Employers interact with employee disability through a number of laws. Until now, there has been little attention focused on how to coordinate statutory compliance to achieve better overall results. Workers compensation, in particular, has operated with little or no coordination with other laws.
Recent efforts, however, have demonstrated that dramatic lowering of new filed comp claims and lowered x-mods can be achieved with inexpensive measures that are only slight extensions of measures already being taken by employers in high comp rates industries such as transportation, construction and many types of manufacturing.
The new efforts require training of key people to slightly modify practices already in place. Virtually nothing has been written about the possibilities. The entire field of simultaneous disability interactions through two or more laws contains surprising results, no longer theoretical since a small group of employers are presently using the methods with entirely favorable results.
Methods for Improving Disability Management
There are several key methods that improve disability management.
1. Improved reporting of first reports of injury.
The number of employer first reports of injury that are filed with gaps in vital information is too large to be due to occasional oversight. The unanswered questions on first report of injury forms (FROIs) is one of the primary reasons for unnecessary delay, and late investigations of questions that should have been answered within a day or so following an injury.
This problem can be solved with a short period of training and a follow up period of working with the employer on actual new FROIs.
2. Coordination of workers compensation with other laws.
Certain types of employers have powers under federal laws which are unappreciated. Transportation companies have the power, under DOT regulations and construction companies, under OSHA, to schedule IME examinations to investigate new claims. Such exams can be done within the first week after an accident report, far faster than the several weeks to several months (and even several years) common in workers compensation claims. These examinations restore the primary control to the employer.
The employer must schedule and pay for the exams. There is no outside control or interference by the carrier/TPA, a comp board, or attorneys; they are not even notified of such exams and the results are sealed without a HIPAA or a valid subpoena.
In addition, other laws, such as FMLA, UI, SSDB, STD, LTD, negligence, no fault MVA, discrimination, ADA and a wide variety of other state and local laws and ordinances contain similar provisions for investigation by the employer.
3. Searches for prior medical records.
Obtaining prior medical records as soon as possible is the single greatest asset in disability control. However, most comp carriers make little or no efforts until a claim has become large and dangerous. Even then, efforts are hampered by state work comp laws. An employer using investigations allowed under other laws can quickly obtain HIPAA releases and have prior medical records in a few weeks, sometime as quickly as a few days, after an injury.
These records will prevent inconsistencies, concealment, exaggeration and incorrect causal relationship from being introduced into other records, such as a workers compensation claim file.
4. Central control of communications and records.
An employer using proactive measures, becomes the center of communication and the central repository of information. This leads to an entirely different role for the employer, which replaces having the comp carrier/TPA as the sole party interacting with a worker.
5. Retaining a proper relationship between the employer and employee.
A proactive employer, using several laws, retains an active role in the disability process. Employees with legitimate claims are pleased to have the employer involved. Often the employer can defuse needless delays and controversies caused, not by the employer, but by the carrier/TPA. Without the employer’s assistance, many unnecessary delays can result in disastrous delays in benefits to a family.
Exaggerated claims, on the other hand, are often dropped when the employer is the first to ask the correct questions and schedule the first exams.
The benefits of improved employer involvement cannot be overestimated.
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 protected]
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