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October 07, 2008
A Top 10 List for Handling Workers' Comp Claims
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By Bob Brady, BLR Founder and CEO

"Learn your 'A,B,C's'- Always Be Closing"--is the workers' compensation mantra of John P. Connolly, an attorney with the Chicago law firm of Brady, Connolly and Masuda. He argues that time is your enemy in most workers' comp claims. The longer they stay open, the more risk and exposure there is. "Remember your 'A, B, C's' and Always Be Closing," he said.

Connolly's recommendation came at BLR's Illinois Employment Law Update, (Chicago, IL, October 1-3, 2008). It was clear from his tone that he and his firm take a very businesslike approach to investigating and resolving workers' comp claims. He advised attendees to take the same approach with their claims: Those that are deserving ought to get resolved fairly and quickly. Those involving fraud or malingering ought to fought strenuously.

He had a list of 10 recommendations for defending and handling claims:

  1. Provide all employees with your accident reporting policy upon hire and on a semi-annual basis; secure signatures of workers verifying their knowledge of the workers' compensation program and accident reporting requirements (notice);
  2. Commit to thoroughly investigating each incident; interview the petitioner, view the accident scene, interview witnesses (investigate);
  3. Communicate with claim representative; prepare a defense plan of action;
  4. Visit the accident site and preserve relevant evidence (Spoliation);
  5. Assess employer liability and subrogation potential; diary Statute of Limitations; be sure to consider civil component of each reported incident;
  6. Be certain you do not waive any employer liability exposure caps;
  7. Provide light duty/transitional work opportunity; communicate light duty/transitional work program to the petitioner, the petitioner's attorney, the treating physicians when possible, and nurse case managers;
  8. Thoroughly investigate and challenge medical treatment and charges; seek to determine what is reasonable, necessary, and causally connected; consider a nurse case manager, consider securing an independent medical evaluation; consider a Utilization Review; consider Free Schedule;
  9. Make an early assessment regarding the need for vocational rehabilitation; take affirmative steps to mitigate exposure and damages before the petitioner reaches maximum medical improvement;
  10. Work toward closure on a daily basis and after reaching resolution , be sure to secure the necessary closing documentation; Lump Sum Settlement Contract, General Release, Resignation, CMS, Medicare Set-Aside.
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