Claims manager reduces the injury liability of a member
Manager of Claims Administration Nancy Barnes reduced the injury liability of a Retail Services member by challenging how Labor & Industries calculated the liability.
In figuring liability for the carpal tunnel injury, L&I reviewed only part of the claimant’s work history.
Barnes protested the claim and asked that an attending doctor also consider the claimant’s prior employers where the claimant was doing similar work. After the doctor reviewed the claimant’s entire work history, L&I removed the liability of the claimant’s last employer, one of our members, in full.
Barnes said a lesson from this case is that Retail Services cannot always accurately predict the cost of a claim or the savings that may result on initial review. In the end, this case became a bigger win for the RS claims management team because the claim went on to become much more costly than originally thought.