The Work Comp Claim Isn’t Over Until It’s Over

Yes, this article honors Yogi Berra, but not for the reason you might think. His now famous phrase, about a game (or a season) not being over until it’s over has become the archetype for a thought which is a) true, b) egregiously obvious and c) useless. But Yogi may well have the last laugh.

 

The remark was made in 1973 to a statement by a reporter to the effect that the season was over for the Mets. Yogi, however, was a true professional athlete and, therefore, he never quit. His response was true, obvious and sent a message to those who would quit before the game ended.

 

 

Meaningful Change Can Take Place On A Work Comp Claim Years Later

 

Does the same apply to workers’ compensation claims? Absolutely. Recall, a game lasts a few hours, a workers’ compensation claim can last decades. But, is there anything one can do to work meaningful change on a claim that has been in progress for years? Yes – but only if you try.

 

Can an employer play a significant role in a claim that has been established and is being paid. Surely that’s a game that’s over, right? Not at all; for two reasons. First, workers compensation claims in many states remain open for years, even decades. This is due to a feature known as “continuing jurisdiction” which permits a workers compensation board to review at any time past rulings and change any that should be reconsidered. Second, workers compensation boards are often asked to consider new problems which appear years after a claim has occurred.

 

It may seem that an employer would have little to add years later, but that is false. The employer has the best memory of all. Employers often know facts that an investigator would have a difficult time discovering. And these facts can be critical in defending claims. Co-workers, years after a claim, may still be in contact and can provide a vital summary of post-injury activities by an injured worker. If the co-worker has retired, the employer may be the only way of locating this valuable source of information.

 


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Surprising Percentage Of Fraudulent Claims Discovered Years After Accident

 

A surprising percentage of exaggerated, or fraudulent, claims are discovered through information provided by the employer years after the accident. People with embellished claims grow lax and imagine that no one cares about the details when weeks and months turn into years.

 

Your correspondent takes keen interest in newspaper stories about workers compensation fraud which has been detected. How did the carrier find out? It is quite obvious in most cases that the employer found out through the social grapevine that always exists in workplaces and forwarded the information to the carrier or the board.

 

The claim isn’t over – until it’s over!

 

Thanks for the tip, Yogi.

 

 

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

 

©2015 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

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