Reference no: EM133162122

1. In Unit VI of this course, you will be tasked with writing about the dispute process when workers believe that they are treated unjustly. For this assignment, you will be creating an annotated bibliography of resources on the dispute process.

The resources you identify in this bibliography will be used in writing your assignment in Unit VI. By locating the necessary resources in this bibliography, you will be prepared to write your paper in Unit VI.

Generally, a workers' compensation dispute is a disagreement between the system participants (e.g., the injured worker, the employer, the employer's insurance company) that must be settled by the state-specific workers' compensation board. Most (but not all) disputes generally involve three main areas:

an indemnity dispute involving compensability or liability,

a medical fee dispute for healthcare already provided where the payment has been reduced or denied, or

a medical necessity dispute, disputing if a medical procedure is actually medically necessary.

Using these common disputes as well as others, create an annotated bibliography, and show how those resources will support your paper by briefly describing the content of each article or referenced source.

When writing your bibliography, think about the different types of coverage available to employees and the fundamentals of claim management. Be sure to include information about these in your bibliography.

2. You are the safety manager for a company that produces widgets in the state of Kentucky. Your business has a solid reputation and is growing and looking to expand to Texas and Georgia in the next few years. The Senior Leadership Team (SLT) wants a better understanding of what insurance coverage they need to have for workers' compensation moving forward in these three states.

You have partnered with the workers' compensation manager, and you want to give the SLT a feel for how much money they have spent the past few years and what they should consider for future workers' compensation insurance coverage. Using information you have learned thus far in the course, make a proposal to the SLT on items they should consider, based on fairly hard facts.

Last year, your company had 12 sprains, four cases of carpal tunnel syndrome, one crushing incident, and the loss of vision for three employees. Your company also has a 6.7% profit margin. Your company pays the first $100,000 aggregate for each category of injuries, and then the insurance company pays the rest.

Discuss how many compensable injuries happened last year. Explain how many incidents and how much and what could happen if the workforce doubled.

Estimate the total direct costs, indirect costs, and the amount of sales of widgets that are needed to cover the total cost of all the company accidents.

Provide guidance on which states should be considered 3A states and 3C states in the workers' compensation insurance policy.

Identify if these projected three states would practice extraterritorial and reciprocity with the main state, and explain to the SLT the impact of these statutory guidelines.

Determine if the employer would need any other extra insurance (insurance that would cover a workplace accident not covered by workers' compensation) or if they should they just pay out of pocket.