Category Archives: Workers Compensation Insurance

Claims Management, Human Services Practice Group Content, OSHA, Workers Compensation Insurance

Healthcare Safe Patient Handling

Healthcare employees are a prime target for on-site injury. The main reason is their job consists of manual labor that usually deals with people. Activities such as lifting/handling human patients are common in the workplace for healthcare employees. One thing that needs to be addressed is safe-patient handling.

It is no surprise then that the main reasons for lost work and worker injuries in the healthcare industry is patient handling. Patient handling injuries makeup over 30% of workplace injuries and cost $1.66 billion in WC claims every year, according to Liberty Mutual data from the U.S. Bureau of Labor Statistics. That does not account for the billions every year spent on medical treatment by the workers themselves. So what are the ways that healthcare workers can maintain their current work duties yet avoid the risk of constant injuries? Well, here are 10 ways/tips to execute safe lifting and patient handling, according to OSHA.

Mechanical Lifting is Safe Patient Handling

Mechanical lifting is not only safer for the workers’ health, it is safer for any patients needing assistance.

Healthy Workers Should Still Not be Lifting Patients

Just because an employee has no previous injuries does not mean they are cleared to carry fully-grown people. Experts say less than 40 pounds is satisfactory for any employee’s heaviest lift.

Manually Lifting Patients can Actually be More Time-Consuming

If the job-site has mechanical lifting technology on-site and nearby, manually lifting may actually be more time-consuming. Do not worry if it takes an extra minute to retrieve/set up the technology. This is much safer than having a load of employees attempt to pick up and lift a patient.

Manual Lifting Costs More in the Long Run

While the mechanical lifting machines cost a pretty penny, medical injuries stemming from manual lifting could end up costing more. Back injury treatment for healthcare workers cost $20 billion every year. Factor in the billions in WC claims, and the lost days of worker productivity. Then, it makes the decision more clear that mechanical lifting is cheaper and more productive.

Learning Good Body Posture for Lifting Does Not Equal Less Injuries

Unfortunately, no matter how much you train to correctly lift a patient manually, it will never be as safe as mechanical lifting. There is no such technique that will teach how to safely lift a patient as our bodies were not built to lift another person.

Management Support

Having company-wide approval for a switch mechanical lifting is a positive step forward. This will help expedite the process of installing new mechanical lift devices without management backlash.

Assessing Potential Hazards

Finding the most hazardous areas of the workplace is crucial to implementation of mechanical lifting. Picking where to install these devices at the most efficient spots for the workers can make a huge difference.

Implementing a Committee to help With Safe Patient Handling

Creating a workers-based committee to help with the implementation of a safe patient handling program can help your company. After all, they are the most knowledgeable on the subject and can provide invaluable insight.

Education on Mechanical Lifting

Of course, mechanical lifting can only be as safe as the one that is operating the machine! Make sure your frontline healthcare workers are fully trained in using the technology.

Monitoring the Implementation of the New Safe Patient Handling

Once the mechanical lifting technology is in-place, that does not necessarily mean the end of the discussion. Management and workers alike must constantly evaluate the efficiency of the devices and judge whether or not another change must be made.

All of these steps and tips obviously lean towards the use of mechanical lifting devices over manual lifting. Following these steps can save your employees injuries and your company billions in claims. Remember, your employees’ health and safety must come first as well as your clients, so do the right thing and invest in the future of healthcare.

Claims Management, OSHA, Other, Workers Compensation Insurance

5 Ergonomics Tips For Desk & Office Workers

Ergonomics, or the study of people’s efficiency in the workplace, is a fast-growing field of research. Part of ergonomics is designing the workplace individually for everyone’s physical status, and lowering the number of Musculoskeletal Disorders (MSDs). Currently, MSDs account for 33% of injured work claims, and $1 billion are spent on treatment every week for this pain. Here are 5 ways in which you can help yourself against MSDs and participate in ergonomics.

Learn How To Correctly Sit in an Office Chair

Sitting in an office chair all day can be exhausting and after a while, our body tends to slide into unhealthy positions. Keeping a good posture by sitting all the way back into the chair will help your back, neck, and hips.

Avoid the Bad Habit of Stretching for Things

If your workspace is spread out and you have the need to reach for frequently used items, you can be in danger of injuring important muscles in your arms and shoulders. Reorganizing your desk to keep your most-used items closer to you can save you the pain later.

Keep your Head Level

Staring at a screen all day is already unhealthy, so doing it the wrong way is even worse. Make sure you are looking at your monitor straight on to avoid your neck from unnecessary stress injuries.

Move Around!

A simple one to stick to, just moving around once an hour. This will help with stretching your legs and keeping yourself moving is a great way to avoid major back issues.

Watch your Elbows

Where you put your elbows is an important part of keeping yourself safe from MSDs. Simply having an armchair to put your elbows and stop growing discomfort is a quick fix for long-term stabilization.

Keeping up with ergonomics will keep you physically healthy and safe. Hopefully, these 5 tips will be useful for you and others in your office.

 

HR Challenges, Loss Control, Risk Management, Workers Compensation Insurance

The 4 Types Of Workplace Violence

Workplace Violence can be difficult to identify because it is more than homicides or physical assaults. This can be non-violent offenses like stalking, threatening words or other menacing contacts. Workplace Violence is defined as any physical assault, threatening behavior or verbal abuse that occurs in a work setting. 

These forms of non-physical and physical violence affect approximately 25 million people a year. When not properly addressed workplace violence can result in a major decline in employee morale, management efficiency, and productivity. There is a cost impact as well, like lost wages, higher benefit payments and greater usage of sick time. 

Workplace violence can be divided into 4 categories. However, most people affected by workplace violence are usually subjected to more than one category of workplace violence. 

In all of the four following types of workplace violence events, a human being or hazardous agent commits the assault:

Type I – Criminal Intent

The perpetrator has no legitimate business relationship to the workplace and usually enters the affected workplace to commit a robbery or other criminal act.

These incidents are normally between employees who have face to face contact and exchange money with the public, work late at night and into early mornings or work alone. While the perpetrator maybe pretends to be a customer of the establishment, the person has no legitimate business relationship to the workplace. 

Type II – Customer/Client/Patients

The perpetrator is either the recipient or the object of a service provided by the affected workplace or the victim. For example, the assailant is a current or former client, patient, customer, passenger, criminal suspect, inmate, or prisoner.


Type II events involve an assault by someone who is either the recipient or object of a service provided by the workplace or victim. These events involve assaults on public safety and correctional personnel, municipal bus or railway drivers, health care and social service providers, teachers, sales personnel, and other public or private service sector employees who provide professional, public safety, or administrative or business services to the public. 

Type III Worker/worker

The perpetrator has some employment-related involvement with the affected workplace. For example, an assault by a current or former employee, supervisor or manager.

Type III events generally involve threats of violence resulting in fatal or nonfatal injury to another worker. Commonly found in type III events are the individual may be seeking revenge for what is perceived to be unfair treatment by another coworker, a supervisor, or a manager.

Type IV Personal Relationship

The perpetrator has some employment-related involvement with the affected workplace but is not employed at the workplace. Rather, the agent is known to or has a personal relationship with, an employee.

Most Type IV events involve domestic or romantic disputes in which an employee is threatened in the workplace by an individual who has personal relationships outside of work.

Prevention

If there are one or more of the following factors present in the workplace, employers should consider the workplace to be at potential risk of violence:

  • Exchange of money.
  • Employees required to work alone at night and during early morning hours.
  • Availability of valued items, for example, money and jewelry.
  • Guarding of money or valuable property or possessions.
  • Employees perform public safety functions in the community.
  • Employees work with patients, clients, passengers, customers, or students known or suspected to have a history of violence.
  • Some employees have a history of assaults or have exhibited belligerent, intimidating, or threatening behavior to others.

Many workplaces are at risk for workplace violence, but certain workplaces are recognized to be at significantly greater risk than others. Therefore, every employer should perform an initial assessment to identify workplace security factors that have been shown to contribute to the risk of violence.

If you have any questions on what workplace violence is and how your organization may be at risk, contact a Risk Advisor by clicking here or by calling at 914-357-8444

Construction Practice Group Content, Food & Beverage Practice Group Content, General Liability Insurance, Human Services Practice Group Content, Risk Management, Transportation Practice Group Content, Workers Compensation Insurance

7 Common Insurance Errors Businesses Make

We recently left a meeting with one of the largest construction companies in the country, whose sales are north of a billion dollars annually. The first comment my counterpart made was, “I cannot believe how poor their systems are…” I turned to him and gave him one of my favorite lines because it still rings true to me on a daily basis, “I’m always amazed, never surprised.” Universally, whether you are a billion dollar construction company, a small manufacturer, a non-profit, or a healthcare company, these are the flaws we see in (over 98%) the companies we are invited into. Here are 7 insurance errors commonly made by any and all types of companies.

1. Wrong Goal: 

Most companies set a goal of lowering their insurance spending every year. They see it as a tax. It’s an expense that doesn’t generate value. We suggest this goal is incorrect. Your claims history and risk-based costs drive your insurance costs; not your broker or the insurance carriers. 80% of an organizations costs are outside the cost of the insurance. Furthermore, the cost of your insurance program tends to be a lagging indicator, reset only once a year. Measuring, preventing, and managing your claims and claims-related costs should be the goal, not lowering your insurance cost. If you can demonstrate to the insurance marketplace that your company is historically profitable (claims to premium ratio) then you will have carriers competing for your business, which will, in turn, lower your costs.

Wrong Goal

2. Insufficient Resources for the Goal:

The best companies at least have a safety budget. Many, sadly, don’t even have that. If you want your arms around your biggest cost drivers, you need to dedicate resources towards the solution. We suggest that you start by setting a Risk Budget, not just a safety budget. It’s helpful if you know how much money you’re leaking due to claims. Having this Risk/Reward context will help you sell your budget number to management. Moreover, if you have solid systems (see 4), you can leverage those systems to bring in other resources in a cost-efficient fashion. This allows you to stretch the budget.

Most companies don’t leverage their carrier relationships or their brokers for resources to help them with their cost drivers. Even when they do, it’s too inconsistent to have much impact. Staffing at most organizations is thin at best, whereby a single staff person is also delegated the risk responsibilities on top of all the other hats they wear.

3. Improper to Absolutely No Data:

When we ask prospective clients how they determine success or failure in their insurance program, they almost always tell us insurance premiums. Again, this is flawed. Premiums by themselves indicate nothing and often are also a false read. Instead, premiums should be converted to a rate per sales, payroll, or vehicle. Also, the insurance contracts themselves might exclude or include more risk which swings costs. Our main point is that companies do not have the proper data to reveal their true cost drivers, hot spots, or success spots in an organization. They can’t benchmark themselves over a year’s time. They can’t benchmark supervisory employees, departments, or locations, nor can they tell you what their ROI is on their safety investment. Or they can’t build compensation incentives around the companies cost savings goals.

Without the proper data it’s nearly impossible to change culture, results, or fix cost drivers that you haven’t even identified. Imagine being a doctor trying to diagnose a patient without running tests, looking at charts, and being able to benchmark vitals. Most companies lack this critical ability to gain insight, let alone the ability to select the correct treatment option.

4. Little Strategy:

Here’s a hint, shopping your insurance with 3 competing brokers is not a sound strategy. Yes, it may have worked for you a few times, but, it’s like shooting foul shots backwards. You may get lucky, but it’s not consistently sustainable. If you set the proper goal, you can then test the marketplace with your (1)broker who can (and will) get you competitive pricing. Set your strategy on controlling and lowering your main cost drivers, your insurance costs will follow.

5. Systems:

The best of these companies use spreadsheets to capture data, and then exchange insights via email. Most don’t even have the spreadsheets! If you have a solid system as a nucleus, you can then build both process and staff around this core system. Further you can leverage the system to hire outside specialties to address thorny issues. In absence of a strong core system, it’s very difficult to get a sustained, consistent effort bent towards solving your most vexing claims issues.

 

6. Lack of Process/Protocol:

There is so much low-hanging fruit that costs so little when it comes to managing claims cost drivers, most of which is just knowing the proper protocol when “x” occurs. Then, it’s all about communicating that protocol organization-wide, with a proper system in place to build in accountability, so it becomes natural.

Note: Having a task list is not a system. Closing the execution loop, holding people accountable, is a system. The loop is closed through a random audit process.

7. Price vs Cost:

This is a big one. Too often, we see companies focus on the price of the insurance against the long term costs. Nothing is more expensive than a cheap insurance contract. You finance your risk with operating cash flows, reserves or worse… loans. Contrary to popular belief the correct answer is not insurance. If you had the correct data, contained within a system, then you would understand the real cost drivers in your organization so you can then attack them strategically. That takes too much work, so folks just look at the premium, write the check and hope for the best.

Here’s the good news (sarcasm). There is a new class of competitor coming to your space that understands these seven points and are executing them with ambitious zeal. They understand that to truly lower their unit cost structure they need to look at their cost of risk rather than the price of their insurance. Having this ability is truly an overwhelming marketplace advantage as they will be cost efficient and cost consistent year in and year out. You will know them by their tale tell signs, high growth, more market share, lower costs and higher profits.

Wash, rinse, repeat.

Claims Management, Construction Practice Group Content, Food & Beverage Practice Group Content, General Liability Insurance, Human Services Practice Group Content, Line of Insurance, Risk Management, Transportation Practice Group Content, Workers Compensation Insurance, Workers Compensation Premium Audits

What A High Experience Mod Means and How It Can Affect You

You’ve just seen your Experience Modification Rating (EMR) and it is high again. Or your worst-case scenario, it has gone up again. Year over year, you’ve spent time shopping for your insurance due to your high EMR. It is time to stop shopping and start proactively working to lowering your EMR because eventually, it will catch up to you.

What Is Your Experience Mod?

Let’s start with a basic definition. What is your Experience Modification Rating or your EMR? A simple definition of EMR is Payroll divided by Claims. The video below explains what your experience mod is and what is expected of your organization. (If the video does not play in your browser click here.)

Remember, an average experience mod is a 1.0, this is like receiving a “C” on your report card. If you’re happy with this, stop reading now. Good luck, you’ll be competing against companies with a greater competitive advantage than you because they’ll have a much lower cost structure, higher profits, and a larger business development budget.  

Some Construction companies bidding on government work are ineligible if their EMR is above 1.0. 

How To Find Your Experience Mod Rate

The NCCI (National Council on Compensation Insurance), is a group that calculates Experience Modification Factors for companies across the entire United States. Some states have their own rating bureaus due to their size and complexity. For example, New York and New Jersey have the NYCIRB & NJCRIB respectively. For a detailed explanation of what your Experience Modification Factor is and how it’s calculated visit this site. 

Why is Your Experience Mod High?

There are a number of reasons why your EMR is high. The biggest factor is the number of open claims. If your organization has a high number of claims or one large claim on your Workers’ Comp policy your EMR may stay high until that claim is closed.

How This Affects Your Organization

What this means is that most companies will see another increase in their Experience Modification Factor following their next recalculation. That takes place on their “Unit Stat Date,” and, if left unchecked, your business could face higher rates, possible penalties, and Labor Department Violations.

What You Can Do To Lower Your Experience Mod:

  1. Track incidents (near misses) not just claims. Most claims can be avoided if you are meticulous about tracking all of the near misses that lead up to the eventual incident. Most claims could have been avoided in hindsight as the employee typically was taking shortcuts long before the ultimate injury occurred. Track these infractions and you will prevent at least one injury a year.

    High Experience Mod

  2. Investigate accidents immediately and thoroughly; take corrective action to eliminate the hazard. If you sense fraud, get aggressive; don’t be an easy target. We suggest Why Analysis follow all incidents. That’s a whole other article that can be accessed HERE.
  3. Report all incidents to your insurance broker or Risk Advisor immediately. Studies show the longer it takes to report a claim, the more expensive it will be. A 4-week delay in reporting an injury drives the cost of that same injury by 48% according to a Hartford Insurance study of over 2 million claims.
  4. Alert your workers’ compensation claims adjuster to any serious, potentially serious or suspect claims. Frequently monitor the status of the claim, and communicate with the adjuster to resolve them as quickly as possible. Too busy to do that,  have our Claims Advocates communicate with the adjuster on your behalf. Our Claims Advocates were insurance adjusters so they speak that language holding the carrier’s adjusters accountable.
  5. Every reported claim to your insurance carrier no matter the line of insurance should have an action plan attached to it to close out the claim. This is a big mistake most businesses make. They report it and then forget it until the policy comes up for renewal. At that point, they are shocked at the increase in the workers’ compensation insurance premium which is always driven by claims experience. Folks forget that workers’ compensation insurance is really a very expensive credit line to the business.
  6. Take an aggressive approach to providing light-duty or transitional to all injured employees upon their release from treatment. Return To Work programs are extremely powerful tools for lowering the cost of a workers’ compensation claim as they give leverage back to the employer, stopping the tail from wagging the dog.  Supervise light duty employees to ensure their conformance with restrictions.
  7. In serious cases that involve lost time, communicate with the claims adjuster to demonstrate your interest in returning the injured employee back to gainful employment.
  8. Set safety performance goals for those with supervisory responsibility. Success in achieving safety goals should be used as one measure during performance appraisals. At Metropolitan Risk this is just one of the K.R.I’s (Key Risk Indicators) we emphasize to establish internal standards and accountability.
  9. Develop a written safety program, and train employees in their responsibilities for safety. OSHA rules dictate for every facility location or job site there must be a competent person. Incorporate a disciplinary policy into the program that holds employees accountable for breaking rules or rewards them for correctly following safety procedures. This should be tied into the employee handbook which each employee receives when they are on-boarded for your org.
  10. Frequently communicate with employees, both formally and informally, regarding the importance of safety keeping safety top of mind at all times.
  11. Make safety a priority – senior management must be visible in the safety effort and must support the initiative.
  12. Evaluate accident history and near-misses at least monthly. Look for trends in experience, and take corrective action on the worst problems first.
  13. Ensure your payroll and class codes are accurate. Over 65 % of workers’ compensation audits have errors. See COMP CHECK .
  14. Ensure the correctness of your mod calculation. Far too often there are errors here as well. See COMP CHECK

You can build all this out organically by yourself OR speak to a Risk Advisor about our COMP CARE PLATFORM. We have this all built. It’s turn-key and ready to be deployed in your organization if you are serious about reducing your workers’ compensation costs. There are no short cuts…

How Metropolitan Risk Can Help

Still looking for more info? Still have question? We have a team of Risk Management specialists who are here to help! Contact a Risk Advisor today for more information on how you can work towards lower workers comp costs by closing claims instead of shopping for insurance.  Click here to book a 5-minute call with a Risk Advisor

Construction Practice Group Content, Loss Control, OSHA, Risk Management, Workers Compensation Insurance

REMINDER: Site Safety Training Requirements Due Dec. 1, 2019

This is just a quick reminder to all our clients and friends that as of December 1st, 2019 per Local Law 196 of 2017, Site Safety Training or SST, workers at job sites requiring a Construction Superintendent, Site Safety Coordinator or Site Safety Manager must have a total of 30 hours of safety training by December 1, 2019 and a total of 40 hours by September 2020. Supervisors must have 62 hours of training by December 1, 2019.

Further for General Contractors (G.C.’s), every site must post worker safety information posters as each job site they are running where safety is required. This was effective as of October 14th, 2019. 

 

Per the NYC Department of Buildings (DOB), the signs must contain the following attributes.

  • Contain specific information about required worker safety training, including all site safety training deadlines and the number of required training hours, and the information must
  • Be in all languages used by workers to communicate at the construction site. In addition, the signs must
  • Be clearly visible to workers and must be posted at the construction site as follows:
    • Sites with construction fencing must post a sign at each egress point on the inside of the construction fencing, including vehicle delivery fence gates and existing loading docks.
    • Sites without construction fencing must post a sign at each egress point within the controlled access zone where construction is taking place and at each existing loading dock or location used for construction delivery or access.

To comply with the new requirements, the posted sign must:

  • be 44 inches wide and 30 inches high;
  • have letters at least 1 inch (25 mm) high;
  • have white letters on a blue background; and
  • be made of a durable and weatherproof material such as vinyl, plastic, or aluminum that is flame retardant.

The NYC DOB also was kind enough to build out templates in various languages for a diverse workforce population. If you wish to obtain a Site Safety Poster in a different language than English CLICK HERE. 

Any questions we recommend so speak directly with Complete Safety Services, LLC Sinead O’Flaherty. CLICK HERE to contact Sinead. 

 

 

HR Challenges, Human Services Practice Group Content, Workers Compensation Insurance

Signs Of Worker Burnout In Home Healthcare

Signs Of Worker Burnout

Worker burnout in the Home Healthcare Sector is a major problem. On top of burn out, home healthcare agencies face a growing problem of worker shortages. The Bureau of Labor Statistics projects 7.8 million job openings between 2016 and 2026. So it is important that agencies hold onto their employees as best as they can.

There are a number of signs that your employees may be suffering from burn out. Employee burnout is categorized as a “physical or mental collapse” caused by overwork or stress.

 

 

We’ve outlined 5 ways to help your organization identify employee burnout. Burnout can be tough to identify because the signs aren’t always easy to see. Sometimes, employees don’t show signs of burnout until after an incident has occurred while on or off the job.

Combating Employee Burnout

As an employer, you should be focusing on ways to help retain your employees and help them combat burnout. Combating burnout may seem like an expensive addition to the resources you’re already giving your employees, but the cost of doing nothing may be more.

Creating moral within your organization is one way to combat burnout. If your employees feel undervalued and overworked, they can start to burnout. This can be as simple as creating easy to obtain goals for your employees or hosting an employee potluck.

If you notice one of your employees suffering from burn out, address the situation. Then, talk to the rest of your employees, if one employee is showing visible signs of burn out, it is likely that other employees may be burnt out as well. For more information on how Metropolitan Risk can help your home healthcare organization manage your risks contact one of our Risk Advisors at 914-357-8444 or Contact us 

 

Workers Compensation Insurance

Understanding The New York State Insurance Fund Reservation of Rights Process

Executing the NY State Insurance Fund Reservation of Rights protocol is critical if you do not want to be surcharged for leaving the NYSIF.

As you may be aware if you want to leave The New York State Insurance Fund for greener pastures or a better offer for workers compensation insurance from the private market place you must reserve your rights within 30 days of the workers compensation insurance policy expiration date. Failure to do so will result in a penalty of at least 10% of the annual workers compensation insurance premium. Naturally, this little poison pill gets many a NY business owner sick, usually after the fact as many insurance brokers are no as conversant as they should be in the rule.

Thus in the spirit of good faith here are two important resources to help you execute.

Click Here

To download a sample letter you need to draft on your letterhead to let the carrier know your intentions so you can reserve your right to leave the NYSIF without penalty. This doesn’t mean you will, you just simply want the option just in case.

Click Here

To figure out who your NYSIF Underwriter is. This is the person the letter should be addressed to AND you should send to both electronically AND by Certified Mail just in case. It’s worth the $4 in case you do exercise your right to leave . If they come back with the penalty you can prove that you reserved your right and provide back up.

If you decide to remain with the NYSIF you must follow up with the underwriter and let them know your intent in writing or they will assume you left and cancel the policy. It’s tricky as reserving your rights SHOULD NOT mean auto cancel the policy, however, that is how the NYSIF interrupts the reservation of rights. Don’t let that trip you up. We suggest that you work with a Risk Advisor to guide you with this process . If they are a Metropolitan Risk Advisor they will do this gratis in appreciation for how time challenged you are. If you have any more questions about NY State Insurance Fund Reservation of Rights contact a Risk Advisor for more details. Simply complete the form below or give us a shout at (914) 357-8444. We are here for you.

 

Claims Management, Construction Practice Group Content, Food & Beverage Practice Group Content, HR Challenges, Human Services Practice Group Content, Transportation Practice Group Content, Workers Compensation Insurance

When An Employee Refuses Medical Injury Treatment For Potential Workers Compensation Claim

Is your employee refusing medical injury treatment for a potential worker compensation claim? Based on the geographic location of your business, many state workers’ compensation statutes limit and mandate certain employer actions when a worker is injured. Depending on the state, there are specific timelines to follow and forms to complete. But what about when a worker injures themselves and refuses to accept treatment or file a claim? What are your responsibilities? While the exact legal answer depends on your situation and state laws, consider the following to limit your liability. Not sure click here.

When You Notice An Employee Injury

If you’ve notice that one of your employees has been injured, whether they have mentioned it or not, gently bring it up. Then, discuss the circumstances of the injury with the employee to determine whether the injury occurred when working. Many state workers’ compensation statutes obligate employers to report injuries as soon as they have knowledge of them. Delay in reporting the injury could result in a much larger claim & fines from the state. Completing the paperwork to report injuries is not an admission of your liability—on the contrary, it could protect you. This is where we see Employers are weakest, as they have no consistent systems in place. This could ultimately help them defend themselves in a workers compensation claim hearing.  

 

In the Case of An Employee’s  Refusal For Medical Treatment For A Potential Worker Compensation Claim

When discussing the injury with the employee, explain that reporting job-related injuries ensures injured workers to certain benefits. This is in action while recovering from the injury. This should have been in writing in your employee handbook as part of your policies and procedures. Further notifying your employees of their obligation to report timely. All potential workplace injuries should be part of your initial on-boarding process. If the employee refuses to file a claim for the injury, file the employer’s portion of the report with a statement of refusal to pursue a claim signed by the employee. It is crucial that you document this conversation to protect your organization from being penalized in the future. Typically we advocate separate reporting forms, one for the employee and one for the direct report supervisor. This serves a dual purpose of taking down details of the incident and as an accident investigation report. 

Employees that do initially report injuries but then refuse treatment under the physician or facility that your organization furnishes should sign a similar form confirming this refusal. The employer also has a right to state to the employee that the only way they could be allowed back at work is if they passed a medical clearance test. This test determines their physical capacity to perform the work. Self-diagnosis by an employee is rarely a good idea. 

Workers Compensation Benefits for Employees that Refuse Medical Treatment

State workers’ comp statutes vary, but in most cases, workers’ compensation benefits are suspended for employees that refuse to comply with any reasonable request for examination or refuse to accept medical service or physical rehabilitation which the employer elects to furnish. Benefits may not be payable for this period of refusal of treatment—check with your workers’ comp carrier. 

What Employers Can Do When An Employee Refuses Medical Treatment For A Workers Compensation Claim

It is important that you prepare for an eventual employee’s refusal to submit a claim or refusal to accept treatment for a workplace injury. All employers should have a legal representative draft a form for refusal of treatment that complies with state requirements so it is immediately available when needed. Discuss with supervisors the importance of documenting and reporting all injuries, whether or not the worker chooses to report them.

 

Workers compensation insurance is obligatory in most states. Contact a Risk Advisor at Metropolitan Risk by CLICKING HERE or call (914) 357-8444 for more information.