Workers' Compensation in Montana - What Makes Us Different?
As of Dec 31, 2015, we have responsibility for 27,518 Workers’ Compensation Claims in Montana, representing in excess of $122,000,000 in Wage Loss, Impairment and Medical benefits. For the past decade, our combined average cost per claim (for Lost Time / Impairment claims) INCLUDING OUR FEES is nearly $50,000 PER CLAIM LESS than the largest writer of workers’ compensation insurance in Montana. During this same period, we have maintained an overall average litigation ratio of less than 1%. The mix of business that has led to such stunning results? Underground mining (including explosives). Oil field drilling and service. Restaurant. Healthcare. Construction. Retirement / Nursing Homes. Twenty-five to thirty Payroll Class Codes in what are thought to be some of the most dangerous, high volume, injurious exposure industries. Using common sense mixed with a home brew of old school techniques and millennial technology we have accomplished this with a staff to claim ratio about 1/4th that of claims operations handling similar lines of WC claims. Are we proud of our work and the results that we have achieved? Yep. Very much so.
How do we achieve these results?
1. Staff – We have the hardest working, caring, professional staff in the industry. Having managed claims in 35 states, Mike can say this will authority. Valued staff should be educated during their employment experience. We actually practice Continuing Education, 1 hour each week. From case law to changes in statutes to processes internally to new surgical techniques; 1 hour each week, everyone. We believe so firmly in the concept of CE that we actually wrote the law that is in place now for WC Examiner licensing and Continuing Education. We believe in CE. We believe in our staff. The MCSi / IIC staff is amazing.
2. Philosophy – We live our philosophy of humanizing the workers’ compensation claims process. We meet people. We talk with people. We listen to people. Consistent with the basic assumptions in workers’ compensation, we investigate claim / injury causation with a fair view towards compensability. We do our best to make sure that the recovering worker gets to the right doctor at the right time, and try to not allow the “system” friction get in the way of appropriate medical treatment. Treat people like you would want to be treated. We don’t always achieve full success on each and every point. But we try to keep the friction, bureaucratic delays and litigation tendencies out of the way of helping people get better and move on with their lives. Workers’ compensation is not a destination, for most it should be a short diversion that each can quickly travel and return to their “normal” life quickly.
3. Partnerships and Teamwork – Montana is a “full authority” state, meaning that the required in-state adjuster must have full, unlimited, unencumbered authority. We take that responsibility very seriously. Contrasted against stories we have heard about some organizations, we return phone calls, provide authorizations for reasonable and U&T compliant treatment, answer questions, pay bills. We could not do what we do, however, at the level of accomplishment that we do, without the buy in and support of our client organizations. It takes a team to remove the system bias for unnecessary delay…the client, the adjuster, the medical case manager, the treating doctor, the employer…and most importantly…the recovering worker. We acknowledge that adjusters/examiners are not miracle workers. We do however understand that they are the center of a complicated, ever-turning wheel where each stakeholder is a spoke in the wheel supporting where the wheel meets the road…the recovering worker. If any of the spokes are too short or too long, used inappropriately or broken, the primary collapse is at the level of the recovering worker. Our job is to make collapse (systemic delay or abandonment) NOT happen. With the help of our partners, clients, MCMs, Voc Rehab professionals, etc (the list is too long for this memo), our staff has been able to remove for the recovering workers that we have been involved with the key element that Dr. Christian speaks about at 60 Summits, “needless disability”. Thank you to the self-insured organizations and insurance companies that place their faith in our staff to handle their WC claims in Montana.