...Worker’s Compensation Claims Process January 21, 2012 HCR/230 Worker’s Compensation Claims Processing is necessary in order to cover an injured worker as timely as possible, and when done properly can have a significant effect on a company and the injured worker who filed a claim. The Worker’s Compensation claims process has several parts. The very first step of the claim process is reporting the worker’s incident to the employer and insurance carrier. This task must be done in a timely manner and should be in writing. There is a deadline for making a claim on an injury and it may vary from state to state. The next step in the claim process is the initial medical exam. The injured employee is sent to a physician. Usually, the physician is of the employer’s or insurance carrier’s choice, but there is an exception. The exception is an employee who specifically states in writing to the employer, that he or she wants their primary doctor to treat them for any injuries. The physician who first attends to the injured worker is now the “physician of record” and must be sure to properly collect and record certain information that will be needed for the worker’s claim. The physician of record is not only responsible for treating the worker’s injury, but also responsible for determining the percentage of disability and the return to work date (if applicable). Progress reports by the physician/provider to the...
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...Executive Summary Widget Production ISCOM/305 Systems Operations Management August 22, 2011 Mario Vaccari Executive Summary Widget Production Taylor Inc. is looking into improving the physical layout of the company in an effort to maximize productivity and reduced worker’s compensation claims. To do this management will need to analyze the current operations management process of the company and come up with two alternatives, which will help determine the best choice to maximize labor productivity for Taylor Inc. The cost-benefit matrix below will show which alternative management technique will maximize productivity with less worker’s compensation claims. Cost Benefit Matrix Current Alternative One Alternative Two Number of employees 17 6 9 Payroll costs per 8 hour day $5,848.00 $2,064.00 $3,096.00 Payroll costs per week $29,240.00 $10,320.00 $15,480.00 Payroll savings per week 0 $18,920.00 $13,760.00 Payroll costs per year (52 weeks) $1,520,480.00 $536,640.00 $804,960.00 Claims per year 4 0.3 1.9 Claims costs per year $436,000.00 $32,700.00 $207,100.00 Claims costs savings 0 $403,300.00 $228,900.00 Wages and claims per year $1,956,480.00 $569,340.00 $1,012,060.00 Wage and claims savings per year $0.00 $1,387,140.00 $944,420.00 Physical lifting in pounds 42 12 23 Capital expenditures $0.00 $1,300,000.00 $967,000.00 Cost difference in capital expenditures $1,300,000.00 0 $333,000.00 Outputs of finished widgets 208 392 288 Life in equipment 0 7 5 Wasted...
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...improve overall worker’s compensation workstation that includes; a) Shorten time between date of injury and date of claim resolution and eliminate over-payments. b) Reduce unallocated expenses by automating filing of state forms and form letters. c) Establish a strong competitive position through fully-automated telephone reporting capabilities and medical bill review. d) Establish the best customer service in the business. e) Maintain consistent, quality level of execution. f) Improve financial controls. g) And provide information to customers that demonstrates the value of Travelers' Loss Payout education Services. Worker’s compensation from the Commercial Lines Department has the largest share of market by insuring 50% of the fortune 500. Management always believed that worker’s compensation market requires additional innovative applications of information technology to improve customer service. In house Information Technology Department...
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...Concept of Compensation The literal meaning of compensation is to counter-balance. In the case of human resource management, Compensation is referred to as money and other benefits received by an employee for providing services to his employer. Money and benefit received may be in different forms-base compensation in money form and various benefits, which may be associate with employee, service to the employer receive or benefits, he enjoy lieu of such payment. Cascio has defined compensation as follows: “Compensation includes direct cash payment, indirect payment in the form of employee benefits and incentives to motivate employee to strive higher level of productivity”. Based on above description of compensation, we may identify its various components as follows: 1. Wage and salary. 2. Incentives. 3. Fringe Benefits. 4. Perquisites. COMPENSATION MANAGEMENT: Compensation management, also known as wage and salary administration, remuneration management, or reward management, is concerned with designing and implementing total compensation package. The traditional concept of wage and salary administration emphasized on only determination of wage and salary administration structure in organizational settings. However, over the passage of time, many more forms of compensation, as discussed earlier, entered the business field which necessitate to take wage and salary administration in comprehensive way with suitable change in its nomenclature . Bench has defined...
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...Characteristics of Workers’ Compensation Plans University of Phoenix FOOTING THE BILL HCR 230 Barbara Hopkins July 12, 2013 Workers’ compensation was developed to benefit both the employer and the employees. It provides employees who are injured on the job with compensation for their injuries, and it protects employers from liability for employees’ injuries (Valerius J., Bayes..L.N., Newby.C., Blochowiak. L. A., 2014,). Work-related illnesses or injuries suffered by civilian employees of federal agencies, Including occupational diseases they acquire are covered under various programs administered by the Office of Workers’ Compensation Programs. OWCP is part of the U.S. Department of Labor (Valerius J., Bayes..L.N., Newby.C., Blochowiak. L. A., 2014,). The four workers’ compensation plans that provide coverage to federal government employees are: 1. The Federal Employees’ Compensation Program 2. The Longshore and Harbor Workers’ Compensation Program 3. The Federal Black Lung Program 4. The Energy Employees Occupational Illness Compensation Program States provide two types of workers’ compensation benefits .One pays the worker’s medical expenses that result from work-related illness or Injury. The other pays for lost wages while the worker is unable to return to work. In some states, state benefits just won't be enough to help an injured or ill worker to survive...
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...humanistic principles. The main task of the designer is to enhance the quality of working life and the job satisfaction of the employee. In turn the achievement of these objectives will enhance productivity and yield added value to the organization. The second set reflects managerial values. Socio-technical principles are merely instruments for achieving primarily economic objectives. Humanistic objectives have no value in themselves but if their achievement produces a better performance from employees leading to the fulfillment of the economic objectives well and good. This paper will illustrate how the first principle proves to shaping the final outcome in Painter’s Case Study. The critical elements to drive the decision of the Worker’s Compensation Board were their workforce, the business plan, and employee development. The social system became the focal point in shaping the final outcome. Shaping the Final Outcome The socio-technical view of knowledge management focuses on a firm’s strategy for harmonizing activities with...
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... TXCOMP Multi-line Phones Organized • MS PowerPoint Citrix Filing Typing (35 wpm) WORK EXPERIENCE: TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKER’S COMPENSATION Claim Service Officer April 2008 – Present • Ensures the appropriate delivery of medical and Income Benefits and resolves disputes. • Investigates and resolves complaints • Monitors and enforces compliance with Workers’ Compensation Rules and Laws • Encourages timely Return to Work through education and disability management and return to work programs. Administrative Technician III May2004 – April 2008 • Answers walk-in and telephone customers' questions; provides preliminary information and general assistance in claims activities including providing brochures and forms. • Verifies, with injured worker's assistance, that claim information on mainframe computer screen is accurate. • Attempts to resolve disputes at all stages of the claim process. • Makes appropriate social service referrals to other agencies Clerk III September 2003-May2004 • Operates telephone switchboard console and performs receptionist duties. • Performs complex data entry work requiring complex work methods& procedures. • Enters and updates data from forms into various systems, updates injured workers or beneficiaries representative info into claim records....
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...analysis process used in problem-solving. Team C will use the IRAC method to present a case heard in the Oregon Supreme Court, Antonio Cortez v. NACCO Material Handling Group, Inc and Swanson Group, Inc. This case is currently pending in the Oregon Supreme Court. Facts Plaintiff worked for a lumber mill, Sun Studs, LLC owned by NACCO Material Handling Group. As the plaintiff walked from one area of the mill to another, a forklift hit and severely injured him. After receiving workers’ compensation benefits, the plaintiff brought an action against Swanson Group, Inc., which owns Sun Studs. The plaintiff alleged that Swanson was liable for negligently failing to require Sun Studs to provide a safe workplace and competent safety personnel. Issues Is the providing of worker’s compensation for the injured plaintiff by the defendants an exclusive remedy? Was the defendants’ negligent under the Employers Liability Law by not providing safety measures to the plaintiff? Rule Did the defendants breach the duty to provide a remedy for the injured plaintiff? Did the defendants breach the duty to provide safety measures under the Employers Liability Law? Analysis NACCO Material Handling Group, Inc and Swanson Group, Inc. owed a duty to provide a remedy in the form of worker’s compensation for the...
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...Dow Chemical Company, the plaintiff and another employee were fired for fighting on the company’s premises. The plaintiff sued for wrongful termination claiming he was defending himself and that the state’s public policy favoring victim compensation in cases of violent crime as a cause of action, the state also has common-law rule favoring at-will employment (Cihon, et al., 2015). In this case, the argument for wrongful termination is that he was defending himself, if the other employee has not started the fight he would not have been involved. The arguments against wrongful termination is that he violated company policy by engaging the employee after he began the fight. Under these set of facts, the plaintiff is entitled to receive unemployment compensation, however, his injuries do not warrant workers compensation as he did not need medical attention, therefore, if should not be factored into the wrongful termination...
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...rank-and-file workers versus that of its executives. Determine whether Allen could legally fire each of the three workers; Donna, Tom, and Ayesha. Suggest steps he should take to minimize the risks to his department and the company. Determine the whistle blowing opportunities, obligations, and protections that could benefit Allen. Assess PharmaCARE’s environmental initiative against the backdrop of its anti-environmental lobbying efforts and Colberian activities. Examine if this renders the company’s purported environmental stewardship better or worse and if the company’s public stance should carry an obligation to be a leader in environmental matters. Analyze the original purposes of and the changes to Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). Determine which provision(s) of CERCLA apply to PharmaCARE in the scenario provided Stakeholders are those individuals and groups that have an investment, share, or interest in an organization. In this scenario that includes PharmaCARE, CompCARE a subsidiary of PharmaCARE, Wellco a large drugstore chain which purchased CompCARE, PharmaCARE’s management and investors, and the African nation of Colberia. Analyze the ethics of PharmaCARE’s...
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...regulatory requirements in any organization is the most important law because the department involves developing, employing, utilizing, managing and understanding the staff in an organization. According to Gomez, Mejia, Balkin, and Cardy (2010) legal concerns can play an important role in staffing, particularly in selection. Many legal restraints, particularly federal legislation such as Department of Labor, the U.S. Equal Employment Opportunity Commission affects the Human Resource Management process. This paper will discuss the effects of legal, safety, and regulatory requirements have on the Human Resource Management process. Laws and regulatory requirements are currently in place for state and federal divisions to standardize and promote workplace safety. Organizations with extensive safety programs have reduced number of accidents keeping employees safe, decreased workers’ compensation claims and lawsuits and lesser accident-related expenditures for employees who go out under worker’s compensation. (Gomez-Mejia, et al, 2010, p. 511). The Human Resource Management department must take into consideration when hiring new employees the many legal requirements that are set in place by the United States government , state, and federal laws. The Civil Rights Act of 1991 prevents discrimination against race, color, religion, sex, and national origin. As a result, Human Resource management departments are responsible for ensuring that the varieties of methods are job related. The Americans...
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...NewCorp Scenarios Legal Brief Many organizations in the United States of America do not have the budget for staff counsel within their company. NewCorp is a business that has found themselves in legal matters and is seeking an assessment on ways to handle these circumstances from a consultant in the organization before refering matters to an attorney and incur costs. This assignment reviews three scenarios involving NewCorp. We will examine liabilities the organization and complainant are subject to as well as any statutory or case laws relevant to support the findings. Legal Scenario One Legal scenario one explains that NewCorp relocated an employee named Pat to manage the real property division of the business. After 90 days of employment NewCorp determined that Pat was not an appropriate fit for the position and terminated him with 30 days of severance pay. Pat feels as though he was wronged because he was not given the opportunity to improve through a corrective action plan as promised upon hire. Because of this, Pat believes that NewCorp should not be able to discharge him at will and believed that this action was taking place because of statements made outside the workplace. NewCorp and Pat both have rights in this scenario. Fortunately for NewCorp they are located in Vermont that is considered an “at will” state. This means that an employer can terminate an employee for any reason at any time as long as it does not relate to a Title VII protected class that includes...
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...reasonableness of behavior leads to a broad range of applications in everyday personal life (e.g., a person’s negligent driving of a car) and in business and professional contexts (e.g., an employer’s negligent hiring of a certain employee, or an accountant’s, attorney’s, or physician’s negligent performance of professional obligations).”(Business Law, ch 7) It does matter whether an employer has evidence that an employee poses a threat or danger to others. Even if an employee has only a reasonable suspicion, and negligence law does not require that we protect others against all foreseeable risks of harm, some dangers or harm can be avoided when an employer takes the proper steps and screens employees thoroughly before hiring. The screening process can make all the difference in protecting employees from any potential danger. In an article taken from the website nolo.com Employer Liability-Employees bad acts, hiring someone who poses a threat or danger to other employees falls under the idea of careless hiring and retention. “Under a different legal theory, someone who is injured by your employee can sue you for failing...
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...reasonableness of behavior leads to a broad range of applications in everyday personal life (e.g., a person’s negligent driving of a car) and in business and professional contexts (e.g., an employer’s negligent hiring of a certain employee, or an accountant’s, attorney’s, or physician’s negligent performance of professional obligations).”(Business Law, ch 7) It does matter whether an employer has evidence that an employee poses a threat or danger to others. Even if an employee has only a reasonable suspicion, and negligence law does not require that we protect others against all foreseeable risks of harm, some dangers or harm can be avoided when an employer takes the proper steps and screens employees thoroughly before hiring. The screening process can make all the difference in protecting employees from any potential danger. In an article taken from the website nolo.com Employer Liability-Employees bad acts, hiring someone who poses a threat or danger to other employees falls under the idea of careless hiring and retention. “Under a different legal theory, someone who is injured by your employee can sue you for failing to take reasonable care in...
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...facility being unionized. The legal issues and obstacles that this organization could encounter would be violation of EPA guidelines and procedures. In this particular organization the company could encounter Environmental problems that could elevate into fines or legal issues if not properly maintained. The company could also encounter safety and workman’s compensation claims for injuries and accidents that may occur on the facility. The company, being responsible for their employees, are responsible for the upkeep of the company and its equipment, without maintaining the facility and its equipment the company could face legal issues due to accidents or violation of employment laws and worker’s rights. The company could face legal action if preventing or interfering with a union. The federal laws that would be broken because of these potential legal issues would be the environmental issues regarding the EPA; this would also closely constitute and go along with state guidelines of the state EPA. When it comes to local laws, the company could be fined or charged with having violated the emissions and waste laws. By violating worker’s rights the company could face legal issues due to federal law. The union is also covered under law and it is unlawful federally to prohibit the organizing of a union. The recommendations I would suggest to minimize possible litigation would be to follow the guidelines set forth within the industry by the federal government...
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