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What is money made of? In workers compensation the answer is SILENCE. Indeed, the more silence the more money the employer pays. Certainly, the employee must say something, but not much. Legal presumptions, always benefiting the employee, mostly take the place of facts.
Workers comp lawyers profit from this well known fact. Other than partially completing a report of injury (C-2) or sometimes testifying in a contested claim, the employer remains unheard from. Unheard, in spite of the fact that the employer is almost always in possession of more than enough information to make a difference. The difference does not necessarily mean defeating a claim; it means getting to the correct result as soon as possible. Delay in workers comp claims means a loss of money to the employer, even if a claim is “won.” (open-ended) (WCxKit)
Employers are generally reluctant to volunteer information and they are not encouraged to do so. When employers do speak out their input is nearly always helps rather than hurts so long as it's truthful. In large part, the problem lies with a workers compensation system permitting the employer to believe in a decades old misconception that they are without control over the defense.
Actually, the law firm selected by the carrier represents the EMPLOYER, not the carrier, in work comp proceedings. If the law firm fails to consult with the employer before and after each hearing, the basic obligations to the employer are not fulfilled.
An employer can remedy these failings in a number of ways. First, in sending initial information to a carrier, understand that the first report of injury is the barest minimum legally demanded and is seldom enough to take a claim to a positive outcome. Therefore, include other relevant documents or notify the carrier of the existence of same.
A failed attempt to receive UI, followed by a compensation claim, cries out for documentation of the reasons for the denial. The same can be said for discrimination claims or a disability benefits claim. Have there been serious claims for illness in the year prior? An unrelated accident claim?
The employer must not assume these prior incidents will automatically come to the attention of the carrier. Even self-insured employers, without carriers, have been known to have communications failures within their own companies. On at least one occasion, a self-insured employer's human resource unit hired an investigator to discover where the employee was currently working, blissfully unaware that the worker had returned to work for the company. It was ignorant of this fact until it read the investigator's report and saw the photos of its own parking lot. (open-ended) (WCxKit)
Another measure an employer can take is to find out precisely who will be attending for the carrier/employer at hearings. (Call the carrier and ask.) Then, if it will be a law firm, call them and request that they speak to you at least two days before every hearing. Such a request is the exception, but it guarantees better attention to the claim.
Author Attorney Theodore Ronca is a practicing lawyer from Aquebogue, New York. 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. Mr. Ronca has 21 years experience in searching and retrieving medical records and many other types of documents for defense of workers compensation claims. Contact Attorney Ronca at 631-722-2100 or medsearch7@optonline.net.
Our WC Manual: http://corner.advisen.com/partners_wctoolkit_book.html
WORK COMP CALCULATOR: http://www.LowerWC.com/calculator.php
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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 Info@WorkersCompKit.com.
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