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Protested or Denied Claims

Employers often consider the validity of claims when they occur. Should this claim be accepted by WCB? Is the injury the result of an employer’s work or other factors outside the place of employment?

Taking the guesswork out of it for our clients, we take the approach of actively reviewing all claims to ensure they align with WCB law and policy. Where it appears there is a mismatch between what is being reported and what is acceptable under WCB standards, DMI will proactively protest claims and seek a denial of the claim.

We want to ensure only those claims that meet the standards of WCB are accepted. While WCB will do a thorough review later in the claim, we advise employers to attempt to protest claims prior to acceptance. Claims can be overturned, but once accepted the process is much lengthier and requires a formal review to overturn the file – leading to lengthier delays and the potential for higher costs for the employer.

In the past years, two of our clients have experienced positive savings as a result of proactive claim protesting through DMI. Read about one of them below.

A&R Metal Industries

Founded in 1969 A&R Metal Industries is a multifaceted metal processing and steel fabricating company. A claim was filed for multiple physical injuries that the employee indicated were sustained as a result of repetitive strain from their work. When DMI submitted the report of injury to WCB we indicated a desire to protest the claim.

In our on-going communication with WCB, we were able to supply them with the employee’s attendance history for the past year, correspondence from the employee indicating concerns with the work, and the steps the employer had taken internally to address the concerns.

Ultimately WCB determined that the claim did not meet the threshold for a work-related incident as there was no evidence that the injuries could be attributed to the employee’s work.

This claim denial saved the A&R Metal Industries over $14,325 in the claim costs that are typically associated with these types of injuries. Their rates were not impacted and there was no affect on their claims experience, because there were no wages lost or healthcare costs related to these injuries attributed to the employer.

Recognizing that providing value to our clients and affecting positive changes to WCB premiums is about more than just filing the applicable paperwork, these additional review services are included at no additional cost.

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Since 2002, the Disability Management Institute (DMI) has been providing comprehensive claim management and review services to over 3,500 clients nationwide. Request a Consultation

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