WorkComp Advisory
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Q & A: Medical appointments during working hours; lump sum payments

Q. “Our insurance carrier has set up physical therapy appointments during working hours for an employee who was injured on the job. Do we have to pay him for the time he is at his appointment?”
A. Yes. Department of Labor regulations state "[t]ime spent by an employee in waiting for and receiving medical attention on the premises or at the direction of the employer during the employee's normal work hours on a day when he is working constitutes hours worked." 29 C.F.R. § 785.43 (2007)

A U.S. Department of Labor opinion letter further supports the conclusion that companies should be bound by the actions of their Workers’ Compensation administrator. According to the opinion letter, an entity acting on behalf of an employer can bind the employer for purposes of directing medical appointments. The letter explains that "[i]f the employer or the employer's agent (insurance carrier) arranged for the employee to see a doctor during the employee's normal working hours, the time spent traveling to and from and visiting the doctor's office would be compensable hours of work."

Q. “We are considering a lump sum settlement with an employee. Can she come back for money in the future?”

A. Lump sum settlements are common in our industry. They should not create any negative issues for you, if the Carrier and the Attorney craft the Settlement Stipulation properly. Settlement Stipulations should clearly state that the injured employee has no right to come back for more – that the settlement is final.