A medical-only worker’s comp claim can evolve into a big problem for the risk manager when that claim becomes a lost time claim. With little to no warning, a small claim can turn into a large amount of money flying out of your company’s bank account. Listed below are some common scenarios and what to do when they arise.
(1.) The employee does not seek medical care
When an employee becomes injured, they may choose to seek medical care as part of their employer’s worker’s comp package. But if that employee is unaware that they will be paid while they cannot work, they may forego seeing a medical professional. Typically, when the employee tells the employer they do not want medical care, it is a relief for that employer. They write an “incident only” record and both men move on with their lives.
However, just an “incident only” record can result in future headaches for the employer. Instead of just writing the record, the employer should recommend that the injured employee to seek medical treatment. If they re-aggravate their injury or it gets worse, their medical bills could skyrocket, which leaves the employer paying for the medical visits, and in search of another worker while that employee has to stay home.
(2.) The employee goes to their general practitioner
Employees that are injured on the job often just go to their general practitioner–it’s simple and familiar. The doctor will often just recommend bed rest for the employee, and will tell the patient that the injury will get better with time. That can result in an employee being out a lot longer than they should. Professional athletes return quickly because they have access to specialists on their training staffs, and they can be referred to doctors who are better suited to consult on particular injuries.
Employees should understand that there are medical professionals that can get them back on their feet quickly, and they should also know where to find them. It is the responsibility of the employer to post a list of recommended doctors, which can result in a healthier and happier workforce. Assemble a training staff for your employees, and your team will perform at a higher level.
(3.) No medical triage nurse
A triage nurse recommends the necessary level of medical care that the employee needs. When an employer does not have a triage nurse, the responsibility of assessing the injuries falls onto the employer. Construction employers generally have much less medical training than a medical professional. By determining the proper medical care required, the nurse is step one to getting employees back on their feet in an appropriate amount of time.
(4.) Employee fakes injury or tries to get treatment for preexisting condition under worker’s comp
As an employer, it is your responsibility to find out the extent to which your employee was injured. You need to know where he was injured, how he was injured and what he needs to do to recover. You can call his doctor to make sure that what the employee has told you is true, and to take the proper precautions when he returns to the work force. If the employee is faking it and the employer is looking into his affairs, he will likely drop his fraudulent claim. Also, by establishing the extent of the injury, the employee cannot seek medical help for a previous condition and be covered by worker’s comp.
If you take these precautions, you lower the risk of being conned into paying for a fraudulent worker’s comp claim. By using these steps, your company will perform more efficiently.