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Reserving 101 For Workers Compensation Claims


05/26/21
Michael Stack
Reserving workers compensation claim files is the art of predicating the financial cost of the claim and setting aside monetary values to cover payments until closing. Unlike other types of casualty losses, many factors are known very early in the workers compensation claim handling process.
Known Factor Examples:
The benefit payments are set by statute and state mandate with minimum and maximum values. These are published and adjusted annually. For example a temporary total benefit might be a minimum of $400 weekly and a maximum benefit might be $900.
Most formulas are based on 66 2/3 % of the employee s average weekly wage. Hence as soon as the wage is known the benefit rate can be calculated. Even if the state does not require them, all files should require mandatory wage statements from the employer. Failure to obtain wage statements allows for benefit calculations using like employee or projection of the employees daily wage at prese ....

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Ohio Injured Workers Cannot Reject Valid Light-Duty Offers


Wednesday, January 20, 2021
In the state of Ohio, a light-duty job offer is a strategic way to either bring an injured worker back to the workforce or bar temporary total compensation, should the injured worker reject a valid offer. Either way, it can aid employers in eliminating, minimizing, and/or stopping temporary total disability compensation from being paid in a claim. 
The Ohio Revised Code prohibits payment of temporary total compensation when work within the employee’s physical capabilities is made available by an employer. The Ohio Administrative Code outlines the requirements for a valid light-duty job offer. While offers will often be presented in person or verbally over the phone, it is always advisable to send a copy via certified mail to ensure proof of receipt. If a verbal light-duty offer is rejected, the employer must provide a written job offer at least 48 hours prior to filing a request to terminate temporary total benefits and supply the w ....

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