Employers and adjusters often inadvertently drive up the cost of workers compensation by not controlling the cost of litigated work comp claims that go before the judicial arm of the state’s work comp system. A small portion of the workers compensation claims account for a disproportionate large amount of the cost of work comp. These high cost claims almost always include an element of litigation.
1- Avoid Lawyers
Lawyers for employees are normally paid a percentage of the amount the employee receives. This builds into the system an incentive for the lawyers to push up the cost of workers compensation. [WCx]
Employees do not normally hire attorneys out of greed (although a small percentage do). The usual reason an employee hires an attorney is the fear factor of not being able to support themselves and the family. Will the employer keep the job open for them, will the employer treat them differently from other employees, will the worker be able to get the medical care they need?
The best way to avoid attorneys is to communicate often and thoroughly with injured employees. Have an employee brochure, lanyard card instructions, weekly meetings, transitional duty meetings, include employees on transitional duty to office functions such as safety meetings, picnics, etc. Communicate, communicate, communicate – the more the better. Medical triage nurses will convey a feeling of caring and compassion, as well as competency in the necessary medical information.
2- Get the Right Level of Medical Care QUICKLY
The employer who quickly arranges medical care for an injured employee and stays in contact with the injured employee throughout the medical recovery period has a much lower percentage of litigated workers compensation claims than the employer who abandons the employee when an injury occurs. When the employer and the adjuster both answer all the questions of the injured employee quickly and honestly, the employee’s level of frustration, fear, uncertainty and anger all are diminished or eliminated. This greatly reduces the employee’s perceived need to “hire a lawyer”. If the employer does not answer all the employee’s questions when they are injured, the Yellow Pages are packed with attorneys willing to offer free consultations to answer those questions.
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3- Invite the Employee Back to Work
In addition to complete and on-going communications with the employee, a solid Return to Work program will reduce the number of litigated claims. Return to Work programs reduces litigated cases in two ways. First, they remove the concern over the employee keeping his job and keeping his rate of pay. Second, by keeping the employee physically active up to the limits of the medical provider’s imposed limitations, the employee is able to self-monitor the physical improvement, eliminating the concern about being able to return to the job. Additionally, return to work programs keeps the employee from sitting at home watching TV and all the commercials for attorneys trying to play on the fears or the greed.
4- Make Sure Medical Bills Are Paid
Employees are often concerned about the little things in the workers compensation claim that the employer takes for granted. A lot of employees, especially younger employees and those who work in businesses that have few workers comp claims, may not know that all the medical expenses will be paid for by workers compensation. The injured employee should be told that all of the medical expenses, including prescriptions and diagnostic tests will be paid for them. The injured employee needs the reassurance that the medical cost will not come out of the pocket. The injured employee should also be advised that the medical transportation cost will be reimbursed at the state’s set mileage reimbursement rate.
5-Don't Settle Too Quickly
One way employers inadvertently encourage employees to get an attorney is by paying a quick settlement to injured employees “to get rid of” the work comp claims. A settlement that is larger than it should be is like blood in the water to sharks. It will encourage employees to exaggerate legitimate claims and it will encourage employees of lower moral standards to make bogus claims. Also, the quick settlement, especially if it is higher than it should be, will result in the employee boasting about how easy it was. The best approach to the settlement of litigated claims is to pay what is fair and reasonable, even if requires higher defense attorney fees. [WCx]
While not being able to avoid all litigation in workers compensation, we recommend the use of these methods to significantly decrease the number of employees who file for a hearing before the judicial arm of your state work comp system.
*Also known as the Workers Compensation Bureau, the Department of Labor, the Department of Insurance, the Board of Workers Compensation, and other names
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: [email protected].
WORKERS COMP MANAGEMENT GUIDEBOOK: www.WCManual.com
FREE WORK COMP CALCULATOR: www.LowerWC.com/calculator.php
FREE 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.
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