Performance Audit of the Workers’ Compensation Claims Management for Fire and Police Personnel

Workers’ compensation insurance provides benefits that cover lost wages, medical and other expenses when an employee is injured on the job. Temporarily injured employees are considered “Injured On Duty.” They are eligible to receive their full salaries–tax-free- for up to one year. Like most public employers, the City is self-insured for workers’ compensation claims.

When administered appropriately and efficiently, workers’ compensation insurance can be a cost-effective way to guarantee that no worker loses his or her livelihood as a result of a job-related injury.

Claims management and medical bill reviews should be about more than just processing claims–they should be about minimizing costs through close scrutiny, aggressive oversight and careful investigation. These aspects are lacking in the current process–in some cases costing the city millions of dollars in unnecessarily high workers’ compensation payments.