Employers have the legal duty to obtain workers’ compensation or to qualify as a self-insured employer since all employees should be protected if they are injured at work. When an employee becomes injured and reports this injury, their employer has to provide the injured employee with a workers’ compensation claim form within one working day. Aside from having the current Worker’s Compensation insurance, employers should be able to produce proof of coverage if requested by the Regulator and prominently display it at each workplace detail of insurance coverage.
What Are The Penalties?
There may be instances where employers are sued, but most states consider workers’ compensation the exclusive remedy for workplace injuries. For this reason, negligence to provide workers’ compensation insurance coverage will result in costly sanctions against the offending employer, which include criminal prosecution, fines, employer’s personal liability for any workers’ compensation benefits due for injured workers, as well as employee’s exercising the option to sue the employer instead of filing a compensation claim.
What Should Employers Report For Workers’ Compensation?
Employers should report each of the work-related injuries to their workers’ compensation insurance company, even if it’s just an incident that draws blood or the employee has no visible wounds and seems “fine.” This is because minor injuries may seemingly develop into significant claims. In that case, acknowledging an incident with the employee and letting the insurance company learn about it while helping the injured worker obtain medical treatment can lead to the claim’s best possible outcome.
If an employee suggests that he/she is sick because they were at work, following the same procedures for injuries is important. Although it’s easy at that moment to say that a specific condition is not a covered workplace illness, it is important to note that it can’t be 100% certain if the employee’s condition isn’t related to their job and/or workers’ compensation insurance covers that.
Moreover, some state workers’ compensation laws gauge the responsibility of proof on the employee when contracting a workplace’s covered illness. At the same time, other states support a work-related illness since it may have been contracted at work. Moreover, these variables reinforce the need for claims professionals to be on the case as soon as possible after employees have articulated that they believe an illness was contracted due to being at work.
There are workplace incidents sometimes caused by third parties responsible for an employee’s injury. While it sounds reasonable for an employer or employee to manage these directly with the third party, state laws dictate that the employer’s workers’ compensation insurance is the primary coverage. For example, an office worker is traveling to the post office to pick up the day’s mail for his employer when he is hit by another vehicle from behind.
Initially, the employee feels fine and returns to the office
However, the following morning he complained of a severe headache, neck pain, and a significant bruise on his forehead.
Since an at-fault third party caused the injuries, the employer advises the employee to contact the other driver’s insurance company.
This is not proper according to most state workers’ compensation laws. Instead, medical treatment of the injured worker and subsequently lost wages are the employer’s responsibility. The employer must report the accident to their workers’ compensation insurance company.
Upon notification by the employer—and as part of the claims process—an investigation by the workers’ compensation insurance company confirms the third party was at fault.
The employer’s workers’ compensation insurance must respond and manage payment of the claim retaining the right to subrogate against the at-fault party (the right to seek reimbursement for payments/expenses of the claim from the other party).
What Can Employer Do To Encourage Report Of Injury?
Employers should have documented policies supporting timely reporting that are effectively communicated throughout the organization. Valuable procedures include:
- encouraging workers to report incidents;
- supplying claim forms directly to employees;
- obtaining written statements from the injured worker;
- securing statements from co-workers and/or eyewitnesses;
- taking photographs of the workplace where alleged injuries/incidents occurred;
- providing a referral to the injured worker for medical care; and
- maintaining regular communication with the injured worker throughout the claim process.
In addition, an employer should notify the workers’ compensation insurance company of injuries or illnesses if the individual(s):
- Is/are your employee(s), and
- Were hurt while working/doing their job and/or
- Became ill because of their work.
Moreover, An employer should file a workers’ compensation claim:
- As soon as an employee states s/he was hurt at work or became ill because of their job;
- Immediately to avoid state regulatory fines and penalties associated with late reporting;
- Promptly to help manage costs (late reporting correlates to higher ultimate claims costs); and
- Even in cases where no medical treatment is obtained (as a “report or notification only”).
Reporting known and potential workers’ compensation claims immediately will save an employer money in the end.
Employer’s Duty Not to Retaliate
Workers’ compensation laws not only provide remedies to injured employees but also protect employers since they are designed to be the only solution injured employees may seek from their employers. In fact, discrimination can happen to employees when employers often appear to disapprove of employees who file workers’ compensation benefits claims.
For employees to be protected from discrimination, harassment, or unjustly terminate of injured employees, there are most states that prohibit employers from doing all these things while exercising their rights under workers’ compensation laws, which also allow employees to bring civil actions against the employers for the tort of “retaliatory discharge.”
Aside from termination, retaliation can also be in subtle types of discriminatory treatment like salary deduction or demotion. In this case, injured employees are covered from conduct that is discriminatory immediately after an injury and prior to a formal workers’ compensation claim that is filed. Even so, the cause of action of the employee may be successful, although all the employee did was notify the employer of a claim.
The Bottom Line
Suppose you work in an industry where employer workers’ compensation responsibilities apply. Risk Managers offer Workers’ Compensation, a type of insurance that provides wage replacement and medical expenses to employees injured during work. Furthermore, workers’ compensation insurance helps protect employees from the potentially devastating costs of work-related accidents, and it can also help protect the business owner from the expensive costs of employee claims.