Resolving work injury compensation claims: More than just paperwork
23 July 2013
It sounds straightforward. When an employee is injured due to work, he can lodge a work injury compensation claim with MOM to get compensation from the employer under the Work Injury Compensation Act (WICA). Officers from our Work Injury Compensation Department (WICD) process his claim and inform the employer of the compensation amount. The employer pays the compensation amount to the employee, and gets reimbursement from his insurer.
The whole process of claiming compensation under WICA is relatively quick – in fact, eight out of 10 cases are settled within six months. And even if disputes arise, most are resolved within another two to four months. It is also not necessary to engage a lawyer to file a claim, as the process is straightforward. Last year alone, WICD processed 13,298 claims, with more than $76 million worth of compensation paid out to injured employees.
This is all thanks to officers such as Claims Manager Jasmine Foo, who juggles about 200 or more cases at any one time. Her phone is indispensable to her – most of her work day is spent on the phone advising injured employees about what they should do for their claim to progress, or arranging meetings with the parties involved in a claim. When she’s not on the phone, she’s meeting employers and employees to hear their concerns. In summary, Jasmine said, “I have to talk a lot, and I have to listen a lot.”
And every so often, she hears complaints that the work injury compensation claim process takes too long.
Jasmine, a mother of two young kids, can empathise, but explained that WICD has simplified the process, and some injuries just need that time to stabilise.
She said, “We know that the human body doesn’t recover so quickly, and depending on how complicated the injury is, the recovery period might be longer. If an assessment is made too early, the longer-term effects of the injury may not be factored into the compensation, and it will not benefit the employee at all.”
Road bumps ahead
In addition to the employee’s recovery time, objections and disputes also contribute to the time taken to resolve a claim. Disputes can occur at any stage of the process. Over the years, Jasmine has encountered many types of disputes: employers who failed to pay their employees medical leave wages, or did not provide acceptable housing for foreign employees etc. Most such disputes, she says, stem from a misunderstanding of the requirements under the law.
Take the non-payment of medical leave wages, for instance. “There have been situations where employees have not submitted their original MCs, and their employers are unable to process the payment of their MC wages,” said Jasmine. But as soon as she informs the employee that the original copies need to be submitted, the mistake is usually quickly rectified and the dispute resolved.
To minimise such disputes, Jasmine hopes that employers can engage employees more throughout the claim process. “If employers can keep their employees constantly updated about the progress, it will go a long way in reassuring employees that they will be compensated.”
Going above and beyond
Not all disputes are as simple to resolve. Jasmine once had to deal with a case that had reached an impasse at the delicate stage where the employee was still undergoing medical treatment.
Jasmine recounted, “The injured employee had undergone an operation in a hospital and later required a second operation. However, because he didn’t recover well after the first operation, he wanted to transfer to another hospital for treatment. The employer, however, was very adamant about not letting his employee transfer.”
Jasmine had to intervene, although she admitted that she was reluctant to press the employer at first. Normally, injured employees are not encouraged to change hospitals while undergoing treatment. This was because the first doctor who saw the employee would be more familiar with the severity of the injury from the start and better able to see through the treatment. A change in doctors may jeopardise the employee’s recovery and incur unnecessary medical costs for the employer.
However, Jasmine knew that the employee would continue to reject a second operation if he were made to stay at the first hospital, and this would adversely affect his recovery. She tried coaxing the employee to continue treatment at the first hospital, but at the same time she attempted to persuade his employer to facilitate the transfer.
Though she had to face displeasure from both parties, she felt her efforts were worth it as the employer ultimately relented and facilitated the transfer. After the employee was transferred, he finally consented to a second operation. Jasmine was relieved when the employee recovered fully from his injuries and received his compensation. “Our top priority really is to help employees recover well, and resolve their claim so they can move on to the next stage of their lives.”
|Claims Manager, Jasmine Foo|
“Whose side are you on anyway?”
Although she brought the “hospital transfer” case to a successful outcome, Jasmine remembered that she had to endure a few “scoldings” from the employer who thought she was siding with the employee.
In fact, claims officers such as Jasmine often face criticism from employers and employees alike for helping the other party more. Jasmine emphasised that MOM officers do not take sides.
“We are a neutral party. We work to resolve issues according to the law, and we try to bring all disputes to an amicable resolution.” said Jasmine. She added that MOM would not hesitate to take stern enforcement action against employers who do not pay medical leave wages or work injury compensation. This serves as a deterrent for errant employers.
Nonetheless, in Jasmine’s experience, meting out harsh punishments often widens the rift between both parties. On the other hand, maintaining a good relationship prevents disputes from occurring. “Employers are usually more compliant when they have a good relationship with their employees.” said Jasmine. “Their compliance reduces the amount of time taken to resolve claims, which in turn minimises the disruption to the injured employee’s life.”
There are also occasions when employees are reluctant to damage their relationship with their employers.
“An employee once came to me saying that he didn’t think it would be necessary to punish his employer for paying his medical leave wages a few days late. He didn’t want his employer to be resentful about being fined as he was still working for the employer. So we try to take that into account as well,” said Jasmine. “It’s difficult to balance taking harsh actions with maintaining a harmonious relationship between employer and employee.”
WICD officers have also encountered injured employees who created unnecessary problems. Jasmine said, “My colleague had to convince an injured employee to leave the hospital. He had already recovered from his injury, and his employer had prepared his accommodation. However, he absolutely refused to leave the bed. He only complied when the Police was going to take action against him for trespassing hospital premises.”
Despite what these anecdotes might suggest, most employers and employees are honest and law-abiding. In fact, many of the cases that Jasmine handled were resolved amicably with little fuss.
She added, “It complicates matters when employees don’t come to MOM directly. Some end up getting inaccurate information from hearsay. Come to us first, and we will help you.”
Prevention is better than cure
In her seven years in WICD, Jasmine has seen and heard of many types of injuries. Jasmine shook her head as she said, “A lot of accidents could have been avoided. I remember one where an employee was made to wear a harness but he didn’t anchor it to a lifeline. His employer didn’t notice and the employee continued to work in this dangerous manner. In the end, the employee fell and sustained serious injuries. This is why both employee and employer need to play their part in ensuring safety at the workplace.” Employers need to ensure that adequate safety measures are taken and employees need to conscientiously use safe working methods.
And when accidents happen, Jasmine feels that employers should do their best to help employees be on their road to recovery.
Helping people keeps her going
Even though her work can be challenging at times, Jasmine gets great satisfaction every time a claim is successfully resolved. “The process can be quite tiring because we have to keep talking to people, and there’s a lot of mediation work to be done. But knowing that we are actually helping employees to move on from their injuries is what really keeps me going in the job.”