Multistate Workers Comp Claims Adjusting = Balancing Act

Becoming a Multistate Workers Comp claims adjuster ends up as an eye-opening experience. A recently promoted Senior Claims Adjuster messaged me through LinkedIn earlier this month. The message read (paraphrased) –

My employer (WC carrier) recently promoted me to a remote Senior Adjuster position. For the past seven years, I have adjusted claims in one state.  Now I adjust five states at the same time.  Any advice for me?

My answer –

Congrats on your promotion to Senior Adjuster.  Having a remote position means that your employer trusts you to handle multistate workers comp claims.  In the 80s and 90s, I was responsible for seven states simultaneously.  The states were not regionally located.

My supervisor at the time told me to think of the similarities with multistate workers comp claims – more of a process.  She listed them for me:

1. The employer files a First Report of Injury
2. You make a compensability decision
3. Forms are filed with the state
4. Benefits are paid until a full return to work unless you issue a denial
5. Maximum Medical Improvement – MMI attained
6. Permanency benefits  paid – Forms filed with the state – if applicable
7. File closed

Yes, even with multistate workers comp claims, the process does not change that much from state to state.  The list could cover 20 points in each state.  The idea was to keep it simple and lower the stress of juggling multiple deadlines under seven sets of different rules.

Some other advice that may assist with multistate claims adjusting

1.  Your local defense attorney usually will provide an invaluable cheat sheet.  I referred to those until I wore out the paper.  I had 20 pages of the cheat sheets at my fingertips at all times.
2. If your carrier employer will pay for attending each state’s claims conference, do go to them.
3. Subscribe to all the claims publications possible.  Many of them charge little or nothing.  At least read the headlines.   Check out the list that I read each week.
4. Obtain your Associate in Claims designation.  This helps with covering subrogation issues in multistate Workers Comp claims.  The AIC designation makes your CV shine if you wish to move up with your current employer.
5. Do not send a rapid-response email to anyone – unless it is a critical situation.  Set your email to hold emails for a few minutes to a few hours.   I learned my lesson early on with this one.

Bottom Line on MultiState WC Adjusting

Multistate Workers Comp claims adjusting can be challenging.  Take the assignment from the viewpoint that not all TPAs or carriers trust all their adjusters with more than one jurisdiction.

Courtesy of J&L Risk Management Consultants

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