There’s very little publicly-accessible data about who reports work comp claims, via what channel. We just finished up a brief project for a client interested in comparing their data to national benchmarks, and we found precious little data on the topic. It may be out there, but it sure is hard to find…
We know the sooner claims are reported the better; there’s some good research out there altho arguably the best – the Hartford study – is dated. There is more info about the impact of delays in reporting on ultimate claim costs, which is certainly critical, but that’s “outcome” information. What we don’t know is the “process” information – which helps payers understand where they stand and what they can and need to do to improve.
Payers need to know when and who and via what channel claims are reported, by type of payers, states, industries, employer sizes, class codes – if they want to set goals, figure out where to put their efforts, who to target.
In general, we learned that the vast majority of claims are reported by employers via phone. Whilst many payers have web- or email-based reporting capabilities, these are rarely used. Some have developed smartphone-based reporting, but with a couple exceptions (very large self-insured employers) very few claims come in via this channel.
What does this mean for you?
Should we do a Survey of Work Comp Claim Reporting? I’m thinking this may be worthy of study; perhaps HSA should develop and conduct a quick study to gather some baseline intel on the current state of the industry.
If this makes sense to you, please say so in the comment section.
Thanks!
Joe,
I tried some years ago to find about reporting. Workers’ Compensation is only one of the reports which needs to be made when a serious accident occurs. You might want to ask a few employers about this, in different industries. You also need to ask what is meant by “reporting”. Often the first call is to the Emergency Services, and then to other investigating agencies. The adjuster will get called pretty quickly, but the “First Report of Injury” filed may be later than in a less serious accident, since in the serious case everyone is doing triage with multiple agencies and getting things done, with the reporting – the formal reporting – following later. This is actually a good thing. Its worth looking at. And if I can help, I’d be delighted.
John
Joe – the State of CA provides aggregated claims reporting for all self-insured public entities once a year. Might be useful.
http://www.dir.ca.gov/osip/PublicEntitiesAndJPA.htm
WC claim officers may receive dozens if not hundreds of reports a day, but most employer locations report one injury (or less) per year. The infrequency of employment-based injuries at the employer level is the reason why the reporting process isn’t more streamlined: it happens too infrequently at the employer level to build a better process.
I worked for a self insured fortune 500 company in Southern CA. I was also in management. I had a work related injury, filed out the proper forms and turned them into my HR department. I also received treatment for 7 months at an industrial clinic. It was not until I hired an attorney, 7 months later I found my employer never reported the injury. This happens all the time with self insured employers. I wonder what would have happened after a year went by, and SOL was up. I was receiving medical treatment, PT and MRI’s all paid for by my employer, but they never turned in my form to the WCAB.
Joe –
I you do take a look at this, you may also want to add who is taking in the information (traditional intake company, nurse intake) and the purpose of the data gathering (is it for FROI only, supporting initial investigation, medical direction of care, triage).
Joe,
Yes, pursue this. When my dispute resolution staff are brought in on “questionable claims”, it is not uncommon to find that the reporting of the injury by the employer was delayed in the hopes that the employee would recover without the need for formal medical treatment.
I was the product manager of a software system developed in 2003 that required both the SOURCE of the first report (agent, claimant, insured, doctor, regulator, other, etc), the MEDIA used to report it (paper form, telephone, web, fax, EDI, etc) and the dates associated with reporting. Some insureds (OK the staff doing the capture) did not see the value of collecting that information at that time though those were required fields in the software. So there is some data out there.