Specious Claims Adjuster Education: A Sixty-Second Seminar in Workers’ Compensation Claims Handling

On February 22, 2006, mandatory continuing education for workers’ compensation claims adjusters became required in California when Title 10, § 2592.10 of the California Code of Regulations became operational. Coupled with the 2005 enactment of Insurance Code 11761, adjusters became obligated to accumulate no less than 32 hours of continuing education every two years to assure that they possessed the minimal levels of training, experience, and skill to competently adjust claims for workers’ compensation benefits.

Faced with the duty to assure that their claim adjusters possessed the necessary skill and training to adjust claims in an objectively verifiable way, insurers and third-party administrators scrambled to identify programs and resources to assist them in meeting that burden. Many started to rely heavily on educational programs offered on a complimentary basis by law firms, physicians and other vendors servicing the workers’ compensation claims industry.

While generally valuable, the continuing education given by vendors quite often took the form of extended marketing sessions, where lawyers, doctors and ancillary service providers would come into a claims adjusters’ office, provide lunch and swag, and a bit of generic instruction about the latest development is the fields of workers’ compensation law and industrial medicine. On “paper” the adjusters obtained the required educational hours necessary to comply with state requirements; however, the question remained, “did they receive the right education”?

Although an attorney’s proffer of case law decisions to a claims team can be highly useful, typically the cases discussed involve situations seldom encountered by the team, and therefore, are quickly forgotten. As for medical presentations, do adjusters really care what type of radiopaque fluid is used when administering an arthrogram? This information is nice to know but has nothing to do with the everyday handling of a claims desk.

At the risk of being immodest, we at Friedman + Bartoumian submit that the education we provide consists of information and strategies which adjusters reference daily in the performance of their job duties. By way of corroboration, we invite you to review the 21 prior editions of this blog, each of which provides exceptionally relevant subject matter not offered elsewhere. When a well-educated claims staff works together with our attorneys, we become a formidable foe to deal with at the Board. Our firm’s motto “For the Best Defense” is reinforced every time we provide education to our clients!