Canadian Occupational Safety (COS) magazine is the premier workplace health and safety publication in Canada. We cover a wide range of topics ranging from office to heavy industry, and from general safety management to specific workplace hazards.
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May 2013 15 BY DAVID MARCHIONE COMPENSATION WATCH TRAINING I LEGAL CONNECTION When it pays to dig deeper Effective investigation and reporting can limit claim costs, save money T he two things that aff ect an employer's experience rating with the compensation board are, generally, frequency and dura- tion of claims. Most claims management courses or articles provide information on how to either decrease the occur- rence of claims (or try to have benefi ts denied) or decrease the duration of claims (through return-to-work pro- grams). While those techniques do work, it is important to consider other mechanisms of limiting entitlement — such as having claims constrained to an acute period of injury. In previous articles, I have stressed the importance of a thorough inves- tigation when an injury is reported. A thorough investigation can help determine information that may help limit entitlement in a claim that is otherwise been allowed, thus reduc- ing the impact to your experience rating and saving you money. When conducting the investiga- tion a er a report of an injury, some things an employer should consider include: • whether this worker had prior similar claims or injuries — work related or not; • any pre-existing conditions (i.e. prior surgery); • whether modified work was required in the past for similar issues. is information can be gathered from the worker, any witnesses or co-workers and human resources doc- umentation. ese should be gathered when the employer learns about the injury. It should be provided to the compensation board with the initial report so it can be considered in the entitlement decision- making process. When compen- sation boards allow claims on an aggravation basis, they generally accept that the person had a pre-existing condition or impairment that has been aggravated or become symp- tomatic because of the work-related incident or situation. Entitlement is generally limited to the acute period of injury and recovery. Entitlement ends when the person has returned to their pre-injury level. In these situations, full recovery has been achieved when only the pre-existing impairment or condition remains. It is possible that a person may suff er a permanent aggravation of a pre-existing condition. is may happen when the workplace inci- dent causes a person's condition to worsen below their pre-injury level, and they never return to that level. In those cases, a permanent impairment is likely under that claim. However, that should be the exception and not the norm. Employers should strive to give the compensation board as much information as possible about any pre-existing conditions or impair- ments, in order to either try to have entitlement denied or limited to the acute period of recovery. If the claim is allowed as an aggra- vation, it should be monitored, through communication with the compensation board, to determine when the worker has reached their pre-injury level. Claims management techniques that lead to cost savings make good fi nancial sense. Employers should use all tools in their toolbox when reporting and managing claims to try to minimize claim duration, thereby keeping costs down and helping their experience rating—which ultimately results in workers' compensation cost savings. David Marchione is OHS and work- ers' compensation specialist with Compclaim, a consulting practise of Mathews, Dinsdale & Clark LLP based in Toronto. You can contact him at DMarchione@compclaim.com. The nationwide search for the most outstanding safety professional is on! Canadian Occupational Safety is now accepting nominations for 2013 Safety Leader of the Year. If you know an OHS professional who deserves to be recognized for outstanding leadership, we would like to hear from you. Visit cos-mag.com for nomination details. The 2013 Safety Leader of the Year is sponsored by: Jim Duthie Health, safety and environment manager Valeant Pharmaceuticals 2012 Safety Leader of the Year EMPLOYERS SHOULD STRIVE TO GIVE THE COMPENSATION BOARD AS MUCH INFORMATION AS POSSIBLE ABOUT ANY PRE-EXISTING CONDITIONS OR IMPAIRMENTS Effective investigation and repor • whether mod required in th issues. is in gathered any witne and hum umentation gathered w learns abo should b compen the ini can be entitl mak W satio claims basis, they EMPLOYER STRIVE TO