Don’t let claims suck the lifeblood out of your business
After a claim occurs, the most frequently asked question from our Retro group members is, “How is this claim going to impact me in the future?” It’s best to know the answer to this question before a claim happens because a bad claim can suck the lifeblood out of your business.
Preventing time-loss claim expenses is the winning formula to limit a claim’s impact on your company’s future L&I premiums and Retro refund. There are two ways to achieve this goal:
Light duty return-to-work (RTW)
Your company can benefit from a proactive and efficient RTW program in three ways:
- First, keep the medical-only discount intact for each claim. For claims affecting employers’ 2023 experience modification factors (EMF), there is no impact on future EMF if the claim stays at or below $3,570* and only includes medical expenses. However, if L&I pays even as much as $1 of time-loss, the discount is lost.
* The $3,570 threshold typically increases approximately $100 to $120 each year, meaning if a claim happens today, it will first impact your EMF in 2025 with a threshold likely closer to $3,800.
- Second, maintain the claim-free discount on your L&I account. With a claim-free discount**, incurring a time-loss claim could result in the loss of your discount for up to three years! Typically, the cost of losing it most often outweighs the cost of preventing time-loss in your claim.
**If unsure as to whether you have the claim-free discount or might be close to earning it, contact your Claim Analyst and they will help you figure it out.
- Third, get reimbursed for light duty wages. The L&I Stay at Work program reimburses employers 50% of wages paid to employees working in a doctor-approved light duty position—up to 66 light duty days or $10,000 reimbursed, whichever occurs first. Funds are also available for training, equipment, and clothing necessary to perform the light duty job.
Kept-on-Salary (KOS)
Keeping your injured employee on salary is a good strategy to maintain the medical-only and claim-free discounts. It is appropriate when you’re working to arrange a light duty RTW or waiting for the healthcare provider’s approval to release the worker back to regular duty.
Though providing KOS is not reimbursable by L&I’s SAW program, preventing time-loss through KOS will usually be the most cost-effective option. Time-loss claim expenses make the most significant impact on experience rates and are the most expensive factor when it comes to the Retro refund calculation.
Therefore, developing an effective KOS/RTW program is the best way for employers to limit the financial impact of a claim.
If you’re interested in more information about creating an effective RTW program, or have questions about KOS, contact Chris Ristine, Director of Retro, at (360) 200-6456 or [email protected].
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