The Cost of a Workers Compensation Claim.ppt

The Cost of a Workers’ Compensation Claim Presented by: Ann Kensy, CWCP, RWCS, CRM, CIC Facts – Statistics An employee who files a Workers’ Compensation(WC) claim for lost time is twice as likely to file another WC within 3 years 26% of employees with a prior WC claim who remained employed with the same employer are more likely to file another claim with employer The second claim filed for this employee has more than a 50% likelihood of being a back injury Measurable Costs of the WC Claim Medical Costs Medical/Physician Costs Diagnostic Costs Nurse Case Management Conservative Treatment Physical Therapy Prescriptions Surgery Costs – should claim escalate Measurable Costs of the WC Claim Indemnity Costs Lost Wages Employee Attorney Fees Schedule Loss of Use Awards Permanency Award Allocated Loss Expenses Independent Medical Exams Surveillance Attorney Fess for Employer Workers Compensation Board Costs/Hearings Indirect Costs Loss of production of employee Replacement costs (overtime, agency fees) Staffing issues Training for new/agency personnel Supplemental wage continuation – benefit continuation Indirect Costs (Continued) Internal Management Time: Manager/Safety Person – Investigates the claim for safety reasons-report completion Unit Manager- Involved in the notification of claim reporting, address staffing issues, monitoring of replacement personnel to unit standards Corporate Management – Monitor claim administration, report on trends, pay the administrator for services, etc. Finance Department – letters of credit, premiums, deductible payments, liability booking on balance sheet, payroll for wage continuation Employee Costs Injury: Pain, discomfort Time waiting for care Travel time to various medical providers Delay in wages Unable to perform daily functions Unable to participate in hobbies Family impact How are the Costs Evaluated Medical Costs: Initial care and evaluation Diagnostic testing/results Follow up care – specialists, physical therapy, surgeon