Attorneys meeting to discuss their experience mod.

Experience Mod Explained

An experience mod commonly called an “e-mod,” is an important factor used to adjust your workers’ compensation premium.

What is an experience modification factor?

An experience modifier (e-mod) is a multiplier applied to the premium of a qualifying policy and provides an incentive for loss prevention. The e-mod represents either a credit or debit that is applied to the premium before discounts. If your company’s loss experience is more costly on average than other company’s loss experience in your industry, the result is a debit e-mod or surcharge on premiums. If your company’s experience is less costly than the industry average, you will receive a credit e-mod, or discount, on your premium.

Who determines experience ratings?

The National Council on Compensation Insurance (NCCI), based in Florida, computes experience ratings for all businesses and industries. The same factors are used to calculate each employer’s experience modification regardless of which insurance company provides coverage. The e-mod stays with the business even if the business is sold.

Who qualifies?

All employers whose premium before discounts averages $4,000 or more a year for a three-year period are eligible for an experience modification rating. Approximately 90 percent of workers’ compensation premium dollars come from experience-rated policies.  Employers with less than $4,000 in premium are not experience rated because of their low exposure to claims.

What years are included in e-mod calculations?

E-mods are based on claims costs for a prior three-year period. An interval year is incorporated between the current year being rated and the three-year period. The interval year is the year previous to the current year and is excluded because ultimate claims costs and final premium amounts are not known for that year when the e-mod is being calculated.

How is an e-mod calculated?

  • The e-mod is determined by comparing actual losses to expected losses for the experience period based on the employer’s industry. In other words, clerical employees are compared only to other clerical employees, etc.
  • The number of person-hours worked is used to indicate the employer’s audited premium dollars since an employer with 20 employees would be expected to have more claims than an employer with two employees. For example, a roofing business is only compared to other roofing companies with approximately the same gross premium amount.
  • The formula adjusts the actual losses used to give frequency greater weight than the severity of an injury or illness. For example, six claims that occur over a three-year period totaling $20,000 have a greater impact against the e-mod than one claim in three years totaling $20,000. Again, both industry and business size are considered.
    • Claims with zero costs are not included in the e-mod calculation.

How can I lower my e-mod rating?

A sound safety program, a return-to-work plan, and loss prevention procedures will lower your e-mod and are crucial to helping you effectively manage your workers’ compensation costs. The following example compares two companies who perform the same services and employ the same number of workers:

It's vital law firms implement return-to-work programs.

Return-to-work Program Benefits

Benefits of an effective early return-to-work program accrue to both a law firm and its injured employees. The law firm realizes significant cost savings by minimizing lost productivity, resource replacement costs, workers’ compensation indemnity benefits, and medical treatment costs. The employee benefits from reduced stress and a feeling that their employer cares for their physical health and values what they bring to the workplace.

Chief components of effective early return-to-work programs

The most effective return-to-work programs contain the following components or employ the following best practices:

  • Executive mandates are issued to departments, requiring that they temporarily accommodate injured workers by physical restrictions determined by a physician.
  • Dedicated return-to-work providers are responsible for coordinating early return-to-work among the treating medical providers, injured workers, department managers, and the third-party claims administrator.
  • Medical providers and third-party claims administrators must also be held accountable for their efforts to assure the program’s success.
  • The workers’ compensation manager, perhaps with the assistance of the third-party claims administrator, conducts education sessions and meetings to train department managers in the importance of early return-to-work.
  • Medical providers are required upon the completion of the first office visit and each subsequent office visit to convey physical work restrictions to the return-to-work coordinator (sometimes via the third party administrator) for accommodation or modification of a prior accommodation.
  • Modified duty is accommodated for a limit of either 60 or 90 days, subject to possible extension if the medical provider and law firm believe that the employee continues to improve physically.
  • As modified positions are identified, a bank of a modified job description.

Understand workers compensation may have policy exclusions.

Workers Compensation Exclusions for Law Firms

Every law firm should be aware of their policy’s workers compensation exclusions. The key idea behind workers’ compensation laws is that a non-exempt employer provides a benefit to cover all on-the-job injuries, regardless of what they are, without determining fault. The real limits of the law come not in the type of injury but in how the injury occurred.

Exclusions from workers’ compensation take place when an employee is injured while committing a crime, if the injury is self-inflicted, if the injury takes place while the employee is under the influence of drugs or alcohol, or if the injury is the result of a specifically restricted activity. In these instances, an insurance provider is not liable to approve the claim.

A work-related injury need not occur on the employer’s premises. If an employee is at an off-site conference, traveling from one facility to another, or in the course of working at a place of business or home of the employer’s client, any injury which occurs will be considered a work-related injury. Any activity conducted in the name of the employer needs to be expressly excluded in advance if, for some reason, workers’ compensation benefits would not be extended in the case of an accident or occupationally related exposure.

Additionally, an employer may contractually add a covered benefit that might otherwise not be included under a particular state’s worker’s compensation laws. If an employee needs to conduct an activity completed on their own time, off the employer’s premises, and/or not directly work-related, but to the employer’s benefit, a claim may be approved. Such instances, however, need to have a written agreement in place before the accident.

In some instances, an employee might experience an illness that results in injury rather than an accident. An exposure to a toxic substance, the activity of a repetitious nature, or a traumatic incident that creates mental health issues could lead to an approved claim. Occasionally, the illness might not surface for many years but still be considered compensable. However, commonly contracted illnesses such as influenza, sickness from mosquito bites, or a headache that the employee believes results from on-the-job contact are excluded from workers compensation laws.

Each state has its own worker’s compensation laws. While they are all similar in content, they may differ from one another on specific issues. It is wise to consult individual state laws to determine if a particular injury or occupationally related illness or the circumstances behind the exposure are compensable under those laws.

Workers’ compensation covers the vast majority of work injuries and diseases. Injuries not covered by workers’ compensation in many states are:

  • Injuries occurring as a result of crime
  • Injuries from violation of posted and known company policies
  • Injuries from intoxication or drug use
  • Off-work injuries
  • Self-inflicted injuries
  • Pre-existing conditions, unless exacerbated by current work

Some exceptions to employer immunity or situations that would usually allow injured employees to sue their employers outside of the workers’ compensation system are:

  • Injuries caused by employers’ malice or recklessness
  • Injuries caused by employers’ violations of state or federal law, such as violations of the Occupational Safety and Health Act (OSHA)
  • Intentional injuries
  • Injuries caused by employers when acting in dual capacities, such as breaches of legal duties as property owners, landlords, medical providers, or manufacturers of work equipment
  • Injuries to employee property
  • Bad faith administration of workers’ compensation claims
  • Employers’ retaliation against employees for pursuing workers’ compensation claims, such as by firing or demotion
  • Nonphysical injuries such as defamation or discrimination

Workstation ergonomics help prevent overuse injuries.

Overuse injuries are one of the biggest risks law firms face in regards to workers’ compensation injuries.  The following is a list of basic ergonomic tips to avoid overuse injuries:


Place the keyboard in a position that allows the forearms to be close to the horizontal and the wrists straight. That is, with the hand in line with the forearm. If this causes the elbows to be held far out from the side of the body, then re-check the work surface height.

Some people prefer to have their wrists supported on a wrist rest or the desk. Be careful not to have the wrist extended or bent in an up position.


Adjust the seat tilt so that you are comfortable when you are working on the keyboard. Usually, this will be close to horizontal, but some people prefer the seat tilted slightly forwards.

Your knees should be bent at a comfortable angle and greater than 90º flexion. If this places an uncomfortable strain on the leg muscles or the feet do not reach the floor, then a footrest should be used. The footrest height must allow your knees to be bent at 90º; the footrest height may need to be adjustable.

Adjust the backrest so that it supports the lower back when you are sitting upright. A range of chairs is available.


Avoid cradling the phone between your head and shoulder when answering calls. If you need to use your computer simultaneously, use a headset or the phone’s hands-free/speaker-phone capabilities if the environment is suitable.


Set the eye-to-screen distance at the distance that permits you to focus on the screen most easily. Usually, this will be within an arm’s length.

Set the monitor’s height so that the top of the screen is below eye level, and the bottom of the screen can be read without a marked inclination of the head. Usually, this means that the center of the screen will need to be near shoulder height. Your eyes should be level with the toolbar.

People who wear bifocal or multi-focal lenses will need to balance where they see out of their lenses and avoid too much neck flexing. The height of the monitor can be adjusted using a monitor riser.

Document holder

Place the document holder close to the monitor screen in the position that causes the least twisting or inclination of the head.


Adjust the height of the work surface and/or the chair’s height so that the work surface allows your elbows to be bent at 90º, forearms parallel with the floor, wrist straight, shoulders relaxed.

Place all controls and task materials within a comfortable reach of both hands so that there is no unnecessary twisting of any part of the body. Most people prefer the document holder to be between the keyboard and the monitor. There are many different types of document holders available.


Work-related stress may cause workers comp claims.

Claim Scenario: Workers Comp. Benefits Awarded for Stress

In a recent ruling, an employee was awarded workers comp benefits for stress. We want to share claim scenario details and court rulings as it could affect your law firm’s insurance.  The following is a recently issued ruling on work comp. A policy that awarded benefits to a paralegal for health problems related to stress:

A second-grade teacher should receive limited workers compensation benefits for health problems she says she suffered while working in a stressful classroom, a Pennsylvania court has ruled.

Shirley Hilton worked for the Philadelphia law firm from November 2018 to March 2019. On her last day at the firm, she suffered heart palpitations, headaches, dizziness, and nausea “as a result of a tough day with her challenging work environment,” according to the ruling.

Ms. Hilton went that afternoon to a regularly scheduled appointment with a doctor who had treated her for some time. The doctor’s office called Ms. Hilton’s firm that day and told the partners that she would not be returning to work because of the firm’s “overly stressful environment,” court records show.

A doctor appointed by the law firm treated Ms. Hilton and “made her return” to her regular job in May 2019. Still, she worked only four days upon her return and was not paid beyond the firm’s March date.

In June 2019, the law firm reassigned Ms. Hilton to another position, which she characterized as being quiet with “excellent work… going on,” records show. However, Ms. Hilton did not begin work that September because she said she was still undergoing treatment for the job-related stress she suffered at her previous position.

Ms. Hilton filed a workers comp claim for work injuries she suffered in March 2019, including vocal cord injury, aggravation of pre-existing lupus, heart murmur, and court records show.

A workers comp judge granted Ms. Hilton’s petition after finding her testimony was credible in describing “serious behavioral problems” at the law firm that caused her injuries, records show.

The Pennsylvania Workers’ Compensation Appeal Board affirmed the benefit award, and the Philadelphia law firm appealed.

A three-judge panel of the Pennsylvania Commonwealth Court affirmed Ms. Hilton’s benefit award on Tuesday. Still, it reversed a portion of the appeals board decision that would have allowed her to receive ongoing benefits.

The appellate court found that testimony from Ms. Hilton’s physician credibly established that she suffered injuries from working at a law firm, including exacerbating her pre-existing lupus in March 2019.

However, the doctor testified that Ms. Hilton was not disabled from working as a paralegal “as long as she did not work somewhere like her former frim,” records show. Therefore, the appellate court granted benefits to Ms. Hilton only from March 2019 to September 2019, when she could have begun working at the less stressful firm or position.