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Greater efficiency in handling workers’ compensation claims can contribute to a reduction in claim costs and improved claim outcomes. These gains are quickly undone when errors result in penalties for the violation of state-specific workers’ compensation laws.

According to the article Avoid Workers’ Comp Penalties and Other Pitfalls, two of the five most common errors that result in penalties occur when filing First Report of Injury (FROI) and making mandated benefits payments to claimants. The use of workers’ compensation technology solutions can reduce the likelihood of making these errors, in addition to streamlining the claims process.

1. Simplify the process of completing First Report of Injury (FROI) forms

As mentioned in Improving adjuster efficiency and accuracy with an integrated forms solution, the process of locating a workers’ comp form and then keying claim details into form fields for every claim can be tremendously inefficient. This administrative burden reduces the time available for staff to engage in other activities that can have a positive effect on claim outcomes. This approach to populating forms also has the potential to add costs, including fines for late filing, errors, or the need to correct and resubmit forms.

The article states: “A reliance on manual data entry increases the likelihood of error and exposes the organization to the costs of bad data. In most cases, the work is also duplicative, with claimant and accident details having already been keyed into the claim system.”

The submission of inaccurate or incomplete claim details in the FROI can have consequences beyond the potential for incurring penalties. In the article First Report of Injury Accuracy Critical for Workers Comp Success, Rebecca Shafer, an expert in the field of workers’ compensation, points out that multiple parties typically use the information in the FROI when setting up their workers’ compensation files. As a result, even minor errors on the reports can be copied, creating complications down the road. And while these errors can be fixed by re-submitting a corrected form, Shafer writes that doing so “is a waste of time for all the parties involved. Plus, when the First Report of Injury is inaccurate or incomplete, it can often be exploited by the employee’s attorney.”

The Forms & Correspondence application from Origami Compliance integrates with any claims management system to put the current version of state and federal workers’ compensation forms right at your adjusters’ fingertips. While working in the system, users can quickly find and select the right form. Then, based on mappings defined during the implementation process, claim information is automatically merged into the appropriate form fields.

Adding to the solution’s usefulness, custom forms and letters—for example, paperwork and guidance that must be provided to an injured employee—can be added to the library to provide adjusters with access to a single, comprehensive document generation system.

2. Include a workers’ comp reporting failsafe

As the article What’s next when it comes to workers’ compensation compliance? points out, “taking a close look at the procedures and best practices used by adjusters—to determine where the potential for delays can be significantly reduced, if not eliminated altogether—is essential to reducing the cost of claims and improving outcomes.” Among the factors to be considered:

  • Do adjusters always know when submission/resubmission of a specific state form is required based on changes to claim data or date-related events?
  • Is there an explanation of why a form must be submitted/resubmitted?
  • Are adjusters clear on the action to be performed next?

Including detailed instructions in adjuster action plans, or in claim tasks and diary notes can be helpful. Even so, given the caseloads of busy adjusters, this approach can result in details being unintentionally overlooked.

Origami Compliance designed the Forms Compliance Check application to seamlessly integrate with any claims system to enhance the workers’ compensation forms submission process. The customizable rules engine of the Forms Compliance Check continuously monitors changes made to claim data and automatically alerts adjusters when the submission (or re-submission) of a state-specific workers’ compensation form is required, informing them what triggered the alert and when the updated form is due.

3. Make it easier for adjusters to find specific workers’ comp rules, rates, and regulations

State-specific workers’ compensation rules, rates, and regulations to which adjusters must refer in the course of their day often lie deep within the pages of byzantine agency websites. This includes what Michael B. Stack refers to in Avoid Workers’ Comp Penalties and Other Pitfalls as critical information for an adjuster to know in order to avoid late-payment penalties: “the first day of disability, when the employer received notice of the injury or disability, if the employer is paying the ongoing employee wages, and requirements regarding the payment of wage loss benefits.”

Origami Compliance’s Workers’ Compensation Search tool makes it easier for adjusters to find the most up-to-date, state-specific workers’ compensation requirements by providing adjusters with the ability to quickly search across an indexed library of more than 9,000 workers’ comp rules, rates, and regulations.

A team of compliance experts keeps this library updated. This means that adjusters can depend on current and accurate information. The solution can also be configured to give adjusters immediate, in-system access to an organization’s proprietary content, such as claims handling instructions and best-practices guidelines.

As with the Origami Compliance applications previously mentioned, Workers’ Compensation Search is available as a bundled solution or standalone offering that seamlessly integrates with any claims management system via a secure API.

Improved efficiencies, reduce exposure to penalties and fines: a workers’ compensation claims win/win

Origami Compliance solutions can be used to streamline your workers’ compensation claims process. Each solution integrates, seamlessly and securely, with any claims management system to facilitate faster and more accurate reporting and reduce the amount of time it takes to find the answers to questions related to workers’ compensation laws, indemnity benefit rates, and more.

Speed up the process of finding and completing forms; put into place automated monitoring and alerts that indicate when a new, or corrected, form is required; and make it easier for adjusters to find the information they need. This reduces the likelihood that errors will be introduced, that changes made to a claim will be overlooked, or that outdated information will be used when making decisions. In turn, this leads to fewer penalties. Furthermore, with the time saved, adjusters can focus on providing superior service to claimants, improving claim outcomes, and enhancing the reputation of your business.