Do You Have Employees That Are Repeat Accident Offenders?
If your business suffers from the high cost of employee injuries on their workers’ compensation insurance due to the same employees becoming injured repeatedly; this article is for you!
While the vast majority of workers comp claims are legitimate accidents from honest, hard-working employees some of these workplace injuries are from employees with ulterior, personal motives. When a “rogue” employee attempts to beat the workers’ compensation insurance claim system with frequent, sometimes suspicious workers compensation claims, those claims can cost your business ample time, resources, and substantial amounts of money. Here are 5 innovative tactics we use to challenge repeatedly injured employees we call “frequent filers”.
- Thoroughly Investigate: Seems basic and intuitive to state the obvious with respect to prioritizing accident investigations. That said if you have one individual who has filed several WC claims, we suggest investigating their claims more aggressively. Remind them that insurance fraud is a felony. If they understand you are not just rolling over they might not have the stomach to pursue their claim. Too many companies we consult with are not aggressive enough in their accident investigations which makes them a soft target. We had one company in particular that had an employee who injured himself like clockwork around the holidays and again during the summer using it as paid time off. His name appeared in claims reports 6 times over a 3 year period. That is a failure of leadership in that company as they simply accepted that sort of behavior.
Click to download our ACCIDENT INVESTIGATIONS eBook f0r organizations with repeat offenders.
- Get a Medical Professional Involved: If this claim is resulting in an injury, make sure a physician/medical professional takes a clear look and makes their own judgment on the seriousness and legitimacy of the said injury. A professional evaluation provides a baseline for the injury and becomes permanent documentation to support the file. Further one of the biggest mistakes companies makes (especially with back / soft tissue) injuries is that they don’t take it seriously enough. The worker comes back too early, resulting in a much worse injury as a small back tweak becomes full-on displacement. Getting soft tissue injuries professionally evaluated save considerable sums of money long term in aggregate when it becomes habitual practice.
- Talk to the Worker’s Closest Peers: Talking to fellow employees that work on-site with the worker in question the most can give you a real understanding of this worker’s character, work ethic, and motives. Worker’s may pick up on his/her personal life and any issues stemming from it that can influence whether or not they may fraudulently file a WC claim. These can be but are not limited to, financial issues, domestic problems, serious health issues, or mental problems/instability that can affect their day-to-day work life. Further workers sometimes resent when their colleagues are taking advantage of the situation as it affects their workloads and team cohesion.
- Talk to the Employee 1 on 1: Lastly, if no other avenue seems to be giving any leads, having a 1 on 1 real discussion with your employee can help them open up about anything ranging from their happiness at work, their personal problems, and even if their WC are legitimate.
- Execute WHY ANALYSIS to determine the root cause of the injury. Perhaps this employee needs more training, more support with respect to executing their job. This is important rather than just jump to conclusions. In fact, this is the #1 reason we see repeat injuries.
While not all frequent workers’ compensation claim filers are fraudulent, they’re worth taking a closer look at these steps to make sure your company is not being taken advantage of. For assistance in how to build your workers’ compensation cost containment program please consider our Comp Care Program. This is Metropolitan Risk’s turnkey program that can be implemented very quickly, delivering results for your org in record time.
*If you’re an existing Metropolitan Risk Advisory client, call or email your risk advisor for quick access to our eBook.
