The NHADA Workers’ Compensation Claims Team is made up of five staff members who bring their own unique experiences and personalities to the table; we are talking about a remarkable amount of time and experience in the medical field, underwriting, and claims management. You can rest easy knowing that we have the answers to your claims-related questions and then some. Your first phone call to report an injury gets the team engaged in the process of getting the injured employee to the best, most appropriate medical provider; educating the injured employee on the workers’ comp process, sometimes involving a visit from our road adjuster; obtaining the medical records and getting bills processed and, often times, assisting the injured employee with a return to work plan; etc. If that sounds like a lot of moving parts, it is; but we are up to the challenge. We understand at times the workers’ comp process can seem overwhelming and that our members are in the auto business, not the injury reporting business. We are here to walk you through the steps to help your injured employees recover as soon as possible and to keep you in compliance with state regulations.

Meet Our Team

Peter (Pete) Sheffer — WCT Director

Pete is responsible for the day-to-day operation of the claims department and oversees the staff. As well as his management duties, he is responsible for opening and closing claims, appropriately reserving all claims, and reviewing all open claims every 30 and 60 days. Pete also maintains an active caseload of lost time and medical-only claims. Once a week, Pete runs a meeting with a member of the claims team to review all claims that may involve lost time from work; the focus of the meeting is to strategize their return to work, update medical statuses, and bring all of the team up to date on the claim status. When the road adjuster, Heather Overson, investigates claims and reports back to Pete, he may also have his own set of questions for the employer and the employee. It may seem like some team members ask the same questions, but it is all part of the investigation and claims management process. Pete is also an expert on the NHADA WCT drug testing policy. Pete is happy to take calls from members with questions regarding the NH Workers Comp Statute, claims management concerns, reserving, or cost containment opportunities. Pete’s email is psheffer@nhada.com.

Marta Silakka RN, BSN, CCM, COHN-S — Nurse Case Manager

Marta is a Certified Case Manager as well as a Registered Nurse and a Certified Occupational Health Specialist. She is responsible for managing the medical portion of the injured worker’s claim. Most claims start with a call to Marta; actually, we hope that is how they always start. When an employee is injured on the job, either the employer or the injured worker should phone Marta for assistance. She will assess the extent of the injury by asking a variety of medical questions. Then, she will assist the injured worker in accessing the best and most appropriate medical care within the managed care network. Based on the injury and extent of medical care, Marta will continue to follow the injured worker’s claim after the initial assessment. She will monitor all open claims; assist with referrals for specialty care, and physical and occupational therapy; communicate with providers; and follow the medical care through to maximum medical improvement. Marta’s role includes sharing pertinent medical information with trust members and the claims team to help expedite their return to work. Her role continues throughout the claim and those injured workers who are out of work will hear from her weekly to check in and “see how they are feeling.” Marta’s email is msilakka@nhada.com.

Marianne Gourgiotis — Underwriter

Marianne is the Underwriter for the Workers’ Comp Trust. She is responsible for giving quotes to new members, overseeing premiums and billing, and is highly involved in audits, rebates, and calculations of experience modification factors. She is a wealth of information for members who have questions regarding payroll audits, changes in your operation and secondary locations, and their effects on your premium. Marianne also shares information with the Department of Labor, the actuary, and the reinsurance carrier, and she provides members with OSHA-required reports. She is also a licensed adjuster and oversees a caseload of medical-only claims. Marianne is the employee with the most longevity in the claims department, having worked here for over 38 years. She has worked in many different roles over the 38 years with the longest being in workers’ comp. Marianne is here to help you with questions regarding payroll audits, premiums, and coverage of executive officers, and she has experience in modification calculation and aircraft questionnaires, just to name a few topics. Having been here the longest and having seen the WCT grow to the successful program it is today, chances are Marianne is going to know the answer. Marianne’s email is mgourgiotis@nhada.com.

Heather Overson — Road Adjuster

Heather represents the claims team as the road adjuster. She establishes a face-to-face contact with the injured worker, the employer, witnesses and other parties as part of the investigation process of the claim. Heather covers the “how/when/where/why” of an injury. Her initial interviews with the injured workers are a crucial piece of the claim’s management process. The purpose of the investigation is to determine whether the injury, as reported by the injured worker, meets the definition of an “injury” per the NH Workers’ Comp statute. An injury is defined as one that “arises out of and in the course of the employment.” Heather’s questions to the injured worker and the employer are designed to determine whether the injury happened while the employee was at work and was caused by a risk or hazard created by their employment. Not every injury that happens at work was caused by work. It is Heather’s responsibility to collect information during her investigation to help the adjuster assigned to the case, Pete or Heather, to determine which claims are covered and which are not. Heather also carries an active caseload of both lost time and medical-only claims. She is a crucial part of the weekly claims meetings, sharing overviews of her meetings with the injured workers. Heather is happy to take your claims questions but is on the road frequently, so always feel free to leave her a message, drop her an email or call Pete Sheffer. Heather’s email is hoverson@nhada.com.

Deborah (Deb) Handrahan, AIC-M, CCP, AINS — Member Services Coordinator

Deb has been with NHADA WCT since 2008. She has been a NH licensed workers’ compensation adjuster since 1996. Deb was the road adjuster for NHADA WCT for 11 years prior to her transition into the Member Services Coordinator role. In her current position, she focuses on helping the members understand and comply with the NH Workers’ Compensation Statute RSA 281-A. Deb enjoys welcoming new members to the Trust and provides guidance in the hiring process in accordance with the Trust Agreement and the injury reporting process. She also takes pleasure in helping our members lower their claims costs by taking full advantage of the Second Injury Fund, negotiating charges with medical providers, and assisting with the injured worker’s return to work. In addition to all that, Deb appreciates being part of and supporting the workers’ comp claims team. If you have any questions regarding the injury reporting process, return to work process, Second Injury Fund, or anything workers’ comp related, please feel free to reach out to Deb at dhandrahan@nhada.com or (603) 224-2369.