Can I Sign Arizona Claim

Can i document type sign claim arizona

thank you for joining me today for a webinar how timeliness of injury reporting can have a big impact on claims cost if you have questions during the presentation please ask them in the Q&A window that should be in the lower right corner of your WebEx screen I'll be answering any questions posed in that Q&A at the end of this presentation you may also see a chat window we ask that you please keep comments in that Q&A and refrain from using the chat hi I'm Tracy Trotsky director of regional claims management for copper point insurance companies I've been with the company since 1991 so I have 28 years of claims experience I currently oversee our active claims teams to include our staff located in Colorado Nevada and New Mexico I also oversee the claims management of our other states program I came up through the company having performed the functions of claims technician senior claims adjuster and Claims Manager I hold a bachelor's of science and communication from the University of California San Diego as well as certifications as an associate in claims and associate and general insurance Piper point insurance companies was founded in 1925 we are a leading provider of workers compensation and commercial insurance solutions copper point currently operates in six states Arizona California Colorado New Mexico Nevada and Utah upper point mutual insurance holding company is the corporate parent of Arizona based copper point insurance companies and california-based Pacific compensation insurance company all copper point companies are rated a minus or excellent by am best today I would like to promote timely claim filing I will talk about why claims should be filed timely when to file how to file and what an employer should do when their employee indicates they have been injured on the job why does timeliness matter lag time and reporting worker injuries can be higher claims costs when an employee is injured time is of the essence when it concerns medical treatment costs studies show delays in reporting worker injuries will often increase the cost of a claim a national council and compensation insurance or NCCI 2015 study reports occupational injuries showed the lowest median cost was thirteen thousand one hundred and twenty dollars her claims reported within two weeks add a reporting delay of similar injuries and claim cost arise thirty five percent by week three plus another twelve percent in week four NCCI used data collected in 2010 and 2011 for this study an earlier study by a major carrier using its own data showed a correlation between increased compensation costs and delays in reporting and CCI data shows some common injuries often see delayed reporting because of their nature for example almost half of all lost time claims are sprains or strains when you put sprains and strains together with fractures contusions and lacerations these for injury classes account for more than 70% of all claims and CCI found a delay in reporting perhaps because an injured worker and his or her manager think an injury is not severe and might heal quickly results in higher costs when recovery gets delayed or doesn't occur at all ncc I found the median cost of a sprain or strain reported four weeks after the injury is about 70 percent higher than a similar claim reported during the first week minor injuries may worsen if timely treatment is not sought prompt reporting may allow the claims adjuster to direct treatment to the most appropriate medical specialist resulting in better care prompt reporting of work-related injuries is in everyone's best interest prompt claim reporting allows for timely communication and the building of a trusting relationship the claims adjuster can answer questions and concerns upfront which ultimately puts the injured worker more at ease and provides an understanding of expectations an injured worker needs to understand how the compensation process works how he or she will get medical care and wage replacement compensation they should not be left hanging wondering if their claim is being addressed and potentially feeling neglected or not valued as an employee a thorough accident investigation should include collection of facts evidence which may not be available after time and interviews with witnesses whose memories are freshest immediately after an incident rather than days or weeks later wrapping up an investigation helps an employer and claims adjuster determine the most appropriate plan of action for claim resolution in a quick and efficient manner fast reporting can reduce or completely mitigate time lost from work if appropriate light or regular duty releases can be obtained within the state waiting period that could be the difference between a medical online versus of time loss claim remember NCCI will discount medical only claims costs by 70% Heim leanness and reporting also may reveal signs of fraud it could help determine whether surveillance or subrogation against a third party is needed Porter claimed when an employee reports an injury or illness they believe is related to work for which they are seeking medical treatment note injuries the employer should be aware of should also be reported within the jurisdictions required time line whether or not the injured employee formally reports the incident each state has a regulatory requirement for claim filing there are some would state a reporting requirement of immediate but no matter what the jurisdiction requires pomp filing is important if an employee reports an incident that indicates they do not feel a need to seek treatment at that time you may not need to report a claim to your carrier you should however investigate and document the incident this can be done on an employer's internal investigation form or you may use copper points supervisory reports of injury form sure to perform your investigation take statements from witnesses and retain any information or materials related to the cause of the incident in the event a claim to need to be filed in the future how long does an employee have to file their claim after an incident that depends upon the jurisdiction of the claim however many jurisdictions are like Arizona which gives the injured party one year from the date of injury onset of an illness or diagnosis of the condition to file their claim how does the employer file or work position claim for Arizona Colorado Nevada New Mexico and Utah preferred method is online at our website the employer fully completes the state employers report form days and like trying to copy then just drags and drops it into the portal answering a few basic questions eight specific fillable forms are available on our website Oertel submissions require less human processing therefore a faster flow to the adjuster if the employer can fully complete the form the claim will go straight to the designated adjuster allowing them to expedite the compensability investigation and begin paying benefits faster no worries if you don't have all the information for the form just give us what you have and we'll get the rest we'd rather have the claim timely then wait while you gather additional information in order to file it other methods to file include email fax phone or via United States Postal Service no worry if you don't get a chance to jot down this information from the slide it's available at our web site www.kpbs.org/news/evening edition California claims with Pacific comp can be submitted online at Pacific comp comm other methods to file include email fax and phone policy is written in partnership with Argonaut insurance company and you need to file a workers compensation claim visit our go online the web division of Argonaut @ww agro limited calm or convenient online claims filing tools what happens next early intervention via three-point contacts adjusters are required to timely reach out to three primary parties on time loss claims the injured worker the employer and the provider this begins investigation for compensability of the claim and activates the payment of benefits the employer will be contacted to obtain missing or new information the medical provider to obtain reports treatment plans and work status information the injured worker to obtain their statement additional personal information and to explain the workers compensation claims process it's indicated previously fast clean filing expedites investigation process and allows more time to gather fresh information it also allows the adjuster an opportunity to begin building a relationship with the injured person quickly after the injury the adjuster can explain the complex and often confusing workers compensation claims process early in the claim which will often reduce legal representation and litigation the employee is more likely to return to work faster and less likely to draw their claim out farther than medically necessary many injured workers have never gone through the experience of filing a claim compare this to when you may have filed your first auto claim on your personal insurance was intimidating to work through a new and unknown process with the filing of the claim easy did you know what the next step would be was it easy for you to find a good repair shop that you would be confident in did you understand all your rights and responsibilities that can be a daunting process even without the addition of suffering and injury the same may be true for an injured worker or business owner how do I file a workers compensation claim what kind of information do I need to tell the insurance company what happens next which doctor should be chosen how will lost wages be paid what are my rights the adjuster is there to educate all parties and to help them through the claim process if they can reach out to the injured worker as soon as possible after the injury occurs they can start to educate the worker set expectations and answer their questions building that rapport and establishing themselves the helpful expert can ease many concerns that the injured worker may face in lieu of fat the injured worker with no prompt involvement or direction from an adjuster may start to make up their own answers for what to do next they might delay doing anything at all it might make things worse by saying the wrong type of doctor or they might feel as though they need to get an attorney to have someone on their side we know when they are sitting at home on the couch healing they seen many commercials inviting the viewer to call their law office they can help with a myriad of issues and protect you against the big bad insurance company we want to mitigate negative perceptions what are other benefits of timely claim filing depending upon the jurisdiction of the claim timely reporting may allow the employer to have at least some ability to direct care this can ensure the employee will be treated with the right level of care by an appropriate provider appropriate meaning the best type of doctor for this type of injury one who specializes in occupational injuries with proven treatment success rates employers who work with providers and build working relationships that benefit all is they can educate on the employers business work requirements light duty program options drug screening requirements etc without assistance in provider selection the employee may seek their family doctor or a general practitioner for what may be a complex injury ensuring the injured employee receives the right level and type of care will result in better outcomes fast filing naming faster treatment as some employees and providers are hesitant to treat without evidence the claim has been filed or would rather put off seeking treatment and just wait and see how they recover think about the construction worker who may have strained their back while working if he believes it will just get better with time decides to work through the pain a strain could become a far more complex medical condition requiring more treatment for longer periods of time it may also suffer additional injuries due to the physical limitations resulting from the initial accident get involved and show you care it's important for employers to let their employees know they are appreciated and valued injured employees tend to recover more quickly and have higher morale when they know their employee values them and wants them back if they sit at home without contact they may feel isolated from their company and work friends it may get used to their change world getting up later than usual not having to pay their usual childcare or fuel expenses perhaps realizing they can live on less income this does not motivate someone to get back to work offer light duty whenever possible when you have an appropriate return to work program it means you're making a commitment to your employees by identifying a plan of action to get them back to work quickly and safely countless studies show that injured workers who missed more than 6 months of work have only a 50% chance of returning to their jobs and that percentage continues to drop the longer they are out the reverse is also true injured workers who miss few or no days from work have the best chance of a full recovery and if you find ways to keep an injured worker on the job as they rehabilitate you'll be controlling your workers compensation costs maintain communication with the employee whether they are off work or released back to work while they complete their recovery if your injured employee is working a modified Duty make sure they assigned duties are within the physical restrictions or the injury employees who know their employer cares about them will be more likely to be compliant with their treatment plan desire return to work in some capacity and recover faster which benefits everyone so in recap what should you do you should gather and document injury facts you should report claims promptly get involved in the action plan stay in touch with your employees through their recovery process how will this help it shows your employees you care about them which will facilitate better morale and compliance to treatment plans it reduces claim costs and potentially the emod which can reduce premiums now's the time that I'll take questions you okay so let's look at some of the questions that we have I have one well we were always told we had to report within 24 hours is this in true fact well there are state specific requirements as well as OSHA specific requirements for certain types of claim reporting so OSHA for example when it comes to fatalities and cat reporting actually have our reporting requirements state specific you know of courses by the state Arizona for example has a requirement that employers report or submit their home employers report of injury form within 10 days of them being aware or having the injury reported to them but that's minimum requirements by state statute we don't really want to look at minimum requirements you want to do what's best for all the reasons that I've discussed during this webinar but let me give you an example so if in the state of Arizona the waiting period that I talked about as far as when indemnity is due to an injured worker is if their awful work in excess of seven days if you wait that ten days out from the int date of injury to give us the claim report we've already broken that time period our ability to potentially convince the doctor that light duty is available appropriate for that person and get them back on the job performing the functions of that light duty if you wait ten days or longer it's another question can employer reduce costs by paying for the medical treatment of their employees I always love getting this question the simple answer is no barring limited state exceptions self-insured employers and carriers are required to pay for all reasonable medical benefits related to the industrial injury not the employers have recovered by carriers to go deeper into that issue be aware that employer payment of benefits may be construed as acceptance of an injury illness or condition under your workers compensation policy most employers are not experts in what is and is not covered under the work comp statutes please let your claim experts be the ones to determine what should be covered if you pay initial medical then report he claim once it gets too expensive to continue to pay you've removed us from the process that could lead to some of the concerns I've addressed today such as inappropriate or untimely treatment leading to more complex injuries and longer recovery periods you may also be impacting the employers right to certain benefits such as dependents allowance permanent awards or rights to future benefits related to that injury it's another question let's see regarding HIPAA laws does it put an agency at risk if they report a workers compensation claim for the insured we encourage employers to do the reporting however if an agent gets that information and can timely flip that that information over to us by calling us emailing us or whatever we certainly we want to get that claim filed as quickly as possible should you actually be the one to go online or to fill out the form no you should not see how do we get more information about the one year time frame for Arizona work comp information give us a call you can call our acclaims contact center at six oh two six three one two three zero zero or two thousand you can contact your adjuster directly if you're an employer you can go through your agent they are often experts in in that one-year time frame just give us a call and let us let us help you with that has copper points seen any correlation between workers compensation claims and other employee benefit programs like disability insurance with off job coverage correlation between workers comp and employee benefits there are two completely different scenarios workers comp you know compensates for time loss from work by the statutes employer disability insurance is a labor issue workers comp is separate from those labor issues one will take credit disability insurance for example will take credit there isn't a lot of double pay so depending upon what you're looking for in that question I hope I hope that answers that if an employee does not want to go to a doctor should the employee still employer still file a claim if the employee doesn't want to go to the doctor they're not going to have a diagnosis and a medical record skin without a diagnosis we really don't have a claim a legally filed claim for example the state of Arizona requires the employees signature on a document that document is most commonly the injured worker physicians report of injury which is completed by the provider as well as the injured worker so I would encourage you as I said during the webinar to investigate the injury the incident document it well and you know follow with that employee in a very short time period to make sure are you okay do you still just you'll feel that you don't need to seek treatment a minor you know minor bumps you know types of things you know that's okay if they have you know if they have a laceration if they if they're you know have loss of range of motion certain things back injuries really shouldn't wait to seek treatment I would encourage them to go to a provider a preferred provider hopefully one that you've worked with as a as an employer so they know what to expect let's see can employer reduce cost by continuing to pay their employees salary when they're on a no work status I already answered that question let's see to answer that question no I didn't again there's a simple answer to that it's also the same thing with the with the medical benefits carrier or self-insured employer responsible for paying those benefits employer payment would lead to the injured worker being double paid there's a few states that have statutes that do allow what they call continuance of pay to allow the employer to pay some of the upfront benefits but NCCI requires carriers in those states to report the indemnity paid by the employer as though it had been paid by the carrier so employer pay when it's allowed isn't going to offset the costs which get reported to NCCI for your emod calculation in addition employees or employers who continue to pay may not be fully compensating the employee for their loss if the individual doesn't work a set schedule or they don't have a set salary so their monthly or weekly wages can vary over 365 day period what the employer pays when their offer work may not be equal to the average monthly or average weekly wage which would be calculated to compensate them per the state statute which would leave your employee underpaid see can you assist us in finding the right providers in our area yes all the way may be restricted by certain statutes to direct care we do have resources to assist you with finding providers and creating medical panels both copper point and Pacific comp websites have access to provider networks for most of our covered States or your claims adjuster can help you let's see here's a good one what did you mean by saying employee morale to be impacted by the employers benefits when they're off of work or released or light duty well besides what I already mentioned about feeling cared for and supported by your employer you also have to consider your other employees the ones that aren't injured hopefully never will be injured but aren't injured our lost control team always talks about the hidden cost of claims perhaps you've been to a presentation where they show you the iceberg and talk about the hidden part of the iceberg that's below the waterline some of those costs are due to the fact that when you have someone out you have to provide someone else to cover that job so somebody that's already has a full-time job is pitching in to cover for the injured employee or you might have to hire a temp employee to fill in that impact impacts the employees productivity increases payroll costs and potentially the company's bottom line that's just one cost think about the employees who see their co-workers brought back to work and modified positions those are the ones I'm talking about with even than not injured employees by bringing back your injured employees you're showing all of your staff that you care about your employees you can give them the comfort that note in the event that they were to unfortunately have an injury you've got their back you've got them covered and you care about them where do I find all the online information that I keep on talking about well if you go to WWE comm you click on the claims incidence or claims and incidents drop-down it's on the orange bar to scroll down under the picture of the pretty lady and you'll see how to file a claim where to find a medical provider and our claims kit also on that orange bar you'll see links to resources here you'll find that portal user guides for claims system registration claims filing and online claims viewing this is also location of our safety materials educational materials and videos posters etc Pacific comp also has a wonderful website with valuable information again at WWDC I am calm so look for the dropdowns in there blue bar for broker policyholder and medical provider network information they also have an exceptional loss control team and resources to assist with brokers and policyholders you so that's all the time I have today for questions I'd like to close the session by commenting that once an injury occurs there are only so many ways that we can work to control those claims costs ultimately the best way to do this is by not having claims at all or at least by reducing their frequency and severity copper Point has an exceptional loss control team available to assist with customer focus loss control programs services and training solutions to our agency partners and insured clients they will partner with you to tailor and customize resources in order to achieve outstanding results which will lower your claims cost by mitigating losses our lost control consultants are also available to discuss state specific requirements for further information on how to control your cost please visit our website where as I mentioned earlier you'll find a learning management system streaming videos and printable materials to utilize for your business you'll also find the webinars we've presented in this series we would like to thank you for attending this installment of copper points educational webinar series a recording of this presentation will be available on our website and will also be a blog posted regarding what we've discussed today we'll be sending out a survey after the presentation and would appreciate any and all feedback you have finally our what next webinar will be on October 3rd and will cover safety committee meetings again by our exceptional loss control teams thanks again and have a great and safe day you