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HR Question of the Week –September 15, 2016

Question:

Yesterday an employee went outside to take a paid break and he got stung by a bee. He is allergic and had to go the ER. Will this be considered a workers’ compensation injury?

Answer:

Possibly so. Whether this work injury comes under workers’ compensation will depend on a few different factors. The sting was not work-related, but the employee was on the job. Your worker’s compensation carrier will have to determine whether or not the sting was the result of and in the course of employment. A preexisting condition or existing illness is usually only covered under workers’ compensation to the extent that it was exacerbated due to job duties or working conditions. It may depend on how much the parties want to fight for the case. A visit to the ER may or may not be worth this battle on insurance and the payment for the time of the lawyers involved.

I recommend that you offer the workers’ compensation paperwork to the employee, telling him that he must file a claim in order to receive the worker’s compensation benefits. If the employee chooses not to, you have to ask him to put the decision in writing and also note down on the workers’ compensation form that the employee did not want to file a claim. Let him know that the company will not retaliate against him either way.

In most circumstances, I recommend letting the employee file a claim and contacting the carrier so as to inform them of any concerns. Once the carrier has the claim and other related information, they can analyze the claim and then decide if they want to contest the benefits. In general, it is best to let them handle the approval process and complicated appeals. After all, they also hope to control costs just like you do.

No matter how this particular claim works out, do check the facilities and arrange to safely remove beehives or other pest infestations that pose as a hazard.

Source: HR Support Center | Copyright © 2017 AdvaPay Systems, LLC

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