ARI Blog: Article

Restoration Insurance: Avoiding Long-term Workers Comp Claims


Failing to pay adequate attention to an employee immediately after an injury can quickly result in expensive, tough-to-close workers compensation cases for many restoration contractors.

Failing to assign adequate resources to a newly reported claim or assuming such claims will be appropriately handled is why typical employee injury cases spiral into legacy claims that defy resolution. Many of the restoration companies' most extensive claims start as medical-only claims when they are first opened.

Medical-only claims result from injuries expected to require only limited medical attention without the employer paying indemnity benefits since the injured worker remains on the job while recuperating. You have to pay special attention to medical-only claims, though they can quickly escalate into more significant lawsuits.

Not acting immediately can push injured workers down a path that turns otherwise ordinary claims into more significant problems.

Legitimately injured workers are often lost and possibly fearful of the worker's comp system. Many don't understand how workers comp operates; they may even fear that making a claim could cost them their job. The first thing they do is get an attorney, get a new doctor, and get taken off work immediately for lost employees. If they don't hear from the employer, they will get a temporary total disability slip.

A claimant's age, health conditions such as obesity, diabetes, heart problems; salary; and previous claims history are essential factors to learn about early in the claim. He said that failing to get such information quickly diminishes the employer's chances of adequately managing the claim.

For example, health conditions may indicate that the worker's recovery will require managed care resources or nurse case management services and closer communications with the claims adjuster, so the claim doesn't turn sour.

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Environment & Restoration Insurance