5 Unexpected Ways Legal Fees Are Making Workers’ Comp Claims More Painful (Risk & Insurance)

5 Unexpected Ways Legal Fees Are Making Workers’ Comp Claims More Painful

  Friday, August 14th, 2020 Source: Risk & Insurance

Legal peer reviews — a service where you pay attorneys to analyze your organization’s legal work. Seems redundant, right? Well, that’s probably why a lot of workers’ comp programs don’t have them.

While peer reviews for complex medical claims have become commonplace, organizations could be unwittingly wasting money on other legal claims that forego a review.

A “bulk business” mentality and lack of understanding of the legal process in workers’ comp defense is often the culprit of unnecessary spending. Here are the five things to look out for when dealing with a legal claim in workers’ comp:

1) Not Accurately Recording the Whole Accident Story
Imagine it this way — your favorite Starbucks barista slips on a spilled drink. It is not caught on video and they don’t file a claim. “A failure to understand and record the ‘mechanism of injury’ at the time of the accident could expose the carrier to significant financial burdens for which it is not truly liable,” said Pamela Davis, vice president of legal services for Veriten Legal.

“The description that ‘Employee X was injured while walking down the stairs’ is simply inadequate. Did the claimant put his left hand down to break his fall? Did he put his right hand down to break his fall? Did he fall down two steps? Did he fall down one step? Did he hit his head? These facts become significant when, six months after the accident, the claimant suggests that he injured a body part clearly not engaged during the accident.”

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