Posted on January 8th, 2018
If a member of your staff gets hurt while working, a work injury compensation claim could be soon to follow.
After reading this article you will learn the best way to handle any claims.
Every small business should have worker’s compensation insurance. The costs of not having it are overwhelming.
The typical cost of a court case alone can run anywhere between $50,000 and $100,000.
Not to mention the government will fine you if they discover you don’t have insurance. The fine varies by state and number of employees, but believe us when we say it will be expensive.
AND workers comp is the one area of employment law where you can be held criminally liable! Now granted it almost never comes to that but very scary that its even a possibility.
No one should be operating a business in California without it. Its just not worth the risk.
So now that we are 100% clear on why you need to have this insurance lets move on to what to when you actually need it.
Let’s take a look at these common questions.
When it comes time to use your insurance, how do you handle the claim?
What steps do you need to take when an employee is seeking work injury compensation?
Your Responsibilities As the Employer
As an employer, your most important responsibility is to ensure your employees’ safety.
Do your utmost to avoid work accidents by providing proper equipment, training and safe working environment.
If an employee does get injured on the job, you should support that employee.
Don’t try to avoid the claim so that your insurance premium doesn’t go up. In the end it could come back to bite you and instead of higher premiums you will be paying much more trying to keep your business open.
A legitimate work injury compensation claim deserves your attention and support.
Know the Law about Work Injury Compensation
As an employer, you should know the laws about work injury compensation. Remember, they are not the same in all the States.
If your headquarters are here in California, you should know the laws here. You should also know the laws in any States where you do business or have other offices.
Of course being California we have the distinction of being the highest in worker comp costs in the nation for employers according to the latest in-depth study. According the to the study California employers pay over $3 in workers comp premiums for every $100 towards payroll! To put that in perspective one of the lowest states, North Dakota employers pay less than $1 for every $100.
Investigate Claims Right Away
When an employee is claiming injury, don’t put it on the back burner. Investigate the issue right away.
Talk to the employee’s supervisor and any other employees that know what happened. Keep very careful records. You will need to provide these to the insurance company for their investigation.
Work With the Insurance Company
The insurance company will put in the legwork to investigate the claim. They are not interested in paying a fraudulent claim any more than you are.
You can trust that they’ll do their part.
Do your part by working with them. They will need documents from you during the investigation.
Often they will want to see the employee’s payroll history and personnel file. They also may want to talk to the employee’s supervisor or coworkers to corroborate the story.
Whatever they ask for, give it to them on time. Remember, they’re on your side.
Your employee’s lawyer may contact you for paperwork. Refer them to the insurance company’s lawyer. It’s better that all requests and information exchanges pass through them. You have already paid them after all.
The Employees Return to Work
Getting your employee back to work as fast as possible is beneficial to you. Not only do you get your employee back but also you minimize lost-time claims.
Most of the time, injured employees performed tasks that are physically challenging. That’s often how they end up getting injured.
Depending on the severity of their injury they may not be able to return to their previous job right away. But they may be able to perform a different job within your organization.
This is where a transitional return to work program comes in handy. They can still come back to work, even though they can’t perform their previous job yet. It also helps the employee to feel that the company values them and their efforts.
This is often called “light-duty”. Many employers come to us about an employee that was injured awhile back and still wants to be kept on “light-duty”. The employer often suspects that the employee is milking it. Or the employer does not realistically need that position so they are just wasting money with it.
The question we get is can we now fire this person? That question is very complicated and of course depends on the circumstances. Its to complex to answer so I will do a full article on it later. California is an at will state but a workers comp claim complicates things because you cannot be seen as retaliating against the employee which is illegal.
Don’t ‘Retaliate’ Against the Employee
Some employers, frustrated by fraudulent claims, get suspicious of employee injuries. Sometimes they even go so far as to find a ‘reason’ to fire that employee in the future.
An employee with a legitimate work injury compensation claim is protected by the law. Rather, keep in touch during the investigation and provide support as needed. Then help them get back to work as fast as possible.
This is not only the kind approach but also a great way to gain a loyal employee.
If you are sure the employee is defrauding you and is no longer injured still be very careful! As I said earlier you cannot be seen as retaliating against them.
Don’t Commit Fraud
You hear about employees committing work injury compensation fraud all the time. Some employers try to do it too.
Sometimes employers won’t submit their First Reports of Injury. It might be that they don’t want their premiums to go up. Or they might not want to deal with the headache that comes with a claim.
But at some point, your employee is going to start asking why they haven’t received their benefits. Believe us, a court case is a much bigger headache that a work injury compensation claim.
Don’t be one of those employers. Keep people safe and help them pay for their injuries. It’s an important part of employment.
Responsibilities of the Employee
The employee is also responsible for certain actions about their case. The first and most obvious one is reporting the injury as soon as it happens.
The employee should also be cooperative and seek appropriate medical treatment right away. Some injuries can worsen without immediate help. This could result in more time off work and a higher work injury compensation claim overall.
This has a negative impact on you as the employer. To avoid these issues be sure that your employee knows what they should do.
Employees should also be cooperative and work with the insurance company as well.
When Things Get Complicated
In California, there are hoards of lawyers ready to jump to an employee’s defense. And, let’s be honest, the laws are already more in the employee’s favor.
You may feel that a work injury compensation case is getting out of hand. You may think that the insurance company doesn’t seem to be handling things well.
What if a worker got injured and you did not have workers comp insurance at the time?
Who do you turn to? There aren’t too many California lawyers ready to defend businesses.
That’s where we come in. We’ve built our entire practice around defending businesses. You can find out more information here about the services that we offer. When the law is already somewhat against you, you need the most experienced lawyers to defend you.
To find out if we’d be a good fit for your case, take advantage of our free 15-minute consultation. If you think you’re getting the short end of the stick, don’t hesitate!
We can’t guarantee a favorable outcome, but we’ll fight for a fair one every time.
