The two types of claims
When one of your employees gets hurt on the job in Oklahoma, the claim that gets filed will fall into one of two categories. Understanding the difference matters — because they don’t hit your insurance the same way.
Medical-only claims are exactly what they sound like. The employee gets hurt, receives medical treatment — an ER visit, a few doctor appointments, some physical therapy — and returns to work without missing any significant time. Workers comp covers the medical bills, the employee is back on the job, and the disruption is minimal.
Lost-time claims (also called indemnity claims) are more serious. The injury keeps the employee out of work long enough that they’re entitled to wage replacement benefits. In Oklahoma, that’s typically around 70% of their average weekly wage while they recover. These claims involve not just medical treatment but ongoing income replacement, sometimes lasting weeks or months — and in severe cases, much longer.
Why the difference matters for your premiums
Workers comp premiums in Oklahoma are directly affected by your claims history through a number called your Experience Modification Rate, or EMR. Think of it as your workers comp GPA — a number that reflects how your actual claims compare to what’s expected for a business your size and type.
An EMR below 1.0 means you’ve had fewer or less costly claims than average. That earns you a discount on your premium.
An EMR above 1.0 means your claims history is worse than average. That adds a surcharge.
Here’s where the medical-only vs. lost-time distinction becomes critical:
Lost-time claims carry significantly more weight in your EMR calculation. A single lost-time claim can do more damage to your EMR — and your future premiums — than several medical-only claims combined. The reason is straightforward: lost-time claims are more expensive overall, involve wage replacement on top of medical costs, and signal a more serious injury or a slower return-to-work process.
Medical-only claims still affect your EMR, but most rating formulas discount them at roughly 70%, meaning they count for less than their full value. The intent is to encourage prompt medical care without punishing employers for minor incidents that were handled quickly and correctly.
What this means for your business
A few things worth keeping in mind:
Report everything, but manage return-to-work aggressively. A medical-only claim that lingers into lost time because of delays — in reporting, in authorizing treatment, or in getting the employee back to light duty — becomes a much costlier problem. Prompt reporting and a clear return-to-work plan can be the difference between a minor blip and a claim that affects your rates for three years.
Your EMR follows you. Oklahoma’s EMR calculation looks at the three most recent policy years (excluding the current year). A bad lost-time claim today affects what you pay for the next several years. That’s why businesses with strong safety programs and active return-to-work policies consistently pay lower premiums than those that don’t.
Smaller businesses feel the impact more sharply. The EMR calculation is designed to be statistically credible, which means a single serious lost-time claim can move the needle significantly for a small business — far more than it would for a large employer with a higher volume of claims spread across the formula.
The bottom line
Medical-only claims are manageable. Lost-time claims are expensive — not just for the claim itself, but for the premium increases that follow. The best way to protect your EMR is a combination of workplace safety practices, fast incident reporting, and a return-to-work program that gets injured employees back on the job as soon as medically appropriate.
Not sure how your current claims history is affecting your EMR? We review this for free as part of every policy review. Give us a call or Click Here — we can usually tell you exactly where you stand in about 15 minutes.
Eagle National Insurance Group | Tulsa, Oklahoma | (918) 213-4443 | enatinsurance.com