How to Deal with the Monday Morning Workers’ Comp Surprise

The Monday morning surprise the term for when an employee approaches you on the first morning of the working week to report an injury he or she sustained at work on Friday can be a dreaded situation for an employer.

Nearly all organizations face this at some point and the injury report is likely to trigger an agonizing chain of events, according to a report by the Society of Human Resource Management.

The Monday morning surprise comes with several questions. Is the injury truly work-related?

Could it be a case of cumulative effects? Was this an injury sustained over the weekend, on the employee’s personal time? Do you have evidence to prove it?

The injury could be legitimate (especially if it involves the musculoskeletal system) or due to cumulative exposure, but employers should be wary of instances where an employee clocks out of a shift on Friday with no reported injury and returns on Monday with an injury.

That’s a red flag for workers’ comp fraud.

 

What not to do

Workers’ compensation fraud experts recommend that you do not:

  • Spy on employees If the employer plays investigator and creates a Big Brother atmosphere of spying on workers, especially when they’re injured, a huge divide in trust is created between employees and managers. When a supervisor functions as a spy, employees are quick to notice and feel devalued.
  • Have employees sign a no-injury pledge While the intent may be positive, to eliminate work-related injuries and illnesses, such an agreement discourages early reporting and could deter a worker from reporting an actual injury that gets worse over time.
  • Restrict employees’ personal activities The range of activities outside of work that could be deemed too risky for employees is impossible to define, and is not legally defensible. An employer who tries to dictate employees’ personal lives will end up with disgruntled workers.

 

What you can do

First you should put a policy in place that all workplace injuries should be reported to management on the day they occur. That way, the employer can investigate immediately and talk to other staff that may have witnessed the event.

The more time that goes by, the less likely that witnesses will remember anything pertinent to the claim investigation.

As you gather the facts on your injured worker, be sure to address how and when the injury occurred. Did they cite a very specific incident, or was it a gradual onset that worsened over time? If it was gradual, how long ago did the symptoms start? Did the pain stay in the same location, or is it moving around into extremities? Is it worse now after some rest or is it feeling better?

You should ask the employee why they are only reporting it on Monday, instead of Friday when the injury occurred. Often it could be an honest mistake.

Perhaps they told a supervisor who didn’t kick the information to management. Or perhaps they didn’t report it because they didn’t want to go to a clinic and thought they’d feel better after the weekend.

But the biggest violation may not be the employee’s fault, it could be yours. If they did not know they were supposed to tell you about a near-miss or incident-only injury, that’s due to poor communication on your part. Workers need to know that should any incident happen, they are required to report it.

 

End-of-week employee injury statement

One way to address the Monday morning surprise is to develop an “End-of-Week Employee Injury Statement.”

Your accounting department can attach something like the following statement to each employee’s paycheck:

I have not received or witnessed any injury during the course of this week’s work with [Employer Name Here.]

Employees would be required to complete the form, sign it and return it to their supervisor.

The benefits of such a reporting program include:

  • Employees reporting workplace injuries in a timely manner.
  • Improved management-worker communications.
  • Strengthened accident prevention and employee safety.
  • The ability to reconcile injuries that have occurred and to alert supervisors and management of hazardous conditions and unreported injuries.
  • The identification of witnesses who should be interviewed during accident investigations.

 

It should be noted, however, that the use of an end-of-week statement would not be defensible against a claim for benefits at the Workers’ Compensation Appeals Board, but it could be used to establish the condition of the employee leading up to the at-work injury.

BGES Group’s office, located in Larchmont, NY is a full service insurance agency offering, Property, Liability, Umbrella Liability, Business Auto, Bid & Performance Bonds, Inland Marine, Workers Compensation Insurance, Worker’s Compensation Premium Recovery, New York State Disability, Group Health, Life insurance, Personal lines and Identity Theft.

Special Contractor Insurance Programs (NY, NJ, CT) – We we have 60+ insurance companies to market your general liability, umbrella liability, business auto, workers compensation, bid & performance bonds and group health coverages. We help contractors set up proper risk transfer. If you’re a contractor we offer extensive information about insurance markets, coverages, risk transfer, subcontractor screening, ways to lower your insurance costs.

BGES Group are Worker’s Compensation Specialists for the States of New York, New Jersey and Connecticut – Issues we address: 1) Lowering pricing – we have specialty programs that can save you up to 40%; 2) Finding a new company; 3) Replacing policies that are being cancelled or non renewed; 4) Audit disputes; 5) Company creating fictitious payroll at audit time; 6) Lowering high experience modifications factors; 7) Misclassification of payrolls; 8) Lowering or eliminating renewal deposits;  9) Getting coverage when you’ve been without for a few months; 10) Covering multiple states under one policy; 11) Eliminating 10% service or policy fees; 12) Timely issuance of certificates; 13) Always being able to get someone on the phone or by email when you need to.

If you would like to speak with us call Gary Wallach at 914-806-5853 or click here to email or click here to visit our website.

 

Company: BGES Group, 216A Larchmont Acres West, Larchmont, NY 10538

e-mail: bgesgroup@gmail.com

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