Bits & Pieces Definition The "arising out of employment" requirement addresses the causal connection between employment and injury. An injury arises out of employment when the employment exposes the worker to a risk that contributes […]

Back to Claims School A strong fraud investigation begins long before anyone is caught doing anything. It begins when a claims professional recognizes that the available information requires closer examination and responds with discipline. The […]

The First 72 Hours of a Lost-Time Claim Purpose The first 72 hours largely determine whether a claim becomes: This playbook provides a structured approach to investigation, communication, medical management, and documentation. Claim Profile Scenario […]

Back to Claims School Jim Frerking has spent his career seeing workers’ compensation from several sides of the industry. He has worked for a large insurance carrier, a major property and casualty broker, and now […]

Back to Claims School A workers’ compensation claim can gather people quickly. A nurse case manager enters the file. Transportation is arranged. Equipment is delivered. An interpreter joins a medical appointment while a rehabilitation professional […]

Back to Claims School Hope Remetta, CLMP, has spent 21 years in workers’ compensation developing the judgment required to manage some of the industry’s most difficult claims. She serves as Director of Catastrophic Claims for […]

Back to Claims School A claim can remain open for years and still lack a clear sense of direction. Medical appointments continue, reserves receive periodic review, and conversations repeat without moving the parties closer to […]

Back to Claims School Julio E. Martinez never planned on building a career in workers’ compensation law. He graduated from UCLA with a degree in Neuroscience and originally expected medicine to be part of his […]