When the cost of a workplace injury is exacerbated due to a pre-existing condition, employers may feel trapped. The Ohio Bureau of Workers’ Compensation’s (BWC) Handicap Reimbursement Program is designed to offer premium relief to employers when an employee with a qualified pre-existing condition suffers a lost-time injury. Read on to learn more about how the Handicap Reimbursement Program can help you recoup a percentage of claims costs for qualifying claims.
How it works
Recognizing that a pre-existing handicap condition can have a significant impact on the claim costs associated with a workplace injury and the recovery period, the Handicap Reimbursement Program offers employers the opportunity to realize significant savings on the final cost of approved claims. To be considered for Handicap Reimbursement, the injured worker must have a qualifying pre-existing injury and the BWC must have paid either temporary total compensation, permanent total disability compensation, scheduled loss awards, death benefits, or wages in lieu of temporary total compensation.
For qualifying claims, employers can recoup between 5% and 100% of the claims costs. Not only can employers recoup these costs by participating in the Handicap Reimbursement Program, but they can also help lower premiums for the period the claim is in the employer’s experience. Handicap Reimbursement Program participation has no impact on the injured worker’s claim or treatment.
Nearly all employers qualify for the Handicap Reimbursement Program, with a few exceptions. Employers who have no coverage or whose coverage has lapsed at the time of injury, employers who are out of business, self-insuring employers, bankrupt employers, and state agencies and universities are restricted from participating in the program. Don’t qualify for the Handicap Reimbursement Program? Check out these 3 Discount Programs You Should Talk to Your TPA About.
When an employer has sufficient reason to believe that a claim qualifies for the Handicap Reimbursement Program, the employer can request that a percentage of the costs of the claim be charged to or refunded from the Statutory Surplus Fund.
All claims submitted for Handicap Reimbursement must be for injured workers with certain specified conditions. Reimbursement may be granted for a number of conditions, including epilepsy, diabetes, cardiac disease, arthritis, amputated limbs, loss of sight, cerebral palsy, multiple sclerosis, varicose veins, cardiovascular disease, and pulmonary disease, to name a few.
Your third party administrator (TPA) should review all lost-time claims for Handicap Reimbursement eligibility. Sheakley’s Handicap Reimbursement specialists review claims for evidence of pre-existing conditions, gather appropriate medical documentation, file applications with the BWC, and attend all BWC hearings on your behalf. Your TPA should work hard to seek the highest possible reimbursement for your company. Check out 5 Reasons You Need a TPA in Your Corner to learn more about how a TPA partner can help save you time and money.
For a claim to qualify for the Handicap Reimbursement Program, the employer or their TPA partner must demonstrate two things:
- The handicap condition existed prior to the injury
- The handicap condition either caused the injury or contributed to the costs or delay in recovery from the injury.
Examples of evidence that can be presented to the BWC to support the Handicap Reimbursement application include medical evidence, such as doctor’s reports or pharmacy records demonstrating that the injured worker suffered from a qualifying condition, and evidence that the condition constitutes a handicap within the meaning of the law. When you work with a TPA partner like Sheakley, the TPA’s experts can help you gather the evidence necessary to present to the BWC along with your Handicap Reimbursement application.
Looking out for your bottom line
Although the Ohio BWC doesn’t require employers to work with a TPA, a successful partnership not only leads to less stress for you when a claim is filed, it can also provide significant cost-savings for your company. In fact, Sheakley is consistently ranked as a top TPA in Ohio for securing the most handicap reimbursements for our clients according to BWC data reports! By allowing your business greater access to cost containment strategies, your partnership with a TPA can often pay for itself. While the Bureau of Workers’ Compensation looks out for the interests of your injured employees, your TPA will help you save money and provide assistance with claims.
Learn more about Workers’ Compensation today by contacting a Sheakley WC professional. Stay up-to-date on all things Sheakley by subscribing to our blog and following us on social media. Join the discussion by commenting below.