Q: As an employer a WC claim is opened, can we pay some of the bills ourselves and put later bills thru on the open claim?
Meaning, if we want to pay out of pocket on medical bills initially so our WC insurance does not pay toward the open claim, and then later we see the employee who got injured continues to have lingering expenses as a result of the injury, can we then pass through subsequent medical bills and/or lost wages on the claim that was opened originally on this employee? Or, if we open the claim, and we initially pay the medical bills, are we then required to continue to pay out of pocket for as long as the employee has issues related to this employee's injury since we paid the initial bills ourselves? We want to see what we are allowed or not allowed to do in this scenario. We really would rather pay out of pocket initially in an effort to not have to turn things into WC to pay but yet have the open claim as backup for continuing, lingering bills related to this employee if problems persist. Please let me know your thoughts on this. Thanks
A:
My first concern would be that there are time frames that you should report claims to your carrier and to the Bureau of Workers' Compensation, and if you fail to abide by these requirements you may have issues later in the claim. Furthermore, the carrier may want to have an active role from the beginning to minimize potential recovery.
My second concern is that if you pay wage loss benefits without filing the proper temporary notice this is treated as accepting the claim and can result in ongoing liability regardless of what you may learn later. There is a Bureau form that allows a claim to be accepted for the first 90 days while the claim is investigated. By using that form you can avoid liability if it turns out that the injury did not really happen at work or is not as severe as indicated by the employee.
So in summary, I do not believe there is anything illegal in what you are suggesting, but to avoid complications from late or incorrect filings that could prove very expensive in the long run, I would suggest that at a minimum you contact your carrier and clear with them (in writing) their agreement with handling the claim in this manner.
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