Workers’ Compensation Basics: An Employers’ Perspective Presented to the American Academy McAllister Institute of Funeral Service McAllister Institute

Workers’ Compensation Basics: Workers’ Compensation Basics: An Employers’ PerspectiveAn Employers’ Perspective

Presented to the American Academy Presented to the American Academy

McAllister Institute of Funeral Service McAllister Institute of Funeral Service

April 30, 2011April 30, 2011

Copyright © 2011 Nance L. Schick


Employers underestimate their value in Employers underestimate their value in resolving their injured workers’ claimsresolving their injured workers’ claims.

INSERT PHOTO HERE INSERT PHOTO HERE THAT REPRESENTS THAT REPRESENTS

“NO ENTRY” OR “NO ENTRY” OR “UNWELCOME”“UNWELCOME”


The NYS WCB does The NYS WCB does not recognize you as not recognize you as a necessary party.a necessary party.


Insurance carrier Insurance carrier or TPA goals:or TPA goals:

•Pay as little as Pay as little as possiblepossible

•Do so with as little Do so with as little effort as possible effort as possible

•Do so as quickly Do so as quickly as possibleas possible


This is how the NYS WCB sees you.This is how the NYS WCB sees you.


Next to the injured Next to the injured worker, you are the worker, you are the most important most important party-of-interest.party-of-interest.

http://www.sxc.hu/browse.phtml?f=download&id=473721&redirect=photo


Assert your interests. Assert your interests. Get better results.Get better results.


Workers Compensation:Workers Compensation:

•No-faultNo-fault•Form-basedForm-based•Strict complianceStrict compliance

A small percentage A small percentage of claimants, of claimants,

medical providers medical providers and lawyers will and lawyers will

generate huge generate huge costs through fraud costs through fraud

and abuse.and abuse.


Responding to a ClaimResponding to a Claim



Secure treatment and Secure treatment and prevent further injury firstprevent further injury first

http://www.sxc.hu/photo/206474

http://www.sxc.hu/photo/1232546


The C-2 The C-2 report is one report is one of the of the Board’s Board’s mandatory mandatory formsforms


RED FLAGSRED FLAGSThe accident was: The accident was: a) unwitnessed, b) not reported immediately or to a) unwitnessed, b) not reported immediately or to anyone other than the Board or c) on a Friday or the anyone other than the Board or c) on a Friday or the day before a holiday.day before a holiday.

The claimant: The claimant: a) had not been working for the employer long, b) was a) had not been working for the employer long, b) was unable to articulate how the accident occurred or gave unable to articulate how the accident occurred or gave a history that does not make sense, c) is known to be a history that does not make sense, c) is known to be friends with another claimant who had a similar friends with another claimant who had a similar accident, is disgruntled or planning to retire, d) did accident, is disgruntled or planning to retire, d) did not seek treatment immediately, or e) sought legal not seek treatment immediately, or e) sought legal representation before the claim was denied.representation before the claim was denied.

Know:Know:

• Your employeesYour employees

• Their hobbiesTheir hobbies

• Their potential Their potential motivations for motivations for fraud or abusefraud or abuse



Avoid Unnecessary Penalties Avoid Unnecessary Penalties and Prejudiceand Prejudice

Maintain CommunicationMaintain Communication



Litigation Will Move Far More Litigation Will Move Far More Quickly Than in the CourtsQuickly Than in the Courts


No Adjournments or ExcusesNo Adjournments or Excuses


The Judge presumes the The Judge presumes the injured worker is telling the injured worker is telling the

truth absent direct and credible truth absent direct and credible evidence to the contrary.evidence to the contrary.


The Board is not concerned The Board is not concerned with getting with getting youyou justice. justice.


Medical and photographic Medical and photographic evidence is most persuasive.evidence is most persuasive.


Many decisions will Many decisions will be made from the be made from the

bench at trial.bench at trial.


Although you will probably Although you will probably be liable, there are be liable, there are

mitigation opportunities.mitigation opportunities.


Not all treatment is covered.Not all treatment is covered.


This is not a This is not a retirement plan.retirement plan.


Activity Activity at home at home suggests suggests ability at ability at work.work.

SettlementSettlement


The injured worker might return to work.


The injured The injured worker worker

might might resign.resign.



Or retire.Or retire.


Copyright © 2011 Nance L. Schick Copyright © 2011 Nance L.

Schick

You know what we don’t.You know what we don’t.

.


You are my best You are my best investigator.investigator.

Sometimes Sometimes your safety your safety programs programs will fail.will fail.



Take Take action.action.


Stay involved.Stay involved.


Get good results.Get good results.

Nance L. Schick

212.804.7039

www.nschicklaw.com

[email protected]


Thank you!Thank you!

Documents

Workers’ Compensation Basics: An Employers’ Perspective Presented to the American Academy McAllister Institute of Funeral Service McAllister Institute