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Managing workers compensation claims remotely

As businesses embrace working-from-home arrangements, the change comes with its own challenges and complications, particularly when it comes to managing workers compensation claims. 

Joe Murphy, Managing Director – National Workplace at Australian Business Lawyers & Advisors (ABLA) explains what you should be aware of when managing – and challenging – claims remotely.

Legal obligations in regard to workers compensation

Under the work health and safety (WHS) laws, employers have a legal obligation to ensure, with reasonable practicability, a safe workplace and to protect employees from both physical and psychological injury no matter where they’re located.

Although it can differ depending on your state and territory, employers are required to have workers compensation insurance. This is to provide support to injured workers in the form of income support, treatment and rehabilitation expenses, and sometimes compensation in the event an accident or injury occurs in connection with that person’s work, even if it is done remotely.

HOW REMOTE WORK AFFECTS WORKERS COMPENSATION CLAIMS

According to Joe Murphy, workers can pose a greater risk when working remotely, from a workers compensation perspective, than if they were in the workplace.

"Employees are working from home in an environment in which the employer does not have the usual oversight or responsibility for the working environment, and so it's important that employers are conscious that when they are allowing employees to work from home, they require them to conduct themselves in a safe manner," he says.

According to Murphy, the likelihood of injury occurring is because basic health and safety requirements, taken for granted in the workplace, usually aren't being met at home.

"Even with people performing sedentary work from home, they're sometimes sitting in their lounge typing with their laptops in their laps and that actually gives rise to a greater risk that they'll suffer an injury, that for example can lead to back or neck problems."

To reduce these types of claims, employers overseeing virtual computer-based work should have a policy outlining what employees' at-home desk setup should look like and to cover the broader safety issues of the working from home environment.

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WHAT TO DO IF A WORKERS COMPENSATION CLAIM IS MADE REMOTELY

When it comes to managing a workers compensation claim arising from an incident that occurred while the person was working remotely, the process largely remains the same. This means your first reaction should be to show support.

"Expressions of sympathy are always recommended — even in circumstances where you have some doubts about the claim," says Murphy. If a claim is being assessed, you need to communicate this, quickly and in writing, to the sick or injured individual.

To ensure you are affording procedural fairness to all parties, it's important that the injured party is always given the opportunity to state their case in an interview. If in-person is not an option, then video conferencing is preferred where possible.

Keeping an accurate record of any communication is a crucial part of a workers' compensation claim investigation.

If you plan to record the interview, while the laws differ in each state and territory, as a general rule you'll need their permission.

If you are taking notes, the interviewee should be given the opportunity to read and sign off on any statement attributed to them.

If the claim is accepted, remain supportive and maintain regular contact with the individual.

This way you can monitor their progress and encourage them to return to work as soon as it is safe and possible for them to do so.

"Where you've got an injured worker, who can perform some duties, it can really help to keep the cost to the business of the claim down by getting that employee back to work as soon as is reasonably practical," says Murphy.

"People that return to work as quickly as possible generally recover faster and the chances of them not becoming a long-term claim are significantly decreased by getting them back to work in some capacity."

Challenging questionable claims

When it comes to doubtful claims, there are two categories: claims that, while legitimate, the employee is not entitled to compensation, and those you suspect or know are fraudulent or exaggerated.

"If you are going to make any allegations about a claim being illegitimate, fraudulent or otherwise, then you need to make sure that you have a factual basis for making that allegation," says Murphy.

"Simply suggesting or making an allegation that a claim is fraudulent or illegitimate without having the evidence to do so is inappropriate and it won't get you anywhere."

If you decide to proceed with challenging a claim, investigate thoroughly, and be sure to gather and pass any evidence along to the insurance company as quickly as possible. They will then take it into account when assessing the claim.

"Don't just rely on the insurer to do the investigation themselves. They're not necessarily focused on the same things you are," says Murphy.

In the event you don't have the evidence to support a concern about a claim being illegitimate, it's important to let it go, treat it as legitimate, and move on. "That way you'll be able to get on with business, and that's what's more important," says Murphy.

Managing a remote workforce presents a number of challenges, especially when it comes to workers’ compensation where the risks of a claim occurring are greater. Remember that the principles of overseeing and challenging claims remains the same, regardless of where the individual works.

To learn more about covering your employees with workers' compensation, watch ABLA's free webinar

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