American Association of State Compensation insurance Fund
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member fund.


CopperPoint Mutual Insurance Company
Phone: (602) 631-2000
Address: 3030 North Third Street
Phoenix, AZ   85012
Website: www.copperpoint.com

State Compensation Insurance Fund
Phone: 888-STATEFUNDCA
Address: 333 Bush Street
Suite 800
San Francisco, CA   94104
Website: www.statefundca.com

Pinnacol Assurance
Phone: (303) 361-4000
Address: 7501 East Lowry Boulevard
Suite 800
Denver, CO   80230-7006
Website: www.pinnacol.com

Hawaii Employers' Mutual Insurance Co. Inc.
Phone: (808) 524-3642
Address: 1100 Alakea Street
Suite 1400
Honolulu, HI   96813
Website: www.hemic.com

Idaho State Insurance Fund
Phone: (208) 332-2100
Address: 1215 West State Street
P.O. Box 83720
Boise, ID   83720-0044
Website: www.idahosif.org

Kentucky Employers Mutual Insurance
Phone: (859) 425-7800
Address: 250 West Main Street Suite 900
P.O. Box 83720
Lexington, KY   40507-1724
Website: www.kemi.com

Louisiana Workers' Compensation Corporation
Phone: (225) 924-7788
Address: 2237 South Acadian Thruway
P.O. Box 83720
Baton Rouge, LA   70808
Website: www.lwcc.com

Maine Employers Mutual Insurance Company (MEMIC)
Phone: (207) 791-3300
Address: 261 Commercial Street
P.O. Box 11409
Portland, ME   04104
Website: www.memic.com

Chesapeake Employers’ Insurance Company
Phone: (410) 494-2000
Address: 8722 Loch Raven Boulevard
P.O. Box 11409
Towson, MD   21286-2235
Website: www.ceiwc.com

SFM Mutual Insurance Company
Phone: (952) 838-4200
Address: 3500 American Boulevard West Suite 700
P.O. Box 11409
Bloomington, MN   55431-4434
Website: www.sfmic.com

Missouri Employers Mutual Insurance
Phone: (800) 442-0590
Address: 101 N Keene St
P.O. Box 11409
Columbia, MO   65201
Website: www.mem-ins.com

Montana State Fund
Phone: (406) 495-5015
Address: 855 Front Street
P.O. Box 4759
Helena, MT   59604-4759
Website: www.montanastatefund.com

New Mexico Mutual Group
Phone: (505) 345-7260
Address: 3900 Singer Boulevard NE
P.O. Box 4759
Albuquerque, NM   87109
Website: www.newmexicomutual.com

New York State Insurance Fund
Phone: (212) 312-7001
Address: 199 Church Street
P.O. Box 4759
New York, NY   10007
Website: www.nysif.com

Workforce Safety and Insurance
Phone: (701) 328-3800
Address: 1600 East Century Avenue Suite 1
P.O. Box 4759
Bismarck, ND   58506-5585
Website: www.WorkforceSafety.com

Ohio Bureau of Workers Compensation
Phone: (800) 644-6292
Address: 30 West Spring Street
P.O. Box 4759
Columbus, OH   43215-2256
Website: www.ohiobwc.com

CompSource Mutual Insurance Company
Phone: (405) 232-7663
Address: 1901 North Walnut Ave.
P.O. Box 53505
Oklahoma City, OK   73152-3505
Website: www.compsourcemutual.com

State Accident Insurance Fund (SAIF)
Phone: (503) 373-8000
Address: 400 High Street SE
P.O. Box 53505
Salem, OR   97312-1000
Website: www.saif.com

Pennsylvania State Workers Insurance Fund
Phone: (570) 963-4635
Address: 100 Lackawanna Avenue
P.O. Box 5100
Scranton, PA   18505-5100
Website: www.dli.state.pa.us/swif

Beacon Mutual Insurance Company
Phone: (401) 825-2667
Address: One Beacon Centre
P.O. Box 5100
Warwick, RI   02886-1378
Website: www.beaconmutual.com

South Carolina State Accident Fund
Phone: (803) 896-5800
Address: P.O. Box 102100
P.O. Box 5100
Columbia, SC   29221-5000
Website: www.saf.sc.gov

Texas Mutual Insurance Company
Phone: (800) 859-5995
Address: 6210 East Highway 290
P.O. Box 5100
Austin, TX   78723-1098
Website: www.texasmutual.com

Workers Compensation Fund
Phone: (800) 446-2667
Address: 100 West Towne Ridge Parkway
P.O. Box 2227
Sandy, UT   84070
Website: www.wcfgroup.com

Washington Department of Labor and Industries
Phone: (360) 902-5800
Address: P.O. Box 44001
P.O. Box 2227
Olympia, WA   98504-4001
Website: www.lni.wa.gov

Wyoming Division of Workers Safety & Compensation
Phone: (307) 777-7159
Address: Cheyenne Business Center
1510 East Pershing Boulevard
Cheyenne, WY   82002
Website: wydoe.state.wy.us

Workers Compensation Board - Alberta
Phone: (780) 498-3999
Address: 9925-107 Street
P.O. Box 2415
Edmonton, AB   T5J 2S5
Website: www.wcb.ab.ca

Workers Compensation Board of British Columbia (WORKSAFEBC)
Phone: (604) 273-2266
Address: P.O. Box 5350 Station Terminal
P.O. Box 2415
Vancouver, BC   V6B 5L5
Website: www.worksafebc.com

Manitoba Workers Compensation Board
Phone: (204) 954-4321
Address: 333 Broadway
P.O. Box 2415
Winnipeg, MB   R3C 4W3
Website: www.wcb.mb.ca

WorkSafeNB
Phone: (506) 632-2200
Address: 1 Portland Street
P.O. Box 160
Saint John, NB   E2L 3X9
Website: www.worksafenb.ca

Workers Compensation Board of Nova Scotia
Phone: (902) 491-8999
Address: 5668 South Street
P.O. Box 1150
Halifax, NS   B3J 2Y2
Website: www.wcb.ns.ca

Prince Edward Island Workers Compensation Board
Phone: (902) 368-5680
Address: 14 Weymouth Street
P.O. Box 1150
Charlottetown, PE   C1A 7L7
Website: www.wcb.pe.ca

Saskatchewan Workers Compensation Board
Phone: (306) 787-4370
Address: 200 - 1881 Scarth Street
P.O. Box 1150
Regina, SK   S4P 4L1
Website: www.wcbsask.com

Puerto Rico State Insurance Fund Corporation
Phone: (787) 793-5959
Address: G.P.O. Box 365028
P.O. Box 1150
San Juan, PR   00936-5028
Website: www.cfse.gov.pr
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AASCIF Newsletter

Taking the Advocacy Approach

By Shari Truax, Montana State Fund, and Avery Davis, Pinnacol Assurance

The attendees of the 2017 AASCIF Annual Conference in Oklahoma City had the opportunity to listen to Liz Thompson, CEO of Encore Unlimited, provide a presentation on “Creating an Advocacy Culture in Claims and Disability Management.”  It was apparent throughout the presentation that an advocacy-based approach to claim handling has the potential to reduce claim costs and result in a better experience for the injured worker.

Becoming an advocate for the injured worker does not change the claim examiner's responsibility to manage claims in accordance with the laws in effect for the respective jurisdiction. What becoming an advocate can change is the relationship with the injured worker. Through genuine and transparent communication, a trusting relationship is developed, and both parties work together toward the best possible resolution of a work-related injury. As a result, the likelihood of an adversarial relationship developing between the claim examiner and the injured worker is reduced.

The change in our approach begins with how we communicate with the injured worker, starting with the very first contact. Each interaction a representative of the insurer has with an injured worker builds the injured worker's perception of whether the examiner's intentions are honorable or not. There are seemingly harmless words that are used in conversations with the injured worker that have the ability to trigger a defensive response. By changing the words they use, the examiner is able to foster a collaborative relationship with the injured worker. When questioning how an injury may have occurred, ask the injured worker to help you understand what happened rather than only asking why or how it happened. Seeking to understand the injured worker and giving them the opportunity to explain their perception of what occurred results in both parties being able to reach a mutual understanding of each particular issue.

The examiner must explain what the injured worker should expect throughout the claim process and set their expectations of how the claim process will unfold. A thorough explanation of the types of benefits they will receive, when they will receive the benefits, and what their responsibilities are in the claim process will allow the injured worker to take ownership in the process and reduce the anxiety they may be experiencing. Once an injured worker's expectations are established, it is critical that the examiner follow through on the responsibilities they have committed to provide.

Return to work is a key component in an advocacy culture. Injured workers who are off work more than six months have a 50 percent chance of returning to work. The barriers Liz Thompson identified in her presentation were very similar to the barriers noted in the September 2006 report that the American College of Occupational and Environmental Medicine published called “Preventing Needless Disability by Helping People Stay Employed.”  Some findings noted in this report include:

  • Unnecessary prolonged work absences can cause significant harm to workers well-being.
  • Workers who are off work can experience the loss of social relationships with co-workers and can suffer a decrease in the self-respect and self-esteem that comes from earning a living.
  • Being out of work due to an injury is very stressful for many workers. Overall, a small number of workers are medically excused from work.
  • Non-medical factors leading to workers being off work include:
    —Delays in treatment, referrals to specialists not being timely 
    —Ineffective communication
    —Lack of modified/transitional duty work
    —Lack of management buy-in
    —Logistical problems

Offering modified/transitional duty work to an injured worker can reduce stress and aide in the recovery process. The day following Liz Thompson’s presentation, the AASCIF Claims Committee gave a presentation on “Speed Networking,” which included a topic on return to work. The committee agreed that educating employers on the benefits of returning injured workers to work and offering modified/transitional duty work is key to the recovery of the injured worker and to successful claims outcomes. Here’s a look at what some of the state funds are doing to successfully return injured workers to work:

  • Creating modified/transitional duty work by working directly with employers.
  • Providing pre-planned task lists, which helps employers offer modified/transitional duty work.
  • Helping employers create modified/transitional duty tasks specific to their industry.
  • Having certified vocational counselors/specialists or job placement specialists on staff that provide return to work services to get injured workers back to work.
  • Offering volunteer placement as an option to employers who can’t accommodate physical restrictions.
  • Training for employers’ supervisors on how to respond to injuries, what to do following an   injury, and how to keep the injured worker at work while on work restrictions.
  • Using predictive analytics to improve claims outcomes.

Creating an advocacy culture can result in providing a better experience for the injured worker, while at the same time improving claims outcomes. The key pieces of an advocacy culture are:

  • Effective communication.
  • Active listening with the injured worker.
  • Using positive words to explain processes and procedures.
  • Following through with promises.
  • Offering modified/transitional duty work to injured workers.

In today’s world, advocacy-based models are gaining attention as a new way to boost injured worker satisfaction, improve medical outcomes, and speed return to work. Advocacy is about setting expectations, establishing a contact point so that the injured worker is assisted and heard throughout the claim process.

 

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