Recently, there seems to be an almost palpable and growing concern of violence occurring in our communities, schools and workplaces. At the same time there is a confusing dynamic. The issue of workplace violence seems to dominate our news feeds (and interest) in a very predictable manner; for a few days, or weeks after a high-profile incident occurs, then the energy fades.Read More
First aid is one of the most frequent topics of conversation I have with my clients. The confusion typically arises from two main issues:
The WCIRB (Workers’ Compensation Insurance Rating Bureau in California) rule changes, starting in 2019, which deducts $250 from ALL claims in the X-Mod calculation (more on this later).
The differences between a First Aid designation for Workers’ Compensation insurance purposes, and a first aid incident under the OSHA definitions (listed below).
Receiving a subpoena can be intimidating! It comes in the mail and asserts that you must respond and maybe even appear by a deadline or else…
Well, first things first. Nine times out of ten you do not need to go anywhere. You can generally fax, mail, email or even have the copy service company collect the documents requested in person.Read More
Cal-OSHA’s Heat Illness standard (Title 8, Chapter 4, §3395: www.dir.ca.gov/title8/3395.html) requires employers to have a Heat Illness Prevention Plan. Not having a policy, procedure and conducting the required training could result in employee illnesses, increased X-mods, higher insurance premiums and Cal-OSHA citations!Read More
ESM identifies errors by two carriers on incorrect Joint Coverage claims reported to the WCIRB and obtains 59-point reduction in X-Mod for the employer!
click to find out how..Read More
Reduce litigation. Reduce lost time. Save dollars. There are critical steps you should take at the beginning of the policy year to set yourself up for greater success if an injury occurs. Act NOW. Do your part, take charge to be more proficient and effective this year.Read More
UPDATE: July 3, 2018
I’m sure you have heard the news and are trying to confirm its validity. Here’s the answer.
Per Cal-OSHA Consultation, NO!
Click to find out more.Read More
It is unfortunate when an employee will not cooperate with your best intentions for job accommodation. An employee cannot be forced to accept your modified work offer, but if they refuse, they will not be paid Temporary Disability. Click for recommendations on this issue.Read More
An employee can retain an attorney who will file an Application of Adjudication of Claim with the Workers’ Compensation Appeals Board. If you receive a Notice of Representation or an Application for Adjudication you should follow these recommended steps.Read More
Lag Time, or the days from date of injury to reporting the claim to your carrier, is one metric used by your carrier to analyze your risk performance. Studies show that claims reported within 24 hours are 33% less expensive. Click to find out why prompt reporting is important.Read More
An injured worker sustained a back injury that resulted in a 20-day hospital stay. He obtained an attorney and filed an Application for Adjudication of Claim for this specific injury claim and a Cumulative Trauma claim. Find out how communication and teamwork resulted in a $374,409 reserve reduction.Read More
ESM was successful in reducing a client’s 2017 Experience Modification by 26 points and their 2018 Experience Modification by 8 points with a second 8-point reduction projected for a total reduction of 42 Mod points. Click here to find out how...Read More
As a claims consultant I answer employer questions daily regarding their employees, return to work and claim concerns. Here are my responses to the top 10 concerns that I hear most often.Read More
ESM saved a SIG’s members $21,000 by asking a simple question of the Office of Self Insured Plan’s (OSIP) chief. “WHY?” Click to read more...Read More
We have seen UR fees run anywhere from $98 to upwards of $9,500 per treatment.
- Routine treatment such as PT, diagnostics and consults are usually approved with an average UR fee up to $500 per review.
- The UR cost drivers are surgeries and opioids/narcotics - whether approved, modified or denied.
- We recently saw a TPA charge $9,500 in UR fees for a request for spine surgery because of the unbundling of the Utilization Review and fees.
While safety is top of mind for most employers, it typically takes a backseat to production and sales. Completely understandable because without products and sales the business and its benefits simply cease to exist. However, what should be considered in your strategic planning is the cost of risk.Read More
ESM achieves a 39 point X-Mod reduction for an employer by identifying a carrier error in the claim classification reported to the Workers’ Compensation Insurance Rating Bureau (WCIRB).Read More
Effective Jan. 1, 2017, all insured employers within the state of California must report all claims to their carrier or Third Party Administrator for which medical treatment costs are incurred. This includes reporting of first aid claims. If you have previously paid your “first aid” claims directly to the medical clinic, these costs must now be reported to the carrier and will impact your future Experience Modifier.Read More
An active and effective safety committee whose membership and functions are reflective of the company’s size, complexity, and operating exposures will play a key role in the overall performance of that company. The Safety Committee is established to be of benefit first and foremost to the employees it represents, but it is also established as a safeguard and protector of the Company’s assets.Read More
In 2011, Cal-OSHA enacted Assembly Bill 2774. Part of the new legislation included expanding the definition of “Serious Physical Harm” to include a 4th element. Well, if you are still unsure, fret no longer! Here is the definition straight from the amended labor codeRead More