In our last post, we spoke a bit about the fact that employers and their workers’ compensation insurance carriers are continually looking for ways to decrease the costs associated with workers’ compensation claims. It is important for employees to realize that there are both legal and illegal ways an employer may attempt to do this. Here, we’ll look at some legitimate strategies an employer or insurance company may use.
Employees and their insurance carriers can and should attempt to reduce workers’ compensation costs by working to prevent accidents from occurring in the first place. Employers, for instance, can address this issue by requiring additional safety training for employees, addressing any unsafe work conditions, coming up with improved safety protocol, and things of this nature.
Workers’ compensation insurance carriers and employers may also attempt to reduce costs by contracting with health care providers of their choice for the provision of services under the Workers’ Compensation Act. If the employer and insurance carrier are able to save money this way, there is no problem under state law, as long as the rules regarding an employee’s choice of the provider are respected.
An employer or is also permitted to require an injured employee to undergo a medical evaluation by of physician of its own choosing to ensure the necessity and reasonableness of any course of treatment. If an employer does do this, though, it must give proper notice to the employee and must allow the employee to review the physician’s report when it is complete. Likewise, employers and insurance carriers are also able to perform “utilization review” in order to determine the medical necessity of a course of treatment from the past, present or future. The idea here is to allow the employer to verify that the medical care being provided is necessary and reasonable.
In our next post, we’ll continue speaking about this topic, particularly what an employer may not do to decrease its workers’ compensation costs and when it may be necessary to consult an experienced workers’ compensation attorney.