Workers Comp Basics From A Friend's Great Book

A long-time friend of mine Nancy Germond decided to grab the tiger by the tail and write a great book on Workers Comp Basics.   Check out the bottom of this article for the info in case you want to read more excerpts than in this article or to purchase.  I gave the book a big t.humbs-up review on Amazon.

The book gives anyone new to the world of Workers Comp a quick intro or a refresher to anyone who has experience in WC.  Nancy was kind enough to forward a few passages for me to use in this article.

One of the areas covered in her book that I have not covered in my 2,000 articles is Loss Prevention Safety Committees.  (See Chapter 5).  Safety programs reduce Experience Mods and Loss Development Factors when the owners or managers are patient.  You have to give a safety program three years minimum to show the full effect of your efforts.

Let us see what Nancy has to say on  Workers Comp basics.

From the book – Workers’ Compensation In Two Hours

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The workers compensation process

When a claim is work-related, here is a breakdown of the steps in a normal workers compensation process.

• Step One – The employee has a witnessed or otherwise routine workplace injury or reports an industrial illness, such as lung disease.
• Step Two – Your adjuster investigates the claim, accepts the claim, and begins to manage and pay for the medical treatment, paying lost wages when needed.
• Step Three – When the injury has some extent of lifetime disability or your employee becomes disabled, your employee and your insurer agree in front of an administrative law judge to the degree of disability and the appropriate compensation for that disability.
• Step Four – Your employee and the court accept the final settlement offer.
• Step Five – Your adjuster pursues any subrogation by at-fault parties to recoup payments made on your behalf. Subrogation is a right in your policy that allows the insurer to recover loss payments from the party that caused the loss. For example, the adjuster pursues the insurer of the driver who injures your employee when your employee is blameless.
• Step Six – The adjuster closes the claim. In cases of permanent disability, the adjuster continues to pay “supportive care,” court-approved medical care needed for the employee to maintain his or her level of function.

In general, the safety net of workers compensation operates smoothly, administered slightly differently from state to state. States recognize most types of injury, with back sprains and strains one of the most common work injuries. They also recognize certain occupational diseases, such as asbestosis or certain occupation-related cancers. COVID-19 has added to the complexity of these decisions to accept or deny a workers compensation claim, known as “compensability determinations.”

A compensable claim is one that the insurer or the administrative law judge accepts as work-related and thus payable.

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If you liked the passage from Nancy’s book, or have any additions, please let me know in the comments.

The Workers Comp Basics = the forest, not all the trees.

Go here to see more info on the book and recording (George Jack of Insurance Journal). 

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