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4 steps to keep claims from derailing your company & its processes

The COVID-19 pandemic has presented and will continue to present challenges to business in ways we never anticipated. Many have been forced to close their doors and send workers home indefinitely, while others, including construction companies, press on with “essential workers” who continue to show up to jobsites while adhering to procedures that aim to minimize the risk for contracting the virus.

Times of crisis remind us how vulnerable businesses can be to illness and injury, particularly when it is so widespread, and force many companies to review the adequacy of their preparedness for handling emergencies. However, in the construction industry, the possibility of an employee sustaining a workplace injury or illness is always present, so waiting for and reacting to an emergency to develop and implement protective procedures is a potential recipe for disaster.

If you are not already prepared to appropriately handle worksite injuries claims, now is the time to do so. From operating heavy equipment to working in hazardous conditions, construction workers are prone to accidents and injury. No matter the times or circumstances, it is never too early to prepare and take proactive measures to prevent potentially costly workers’ compensation claims before they occur.


 

By adhering to the following steps and recommendations, you can help minimize and prevent costly workers’ compensation claims from disrupting or derailing your company.

1. Document Everything

The first and most important step in any potential workers’ compensation claim is to maintain thorough documentation of every incident that occurs on a construction site. Whether you directly witness an accident or simply notice an employee’s discomfort, it is the responsibility of the employer and the injured employee’s direct supervisors to inquire and collect information, report on the potential injury, and initiate an investigation into the accident.

At this point, employers should also gather and document any statements from individuals who witnessed the incident, obtain surveillance footage if available, and document when and where the worker claims the injury took place.

This is the time to make sure you are aware of any preexisting conditions that the worker might have and not made known in the prior-hire documentation, determine whether or not the employee has group health insurance, and obtain information related to the employee’s work history and any prior workers’ compensation claims. There are many factors that could impact the path of the claim and having everything documented and accounted for will save you difficulty on the back end.

It’s also important to note that, when it comes to large construction jobs, there are often many potential liable parties, from property owners to general contractors to subcontractors. General contractors can be held liable for workers’ compensation benefits for injuries sustained by its subcontractors’ employees if those subcontractors do not have workers’ compensation coverage of their own. 

 

As such, it may be important for general contractors to consider this potential risk when hiring subcontractors and implementing additional procedures to ensure that hired subcontractors have procured adequate workers’ compensation insurance. 

2. Demonstrate Concern & Offer Medical Care Immediately

From the very moment an injury occurs, it is crucial for the employer to express concern and offer immediate medical care from a carefully chosen physician. This will have a tremendous impact in determining whether it is a genuine claim, and it will also demonstrate commitment to addressing workplace injuries with compassion and in a timely manner. As previously mentioned, if the employee refuses medical attention, be sure to document the refusal as well.

If a worker feels ignored or distrusted after an injury, he or she is more likely to visit a doctor of their own choosing and contact a lawyer. At that point, the claim is more likely to enter litigation. Since an employer does not accept a claim as compensable by authorizing medical treatment, offering immediate medical treatment will foster goodwill within the mind of the injured employee and can only assist in the overall claims process.

3. Understand State Laws That Dictate Which Doctors Can Treat Injured Workers

In any workers’ compensation claim, the authorized medical provider who evaluates the injury can be one of the most significant cost-drivers in the case. Depending on the state, the rights of the injured employee to select their doctor can vary. While there are jurisdictions that do allow injured employees to select their own doctor, in other states, injured employees must choose a doctor from a panel of physicians that their employer provides.  

In the state of Georgia, for example, employers are required to maintain a “panel of physicians” that provides a list of medical providers from which injured employees may choose for work-related injuries. There are specific requirements related to the display of this panel of preselected doctors. 

 

It is recommended that this panel be displayed in at least one high-traffic location where employees have easy access for review to avoid the argument that they were unaware of the panel and its purpose. This is typically in a break room. However, construction jobsites are not always afforded the same layout as a standard office building or warehouse. 

Therefore, a high-traffic and highly visible location for the panel might be more difficult to determine. In addition to adequate placement of the panel, it is highly recommended that employers explain the purpose of the panel, again to avoid the argument that the injured employee was unaware of the panel’s existence.  

All employees should also have a clear understanding of the purpose of the panel from the beginning of their employment. If the worker is hired by a subcontractor, it is the subcontractors’ duty to educate its workers.  Unfortunately, if the subcontractor fails to do so and does not have workers’ compensation insurance of its own, then the liability for failure to properly educate the employees of the subcontractor will fall contractors upstream, including the general contractor. 

If the panel is never displayed or explained to an injured worker and the worker is not given the right to choose from a doctor on the panel, they will have the right to choose any doctor of their choice. The result of that could have a substantial impact on the claim exposure and dramatically increase medical costs for the employer.

By understanding the specifics and requirements of your state’s laws regarding medical care, it can save your company considerable resources, including time, energy and money. To ensure you are fully aware and prepared, you should contact your state legal department of workers’ compensation and your workers’ compensation insurance carrier.

4. Implement a Transitional, Light-Duty Work Program From the Beginning

 

After an employee is cleared to return to work a full or limited capacity, contractors should work with the employee’s supervisors and human resources representative to determine the most suitable, transitional work program that falls within restrictions provided by the authorized treating physician.

By having light-duty programs in place, employers can return employees back to work sooner, ultimately transitioning them off benefits, restoring employment and income which allows the business owner to control costs.

Transitional programs demonstrate care for injured employees and the value that he or she brings to construction sites. Examples of light-duty work can include office work, operating trucks or forklifts, performing inspections and training new workers. Of course, the availability of options for light-duty work depend on the nature of restrictions and the work being performed at the jobsite.

 

In every workers’ compensation claim, the first 30 to 90 days are the most consequential. By preparing and following these steps, construction business owners can reduce and potentially costs and return its employees back to work in a timely manner, without derailing the company during these uncertain times.