6/21/2010
Focus on Summer Safety
The summer months often arrive with increased exposure to work injuries and challenges to prevent them - the following are 10 tips to help you through (click "view our blog" below to continue).
6/3/2010
Employee Fraud: unreported earnings while on wc disability
On December 17, 2009, a Framingham, MA man pled guilty to workers compensation fraud and perjury for misreporting his earnings while receiving disability payments from the wc carrier -- As prudent claims management, we recommend that clients check earnings of almost all employees after 45 days of temporary disability – here’s how .
(Massachusetts claims) Ask the claims examiner to send an “Employees Earnings Report” (DIA form # 126) to the injured employee (click view our blog below to continue).
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(800) 298-9330
(800) 922-9161
The objective of our Claims Management program is to provide prompt and appropriate medical treatment for employees who suffer work related injuries and reduce the cost of claims. Our approach in addressing this challenge would be as follows:
Review processes for employer’s first report, including injury assessment and employee statement; and communication, claim file organization and tracking, documentation and follow up of claims;
Establish preferred medical providers for initial evaluation treatment of work injuries and methods to provide prompt post-injury treatment;
Institute process for effective communication among client, medical provider, nurse case manager, claims examiner and injured employee;
Identify potentially false or exaggerated claims, and claims most likely to involve significant lost time;
Implement return to work strategy where appropriate for lost time claims
Identify litigated and controverted claims for special handling, assist in carrier attorney preparation for DIA conciliations, conferences and hearings, and attend when appropriate;
Monthly review of open and lost time claims with client and periodic review of complex, high-exposure and controverted claims with client and carrier’s claims examiners.