The document provides a guide for business owners on managing workers' compensation claims, highlighting that these claims require a different approach than other insurance claims. It emphasizes the importance of getting injured employees back to work, implementing a return-to-work program, and actively managing the claims process to reduce costs. Key strategies include training management, engaging third-party claims management services, and ensuring clear communication between all parties involved.

1. Lowering
Workers Comp
Costs
A Business Owners Guide

2. Workers Comp Is Different
• If you have an auto accident, you report it to the insurance
company and forget it – usually
• If an injured customer sues you or demands that you pay
for their injuries, again, you usually report it to your
insurance company and hear little else about it.
• With workers comp, many people do the same thing, BUT
IT IS DIFFERENT
• Workers Comp claims are unique and require a significantly
different response compared to other types of losses

3. Workers Comp Benefits Paid to Employees
• Benefits paid to employees are set by state in the following
categories:
• Medical Benefits – Hospital and doctors bills
• Disability Payments
• Temporary Disability – 66% of your weekly
earnings up to 104 weeks
• Permanent Disability – Complicated formulas
weekly income $250-$1750
• Job Training – Max $10k to learn new skills
• Death Benefits - $250k - $320K

4. • In 2016 the average medical expense per claim is $40,678
• The average amount received for lost wages is $29,030
• 25% of workplace injuries will involve lost wages
• The longer your employee stays home from work, the more
expensive the claim will become
• Often, the injured worker is capable of working – just not at
full capacity
• Getting a worker back to work, even at a lessor capacity is
the single most effective way to reduce the duration (cost)
of a workers compensation claim
Workers Comp Claims are Expensive

5. Understand the Work Comp Process
• After a work comp claim is initiated your claims adjustor will
spring into action
• The claims adjuster will begin to pay the injured employee any
lost wages according to a formula set by the state
• They will authorize or reject payment for medical procedures
as the circumstances dictate
• This will continue until a doctor has given full release to the
injured employee to return to work
• Claims reps will ask the doctors for a status report as often as
they can but each claims rep has 180 cases on their desk at any
given moment
• The employer or a third party claims management service has
a much better chance of impacting the duration of a claim
than the insurance company

6. Work Comp Claims Handling
• After a claim is reported to the insurance company, the real
work begins
• Claims rep from insurance company starts paying benefits
to the injured employee
• The employer SHOULD enact the following:
• Employer initiates pre-arranged return to work plan
• Manager or supervisor should be trained and given resources to
successfully reintegrate injured worker into the workplace
• Engage a third party claims management service to handle the
considerable administrative task of coordinating communication
between healthcare providers, work comp claims administrators, and
employer management

7. Get Employees Working Again
• Having a defined “Return to Work Program” allows the
employer and manager or supervisor to implement a
predefined protocol
• Management must be engaged in the claims process and
actively seek a doctors full or partial release for the injured
employee
• Once the employee is cleared for modified duty, the
supervisor can have the employee return to the work place
and perform the duties specified in the return to work
program – eliminating any activities that would exceed the
doctors recommendations

8. A Successful Return to Work Program
• Instructions for managers and supervisors
• List of duties
• Job expectations
• Reporting duties and coordination with case manager
• 30-60-90 plan to return worker to full employment
• Clearly communicated milestones
• Manager/supervisor meeting weekly with injured employee
• Case management (third party) involvement with claims
and employer management
• Obtain doctor release
• Work with work comp claims handler, healthcare provider, and
manager/supervisor to coordinate care and return to work

9. Modified Duty
• Employees can be given low-impact tasks
• Examples of modified job duties:
• Administrative paperwork
• Accounting / bookkeeping
• Cold calling
• Social media advertising
• Assistant duties
• Scheduling
• Calendaring

10. Management Involvement and Training
• Management involvement is CRITICAL!
• Owners/senior management commitment
• Supervisors must be aware of duties and
expectations
• Given resources and training to implement
plan
• Provided with assistance and coaching at each
critical stage

11. Claims Administration Duties
• Assign responsibility for tracking claims status between:
• Management
• Medical providers
• Claims representative
• Injured worker
• Who will be responsible?
• Management?
• Insurance Broker?
• Third-Party Administrator?

12. Workers Comp Claims are Different
Don’t let workers comp claims just happen
Get employees back to work as soon as possible
Plan ahead and minimize the impact to your
company!