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Moore: Adjuster Reviews Save Later Headaches

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One of the most reviled forms in the claims process is the workers' comp wage statement.

James Moore

James Moore

Many states require very complex forms to be filed by the claims departments.  Employers usually like them even less. The term “necessary evil” comes to mind on what can be a large task. 

An article on the definition of wage statements can be found here

Then again, in many of the files I have reviewed, the workers' comp wage statements were never reviewed or questioned by the claims staff. The state will process whatever is sent.  

Once a wage statement has been calculated by the workers' comp commission, changing it becomes very difficult. The commissioner or judge may sometimes increase the wage if the injured employee questions the figures.   

An example of one of the more complex wage statements is from North Carolina, a Form 22-Statement of Days Worked and Earnings of Employee. The total blanks to fill in approach 400 in number. Some state’s wage statements are much simpler.   

I am not picking on North Carolina. But the wage statement form from New Hampshire, for example, is not as involved to complete.  

Use Google to find your respective state’s wage statement form. You may have to look further down the page to find it.

Workers' comp wage statement nightmares

Why am I covering this boring topic? Over the last few months, the situations that I have seen pop up several times involve the employer not completing the wage statement, or an inaccurate statement was filed and accepted by the state. 

 Two examples:

  • The employer did not complete the wage statement before the case went to a hearing on many subjects, including a wage rate. The employee was earning $400 a week, according to the first report of injury. Because no wage statement was filed, the judge assigned the state’s maximum rate. What was a $400-a-week rate became $1,250 with an associated comp rate of $833.38. Wow!
  • The employer completed the wage statement incorrectly. An obvious mistake was made. The very busy adjuster filed the wage statement without doing a cursory review. What should have been a $225-per-week compensation rate turned out to be $415. The employee was declared to be permanent/total with lifetime benefits. There was no way to change the overpayment rate of $190 per week for lifetime benefits. 

Bottom line: Workers' comp wage statements may be a pain to complete and review, but doing both of those tasks will result in the employee being paid fairly and timely.  Ignoring the wage statement’s importance can be very costly.

This blog post is provided by James Moore, AIC, MBA, ChFC, ARM, and is republished with permission from J&L Risk Management Consultants. Visit the full website at www.cutcompcosts.com.

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