No Heads Up!

“Communication is the key.” This statement usually rings true and many people can and will attest to it. Along that same thought process, giving notice of absence due to injury or illness is usually regarded as a good thing. Many who have been round for a while can probably remember the spirit Southwest Airlines exhibited years back when agents and supervisors existed as coworkers and there was little need to suspect that random communication would fall on investigatory ears. Most people communicated their intent to be absent due to injury far ahead of time so that they could make sure that their absence did not cause coworkers any undue stress or strain. Some felt like they had to explain why they weren’t “humping” as hard as they did the previous day. As Herb has made his exit, so has that culture that valued the way workers felt and was so conducive to open and honest communication. Working with pain is common in this line of work. In speaking to agents over the last couple of months, it seems as though verbalizing the occasional complaint of an achy back or twinge of the knee or shoulder has been remembered, documented, and in some cases reported to the workers compensation insurance company, Cambridge or Sedgwick—when the agent can no longer take the pain of working through injury and decides to seek treatment for an on the job injury. Daily, many agents in this work group suffer from repetitive motion trauma. When an agent decides to sit down with their supervisor and fill out an I3R/Injury Report there should be no surprises. It usually baffles an agent when they are denied injured worker benefits because of a statement they may have made that was taken out of context or documented solely to convict him when he did decide to “go out”. An agent wants to report a back injury. Upon completion of theinjury report that agent goes straight to the company clinic to see a company doctor and may be taken off work to rest or take therapy. Of course this scenario depends on the extent of the injury. If the agent has been taken off work, 48-72 hours later the agent will receive a call from the insurance adjuster or even an investigator who will take a formal statement regarding the injury and begin to ascertain the compensability of the injury. What most agents don’t know is that this process of ascertaining compensability may lead the insurance company to ask supervisors, management, and maybe even co-workers questions regarding your injured back. If you have previously given a supervisor a “heads-up” that your back has been hurting or that you think you may have to fill out an injury report, your claim could be headed for a denial. You may have been doing the company a favor and worked through the pain for three to four months, or even years, and when inflammation and pain are not diminished by ibuprofen and you need serious medication and treatment you may find that the “heads-up” that you innocently gave to the company may cause your claim to be denied simply because of time and proximity of injury or “timeframes”. Most union agents are familiar with the concept of timeframes as spoken of in the union contract; it’s pretty black and white. Ten days to do this, five days to respond to that, etc. But, an insurance calendar may not be so black and white. They will ask the supervisor, “Has this agent ever complained of back problems before?” Of course this honest hard-working supervisor will tell the truth. If that truth is that he’s heard you complain of back problems for a “long time” the insurance representative takes this into account and your on the job injury claim will likely be denied. In speaking to many agents they feel compelled and even obligated to give the company as much notice as possible and I believe this does help the harmony of the workplace, but in this regard, notice is not required. What is required is that you file a claim sighting when the injury occurred, and it stands to reason that you would report the injury within a reasonable amount of time of the actual incident that caused the injury. What is reasonable? In insurance and workers compensation reporting terms, it has been no more than 30 days. Know when to speak and when not to speak because “everything you do and say can and will be used against you in the ‘insurance court of law’”. Be mindful that what you say to administrators, supervisors, management, and sometimes even other agents can come back on you when you least expect it and hinder your claim for workers compensation. My goal here is not to help agents beat “the system”. My goal is merely to advise agents that there is “a system” and it actually has to be navigated in a systematic fashion that leads to a successfully filed worker’s compensation claim. It has been my experience that it is the more seasoned, higher seniority agentswho give their very best and last out on the ramp and try their best not to ‘go out’, and when they do they have said so much to so many of the wrong people that they end up hurting more than just a body part. The company that they have worked so hard for ends up using the information to hinder their worker’s compensation claim, thus hurting the agent’s heart and leaving them asking, “Where is the luv?” Worker’s compensation laws differ from state to state and each claim and claimant has its own identity. If you have specificquestions regarding workers compensation please contact me.

If you have any questions regarding FMLA, Workers Compesation, or Colonial Life Supplemental Insurance you can reach her at 1-800-595-7672 ext 101 or via e-mail at a.thompson@twu555.org