Which one is it?

System

An ee got into a car accident (off work) and amongst other damage she broke some ribs. Her insurance is paying for her treatment. Well yesterday she was sitting at her desk which is a little too close to the door so when someone opened it the doorknob jammed into her ribs and she had to go back to the doctor.
So who is responsible going forward? She was released to work at her desk job after her accident but not at her "standing up" job. The accident at work will extend this light duty.
WC or personal insurance?

sonny

I would turn it into WC and let them make the call.

Whatever

When in doubt, always submit the claim. Either the wc carrier will reject or they'll pay. But, if they have all the information, they will make the legal decision.

njjel

My guess would be that it would now fall under your WC insurance as it is an injury suffered during work to an existing injury and the injury was caused additional damage. The other posters are correct, report it and let the wc carrier make the determination for certain.

System

It's a useless and futile exercise for an employer to enter the realm of conjecture on these things. That's why we pay comp carriers and personal lines insurance companies to administer our policies. It's their job entirely. Submit the claim and let it run its course. As HR staff, we are not in the business of determining insurance liability. Thankfully, somebody else does this.

mjindra

I'm sorry for the late post on this subject, dredging up an old subject . . . BUT . . .
. . . we are "in the pool", which means only the state will insure us at a huge premium because of our frequent injuries.

We have stupid injuries which we'd like to decline, but as the posters above said, let the insurance company duke it out. Trouble is they aren't challenging anything! Even with my insistence, they will go through the process and pay benefits as our premiums climb.

Short of wrapping the employees in bubble wrap, I don't know how to end the vicious cycle we're in. Just had a injury reported this morning of somebody "pushing a basket" rather than using a forklift and now had another guy come in complaining about carpal tunnel. Well, I'm getting carpal tunnel from filling out the freakin' injury paperwork.

Anybody else in the same boat with me? If so, what have you done to slow the injury cycle OR to get the company to challenge more often?

Balloonman

How to gain control, first educate the workforce on how wc works and how injuries effect premiums and the overall economic condition of the company. Limited resources, large increases in wc premiums may effect the money you have for increases.
Second if people violate policies and safety rules discipline them. It does not matter if there is an injury or not. Start enforcing the policies.
Finally to start this off sit down all the supervisors and managers and let them know you expect them to establish the expectations of safe work with the employees.
My $0.02 worth.
DJ The Balloonman

marc

To piggyback on Balloonman's post, it is a good idea to do a thorough analysis of all of the claims for 3-4 years back. Get an idea of frequency and severity. We are also in the pool, but the state mandates that carriers provide coverage - of course, there is a substantial premium increase. We contacted the carrier and requested a walk-through. We then started a safety committee and began the process of focusing our attention and the staff's attention on the issues, just as Balloonman suggested. We added safety components to existing training sessions, distributed materials on lifting techniques, got our office furniture people to examine each desk work station for proper angles of PC's, sitting heights, foot heights, etc. It was amazing how many services were available from vendors trying to sell related products, like chairs. In any event, after 3 disastrous years, we have been claim free (please, everyone knock on wood) for over a year and have a carrier that will take us out of the pool in 5 1/2 more months - a substantial savings. Hopefully something like this will help.

cebudragonlady

It must be California, but we are in the State W/C pool at a rate ( still expensive ) BUT cheaper than private insurers were offering! You are right, it
is the "stupid" injuries that drive up the rates !

Chari