Overview: Workers' compensation is a state-controlled no-fault insurance system designed to compensate employees injured on the job and provide them with medical benefits and return-to-work initiatives, while also protecting employers from costly litigation. In most states, employers have the ability to purchase private insurance plans to guard against their workers' compensation exposure, self-insure against their exposure, or pool their resources with other employers in similar industries.
Given the detailed regulations in each state, together with the risks of exposure if employers violate state law provisions or contractual obligations with their insurance carriers, it is imperative that employers develop and maintain a robust and thorough workers' compensation policy structure. HR professionals and HR specialists have a key role in setting standards for receiving employee claims of injuries or illness on the job, corresponding with insurance carriers regarding claims, arguing against the validity of claims where applicable, corresponding with employees who are out on workers' compensation leave and working with in-house or external counsel when claims are disputed.
Trends: Some states are imposing more restrictive limitations on the types of injuries that are eligible for compensation, together with increased filing requirements and added pre-claim warnings for employers. The trend is to streamline the claims system while also reducing employers' exposure to claims and the cost of obtaining workers' compensation insurance.
Michigan, for example, passed sweeping legislation at the end of 2011 that restricts employee recovery eligibility while also imposing additional filing requirements on employees. Ohio has a pre-claim warning system that requires employees who plan to file claims for retaliation based on workers' compensation claims to notify employers in advance. California's new workers' compensation bill, set to take effect on January 1, 2013, will cut insurance costs tremendously by eliminating certain conditions from its list of compensable injuries and otherwise streamlining the claims process.
Author: Michael Jacobson, JD, Legal Editor
In Vasquez v. Dillard's, Inc., the Oklahoma Supreme Court struck down the state Employee Injury Benefit Act (Opt Out Act), which allows employers to opt out of the state workers' compensation system.
$600 million in liens filed against injured employees' claims for workers' compensation benefits have been filed by convicted or criminally indicted parties from 2011 through 2015, according to California's Division of Industrial Relations (DIR) and its Division of Workers' Compensation.
Enhanced to improve the scope of coverage regarding billing disputes over responsibility for medical treatments, lien filing fees and lien filing process.
Updated to reflect forthcoming amendments covering penalties and credits, medical reimbursement disputes, reporting requirements and selection of medical providers.
Updated to reflect information on the Supreme Court of Connecticut ruling that the homes of an employer's customers are not necessarily 'places of business' under the state ABC Test for independent contractor classification.
Enhanced to improve the comprehensiveness, organization and scope of coverage and updated to reflect forthcoming requirements for employers to electronically report injury and illness data to OSHA.
Updated to reflect the forthcoming paid family leave requirements.
In-depth review of the spectrum of Wisconsin employment law requirements HR must follow with respect to workers' compensation.
Updated to include information on the 1st Circuit ruling Schwann v. FedEx, which preempts application of the second prong of the ABC Test to motor carriers.
Guidance for HR on managing and complying with state workers’ compensation requirements.