HR Question of the Week –September 15, 2016

Question:

Yesterday an employee went outside for a paid break and was stung by a bee. He’s allergic and had to go the ER. Would this be a workers’ compensation injury?

Answer:

Possibly. Whether or not this work injury qualifies for workers’ compensation benefits will depend on a few factors. The sting was not work-related, but the employee was on the clock. Your worker’s compensation carrier will have to assess whether or not the sting arose out of and in the course of employment. A preexisting condition or existing illness is often only covered under workers’ compensation to the degree that it was exacerbated due to working conditions or job duties. I suspect it may come down to how much either party wants to press its case. An ER visit may or may not be worth an insurance battle and the time of the lawyers involved.

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

In most circumstances, I recommend allowing the employee to file a claim and contacting the carrier to inform them of any concerns. Once the carrier has the claim and related information, they can analyze the claim and decide how much they want to contest the benefits. In general, it’s best to let them handle the complicated appeals and approval process. After all, they want to control costs just like you do.

No matter how this particular claim plays out, you should inspect the facilities and arrange for safe removal of any beehives or other pest infestations that present a hazard.

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