AlignSure

Workers' Compensation Evidence That Moves Your Experience Mod

Document every First Report of Injury (FROI). Track claims from incident through resolution. Produce underwriting stewardship reports that demonstrate measurable risk reduction.

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The Problem

What regulated organizations face today

Workers' compensation is where compliance meets real money. Every unreported injury, every late FROI filing, every undocumented modified duty assignment costs your organization — in claims costs, in Experience Mod penalties, and in underwriter confidence. Most organizations track injuries in disconnected systems: HR has one spreadsheet, safety has another, the broker gets a summary email, and the TPA works from their own portal.

The result is a loss ratio nobody can explain, an Experience Mod that drifts upward, and stewardship meetings where the broker shows charts but cannot show evidence of systematic risk reduction. When underwriters ask "What are you doing to reduce losses?", the answer should not require a week of data gathering.

Financial Impact

The cost of getting it wrong

$42,000

Average cost per lost-time workers' comp claim

3-5 years

Duration claims affect your Experience Mod

72 hours

Typical state FROI filing deadline

20-40%

Premium impact range from Experience Mod variance

The Solution

How AlignSure solves it

01

FROI Documentation & Filing

Structured First Report of Injury workflows that capture every required field, route to appropriate reviewers, and produce state-compliant documentation. Identity-bound submissions ensure accountability.

02

Claims Resolution Tracking

Track every claim from initial report through closure. Monitor treatment timelines, return-to-work milestones, and reserve development. Flag claims that exceed duration benchmarks.

03

Experience Mod Analysis

Connect injury data to financial impact. Model Experience Mod projections based on current claims. Identify which claims drive the most rating impact and where intervention reduces costs.

04

Underwriting Stewardship Reporting

Generate evidence packages for broker stewardship meetings and underwriter reviews. Demonstrate systematic safety programs, claims management processes, and measurable risk reduction — with data, not anecdotes.

Features

Key platform capabilities

State-specific FROI form generation and filing support
Claims tracking with duration benchmarking (BLS/OSHA data)
Experience Mod projection modeling
Loss ratio analysis by location, department, and occupation
Injury-to-return-to-work timeline tracking
Safety program evidence documentation
Underwriter stewardship report generation
Broker and TPA collaboration workspace
Evidence

What your auditor, underwriter, or regulator receives

  • State-compliant FROI documentation packages
  • Claims inventory with status, reserves, duration, and resolution
  • Experience Mod projection reports with claims-level detail
  • Loss ratio trend analysis by location and occupation
  • Stewardship meeting evidence packages (safety programs, claims management, return-to-work outcomes)
  • BLS/OSHA benchmark comparisons for injury rates and days away
Coverage

Regulatory frameworks addressed

State Workers' Compensation Reporting Requirements OSHA Recordkeeping (29 CFR 1904) OSHA Injury and Illness Reporting NAIC Experience Rating Methodology State-Specific FROI Filing Requirements
FAQ

Frequently asked questions

What is a First Report of Injury (FROI)?
A First Report of Injury (FROI) is a mandatory document filed with the state workers' compensation board and the employer's insurance carrier when a workplace injury or illness occurs. It captures details about the employee, the incident, the nature of the injury, and the treating physician. Most states require FROI filing within 3 to 10 business days of the employer learning of the injury.
How does the Experience Modification Rate (EMR) work?
The Experience Modification Rate is a multiplier applied to an employer's workers' compensation premium based on their actual loss history compared to the expected losses for their industry and size. An EMR above 1.0 increases premiums, while below 1.0 decreases them. The calculation uses three years of claims data (excluding the most recent year) and considers both claim frequency and severity relative to industry benchmarks.
What are typical FROI filing deadlines by state?
FROI filing deadlines vary by state but generally range from 3 to 10 business days after the employer learns of the injury. For example, Texas requires filing within 8 days, California within 5 days, and New York within 10 days. Late filings can result in penalties from the state workers' compensation board and may negatively impact claims outcomes.
How do workers' comp claims affect insurance premiums?
Workers' compensation claims affect premiums through the Experience Modification Rate, which factors in three years of historical claims data. Frequent claims (even small ones) and large individual claims both increase the EMR. A single serious claim can increase premiums for three consecutive years. Effective claims management, return-to-work programs, and safety initiatives can reduce the EMR over time.
What is modified duty in workers' compensation?
Modified duty (also called transitional duty or light duty) is a temporary work assignment that accommodates an injured employee's medical restrictions while they recover. It allows employees to return to work in a limited capacity, which reduces lost-time claim costs, maintains productivity, and supports faster recovery. Modified duty assignments should align with the treating physician's work restrictions and the employee's essential job functions.

Related Solutions

Return-to-Work Planning

Coordinate recovery plans and transitional duty after a workers' comp claim.

ADA Job Validation

Essential duties documentation that supports both ADA compliance and workers' comp claims.

HIPAA & BAA Compliance

When injury treatment involves PHI, HIPAA obligations apply alongside workers' comp.

Texas Compliance

State-specific workers' comp requirements including DWC, TDI, and non-subscriber frameworks.

See AlignSure in action

Request a demo configured for your organization's specific compliance requirements.

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