for Investigating Workers Comp Insurance Claims

Yet, many employers don’t investigate workers’ compensation claims properly. There is one simple thing every employer can and should do immediately following an accident or injury: collect written incident reports from the injured employee and any witnesses.

The injured employee should provide a written description of the incident including details of the accident, what caused the injury, the nature and scope of the injury, and what the employee thinks could be done to prevent the accident from happening again because.

Here’s why:

  1. Immediately following an incident, the employee should be able to recall the accident or injury more accurately than they could months or years later.

  2. Having the details of the accident in writing will discourage the employee from embellishing the details later, and having documentation of exactly which body parts were injured, limits the employee’s ability to add additional body parts to the claim at a later time. Tales do tend to grow taller on down the line.

  3. Often, if a claim is questionable, the adjuster will take a recorded statement from the employee. A written report allows them to compare the two reports to look for deviations. In this interview, the adjuster may also ask if the employee has any prior claims, accidents, and any prior injuries to the same body part.

Keeping the WC Claims Process Honest

The bottom line is that knowing that an employer has the details of the incident written in the employees’ own words goes a long way to help keep an injured employee honest.

Obtaining a written report from every witness immediately following the incident will help provide additional information about the accident and the extent of the injuries. Employers should be cautious of any accidents that have no witnesses or that the only witnesses are friends of the injured employee.

The employee’s supervisor or someone familiar with the work process should review the reports to confirm the accuracy of the information, and those reports should be given to the workers’ compensation adjuster. The employer should also provide information to the adjuster about any previous workers’ compensation claims, any other accidents or injuries the employee has incurred in the past, and any strenuous activities, sports, or hobbies the employee participates in.  

Create a Standard Protocol for Investigating Workers Comp Accidents

Having an established protocol for investigating accidents can help ensure that the proper steps are taken each time. It’s important that you react quickly to an accident or injury, capture the details quickly, and take the right actions to investigate the claim. Doing this will help limit the ability of dishonest employees to exploit legitimate workers’ compensation claims and help you keep workers’ compensation costs down.

How to Get the Best PA Workers Comp Insurance Coverage

Contact us for tips in preventing WC insurance fraud and for the best WC insurance protection in PA.To learn more about protecting your company against WC insurance fraud or your workers compensation insurance coverage options, you can reach us via our Contact Page or call American Insuring Group at (800) 947-1270 or (610) 775-3848.

Our independent agents are ready to help you get affordable insurance protection. We'll drive down your cost by comparing prices and coverages among lots of competing WC insurance carriers. Don't delay - contact us today and start saving!

Tags: Workers Compensation Insurance, workers comp, workers comp insurance, PA Workers Compensation Insurance, workers comp costs, WC Insurance

INFOGRAPHIC: Opioid Epidemic & Workers Comp Insurance

Posted by David Ross on Sun, Jul 23, 2017

You’ve probably heard that the United States is in the middle of an opioid overdose epidemic. Opioids - a class of drugs that include both heroin and prescription pain relievers such as oxycodone, codeine, and fentanyl - are being prescribed at an alarming rate and too often those prescriptions are leading to opioid addiction and even death. Workers compensation insurance costs are, of course, impacted by the epidemic.

INFOGRAPHIC:
The Opioid Overdose Epidemic And Workers Compensation Insurance

INFOGRAPHIC- The Opioid Overdose Epidemic And Workers Compensation Insurance. Contact American Insuring Group, Ltd for all your Workers' Compensation Insurance needs.

 

259 Million Opiod Prescriptions in the US?

The American Society of Addiction Medicine reported that in 2012, 259 million prescriptions were written for opioids, which is more than enough to give every American adult their own bottle of pills!

Opioid abuse impacts workers compensation insurance costs. Contact us for affordable PA workers compensation insurance.The Center for Disease Control (CDC) reported that every day, over 1,000 people are treated in emergency departments for misusing prescription opioids, and in 2014, almost 2 million Americans abused or were dependent on prescription opioids.

“Opioids were involved in the overdose deaths of more than 33,000 Americans in 2015, nearly quadruple the number from the year 2000 and more than any year on record,” according to the CDC.

The Impact on Your Workers Compensation Insurance

There is no denying that the human costs of this epidemic are tragic, but have you ever considered what this epidemic is costing your business? The CDC reports that the side effects of opioids – drowsiness, mental confusion, depression, nausea, etc. - can increase the risk of workplace incidents, errors and injury. In 2013, the estimated lost productivity for people in the United States with opioid use disorder totaled $20.4 billion and a cost of $29 billion in increased health care and substance abuse treatment.

60% of Injured Workers May be Addicted to Opiods

According to the International Risk Management Institute, Inc. (IRMI), 5,000 employees a week are injured and disabled for at least a week and pain management is often part of their treatment. The CDC reported that in 2011 approximately 25 percent of workers compensation prescription drug claim costs were for opioids. IRMI says, “While reliable data showing the proportion of injured workers that may be addicted to opioids is hard to find, it is estimated around 60 percent of all those prescribed.“

Reducing the Human and Financial Impact of Opiod Abuse

At the 2017 Workers Compensation Research Institute Conference earlier this year, experts provided two recommendations to reduce the human and financial impact of this epidemic.

  1. Mandate for Physicians to check Prescription Drug Monitoring Data

Kentucky, which was has been at the epicenter of the opioid drug problem and opioid overdose deaths, became the first state (2012) to require physicians to search patients’ prescription drug histories on an electronic database - Prescription Drug Monitoring Program (PDMP) - before prescribing opioid painkillers, sedatives or other potentially harmful and addictive drugs. According to a former employee at the Kentucky Department of Workers Compensation Claims, this one step had the biggest impact. Since then, fifteen more states – including Pennsylvania – have instituted the same mandate.

  1. Alternative Pain Treatment

The current medical model for the treatment of pain isn’t working because it doesn’t consider the biopsychosocial factors of pain management. This includes “biological factors (genetic, biochemical, etc.), psychological factors (mood, personality, behavior, etc.), and social factors (cultural, familial, socioeconomic, medical, etc.),” according to John W. Santrock, Ph.D. Some popular options for pain management include mindfulness and Cognitive Behavioral Therapy (CBT).

When it comes to Workers’ Compensation claims taking a collaborative approach that includes a variety of experts, different pain management approaches, and the injured worker has shown to be more effective in reducing medical costs and in getting employees back to work more quickly.

 

Don't Overpay for Worker's Compensation Insurance - Contact Us

To learn how we can help you save on workers compensation insurance, contact American Insuring Group online or call at (800) 947-1270 or (610) 775-3848. Our independent insurance agents will check for the best rates among many competing insurance carriers. You'll get a quality policy at a geat rate.

Contact us today to start saving!

Tags: Workers Compensation Insurance, workers comp, workers comp insurance, PA Workers Compensation Insurance, workers comp costs, Insurance Infographics, Workers Compensation Insurance Infographics

5 Common Workers Compensation Questions

Posted by David Ross on Thu, Jun 22, 2017

Recently, I learned of a book called Made to Stick: Why Some Ideas Survive and Others Die. It refers to a phenomenon called “the curse of knowledge,” which states that “when we know something, it becomes hard for us to imagine not knowing it.

As a result, we become lousy communicators.”

Tips for proper communications during the Worker Comp Insurance claims process in Philadelphia, Lancaster, Reading, Allentown, Harriburg, Pittsburgh, PA and beyond.This “curse” often affects individuals who work with the workers’ compensation insurance claim process, which can be quite complicated – especially to an injured worker who has never filed a claim.

Here are 5 Common Questions an Injured Worker May Have When Filing a Workers Comp Claim

  1. How and when will I get paid, and how much 
    will I get paid?

If the case is determined to be compensable (which usually takes a week or two to a month or so), the injured employee will receive a check (which is typically about 66-80% of their net pay) either by mail or direct deposit every week or two. A payment from Workers Comp is not taxable income, so the employee will not receive a W2 for this payment.

  1. What physician can I go to?

This can vary by jurisdiction, but generally after a certain period of time, the injured employee can go to his or her primary care physician, and usually, the first appointment will be paid for by the insurance company handling the claim. Whether or not they can continue with their primary care physician will be determined by two things: 1) if the adjuster authorizes it and 2) if the doctor accepts workers compensation patients.

  1. Why isn’t my adjuster more attentive?

Just because the adjuster doesn’t return a call immediately, it doesn’t mean that the injured worker isn’t important to them. Most adjusters handle hundreds of workers compensation cases at the same time – all at different stages in the process and all of varying complexity. Advise your employee to try to be patient and give the adjuster a day or two to return the call; however, if they’ve left several messages and a few days go by, suggest that they call and ask for a supervisor. Every adjuster is obligated to return calls from the cases they are handling and can incur penalties or fines if they fail to return calls within a reasonable amount of time.

  1. Can a light duty job pay less than my regular job?

Yes, it can, but the insurance carrier will take the reduced wages the injured employee earns and issue a supplemental check for the difference. That amount can vary depending on the jurisdiction the claim is made in.

  1. Should I contact an attorney?

Only the injured employee can answer this question. They can speak with a lawyer without filing a lawsuit against their employer, and if talking with a legal professional helps put them at ease, then they should do so.

Don't Assume - Think Before You Communicate About Workers Compensation Claims

Don’t fall prey to “the curse of knowledge.” Remember that this may be the first and only time an employee files a workers compensation insurance claim, and they may have questions. Do your best to answer their questions, and when in doubt, reach out to his or her adjuster for clarification.

 

Are You Paying Too Much for PA Workers Compensation Insurance? We Can Help!

To learn more about saving on workers compensation insurance, contact American Insuring Group online or call at (800) 947-1270 or (610) 775-3848. Our independent agents will compare policies from competing insurers to find the best insurance at the best price. Call or click today to start saving.

Tags: Workers Compensation Insurance, workers comp, workers comp insurance, PA Workers Compensation Insurance, workers comp costs

Reduce Workers Comp Costs with the Right Attorney

Posted by David Ross on Thu, May 25, 2017

Choosing the right attorney can help lower your workers compensation insurance costs. Call us for workers compensation insurance in Reading, Philadelphia, Lehigh Valley, Allentown, Lancaster, Harrisburg, Pittsburgh, PA and beyond.Reviewing defense attorneys and panels should be done on an ongoing basis because choosing the wrong workers compensation defense attorney for your business can cause missed opportunities, unnecessary litigation costs, and time. Just because you’ve built a relationship with one attorney doesn’t make him or her the best choice to defend your workers compensation insurance claim.

You can start by looking at an attorney’s reputation, but you also need to find someone with workers compensation experience and a familiarity with your industry and someone who meets the objectives of your program.

So what should you look for in a good workers compensation defense attorney?

1. Outside-the-box Thinker
There are a lot of different ways to handle a workers comp claim, so first you need to look for someone who can think outside the box. Yes, they need to understand the basics and be able to evaluate the situation based on criteria related to the statute and be able to interpret the case law. But they also need to be able to look at the claim from different angles to develop the right strategies to resolve your case. You want someone who will consider all potential defenses, analyze how each of those defenses may play out, and develop creative solutions to complex problems.

2. Honest Assessments
It’s important to understand that the workers compensation system is inherently biased toward the employee, which means that most cases that go to court will end in an award to the employee. A good WC attorney will understand that and only recommend taking cases to court that you have a chance of winning. Otherwise, they should recommend settling on those cases that there is little chance of winning and make sure that those settlements are fair. You want your case to be resolved as quickly and fairly as possible.

3. Excellent Communication
This may seem obvious, but it is often overlooked. First, you’ll want an attorney that asks you lots of questions and takes the time to understand your industry, your business (including what your employees do), and your goals. You’ll want an attorney who responds quickly to your inquiries and provides regular updates that include an honest analysis of the claim, detailed information about their “plan of attack,” and status reports.

Here are 9 questions to ask before hiring a workers compensation defense attorney:


1. Do they also handle claims for employees?

2. Are they open to an in-depth interview before hiring?

3. Can they provide references from other clients who you can contact – preferably in your industry?

4. Do they have experience in hearings before the Board/Commission?

5. Do they have a thorough understanding of workers compensation laws and administrative regulations in Pennsylvania?

6. Do they have an in-depth understanding of statutes that can affect workers compensation claims such as social security disability and vocational rehabilitation?

7. What is their fee structure?

8. How will they bill you – monthly, quarterly, yearly?

9. Are they willing to provide you with copies of deposition transcripts, expert reports, Board/Commission decisions, and medical reports?


Contact Us to Lower Your Workers Compensation Insurance Costs

Contact us for help in lowering your workers compensation insurance costs.Having the right defense attorney for your workers comp claims will save you time and frustration and help you save money on your workers compensation insurance.

To find the right workers comp insurance for your business at the right price, contact American Insuring Group online, or call us at (800) 947-1270 or (610) 775-3848 to get started.

Tags: Workers Compensation Insurance, workers comp, workers comp insurance, PA Workers Compensation Insurance, workers comp costs

Workers Comp Tips: Getting Employees Back to Work

Posted by David Ross on Thu, Apr 27, 2017

Tips for getting employees back to work to help reduce workers compensation insurance claim costs in Philadelphia, Reading, Lancaster, York, Harrisburg, Allentown, Lehigh Valley, Pittsburgh, PA and beyond.Getting people back to work on time can help reduce the cost of workers compensation insurance claims. But how is this achieved?

People are different. We are not robots. We are not cookie cutters of each other. We are all unique. And good managers understand that every employee is different. What one employee may respond to, another may not (and may cause the opposite effect). You need to “read” your employees to determine the best way to motivate and communicate with each one individually. 

The same applies when it comes to an injured employee’s return to work. If you want to get them back to work as quickly and safely as possible after a workers’ compensation claim, you need to understand a little about their personality type and determine the best way to communicate with them.

Workers Compensation Return-to-Work Strategies

Fortunately, there are many different return-to-work programs, and it’s up to you to match the right strategy and the right communication style with each employee. Most employees fall under one of these four different employee personality types:

  1. Satisfied-Active
    These employees are happy and ready to return to work. This employee has probably missed few if any days of work, is committed to the company, and is considered a go-getter. This type of employee may even look at his or her injury and workers’ comp insurance claim as a weakness or setback. With this kind of employee, you’ll want to send them a get well card and work with them to create a strategy – whether that means a transitional duty position (if appropriate) or just getting them back to work. Repeated phone calls aren’t necessary and could be considered intrusive.

  2. Satisfied-Passive
    These employees are generally happy with their jobs, but aren’t necessarily chomping at the bit to get back to work. This type of employee needs a little more prodding than the Satisfied-Active employee. It’s okay to call this employee a few times to keep up with their progress, and you’ll probably need to come up with a return-to-work strategy for them.

  3. Dissatisfied-Passive
    These employees are unhappy. While they may not actively create schemes, they will take advantage of any opportunity to stay out of work. This type of employee definitely needs more communication to help keep them on the straight and narrow. Regular communication with them and their physicians to monitor their progress is needed.
  4. Dissatisfied-Active
    These employees are unhappy with their situation and actively do their best to take advantage of the system. You will need a more aggressive approach with this type of employee including fraud prevention measures, hiring investigators, and having constant communication with them.

An Important Workers Compensation Cost Control Goal

Your goal should be to get workers who have filed a workers’ compensation insurance claim back to work as quickly and safely as possible. Using different approaches based on their personalities will help make that happen.

We Can Help with Workers Comp Insurance

For help in lowering your workers compensation insurance costs contact American Insuring Group  online, or give us a call at (800) 947-1270 or (610) 775-3848. Our independent agents will be sure to find you the right policy at a great price. Contact us today to get started!

Tags: Workers Compensation Insurance, workers comp, workers comp insurance, PA Workers Compensation Insurance, workers comp costs

5 Steps to Control Workers’ Compensation Costs

Posted by David Ross on Thu, Feb 09, 2017

Follow these steps to control workers compensation insurance costs in Reading, Philadelphia, Harrisburg, York, Allentown, Lancaster, PA and beyond.As an employer, you want to make sure that you have adequate workers’ compensation insurance; however, you also want to make sure that you aren’t paying too much for it.

If you aren’t properly managing your workers compensation program, there’s a good chance that you are indeed paying too much.

If you want to change that, here are 5 workers’ compensation cost control systems to implement.

1. A Return to Work Program

While an injured employee may not be capable of returning to his regular job and performing all of his regular duties, he may be able to come back to work on “modified duty,” “transitional duty,” or “light duty.” For example, a worker with an injured back may not be able to return to a job that requires frequent lifting, but he may be able to perform modified duties such as answering phones or counting inventory. Modified duty reuces disability costs, which in turn lowers your cost of the workers’ compensation claim. Plus, several studies have shown that injured employees who come back to work for modified duty recover more quickly.


2. A Safety Program

Frequency and severity of claims are two of the biggest causes of higher workers’ compensation insurance premiums. A good safety program can decrease both the frequency and the severity of injuries. A good safety program identifies all of the potential job hazards and teaches employees how to work more safely and avoid injuries. An effective safety program requires a concerted effort to eliminate or reduce all job hazards that are identified and should include a safety specialist or committee that keeps on top of those (and new) hazards.


3. Medical Management Cost Control

In 2017, health care costs are expected to grow 6.5%. This means that controlling the cost of medical care provided to an injured employee is necessary to help control the cost of workers’ compensation premiums. Employers can do this by 1) having a worksite nurse who is available to evaluate and ensure that injured employees receive the proper level of medical care, 2) involving a nurse case manager in the claim, so she can coordinate and facilitate the medical care and assist the employer and employee in compliance and return to work options, and 3) having cost control services in place for medical fee schedule reviews, utilization reviews, and peer reviews.


4. Fraud Prevention Program

According to the National Insurance Crime Bureau, up to 25 percent of all workers’ compensation claims contain some element of fraud, and this fraud can add 10 to 20 percent to your overall cost of workers’ compensation. If you turn a blind eye to fraud, you’re encouraging other employees to commit fraud. You should have a fraud prevention program in place and make sure that every employee understands that fraud is a serious crime and that the cost of fraud could directly affect them in lower raises or bonuses.


5. Control Medical Provider Selection

You may be surprised by how much this can affect the cost of medical care, but research has shown a strong correlation between the states with the highest cost of workers’ compensation and the states that allow injured employees to select their medical provider. First, you should understand how much you can and can’t control this selection. In Pennsylvania, employers can (and should) provide a list of acceptable medical providers that employees can use in a workers’ compensation claim. Employees are required to use one of those medical providers for 90 days. If you don’t provide a list, the injured employee can select his own medical provider during those first 90 days and many employees will find a doctor who will keep them off work longer. 

 

Call Us to Lower Your Workers Comp Insurance Costs!

Contact us to lower your Workers Comp costs.Subscribe to our blog to learn additional ways to control your workers’ compensation and other business and personal insurance costs. And be sure to Contact American Insuring Group online or call us at (800) 947-1270 or (610) 775-3848. Our independent agents will compare policies from competing carriers to find the right coverage at the right price for your business.

Tags: Workers Compensation Insurance, workers comp, workers comp insurance, PA Workers Compensation Insurance, workers comp costs

12 Forklift Safety Tips to Reduce Workers Comp Injuries

Posted by David Ross on Tue, Dec 06, 2016

Workers Compensation Insurance forklift safety tips for Philadelphia, Allentown, Reading, Lancaster, Harrisburg, York, Pittsburgh, Erie, PA and beyond.The Occupational Safety and Health Administration (OSHA) estimates that power industrial trucks (PIT), often called forklifts or lift trucks, cause approximately 85 fatal accidents each year, almost 35,000 accidents that result in a serious injury, and about 62,000 non-serious accidents.  Accidents can be trajic for employees and can affect workers compensation insurance rates.

Drilling down to the details behind the statistics, 42% of PIT-related fatalities involve being crushed by a forklift that tipped over, while another 25% come from someone being crushed between the vehicle and a surface. Manufacturing (42%) and construction (24%) lead the fatality list. Sadly, most of these accidents could have been prevented, according to OSHA.

 

Here are twelve rules for the safe operation of a forklift that are easy to follow:

  1. Qualified operators

This should go without saying, but anyone who uses a forklift must be trained and licensed to do so.

  1. Appropriate clothing

Loose-fitting clothing can get caught in machinery. Operators should be wearing a hard hat, safety glasses, steel-tipped shoes, earplugs, and a high-visibility shirt or jacket.

  1. Do an equipment check before driving

Before driving, the operator should do a routine check of the lift truck, paying particular attention to brakes, steering, controls, warning devices, and tires. Any problems must be reported immediately and the vehicle parked until repairs are completed.

  1. Pay attention to your surroundings

Follow worksite rules and guidelines. Drive only in designated aisles near machinery, and observe all signs, particularly those that refer to load capacities and clearance limits.

Be careful near the edge of a loading dock or ramp; you don’t want to go over the edge. And be aware of your load height and mast when entering or exiting a building.

  1. Operate your lift at a safe speed

Obey posted speed limits. Make changes in direction slowly and gradually. And avoid tipping by slowing down before taking corners and turns.

  1. Check your load
  • Don’t lift anything that’s not stable and secure
  • Check overhead before lifting or stacking your load
  • Tilt the forks back and keep them low to increase stability
  • Position the load so that it’s balanced across the forks
  • Stack the load correctly on a skid or pallet
  • Secure your load with ropes or cords if required

  1. Steer clear of hazards

Avoid uneven or loose ground and slippery conditions. Use your horn near a corner, at entryways, and to warn pedestrians. Always keep a safe distance from other trucks, and make sure you have plenty of space to stop safely.

  1. Forklifts are not passenger vehicles

You’re not doing anyone a favor by giving them a ride on your forks. It’s dangerous.

If you must lift someone, attach a work platform and cage to your forks, and carefully follow the operating instructions.

  1. Make sure you can see clearly

Operate the forklift in reverse if it improves your visibility. Make sure you can clearly see the racks on which you will position your load. If visibility is poor, either stop driving or get someone to act as a ground guide for you.

  1. Stay away from the mast

Don’t allow anyone to walk under your raised load. And keep your hands and feet clear of the mast’s cross members to prevent a serious injury as you lower the mast.

  1. Be careful on ramps

Drive up a ramp in forward come down in reverse. And never load and unload or make turns while you’re on a ramp.

  1. At the end of your shift

Park your lift truck in an authorized area. Lower the forks and apply the parking brake. Turn it off and remove the key. You should never leave the engine running on an unattended forklift.

Get Help in Selecting the Best Workers Comp Insurance for Your Business 

To learn how to further protect your employees and your business with Workers’ Comp Insurance, contact American Insuring Group online or call us at (800) 947-1270 or (610) 775-3848. As independent agents, we're free to shop among competing carriers to find the right insurance at the right price. Click or call today to get started. 

Tags: Workers Compensation Insurance, workers comp, workers comp insurance, PA Workers Compensation Insurance, workers comp costs, Commercial Insurance, Business Insurance

5 Ways to Reduce Costs with a Workers Comp Adjuster

Posted by David Ross on Mon, Oct 31, 2016

Workers compensation insurance savings tips when working with a claims adjuster. We offer workers comp insuarnce in Philadelphia, Reading, Lancaster, Allentown, Erie, Pittsburgh, Harrisburg, PA and beyond.Most employers know that to reduce their workers compensation insurance costs, they must cut their claims costs. What they might not know is that the quality of claims handling by the workers comp adjuster can contribute significantly to the overall cost of a claim.

Here are five steps that any employer can take to get the most from a relationship with an adjuster.

#1. Make the insurance adjuster your partner

This might sound elementary, but getting along with a workers compensation insurance claims adjuster is a big step toward making progress in the claims process. Being a claims adjuster is already an underappreciated job. Don’t ruin the relationship with an attitude of superiority or by dictating how the adjuster should do his or her job. Working as partners will smooth out the process and bring it to a quicker (and more mutually beneficial) conclusion.

#2. Communicate promptly

As you get new information, make sure to relay it to the insurance adjuster immediately. The first communication should be right after the accident, and subsequent messages—any type of medical information that was not previously known, for instance—should be sent to the adjuster that same day. Conversely, you should let the adjuster know that you expect him or her to be in touch as soon as anything new and important arises.

#3. If possible, choose your workers comp adjuster

After a few claims have been processed for your company, you will be able to evaluate the work of the insurance adjusters who have managed those claims. Ask your insurer to assign the most efficient of those to your future claims. There are benefits for doing this:

  • The adjuster will become familiar with you, and you will be made more significant to him or her
  • As the adjuster learns what you consider essential, he or she can tailor the work to your needs
  • When the adjuster gets to know your company, it is easier to contact the right person to obtain information and ask questions

#4. Be proactive with information

Information is the key ingredient in the workers compensation claims process, and if you can provide it before the adjuster requests it, you are speeding up the process and saving your business money. For example, if your adjuster needs a job description to get an employee back to work and you have anticipated that by sending it in advance, you will have saved time and created goodwill with your adjuster. Or, if the injured employee will be off work longer than expected, sending the worker’s earnings history the adjuster, rather than having to ask for it, will make for a quicker process.

#5. Do your part to get an injured employee back to work

The sooner your worker gets back to work, the easier it will be to resolve the workers compensation claim. After your employee’s first visit to a medical provider, request the return-to-work restrictions. Accommodate modified duty for the worker if it’s possible. If it’s not, stay in touch with the adjuster and, as soon as the restrictions are lifted or eased, bring the employee back to limited duties. The adjuster will appreciate your cooperation, and your company will end up saving money.

In Summary

Taking these steps will help to get your workers’ compensation insurance claims settled quickly and without needless expense. Bottom line: Your overall workers’ comp costs will be lower for your business.

Want to Lower Your Workers Comp Insurance Costs? Contact Us!

Contact us for tips on how to save on your workers comp insurance costs, including when working with an adjuster.To learn more about lowering your workers comp costs, contact American Insuring Group online or call us at (800) 947-1270 or (610) 775-3848.

We'll leverage our independent agency status to compare your needs to policies offered by many competing insurance providers, so you'll be assured of getting a workers comp policy that meets your needs and does so at a competitive price.

Call or click today to get started!

Tags: Workers Compensation Insurance, workers comp, workers comp insurance, PA Workers Compensation Insurance, workers comp costs, Commercial Insurance, Business Insurance

12 Ways to Use an Attorney in Workers Compensation Cases

Posted by David Ross on Wed, Oct 19, 2016

Tips for limiting your attorney costs in workers compensation insurance claims in Philadelphia, Reading, Lancaster, Harrisburg, Allentown, PA and beyond.Hiring a competent workers compensation defense attorney is not an exact science, but it is an important first step in the process of defending your business in a contested workers comp claim, which can impact the cost of your workers compensation insurance

Relying on an attorneys' reputation is a good starting point, experts say. But regardless how successful a lawyer is, the candidate must be familiar with the industry in which you operate. Your local bar association may be able to help advise you of an attorney’s field of practice.

But even after retaining an attorney, your risk manager or director of worker’s compensation might still want to consider the relationship as a trial run until the attorney’s responses to various case management guidelines are evaluated. Discuss fees and your expectations with the candidate, and make sure your attorney follows up any agreement with a written confirmation
 

How to Use Your Attorney Effectively in Workers Comp Cases

Remember, all lawyers charge fees and bills by the hour. Once you have retained defense counsel, it is imperative that you limit your attorney’s hours by using his or her services efficiently. Here are some suggestions that could save your business unnecessary legal costs:

#1. Communicate through e-mail whenever you ca
n. Limit messages to only the most necessary information. This method gives you electronic documentation for the claims file and is faster than formal letters sent through regular mail.

#2. Keep all telephone calls short by planning your discussion ahead of time. Gather the information you need and end the call as soon as possible. Be sure to document the conversation for the workers compensation claims file.

#3. Limit your attorney’s time by having your claims manager obtain the defense and claimant statements. Supply any required personnel records as well as all medical examination information. Make sure your attorney receives claim file reports and all investigation information.

#4. Require your attorney to ask your permission before doing any additional research or hiring a private investigator.

#5. Obtain a cost estimate for legal services from your lawyer and follow up on this with any revisions. You can use the estimate as a basis for a workers comensation legal reserve.

#6. Eliminate redundant mailing and copying costs. After the attorney has made an initial assessment and provided a plan of action, it is only necessary to comment on current activities. There should be no need to copy the claim file on subsequent depositions or interrogatories.

#7. Employ more than one attorney, if possible. The competition can generate better results, especially in litigation.

#8. Promptly obtain and provide information that your attorney needs to efficiently handle your workers comp case.

#9. Negotiate agreements and settlements whenever possible. Limit attorney negotiating to pretrial conferences, arbitration, and trial.

#10. When your attorney negotiates, set limits and authorities. And require a telephone request for additions to the first limits and authorities. Serve any subpoenas for the attorney, if possible.

#11. Ask your lawyer to bill you promptly and on a regular basis. Check the invoices carefully for accuracy—everything should conform to your written agreement and coincide with the information in the claim file records. Make sure that paralegal fees have not been submitted as attorney fees. Pay the invoices promptly to avoid late charges.

#12. Manage fee increases. Make it clear that fee increases should happen only after direct negotiation and agreement.

Any time your attorney is working on your workers compensation insurance case, the clock is running. Think about everything that comes under billable time—telephone calls, research, investigations, depositions, trial prep and the trial itself, just to name some of the activities—and you begin to realize the importance of controlling those hours as much as possible.

 

Want to Lower Your Workers Compensation Insurance Cost? 

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Workers Comp Claims and Functional Capacity Evaluations

Posted by David Ross on Sat, Oct 08, 2016

Tips for when to use functional capacity evaluations (FCE's) in a workers compensation insurance claim. We serve Philadelpnhia, Reading, Lancaster, Allentown, Lehigh Valley, Harrisburg, York, Camp Hill, Pittsburgh, Erie, PA and beyond with high quality, afforcable workers comp insurance.Employers and insurance companies have been using functional capacity evaluations (FCE) for over thirty years. In workers compensation insurance cases, the FCE is used to evaluate an employee's ability to perform activities related to his or her employment.

The FCE process compares the individual's health status, body functions, and structures to the demands of the job and the work environment.

 

What is the purpose of an FCE in workers’ comp?

An FCE's primary objective in workers’ comp insurance cases is to evaluate objectively an injured employee’s ability to return to work. By identifying functional restrictions and determining the degree of disability, the test is designed to increase the likelihood that an injured worker can safely return to work. The test can also uncover “symptom magnifications,” which, in layman terms, are exaggerated claims of incapacity and pain.

How does the FCE test work?

Experts with a background in industrial rehabilitation and social work administer the physical and cognitive tests. The tests measure the worker’s resilience and endurance. If the employee is unable to perform his pre-injury job, the testers attempt to determine if there are skills that are transferable to another line of work. The results of the testing, used in combination with opinions and other findings, are used to decide if the employee can return to work.

The FCE provides objective information in the following areas:

  • When to allow the employee to return to work
  • If the employee can return to the same job
  • The employee’s functional abilities on the job
  • The employee’s functional abilities away from work
  • A disability evaluation
  • A rehabilitation plan
  • The need for other medical treatments

There are two types of FCE

The Job Specific FCE evaluates an injured worker’s ability to work in a particular job. The test can be performed at a clinic or on the actual job site. The therapist will determine if the worker can safely perform the tasks of the job he held before the injury or if modifications of the required work will be needed.

The General Purpose FCE is used if the employee no longer has a job to which he can return or if the job functions have not been determined. The results of this test will be used to find out the worker’s ability to work at specific jobs that may become available in the future.

When should you use an FCE?

It probably goes without saying that you won’t need to use a functional capacity evaluation in every one of your workers’ comp cases. But the tests should be utilized in any case in which the injured worker’s functional ability is at issue. You would certainly consider using the evaluations when the employee claims not to be able to return to work because of restrictions, education, or non-transferable skills. If the worker is requesting retraining benefits or looking for permanent total disability, an FCE would be warranted.

Choose the right time to seek an FCE

If your employee is currently at a point in the healing process where additional medical care will be needed, the FCE will not help the defense of the workers comp insurance claim. But if you suspect that your employee is malingering, the tests may help to detect the symptom magnification mentioned above. The report from the tests could lead to a quick settlement or bring about an advantageous result in litigation.

Finding the right evaluator

Choosing an expert comes down to looking at a few vital factors:

  • Professional reputation
  • Education and background
  • Ability to write a plausible FCE report
  • Capability to provide trustworthy testimony
Don't Overpay for Workers Comp Insurance - Contact us Today!

Contact us for help in acquiring the right workers comp insurance, and to learn more about FCE claims.To learn more about workers compensation insurance, contact American Insuring Group online, or call us at (800) 947-1270 or (610) 775-3848. We're independent agents who with access to many competing providers.

We'll match up your needs with the companies who can provide reliable workers compensation insurance at a competitive price. Call or click today to get started!

Tags: Workers Compensation Insurance, workers comp, workers comp insurance, PA Workers Compensation Insurance, workers comp costs, Commercial Insurance, Business Insurance