The average active measures used by an employer on a New York comp claim consist of filling out the three most common forms (C-2, C-11 and C-240) and little else, unless they are called to testify.
Employers are rarely asked to do more. But doing more lowers costs, reduces litigation, prevents fraudulent claims and gets the proper benefits faster to the honest workers. (WCxKit)
There are many things an employer can do, but the five most basic are:
1. Have a plan for dealing with the worker, starting as soon as a report of injury is received
2. Know how to fully complete the first report (C-2) and know what additional document should be attached to the C-2 and forwarded to all parties.
3. Have a plan for a return to work (RTW) meeting with an employee out of work due to a work related (or allegedly work related) injury.
4. Have a plan for communicating with the law firm that will be handling the comp hearings for the carrier.
5. Know how to detect and make inquiries about possibly fraudulent activity on the work comp claims.
There are many other things that an employer can do, but the above are indispensably important.
A full description of how the above five can be carried out will vary from employer to employer but the basic measures will serve the following purposes:
1. Dealing with the worker.
Many claims that are filed are due to improper understanding of comp by the employee, or poor leadership by the employer. A surprising number of potential claims are never pursued with proper employer handling. This is called the post injury process, by cost containment experts such as Rebecca Shafer, and should be a tightly controlled process of each step that takes place after an injury. Of course, the process must be in place before the injury occurs, so planning ahead is critical.
2. Completing and documenting the first report (C-2).
A C-2 form must be filed for all reports of an injury involving more than first aid. However, much more information is usually required for proper handling. That can only be put into the WCB’s, or the carrier’s, file if additional documents are attached. The C-2 form simply does not have enough space to properly report for all claims. Never leave spaces blank because that gives the other side an opportunity to provide such information, and that might not be good for the employer.
3. A return to work (RTW) meeting.
In the past, return to work discussions rarely occurred until after a major claim was settled and closed. That, however, is far too late to achieve positive results. A return to work meeting should be held with the worker no later than 6-9 months after the date of accident and ALWAYS before the carrier makes a settlement offer for a serious claim.
4. Communicating with the carrier selected law firm.
If there are hearings, and most claims have hearings, the employer will be represented by a law firm selected by the carrier. In NY, the law firm represents the employer, not the carrier, but that is frequently forgotten and the employer then loses most of its opportunities to engage in a useful way.
The employer should always know who is representing their company and should communicate frequently.
5. Being active in reporting and suppressing fraud.
Most information necessary to defeat a pattern of fraud will come from the employer’s files. Employers frequently suspect fraud, but few are trained in how to detect it and defeat it. Anti-fraud measures require a certain amount of special training to be effective. (WCxKit)
An employer who incorporates the above into its workers comp plan will see a dramatic decrease in comp costs. The measures do not cost much and do not require much effort, with proper training.
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. email@example.com
MODIFIED DUTY CALCULATOR: www.LowerWC.com/transitional-duty-cost-calculator.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.