Dear Work Comp Coach – What about Experience Modification Rate Calculations and How do the Insurance Carriers Work?

Dear Work Comp Coach – What about Experience Modification Rate Calculations and How do the Insurance Carriers Work?
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“ I am reaching out because I recall you mentioning workers comp. due to a personal experience. I am preparing to learn as much as I can about how the system works, not just for the protection of employees but to fully grasp workers comp. I want to know how the experience modification rate is calculated and how the insurance carriers work. Are you familiar with that side of WC?” - HR Newbie

Dear Gentle Human Resources Newbie:

Good to hear from you! I am currently taking a few online courses to put finishing touches on an eCourse and eBook on WorkComp Survival and Virtual Combat Skills! Watch for it! 😊 Deja Vu! "Vocational Rehab" :D OnLine and OnTime!

Workers Compensation does NOT WORK, nor is it an employee benefit.

Work Comp is one of the most dangerous and expensive systems in America, which also curiously overrides civil rights and human rights. It operates on a business model of PROFITS BEFORE LIVES. It is falsely purported to be a non-adversarial ‘Grand Bargain.’

Yes, my experience was horrific and quite typical. Fortunately for me, the parties in my case 'reached resolution subject to a confidentiality agreement" in less than five years. Dealing with a brain injury (aka Concussion) will be my experience 'till last gasps.' Compensatory strategies a degree. Improvements have been measurable with the increasing distance from the Workers' Compensation systems.

Worker’s Compensation is a national problem of hyper corruption that too often costs injured workers their jobs, health and lives. It costs employers lots of money including the loss of valuable employees. It puts undue strain and burden on State Disability and Social Security Administration systems. The Magic Math alone sends SSA into a full tilt mode.

It is a mega billion-dollar industry, and the only losers seem to be the injured Workers and their employers and their families and all American taxpayers. Congress is fully aware of the national concerns but apparently, members do not ‘care enough’ to take corrective action. Some would call that a failure to represent their constituents and failures do their jobs.

California is particularly troubled with hyper corruption, from industry leased doctors to political representatives looking the other way, and a host of unclean hands.

That said, if you are in a position that you can help employees and your employer, I can direct you to some resources that can fill in the gaps for you.

There are approximately 25 industry blogs that mold and shape public opinion and disinformation. In those crowds some people of goodwill can be found.

I have 2 blogs that include resources and awareness issues. (see the resource page there)

In 2015 NPR and ProPublica did a series of articles on Worker's Compensation in America called Insult to Injury: The Demolition of workers compensation. [Google It!]

It was a series of investigative reports that truly rattled the industry. If you are in human resources, it is a series you MUST be familiar with.

Those investigative reports incited a letter from 10 members of Congress last October, directed to the secretary of the department of labor, offering among other things, additional law-enforcement, if that was deemed necessary to protect Injured Workers and other taxpayers. Let’s hope for an update this month as the issues are escalating daily.

All of the foregoing will definitely impact experience modifiers. Some of the carriers are more dangerous and expensive than others.

I hope that helps. I'm currently working on the ecourse and finishing up the e-book on surviving workers compensation. I do some pro-bono coaching with Injured Workers who are unable to find competent legal representation, to maneuver through the system that fails all but the least injured.

The digital products may become a handbook for the human resources community as well as for the ‘gutless leadership’ in the world of lawyers purporting to represent injured workers across America.

Interviews and webinars with experts and survivors are planned for the new year. We’ll attempt to provide a platform for attorneys who have failed the Injured Worker populations across America for so many years to begin to take actions to save face while saving lives.

One very important simple strategy that all employers can easily implement to keep costs down is to send a get well card to any injured worker, and designate someone in Human Resources to follow up to ensure the treatment is happening and that all efforts are being made to help the employee recover and return to work, when and if possible.

Failures by Human Resources staff to show concern and compassion contribute to litigious and costly delays.

Lack of familiarity with safety standards and training and guidance on when to call 911 by management staff also contributes to expensive and dangerous issues.

There are more than 8.9 million injured and disabled American workers shifted to the coffers of Social Security as a further consequence of the failures of Worker's Compensation, and it's cost to labor and corporate America. Review the Social Security Trustee Report 2016 for more details.

That may be more information than you are currently seeking, but if your intention is to save your company money and protect employees, understanding the big picture can be helpful.

Bookmark or follow my blogs…I write about things that industry experts only whisper about.

A noted ‘industry expert’ responded to Your WorkComp Coach’s invitation to guest blog on topics of inciting mediation and settlement. The response is telling, isn’t it?

"Linda while you are obviously well intentioned, your perspective is distorted. The vast majority of workers comp patients are treated fairly and well. A few are not. Your efforts and PP's denigrate and insult the hard work and diligence of many very good people in the workers comp industry." – Anon

The following blog discusses the question:


Something is terribly wrong with Workers’ Compensation, isn’t it?

Feel free to let your WorkCompCoach know if you have further questions. Till then, blog on and #DodgeTheRads!

#DodgeTheRads and think locally * act globally * occupy virtually

PS California WorkComp is bad enough! If you think Florida Workers' Compensation is BAD, google Florida Sink Hole and read about the 18.6 million poisoned --- and how hushed it has been. At least in Workers' Compensation, all the deep dirty dark secrets are OPEN SECRETS....widely known, widely ignored; no surprises there.
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