Get the Best from an Independent Medical Examination

Nothing is more exasperating than to have an Independent Medical Examination challenged or disregarded in a claim where a medical controversy exists.  These examinations can cost thousands of dollars for the examination visit and several more thousand dollars if the doctor testifies.

 

Challenges occur due to timeliness, improper foundation of information, improper doctor choice for the examination, lack of testing by the examining doctor, improper direction or no direction by the adjuster or medical manager for necessary results to meet objective of the controversy and the local state workers compensation law.

 

Many jurisdictions may limit the number of independent medical examinations.  Others make the appointment process and notices to claimant cumbersome.  This allows for delayed appointments.

 

 

Step One Pre-Determine:

 

Every injury has some normal time frame for medical recovery.  As soon as the injury occurs it is essential to research with medical professionals (Doctors, Nurses, Medical Managers, and Or Nurse Practitioners) to expected normal recovery. If this is not feasible the minimum would be to use medical reference materials.  The internet has many such web sites.

 

Once an expected recovery time is established the claim needs to be placed on diary for a medical study at the half way recovery point.  Review current treatment, and status.  Is the treatment in keeping with medical accepted practice? What are current symptoms? Is the claimant compliant with treatment needs? Has there been any underlying pathology discovered?  Are treatment dates and follow up appointment reasonable and in keeping with proper medical practice?  Should a medical case manager be assigned or review the process?

 

If the claim adjuster or employer is not sufficiently knowledgeable for this review, it should be done by a medical management professional.

 

Any hint of deviation requires immediate action to determine appropriate considerations for future modifications.

 

 

Step Two Properly Prepare:

 

Always chose the proper doctor for the Independent Medical Examination or Consultation.  An Orthopedic Specialist should not review an eye case.  Silly as it seems such situations can occur if there is a shortage of good Independent Medical Examiners.  It is best if the Specialist is Board Certified.

 

Set appropriate reserve funds to cover the examination costs, tests, studies, and report preparation. Be prepared to cover costs the claimant may incur.  These could include transportation, hotel and meal cost.

 

The adjuster, employer, or medical manager, need to prepare a complete package for the examination doctor.

 

 

The package must include:

 

  1. A complete history as to how the injury occurred.
  2. Copies of all medical reports, examinations, treatments, x-rays, drugs being used, current course of treatment by attending medical providers, and any information from the employer as to the employee’s health background, job performance,  job attitudes and any other information that could be of value for the examiner to consider.  (Be careful to observe proper protocols for using information and how it is used in the examiner’s reporting.  Telephone discussions should be used prior to written documentation.
  3. A thoroughly complete job description. Include requirements for training, education, experience, physical demands, safety equipment, fellow employee interaction, hours to work, security needs, as well as any other aspects of the job operation.
  4. Discuss with the examining doctor any needs or other items that will help in the exam or evaluation report. Use the Examiner’s judgment as to the examination timing for best results. Discuss all objectives to be met by the exam and the report. Have the examining doctor provide physical functional capacities that the employer might use for light duty work until full recovery.
  5. Obtain a list of items from the defense attorney for needs to address. Telephone before documenting in writing.
  6. Put all appropriate items (from paragraphs: 3, 4, and 5 above) in a full written letter to the Doctor. Add any special or other need you want the doctor to address in the report.
  7. As soon as the examination date, time, and place is established send the claimant necessary notice in writing. Send two copies one regular mail and the second registered mail requiring a signature. Copy claimant and defense counsel where necessary.
  8. If claimant has counsel who will want to attend the examination it may be necessary to have a medical case manager in attendance as well. This would probably best be handled by defense counsel.

 

It will likely be necessary for the claimant and counsel to have copies of the examiner’s report. Have defense counsel review it before release and have appropriate corrections made. If the attending doctor has any objections, advise the examining doctor at once for response.

 

Be certain the latest items for both examining and attending doctors is current at the time of any hearing or testimony.

 

These are just the basics for a successful Independent Medical Examination.  As always, it is best to be guided by defense counsel on investigations, reports and handling to obtain successful judicial results.

 

 

 

Author Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. He is an expert in employer communication systems and helps employers reduce their workers comp costs by 20% to 50%. He resides in the Boston area and works as a Qualified Loss Management Program provider working with high experience modification factor companies in the Massachusetts State Risk Pool.  He is co-author of the #1 selling book on cost containment, Your Ultimate Guide To Mastering Workers Comp Costs www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

 

©2015 Amaxx LLC. All rights reserved under International Copyright Law.

 

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

 

Good News for Many Nevada Employers

Employers are always happy to hear the news of lower costs to their workers compensations premiums.

 
With that in mind, many Nevada employers will see a small decrease in the premiums they pay for workers comp insurance this year.

 
Insurance Commissioner Scott Kipper recently approved a filing from the National Council on Compensation Insurance (NCCI) for an average decrease of 0.5 percent for Nevada workers comp voluntary insurance loss costs. Nevada employers who purchase their workers comp insurance in the assigned-risk market will see an average rate decrease of 5 percent. Both changes are scheduled to take effect on March 1, 2015.

 
While most employers traditionally purchase workers comp insurance in the “voluntary market,” those who find their businesses uninsurable due to extraordinary losses in the past or unique and unusual risks can purchase insurance for their businesses in the “assigned-risk market.”

 
Claims Projected to Grow at Slower Pace

 
The 0.5 percent decrease in the voluntary market is largely a result of projections that indicate workers comp claims will grow at a slower pace than previously expected.

 
The 5 percent decrease in assigned-risk rates is largely due to the significant expense reductions achieved as a result of Nevada’s recent servicing-carrier bid, effective Jan. 1, 2015.

 
The approved loss costs and rates can be found on the Nevada Division of Insurance website http://doi.nv.gov/Insurers/Property-Casualty/Filing-Information/Workers-Compensation/.

 

 

 

Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com.  Contact: kstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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Effective Use of Employee Recorded Statements

The use of recoded statements is one tool claim management teams have to assist in the discovery process.  Before taking a recorded statement, it important to understand the legal and practical implications of this process.

 

 

Understand the “Rules of the Road”

 

Before you take a recorded statement of an injured worker, a member of the claim management team needs to understand the legal implications.  As with most things in workers’ compensation cases, it is important to understand how the law in one jurisdiction varies from another.  Failing to understand this issue can impact the admissibility of the recorded statement later on in the case.

 

 

Develop a Strategy First

 

Once a claim comes into your office, you will have an opportunity to review various documents.  These documents include a First Report of Injury, medical records and other reports.  Before taking a recorded statement, it is important to “size up” the parties involved in the claim.  This can include speaking to the claimant informally as you gather information.

 

During this phase of a claim investigation, it may also be important to talk with an attorney if you feel the claim will result in litigation.  Part of this discussion can also include the development of defenses and subrogation matters.  Following your internal policies and procedures is also important.

 

 

Issues of Admissibility

 

It is important that the recoded statement is admissible later on in the life of a workers’ compensation claim.  This results in many considerations when you anticipate the need for taking this statement:

 

  • Timelines required for when the statement needs to be taken, if any;

 

  • The method in which the statement should be taken. This is an important consideration if the employee has retained an attorney; and

 

  • In most jurisdictions, the recorded statement needs to be signed by the claimant. If this is the case, be aware of any barriers you might have in getting the recoded statement transcribed and sent to the employee.

 

 

Recorded Statement Best Practices

 

Taking a recorded statement costs money and time.  It is important to plan wisely.

 

  • Some attorneys recommend that you wait at least 30 days to take a recorded statement. This allows you to develop defenses and obtain important information.  It is likely that by waiting a short period of time, you will develop key facts it is important to understand later on in the case.

 

  • Receive necessary internal approvals for using a recorded statement. In jurisdictions that require the statement to be signed by the injured worker, it is important to have procedures in place where the timelines can be met.

 

  • Develop effective questions for the recorded statement. Make sure that you obtain the necessary background information about the claimant.  This will include information about their vocational, educational and medical background.  It is also important to have the claimant describe work injury in detail.  This will come in useful when working with a medical expert or at a deposition.

 

  • Listen and be flexible. Remember that everything the claimant is saying is being recorded.  Take some notes as you go, but remember that if you are not listening to what is being said, you could be missing important information.  Use a written outline, but also be prepared to change gears so the statement has a natural flow.

 

Recorded statements can also be taken of lay witnesses.  Be sure to know the procedures and protocols if you plan on taking the statement of a person who is not a party to the workers’ compensation claim.

 

 

Conclusions

 

Recoded statements are an effective tool in workers’ compensation claim discovery.  While this is a rather inexpensive tool, it is important that you understand the law and what it requires when using this method.  Failing to develop a strategy can be costly.

 

 

 

Author Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. He is an expert in employer communication systems and helps employers reduce their workers comp costs by 20% to 50%. He resides in the Boston area and works as a Qualified Loss Management Program provider working with high experience modification factor companies in the Massachusetts State Risk Pool.  He is co-author of the #1 selling book on cost containment, Your Ultimate Guide To Mastering Workers Comp Costs www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

 

©2015 Amaxx LLC. All rights reserved under International Copyright Law.

 

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

New Zealand Director Sentenced, Company Fined

Failing to have in place the proper workplace safety rules has led to consequences for one New Zealand man and his company.

 
The director of a house-moving company has been sentenced to four months home detention, and his company fined $60,000, after a house he was transporting brought down a power line. The power line was left live on the side of the road, killing six lambs, five ewes and two sheep dogs. The shepherd narrowly avoided being electrocuted in the incident.

 
Arthur Britton’s company, Britton Housemovers Limited, was sentenced recently in the Hastings District Court on charges under the Electricity Act 1992, and Health and Safety in Employment Act.

 
On Dec. 18, 2013, the company was moving a house under Britton’s direction along Herbertville Road in Herbertville. The house crashed into the power line which then snapped and fell onto the roof of the house. An employee used a wooden stick to move the power line into a roadside ditch.

 
Several sheep walked into the ditch and were electrocuted. Two sheep dogs then ran after the sheep and they were also electrocuted. The shepherd reached out to grab the dead sheep but was pulled back at the last moment by the farmer, narrowly avoiding electrocution.

 

No Follow-up Action Taken

 
The house-moving convoy moved on, but the farmer and the shepherd chased after the convoy and told them what had happened. Following a verbal dispute, a Britton Housemovers employee returned to the scene to put cones down. Even after this argument, no Britton Housemovers employee called the appropriate authorities – they were called by the farmer.

 
“Electricity is unforgiving. Leaving a live line on the side of the road and not notifying anyone is unacceptable – the shepherd and others in the vicinity could have been killed,” said Brett Murray, general manager of High Hazards and Specialist Services.

 
“This company was involved in a similar incident three years ago. There is no excuse for their behavior and they were very lucky that the farmer’s quick thinking stopped a possible death.

 
“Britton and his company did so many things wrong in this incident. Home detention and a large fine send a clear message to others. It is also worth considering the consequences for this company if there had been a death.”

 

 

 

Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com.  Contact: kstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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Response To ProPublica Report

I am reading the ProPublica Report with great interest because there are many things I agree with. After reading all the press brouhaha over this report however, I still regard the high cost of workers compensation (for those companies which do have high costs) mostly as a management problem.

 

 

TPA or Carrier Is Often Blamed For Workers Comp Problems

 
The companies I see — which are the ones that have huge problems — are clueless about workers comp. They turn their claims and injury process over to their claims administrator or carrier, hardly participating in the process, then they blame the TPA or carrier when costs go up even though they have done nothing internally to manage safety or injuries.

 
These companies never budget for workers’ comp management, don’t staff the risk department (if there even is a “department”) properly. THAT would cost money and our headcount would increase, they say. Often if they do have staff, they do not allow, encourage or require the staff to attend conferences, seminars or join organizations or purchase resources. THAT would cost money, they say.

 

Sometimes their brokers offer to help by providing consulting resources, and the companies with high workers comp costs do not see the merit in such an approach. I worked with a major entertainment facility, speaking with them once per week, on behalf of their broker, hoping to gain insight. I offered to “consult” with them since I am a consultant, getting to the root of the problem, finding the cost drivers, and fixing them is what I do. They did not need a “consultant”. Then, one day I said I could “help them develop their training program” and they accepted instantly! I had used the wrong word — they needed “training help” not “consulting help”. Within months the high cost of their workers compensation program went down to almost zero. Problem solved.

 

 

Workers Compensation Needs To Be Managed

 

If you don’t manage and monitor it, the process (any process, not only workers’ compensation) will not work well.

 
It’s time for employers to become involved in their own business! The first step is assessing the problem in YOUR company, not the industry in general or another company, but get that mirror out and have a look. You are most likely looking at the problem.

 

End.

 

 

 

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact:RShafer@ReduceYourWorkersComp.com.

 

 

 

Editor Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. He is an expert in employer communication systems and helps employers reduce their workers comp costs by 20% to 50%. He resides in the Boston area and works as a Qualified Loss Management Program provider working with high experience modification factor companies in the Massachusetts State Risk Pool.  He is co-author of the #1 selling book on cost containment,  www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

 

©2015 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

SALES TO PAY FOR ACCIDENTS CALCULATOR:  http://reduceyourworkerscomp.com/sales-to-pay-for-accidents-calculator/

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

 

 

Cal/OSHA Reminding Employers of Posting Obligations

In an effort to stay up to date on safety regulations, Cal/OSHA reminds all California employers to post their annual summaries of work-related injuries and illnesses from now through April 30.

 
“This yearly requirement is a graphic reminder on the importance of workplace safety. It provides important data about injuries and illnesses that took place at the worksite, and highlights the need to address potential hazards,” said Christine Baker, director of the Department of Industrial Relations (DIR).

 
Cal/OSHA, also known as the Division of Occupational Safety and Health, is a division of DIR.

 
“Employers must summarize information about every work-related death, and every recordable work-related injury or illness,” said Cal/OSHA Chief Juliann Sum.

 
The definitions of and requirements for recordable work-related fatalities, injuries and illnesses are detailed in California Code of Regulations Title 8 Sections 14300 through 14300.48. Instructions and form templates can be downloaded for free on Cal/OSHA’s Record Keeping Overview.

 
The overview includes the summary template, Form 300A, a required workplace posting which must be placed in a visible and easily accessible area at each worksite.

 
All current and former employees, as well as employee representatives, must be allowed the opportunity to review any injury or illness that took place at the worksite during 2014.

 
Posting Required Even if No Injuries Occur

 
Employers are required to complete and post Form 300A even if no workplace injuries occurred.

 
More information on employers’ posting requirements or how to reduce workplace injuries and illnesses is available on the DIR’s Employer Information webpage. Cal/OSHA helps protect workers from health and safety hazards on the job in almost every workplace in California.

 
Cal/OSHA’s Consultation Program provides free and voluntary assistance to employers and employee organizations to improve their health and safety programs.

 

 

 

Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com.  Contact: kstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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Facts Are Most Important Contribution From Employer In Work Comp

Your correspondent has decades of experience with comp claims and, therefore, decades of contact with angry dissatisfied people – mostly employers and employees. Complaining seems to be their first choice, but this is not effective. Participation, even when uninvited, is a far better alternative.

 

 

Facts Are The Most Valuable Contribution An Employer Can Make

 

What is the most valuable contribution an employer can make to a claim? Facts. All claims are supposed to be based on a collection of facts, starting with descriptions by the parties – employer and employee. But the initial set of facts comes from the first report forms and, in most claims, ends there. But complicated, serious or contested claims will need a lot more than the initial report.

 

Employers usually feel that if more than an initial report is required someone will call and ask. That, however, is an act of faith, not participation. Getting a late start on information is a leading cause of lost opportunity – especially for employers. It is far better for the employer to contribute more information to the carrier in addition to the first report of injury.

 

 

See Attached Is Most Important Thing You Will Write On First Report

 

A first report calls for one sentence descriptions of the accident – hardly enough for the important claims. Therefore, a one page narrative is to be preferred. “See attached” is the most important thing you will ever write on a first report.

 

Another attachment should be a list of all other claims made by the worker. In addition to claiming an accident, did the worker apply for unemployment? Disability insurance? Retirement? Discrimination? These can be very important, even when they preceded the accident report by weeks or months. Unreported claims for unemployment which precede the accident report are especially critical, and often unknown to the carrier, TPA and Board.

 

 

Has The Worker Had A History of Poor Attendance?

 

Has the worker had a history of poor attendance prior to the claim? That is very important to know, especially on contested claims. If attendance problems exist – document them. And send to the carrier with the first report.

 

Did the worker have more than one job? You may have an apportionment opportunity. But only if you document and attach. Name address and phone number of employer, please. Also wages and hours, if known.

 

Medical and disability problems? These are always relevant but you are better off first calling for a private off-the-record talk with the carrier about these. The same goes for marital, financial and legal difficulties – which are often the motivations for an exaggerated claim.

 

Do you have documents? Especially prior decisions by government agencies. Unemployment claims which have been decided in the employer’s favor often precede dubious comp clams but are unknown to the carrier and the Board in the majority of cases. Your defense will be far more effective if a copy of that unemployment decision reaches the carrier as soon as possible, preferable with the first report.

 

 

Any Lawyer Can Make Controversy Out of Silence

 

Any lawyer can make a controversy out of silence. Useful communication now will eliminate the need for complaints later.

 

 

 

Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100. medsearch7@optonline.net

 

©2015 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

 

Washington State Motel Put Workers at Risk

Placing workers in a precarious safety position has led to fines for one employer in Washington State.

 
Exposure of workers to used hypodermic needles while cleaning rooms and a lack of required training on the use of chemical cleaners are among the violations that have resulted in a fine and citation for a Vancouver Motel 6.

 

The Department of Labor & Industries (L&I) has fined the motel $112,450 for multiple willful and serious violations related to health hazards to workers.

 

An L&I inspection at the Motel 6 on NE Chkalov Drive found there were five needle-stick injuries to workers at the motel in the last two years. A person exposed to infected blood from used needles can contract an infectious disease such as HIV, Hepatitis B or Hepatitis C. These diseases can cause permanent disability and death.

 

The inspection began in August 2014 after L&I received a complaint that workers were exposed to used hypodermic needles.

 

The employer was cited for four willful violations of the health standards that protect workers from biological hazards. Each of the willful violations carries a penalty of $27,500.

 
Repeat-Serious Violation Also Occurred

 

The employer was also cited for a repeat-serious violation for failure to train workers on safe use of chemical cleaning products, and two repeat-general violations for not holding regular safety meetings and not maintaining records for blood-borne pathogen training. The employer had previously been inspected and cited for serious violations for in 2011 and 2012.

 

A willful violation can be issued when L&I has evidence of plain indifference, a substitution of judgment or an intentional disregard to a hazard or rule. A serious violation exists in a workplace if there is a substantial probability that worker death or serious physical harm could result from a hazardous condition.

 

The employer was given 15 working days to appeal the citation.

 

Penalty money paid as a result of a citation is placed in the workers compensation supplemental pension fund, helping workers and families of those who have died on the job.

 

 

 

Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com.  Contact: kstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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Dealing With Illegal Aliens in Workers’ Compensation

Over the last several years, many states have confronted the issue of whether illegal aliens are entitled to workers’ compensation benefits.  This emerging topic has resulted in many claim management teams to develop strategies to deal with this complex issue.

 

 

Background

 

Due to concepts of federalism, it is important that claim management teams understand the statutes and case law interpretations in the jurisdiction they are handling the claim.  There are four categories of states when it comes to workers’ compensation benefits entitlement of illegal aliens:

 

1. Entitlement Codified in Statute: In states such as South Carolina and Texas, the state workers’ compensation act specifically entitles persons who entered the United States illegal the ability to obtain benefits if they suffer a compensable workplace injury.

 

2. Entitlement via Case Law. An example of this category is the state of Minnesota.  In Correa v. Waymouth Farms, Inc., 664 N.W.2d 324 (Minn. 2003), the Minnesota Supreme Court held that the workers’ compensation statute only refers to an “employee” and the entitlement to benefits is not dependent on “legal” status.  Other states falling into this category have similar thought processes.  No challenge to this interpretation has reached the Supreme Court of the United States.  Most legal experts are of the option that such rationale would ultimately be upheld.

 

3. Entitlement Granted to only “Employees” of Legal Status. The number of states falling into this category is limited.  One example is the state of Wyoming, where the definition of an “employee” entitled to benefits is limited to the “legally employed…”  The Wyoming Supreme Court upheld this law following a legal challenge.

 

4. Entitlement Undefined. These are jurisdictions that have not addressed the issue in either statute or case law.  It is assumed that barring any statutory changes similar to those found in Category III, courts in these states would follow the rationale of the Correa case.

 

 

Practice Pointers: Essentials for Claim Management Teams

 

Claims involving persons working in the United States illegally can significantly increase exposure in workers’ compensation matters.  This is mainly due to the ability, or lack thereof, of an injured work to obtain gainful employment based on their disclosed employment status.

 

  • Treat ALL injured workers with respect and dignity. The “face” of the American worker is rapidly changing.  With this change, it is important to treat all claimants how you would want to be treated.  Do not assume that someone is in the United States illegally based on their name, primary language or other ethnic background.

 

  • Know the Law (and interpreting case law). Statutes and case law interpretation change.  If you are not aware of the law’s current status, be sure to consult an attorney.  It is also important to consult an attorney if you are handling a claim in Category I, II or IV jurisdictions.  Once you become aware of someone’s immigration status, it may be difficult or even illegal to have him or her engage in certain return-to-work activities.  These include aspects of job search or engaging the employer to offer that person a light-duty position.

 

  • Be creative. A high percentage of people in the United States illegally have limited English proficiency.  While there is no official language in this country, chances of success depend on literacy and the ability to communicate effectively.  When handing a claim involving an illegal alien, some rehabilitation services you might want to consider include courses in “English as a Second Language,” (ESL) reading courses (even in their native language) and other opportunities that increase this person’s chances of success.

 

  • Engage specialized vocational rehabilitation experts. The diversity of American culture has resulted in a growing number of vocational experts of differing cultural backgrounds.  This includes a greater pool of people who are multilingual and have the ability to communicate with non-English speaking persons.   Engaging companies with a wide variety of professionals will only increase your chances of closing your file and mitigating exposure.

 

 

Author Michael Stack, Principal of Amaxx Risk Solutions, Inc. He is an expert in employer communication systems and helps employers reduce their workers comp costs by 20% to 50%. He resides in the Boston area and works as a Qualified Loss Management Program provider working with high experience modification factor companies in the Massachusetts State Risk Pool.  As the senior editor of Amaxx’s publishing division, Michael is on the cutting edge of innovation and thought leadership in workers compensation cost containment. http://reduceyourworkerscomp.com/about/.  Contact: mstack@reduceyourworkerscomp.com.

 

©2015 Amaxx LLC. All rights reserved under International Copyright Law.

 

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

Ohio Man Caught with the Goods

It is pretty hard for a defendant to get away with workers compensation fraud when videotape is involved.

 
A McDonald (Trumbull County) man was sentenced earlier this year in Franklin County Court of Common Pleas after investigators with the Ohio Bureau of Workers Compensation (BWC) caught him on video working while he was receiving benefits following a workplace injury.

 
Michael Buckner previously pleaded guilty last November to one count of workers comp fraud, a fifth-degree felony.

 
“We rely upon the eyes and ears of medical providers, employers, claimants and our own employees to report suspected workers compensation fraud,” said BWC Administrator/CEO Steve Buehrer. “In this case, a tip is what enabled our investigators to catch Buckner in the act of committing fraud. We encourage anyone who suspects claimant, employer or medical provider fraud to contact us immediately.”

 
BWC received an allegation that Buckner reported to his BWC medical appointments with heavily callused hands and dirt under his fingernails, and that he may have worked while receiving temporary total disability benefits. Claimants are not permitted to work while receiving this type of benefit.

 

Working and Receiving Benefits

 
Using financial records, surveillance operations, undercover operations, field interviews and Buckner’s testimony, investigators found that Buckner was working at his family’s automotive repair business while receiving temporary total disability benefits.

 
Buckner was sentenced to 11 months of incarceration, which was suspended for three years of community control.

 
He was also ordered to find full-time employment and to repay $21,642.60 in restitution to BWC. Wages will be garnished from his paychecks until the restitution is paid in full.

 

 

 

Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com.  Contact: kstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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