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OhioBWC - Employer - Service:  (Summary claim data) - Details

Summary claim data

The summary claim data report allows BWC personnel and Ohio employers to view high-level claim information to help better manage workers’ compensation claims. Information includes all claims associated with an individual policy as a result of combination, transfer or merger of accounts.

The summary claim data report provides specific information about your claims. Claim-specific information available in the detail claim data report is consolidated into the following six groupings:

  • MO claims with actual disability days = 0 — These are medical-only (MO) claims where the last day worked and return to work dates are known, and that information indicates no days absent.
  • MO claims with actual disability days > 0 — These are MO claims where the last day worked and return to work dates are known, and that information indicates one or more days absent.
  • MO claims with actual disability days not known — These are MO claims where the last day worked and/or the return-to-work dates are not known.
  • LT claims with actual disability days = 0 – These are lost-time (LT) claims where the last day worked and return-to-work dates are known, and that information indicates no days absent.
  • LT claims with actual disability days > 0 — These are lost-time claims where the last day worked and return-to-work dates are known, and that information indicates one or more days absent. Additionally, this group includes LT claims with continuing days absent, i.e. where the last day worked is known and no subsequent return to work date is known.
  • LT claims with actual disability days not known — These are LT claims where both the last day worked and return-to-work dates are unknown.

Within the above groupings, here is the additional presented

  • All claims – This is a count of all claims filed, regardless of allowance status.
  • Days absent <= optimal – This is a count of non-disallowed claims where both the actual days absent and the optimal days absent are known, and the actual days absent are less than or equal to the optimal days absent.
  • Days absent > optimal – This is a count of non-disallowed claims where both the actual days absent and the optimal days absent are known, and the actual days absent is more than the optimal days absent.
  • Optimal days not known – This is a count of non-disallowed claims where the optimal days absent are not known. This includes claims where the actual days absent may or may not be known.
  • Total non-disallowed claims – This is a sum of the previous three items.
  • Total days absent – This is the sum of the actual days absent for all claims in this grouping. If there are no claims in a particular group, this item will be blank (rather than zero).
  • Average days absent – This is the sum of the actual days absent divided by the total non-disallowed claims. If there are no claims in a particular group, this item will be blank (rather than zero).
  • Average days over optimal – This is the number of days absent in excess of the optimal days absent, divided by the number of claims where the actual days absent exceed the optimal days absent.
  • Average filing lag days – This is the average number of calendar days from the date of injury to the date the claim was filed. If there are no claims in a particular group, this item will be blank (rather than zero).
  • Average conversion lag days – This applies only to claims which have been reclassified from medical only to lost time. This is the average number of calendar days from the date a claim was filed to the date on which the reclassification occurred.

Definitions

  • Days absent — The number of calendar days between last day worked and actual return-to-work date. If a claim has more than one last day worked (i.e., LDW = 1/5, RTW = 1/8, LDW = 1/15, RTW = 1/20), Days absent will not include those days between a return-to-work date and the next last day worked.
  • Optimal days absent — The number of days absent based on the optimal days to return to work. Optimal days to return to work is the expected number of whole calendar days away from work for a specific injury and occupation.



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