Viewpoints from Jeremiah L. Paul, Esq.

We’ve all seen the aggressive advertising of work-injury attorneys on billboards, television, and bus stop benches. However, those advertisements alone are rarely the reason an employee hires an attorney. There is almost always an identifiable reason why they respond to one of those ads and it’s possible to develop a plan to avoid it happening.

Healthcare systems typically have a higher rate of litigated workers’ compensation claims compared to most industries. Litigated claims generally cost 10 to 12 times that of non-litigated ones. Even a small reduction in your litigation rate can have a huge impact on program costs.

The first step in developing a litigation avoidance plan is to determine why your employees are seeking legal representation. The best way to do so is to review the claim notes and documents of each claim file for the time frame immediately preceding the notice of representation. It is definitely worth the time and effort, but it can be a daunting task, so  here are the three common litigation triggers:

  1. A perceived or actual threat to the injured worker’s employment. Employees can often feel that suffering a work-related injury or filing a claim can lead to losing their job, or otherwise being discriminated against.  Uncertainty tends to drive employees to litigate.
  2. A perceived or actual threat to the injured worker’s entitlement to workers’ compensation benefits. A threat to benefits may result from a delay in compensability, denial of medical treatment by utilization review, or failure to pay temporary disability when the employee thinks it is owed. Feeling slighted may quickly drive employees to litigation.
  3. Not receiving information about their claim. It happens all too often that injured employees seek legal help because they haven’t received communication from the carrier or third-party administrator, and they have questions about their claim. Where do they get treatment? When will they receive a check for lost time? These are simple questions, but they mean everything to an employee and if you’re not providing the answers a petitioner’s attorney gladly will.

For a full assessment of why your employees hire attorneys and for assistance in developing a litigation avoidance plan, contact the experts at EPIC.

Jeremiah Paul began his career as a Workers’ Compensation defense attorney before transitioning to risk management for a large, self-insured healthcare organization. He is experienced in complex, high-value litigation and claim management issues that uniquely challenge the healthcare industry. As a Workers’ Compensation Consultant, he specializes in advising self-insured and high-deductible programs on reducing claim inventory, reducing program cost, compliance issues, litigation management and streamlining processes.

EPIC offers this material for general information only. EPIC does not intend this material to be, nor may any person receiving this information construe or rely on this material as, tax or legal advice. The matters addressed in this document and any related discussions or correspondence should be reviewed and discussed with legal counsel prior to acting or relying on these materials.

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Jeremiah L. Paul, Esq. Principal, Workers’ Compensation Consultant
Jeremiah L. Paul, Esq.

Principal, Workers’ Compensation Consultant - Fresno, CA