A Direct Pay
Provider Network, LLC
Company
From The BLOG

The Impact of Covid-19 Pandemic to Workers Compensation Insurance & Claims

Paper man under an umbrella with Workers Compensation note underneath -- on the job injury concept
Paper man under an umbrella with Workers Compensation note underneath -- on the job injury concept

Despite the government’s efforts to contain it, the COVID-19 pandemic is still ravaging the country. In fact, as of July 2, 2020, a total of 2,679,230 confirmed cases have been reported with 54,357 cases happening on July 2 alone. This crisis is a challenge not only for the country’s health administrators but for the business sector which is highly affected by it. Not only did it limit the employers’ capacity to earn, it also increases the possibility for greater claims and added administrative burdens on some industries.

Overall, the frequency of workers’ compensation claims during the COVOD-19 outbreak could slow down because the majority of employees are working less. But its effect cannot be applied across all industries because of the varied nature of their operation.

Working from Home – A Consequence of COVID-19

Many companies are compelled to allow their employees to work from home to enable them to continue performing their duties. While this reduces an employee’s exposure to risks, this however doesn’t keep employers free from workers’ compensation claims because telecommuting workers can still be injured while on duty at home.

Remote working models have become popular during the pandemic. In fact, many businesses have adopted it to promote social distancing. But because of the nature of their business, many companies like manufacturing, construction, medical care, and transportation find it difficult to implement effectively.

It would be hard for these businesses to allow their employees to work remotely. As a result, their workers could still be working closely with one another.  Since this could expose workers to greater risks of exposure to coronavirus, working with a reliable workers compensation provide network would be beneficial to a company.

The Effect of COVID-19 to Employers

Aside from the possibility of exposure, and because of reduced manpower, some workers may be working longer hours which could result to overexertion. This can be claimed as workplace injury which may be compensable pursuant to the workers’ compensation law. Again, a reputable medical provider network for workers’ compensation can help you on this.

In addition to possible claims arising from employee overexertion, you should also prepare yourself for other factors that can possibly be a cause for claims. These are:

  • New Hires. Despite the challenges posed by the coronavirus disease, the demand for some products or services are increasing. This compels a number of companies to hire new employees. The urgency of the job coupled with the pandemic scare compels companies to allow new hires to work with little or no orientation and safety awareness training. This exposes new employees to workplace injuries.
  • Telecommuting. Employees working from home can still be exposed to work-related injuries. There are three possible reasons why accidents happen to employees who have just been allowed to work remotely. These are: absence of proper briefing about the proper use of equipment, lack of oversight, and in-home distractions.
  • Growing Unemployment. The persistence of the coronavirus and its long-term effect on business operations forced many companies to reduce their number of employees or operating hours. As a result, many employees were terminated from service. And since employees were terminated due to financial crisis, they can apply for workers’ compensation benefits. This is a potential expense especially for self-insured employers.

Presently no one can really answer when this COVID-19 pandemic will be over and the extent of its stay and the economic devastation it has done has already caused a huge impact on workers’ compensation claims. These include:

  • A huge backlog of workers’ compensation claim
  • The jobs many injured workers hope to return to are abolished
  • The light duty jobs intended for injured employees are eliminated
  • Non-essential surgeries are no longer performed on time
  • Most on-site physical therapy sessions are discontinued
  • Independent medical examinations are stopped, although some health care facilities perform it virtually
  • Normal office visits are either discontinued or replaced with virtual sessions
  • The demand for medical provider services is increasing
  • Nurse case management is discontinued
  • Employees may resist going back to work to avoid interacting with customers and other employees who might be carrying the coronavirus
  • Employees may have difficulty getting back to work because they need to take care of their children who are affected by school closings
  • State facilities are shut down and employers are not able to settle issues.

Given the length of time that workers’ compensation claims processing are delayed, there’s a significant possibility that many of these claims will increase in cost. Here are factors that can trigger a raise in cost of claims:

  • A decrease in the closure rate of claims. It refers to the rate of claims that stay open longer, as they translate to added cost
  • Increase in the rate of reopened cases – closed cases that are reopened can also mean added cost
  • Increase in the need for the services of an attorney
  • Decreased clout when negotiating settlements
  • Employees with permanent restrictions and those that are previously working on light duty may apply for total disability
  • Increase in deceitful claims

All of the above elements will take you to the same direction – a probable increase in the “ultimate incurred” or final paid number of claims. However, there are ways you can reduce the impact of the increase in claim costs:

  1. Express your concerns to your claim administrator and find ways to manage these. (e.g. Try to ask if it’s possible to use the economic downturn as basis for contesting disability payments).
  2. Conduct an investigation of all reopened cases to make sure that they’re valid
  3. Do a review of current and pending light duty claims to determine if restrictions conform with regular job functions.
  4. Conduct regular meetings with employees who are recommended for light duty and address any issues they’re currently facing.
  5. Assign someone that your injured employees can talk to if they have questions or problems.
  6. Ask your claim administrators about the availability and possible benefits of telemedicine.
  7. If you have sufficient cash flow, conduct a review of high-value claims for possible settlement.
  8. Delegate someone to coordinate with your HR department to prevent duplication of payments.
  9. Check to make sure that all of your injured employees are familiar with your company’s employee assistance policy.
  10. Conduct a regular periodic review of all high-value claims and develop an effective resolution strategy to address them.
  11. Work with a capable workers compensation provider network.

A pandemic is one of the worst things that can happen to a financially sound business. Aside from direct economic effect on your company, it might also make you liable for workers’ compensation benefits should some workers claim that they’ve been exposed to the virus in the workplace.

You should be ready for these eventualities by working with the help of an efficient workers compensation provider network. We can help to mitigate your burdens and facilitate a speedy treatment for your injured worker. We can take a significant portion of administrative weight off your shoulders.

Call us at (866) 214-5920.  

More From the Blog

The Benefits of Using Medical Scheduling for Workers’ Compensation Claims

Meet Joe. He works as a painter and is climbing up ladders on a regular...

Medical Provider Network: What It Is & Its Role in Workers’ Compensation

Generally, a medical provider network (MPN) is a group of medical and healthcare providers including...