Workers' Compensation Cost/Structure Review

Public Sector Special Services

WORKERS’ COMPENSATION COST/STRUCTURE REVIEW



As employees return to work after a months-long hiatus and new employees are hired to fill vacated positions, risk managers’ and supervisors’ primary focus should be exactly what it was before we were blindsided by the COVID-19 pandemic – safety. Only now, there are new wrinkles to consider in safety and liability, particularly Workers’ Compensation.

Generally, workers’ compensation does not cover routine community-spread illnesses like a cold or the flu because they usually cannot be directly tied to the workplace.

The COVID-19 pandemic presents a unique circumstance where many jobs that are not typically considered hazardous have suddenly become very dangerous. Some states have amended their state workers’ compensation statutes or have issued other authority to make it easier for employees to receive workers’ compensation benefits by providing a presumption of coverage for essential workers who test positive for or are impacted by exposure to COVID-19.

Workers’ compensation premiums can be reduced with proper review and implementation of recognized safety and wellness measures.

HERE’S HOW WE HELP

We evaluate payments for appropriate discounts and duplicate payments (with the health plans) and review third-party administrator (TPA) charges in self-insured workers’ compensation programs to determine if fees paid based on managed care discounts are reasonable.


Resources and Case Studies

  • Enhanced Workers’ Comp Coverage Saves School District $900,000 (case study)
  • Claims Processing Structure and Educated Key Personnel Results in Drop in Claims Denials (case study)
  • Ways to Determine if Claims are Covered Under Workers’ Comp During COVID-19 (article)
  • Best Practices for Workers’ Compensation Claims (article)