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Protecting Yourself When Injured on the Job
>>AMY SUSAN: Hi, I’m Amy Susan, Director of Communications for the Missouri Department of Labor. On this week’s edition of Labor Talk, a podcast where experts discuss workplace issues that affect your life, I’m joined here with the Chief Administrative Law Judge out of the Division of Workers’ Compensation, Judge Robert Dierkes, to talk about steps to take when workers are injured on the job. So first, welcome to the show, thanks for coming.
>>ROBERT DIERKES: Thanks for having me.
>>SUSAN: Can you explain what you do here at the Department, and how long you’ve been here?
>>DIERKES: Well, I’ve been with the Division of Workers’ Compensation almost 16 years. I am an Administrative Law Judge and like all the judges, our main job is to adjudicate workers’ compensation disputes. Basically, when the injured employee and their employer or insurance company cannot agree on how the benefits are being provided, then a judge does have to kind of step in and sometimes, often, we have to have trials to determine what the proper compensation is.
>>SUSAN: Okay, let’s go ahead get started. Tell us what a worker should do if they are injured on the job.
>>DIERKES: The two most important things are reporting the injury promptly, and also getting prompt medical attention, particularly if it’s a serious injury that requires an emergency room or hospitalization or something like that. The law does require that the employee file a written report of every injury within 30 days of the accident happening. Most employers have internal procedures, internal reports of injury or internal incident reports that the employee should fill out. This will usually take care of the legal written notice portion. If an employee is not familiar with those procedures, then they should talk to Human Resources or talk to their supervisor to make sure that they understand what the steps are and to take care of those promptly. As far as the medical treatment, the employer is required to provide medical treatment, but the employer has to know that the employee needs medical treatment. And so, an employee should always request medical treatment, even if its just kind of to get checked out to make sure everything is okay. Once an employee sees a healthcare provider, even though the employer has set up the appointment, they should not assume that the healthcare provider knows that they are there for a work-related injury. They should always make it clear that they are there for a work-related injury or condition, and if they are asked to give a history to the healthcare provider, they should make sure that history is consistent with what happened at work.
>>SUSAN: Can we go ahead and kind of explain some scenarios, or what types of injuries are covered, and what aren’t covered? I mean, is it a paper cut, is it a sprain to the ankle, or back injury? Can you kind of tell us what is reportable and what isn’t?
>>DIERKES: Well, all injuries should be reported and that would include even a cut on the hand or something like that. One thing that we see is a lot of employees have a back strain or a shoulder strain from lifting or pulling, and they think oh, this is going to get better and we’ll just give it some time. Those should be reported promptly, because many of those, thankfully not all of them, but many of those do become serious injuries. And then if they have not been promptly reported, it always give the employee some problem in substantiating that that was in fact, a work-related injury. The law also requires that occupational disease or repetitive motion injuries be promptly reported as well. There is a written notice requirement for that as well. And it’s within 30 days after the diagnosis. So if someone is diagnosed with, let’s say for example, carpal tunnel syndrome, or Epicondylitis, and they think it may be work related, they should report that to the employer as soon as possible after the diagnosis.
>>SUSAN: Should all injured workers file a Workers’ Compensation Claim? I understand some people think as soon as they’re injured, they need to go ahead and go online or call the Division and get that claim filed. Is that true for all instances?
>>DIERKES: Well, it is important for workers to understand that reporting the injury to the employer, filling out internal incident reports, or even the employer filing a report of injury with the Division of Workers’ Compensation is not the same as filing a claim. A claim is really a formal request for workers’ compensation benefits that the employee can file. The employee should always file a claim if medical treatment is not being provided, or time off benefits are not being provided. The employee does have two years to file a claim after the accident or after the employer stops paying the benefits. So if there is a time lag, then they definitely should file the Claim for Compensation at that time.
>>SUSAN: As a judge, tell us about some of the common problems you see regarding work comp cases.
>>DIERKES:Just talking about medical bills, one of the common problems that we see, I’ll be talking to an employee and I’ll ask him, at a settlement conference, have all your medical bills have been paid? And they say yeah. I’ll say, including prescriptions? Its surprising that prescriptions are the ones that kind of fall through the cracks. And so, the employer is required, in other words, if they have a back injury and the doctor prescribes muscle relaxants or whatever, thats part of their medical treatment and the employer should pay for that. Failure to report promptly. Somebody says, well I thought it was going to get better, and I took a couple of weeks of vacation and thought it would get better. Then when the injury is reported, two, three, four weeks later or longer, then there is always some suspicion that well, since they didn’t promptly report it, and of course they know the procedures and that type of thing, that there’s actually some type of intervening cause for the accident or condition. Most problems have to do with miscommunication. Miscommunication between the claims adjustor and the employee, miscommunications between the employee and the physician, miscommunications between the claims adjustor and the phsycian. Those, if not corrected promptly, can kind of spiral into much bigger problems that end up getting the lawyers and judges involved. And while I appreciate the business, most employees can kind of nip those things in the bud if they see a problem and they communicate that promptly, those things can usually get sorted out.
>>SUSAN: So the overarching themes today that you touched upon is again, there is no disadvantage to reporting it to the employer, go ahead and do that and protect yourself, and communicate effectively to those that you’re dealing with, such as the doctor, physician, insurance group, and of course, lastly, the employer.
>>DIERKES: Right, right.
>>SUSAN: Well thanks for joining us today, we really appreciate it.
>>DIERKES: Well its been a pleasure, thank you very much for having me.
>>SUSAN: Of course, thank you. And if you guys have any other questions or comments, you can visit labor.mo.gov, click on News and Notices, and then click on Labor Talk Podcasts.