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WCB DISABILITY CLAIMS MANAGEMENT

*These programs can be paired with WCTL’s Nurse Triage program for enhanced results. Learn more by clicking here. All third party management programs are supported with legal and/or para-legal support when required. These programs require that all claims where an employee seeks external medical are reported into the WCTL claims management system. 
PRIMARY

ROI:2.5X

CLAIMS MANAGEMENT SERVICES ONLY

A Case Manager is assigned to manage the Employer’s claims utilizing a sophisticated database that collects and consolidates your safety and claims data to satisfy internal and external reporting requirements.


The Case manager acts as the conduit between the Employer and the corresponding provincial WCB to ensure claims are reported within the respective timelines then follows up with the WCB to advocate proper management and resolution of each claim.


An interactive online portal allows the Employer to submit claim information and access claims management status (and reports) quickly and efficiently. 

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HYBRID

ROI:3.5X

CLAIMS MANAGEMENT WITH SELECTED OR TARGETED MEDICAL MANAGEMENT

This program is a cross between the Primary and Full Medical management model. In addition to the claims administration offered in the Primary program, the hybrid program introduces Nurse involvement and an element of medical management in order to affect positive claim outcomes. 


The medical management initiatives in this model are not as comprehensive as in the Full medical management program but are prioritized in such a way that optimizes outcomes with the resources available. The focus is on minimizing paid claim durations and associated costs with an emphasis on challenging Time Loss decisions. (Continued on page 2.)

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FULL MEDICAL

ROI:4.5X

CLAIMS MANAGEMENT WITH FULL MEDICAL MANAGEMENT

WCTL’s most comprehensive program offers all the Primary Services combined with WCTL’s full complement of Medical resources deployed using defined processes and protocols. WCTL Nurses, Occupational Physicians and Specialists monitor the medical care of injured employees to ensure accurate diagnosis and appropriate treatment. Occupational Physician’s and or Specialists help establish Full Return to Work (FRTW) and Modified Work goal dates based on current medical information obtained from the employee’s attending physician and other care providers.  
The Nurse regularly (at least weekly) communicates with the employee and the various treatment providers throughout the life of the claim to help ensure that established recovery guidelines are met. (Continued on Page 2.)

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FINANCIAL EXAMPLES

PRIMARY FINANCIAL EXAMPLE

Approximate Cost per Claim:
 

 

Approximate ROI per Claim:
 

 

Total Cost Savings per Claim:
 

 

Less Cost per claim:
 

 

Net Savings per claim:

$500

 


2.5 x

 


2.5 x  $500  =  $1,250

 


$500

 


$750

HYBRID FINANCIAL EXAMPLE

Approximate Cost per Claim:
 

 

Approximate ROI per Claim:
 

 

Total Cost Savings per Claim:
 

 

Less Cost per claim:
 

 

Net Savings per claim:

$750

 


3.5 x
 

 

3.5 x  $750 = $2,625
 

 

$750

 


$1,875

FULL MEDICAL FINANCIAL EXAMPLE

Approximate Cost per Claim:
 

Approximate ROI per Claim:
 

Total Cost Savings per Claim:
 

 

Less Cost per claim:
 

 

Net Savings per claim:

$950

 


4.5 x

 


4.5 x  $950 =  $4,275

 


$950

 


$3,325

 

TYPICAL CLIENT PROFILES

PRIMARY
  • Physically undemanding industries (Retail, Banking, Administrative etc.)

  • Lower WCB Base Rate

  • Lower severity injuries

  • Multi Location/Decentralized/National

  • Minimal Disability Management (DM) personnel

  • Minimal internal DM Technology or Process

HYBRID
  • Miscellaneous Public & Private Employers

  • Some internal DM personnel & Process

  • Require medical and legal expertise

  • Require administrative technology/reporting

  • Unionized

FULL MEDICAL

  • Physically demanding industries (Oil& Gas, Construction, Forestry, Healthcare etc.)

  • Higher Wage businesses

  • Higher WCB Base Rate/Assessment industries

  • Higher severity injuries

  • Privately owned vs Public entities

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