While statistically fewer than one in ten workplace injuries are fraudulent, employers can make the mistake of treating injured employees as damaged goods causing the claim to take on a life of its own.
1. Develop a pre-injury understanding of your return-to-work program – Workers must understand the workers compensation and return-to-work process. A wise approach is to educate them up-front by way of video, frequently asked questions, and other training tools. Stories of workers who were injured and had a successful return-to-work experience can encourage others to do the same.
2. Understand that emotions are involved – One of the first things to manage is everybody’s emotional response to an injury. Unfortunately, many managers think they have to now distance themselves from an employee, but nothing is further from the truth or more damaging to the relationship. Employees will be filtering to see if the company cares. If ignored when injured, they have the right to assume the company does not care. One can imagine how an employee will respond to the claims process fueled with the belief that perhaps they shouldn’t care either and the way to “get back” at the employer is to manipulate the system. Unfortunately, this result benefits neither the employee nor employer.
3. Create a post injury “We Care” package – Once somebody has reported an injury, it’s time to begin the return-to-work process. A “We Care” packet including a get well card, perhaps a meal coupon or gift card, a phone call from the manager, as well as an outline of the return-to-work process and frequently asked questions is a great starting point.
4. Stay in touch – One touch is not enough; it’s an ongoing process. Send that card, stop by with that dinner, and make that call. Anything to show the company really cares.
5. Get an employee back to work ASAP – Whether it’s light-duty or full duty, do everything possible to get an employee back to work. Remember this: insurance companies don’t pay claims, they simply finance them. The company pays the claim and the financing. The best practice is to pay the comp portion of the claim by returning employees to light-duty work. If the company doesn’t have a light-duty program, develop relationships with non-profit agencies in the community that can benefit and offer meaningful work. Make sure light-duty work is viewed as transitional work and take action when employees stop transitioning in their recovery. Legal note: Forcing demeaning light-duty work that can be viewed as a “punishment” for getting injured may trigger a work comp retaliation type claim. Contact your CWCA to obtain a sample of a light duty offer letter.
6. Challenge incomplete or suspicious medical information – Work with the claims adjuster and broker to get accurate medical information. It’s important to coordinate with federal and state laws.
7. Beware of the interplay of disability and medical leave laws – If there are more than 15 employees, the Americans with Disabilities Act (ADA) applies. Employers are required to help accommodate employees with a disability, regardless of its source, so that they can do the essential functions of the job they were hired for. If there are 50 or more employees, the Family and Medical Leave Act (FMLA) applies. An employee must be granted up to 12 weeks off for medical leave for a serious medical condition. Unlike the ADA, there is a requirement that the employee had to work at the company for 1,250 hours within the last twelve months. Therefore, new employees cannot apply for FMLA leave. Savvy employers begin the FMLA process at the beginning of any injury that looks like it might last more than a few days.
by Paul Hughes
The UNICO team is here to help you make the right choices when it comes to risk management. Give us a call today at 402-434-7200 or visit us online at www.unicogroup.com.