Defending Home Office Work Comp Claims

Moving to the home office environment has seen several new challenges for claim handlers, defense attorneys, and other interested stakeholders. This is because the employee is generally a witness. This creates a problem during the investigation phase of the claim. Now is the time for all parties who defend these claims to understand the complexities and develop strategies to reduce the frequency and severity.

Develop Efforts to Mitigate Exposure

Interested stakeholders can work with members of the claim management team to mitigate exposure from work injuries that occur at the home office. Additional teams can also be formed to educate employees who work at home on reducing the severity of injuries, receiving the best possible first aid, and assisting employees in receiving directed medical care.

• Work Location and Ergonomic Analysis: Any employee allowed to work at home should require employees to complete a contract to maintain a specific work location and ensure safety. Ensure the employee performs all work functions at a specified workstation. It should also be a requirement that employees have an ergonomic assessment and training to minimize the frequency of injuries.

• Develop Hoteling Policies In the Office: The contract that allows work-at-home activities should also include the requirement of when work is to be performed. This should include the necessity of the employee to work within the traditional office setting once or twice per pay period. This concept is commonly called “hoteling,” where employees no longer have assigned cubicles or offices but a safe workspace within the office.

• Injury Reporting and First Aid Education: Interested stakeholders should also ensure that all employees working at home receive instruction on how to report a work injury and education in first aid. Injuries that are reported promptly and in a consistent format have better results. Employees trained in self-care can also minimize the extent of a work injury and have a better medical outcome.

The home office work environment is also an opportunity to invest in telephonic nurse triage services. This allows managers and supervisors the ability to better direct post-injury medical care. Employees can also use it in a home office to receive instruction on self-care and determine if additional medical services are required following a work injury.

Challenges in Home Office Work Comp Claims

Many challenges inhibit a successful defense against work injuries sustained in the home office environment. Thought needs to be put into these and many other issues when designing, implementing, and maintaining work-from-home policies.

• Personal Comfort Doctrine: This doctrine applies to work injuries sustained when an employee suffers an injury while performing certain on-the-job acts that are necessarily contemplated” or are incidental to job duties. Common examples include injuries sustained while retrieving beverages or snacks during the work day or using the bathroom. A complete investigation may be required when investigating these claims, including a request to access the employee’s premises to take pictures or measurements.

• Prohibited Acts Doctrine: Work injuries sustained while an employee engaged in an act or activity that violates a policy may not be compensable if that activity is the proximate cause of the work injury. Problems arise when the activity is not explicitly defined as prohibited or exceptions render the defense useless. Policies must be carefully created and enforced with consequences to sustain a denial of primary liability.

• Ingress and Egress Challenges: Employees are generally afforded coverage under a workers’ compensation act when they enter and leave a workplace. This issue becomes complex when it involves the employee’s home as the workplace. These issues are incredibly fact-dependent and focus on various details and circumstances of an injury.

These are some of the many challenges members of the claim management team and other interested stakeholders face when addressing workers’ compensation matters in the home office environment. Now is the time for employer representatives to work closely with defense counsel and the claim team to ensure only the correct claims are admitted and better defend them when in dispute.

Conclusions

The home office environment is growing in workers’ compensation claims. Now is the time to better understand what policies and procedures are needed to ensure a safe work environment that provides the tools to employees to report and provide aid following an injury. It is also crucial to understand various pain points and how best to address them during the investigation portion of a claim. Taking steps now will help reduce program costs and create a better workers’ compensation program.

Michael Stack, CEO of Amaxx LLC, is an expert in workers’ compensation cost containment systems and provides education, training, and consulting to help employers reduce their workers’ compensation costs by 20% to 50%. He is co-author of the #1 selling comprehensive training guide “Your Ultimate Guide to Mastering Workers’ Comp Costs: Reduce Costs 20% to 50%.” Stack is the creator of Injury Management Results (IMR) software and founder of Amaxx Workers’ Comp Training Center. WC Mastery Training teaching injury management best practices such as return to work, communication, claims best practices, medical management, and working with vendors. IMR software simplifies the implementation of these best practices for employers and ties results to a Critical Metrics Dashboard.

Contact: [email protected].

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