HR folks need to be aware of ‘long-tail’ secondary injuries
- statistical property
- Sales made for less usual goods within a very large choice
- how the normal distribution curve has elongated as a consequence of the internet reshaping of buying habits
- the exposure of content beyond the initial released time frame
- something “First coined by Chris Anderson in an October 2004 Wired magazine article” about Amazon or Netflix
- then–finally–”refers to a type of insurance where claims may be made many years after the period of the insurance has expired. Liability insurance is an example of long tail business.”
The Wyoming Supreme Court ruled that a man’s former employer is responsible for a 2007 medical condition because it was related to treatment for a 1993 workplace injury. While that already is the situation in some states, it is not in others — although their courts or regulatory agencies may start seeing claims with such arguments popping up.
In this case, the Wyoming Supreme Court recently overturned a ruling about a man who was injured on the job, about 15 years previously, and then injured again during treatment. The second injury, a hernia apparently “caused by a malfunctioning electrical spinal-cord stimulator” was initially ruled compensable.
Hence, the “long-tail”: first the employer is responsible, then not, then years later is finally found responsible once again.
In overturning the first ruling, the second court found that the man’s hernia “did not qualify as a compensable injury because it did not occur ‘during the course of the employment.’ ”
According to the article:
Some states already have rules or laws that mandate that secondary injuries such as this are covered by workers’ compensation, but those that do not may face the prospect of a longer tail on some workers’ comp claims, experts say. For HR managers in charge of workers’ comp programs, it’s good to be aware of the potential long-term costs, no matter how remote they may initially seem.
Injured workers in those states without specific legislation may opt “to make the same argument” for coverage of secondary injuries that can be linked back to the original job-related medical injury, says James E. Pocius, a shareholder at Marshall, Dennehey, Warner, Coleman & Goggin, based in Scranton, Pa.
Proximate cause is the balancing test, he says: “It’s more a matter of public policy as we move ourselves further and further away from the original accident. The conclusion is that you’ll have a long tail in workers’ comp cases in Wyoming.”
The concern, of course, is the potential for higher costs–but not only for workers’ comp premiums. The concern extends to “insurance costs and an impact on Medicare set-asides related to permanent disability cases.”
Some states already agree with Wyoming, and Florida exceeds it. According to a Florida workers’ comp attorney quoted in the article, “Under Florida’s workers’ compensation law, if you sustain an injury in the course of treatment for a workers comp injury, it’s compensable. In fact, if you sustain an injury on your way to treatment for a workers’ comp injury, that is also compensable.”
One point the article emphasizes is that human resource departments need to be aware that secondary injuries may indeed be compensable, because it may seem counterintuitive to be held responsible for injuries occurring away from the job.
Indeed, it’s a worthy question: Why isn’t the medical provider or device manufacturer held responsible.
One expert attributed in the article, Rebecca Shafer, president of Amaxx Risk Solutions and a leading workers’ comp cost-containment consultant and attorney based in Hartford, Conn., recommends pushing the insurance company seek recovery from the medical side of the equation, even if the employer has to pay and get reimbursed.
“Following claims closely and checking with the insurer about recovering costs is an extra step that involves a lot of work, but in the end, it will control workers’ comp costs, Shafer says.”
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Frequently enough, a workmen’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:
