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The American Equity Underwriters, Inc. The American Equity Underwriters, Inc.
Longshore Insider
Consistency is Key: Pitfalls to Avoid when Dealing with Injured Workers
Jul 29, 2019 - Will Scheffler, The American Equity Underwriters, Inc.

I am a father to two young men, ages 21 and 17. My wife and I try our best to treat them equally. I coached both in youth sports, we drove carpool for both sets of friends, and we’ve offered them equal opportunities for education. This consistency has kept any feelings of Mom and Dad playing favorites at bay.  

Establishing consistency in the business world amongst employees is more difficult. It’s my personal belief that hard working employees should be rewarded, and employees with natural leadership abilities should be given the opportunity to develop into leaders when the need arises. I also believe that disruptive employees should be held accountable for their behavior in accordance with their employer’s human resources policies.

These are circumstances where employees should be treated differently based on their actions and abilities. The world of workers’ compensation claims is one where employees should be treated the same.

Here are four examples of areas where consistency in policies, practices and procedures will support a smooth claims resolution process.

 

Visits to the Doctor


Some employers have a protocol where a supervisor or other employee brings an injured worker to the doctor either for initial visit and/or subsequent visits. If this protocol exists at your company, you must be sure to do this for every employee who is injured. Excluding an employee from this protocol for any reason and making them provide his or her own transportation to the doctor is a sure-fire way to get a claim started off poorly. These reasons can include a supervisor (or anyone) thinking the employee is “faking it” or wasn’t involved in an incident at work. Treat everyone the same when it comes to company policies and procedures.

 

 

Waiting Period for Lost Time Claims


Under the Longshore Act, injured workers are not compensated for the first three days of medical lost time unless they are medically disabled more than 14 days. These first three days are referred to as the waiting period. Some employers choose to voluntarily continue the employee’s salary for the waiting period. This is not required, but if you do this for one, it’s best that you do it for all.

 

 

Providing Compensation to Injured Workers


We once had an employer who wanted us to send an employee’s compensation checks to their office to force the injured worker to physically pick them up bi-weekly. We could not comply with this request for several reasons:

 

  1. Section 14(a) of the Longshore Act states, “Compensation under this Act shall be paid periodically, promptly, and directly to the person entitled thereto…”.
  2. Payment is considered made when it is received by the claimant. Should the claimant not make it to the office to pick up the check, an additional 10% may be owed under Section 14(e), which states, “If any installment of compensation payable without an award is not paid within fourteen days after it becomes due, as provided in subdivision (b) of this section, there shall be added to such unpaid installment an amount equal to 10 per centum thereof.”
  3. Notwithstanding the first two reasons, it’s not a good reflection on the employer if they are asking this of only certain employees.

 

Transitional Duty


In a previous Longshore Insider article, Erica Janssen outlined the benefits of a solid transitional duty program. Companies must consistently apply their transitional duty program to all employees. If you can accommodate an injured employee’s medical restrictions and that person can perform the job, then an offer of transitional duty should be made.

 

In the workplace, strong work ethic, dedication, and strong performance will often separate one employee from others through compensation and perks. But in the world of workers’ compensation, when employers are dealing with injured workers, remember that consistency is key.



ABOUT THE AUTHOR

Will Scheffler joined The American Equity Underwriters, Inc. in 1998 and serves as Senior Vice President, Director of Claims. His insurance experience began in 1993 with FARA and continued with the ALMA branch (now AEU) in 1998. He has been a speaker at Loyola Law School’s Annual Longshore Conference, U.S. Department of Labor seminars, and ALMA conferences. Will is licensed as an adjuster in Maine, Alabama, and Louisiana and is a licensed Qualified Manager in California. He serves on the Advisory Board for Loyola’s Annual Longshore Conference. Will received his bachelor’s degree from Louisiana State University and earned the CPCU and AIC designations from The Institutes.
 
The opinions and comments expressed in this article are those of the authors and do not reflect the opinion of ALMA, AEU or AmWINS. None of ALMA, AEU, AmWINS or the authors are responsible for any inaccuracy of content or for any loss or damages incurred by any party as a result of reliance on information contained in this article. Content may not be published or reproduced without the written consent of the authors. Prior articles may not be updated for accuracy as pertinent information changes over time. The Longshore Insider is intended to provide general information about the industry and should not be construed as legal advice under any circumstances. For legal advice, please consult a licensed attorney.
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