Debunking Five Misconceptions About Workers Compensation and Workplace Injuries

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Per the latest data released by the Bureau of Labor Statistics, U.S. Department of Labor on October 27, 2016, 2.9 million Americans were injured in the workplace, in 2015 alone. The current rate of injury for workers in the United States is 3.0 cases per 100 full-time employees, but reflects a continued decline pattern that has been recorded for the past thirteen years. Six of the 19 private industries that were evaluated had a notable decline in work related employee illness, and injuries.

The expectations that employees have of the support and compensation however for their injuries, is misaligned with what is provided in terms of rehabilitation and expense coverage. We’ll discuss five prevalent misconceptions that employers and employees have about worker’s compensation and injury recovery and re-employment programs.

1. The Employer Has Minimal Involvement
When an employee is injured, the employer is required to assist with filing the insurance claim for benefits, through the worker’s compensation program. However, once that process is completed, many employees feel that the employer will have done their due diligence to assist; they believe that employers will have no further involvement in their case, once they have begun to receive compensation and expense reimbursement for their injury or illness. This is not the case.
When an employee begins to receive worker’s compensation benefits, the journey for the employer is just starting. Employers are required to remain in contact with the employee, and to be apprised of the progress of rehabilitative therapies and treatments, as they impact the employee’s ability to return to work in normal capacity, or under a modified arrangement or “light duties”.

Return to Work (RTW) programs help to keep employees gainfully employed, while reducing costs and premiums to the employer. While an injured employee is collecting benefits, he or she may be entitled to up to 70% of their pre-injury salary or hourly earnings while at home, convalescing. However, by engaging the employee in a RTW program, the employer can anticipate a cost savings, while benefiting from thirty to forty hours of productivity.

2. Lengthy Disability Claims Will Eventually Be Abandoned
Insurance adjusters and claims experts may periodically “cherry pick” injury cases, placing the most complex at the bottom of the stack. What is a complex injury case? One that may require long-term convalescence, expensive therapies and lengthy recovery times, with a minimal chance of resumption of pre-injury employment. One example would be a case of Mesothelioma (cancer) from asbestos exposure in the workplace, which can take years to resolve. Depending on the severity of certain illnesses, the anticipated success rate of recovery may weigh against a RTW resolution, and claims adjusters may take a “wait and see” attitude toward the case file.

However, no matter the condition or complexity of the claim, or improbability of recovery, the longer an individual with an injury is under-employed, the more likely they are to remain that way, which neither benefits the employer nor the injured employee.

According to data provided by a New York State guidebook on RTW, there is only a 50% chance that an injured worker will return to gainful employment, if they are unemployed for more than six months. If the worker is unemployed for one-year, the successful reemployment probability drops to less than 25%, and 1% if the employee remains at home and injured, after two years.

3. Injuries Sustained by Other Employees Do Not Qualify
Many workers believe that it is only in cases of employer negligence, that they may qualify for worker’s compensation. That is not the case. Any injury that is sustained through the delivery of normal activities and job related duties for a full-time employee (does not apply to contract laborers), qualifies for compensation entitlement.

The injuries can include:

  • Physical injuries, falls, strains, sprains, burns, blindness or injuries that impact mobility.
  • Chronic illnesses from chemical, dust, heat, cold or other elemental exposure on the job.
  • Accidental injuries from equipment or other facility related hardware on the job site.
  • Violence between a manager or supervisor and the employee, or between the employee and other workers employed on a full-time basis.
  • Injury sustained by a distributor, supplier, or contractor hired by the employer for a specific task.

If any sustained injury, or incapacity has occurred that is a direct result of a condition, situation, accident or incident experienced at work, the employee has the right to file a claim for worker’s compensation. But many cases are accidental, per a leading workers’ compensation lawyer in Chicago, and do not directly involve employer negligence.

4. All Expenses Are Paid by Workers Compensation
There is a misconception that in cases of gross negligence, where the employer is clearly at fault for the injury due to error or omission, that the employee may be entitled to additional compensation, considering the severity of injuries. There is no sliding scale that increases compensation, based on the extent of the injury, or level of medical and therapeutic care required to resolve, or rehabilitate the employee.

5. Workers Compensation Insurance Is Not Required for Contract Laborers
Imagine if every employer in America suddenly declared that they were going to operate their businesses using the labor of contract employees only. Wouldn’t the employer save hundreds, to millions of dollars per year in premiums and injury compensation, if every employee was disqualified simply by status, from being protected through the worker’s compensation program?

It is legal to structure your business that way, however they are exemptions and laws that prohibit businesses from engaging in the loophole that leaves employees without adequate coverage. If employers are found to have incorrectly categorized full-time employees as contract, by Federal and State definitions, there are serious tax fines and consequences for insurance fraud. The IRS evaluates and audits independent contractors as part of its tax fraud division, and back taxes have been payable by individuals and employers who have been charged.

There are many benefits to both employers and employees to encourage participation in worker’s compensation programs. By participating in an RTW program, with added support from the employer, injured workers can be assured that there will be a place for them to return to, once their condition has resolved successfully, which prompts a motivated recovery. Employers can also retain experienced and loyal staff, by implementing an effective return to work program.

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