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ACHIEVING SUCCESS TIPS

Pre-existing Conditions and a Second Injury Fund

Twenty states still have a second injury fund. A second injury fund is a pool set aside to reimburse employers who hire previously injured employees. The employer informs the adjuster about the pre- existing condition, whether from a prior work injury or other medical condition.  

 

The risk management department, together with the human resources department, needs to identify every new hire with a pre- existing condition for any possible future cost impact of a workers compensation claim.  

 

For example: In Ohio an employer in the state fund is entitled to reimbursement for payments to a handicapped employee, IF the employer notified the board, prior to the injury, that it had employed a person with an existing handicap (Ohio Statute 4123.343 Handicap Reimbursement).  

 

When the claim is reported, the adjuster should be made aware of the pre-existing work injury or other medical condition possibly affecting the employee's ability to recover from a new workers compensation injury. The adjuster can then calculate the appropriate settlement value of the claim, and/or file the necessary forms with the second injury fund for reimbursement of the additional claim costs caused by the pre-existing condition.

 

WC COST REDUCTION NEWS

How much can we save? What is the ROI? How quickly will I see the savings? Those are the primary concerns of employers today.

Workers comp industry professionals not only have to deal with their own life stressors but also have to figure out a way to try and solve the the claimants' stressors. Read it.

Employers often are focused on the product or service they provide and inadvertently overlook several areas where they could reduce the cost of workers' compensation.

Keeping employees safe from violence is unfortunately a necessary part of any risk management program. How can proper hiring procedures prevent problems and what are red flags of violence?

By preparing, managing, and planning for settlement negotiations from the start of the claim, the in-house adjuster can obtain a fair and reasonable settlement. How?

A significant portion of claim handling problems are in the communications between the self-insured employer and the TPA adjuster. Be aware that every adjuster works differently and use these 15 recommendations to help. 

The 2013 edition has many exciting revisions including Standard Defenses, Claim Leakage, FECA (by Managed Care Advisors), Opioid Abuse control Measures, Wellness, Drug Testing Policies, Control Techniques, Structured Settlements, Physical Therapy Management, Social Media and Workplace Monitoring Fraud Controls and much more.  PRICE SAME AS in 2012.

EDUCATIONAL OPPORTUNITIES
 "Understanding the Urgency for Reducing Unnecessary Medical Care and Costs" February 27-28, 2013 Cambridge, This problem is addressed in the context of the larger fiscal and political challenges faced in workers compensation.  
RIMS '13 will introduce new products, establish your presence in the marketplace, reinforce relationships with existing clients,
and discover new clients from your target audience-all
for a great value-all at RIMS '13. 
SEAK is the sponsor of the largest and most highly regarded national workers' compensation and occupational medicine conference. SEAK's Workers' Compensation and Occupational Medicine Conference was first held in 1980 and takes place each July on Cape Cod. 
NEWS FROM LowerWC.com
New summaries for "drug testing and workers compensation state laws" for every jurisdiction are NOW posted on our website. Click on the link above to check it out.
REDUCE WC COST 20% to 50%
Workers Compensation Management Program
Learn more about our book on
COST SAVINGS
for employers.
Article Library

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Set Asides (MSA)



AMAXX RISK SOLUTIONS, INC.
Lowering Workers Comp Costs for Employers

Rebecca Shafer, Attorney & Risk Consultant

Contact Us: [email protected]

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