Prevent OH Claim Delays with Workers' Compensation Case Management

Navigating the often-confusing and time-consuming process of workers’ compensation can be overwhelming for Ohio employers and employees. Reporting the incident immediately after an employee has been injured is vital for ensuring timely payment. Fortunately, with the help of a third-party administrator who does workers' compensation case management, claim delays become rare, and employers’ costs can plummet. This type of professional has years of experience with the ins and outs of workers’ compensation in Ohio. With their help, you can ensure that your employees fulfill their case obligations, leading to reduced costs for you.

A case manager plays a pivotal role in helping employers and payers navigate any claim obstacles, while also managing return-to-work outcomes and keeping all costs in line. They establish trust and set measurable goals that help the injured employee commit to their recovery. This makes hiring a workers' compensation case management company a valuable asset for any business.

Common Reasons for Workers' Compensation Claim Delays

To receive compensation quickly and resolve your case in the shortest amount of time, you must have the proper documentation. It helps to streamline the process from the beginning.

There are many reasons that a workers' comp case can be delayed, but someone specializing in workers' compensation case management can work through them all, including:

• Incomplete/missing paperwork: This causes significant delays due to the volume of claims processed daily.
• Medical documentation problem: This includes an incomplete finding or record or a missed appointment.
• Insufficient evidence: When the proper paperwork isn’t sent, the claim is delayed if additional information is requested.
• Pre-existing conditions: If the employee has a pre-existing medical condition related to their injury, additional testing may be requested because it can delay recovery, lengthen missed time away from work, and increase medical costs.
• Claim discrepancies: This may involve conflicting statements about how an injury occurred or a lack of witnesses.

Hiring a workers’ compensation case management company enables you to anticipate any of these potential issues and keep employees on track for the quickest possible compensation.

Responsibilities of a Workers' Compensation Case Management Team

Hiring someone experienced in workers’ compensation case management can streamline the process, reduce costs, and improve outcomes related to recovery and a return to work. Getting the case approved is only one of the many responsibilities of your case manager.

For Employers

A workers' compensation case manager is responsible for serving as the liaison between an employer and their employee when an injury occurs. Their responsibilities with the employer include:

• Educating and guiding them on state insurance programs in Ohio
• Defending them with legal representation when needed in front of the Industrial Commission of Ohio regarding claim matters
• Predicting future premium costs based on how many claims are made
• Consulting with employers through their case management strategies to keep costs down
• Providing any needed audit support

For Employees

The responsibilities of your company’s workers’ comp case manager on the employee’s side include:

• Acting as a liaison between the injured worker, employer, insurance, and medical providers
• Coordinating medical treatment and rehabilitation to help facilitate a safe return to work
• Identifying challenges early on to prevent the need for a costly intervention
• Controlling costs by anticipating issues like delays in the process and any unnecessary medical treatment
• Facilitating return-to-work plans, sometimes with transitional or modified duties to get them back to work sooner
• Preventing unnecessary visits or treatments and ensuring that employees get appropriate and efficient care, which saves employers money

A successful workers' compensation case management team keeps everyone informed and aligned, which helps streamline the process. They're an advocate and have your best interests in mind, so your bottom line is always at the forefront. Having a workers' comp manager also creates a culture of understanding in the workplace, as employees feel that if they get injured, there is someone invested in helping them.

When Is Workers' Compensation Case Management Imperative?

Using a workers’ compensation case manager is vital for any claim or injury. In Ohio, there are many instances where using a workers’ compensation case management firm is valuable, including:

• The claimant has had other injuries.
• It’s approaching their time to return to work, and there’s no indication that they’re coming back.
• There are many physicians on one claim.
• The treatment differs from what is recommended in the guidelines.
• The injury involves a major joint or body part that limits function or mobility.
• A catastrophic event occurred, resulting in burns, amputation, or paralysis.

Streamline Claims with a Workers' Compensation Case Management Service Today

Compensation Solutions, Inc. (CSI) is a full-service third-party administrator specializing in workers’ compensation in Ohio. With a proven reputation for offering risk management and cost containment services, it can minimize your business’s future premium liability.

Employers in any industry can benefit from a successful workers’ compensation program. Unfortunately, the claims can sometimes have detrimental effects, such as increased costs. With the help of CSI, you can manage claims to help minimize future impact. Its team gives the employers the peace of mind that their workers’ compensation claims will be handled professionally and efficiently and that the employees will receive the medical treatment and stability that they need to recover as quickly as possible.

Managing workers' compensation claims in Ohio shouldn’t be a headache. Partner with CSI to take the hassle out of claims, lower costs, and stay compliant with Ohio BWC regulations. Focus on your business and employees, and let our seasoned experts guide you through the complexities of workers' comp. Contact us today to streamline the process and experience stress-free claims management!