Worker's Comp Claim Filing

In an effort to reduce claims, I know of an employer who wants to offer to pay the medical bill of injured employees, whose injuries are not too serious, instead of filing a worker's comp claim. Only if the employee agrees. Is this legal???

Thanks in advance for any help.............

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  • "In an effort to reduce claims, I know of an employer who wants to offer to pay the medical bill of injured employees, whose injuries are not too serious, instead of filing a worker's comp claim."

    They can't do it.

    Nevada has a worker compensation program - through the state & also through self-insurance. If this employer operates in the state, they have to participate in one of the programs. I'm unsure as to how long an employee has to report the injury and/or if it's part of the employer's responsibility - check with the state to find out. [url]http://dirweb.state.nv.us/[/url]

    In most states - this is general so check with your state - the increasing costs of worker comp. don't come from the medical bills - they come in the form of time-loss (time employee spent away from work due to a work related injury). In my state, it's the time-loss that affects our experience factor & in an effort to decrease our exposure to time-loss we have a Kept on Salary policy. Essentially, our company policy pays the employee their full WAGES while they are recuperating/attending doctor's appointments for their work related injuries. The medical bills are absorbed by the worker comp. program (we eventually end up seeing these costs through state-wide increases to the program - but we can't directly affect those increases the way we can with KOS).

    I've also included a link that may be informative - if only the section on the history of workers compensation - I also included the statement that I find the most helpful.

    [url]http://www.leg.state.nv.us/lcb/research/Bkground/97-06.htm[/url]

    "Early in this century, American policymakers looked to Europe where the idea of workers' compensation had originated in Germany in the 1800s and later was adopted in Great Britain, France, and other countries. Under a workers' compensation insurance program, the right to bring legal action against an employer on the grounds of negligence was exchanged for a system whereby benefits were paid for all injuries arising out of and in the course of employment. The costs of the work-related injuries were allocated to the employer, not because of any presumption that he was to blame for every individual injury, but because the inherent hazards of employment were considered to be a cost of production."

    The need for a workers compensation program, no matter how distasteful, irritating, convoluted (and the list goes on) is a necessary evil if the alternative is employees suing employers for every injury (and my cynical side says 'and every bogus injury') incurred. Bottom-line - very often when you try to 'beat the system' by some creative approach, it's been tried before and failed miserably. This employer should buck up, learn the system & conduct the business according to the systems in place. Give wise council to this employer - good luck.

  • [font size="1" color="#FF0000"]LAST EDITED ON 10-26-03 AT 10:29PM (CST)[/font][p]I attended a seminar facilitated by my W/C carrier last thursday and this very question came up. The w/c atty gave the same answer as mwild - "no - do not pay the med bills yourself. Report every claim that involves medical attention or lost time greater than 7 days. When in doubt about whether or not the claim will result in lost time, report it."

    Instead of worrying about trying to "hide" the expense of the claims, focus on preventive measures. What are the most common incidents? What are the biggest expense/time lost incidents? Does the company track "near misses"? Your w/c carrier should be happy to work with you on this.

    Good luck!


  • As long as the injuries/illnesses are not recordable per OSHA regs.

    We take care of a lot of what is classified as 'first aide'. But we still require the ee to complete an 'Incident/Accident Repport Form, and the supervisor a 'Supervisor Report Form'. But just not reporting injuries/illness that SHOULD be reported can get you into a lot of hot water if the ee should re-injure himself; or if it turns into a huge cost. It's much better to be honest with your W/C carrier, and get a Safety Handbook put together for each of your people.

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