Workers’ Compensation Basics: An Employers’ Perspective Presented to the American Academy McAllister Institute of Funeral Service McAllister Institute of Funeral Service April 30, 2011 Copyright © 2011 Nance L. Schick
Employers underestimate their value in resolving their injured workers’ claims Employers underestimate their value in resolving their injured workers’ claims.
INSERT PHOTO HERE THAT REPRESENTS “NO ENTRY” OR “UNWELCOME” Copyright © 2011 Nance L. Schick The NYS WCB does not recognize you as a necessary party.
Copyright © 2011 Nance L. Schick Insurance carrier or TPA goals: Pay as little as possiblePay as little as possible Do so with as little effort as possibleDo so with as little effort as possible Do so as quickly as possibleDo so as quickly as possible
Copyright © 2011 Nance L. Schick This is how the NYS WCB sees you.
Copyright © 2011 Nance L. Schick Next to the injured worker, you are the most important party-of-interest.
Copyright © 2011 Nance L. Schick Assert your interests. Get better results.
Copyright © 2011 Nance L. Schick Workers Compensation: No-faultNo-fault Form-basedForm-based Strict complianceStrict compliance
A small percentage of claimants, medical providers and lawyers will generate huge costs through fraud and abuse. Copyright © 2011 Nance L. Schick
Responding to a Claim Copyright © 2011 Nance L. Schick
Secure treatment and prevent further injury first
Copyright © 2011 Nance L. Schick The C-2 report is one of the Board’s mandatory forms
Copyright © 2011 Nance L. Schick RED FLAGS The accident was: a) unwitnessed, b) not reported immediately or to anyone other than the Board or c) on a Friday or the day before a holiday. The claimant: a) had not been working for the employer long, b) was unable to articulate how the accident occurred or gave a history that does not make sense, c) is known to be friends with another claimant who had a similar accident, is disgruntled or planning to retire, d) did not seek treatment immediately, or e) sought legal representation before the claim was denied.
Know: Your employeesYour employees Their hobbiesTheir hobbies Their potential motivations for fraud or abuseTheir potential motivations for fraud or abuse Copyright © 2011 Nance L. Schick
Avoid Unnecessary Penalties and Prejudice
Maintain Communication Copyright © 2011 Nance L. Schick
Litigation Will Move Far More Quickly Than in the Courts
Copyright © 2011 Nance L. Schick No Adjournments or Excuses
Copyright © 2011 Nance L. Schick The Judge presumes the injured worker is telling the truth absent direct and credible evidence to the contrary.
Copyright © 2011 Nance L. Schick The Board is not concerned with getting you justice.
Copyright © 2011 Nance L. Schick Medical and photographic evidence is most persuasive.
Copyright © 2011 Nance L. Schick Many decisions will be made from the bench at trial.
Copyright © 2011 Nance L. Schick Although you will probably be liable, there are mitigation opportunities.
Copyright © 2011 Nance L. Schick Not all treatment is covered.
Copyright © 2011 Nance L. Schick This is not a retirement plan.
Copyright © 2011 Nance L. Schick Activity at home suggests ability at work.
Settlement Copyright © 2011 Nance L. Schick
The injured worker might return to work. Copyright © 2011 Nance L. Schick
The injured worker might resign. Copyright © 2011 Nance L. Schick
Or retire. Copyright © 2011 Nance L. Schick
You know what we don’t.
. Copyright © 2011 Nance L. Schick You are my best investigator.
Sometimes your safety programs will fail. Copyright © 2011 Nance L. Schick
Take action.
Copyright © 2011 Nance L. Schick Stay involved.
Copyright © 2011 Nance L. Schick Get good results.
Nance L. Schick Copyright © 2011 Nance L. Schick Thank you!