CPWC3 – Workers’ Compensation Claim Initiation and Set up



Module 3- Workers’ Compensation Claim Initiation and Set Up

In this third module – Workers’ Compensation Claim Initiation and Set Up, we will look at the initial claim documents as evidence in the preliminary phase of the claim investigation which will ultimately be used to determine if a claim will be compensable or payable under the Workers compensation statutes.  This module is a prerequisite to the following two modules and together provide the necessary skills to conduct a Workers Compensation claim investigation.

CPWC (Claims Practitioner in Workers’ Compensation) is a 24 module certification program developed to meet the needs of emerging claims practitioners. This program offers comprehensive training in foundation principles required to become a certified California WC Claims Adjuster and provides the required 120 classroom hours. Presented at a practical desk level, this curriculum includes learning tools such as case studies and soft skills along with technical information.  Components of the CPWC will also help fulfill certification requirements for California WC Medical Review or Medical Only adjusters.

Lecture Topics Covered:

  1. Pre-injury notices; pre-designation notices
  2. Notice of injury to employer
  3. Claim set up
    1. DWC-1
    2. Employer 5020
    3. Employer Internal investigation
    4. DWC 5021- doctor’s first report
    5. Wage statement
  4. Claim Investigation
    1. Documentary evidence
    2. Informal witness statements
    3. Formal witness statements
    4. Evidence analysis
    5. Medical authorizations
    6. social media checks
  5. Fraud

Who should attend.

  • Indemnity Workers’ Compensation Claims Adjusters
  • Medical Bill Review Adjustors
  • Medical Only Claims Adjustors
  • TPA / Self Insured Claims Personnel
  • Safety and Risk Management Professionals
  • Agent/Broker Workers’ Compensation Claims Staff

Difference between 3 and 5 hour versions:

  • The Indemnity Track requires the 5 hour version to meet the requirement of 120 hours.
  • The 5 hour version includes Case Studies and homework
  • All other tracks only require the 3 hour version

Key updates in progress.  Please check back soon.