Page 19 - Ohio RA 2011 Winter FlipBook

www.ohiorestaurant.org 17 Winter 2012 Issue

Questionable Claim?

Lessons from the trenches

Did you ever get the feeling that a workers’ compensation claim against your company was suspect, or worse? If so, you should contest the claim. Below are some tips that can help minimize or eliminate the claim and its potential to increase your workers’ compensation premium cost. These tips are useful at either the allowance stage of the claim or at later disputes in the claim.

The goal is to discover early on whether there is a basis to contest the claim or whether it is valid.

Here’s what to do to help in the management and defense of suspect claims.

• Establish and enforce a work rule that all injuries must be immediately reported to the worker’s supervisor or other responsible employee.

• Have your employee complete, in his/her own handwriting, your company’s injury report form. Encourage the employee to use as much time and paper as is necessary to tell his/ her story of what happened. Always ask, “Anything else?”

• Identify witnesses and obtain statements from each witness, in each witness’ own handwriting, what was seen, heard or is known. If the witness claims to have seen nothing or knows nothing, have the witness write this on the witness statement.

• Photograph the scene/area where the injury allegedly occurred.

• Always have the employee sign a medical authorization when the injured worker is completing the injury report form.

• Always ask the employee to write on the injury report form the name and address of the employee’s personal care physician.

• Know your employees. What are their hobbies, second or third jobs, sports participations, “weekend warrior” or high school sports injuries?

• If an employee turns in a slip/report/note from a doctor for time off for regular check-ups, non-work physical or psychological problems, etc. always retain the slip/report/note in the employee’s medical fle.

• If feasible, establish light/modifed/ transitional duty-work for injured workers.

• Educate the physician you direct your employees to for treatment about your business and work procedures.

• When an employee is en route for the initial medical care, always call ahead to the medical facility and alert the offce that you can and will provide light/modifed/transition work.

• Require your physician to report back to you on the same day as treatment was rendered, the doctor’s opinion on light/modifed/transitional duty and the abilities of your employee.

• Be aggressive in utilizing your doctor’s opinion as light/modifed/transition work ability in offering this type of work to your employee.

• Should your employee refuse an oral offer of light/modifed/transitional duty, immediately contact CareWorks Consultants, Inc. and/or your attorney to create a written offer of light/modifed/ transitional work to send to your employee. This is a very technical procedure, but, done properly, could eliminate a payment of temporary total disability (TTD) compensation to the employee.

• Document all discipline discussions and actions in writing and place in the employee’s personnel fle.

• Exercise caution in terminating the employment of an employee with an active workers’ compensation claim. This can result in a workers’ compensation retaliation lawsuit against you. As an alternative, consider trying to settle the claim with a resignation and release of all types of claims as part of the deal.

Defending and managing workers’ compensation claims can be frustrating and time-consuming. Nevertheless, the tips and techniques listed above can help control claims costs and your workers’ compensation premium.

For additional information or to discuss these recommendations, please call Bruce Fahey, esquire for Kastner Westman & Wilkins (KW&W), at 330-867-9998. KW&W is committed to helping companies build the solid foundations they need for effective human resources management. KW&W’s practice is limited to representing management exclusively in the full range of workplace issues – labor and employment law, workers’ compensation, employee benefts and human resources consulting.

By Bruce Fahey, Esquire

Kastner Westman & Wilkins