There are many employers who, at some point, are going to encounter some type of challenging employee. This is the employee that you may think is trying to “game the system” when it comes to making a workers’ compensation claim.
There are usually two different behaviors that will result in this action. The first cause may be a personality flaw, or some type of characteristic that makes the employee feel as though they are entitled. The good news is, there are a number of pre-employment personality tests that may help to identify this type of individual. It’s important to note that a personality test isn’t completely foolproof; however, you should still add them to your toolbox. Use the process of trial and error to find out what is going to work best for your firm or company.
In many cases, the main reason that an employee may try to “game the system” or use similar behavior is how the employer is managing their employee during periods of healing.
How an Employer May Fail an Injured Employee
How an employer treats an employee after an injury can have a huge impact. In some situations, the employer may be disconnected, they could turn the claim over to the insurance carrier, and the employee may be left feeling as though they have been completely discarded.
If an employee doesn’t feel as though their employer is really concerned about their injury or recovery, then they may become disgruntled. This is added to the fact that an employee who is injured may not be receiving quality communication from the insurance carrier, and this may lead to late pay and even uncoordinated medical care. If an employee feels helpless, then they may seek assistance from their closest friend or family member, and in some cases, an attorney.
The good news is, there are several steps that an employer can take to ensure they do things right by their injured employee, all the while and protecting themselves from a worker who may be trying to abuse the system. The audit of a claims process has several elements. Keep reading to learn more about them.
Ensure the Employee is Receiving Benefits on Time
If an insurance carrier is relying on receiving payroll information from the employer, then this is something that needs to be done right away. It’s important that an employer doesn’t take the attitude that they will get to it when they get to it. If an employee isn’t able to pay his bills or enjoy the simple things due to an injury, then they are going to get jaded rather quickly.
Contact the Employee Frequently to See How they are Feeling
This is something that should be done by a person who actually knows the employee. In most cases, the person’s direct supervisor will be the best candidate for the job. It’s not a good idea to have the HR manager, someone the employee has never interacted with in the past, make the call. Human connections have quite a bit of power. Also, be sure to exercise the all-important listening skills.
Provide the Employee with a Preview of Their Post-Injury Job Duties
Modified or light duty work programs need to be communicated to an employee during their training. It should also be clear that the employer is dedicated to having the employee get back to work. When this is done, employees can do alternate work, and they won’t feel as though the tasks they are doing are retaliation or punitive.
Remain Involved in the Conversations with the Insurance Adjuster
Employers are responsible for working with an insurance adjuster to help and solve issues that an employee brings to you. It’s important not to turn your back on an employee. Telling a worker that they should call the insurance adjuster or company and that you aren’t able to help them is just passing the buck. Instead, join a conference call along with the insurance adjuster and discuss the concerns.
The fact is, a workers’ compensation claim isn’t something that has to be adversarial. If everyone has a negative attitude from the very beginning, then there’s a very good chance that the claim’s outcome will also be negative.
An employer can add a layer of protection for themselves by using the aforementioned personality test during the hiring process. They should also have a sound, standard claim management process in place. Using the steps mentioned above will help improve the overall claim experience for everyone involved.