Tactics vs. Strategy

Tactics are steps you take to win short term goals on the way to achieving your strategic objective. Sometimes tactical skirmishes distract workers compensation professionals from pursuit of their strategic goal. On the other hand, you can’t reach your strategic objective without well-thought-out tactics. The Disputed Doctor’s Deposition Take the case where an attorney insisted […]

Understanding Insurance Reserves

Understanding insurance reserves can help settle a claim. A reserve is a pot of money set aside to pay for a specific expense category. Typically, there are separate pots for indemnity, medical and med-legal expenses. Sometimes a negotiator finds that a claim can be closed for an amount more than remains in the indemnity and […]

Ghosts, Goblins and Mediators

Halloween is just around the corner, a time when people love to be scared. It’s fun, because everyone knows there’s really nothing scary at all. Mediation isn’t scary. Yet some Workers Compensation professionals fear it. Fear of losing control Adjusters and attorneys know their jobs. They may bristle at the idea of someone else getting […]

How Medical Identity Theft Affects Claim Resolution

Medical identity theft occurs when a thief obtains treatment using the victim’s social security number or health insurance identification number. Authorities also report arrests of care providers who have stolen medical identities and submitted bills for treatment they never performed.  Cyber-attacks on medical data have produced a market for this kind of information. Treatment  A […]

Teaching Risk Management to an Eight-Year-Old

“Grandma, why did you move my chopsticks?” My extended family was dining on Cashew Chicken, Mongolian Beef, and fried wantons. Without missing a beat I answered, “Well, Ashley, I’m all about risk management. I noticed your chopsticks were sticking out over your lap, and there was a risk you or I might knock them to […]

Get “In Pro Per” Claims Off The Books

You know the claims I’m talking about: the really old claims where the Injured Worker is representing himself/herself. Let’s call them “in pro per”s.  Active in pro pers file one court paper after another, causing the insurer or self-insured employer to fund what seems like a never-ending stream of money to send a representative to the […]

Are You A Rule-Breaker?

Workers Compensation professionals have to know a lot: the California Labor Code, Title 8 regulations, state and federal rules governing health care entitlements. To make things even harder, the rules of this highly-governed road keep changing. Workers Compensation may be the most intricate, heavily regulated area of practice. These rules can constrain the parties’ ability […]

HOW POLITICS DRIVES UP THE COST OF YOUR MSA

For President George W. Bush and Congress to get Medicare Part D drug coverage passed in 2003, they had to make significant concessions to big business, including the drug industry. One of the law’s provisions forbids the government from setting rules for negotiating better drug prices. The “noninterference” section says: In order to promote competition […]