Workers’ compensation cases tend to be a headache. So it’s understandable when employers shrug them off by funneling comp cases to their insurance adjusters or state/third-party administrators. After all, the easiest way to deal with pain is to shift it to someone else. Often, however, that is not the best approach.
Instead, designate a point person in your company to establish a pro-active working relationship with an adjuster or state/third-party administrator. This can pay off by streamlining claims and getting good workers back on the job as quickly as possible.
Your point person should be a little bit of a comp specialist, but doesn’t have to do that work full time. He or she needs to have a good understanding of your state’s workers’ comp system. Many times, all that is needed is simply allowing the point person the time and money to attend one good workers’ comp seminar and granting one full day to meet an adjuster in person.
Here are just some of the things a good workers’ comp point person can do:
• Begin and maintain a causation file. This file documents how an injury occurred and who witnessed it, along with statements if necessary. A good causation file helps all parties determine whether an injury is legitimate or whether it borders on the fraudulent and should be defended.
• Monitor medical treatment and coordinate return-to-work with supervisors as quickly as possible, or determine when steps should be taken to help bring a claim to an end.
• Evaluate whether lighter duty work is available on a short-term basis.
• Help determine fitness for duty by supplying a list of physical requirements for the current job, or another job that might be more physically compatible.
• Assist in supplying timely wage information that the state requires for paying temporary total disability benefits. Nothing is more galling to a state regulator than tardy and incomplete wage information from an employer.
• Act as an information liaison for those in the business who must make budget and contract decisions on workers’ comp coverage and premiums.
• Coordinate with an attorney if the workers’ comp case heads into the adjudicatory system, either at the administrative or the state court level.
• Ensure that motivated employees get back on the job. Unfortunately, the poor handling of medical and wage benefits can turn a worker from sweet to sour. A point person can help work out kinks in the benefit system to get a good employee back to work.
• Coordinate with the human resources department if grievance, termination, discrimination or unemployment issues arise.
A good point person is helpful no matter where your business is situated. In Kentucky, most employers carry private insurance or belong to a self-insurance group. These groups have adjusters who typically handle the claim from start to finish and even hire legal counsel when necessary. In Ohio, the system is much different. Most employers rely on the state-funded system and its administrators to handle claims. Regardless of the state, relationships can be built that will pay benefits down the road.
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