OhioBWC - Common - Service: (Individual claim reserve history) - Details

Individual claim reserve history is a portable document format (PDF) report that shows running history of reserve predictions, a breakdown of the reserve, and medical and indemnity payment history for a specific claim.

This information will be available after July 1, 2008, and beyond. The report will include information as of the last prediction date (weekly reserves) and as of the quarter end date beginning Sept. 30, 2008. Eventually, the report will show 16 quarters worth of information. The report is split into six sections.

Reserve as of current date
This section will display if there has been any reserve adjustments due to salary continuation or living maintenance paid, or if the the claim is medical only.
Total original reserve minus reduction amount equals published reserve
Reasons for reductions include:

  • SCO - Salary continuation only set reserve to zero;
  • SCLMO - Salary continuation and living maintenance only non-vacated benefits set reserve to zero;
  • SCIND-LMLWL - Combination of salary continuation and living maintenance;
  • SCIND - Salary continuation and other indemnity payment subtracts salary continuation amount from reserve;
  • LMLWL - Living maintenance and living maintenance wage loss multiplies reserve by 0.5

Reserve injury type
This section contains information such as injury type and primary International Classification of Diseases (ICD-9) code.

Total predicted claim costs
This section gives you the ultimate claim cost prediction (or incurred cost) as well as medical and indemnity paid, and medical and indemnity reserve amounts. The ultimate claim cost prediction is the amount BWC receives from the reserving system and represents the predicted total claim cost over the life of the claim.
Ultimate claim cost prediction minus medical and indemnity paid amounts equals total original reserve.
Medical and indemnity reserve amounts in this section add up to the published reserve, which is the reserve used for rate making.

Indemnity reserve breakdown
This section gives you the breakdown of indemnity reserve as of each date listed. The indemnity reserve is broken out into different categories or buckets.

  • Permanent total disability (PTD);
  • Permanent partial/Percentage of permanent partial (PP/%PP);
  • Temporary total disability/Temporary partial/Wage loss (TT/TP/WL);
  • Facial disfigurement;
  • Change of occupation;
  • Death;
  • Other benefits.

Paid medical amounts
This section displays the breakdown of the different medical benefits paid or medical buckets. The amounts listed as of each date are a running total to that date. The medical buckets are:

  • Hospital;
  • Clinic/nursing;
  • Doctors;
  • Nursing services;
  • Drug/Pharmacy;
  • X-ray/Radiology;
  • Laboratory;
  • Miscellaneous medical;
  • Prostheses devices;
  • Prostheses exams;
  • Ambulance;
  • Travel;
  • Medical devices;
  • Emergency room;
  • Court cost;
  • Funeral expenses.

Paid indemnity amounts
This section displays the breakdown of the different indemnity benefits paid indemnity buckets. The amounts listed as of each date are a running total to that date. The indemnity buckets are:

  • Permanent total;
  • Temporary total;
  • Temporary partial;
  • Permanent partial;
  • Facial disfigurement;
  • Death;
  • Change of occupation;
  • Living maintenance;
  • Living maintenance wage loss;
  • Wage loss;
  • Lump sum settlement (LSS);
  • % Permanent partial
  • Attorney fees;
  • Other benefits.



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