What Now?

Workers' Compensation Part Two: The Next Step

You’ve just been informed that the new employee you just hired fell off the ladder at a worksite and the paramedics are pretty sure he has a really bad shoulder injury, his arm may be broken and his head was bleeding pretty heavy too. The paramedics took him to the hospital. 

What is your immediate response? Do you know what to do now? When it comes to workers’ compensation you need to know which actions you should take, and which you shouldn’t.

What do we have to do?

All states require that you complete paperwork regarding the accident or illness. You usually can print these off the Internet. The directions with timelines are written on the form. There will be a number of questions to answer including information about the accident, witness names and personal information about the injured employee. You will need to mail this to the address indicated on the form.

What if the employee was negligent?

If an injury happens at work,the employee is entitled to workers’ compensation benefits, even if the injury was his or her own fault (unless they intentionally selfinflicted an injury).

For example, falling off a ladder, or lifting a box resulting in a back injury is eligible under workers’ compensation; getting a skin rash from an allergic reaction to cleaning solvents is eligible under workers’ compensation. The injury or illness must be work-related “in and out of the course of employment,” regardless of whose fault it was.

What if the employee is killed on the job?

Talk to the family in-person and express your sympathy. Call OSHA -there is a 24-hour notification requirement when a death occurs. Call your lawyer to seek advice. Do not talk to the media until all facts are learned. Call your company hierarchy to advise them of the situation.

Do I have to pay an injured employee if they cannot work, and cover all related medical benefits?

The answer to that question is yes and yes. Usually, the employee’s exclusive remedy against the employer is wage-loss benefits and necessary medical or rehabilitation treatment.

Employees are also entitled to the full cost of all reasonably necessary medical treatment with no deductibles or co-pays. For this reason, there is a question about whether something is work-related because employees will get full medical coverage, unlike the coverage that they might be entitled to under a typical health insurance plan. 

Rehabilitation benefits can include physical or occupational therapy to enable the worker to recover some of his or her lost work capacity.

How should I treat the person when they come back?

Always work with the employee to get him or her back to work as soon as possible. Find out if there are restrictions from the physicians. Treat the employee well; after all they were injured in the course of employment with your company. Make the employee feel you are glad they are back to work.

Another important loss-prevention technique is to avoid discrimination or retaliation against employees who file workers’ compensation claims. They should not demote or fire current employees who file claims. 

Nevertheless, at some point, if a worker exhausts all of his or her available leave and is no longer able to work, the employer may legally terminate his or her employment so long as they do not violate any other law or regulation, i.e. the Americans with Disabilities Act or Family Medical Leave Act.

What could happen if the proper procedures are not followed?

This may serve as a catalyst to the worker to seek representation by a workers’ compensation attorney or file some type of claim with a state agency.

A dispute that might arise over such a claim can often result in a settlement in which the employee receives some cash amount and signs an agreement that their employment is terminated and that they have no legal right to file any other claims against the employer in the future. 

Nancy Roehrkasse is the Senior Human Resources Consultant at HR OneSource, Inc., in Johnston, Iowa.

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