Introduction: Rationale

Recently, WCTL has launched a new program to Assist Employers with Self- Managed, In-House Claims Management Programs.


WCTL has worked with large employers in the Public and Private sectors for more than 20 years and has seen firsthand that the 80/20 rule clearly applies to disability claims – that is - that 80% of an employer’s claim costs are attributable to 20% of its claims.  Furthermore, WCTL has found that most in-house programs are effective in managing the 80% but lack the medical and legal expertise required to effectively manage the expensive, more complex 20%.  For most employers, the cost of employing in-house medical and legal staff to address the complex claims is not cost justifiable.


WCTL’s Claims Assistance program provides cost effective Medical and Legal expertise to augment self-managed, in-house disability management programs in the following key areas:

 

  1. Legal Representation on all Workers’ Compensation Appeals

  2. Medical opinion and documentation to support Cost Relief Applications

  3. Medical review and opinion on challenging/ complex claims with high cost potential


WCTL uses claim analytics to identify claims with the highest cost potential so that a set of criteria can be established that will determine which claims would be referred into the WCTL Claims Assist program.

Questions? Call us at 1(800) 562-7001