“Medical-only” Claims

Businesses with no claims or “medical-only” claims in the experience period click here qualify for the Claim-Free Discount.

Nearly 75% of all claims are “medical-only” claims where only:

·         Medical Benefits are paid.

·         Stay at Work reimbursements are paid.

·         Both medical benefits and Stay at Work reimbursements are paid.

“Compensable” Claims

Businesses with compensable claims in the experience period do not qualify for the Claim-Free Discount.

Compensable claims include those claims for which the following benefits are either paid or are estimated to be paid at a future date:

·         Wage-replacement payments:

o    Time-loss payments: Payments made to a worker to replace wages lost from a work-related injury or disease, certified by a medical provider. Time-loss is not paid for the first 3 days from the date of injury unless the worker is disabled for 14 consecutive days.

o    Loss of earning power: Payments made to workers when they return to work with fewer hours or less wages due to their work-related medical condition.

·         Disability payments:

o    Permanent Partial Disabilities: Payments made to workers whose work-related injury or disease has reached medical stability and resulted in a permanent loss of function or an amputation.

o    Pensions: Payments made to workers who have been deemed permanently and totally disabled.

o    Fatalities: Any payments made when a work-related injury or illness results in an employee’s death.

For the 3 years that the compensable claim remains on your account, all claim costs, including the medical-only claims, are included in calculating your new rate. Because of that, one relatively inexpensive compensable claim can greatly impact your rates.

Claims only stay on your record for the 3-year experience period. When these claims drop off, and you have no other compensable claims, you will again qualify for the discount.

A business advantage :Claim-Free Discounts

The example below shows how employers who actively manage workplace safety and injury claims can lower their premiums.

Employer A and Employer B both started wood-framing businesses at the same time, starting with 1 full-time employee. They both started with the same experience factor, 1.000, and paid the same amount every quarter. As business grew, they both added employees until they each had 3 full-time employees. They took different approaches to safety.