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Workers' Compensation Insurance

June 29th, 2011

Return-To-Work Programs

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Martin Summers

Insurance Agent

An employer’s involvement in workers’ compensation is extremely important. This involvement takes many different forms. However, the most important involvement begins when the treating doctor releases the injured employee to return to work in some type of modified work or employment without limitation.

Only the employer can make a difference as to whether or not a small claim turns into a much larger quantity requiring greater financial payouts. This is the time when it can make or break the whole system. This can be done by developing an aggressive rehiring program, especially in the area of adapted work. A program like this can save a significant amount of money. Failure to set up rehiring procedures can result in high payouts. An insurance company cannot withdraw or cancel the employee’s workers’ compensation policy because the employee has returned to work.

An injured employee is denied workers’ compensation if he refuses to accept employment suitable to his abilities unless the judge determines that the refusal to accept the employment is reasonable. A great way to defend a permanent total claim is to show that a good faith offer of employment has been made to the injured worker. Another way is to make sure the employee has a job within a 50-mile radius of their home at least at the sedentary level of employment. Injured employees cannot be considered permanently and totally disabled if they can perform sedentary work and there is a job available with 50 miles of their home.

A real incentive for returning an injured employee to work is to avoid excessive liability for a permanent total case or the payment of temporary partial benefits. Another potential incentive is the creation of the “Preferred Worker Program.” A preferred worker is basically an individual who because of a permanent impairment from an injury or occupational disease is unable to return to regular employment. An injured employee may also qualify as a preferred worker and has been issued an identify car by the Division of Workers’ Compensation. If the employer then rehires the individual, the Special Disability Trust Fund will reimburse the employer the cost of three years of continuous employment after returning to work. This programs efficiency has not yet been recognized and there has only been a small use of it by Florida employers.

In 1993, changes were made in the Law and an injured employee now had to make sure to review early and continuous their employability. It encouraged the coordination of medical care and re-employment services. Sixty days after the date of an injury, the carrier must determine whether an employee is likely to return to work. The employer can also access alternative assessments which are provided to the carrier. The Division of Workers’ Compensation provides vocational evaluations and the training and education screenings to help with this process. This division is also sanctioned to apply monies for the actual training and education that is suggested by a vocational evaluator and considered necessary by the Division, his weekly compensation benefits can be reduce by 50%. A judge of Compensation Claims may not arbitrate an employee permanently and totally disabled until the carrier is give the opportunity to provide a re-employment evaluation.

Testing can be provided by a rehabilitation advisor or provider chose by the employer or carrier. Training can also include referrals to community colleges and vocational-technical schools and securing a general education diploma if necessary. When an employee reaches maximum medical improvement and is unable to earn at least 80% of the compensation rate and requires additional training and education, up to 52 weeks are payable. These benefits are not in surplus of the maximum 104 weeks of temporary benefits payable.

Any return to work program should be very specific with management support and each department sharing different responsibilities. Returning an injured employed should be everyone’s responsibility.

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