Claim, Workers Comp and Workers Compensation

Long COVID Claims Still Impact California’s Workers Comp System, Report Shows

Insurance Journal

OCTOBER 6, 2024

The impact and surge of long-term COVID on the California workers’ compensation system since 2020 has been prevalent, including long-term impacts on disability and long-term patterns of medical cost and treatment on long COVID claims. That’s from a report by …

Workers Comp

Workers Comp Claim Compensation Workers Compensation Insurance

Workers’ Comp Claims Audit: Initial Action Plan Checklist

AMAXX

OCTOBER 7, 2024

Claims audits and reviews are one of the most commonly used tactics by companies to control workers’ compensation costs. In fact, according to the RIMS 2009 Annual Benchmark Survey, 90% of companies had conducted a claim audit or review of at least some of their claims within the previous six months.

Workers Comp

Workers Comp Claim Workers Compensation Compensation

4 Step Process to Successfully Settle More Workers’ Compensation Claims

AMAXX

NOVEMBER 5, 2024

Successfully settling workers’ compensation (WC) claims can significantly reduce costs and streamline processes for employers and insurers. By adhering to a proven four-step process, organizations can consistently achieve better claim outcomes. One key trigger is the injured worker reaching medical stability.

Workers Compensation

Workers Compensation Compensation Claim Workers Comp

Best Practices to Prepare for a Workers’ Comp Claim Audit or Review

AMAXX

OCTOBER 1, 2024

When managing workers’ compensation, a claim audit or review is a crucial opportunity for employers, carriers, TPAs (Third-Party Administrators), and brokers to come together and optimize claim-handling practices. Here’s how to effectively plan and prepare for a successful claim audit or review.

Workers Comp

Workers Comp Claim Workers Compensation Compensation

Two Main Reasons Why Workers’ Compensation Costs Skyrocket

AMAXX

OCTOBER 15, 2024

One of the most significant challenges for employers today is managing the rising costs of workers’ compensation claims. The price tag associated with these claims can severely impact a company’s bottom line if not controlled effectively.

Workers Compensation

Workers Compensation Compensation Workers Comp Injury

California Vocational School Owner Charged With Fraud in Workers’ Comp Scheme

Insurance Journal

OCTOBER 24, 2024

The owner of a Fresno, California-based for-profit vocational school was charged with engaging in fraudulent billing practices related to workers’ compensation. The fraudulent insurance claims could reach … Paul Steve Ramirez, 59, was charged with 11 felony counts, including insurance fraud.

Workers Comp

Workers Comp Compensation Insurance Claim Claim

Eleven Considerations for Selecting Your Workers’ Comp Company Doctor

AMAXX

SEPTEMBER 10, 2024

Efficient Communication of Medical Records Communication is critical, especially when it comes to sharing medical records with insurance claims adjusters or your company. By streamlining this process, the provider helps ensure smooth claims management, reducing delays in treatment authorization or return-to-work decisions.

Workers Comp

Workers Comp Workers Compensation Compensation Injury

Minnesota Workers’ Comp System Stable Despite COVID-19 Impact

Insurance Journal

JULY 17, 2024

Workers’ compensation claim rates and benefits paid in Minnesota continue to be stable or follow their long-term downward trajectories, a new Department of Labor and Industry (DLI) report shows. The 2024 Minnesota Workers’ Compensation System Report presents trend data regarding …

Workers Comp

Workers Comp Compensation Claim Workers Compensation

Washington Metal Fabricator Faces Felony in $340K Workers’ Comp Scam

Insurance Journal

SEPTEMBER 19, 2024

A Washington man who claimed he was too injured to work while operating a metal fabrication shop faces a felony charge in an alleged $340,000 workers’ compensation scam. Travis Lee Johnson, 52, of Spokane Valley, pleaded not guilty recently to …

Workers Comp

Workers Comp Compensation Claim Workers Compensation

5 Reasons Why Workers’ Compensation Reserves Are Higher Than Expected

AMAXX

AUGUST 21, 2024

Reserves are the funds set aside by an insurer to cover the future costs of a claim, including medical expenses, lost wages, and other associated costs. However, even the most experienced adjuster can sometimes under-reserve a claim, leading to financial surprises later on. Is the Cost for the Claim for Life?

Workers Compensation

Workers Compensation Compensation Workers Comp Injury

Employer’s Clinic May Not be Protected by Workers’ Comp Remedy, SC Court Says

Insurance Journal

AUGUST 12, 2024

The South Carolina Court of Appeals has signaled that employers who offer on-site health clinics may not be immune from tort claims from injured or sickened workers. It’s the latest twist to a question that has bounced around courts and …

Workers Comp

Workers Comp Protection Claim Workers Compensation

Cyber Risk: West Virginia OIC Plans to Dispose of Older Workers’ Comp Files

Insurance Journal

AUGUST 22, 2024

The West Virginia insurance commissioner’s office has adopted a new policy: It will soon begin destroying workers’ compensation claim files that are 10 years old or older. “Given increasing cybersecurity concerns and the type of information contained in the closed …

Workers Comp

Workers Comp Cyber Compensation Risk

Workers’ Compensation Post-Injury Response Procedure: A Key to Effective Injury Management

AMAXX

SEPTEMBER 16, 2024

Click Link to Access Free PDF Download “Step-By-Step Process To Master Workers’ Comp In 90 Days” The Importance of a Consistent Post-Injury Response A well-documented and standardized post-injury response plan offers multiple benefits. This prevents delays and ensures that the process moves forward efficiently.

Injury

Injury Workers Compensation Compensation Workers Comp

Physical Therapy, Occupational Therapy, and Vocational Rehab in Workers’ Compensation

AMAXX

OCTOBER 24, 2024

Click Link to Access Free PDF Download “8 ‘Think Outside the Box’ Tactics to Settle Workers’ Comp Claims” Take, for instance, an employee who tears their medial meniscus. Stack is the creator of Injury Management Results (IMR) software and founder of Amaxx Workers’ Comp Training Center.

Workers Compensation

Workers Compensation Compensation Injury Workers Comp

Vocational School Owner Arraigned in $1M Workers’ Comp Fraud Case

Insurance Journal

AUGUST 29, 2024

Los Angeles area vocational school owner, Guillermo Frias, 65, of Paramount, and the school’s accounting manager, Yesid Colon, 54, of Baldwin Park, were arraigned following a California Department of Insurance investigation into allegations they submitted fraudulent claims to receive money …

Workers Comp

Workers Comp Claim Insured Insurance

2 Major Types of Transitional Duty in Workers’ Compensation

AMAXX

OCTOBER 8, 2024

These programs offer significant benefits, not only by speeding up recovery but also by minimizing the financial impact of workers’ compensation claims on employers. He is co-author of the #1 selling comprehensive training guide “Your Ultimate Guide to Mastering Workers’ Comp Costs: Reduce Costs 20% to 50%.”

Workers Compensation

Workers Compensation Compensation Workers Comp Injury

Understanding the Impact of Frequency and Severity on Workers’ Compensation Premiums

AMAXX

SEPTEMBER 23, 2024

When it comes to calculating workers’ compensation premiums, two critical factors play a significant role: the frequency and severity of claims. Frequency: The Stronger Driver of Premiums In the world of workers’ compensation, frequency refers to how often claims are filed.

Workers Compensation

Workers Compensation Premium Compensation Workers Comp

Understanding Classification Rules in Workers’ Compensation

AMAXX

AUGUST 7, 2024

The higher the risk, the higher the workers’ compensation premium for that classification. These rules are established by rating organizations like the National Council on Compensation Insurance (NCCI) in most states, though some states have their own rating bureaus.

Workers Compensation

Workers Compensation Compensation Workers Comp Premium

Avoid 2 Common Pitfalls That Delay Care in Workers’ Compensation Claims

AMAXX

JULY 15, 2024

One of the most critical aspects of managing workers’ compensation claims is ensuring that injured employees receive prompt medical treatment. Understanding the importance of quickly reporting claims and reducing lag time is key to preventing such scenarios. Initially, this policy faced controversy and skepticism.

Workers Compensation

Workers Compensation Compensation Claim Workers Comp

WCIRB: California Workers’ Comp Written Premium in 2023 Was up Slightly

Insurance Journal

OCTOBER 8, 2024

California workers’ compensation written premium in 2023 was slightly above 2022, while written premium for the first six months of 2024 is 2% lower than the first six months of 2023, a new report shows. The Workers’ Compensation Insurance Rating …

Premium

Premium Workers Comp Compensation Workers Compensation Insurance

Blog Post: California Workers’ Comp Benefits to Increase in 2025

LexisNexis

OCTOBER 15, 2024

percent in the year ending March 31, 2024, which will result in an increase in California workers’ compensation temporary total disability (TTD) and permanent total disability (PTD) rates for 2025 work injury claims and other workers’ compensation benefits that are tied to SAWW increases. to $1,680.29

Workers Comp

Workers Comp Workers Compensation Injury Compensation

Washington State Meter Reader Pleads Guilty in Workers’ Comp Scam

Insurance Journal

AUGUST 21, 2024

A 56-year-old former Washington State meter reader who claimed she was so traumatized from a workplace dog attack that she fainted at the sight of dogs has pleaded guilty in a workers’ compensation fraud case. According to a Washington State …

Workers Comp

Workers Comp Compensation Claim Workers Compensation

Average Weekly Wage Increase Bumps California Workers’ Comp Benefits for 2025

Insurance Journal

OCTOBER 15, 2024

in the year ending March 31, resulting in an increase in California workers’ compensation temporary total disability and permanent total disability rates for 2025 work injury claims and other workers’ comp benefits … California’s State Average Weekly Wage rose nearly 3.8%

Workers Comp

Workers Comp Injury Compensation Claim

NCCI Event Shines a Light on Workers Comp

Triple-I: Workers Compensation

JUNE 10, 2024

William Nibbelin, Senior Research Actuary, Triple-I The recent National Council on Compensation Insurance (NCCI) Annual Insights Symposium (AIS) in Orlando, Fla., provided important context and clarity around the state of the workers compensation line of business. most profitable) in the past five years. percent and below the 3.5

Workers Comp

Workers Comp Workers Compensation Compensation Claim

Washington Adult Family Home Operator Facing Felony Charge in Alleged Workers’ Comp Scam

Insurance Journal

JULY 16, 2024

A Spokane, Washington woman who ran an adult family home while claiming she was too injured to work faces a felony charge in a $60,000 workers’ compensation fraud case. Serah Kamau, 52, reportedly operated her business, Brookhouse Adult Family Home, …

Workers Comp

Workers Comp Compensation Claim Workers Compensation

California Workers’ Comp Report Shows ‘Relatively Stable’ System Post-Pandemic

Insurance Journal

JULY 29, 2024

The California workers’ compensation system has been relatively stable in the post-pandemic era, as premium levels rose by 1% in 2023 and are forecast to increase modestly in 2024—while decreases in average insurer charged rates are moderating, a new report …

Workers Comp

Workers Comp Compensation Premium Workers Compensation

Part 1: Permanent Total Disability in Workers’ Compensation: Now What?

AMAXX

JULY 1, 2024

Issues concerning permanent total disability (PTD) benefits are a significant cost driver in workers’ compensation claims. When facing these claims, members of the claim management team and other interested stakeholders need to identify the issues early on, evaluate and develop defenses, and avoid costly mistakes.

Workers Compensation

Workers Compensation Compensation Workers Comp Injury

5 Proven Strategies for Physician Oversight to Contain Workers’ Comp Medical Costs

AMAXX

SEPTEMBER 9, 2024

Medical cost containment is an essential aspect of managing workers’ compensation claims effectively. Various medical cost containment strategies play a pivotal role in managing these claims efficiently. A timely review could have prevented an unnecessary claim. However, IMEs are sometimes overused.

Workers Comp

Workers Comp Injury Compensation Workers Compensation

The Role of an Injury Coordinator in Workers’ Compensation Management

AMAXX

JULY 29, 2024

Claims Management Oversee the workers’ compensation claims process, ensuring timely filing and follow-up. Work with insurance adjusters and third-party administrators to manage and resolve claims efficiently. Workers’ Comp Roundup Blog: [link] Injury Management Results (IMR) Software: [link] ©2024 Amaxx LLC.

Workers Compensation

Workers Compensation Injury Compensation Workers Comp

Blog Post: California: Are Migraine Drugs Becoming a New Workers’ Comp Cost Driver?

LexisNexis

OCTOBER 8, 2024

Oakland, CA – Migraine Drugs represented less than 1% of all prescriptions dispensed to California injured workers in 2023 but they consumed 4.7% of California workers’ compensation prescriptions filled in 2023, that was up from 0.2% of the California workers’ comp Migraine Drug spend and by 2021 it represented 8.8%

Workers Comp

Workers Comp Workers Compensation Compensation Injury

One AI Takeaway from 2024 National Comp in Las Vegas

AMAXX

OCTOBER 28, 2024

Every session seemed to touch on AI in some form, particularly in how it’s being used in workers’ comp and claims analysis. However, the principles of workers’ compensation will never change. They will evolve as technology advances.

Workers Comp

Workers Comp Workers Compensation Compensation Injury

Workers’ Comp Cost Formula To Accurately Assess Your Risk

AMAXX

JULY 30, 2024

Michael Stack, CEO of Amaxx LLC, is an expert in workers’ compensation cost containment systems and provides education, training, and consulting to help employers reduce their workers’ compensation costs by 20% to 50%.

Workers Comp

Workers Comp Risk Workers Compensation Injury

Blog Post: Herlick, California Workers’ Compensation Handbook: 2024 Developments

LexisNexis

OCTOBER 22, 2024

By Julius Young, Richard Jacobsmeyer, Barry Bloom, Editors-in-Chief for Herlick, California Workers’ Compensation Handbook [Note: This article is excerpted from the upcoming 2025 edition of Herlick, California Workers’ Compensation Handbook. The AI revolution is starting to come to workers’ compensation.

Workers Compensation

Workers Compensation Compensation Claim Injury

Blog Post: Larson’s Workers’ Compensation Law Case Spotlights (Fall 2024)

LexisNexis

SEPTEMBER 9, 2024

Robinson, co-author, Larson’s Workers’ Compensation Law Editorial Note: All section references below are to Larson’s Workers’ Compensation Law, unless otherwise indicated. Illinois Workers’ Comp. Workers’ Comp. Workers’ Comp. By Thomas A. LEXIS 819, § 7.04 Appeals Bd.

Workers Compensation

Workers Compensation Compensation Injury Workers Comp

National Workers’ Comp Adjuster Day: Unsung Heroes Who Improve People’s Lives

Triple-I: Workers Compensation

AUGUST 15, 2023

By Loretta Worters, Vice President, Media Relations, Triple-I When Victoria Aumiller , AIC, WCP, claims specialist, Chesapeake Employers Insurance came to the organization 14 years ago, she didn’t realize how meaningful her job would be. It’s a day of celebration, not only for workers comp.

Workers Comp

Workers Comp Workers Compensation Compensation Injury

Acting Governor Signs Legislation Increasing Counsel Fees to 25% in Workers’ Compensation Cases

New Jersey Workers' Comp

AUGUST 22, 2024

The New Jersey Division of Workers’ Compensation has historically assessed against employers the obligation to pay 60% of the fee of the injured worker. Injured workers pay 40% of the fee of their own attorney in New Jersey. This new counsel fee legislation affects both parties and petitioners’ attorneys.

Workers Compensation

Workers Compensation Compensation Claim

What’s Your Why? A Collective Portrait of Purpose and Compassion at National Comp 2024

AMAXX

NOVEMBER 12, 2024

At the heart of the 2024 National Comp conference in Las Vegas, Paradigm invited attendees to participate in a unique and interactive experience, transforming personal reflections into a striking work of art. Stack is the creator of Injury Management Results (IMR) software and founder of Amaxx Workers’ Comp Training Center.

Workers Comp

Workers Comp Workers Compensation Injury Compensation

Economic Trends Bode Well for Workers Comp, But Emerging Issues Warrant Attention

Triple-I: Workers Compensation

JULY 27, 2023

Workers compensation insurance provides for the cost of medical care, rehabilitation, and wage replacement for injured workers and death benefits for the dependents of persons killed in work-related accidents. Combined ratio represents the difference between claims and expenses paid and premiums collected by insurers.

Workers Comp

Workers Comp Workers Compensation Workers Compensation Insurance Compensation

Identifying and Preventing Provider Fraud in Workers Comp Cases

Risk Management Monitor

DECEMBER 20, 2022

Claimant fraud and premium fraud are two of the most well-known types of workers compensation fraud. In these cases, a worker may intentionally fake an injury (claimant fraud) or a business owner may misrepresent their employee headcount or incorrectly classify employees to obtain lower insurance premiums.

Workers Comp

Workers Comp Workers Compensation Compensation Claim

Federal Court Rejects Intentional Harm Burn Case Filed Against Auto Repair Shop and Holds Only Remedy Lies in Workers’ Compensation Court

New Jersey Workers' Comp

JUNE 20, 2024

The employer argued that Lopez could not sue and that his only remedy was in the New Jersey Division of Workers’ Compensation. 449 (2012) for the proposition that a violation of a safety code is just one factor in proving an intentional harm claim. Oakland Bd. of Educ. , The court relied on Van Dunk v. 21cv17366, 2024 U.S.

Workers Compensation

Workers Compensation Compensation Injury Claim

Effective Communication with Injured Workers: Best Practices for Success

AMAXX

AUGUST 12, 2024

In workers’ compensation, communication with injured workers is a critical aspect that can significantly influence the outcome of a claim. Proper communication helps facilitate a smooth return-to-work process and plays a crucial role in maintaining the injured worker’s morale and engagement with the organization.

Workers Compensation

Workers Compensation Workers Comp Injury Compensation

The Little Known “Authorized Vehicle Rule” in Workers’ Compensation

New Jersey Workers' Comp

MAY 6, 2024

I had the pleasure of Speaking on Law Day in Plainfield Workers’ Compensation Court on May 1, 2024 and wanted to share with readers part of the discussion in our session, namely the discussion of the New Jersey authorized vehicle rule contained in N.J.S.A. I also want to thank my co-presenter Rick Rubenstein, Esq.,

Workers Compensation

Workers Compensation Compensation Injury Theft

Hear from Injured Workers and Join Paradigm in Supporting Passion, Purpose, and Kids’ Chance at National Comp

AMAXX

OCTOBER 9, 2024

This activity ties directly to Paradigm’s key session, Human-Centered Care & Compassion: Real Workers, Groundbreaking Recoveries , where two catastrophically injured workers will share their why, the purpose they have found in the wake of life-changing injuries, and the critical importance of family and a holistic, team-based approach to care.

Workers Compensation

Workers Compensation Compensation Workers Comp Injury

Part 3: Permanent Total Disability – Other Defenses to Consider

AMAXX

JULY 9, 2024

Defending Permanent and Total Disability (PTD) cases presents many challenges for the claim management team and other interested stakeholders. These matters must be considered when seeking to maximize the efficiency of any workers’ compensation program and reduce costs. There are many defenses to these claims to consider.

Workers Compensation

Workers Compensation Workers Comp Injury Compensation

Long COVID Claims Still Impact California’s Workers Comp System, Report Shows

Workers’ Comp Claims Audit: Initial Action Plan Checklist

Trending Sources

4 Step Process to Successfully Settle More Workers’ Compensation Claims

Best Practices to Prepare for a Workers’ Comp Claim Audit or Review

Two Main Reasons Why Workers’ Compensation Costs Skyrocket

California Vocational School Owner Charged With Fraud in Workers’ Comp Scheme

Eleven Considerations for Selecting Your Workers’ Comp Company Doctor

Minnesota Workers’ Comp System Stable Despite COVID-19 Impact

Washington Metal Fabricator Faces Felony in $340K Workers’ Comp Scam

5 Reasons Why Workers’ Compensation Reserves Are Higher Than Expected

Employer’s Clinic May Not be Protected by Workers’ Comp Remedy, SC Court Says

Cyber Risk: West Virginia OIC Plans to Dispose of Older Workers’ Comp Files

Workers’ Compensation Post-Injury Response Procedure: A Key to Effective Injury Management

Physical Therapy, Occupational Therapy, and Vocational Rehab in Workers’ Compensation

Vocational School Owner Arraigned in $1M Workers’ Comp Fraud Case

2 Major Types of Transitional Duty in Workers’ Compensation

Understanding the Impact of Frequency and Severity on Workers’ Compensation Premiums

Understanding Classification Rules in Workers’ Compensation

Avoid 2 Common Pitfalls That Delay Care in Workers’ Compensation Claims

WCIRB: California Workers’ Comp Written Premium in 2023 Was up Slightly

Blog Post: California Workers’ Comp Benefits to Increase in 2025

Washington State Meter Reader Pleads Guilty in Workers’ Comp Scam

Average Weekly Wage Increase Bumps California Workers’ Comp Benefits for 2025

NCCI Event Shines a Light on Workers Comp

Washington Adult Family Home Operator Facing Felony Charge in Alleged Workers’ Comp Scam

California Workers’ Comp Report Shows ‘Relatively Stable’ System Post-Pandemic

Part 1: Permanent Total Disability in Workers’ Compensation: Now What?

5 Proven Strategies for Physician Oversight to Contain Workers’ Comp Medical Costs

The Role of an Injury Coordinator in Workers’ Compensation Management

Blog Post: California: Are Migraine Drugs Becoming a New Workers’ Comp Cost Driver?

One AI Takeaway from 2024 National Comp in Las Vegas

Workers’ Comp Cost Formula To Accurately Assess Your Risk

Blog Post: Herlick, California Workers’ Compensation Handbook: 2024 Developments

Blog Post: Larson’s Workers’ Compensation Law Case Spotlights (Fall 2024)

National Workers’ Comp Adjuster Day: Unsung Heroes Who Improve People’s Lives

Acting Governor Signs Legislation Increasing Counsel Fees to 25% in Workers’ Compensation Cases

What’s Your Why? A Collective Portrait of Purpose and Compassion at National Comp 2024

Economic Trends Bode Well for Workers Comp, But Emerging Issues Warrant Attention

Identifying and Preventing Provider Fraud in Workers Comp Cases

Federal Court Rejects Intentional Harm Burn Case Filed Against Auto Repair Shop and Holds Only Remedy Lies in Workers’ Compensation Court

Effective Communication with Injured Workers: Best Practices for Success

The Little Known “Authorized Vehicle Rule” in Workers’ Compensation

Hear from Injured Workers and Join Paradigm in Supporting Passion, Purpose, and Kids’ Chance at National Comp

Part 3: Permanent Total Disability – Other Defenses to Consider

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