Since presumption laws related to COVID-19 vary by state, it’s important for workers comp adjusters to know how to approach the clinical records and files to ensure accuracy in their claims. With legislation related to the virus and workers compensation changing every day, it can be difficult to appropriately determine compensability in workers comp claims with all the variables at play. This is why it’s crucial that workers comp adjusters utilize a comprehensive Early Compensability Assessment (ECA) within the first 60 days of evaluating a workers comp claim to establish what the injury is and – more importantly – what it is not.
ECA’s can help adjusters determine early on in a claim what components of the reported injury are compensable and which items should be contested, saving time and money on treatments, surgical interventions and ongoing therapy.
During an ECA, C³’s team of expert physicians – who specialize in various clinical fields – apply the standards of evidence-based medicine to determine what issues are a function of the event and those findings that have not been aggravated, exacerbated or otherwise compromised by the compensable event.
C³’s early compensability assessments are proven to significantly reduce claim expenses as well as expedite the overall claim process for adjusters.
All adjusters should consider an early compensability assessment within the first 60 days of evaluating any new claim, especially during this unprecedented pandemic. In order to be certain that there are no unanswered questions or unaddressed issues, an objective opinion should be obtained. Early Compensability Assessments provide these necessary clinical perspectives that bring a medical, evidence-based approach to file review. With this detailed, concise report, completed by specialized physician providers, adjusters can effectively mitigate claim costs, save time and ensure that all files are evaluated with the utmost attention to detail and accuracy.