Claims Manager saves Retro pool from a financial loss
Nancy Barnes, RS’ Claims Administration Manager, shared an example of how she works to save potential losses of funds from the Retro refund pool.
An injury claim from last December originated when an employee complained of back pain from walking while on the job. The employee’s doctor diagnosed a lower back strain, probably from walking. Nancy challenged the claim and asked for a review by Labor & Industries’ Occupational Nurse Consultant. Nancy also quoted the Revised Code of Washington to submit that the man’s injury, as described in his claim, was not considered an injury according to the circumstances and definition for injury in the code.
Labor & Industries rejected the claim. Had it not been, it would have diverted more than $3,000 from the Retro reserve fund for premium refunds. Eliminating these sorts of overpayments saves costs for employers and employees who share in workers’ compensation insurance premiums in Washington State.