How should an employer handle a doubtful employees’ compensation case?
Employers should carefully handle suspicious and doubtful employee’s compensation cases. If the employer is in doubt about the cause of an employee’s injury or sick leave, he may conduct preliminary investigation as soon as practicable by interviewing the injured employee to obtain details of the accident, inquiring of the witnesses about the circumstances, assessing the possibility of the work environment leading to the accident, and requesting the attending registered medical practitioner, registered Chinese medicine practitioner or registered dentist of the injured employee to provide a medical report for reference.
On the other hand, the employer can contact the insurer for appropriate follow-up action, such as arranging a medical examination to be conducted by a registered medical practitioner, registered Chinese medicine practitioner or registered dentist named by the employer for the injured employee.
If the employer is still in doubt about the work injury case, it may pass its views and the relevant information to the Labour Department. The Labour Department has an occupational clinic and may give its views to both parties on the likelihood of the case being a work injury from the medical point of view and according to the provisions of the Ordinance.
However, the Labour Department is not in a position to make adjudication on any dispute over compensation. If the employer and the employee do not reach any settlement even with the assistance of the Labour Department, the case will have to be determined by the Court.
On encountering a suspected fraudulent case, an employer should consider forwarding the evidence collected and other relevant information to the Police for action.