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Common Themes & Strategies for Managing Uncommon Claims

  • PRIMA National Convention, Gaylord Palms Resort 6000 West Osceola Parkway Kissimmee, FL, 34746 United States (map)

A small percentage of workers’ compensation claims drive a majority of costs. A closer examination reveals that claim complexity is often driven by a few common factors that contribute to a deteriorating situation or difficult conditions. Eliminating or mitigating these factors demands a very different approach than handling more traditional claims.  Individual injuries and claim circumstances can vary widely.  When facing cases with a high potential for escalating, there are proactive measures that employers should consider.  First, understand a person’s individual circumstances and identify any potential barriers to recovery.  Holistic health solutions aimed at achieving physical, mental, and emotional well-being can facilitate healing and return to normalcy. Further, litigation can prolong claim durations, increase costs, and impact permanent impairment issues. To avoid and mitigate litigation, it is important to Identify and engage the proper resources and experts at the onset of injury. Additionally, prescription drugs should be monitored so as not to create unintended consequences or addiction. This session will look at some of the contributing factors to complex claims and use real life illustrations and solutions for managing these situations.