What You Never Told The Comp Board Can Hurt You

 

Employer Files Contain Most Useful Information
 
A comp board, and carrier, can only deal with facts they know. What is not known is dealt with by presumptions, nearly always resolved in favor of a worker. The largest source of useful info is in the employer’s files – where it nearly always remains, silent and drawing no attention to itself.

Facts are totally impersonal and indifferent to whether or not they are invited to work comp hearings. If they are overlooked, ignored, unmentioned or regarded is irrelevant only the employer will pay if those approaches are wrong. A fortuitous discovery yesterday illustrates this.

 
Prior Unemployment Claims Are Common
 
Have you, as an employer, ever had an unemployment claim by a worker with a terminally anti-social attitude? Did you win the bitter, hard fought claim for unemployment benefits? Did you think that was the end of it, only to be faced with a claim for work comp? Many employers have.

But did you notify the comp board and the carrier, with supporting documentation, of the older UI claim and its outcome? If not, your performance has been typical. Few employers do, and few are asked about prior UI claims.

Yesterday, this writer was doing routine research of a 1985 NY comp decision through google. The name of the case, never mind what it was, unexpectedly produced not one, but THREE cases with the same name, one in 1985, but two in the early 1970s, which were not comp decisions, but UI.

The 1985 decision is useful for claims that require a worker’s signed release, especially where the worker refuses to provide one. The case involved a worker who, for undisclosed reasons, simply refused to provide a post-injury IRS return.

Yesterday, the two earlier UI decisions provided the answers. The worker had been, to put it politely, simply impossible to abide. His battles for UI, after being dismissed, did not change that impression. He lost…….and then filed a comp claim.

He won the comp claim, seemingly without much effort, but when the carrier tried to get documentation of post-injury earnings it met with a stone wall of unexplained resistance.

 
You Need To Ask
 
What is disturbing is that the decision strongly points to the fact that even at that point in the proceedings the carrier, the board, and later the court, were unaware of the prior two reported UI decisions. There is an old joke involving a 35 year old, believed to be a mute, who suddenly speaks. When relatives say, “We never knew you could speak”, he answers, “You never asked.”

Had the carrier known of the prior history, the outcome almost certainly would have prevented the claim from being allowed in the first place.

There are many, many claims which fit the above pattern. Wherever there is a claim in which there were prior applications for other benefits, or complaints such as harassment and/or discrimination, inform the board and carrier, and include a copy of any determinations. Do not be mute.

 
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  

 

Editor Michael B. Stack, CPA, Director of Operations, 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: mstack@reduceyourworkerscomp.com.  

 

©2012 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 about workers comp issues.

Workers Comp Insurance Idiots

The above title refers, according to a Google search, to a common phrase used by persons complaining about the handling of their claims.

 

Let’s put that to a test.

 

One person, several years ago, reported that she had successfully returned to work a year before. A favorable outcome? Not really, according to the worker.

 

The return to work, it was related, was not due to the wishes of the worker, nor the advice of her doctor. Instead, it was caused by “the work comp insurance idiots”.

 

The complaining worker went on to say that she was “glad to be back to work”. (After a year’s absence)

 

What sense can we possibly make of this? All the goals of the work comp system have been met by “idiots”. Was there any statement of gratitude by the worker? No, but she was glad to be back to work.

 

The person was apparently single. It would be interesting to hear what a spouse might have said about the “work comp idiots”.

 

The lesson seems to be that subconsciously the workers have adopted the negligence claim paradigm. The best outcome for disability is a large settlement figure, followed by a near miraculous cure shortly after the check clears.

 

But the worker above coped with the mishandling of her disability claim, even to the point of being “glad to be back to work”.

 

Everyone in the comp process knows that they too are one of the “idiots”, especially the workers’ lawyers who, perhaps not surprisingly, get the brunt of most of these comments. Notice, no one in the above received credit. Why should the worker thank the treating doctor and her lawyer for failing to stand up to the other “idiots”?

 

From one idiot to another, let us all push on and do our best to produce such failures.

 

 
 

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

 

Editor Michael B. Stack, CPA, Director of Operations, 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: mstack@reduceyourworkerscomp.com.

 

©2012 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 about workers comp issues.

The Employers Secret to Workers Comp Defense Lies in these Three Quotes

 

Three quotations are all an employer needs to understand handling difficult comp claims. Two are actual quotes, but the third – and best – was made up and appeared in a 1917 newspaper story.
 
Three Quotes:
 
1. “Justice is truth in action”, written by Benjamin Disraeli in a novel.
 
2. “Justice delayed is justice denied”, an old legal maxim.
 
3. “Git thar the fustest with the mostest”, supposedly, but actually never, said by Confederate Gen. Nathan Bedford Forrest. Winston Churchill, however, called it the most delightful summary of military tactics ever spoken
 
So, to get the best justice, an employer needs “truth”. To get “truth” too late is to get no justice at all.  Therefore, get truth as early as possible and be “the fustest with the mostest”. Even if  Forrest never said it, Churchill endorsed it.
 
 
Be the First with the Most
 
But how does an employer be the first with the most? The only way that can happen is for an employer to be prepared to locate, retrieve and forward a portion of the large amount of information available to an employer. Even if an employer does not possess actual documents, an employer has clues as to where those documents might be.
 
 
Write Outline Summary, Attach to First Report of Injury
 
The best advice for an employer is to write a one, possibly two, page outline of what documents might contain information about past, relevant events, who might have them, and where they might be, even if not with the employer. Forward it to the carrier, preferably attached to the First Report Of Injury. Then, follow up with a call to make sure that the outline has been received, noticed, read and acted upon.
 
Attaching the outline to a First Report of Injury insures that the information will be “the first”, but will it be “the most”? Almost certainly, it will. Initial claims handling is mostly a matter of taking care of the first medical reports and bills. Collecting the information needed for long term results waits. And whatever waits cannot be in action and is, therefore, delayed. And, finally, will never be the first or the most.
 
 
 

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

 


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com
MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

Tulsa Defense Attorney Pleads Guilty in Workers Comp Fraud Case

A longtime Tulsa, Oklahoma criminal defense attorney has pleaded guilty in Tulsa County District Court for his role in helping embezzle more than $1 million from clients, Attorney General Scott Pruitt’s office reported.
 
 
Fred Schraeder entered a guilty plea to one count of conspiracy to commit workers compensation fraud. He received a 5-year deferred sentence and will pay more than $36,000 in restitution, $500 in fines and a $100 victim’s compensation assessment. (WCxKit)
 
 
The Oklahoma Bar Association's Clients Security Fund is also assisting in reimbursing victims. Schraeder must surrender his law license and is not eligible to re-apply while on probation.
 
 
Schraeder’s accomplice, William Anton, received four consecutive sentences totaling 35 years, with 25 years suspended. He was ordered to pay $702,813 in restitution and surrender his law license. (WCxKit)
 
 
The Attorney General’s office filed charges against Schraeder and Anton, alleging they embezzled money from clients personal injury benefits, insurance settlements and workers comp benefits. The defendants purportedly embezzled more than $1 million from 49 identified victims.
 
 
Author Robert Elliott, executive vice president, Amaxx Risk Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.
 
 
THE BEST WORKERS COMP BOOK:  www.WCManual.com
 
WORK COMP CALCULATOR:  www.LowerWC.com/calculator.php

 
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
 
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact

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