“What do you want to watch?”
“I don’t know.”
“How about The Office?”
I had this conversation with my wife a few weeks ago after we put our son to bed. That night we ended up watching Episode 2 of Season Six. In that episode warehouse manager, Daryl, makes a workers’ comp. claim for a knee injury. The claim leads to Dwight to suspect fraud.
Of course, I thought the episode got a quite a bit wrong about workers’ compensation, but the episode got some things right as well.
Workers’ compensation as a substitute for health insurance — Daryl claims in the episode that he wouldn’t have to claim workers’ compensation if the United States had “universal health care.” This is a misconception for two reasons.
One study showed the expansion of health insurance under the Affordable Care Act means more claims are pushed onto workers’ compensation because health insurers don’t want to pay benefits for medical treatment that should be paid for by workers’ compensation.
Secondly, Canada has universal single-payer health insurance. Canada still has workers’ compensation laws. Work injuries also lead to income loss, so workers’ compensation doesn’t just pay medical bills, but it also provides payment for loss of income and permanent disability.
So, to quote Oscar Martinez, actually even if an employee has health insurance, they could be claiming workers’ compensation for both income loss reasons and because their health insurance is pushing them to claim workers’ compensation.
Presumption of fraud — Dwight assumes that Daryl’s claim was fraudulent. At the end of the episode it is strongly implied that Daryl lied about how he hurt his knee. This plot development lines up with the presumption that workers’ compensation claims are almost per se fraudulent. This ignores the fact that most serious workers’ compensation fraud is committed by employers and medical providers. (For the record misuse of company property isn’t a per se defense to denial of workers’ compensation benefits.)
What “The Office” Gets right about workers’ compensation
The stigma of workers’ compensation
The Office episode accurately portrays the skeptical attitude that many employers have about workers compensation. Dwight and Toby’s spying on Daryl is not out of the ordinary for employers. Daryl’s comment that he wouldn’t be filing a claim if he had better health insurance also indicates an attitude on his part that he is doing something wrong by filing a workers’ compensation claim.
The episode also includes Dwight and Toby spying on Daryl. Surveillance of injured workers is fairly common. I have also seen my share of managers engaging in the type of freelance surveillance of the type engaged in by Toby and Dwight.
Employment law issues and workers’ compensation
The episode also portrays the fundamental truth about Human Resources – they are there to protect the company. Even if HR comes off as being on the employee side, as shown by Toby’s fist bump to Daryl when Daryl turns in his injury claim, Toby is willing to go along with Dwight’s “investigation” of Daryl’s injury. Further the normally mild-mannered Toby even goes so far to yell an insult at Daryl’s sister when he mistakenly thinks she is Daryl committing workers’ compensation fraud.
The story line ends with Dwight filing a grievance against Daryl for misusing company property and Daryl filing a grievance against Dwight and Toby for spying on him. The episode is accurate that work injuries often create employment law issues related to retaliation. While the Daryl claims workers’ comp. plot line ends with the episode, workers’ compensation retaliation can have long-lasting and serious effects.
The scene where Daryl confronts Toby and Dwight about the spying also contains an undercurrent of racial tension between Daryl, who is black, and Toby and Dwight – who are white. Workers’ compensation retaliation can also be mixed in with other forms of discrimination such as racial discrimination.