Why Employers Need To Actively Participate In Work Comp Claims

Most employers could be paying less in workers compensation premiums if they participated more. An example of an employer who tried a little, but not enough, shows how effective participation is essential. What follows took place a few years ago and is completely true.



Employer Heard A Rumor The Employee Was Working


A large employer had a problem workers compensation claim. The employee was not trusted. The employer heard a report that the employee was, in fact, working. The employer notified it’s carrier who began an investigation. An investigator was assigned to catch the employee working and document it, if possible, with films.


The investigator succeeded, but requested additional time to fully document the work activity. It was granted. The investigator sent a considerable amount of film showing the employee driving to work and parking his car every morning at 8AM.



The Problem? He Was Working At His Old Job


The problem? He was driving to the employer’s main plant. He had, in fact, returned to his old job.


Bad communication. Very bad! The personnel department did not automatically communicate with the risk manager. The risk manager took a rumor and assumed that the carrier would find out the truth, which, eventually, it did. The attorney for the employer/carrier was the last to know that all this was in progress. The investigator said that it had completed the assignment as requested. Who was he to question why the employer wanted to photograph its own employee going to his usual job?


A lot of people were left looking more than foolish. Mercifully, the employee never found out what had happened. He was never overpaid and never suspected that his every move in the employee parking lot was being watched and filmed.


This was the most extreme example of good intentions leading to a result that should have been the script for a television sit-com.



Employers Need To Be Active Participant In Work Comp Management


What should have happened was that risk manager should have spoken to personnel first. A hearsay report should never be the start of an outside investigation since the employer still had untapped resources to go to first. And a call to the outside lawyer would have warned that second hand rumors need to be seasoned with a grain of salt.


Employers are the single best source of information for the defense of workers compensation claims. The above example shows that good intentions are sometimes not enough. Raw information is at the start, not the finishing line. Information, to become useful, needs to be processed and the employer is the most efficient partner in that process.



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


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