Introduction to Claims Management

Two-Day Course | 13 Hours

On-Demand Video
Cost: $425 Members, $700 Non-Members

Level: Basic/Intermediate
Issues Covered: Validity | Medical | Compensation | Work Disability Prevention

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

As a condition of Labor & Industries approval for on-demand/self-study courses to satisfy the requirements of WAC 296-15-350 and 360 for state certification, we are required to have on-demand/self-study WWCP participants who intend to sit for the state certification exam complete an attestation form for each course in the curriculum verifying full participation, and successfully complete a brief quiz on the material covered. Each course quiz must have a 80 percent correct rate, and can be completed while reviewing the recording if necessary.