Evansville city government in 2013 paid nearly $1 million to employees who suffered work-related injuries.
“It’s a big-ticket item for the city,” said George Fithian, director of administrative services for city government. “It’s certainly more than we would like it to be, because first, it means a lot of people were injured, and second, it’s a big cost to the taxpayer.”
Discussion of workers’ compensation in city government came into public view at Monday’s City Council meeting when a firefighter, Shawn Oglesby, disputed a third-party administrator’s denial of a claim he filed.
Oglesby on June 5 was riding on a truck to a fire call when he had breathing difficulties later diagnosed as an anaphylactic reaction. He said his throat closed and he began to lose consciousness. Fellow firefighters treated him.
Oglesby said his family has significant medical expenses, and although he received support from the fire department and others, his workers’ compensation claim was denied by JWF. The company has had the city’s workers’ compensation contract for about eight years.
When a city employee is injured at work, they report the incident to their supervisor, who then sends it to the city’s safety manager. It then goes to JWF.
“They do the investigation into the claim. They make the determination of it’s compensable or not,” said Fithian, referring to cases in general. “(Employees) obviously have to be on the job. More times than not there is an unexpected, unplanned event that occurs. Because someone had an episode of illness or the onset of pain if you will, and it happened during their time at work, it doesn’t necessarily mean it’s a workers’ comp claim. It’s just hard to nail down. You look at, did they have a prior condition that’s been exacerbated. These are fact-driven, specific kinds of decisions.”
When a decision by JWF is in dispute, Fithian said, an employee can speak to JWF about reconsidering or adjudicate the matter with the Indiana Workers’ Compensation Board.
Disputes over claims can sometimes take years, Fithian said, and upon reaching litigation, “It becomes a matter of the cost to defend it, what your risk exposure is. There’s other factors that come in besides whether it’s a valid claim ... It’s certainly not a rare occasion when we settle.”
After listing to Oglesby’s account of his incident on Monday, Council members asked city officials to provide information about workers’ compensation claims filed with JWF and what the city has paid. Fithian said he was compiling that data.
Evansville has nearly 1,200 employees.
“We want to get a feel for what’s going on in that area,” said Councilman Conor O’Daniel, D-At-large. “I don’t want to micromanage it but as someone indicated Monday, we’ve only heard from one side of it.”