Introduction to Claims Management

Two-Day Course | 13 Hours

On-Demand Video | Recorded February 3-4, 2021
Cost: $425 Members, $700 Non-Members

Level: Basic/Intermediate
Issues Covered: Validity | Medical | Compensation | Work Disability Prevention
Faculty Includes: Krishna Balasubramani, Esq. | Kevin Kincade | Julie Busch, MS, CDMS | Lloyd Brooks, WWCP

The second step in our IIU's comprehensive, goal-oriented workers' compensation curriculum, Introduction to Claims Management builds on the foundational elements learned in Workers' Comp 101: Industrial Insurance and Work Disability Prevention and focuses on the basic principles of adjudicating Washington workers’ compensation claims. This two-day course provides instruction on basic claims handling in the topic areas listed below.  Attendees will receive a link to electronic study materials for use in this and subsequent workshops.

Topics Covered

  • Washington's Statutory Framework: RCW, WAC, Medical Aid Rules, L&I Policy
  • Claim Adjudication Guidelines
  • Board of Industrial Insurance Appeals and Significant Decisions
  • Investigation of accidents and claims
  • Compensability of injuries and occupational disease claims
  • Apportionment of injuries
  • Communication with injured workers and other system participants
  • Management of the medical dimensions of the injury claim
  • Medical Aid Rules
  • Fee Schedules and Payment Policies
  • Management of the disability aspects of the injury claim, including leaves of absence and return to work
  • Reserving the cost of the claim
  • Closing the claim
  • Permanent Partial Disability compensation
  • Introduction to litigation and litigation management
  • Integrating investigation, medical, disability, and litigation management

 Attendees take both a pre and post-class quiz as a learning exercise and to measure the effectiveness of the instruction provided.

Pre-class Self-Study Reading Assignments:     
Chapter 1-4: Washington Administrative Code
Chapter 1-5: Medical Aid Rules and Fee Schedule
Chapter 1-6: Department of Labor and Industries Policies
Chapter 1-8: Return to Work
Chapter 1-10: Permanent Partial and Total Permanent Disabilities
Chapter 1-12: Labor and Industries Orders
Chapter CM2: Initial Investigation
Chapter CM3: Time Loss Compensation