Working virtually during a quarantine presents interesting challenges. But working virtually on workers’ compensation claims presents unique issues above and beyond the ordinary logistical issues like internet glitches, wardrobe malfunctions, and barking dogs. Workers’ compensation claims affect companies’ productivity and workforce, on the one side, and workers’ health and livelihood, on the other. In many of these cases, simply “waiting” until the quarantine is over to work on a claim can spell disaster for both the claimant and the employer.
Unique times like ours call for creative thinking to keep things moving forward. Here is Anders Newton’s list of the Top 3 strategies to efficiently handle workers’ compensation cases through this pandemic:
- Play Offense to Identify Defenses
When a claim is accepted and those temporary total disability benefits are flowing, every day of downtime is costing money to the insurer or self-insured employer. Worse, downtime delays healing and recovery, assuming the claimant is not receiving care. Although North Carolina evidentiary hearings may be temporarily postponed, you can use this time to identify or bolster defenses. Some of these ideas may help you discover an overlooked defense to medical causation, disability, or even compensability:
- Internet / social media investigations…because people post dumb stuff when they drink all day during a quarantine.
- Medical summaries and second opinions…because the ban on elective procedures means workers’ comp doctors such as orthopedic surgeons are probably eager for extra-curricular projects.
- Vocational assessments…because this is the perfect time to ascertain transferable skills and provide retraining or online education for claimants whose limitations have kept them out of the workforce.
- Telephone interviews of witnesses…because, during a quarantine, everyone is very lonely and very chatty.
- Get Those Claimants to the Tele-Doctor
Now is the time to schedule some doctor’s appointments. Is there any group of people who appreciates health as much as a doctor? Doctors want their patients and themselves to stay healthy, and they take very seriously their obligation to comply with social distancing guidelines. For a group of folks not exactly known for being easy-going and flexible, doctors during this pandemic are showing unprecedented willingness to offer telehealth appointments or other distance arrangements for claimants whenever possible.
The downside for insurers authorizing telehealth treatment is the increased difficulty in assessing subjective matters like symptom magnification and malingering. However, credibility usually can be revisited later, while delaying treatment altogether often causes irreversible medical complications. Another reason to embrace telehealth rather than delaying treatment is that adjusters likely will encounter a tremendous backlog when trying to schedule appointments after the quarantine ends. At Anders Newton, we believe the pros outweigh the cons.
- Ask Permission to Bend the Rules
If you encounter a statute or rule that is delaying your handling of a claim, think outside the box. The Industrial Commission has considerable discretion over many of its rules, especially when both sides consent, so now is the time to consider options. For example, if a hearing is bumped from the hearing calendar because witnesses must testify, consider requesting a videotaped deposition or affidavit instead. If a claimant uses lack of technology as an excuse to avoid treatment or a job search, consider buying them a laptop and filing a motion requiring them to use it. Above all, do not assume the pre-pandemic procedures and norms still apply in this upside-down world. Whatever your obstacle, use your imagination to work out a solution, then ask the Commission’s permission to do it your way.
The workers’ compensation team at Anders Newton is still hard at work helping employers and insurers defend claims. If you have questions about moving forward with claims during the quarantine, contact us at 919-516-8400.
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Disclaimer: The information on the blog is provided for informational purposes only and does not constitute legal advice. Cases referenced do not represent the law firm’s entire record. Each case is unique and must be evaluated on its own merits. The outcome of a particular case cannot be based on past results.