Rancho Mesa's Media Communications & Client Services Manager Alyssa Burley and Account Executive Casey Craig discuss how employers can handle cumulative trauma claims.

Show Notes: ⁠⁠Subscribe to Rancho Mesa's Newsletter⁠⁠.

Director/Host: ⁠⁠Alyssa Burley⁠⁠

Guest: ⁠⁠Casey Craig⁠⁠

Producer/Editor: Jadyn Brandt

Music: "Home" by JHS Pedals, “News Room News” by Spence

© Copyright 2024. Rancho Mesa Insurance Services, Inc. All rights reserved.

Transcript

Alyssa Burley: Welcome back, everyone. My guest is Casey Craig, Account Executive with Rancho Mesa. He specializes in providing commercial insurance for paint, plaster and drywall contractors. Today, we’re going to talk about how employers can handle cumulative trauma claims.

Casey, welcome to the show.

Casey Craig: Thanks for having me.

AB: Of course. Now, we know that there is a rise in worker’s compensation cumulative trauma claims or CT claims. Will you give us a brief overview of what these types of claims are?

CC: Yeah sure. So, cumulative trauma refers to the ongoing psychological or physical injuries that accumulate over time, often resulting from repetitive stress or exposure to adverse conditions.

AB: Ok, so these types of claims are not a result of one incident, but minor traumas that over time, turn into a larger issue.

CC: Yeah, and the employees missing time due to cumulative trauma can lead to larger workers’ compensation claims, lower moral and cause less efficiency. It can be easy as an employer to take a defensive stance and fight every one of these but there are a few factors that need to be taken into consideration prior to deciding if you should settle or challenge these claims.

AB: Good point. And how does an employer know if they should settle or fight the claim?

CC: Yeah not every claim should to be fought. As hard as it is to hear, you can win the battle but lose the war. Sometimes the cost of gathering information, medical reviews, time spent away from operations and litigation can add up to more than it would have cost to settle these claims.

Getting a CT claim denied is extremely tough to achieve in construction as the burden is on the employer to prove that there is no way that their stated injuries could have happened while working for you.

AB: All right, so, what do you recommend employers do?

CC: Employers can proactively fight CT claims by staying ahead of the exposures as much as possible. This means making sure your workers have the safest, most ergonomically-friendly environments possible. Stress and repetitive motion are two of the largest causes of CT claims. So, trying to keep your employees from doing the same repetitive tasks over and over is extremely important in keeping both moral high and frequency of claims lower.

This can be difficult for most construction companies with the need to perform the same motion over and over, but it is necessary to have your employees switch up tasks if at all possible.

AB: Now, if the employer does all that they can to prevent CT claims, but it still happens, does that mean that they should just settle?

CC:  No, it doesn’t mean that every cumulative trauma claim should be settled. These post termination claims typically come with an applicant attorney and can include multiple body parts being named that appear initially as fraudulent statements. If it is determined that there truly was no record of injury and they are able to perform all normal duties, fighting the claim might make sense.

AB: So, it does just depend on the unique situation?

CC: Yeah, each claim is unique and should be handled as such. Relying on your insurance broker and carrier claims consultant for guidance is critical in staying focused on the facts, not the frustration and emotions that can accompany these types of claims.

While settling a claim that could be fraudulent can be frustrating and does have an impact on your experience modification rate, it is often the best path towards minimizing costs and maintaining lower loss ratios that lead to the lower renewal premiums, which is the ultimate goal.

AB:  Right. And employers can lean on their broker and carrier partners to guide them through the process. Now Casey, if listeners have questions about how to handle cumulative trauma claims or manage their company’s overall risk, what's the best way to get in touch with you?

CC: You can reach me at ccraig@ranchomesa.com or (619) 438-6900.  

AB: All right, well Casey, thanks for joining me in StudioOne™.

CC: Thanks for having me again.