“I Object!” Now What?

August 20, 2019

 

Okay, you receive a workplace injury claim, and you do not agree with the injured worker. This can be costly and perhaps you disagree with the worker’s claims, or you receive a decision back from the compensation board that you don’t agree with? Now what?

 

One of the most important parts in effective claims management is objecting to the validity of a worker’s compensation claim or board decision when you don’t agree. Never ignore it because not doing this level of due diligence can be extremely costly for your organization.

 

In order to help you decide whether a claim was warranted, here are our top reasons why we see employers object to claims:

 

  • Non-occupational vs. occupational (for example, did the worker come into work on Monday complaining of a sore back, but you discover that they helped move a friend on the weekend?)

  • Lack of compatibility of the injury to the accident (for example, the worker is claiming they hurt their knee just walking down the hall)

  • No witnesses to the incident

  • Delay in reporting the accident and/or seeking medical treatment

  • No medical treatment sought after the accident 

  • Worker is not cooperating with Return to Work efforts (for example, the worker declined an offer of suitable modified duties with no reason)

  • Timing of the claim (for example, does the claim come in conveniently so they can have the summer off, before Christmas holidays, or when they were previously denied requested time off?)

  • Was the injury a result of fighting or horseplay – remember if this is the case, the worker should be disciplined not for the injury but for the cause

  • Pre-existing non-work-related injury

 

Need help or assistance? Give us a call! We’re here to help!

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