The dark and mysterious world of workers' compensation

Sept. 30, 2014
A dental assistant files a workers' compensation claim stating that she has carpal tunnel syndrome due to her work duties.

By Tim Twigg and Rebecca Boartfield

A dental assistant files a workers' compensation claim stating that she has carpal tunnel syndrome due to her work duties. The doctor had knowledge of this employee filing a similar claim with her previous employer. Given the employee's previous history, the doctor assumed this would prevent liability on her insurance, which turned out not to be the case.

Workers' compensation insurance is intended to compensate employees who suffer occupational diseases and work-related illnesses or injuries, including repetitive stress injuries. Injured employees receive benefits regardless of fault.

In this case, the employee complained of a repetitive stress injury and claimed that the injury was work related. Since she had been treated, and released to work without any limitations or restrictions in the previous claim, this was assumed to be a new injury or that her prior injury had been aggravated by her present job duties. So regardless of the previous similar claim, the liability for this claim landed with the current employer.

Due to the high costs of carrying workers' compensation insurance, it is natural that employers want to minimize, if not eliminate, workers' compensation claims. While complete elimination may not be possible, the best way to minimize workers' compensation claims is to ensure a safe work environment and full compliance with OSHA regulations. In other words, take the time and invest the money to implement preventive measures to avoid claims altogether.

Through well-written policies, employees should understand that they must inform the employer immediately if an injury or illness occurs that they believe may be work related. Workers' compensation claims should be initiated by the employer when 1) an employee believes he or she has an injury or an illness, and 2) he or she has indicated it is due to work conditions.

Once notified that there may be a work-related injury or an illness, an accident report should be completed and the workers' compensation insurance provider should be notified. This information should be recorded on an accident report form (call if you'd like to receive a copy of our Form No. 412). The report should include such items as: time and date, names of witnesses, location, description, cause, type of illness/injury, and medical treatment.

Be sure to interview any witnesses and record exactly what took place, including your response. When reporting the matter to your carrier, also include any fact-based information that might indicate that the claim is not work related. Make sure you save copies of all correspondence with your insurance carrier and all relevant medical information related to the workers' compensation claim.

Once an employee has filed a workers' compensation claim (whether it is accepted or not), the employee is automatically extended protections from discrimination and retaliation under the law. Therefore, adverse actions, such as disciplinary measures and/or termination, are particularly risky and should be handled with care, which may include speaking with an HR specialist or retaining a lawyer prior to taking such actions.

Here are some additional tips:

1. Use hiring practices that ensure new employees are capable of performing the duties of the position for which they were hired. This should always include having a background check conducted (contact our office if you want more information).

2. Provide regular safety training on proper use of equipment and how to identify and address potential hazards - post safety requirements.

3. Promptly investigate accidents and establish preventive measures.

4. Manage claims closely in conjunction with your workers' compensation insurance provider to ensure injured employees return to work as soon as possible (i.e., don't sit back and wait for the carrier to manage the claim; keep on top of the situation to ensure the claim is handled expediently).

Workers' compensation is an inevitable part of owning a business. That doesn't mean, however, that the employer should feel helpless. The worst thing employers can do is assume all preventive measures are in place and that employees are complying. Be proactive, even when a claim has been filed. You may not be able to control that an injury occurs, but you can make an effort to prevent future injuries.

Tim Twigg is the president of Bent Ericksen & Associates, and Rebecca Boartfield is a human resource compliance consultant with Bent Ericksen & Associates. For 30 years, the company has been a leading authority in human resource and personnel issues, helping dentists successfully deal with the ever-changing and complex labor laws. To receive a complimentary copy of the company's quarterly newsletter or to learn more about its services, call (800) 679-2760 or visit the website at