workers’ compensation basics: an employers’ perspective presented to the american academy...
TRANSCRIPT
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
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”
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The NYS WCB does The NYS WCB does not recognize you as not recognize you as a necessary party.a necessary party.
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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
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This is how the NYS WCB sees you.This is how the NYS WCB sees you.
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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.
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Assert your interests. Assert your interests. Get better results.Get better results.
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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.
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Responding to a ClaimResponding to a Claim
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Copyright © 2011 Nance L. Schick
Secure treatment and Secure treatment and prevent further injury firstprevent further injury first
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The C-2 The C-2 report is one report is one of the of the Board’s Board’s mandatory mandatory formsforms
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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
Copyright © 2011 Nance L. Schick
Copyright © 2011 Nance L. Schick
Avoid Unnecessary Penalties Avoid Unnecessary Penalties and Prejudiceand Prejudice
Maintain CommunicationMaintain Communication
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Litigation Will Move Far More Litigation Will Move Far More Quickly Than in the CourtsQuickly Than in the Courts
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No Adjournments or ExcusesNo Adjournments or Excuses
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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.
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The Board is not concerned The Board is not concerned with getting with getting youyou justice. justice.
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Medical and photographic Medical and photographic evidence is most persuasive.evidence is most persuasive.
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Many decisions will Many decisions will be made from the be made from the
bench at trial.bench at trial.
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Although you will probably Although you will probably be liable, there are be liable, there are
mitigation opportunities.mitigation opportunities.
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Not all treatment is covered.Not all treatment is covered.
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This is not a This is not a retirement plan.retirement plan.
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Activity Activity at home at home suggests suggests ability at ability at work.work.
SettlementSettlement
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The injured worker might return to work.
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The injured The injured worker worker
might might resign.resign.
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Copyright © 2011 Nance L. Schick
Or retire.Or retire.
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Copyright © 2011 Nance L. Schick Copyright © 2011 Nance L.
Schick
You know what we don’t.You know what we don’t.
.
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You are my best You are my best investigator.investigator.
Sometimes Sometimes your safety your safety programs programs will fail.will fail.
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Copyright © 2011 Nance L. Schick
Take Take action.action.
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Stay involved.Stay involved.
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Get good results.Get good results.
Nance L. Schick
212.804.7039
www.nschicklaw.com
Copyright © 2011 Nance L. Schick
Thank you!Thank you!