Employers and employees are the most important persons in a comp claim. The law does not treat them very differently, although it gives a few advantages to the employee. However what makes a very big difference is how they communicate during a claim.
Communication is vital to the success of any claim or other legal action, but in workers comp two very different methods have evolved: one for the worker, but a very different one for the employer. [WCx]
A worker in a serious comp claim generally has a lawyer to coordinate the communications. Indeed, the worker is strongly advised not to communicate with anyone but the employer. The employer, in turn, will encourage regular communications from the worker, especially before a hearing. Also, a worker will generally have direct communications shortly after a hearing to provide information, documents, etc.
It might be expected that the employer has a similar relationship with the lawyer or representative appearing at hearings on the employers’ comp claims, but it is rarely so, even though close communication and participation inevitably reduces expense and hearings. In NY, more so than nearly every other state, the employer is typically invisible in the proceedings.
Comp insurance agents were recently asked what employers said about actual claims, and when they said it. The answers exposed a glaring deficiency. The employers complained long and hard about the FINAL results of a claim, but almost never spoke to a carrier, lawyer or agent while the claim was in progress. Communication was inevitably too little and far too late.
Employers should be aware that a person complaining is a person saying things that can no longer be effective. So the first thing an employer should do is to be the first person to speak, never the last.
A second piece of advice for employers is to speak, with caution, to as many people as possible, not just a single claims examiner. Many people have to be informed ASAP in order for a claim to be handled effectively, and the law expects the employer to be involved. In addition to a carrier, the Board, the doctor, the worker, and many others must be informed simultaneously, not in sequence. Communication by forwarding through one person to another ceases with the first break in the chain and, at best, is only as quick as the slowest link.
Communication takes a bit of work, but it costs a lot less than paying three to four times as much on a moderate size claim. And it can save a lot more than that. [WCx]
A final benefit to all that communication is that whoever volunteers to do it becomes the “center of communication”, which has priceless advantages. Whatever extra efforts are involved save far more time, and money, in the overall reduction of “claim friction”.
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
WORKERS COMP MANAGEMENT MANUAL: www.WCManual.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.
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