How Employers SHOULD Communicate in NY Workers Comp

Employers and employees are the most important persons in a comp claim. The law does not treat them very differently, although it gives a few advantages to the employee. However what makes a very big difference is how they communicate during a claim.

 

 

Communication is vital to the success of any claim or other legal action, but in workers comp two very different methods have evolved: one for the worker, but a very different one for the employer. [WCx]

 

 


A worker in a serious comp claim
 generally has a lawyer to coordinate the communications. Indeed, the worker is strongly advised not to communicate with anyone but the employer. The employer, in turn, will encourage regular communications from the worker, especially before a hearing. Also, a worker will generally have direct communications shortly after a hearing to provide information, documents, etc.

 

 


It might be expected that the employer
 has a similar relationship with the lawyer or representative appearing at hearings on the employers’ comp claims, but it is rarely so, even though close communication and participation inevitably reduces expense and hearings. In NY, more so than nearly every other state, the employer is typically invisible in the proceedings.

 

 


Comp insurance agents were recently asked
 what employers said about actual claims, and when they said it. The answers exposed a glaring deficiency. The employers complained long and hard about the FINAL results of a claim, but almost never spoke to a carrier, lawyer or agent while the claim was in progress. Communication was inevitably too little and far too late.

 

 


Employers should be aware
 that a person complaining is a person saying things that can no longer be effective. So the first thing an employer should do is to be the first person to speak, never the last.

 

 


A second piece of advice for employers is to speak
, with caution, to as many people as possible, not just a single claims examiner. Many people have to be informed ASAP in order for a claim to be handled effectively, and the law expects the employer to be involved. In addition to a carrier, the Board, the doctor, the worker, and many others must be informed simultaneously, not in sequence. Communication by forwarding through one person to another ceases with the first break in the chain and, at best, is only as quick as the slowest link.

 

 


Communication takes a bit of work
, but it costs a lot less than paying three to four times as much on a moderate size claim. And it can save a lot more than that. [WCx]

 

 


A final benefit to all that communication 
is that whoever volunteers to do it becomes the “center of communication”, which has priceless advantages. Whatever extra efforts are involved save far more time, and money, in the overall reduction of “claim friction”.

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.
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In NY Workers Comp – What You Pay for is What You Get

Data, being released and discussed, shows that assessments for operating expenses made by the NY WCB against carriers (and passed on to employers) are five times higher than the national average for all states.

 
 
Why?
 
 
Well, the number of people employed by the NYWCB is greater (1500+) than the number of people employed by all comp boards east of the Mississippi (if Florida is excluded). By 1990, the NYWCB had 650,000 workers comp hearings per year, a number so large and anomalous that a major comp research institute studying New York twenty years ago at first thought that a zero had been added by mistake. [WCx]
 
 
In addition, NY has had for decades far higher assessments for second injury funds. (One eastern state has a second injury fund law that, for several decades, had only a single claim which qualified for reimbursement.)
 
 
The reasons for the New York anomaly can be traced back to a highly broad interpretation of a requirement that no claim for workers comp could be closed without affording the parties to a hearing. It did not say that more than one hearing was required, nor did it say that a hearing had to be automatically scheduled if no one requested it.
 
 
However. New York gradually drifted into the practice of automatically scheduling at least one hearing on every claim. If any party (claimant, carrier or an attorney) for some reason failed to attend, an adjournment was automatically granted. Lawyers, whose fees were, and are, proportional to the number of hearings, were never heard to complain about such policies.
 
 
By the 1980s, some claims were breaking all records for administrative tolerance. In one claim (and probably a lot more) a claimant was granted eleven consecutive “final opportunities for the claimant to appear. In 2009, a case was reported where two law firms, and the Board, required seven years of hearings and two years of court appeals to decide which of two carriers was responsible for a claim. (A board clerk had made a key stroke error which placed the wrong carrier on notice for the first hearing. No one ever thought to contact the Compliance Bureau.)

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The message for employers is to avoid thinking that others (carriers and the Board) will be the first to limit unnecessary costs on claims. A principal reason (more likely, an excuse) for hearings is that necessary information is not in the carrier’s claim file or the WCB e-file. Yet much of the information (payrolls, lost time information) is obtained from the employer.
 
 
An employer can reduce the costs on claims by submitting as much information as possible prior to the first hearing. The itemized payroll for the year prior to the accident, for example. That information will be required on all claims with significant lost time (more than a week) and a substantial percentage of all adjournment is to “obtain a payroll prior”. [WCx]
 
 
The above suggestion can reduce hearing costs by 10-20% on a claim. Many other suggestions can do the same, but that should do for a start.
 
 
 
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

VIEW SAMPLES PAGES

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.

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New Times for Transitional Duty, Modified Duty in New York

Things are changing in workers comp. Lost time has become something to be limited, a concern that did not always receive the highest priority in the past.

 
 
The reasons are clear: a less than powerful economy and a rising cost of living.  Return to work, for decades in NY comp, has been viewed as a way to deprive a worker of a settlement and a way to deprive a lawyer of a substantial fee. But a mounting sense of uncertainty has changed that.[WCx]
 
 
For the employer, having a plan, not necessarily firm written guidelines, for returning employees to have some form of useful activity will have large benefits, and will not meet with the forms of resistance encountered in the past. A lawyer who ignores a return to work offer made to a client is playing a dangerous game, as recent court decisions have shown.
 
 
Employers who are not large enough to warrant an ongoing RTW program have traditionally stated, “We have no light work”, but that misses opportunities. Naturally, prior to most accidents, the mid-size or smaller employers probably do not have a firm plan in place, but that does not mean that something, somewhere, somehow cannot be done.
 
 
Doing something without having a prior plan in place has certain advantages. It means that whatever is tried is more likely to be a good fit with the circumstances than a prior plan. What is planned when nothing has yet happened is built on assumptions, not facts.
 
 
The first, and strongest gain from an employer meeting with an employee and exploring a RTW plan is to shift the relationship for both from passivity to active measures. And that means a rise in morale for both.
 
 
If the employer cannot think of useful work within the limits on activity imposed by an injury, then both the employer and employee should consider a joint search for light, but temporary, work in the general area. The advantage to this effort is that the employee, and the employee’s doctor, will also start thinking in terms of return to work.
 
 
In all of this, the comp board, the carrier/TPAs and the lawyers have been set aside. The comp law, at least in NY, does not give any of those the power to direct, or prohibit, return to work efforts.[WCx]
 
 
RTW efforts encounter many problems, both small and large, which will be discussed in the next piece.
 


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

 


MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com

VIEW SAMPLES PAGES

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.

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