Difficult workers compensation injuries and claims can have a dramatic people, business and financial impacts that can cause problems for your customers/clients. ABILITY GROUP specialises in providing a variety of injury and claim management related services that assist businesses and brokers navigate the complexities of workplace injuries and workers compensation claims in achieving favourable outcomes and allowing them to focus on their core business. As an example, 9 months after the original injury ABILITY GROUP was engaged to assist a client with a difficult workers compensation claim. Our client had typical time pressures and with the injured worker continuing to be paid, claim costs were escalating.
Difficult Claim Intervention – Case Study.
Difficult claims can have a dramatic impact on your business, people and customers/clients. ABILITY GROUP specialises in Injury/Claim management to achieve favourable outcomes and allow clients to focus on their core business.
CASE STUDY: Injured worker had a physical injury incurred in a workplace, however their treatment and return to work was complicated by drug & alcohol issues. These circumstances subsequently resulted in psychological concerns that represented a much larger liability for our client as the insurer indicated they were a related outcome of the original injury.
Our client was busy running their successful business and assumed the insurer would naturally question the injured worker on their behalf. The insurer processed the claim in accordance with legislation guidelines and continued to pay wages. Communication channels progressively broke down between the insurer, client and injured worker causing further complications. ABILITY GROUP was asked to intervene and after reviewing the claims historical details, our Injury/Claim Management Specialist identified a number of issues.
ABILITY GROUP actively worked with insurer and the various medical professionals in order to successfully separate the physical and psychological issues. Our Injury/Claim Management Specialist developed strategies and new claim goals before actively managing the process required to ensure desired outcomes were achieved. ABILITY GROUP identified medical evidence supporting the physical injury has ceased allowing the claim to be closed and more importantly in doing so avoided the psychological claim from progressing.