In the course of my travels, I talk to many people. Mostly people in the insurance world as you can imagine.
Every now and then when I am on location I like to talk to the employees if my partners or employer hosts are not around. This is when you will get the truth about everything at this employer. Some of the common questions I ask are “How bad is the work comp situation here—anyone get any big cases or settlements? Is there a safety team? Do you know what to do if you cut half your hand off in that press while talking to me?”
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Employees’ Most Common Question Is If They’ll Be Fired
The last question usually gets their attention. However it is the questions they ask me that make it interesting. The question that I get asked a lot is “How will my bad shoulder (or whatever body part it is) affect getting another job if I get laid off or fired here because I can’t work full duty?”
That is an interesting question, and one that has many answers. This question is also one that can send otherwise good people off the deep end of malingering and secondary gain. This malingering, however, does not have to be the case. It all lies in the hands of how the adjuster handles the file combined with the relationship between the employer and employee.
Employee Answer #1: Do Not Worry If You Can Not Perform Your Job 100% Right Away
First of all, if you are worried because you have a heavy duty job and you need to be able to work full duty, don’t worry. You are not going to be full duty overnight. It is going to take some time, and a lot of rehab, but it can be done. You have to do the work, there is no magic pill that will make your shoulder or lower back 100% again. That is if it can even be 100% again, ever. Only time will tell.
Employee Answer #2: Communicate With Your Employer
Second, communicate with your current employer. If it has been a year since your surgery and you are only 75% better, try to work. Make yourself available. The worker still has the responsibility to take their medical slips to their employer each time they see the doctor. This is a good time for a conversation about the future and about light duty work. If you fail to properly communicate with your employer regularly, I could bet you will be terminated. If you are out of sight, you are out of mind.
Adjusters: Be Sensitive to Employees Real Concerns Regarding Future Income
Third, if I am the adjuster and my claimant says “Boy I don’t know if I can ever return to work again, I don’t know what I am going to do” I am immediately calling that employer and forcing him back to work in some capacity within the next 3-5 days. This is because the claimant is at the crossroads of not knowing about future income. If they are unsure about work, they are going to try and stretch that comp case out for all it is worth. If the employer cannot work the claimant, then I am going to place them in a non-profit or some sort of light duty somewhere through a re-employment facility.
If you fail to work the claimant in some capacity at this crucial apex then you are going to be in trouble. All of the sudden the pain is back, and worse, and radiating all over the place. Prescriptions are not working. This case is going to plummet into a disaster within 30 days and exposures are going to skyrocket.
Any adjuster would just set up an IME at this point. But remember this is for a legitimate, compensable, and complicated injury that you have already accepted. What is your IME going to tell you that the treating doc didn’t already say—that this person can work with restrictions?
Many Malingering Claims Can Be Solved With Light Duty Work
This highlights only a fraction of the reasoning as to why having a light duty job program is so important at every employer. I see tons of malingering claims, just hanging out there. They could be resolved by light duty work. It doesn’t have to be great work or work that pays a lot. It just has to be work. Just providing some work, and a purpose, can be the answer this person was looking for. Plus if they fail to comply now you can stop their wage benefits for non-compliance.
The work comp game is all about money and wages to the injured worker. They can deal with the pain, it is the unknown that worries them. These workers are providers for their family. They are going to do whatever it takes to secure income, even if that means stretching a comp case out as far as they can, selling their medications to friends, doctor shopping to get results they desire, retaining counsel, and so on.
So when I get asked the question about work comp cases affecting future employment my answer is this: “Why give your employer a reason to terminate you in the first place? If you are doing your job and doing it well, and you show up on time and work hard each and every day, you sound like an asset to this company. Not a liability.”
Author Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: [email protected].
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