GQ Corner
Q. The claimant was in the conference room for lunch when a bank robbery happened at the branch. The manager was not present, but believes the employee may have witnessed the event through the windows of the conference room.
The employer continued wages for her first five days of absence, and she did return to work as of today at a new branch. No outside treatment was rendered, no physical injury was sustained, and she is reporting anxiety & stress as a result of the robbery.
Would I owe TTD beyond the waiting period without any documentation that she was unable to work?
A. You might—the question is whether you’re going to accept a compensable injury and, if so, what the scope of that injury is. You then have to review the facts of the case to determine whether the injury you’ve accepted is the cause of her inability to return to work. Since disability is a fact question, the claimant doesn’t actually need a DWC-73 or off work slip from a doctor to support her case, though it helps. All she needs is her own testimony that the injury, whatever it may be, prevented her from going back to work. I’d therefore make sure you’re making contact with her as often as you can and see about getting her to a doctor as soon as possible.
Remember, however, that the claimant still has to show she sustained an injury as a result of the robbery. It may very well be that she actually has PTSD or some other definitive diagnosis as a result of the robbery, but if she hasn’t even seen a health care professional to get an actual diagnosis plus treatment, I’d be hesitant to accept the claim without question until she provided you with a mental health diagnosis from a HCP.
Q. I have a question regarding an independent contractor vs. an employee. Our insured suffered a fire this weekend at one of their Texas locations. Because of the fire, they are planning to hire workers via 1099 to assist with warehouse work, fulfilling orders for delivery, no driving. The workers will be paid by the hour. The agent is asking if they will qualify for WC benefits.
A. It appears from these facts that they will be considered employees. If the duties will be in the usual course of the insured’s business and the insured will have the right to control the details of the work, the method of paying them is not going to be relevant to their employment status.
FOLIO
