By Christopher D. Vanderbeek
When a Missouri business is faced with a workers’ compensation case, what can its supervisory employees do to assist in the defense of the business?
There are six essential tips to follow that apply in all workers’ compensation cases. These apply regardless of whether (a) an employee suffered a work injury that is indisputable and the injury is of the severity that the employee alleges; or (b) there is a dispute regarding an injury, such as conflicting accounts of how, when, and/or where an injury occurred.
Following these tips will result in a stronger defense for the employer and insurer. Conversely, ignoring them could irrevocably weaken the defense.
1. Be Proactive and Diligent.
- As soon as you find out that an injury has allegedly occurred, first write down all the facts you know.
- Next, speak to the injured employee and any witnesses. Witnesses would be any employees/vendors/visitors that were in the injured employee’s vicinity at the time of injury, even if they didn’t necessarily see the alleged incident.
- Note the conditions where the injury allegedly occurred and how it allegedly occurred.
In some cases, this is easier said than done. In cases where the injured employee does not immediately notify the employer of the alleged injury, it will not be possible to go to the scene of the alleged injury and speak to those present.
- In these cases, as soon as you become apprised of the alleged injury, write down the details as quickly as possible.
- Compile your witness list. Be sure to include any vendors and visitors who were in the vicinity at the time of the alleged injury.
- Figure out what employees were supposed to be working with the injured employee when the injury allegedly occurred. Find out if these employees were working with the injured employee at the time. Speak with the ones who were, with regard to the circumstances surrounding the alleged incident.
And part of being diligent is making sure to…
2. Pay Attention. Don’t just let the issue rest after the initial investigation.
- Take note of conversations in the days following the incident, as other employees might discuss the incident and pertinent information could arise out of their conversations.
- When the injured employee returns to work, note his or her interactions with other employees and take stock of the body part alleged to be injured.
- If you notice that there is or are one or two specific employees with whom the injured employee seems to talk to a lot and spend a lot of time around, seek out those employees, as they may have pertinent information.
- If possible, evaluate the injured employee’s behavior when he or she believes no one is watching.
And when being diligent and paying attention…
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09/11/11 6:00 AM
Business Law, Employment Law, Litigation | Comments Off |
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Six Must-Follow Tips for Employers with Workers’ Comp Cases
By Christopher D. Vanderbeek
Did you know that when a Missouri worker injures (or claims to have injured) himself during the course and scope of his employment, the worker’s employer automatically has a statutory duty to get the ball rolling to ensure that the worker receives workers’ compensation benefits? In Missouri, it starts with the employer filing a “First Report of Injury” with the state.
From this moment forward, the company will play a substantial and vital role in the defense of its interests, as well as the interests of its workers’ compensation insurance carrier. Other employees of the company, such as human resources personnel and the injured employee’s supervisors, are also in an invaluable position to assist in this defense.
For example, consider an employee who claims that a work-related injury has rendered him unable to use his dominant shoulder. If that same employee were to come into work one morning and brag to his co-workers that he caught a giant fish during the previous weekend, it would cast doubt on the severity, or even existence, of the shoulder injury. But without vigilance in reporting from other employees, it is likely that defense counsel would never come to know this information.
Missouri businesses must remember that when a worker allegedly suffers a work-related injury, defense counsel acts on behalf of the company’s workers’ compensation insurer as well as the company itself. This is because in every workers’ compensation claim filed in Missouri, both the insurer and the employer are named as defendants.
Furthermore, the more a company aids in the defense of a workers’ compensation claim, the lower the liability exposure likely will be. This in turn keeps the company’s insurance premiums lower than they would be otherwise.
Naturally, then, it is in the employer’s interest to assist in the defense of the claim.
Next up: Six must-follow tips when dealing with workers’ compensation cases.
Posted by Attorney Christopher D. Vanderbeek. Vanderbeek is involved in the evaluation and defense of workers’ compensation and other insurance claims, protecting the interests of employers and insurers.
09/6/11 10:00 AM
Business Law, Employment Law, Litigation | Comments Off |
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Workers’ Compensation Claims: What Comes First for the Best Defense
By Christopher D. Vanderbeek
The National Counsel on Compensation Insurance (NCCI) and the Missouri Department of Insurance, Financial Institutions and Professional Registration recently approved a change regarding the filing of work-related medical claims in Missouri. The change reportedly reduces the impact of medical-only claims on Missouri businesses’ experience ratings by 70%.
The change is effective in Missouri as of July 1, 2011.
To understand the change’s effect on Missouri businesses, one first must understand the “experience rating” (i.e. “experience modifier,” “experience modification rating”). The experience rating is a mathematical formula used by insurance companies to assess premiums. In part, the formula takes into account insurance-paid losses over the past three years.
Small losses (i.e. less than $5,000) have a greater impact on a company’s experience rating than large losses, because small losses are more frequent and more predictable than large losses. Medical-only claims (i.e. claims involving no lost work time) typically constitute small losses. Therefore, medical-only claims have a substantial impact on the experience rating computation.
It is for this reason that Missouri businesses have commonly paid medical-only claims in-house, without reporting the claims to their insurance carriers. Not reporting the claims has allowed businesses to insulate themselves from the impact that reporting the claims would have on the businesses’ experience rating and, as a result, on insurance premiums. However, this practice inevitably leads to employers failing to report proper loss data to the state Department of Labor. Accordingly, the change is intended to deter businesses from handling medical-only claims without the involvement of their insurance carriers.
The change comes just as data for the first quarter of 2011 has indicated that workers’ compensation insurance premiums increased nationally for the first time since 2005. The data was produced by a survey involving 39 insurance carriers (approximately 20% of the market). It indicated a modest 2% increase. Factors such as decreased investment income, increased medical treatment costs, and an increase in total claims filed (for the first time in 16 years) are said to account for the price hikes.
It is imperative that Missouri businesses understand the effect of this change. It is now financially beneficial for businesses to report all claims, even medical-only claims, to their workers’ compensation insurance carriers. Missouri businesses must act accordingly, ensuring optimal financial success in today’s economy.
Posted by Attorney Christopher D. Vanderbeek. Vanderbeek is involved in the evaluation and defense of workers’ compensation and other insurance claims, protecting the interests of employers and insurers.
08/14/11 11:00 AM
Business Law, Employment Law, Litigation | Comments Off |
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New Change in Workers’ Compensation Premium Calculation: Missouri Businesses Now Have Financial Incentive to Report Medical-Only Claims
By Christopher D. Vanderbeek
Good news for Missouri: A survey conducted recently by the United States Chamber of Commerce has determined Missouri to be the seventh most business-friendly state in the country, according to its ranking in the survey’s “taxes and regulation” category.
The category took into account five criteria affecting businesses and economic functioning: overall state and local tax burden, corporate tax burden, impact of “government-imposed and related costs” on small businesses and entrepreneurs, anticipated state budget gap in fiscal year 2012, and cost of living. Missouri was ranked in the top twenty in all five criteria. It ranked eighth in terms of cost of living.
The study specifically recognized Missouri for “comprehensive reforms” in its workers’ compensation system in recent years. This language undoubtedly refers, at least in part, to the sweeping amendments enacted in 2005. Prior to 2005, the system generally favored injured employees. However, the 2005 amendments dramatically shifted the landscape in favor of employers. A microcosm of the shift can be found in Missouri’s statutory directive regarding judicial interpretation of workers’ compensation statutes: prior to 2005, judges were directed to generally interpret the statutes liberally and in favor of employees, but the 2005 amendments called for “strict interpretation” of all statutes and struck the language regarding favoring employees.
The survey further noted the recent passage of legislation in Missouri to eliminate the state franchise tax. It is suggested that the measure will save Missouri businesses $80 million over the six-year period during which the tax is phased out.
Finally, the survey credited Missouri’s tax credit programs and state tax structure with providing corporations with “one of the most favorable situations in the nation.” For example, the state only considers income earned within the state taxable. Furthermore, manufacturer inventories (such as raw materials), as well as goods held by retailers, distributors and wholesalers, are exempt from property taxes.
What this means for Missouri businesses is, essentially, that Missouri is a great place to start, run, or relocate a business. The state tax structure allows businesses to keep a higher percentage of earned income than they would be able to keep in most other states. In addition, the employer-friendly workers’ compensation system keeps workers’ compensation insurance carriers’ liability exposures down relative to other states, which in turn bolsters relative the earning capacities of Missouri businesses even further.
The full U.S. Chamber survey report is available here.
07/18/11 7:36 AM
Business Law, Emerging Business, Tax | Comments Off |
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Missouri Ranks High for Businesses in U.S. Chamber Survey
