Workers Comp question

DBunger · September 2003

We had an employee who injured his back on Monday and went home - said he'd be fine and back to work the next day. I was not in so needless to say no information was taken. Today I receive a phone call asking what to do about hours on his time card since he was injured on-the-job and is still not at work.My questions are: #1 do we have to pay him for the time he has missed? (isn't there a 7 day waiting period)I should mention that we pay for the waiting period for disability. #2 Can we request that he goe to the DR? He is refusing. #3 Should I still report this to our insurance carrier?

Any input would be greatly appreciated.
Nikki

LindaS · September 2003

I would report it to your WC carrier just to be on the safe side. If he is refusing to seek treatment, I would also advise the WC carrier of that as well as inform the employee that his failure to seek medical treatment results in these absences counted against him in accordance with your attendance policy. I would not pay him for his time missed since there is nothing that indicates he should be off work from a medical standpoint. If there was, in fact, an "accident" that can be verified you may want to pay him for the rest of his shift but I wouldn't do anything above that.

Whatever · September 2003

Seven day waiting period is for statutory disability. We are union shop and therefore pay for the day of the accident. If he was injured on the job (unless you self-insure), report it to the workers compensation carrer. When we report a claim to our insurance carrier, they have a nurse who contacts the employee and arranges for medical treatment (sort of a mandatory HMO for wc). The wc carrier is responsible for paying for loss of time etc.

I would follow the company rules about proof of disability if out for a period time and certificate of fitness. Furthermore, they may be entitled to FMLA (of course, you need a doctor's statement for that). Follow your normal procedures.

WT · November 2003

In New York, there is a seven day waiting period before workers comp payments start. After 14 days off, comp goes back to day one and picks up all the time. The employee must go to a doctor to get any reports out to the comp carrier. If not, there is no way to prove the employee cannot work. Most employers require a doctor's note that certifies the employee is capable to return to duty. Maybe you could use that to get the employee to see a doctor. You do not want an employee taking time off on their own and claiming job related injuries. It is bad enough dealing with the doctors.

E Wart · November 2003

I can't tell from your message whether or not there is any question as to whether he was injuried at work or not. I would definitely go ahead and report to w/c ASAP and let them investigate and handle if w/c. (Need to do this within 3 days so you don't get your hands slapped by your w/c carrier.) If it turns out not to be a w/c then you won't get "penalized by your w/c carrier for reporting it. You should have a STD form that you use for disability certification. If you aren't sure whether he was hurt at work or otherwise,you should get this to him as soon as possible. It should ask the question as to was this injury incurred by an accident and was it at work. This will clear the w/c or disability problem. You should handle the pay according to your policy. If it is w/c there is a 7 day waiting period under w/c (and we don't pay for this out time, but don't know your policy). After 14 days out, w/c will go back and pay the loss time. (I would normally pay him for the rest of his shift the day he was injuried if was w/c, but not if it was some personal injury/illness.)
Now about employee going to doctor... if w/c you don't need to worry about this, let them handle it. They will get him to a doctor if needed or he won't get benefits (more than likely). If he says not hurt at work, then you need to give him a form (or your STD carrier does) for him to have his "disabilty" certified by his doctor. If he chooses not to go to doctor, then he isn't able to provide a doctor's certification and therefore he wouldn't be eligible for benefits. (Under our STD, there is a 7 day waiting for illness but takes affect on 1st day for accident, which this would probably fall under. However, I still think it is w/c.. get them to handle it and you don't need to worry.)
E Wart

Workers Comp question

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