I followed a link from AdvisenFPN to an EHS article titled Affordable Care Act: Should You Treat Worker’s Comp Claims Like Crime Scenes?
At first blush, it would seem workers' comp falls outside the bailiwick of the Enterprise Risk Management practitioner.
But maybe not.
ACTUALLY WE SHOULD BE LOOKING at Workers' Compensation abuses
The EHS leed paragraph reads:
- An unintended consequence of the Affordable Care Act is that it’s making workers’ compensation a more-attractive option for employees who are injured while off the job.
The article , by David R. Leng (CPCU, CIC, CBWA, CRM, CWCA), continues on the EHS website - and others, see End of File (EOF):
- Workers’ compensation fraud has been around, one way or another, since the first slacker hurled a spear at a woolly mammoth and then complained to the tribe leader he couldn’t go out on the next hunt because he hurt his back, when in reality he just wanted to hang around the cave, painting on the walls.
A “free” vacation long has been a motivation of workers’ compensation fraud, as is monetary rewards. But the Affordable Care Act (a.k.a. ACA, a.k.a. Obamacare) has dumped millions of additional bodies into the healthcare system, putting a significant strain on everyone’s budget.
As usual, the "bottom line" is how much someone - employee or employer - will have to pay, or, to put it another way, how much will the medical providers be able to charge?
Author Leng suggests that even though Obamacare may seem to be "cheap" coverage, the frequently high deductibles prevent many people from using the no longer affordable coverage. The fall-back is to claim the malady is work-related so the employer has to foot the bill.
Medicos also more inclined to welcome workers' comp claims since their payment is higher than under Obamacare.
The article goes on to list seven (7) ways that can be used to determine if the injury-causing incident actually happened on the job or was "brought to work" by the injured employee.
So what are the threats the Risk Management practitioner needs to consider?
- Increased workers' comp costs
Visits from federal or state OHSA and similar organizations