# Why does Worker's Comp pay for Idiocy?



## riley40 (Jun 20, 2008)

My office guy... OFFICE guy... got hurt at work.

His job description is to be a desk jockey (he enters receipts on quickbooks, coordinates materials to be on sites, answers the phone, etc.)

The other day he was alone in the office and accidentally locked himself out. I was on my way to the office. It was Thursday and I do payroll every Thursday so he knew I was going to be there. You'd think he'd call me, tell me what's going on, and go get himself a cup of coffee until I got there. No, that would have been reasonable.

What does he do? He makes like Spiderman and decides to get up on a chair with the intention of climbing over a wall (12' high) removing the ceiling panel and getting back into the office.

Spidey wasn't that good at climbing the wall... he made it to the other side and promptly fell, landed on his feet... and broke his heel in 3 places.

I feel bad for the guy... mostly because the guys that are on the job sites and actually have dangerous work have taken to calling him Spidey as well.

He wants me to file a Worker's Comp claim. Now, my company is in Illinois and, thanks to our generous legislature, I pay double in Worker's Comp insurance than my neighbors in Indiana. If I file the claim, I lose the discount my broker got me... which is beaucoup $$$$.

I called the broker thinking he'd laugh too and tell me something logical like "worker's comp only covers work-related accidents that are within the scope of work".... nope. He tells me ... in between chuckles... that ANYTHING these characters do on the job is covered. UNBELIEVABLE. The only thing that may be rejected is a claim for an accident that occured while the worker was intoxicated or under the influence of drugs... which is why I tell them they have to give a urine sample for a drug test if the want to go to the ER on my dime.

So now my options are to pay Spidey's medical bills off the books or risk losing my discount on the WC insurance. It would be more cost-effective if I paid his med bills.

I was shocked to learn how loose the WC parameters were. And I think they're stupid, so there.


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## MALCO.New.York (Feb 27, 2008)

You need a real good sit down with this IDIOT and explain to him the facts of YOUR BUSINESS.

If he does not respond properly and you can not convince him that it was ENTIRELY his fault, sue his arse! Either way, get rid of him.

The action that he committed was NOT in his job description not was it a task that you delegated to him.

His choice. His consequences. His dime.


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## riley40 (Jun 20, 2008)

>The action that he committed was NOT in his job description not was it a task that you delegated to him.

>His choice. His consequences. His dime.

Oh trust me, I completely agree. And he agrees that it was his mistake... but he's got a $5000 deductible on his insurance policy and knows that WC will cover it.

I feel like I'm between a rock and a hard place here. Legally, we're on the hook for this via our WC insurance.


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## MALCO.New.York (Feb 27, 2008)

Got Legal Counsel on retainer???? Have a sit down. Scare this little fooker!


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## riley40 (Jun 20, 2008)

Yep, I have already sent the email to the lawyer to discuss options.

It just burns my toast because it was totally HIS bonehead move... nothing to do with the business!


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## MALCO.New.York (Feb 27, 2008)

riley40 said:


> Yep, I have already sent the email to the lawyer to discuss options.
> 
> It just burns my toast because it was totally HIS bonehead move... nothing to do with the business!



If your Lawyer is worth a dime, he will convince this JO to deal with his own crap on his own dime.

It may be time to play hardball in order to save your W/C status.


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## MattCoops (Apr 7, 2006)

Too bad you weren't there to yell "you're fired" before he hit the ground.


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## Brock (Dec 16, 2007)

Did you train him in climbing?
Did you instruct him to climb when you hired him?
Did you tell him to climb if he was locked out?
Nope. Well it's your fault anyway because you own this huge conglomerate construction company. You have to pay all his bills. 

Once he is healed up though take him on a three hour drive into the forest and tie him up to a tree and rub him down with fish oils. Leave him there for a couple days. (you can hook up a water I.V. if you want to his mouth but that is optional) When you come back and untie him tell him he gets to keep his job but he has to pay you back in weekly instalments. 

Note; Only a suggestion. I would never do anything like this to anyone.


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## MALCO.New.York (Feb 27, 2008)

Brock said:


> Did you train him in climbing?
> Did you instruct him to climb when you hired him?
> Did you tell him to climb if he was locked out?
> Nope. Well it's your fault anyway because you own this huge conglomerate construction company. You have to pay all his bills.
> ...



That is the approach that I am suggesting. Only a little more physically subtle with the emphasis on mental.



As the line was once said so simply said....................








http://www.youtube.com/watch?v=G4KRDVsSsKE








And with this, I am serious.


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## nap (Jan 27, 2008)

> When you come back and untie him tell him he gets to keep his job but he has to pay you back in weekly instalments.





> If your Lawyer is worth a dime, he will convince this JO to deal with his own crap on his own dime.
> 
> It may be time to play hardball in order to save your W/C status.


 





it's really great that MALCO and Brock are suggesting taking ILLEGAL actions that would end up costing riley much more in defending the lawsuit that followed than just paying for the injury.
You cannot make him pay for something that is covered under WC and threatening to do so is illegal as well.

Even firing him because he claims it under WC is going to get riley in big trouble. Retaliatory actions due to an employee making a WC claim is not taken lightly by the government.


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## Brock (Dec 16, 2007)

nap said:


> it's really great that MALCO and Brock are suggesting taking ILLEGAL actions that would end up costing riley much more in defending the lawsuit that followed than just paying for the injury.
> You cannot make him pay for something that is covered under WC and threatening to do so is illegal as well.
> 
> Even firing him because he claims it under WC is going to get riley in big trouble. Retaliatory actions due to an employee making a WC claim is not taken lightly by the government.


No not suggesting, and I don't want anyone to think that I ever had or ever would do something like that to another human. We don't have forests in the midwest. I just mentioned it as an idea. Revenge is never a good thing. (if caught of course)


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## riley40 (Jun 20, 2008)

nap said:


> You cannot make him pay for something that is covered under WC and threatening to do so is illegal as well.
> 
> Even firing him because he claims it under WC is going to get riley in big trouble. Retaliatory actions due to an employee making a WC claim is not taken lightly by the government.


*SIGH*.... I know.

But this is just so .... BLATANTLY A STUPID, BONEHEAD, SELF-INDUCED, .... awww, hell. You all know what it is.

But it makes me angry enough to want to take on the WC laws in Illinois just for the principle.


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## riley40 (Jun 20, 2008)

Spidey just walked into my office and asked how my husband - the other owner of the company - is taking it.

I told him that he feels like he's being extorted. We either pay the med bills or file the claim - which screws us either way.

He offered to share the document he got from Illinois stating the WC law! AS IF that makes a difference. 

I told him that we are aware of the law... and it's still extortion so, no, he's not at all happy at the moment.

I'm surprised that he expected anything different.


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## Mike Finley (Apr 28, 2004)

Stop the whining. He's an employee, he got hurt while working for you. Case closed.

I'd rather have a guy working for me that was a doer, a problem solver then to find him sitting on the front steps smoking all day because he was locked out. 

Is he an idiot? Who knows, it was an accident. I guess if somebody gets hurt on the construction site you're also supposed to make a determination of the injury and apply your standards to it such as? WTF don't you know a saw blade is sharp??

Stop the whining, you sound like a moron. What do you think, WC is only for a construction crew? You think IBM or Microsoft don't have WC?

"EXTORTION" give me a break.


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## SelfContract (Dec 6, 2007)

riley40, how many years does Mr. Spiderman has worked for you since?... Any other problems with him before we don't know yet?


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## riley40 (Jun 20, 2008)

He's worked for us for less than 3 months.

And regarding the previous poster, I think this guy has lousy judgement. And now I think that going forward he will have lousy judgement. I don't trust him.

He got hurt playing Spiderman which is so far removed from ANY job description and expected activity, that it's blatantly stupid so your comparison to someone getting hurt using a tool on a job site is a bit off.

And yes, I'm whining because I'm going to get hit with the jacked-up cost of WC - in the form of me losing my discount - because of his bad decision. 

And if you don't like my whining, scroll.


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## Mike Finley (Apr 28, 2004)

Who hired him? 

His bad decision or yours for hiring him?

I actually do feel sorry for you losing your discount, but keep some perspective on business. Most of us need to get out of the thought process of insurance is just a bill to pay and something not to be used. That's what puts us in this type of mind F&&K where we think the discounted price is the normal price. The normal price is the normal price, the discounted price was a perk, it wasn't something that could never change.

You're in business, you made a business decision to hire the guy, you now regret it and are paying a small consequence as a result. Things could be waaaaaaaaaaaaaaay worse.

Keep this all in perspective.

He is covered by WC.
He does deserve to be covered by WC.
He does deserve a payout by WC.

Any of this that you don't agree with is in your head and causing your own torment.



riley40 said:


> I think this guy has lousy judgment. And now I think that going forward he will have lousy judgment. I don't trust him.


I hope there is a lot more to why you think that then the guy trying to climb over a wall.

Unfortunately, now things are going to be a bit stickier especially if you are lax in your administrative and human resource systems. To get rid of him you should think about starting a formal paper trail, starting with reviews, setting goals and you recording his failures to meet them before you fire him. Either that or just roll the dice and boot him and see how it plays out.



riley40 said:


> He got hurt playing Spiderman which is so far removed from ANY job description and expected activity, that it's blatantly stupid so your comparison to someone getting hurt using a tool on a job site is a bit off.


That's all in your head too. 

#1 If you work on a job site you will know how many close calls a day there are where fate could change a non-incident into an incident. A split second, a millionth of a degree is all the separates an accident and stitches from just another nail shot in a board @ 9;16 AM on a Tuesday.

#2 WC is to protect an employee in your employ. Get it out of your head there is any judgment call on your behalf.

Let us know what your attorney says. I'm going to be very shocked if the laws in your state are going to be so cut and dry your lawyer doesn't tell you "You might be able to fight it, but you might still end up paying and paying the costs to fight it too."

I stopped worrying about stuff like this a long time ago. Insurance is there for a purpose, it isn't just an irritating bill to pay, a fee to be in business.

And now you need to post a sign that says do not climb over walls if locked out! :laughing::laughing::laughing:


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## riley40 (Jun 20, 2008)

Mike, 

You are right. On all counts. But it's a big hit, financially so it's a sore point right now.

No, I'm not going to fire him because I don't need the lawsuit. But working with him is going to be difficult at best.

I called my state's WC hotline and they told me that it's up to the ins co if they choose to cover or not - but I have to file a claim to find that out so it's a catch-22.



Mike Finley said:


> And now you need to post a sign that says do not climb over walls if locked out! :laughing::laughing::laughing:


Years ago, I remember a case where Kumatsu was sued because some Einstein decided to bungee jump off one of their cranes and got hurt. He smacked the bottom of the crane on the way up. 

Now there are signs on cranes that say "No Bungee Jumping"... 

We live in a crazy world.


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## nap (Jan 27, 2008)

riley40 said:


> Years ago, I remember a case where Kumatsu was sued because some Einstein decided to bungee jump off one of their cranes and got hurt. He smacked the bottom of the crane on the way up.
> 
> Now there are signs on cranes that say "No Bungee Jumping"...
> 
> We live in a crazy world.


I don't know how that ended up but obviously that was an "extracurricular activity" and had nothing to do with work unless he was an incident investigator and was really into the hands on thing. In your situation, he was actually trying to continue with his work and (not so wisely) figured he could access his office and continue on with his work.

Think about it;

he could have waited and provided no benefit to your company and still collected pay or;

he could have found a method to return to work and be a benefit to your company.

granted, the thought process took a sharp left turn somewhere but he was at least trying to do his job. Don't forget that many many of the discoveries that have improved our lives were due to accidents or accidental discoveries. Sometimes those risk takers are the ones the take the world forward in leaps rather than steps.

or;

he could simply be an idiot.


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## Mike Finley (Apr 28, 2004)

I kind of lean the same way as nap on this one in regard to the guy. On the one hand I hate to deter problem solving, of course when it goes wrong, you are left with the predicament you are in now.

Riley,

I don't know how long you have been at this, it kind of sounds like you're somewhat new to this. 

A couple of things to keep in mind, are look at the big picture, and always run your company like a big company no matter what size you are right now.

I get the idea you're newer at this because you are focused so much on this discounted rate you have, which is a newbie mentality of that rate was yours forever. With enough time in business you start to look at things in terms of averages. Just think of that low rate as a great thing it was to offset the higher rates you are sure to have over the next 20 years of being in business. Over the next 20 years you will have even higher rates then you will have after this incident and you will have lower ones too. That's the way it and you have to start accepting that as soon as you make the decision to grow your business beyond what can be accomplished by yourself in a day, the change to delegating duties to others and making the leap to employees brings on a whole new measuring stick. You have to start measuring things on a curve.


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## mikezap (Aug 10, 2007)

That's some damn good advice.


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## riley40 (Jun 20, 2008)

Yes, that is good advice.

Thanks Mike, for the perspective.

A new wrinkle: our company policy is if you want to file WC, you take a drug/alcohol test at the time of the accident. 

This person knows this and has enforced this policy on more than one occasion with other workers.

Yet.... he didn't take one himself. That coupled with the fact that he was all alone when the accident happened - meaning no one saw him on site that morning - is making me really wonder.

But no matter what happens here, you're right about thinking about the big picture. I will do what my legal responsibility is - after legal counsel - and move on.

But thanks for listening and taking the time to offer advice - I appreciate all of it.


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## Patrick (Apr 12, 2006)

riley40 said:


> Yes, that is good advice.
> 
> Thanks Mike, for the perspective.
> 
> ...



Im surprised people actually work for you. Why dont you just drug test everyone period, so that you know you have a drug free workplace? Drug test at the time of the accident??? So If one of your framers falls off some staging and breaks his back, your going to make him submit to a piss test before he can go to the hospital? How much is your comp rate REALLY going to go up? I have NEVER had to file a claim, yet we still pay at the highest rate, for roofing and siding.

If one of your guys got a flat tire on one of the trucks, would you make him pay for it cause he probably saw the nail in the road and didn't avoid it.


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## riley40 (Jun 20, 2008)

Around here it is very common to be drug tested at the time of an accident. And I have guys working for us who are familiar with that procedure who have worked elsewhere as well.

Drug testing at the time of employment is fine but people can plan ahead for that. Testing at the time of an accident gives you a snapshot of that person's state at the time of the accident. 

Doesn't everyone test at the time of an accident? Around here, ER nurses will ask you if you got hurt for work and then say "so you need a drug/alcohol test..." and go get the doctor to order one. The ER runs the test. Your comment about me making him submit to a test before he goes to the hospital makes no sense since THAT'S where he gets tested - at the time of treatment.

If one of my guys got a flat tire on one of the trucks it would fall under him doing this as part of his work assignment. Let's not forget we're talking about Spiderman here ... who went pretty far off the reservation with the wall climbing stunt.


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## genecarp (Mar 16, 2008)

riley40 said:


> Around here it is very common to be drug tested at the time of an accident. And I have guys working for us who are familiar with that procedure who have worked elsewhere as well.
> 
> Drug testing at the time of employment is fine but people can plan ahead for that. Testing at the time of an accident gives you a snapshot of that person's state at the time of the accident.
> 
> Doesn't everyone test at the time of an accident? Around here, ER nurses will ask you if you got hurt for work and then say "so you need a drug/alcohol test..." and go get the doctor to order one.


SOUNDS LIKE SOMETHING THEY SHOULD DO EVERYWHERE. THEY DONT DO IT HERE IN NY, I HAVE HAD 2 COMP CLAIMS OVER THE LAST 25 YEARS. AND 1 LIABILITY CLAIM.


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## davy crockett (Dec 19, 2007)

Around here they grill you good at the E.R. to find out where it hapeened because folks get intimidated into believing they shouldn't file a W.C. claim, which is why it exists.I think the guy should be commended for trying to get back to work. Stupidity is not illegal,,if it were we prolly wouldn't be posting as I don't think you can do the forum deal in jail..oh well at least he's at a low rate(I think office work is .038 per 1 dollar as opposed to a tree climber at .25 per dollar) file it and train the guy better.P.S. locking yourself out is embarrassing enough, so don't make your folks scared to talk to you. If you have a good repoir with folks it's amazing the stuff they're not afraid to ask help for.


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## Brock (Dec 16, 2007)

Patrick said:


> Im surprised people actually work for you. Why dont you just drug test everyone period, so that you know you have a drug free workplace? Drug test at the time of the accident??? So If one of your framers falls off some staging and breaks his back, your going to make him submit to a piss test before he can go to the hospital? How much is your comp rate REALLY going to go up? I have NEVER had to file a claim, yet we still pay at the highest rate, for roofing and siding.
> 
> If one of your guys got a flat tire on one of the trucks, would you make him pay for it cause he probably saw the nail in the road and didn't avoid it.


Oh yeah it is common in this country. You get hurt at work your pissing at the hospital, ER, or doctors office. That's been the deal for atleast 15-20 years now. You dirty you screwed.


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## riley40 (Jun 20, 2008)

As a follow-up.... I talked to my lawyer.

He's been a WC lawyer for years (around 25) both as a plaintiff's lawyer and a defense lawyer in Cook County, where we are located. 

His exact words: No piss test, No claim. Tell him he's SOL.


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## Mike Finley (Apr 28, 2004)

How exactly does that work?

Is this drug test a requirement in your WC policy?

If so how is it to be enforced? Do hospitals ask the person to submit and he refused? Are you supposed to enforce it through education of your employees through an employee manual?

I'm real curious of the details of your lawyer's statement. You can understand how this seems like there needs to be some clarification. If your WC company requires a drug test with every claim, what is the language they use to deny a claim based on no drug test? Who's responsible for the drug test? An employee is cuts his finger off and while he is at the hospital says "Oh yeah, make sure you give me a drug test while I am here."


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## SelfContract (Dec 6, 2007)

riley40 said:


> As a follow-up.... I talked to my lawyer.
> 
> *He's been a WC lawyer for years (around 25) both as a plaintiff's lawyer and a defense lawyer in Cook County, where we are located. *
> 
> His exact words: No piss test, No claim. Tell him he's SOL.


 
...


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## riley40 (Jun 20, 2008)

Mike, 

Based on what the lawyer said, it's SOP for hospital staff to administer a drug test to people coming in hurt from work. If the test comes back dirty, or if there is no test, that gives the insurance co an "out" to not pay the claim. If the employee chooses to fight this in court, precedence and case law show that they've been regularly unsuccessful. Also, the wording of WC coverage in Illinois is: "In most instances, the law covers injuries that are caused, in whole or in part, by the employee’s work." That's straight out of the WC handbook.

Since his injury was not a result of his work and there is no piss test, he has a very weak case. 

Now, I need to clarify with my lawyer if I still have to go through the motions and file this claim and then let the insurance deny it, but the bottom line is that the insurance will most likely deny it and not pay out.



His advice to me


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## Mike Finley (Apr 28, 2004)

I still don't get it. If he went to the hospital and it's SOP as you say for them to do a drug test, why didn't they do a drug test? Did he refuse it?


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## riley40 (Jun 20, 2008)

He says that he couldn't produce urine so they couldn't take a piss test.

I don't know the details - I wasn't there.

In fact, no one was there when it happened - I think he called his wife to drive him to the hospital.

But the lack of drug test results is relevant according to the lawyer.

Again - I'm not a lawyer, I'm just relaying what I was told.

Also, I think there's a misconception about how liberal WC coverage is. A common perception is that "anything" occurring at work is covered by WC. But based on the WC handbook, that's not exactly true... sounds like anything resulting from the employee's work is covered - which is a very different thing.


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## thesidingpro (Jun 7, 2007)

All I have to say Is I'm a believer in Karma. 

If I was going to fight one of my employee's over an WC claim I sure wouldn't be talking about on some public internet forum. 

You kinda remind me of my old boss. One of the guys walked off the roof and fell 11ft and broke his wrist. He tried to keep working but after a couple hours he realized it was broken.

He went to the doctor the next day on his own time and they x-rayed it saying it was broken. He called the boss and boss tried getting him to put it on his parent homeowner's insurance.

Suck it up and move on. You sound like a horrible person to work for. Forget about your discount. Do what's right and move on. 

You tell your WC all the facts you know and let them decide to fight it or not. Karma's a *****.


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## riley40 (Jun 20, 2008)

I'm not trying to screw him over, but I'm not going to take the fall for something that's not my legal responsibility, either. And everything I've written on this forum, I have discussed with this person face-to-face. 

In fact, I showed him in the WC manual he brought to me where it describes what exactly is covered and what is not. 

I agree Karma is a *****... hitting your boss with a false WC claim may come back to haunt you.


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## davy crockett (Dec 19, 2007)

Duh!!I didn't get the refusal part,,my bad,,what a goof,,,maybe he left a little doobie on his desk and then locked himself out. I can see why he was not waiting around,I should read more thoroughly.ADHD is a real problem that I ,,,,,,,,,OOOH! look a chicken.:jester:


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## genecarp (Mar 16, 2008)

i have some exp with claims, as the employer. the last was a nail in the hand, my lead guy shot himself with a 10 common right through 3 knuckles. he needed surgery , overnight stay, 4 weeks out. how much did it cost me in the end? i dont know, i dont really want to know. how did i feel about it? part of me has a hard time paying for someone elses stupidity. however thats the way it is, he works for me, he makes me $. i pay up and move on..


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## The_Game (Jun 8, 2008)

genecarp said:


> i have some exp with claims, as the employer. the last was a nail in the hand, my lead guy shot himself with a 10 common right through 3 knuckles. he needed surgery , overnight stay, 4 weeks out. how much did it cost me in the end? i dont know, i dont really want to know. how did i feel about it? part of me has a hard time paying for someone elses stupidity. however thats the way it is, he works for me, he makes me $. i pay up and move on..


I agree with you Genecarp, a lot of bla bla for nothing, he got hurt working for you, doesn't matter how. people get hurt serving coffee. 
My wc is .50 on a dollar i bury one of my guys 3 weeks ago, 
we did a page for him . r.i.p.Dylan was is birthday 2 days ago 
memorendum page http://www.myspace.com/skillztreeman
our company:http://www.ftellc.com


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## Mike Finley (Apr 28, 2004)

riley40 said:


> He says that he couldn't produce urine so they couldn't take a piss test.


Okay, now it's clearer what you were trying to say.

I don't know what to tell you, I think there are a lot of very relevant posts here.

I returned to a job site this week, the homeowner meets me at the door that morning before anybody else had arrived for the day. She said "Boy, that guy of yours sure worked hard yesterday, he was here until 8:00 last night."

First thought was WTF? What is this guy doing? Eleven and 1/2 hour day is overtime and we don't do overtime. WTF?

My guy shows up and I ask him how yesterday went, I heard you had a long one? 

Turns out the plumbers fell way behind or down on the job, how ever you want to look at it. My guy knew we were going to have our inspection today according to the schedule, the July 4th weekend is dictating our schedule in order for subs that follow to get on the job. Turns out he stayed til 8:00 that night to help out and make sure that the plumbers stayed and got done.

(Turns out I had the inspection scheduled for the afternoon and there was time for the plumbers to finish this morning and still meet the schedule-- but my guy didn't know that)

So what do I do, he burns into unscheduled overtime, against compay policy. But his intentions were 100% honorable, the guy as far as I'm concerned has buy in into his job, made a judgement call with good intentions. Do I rat whip the guy for it? Hell no, he gets a pat on the back and a speach about how much I appreciate what he did and I buy him lunch.

Riley, you sure seem to have your guy pegged as a bad apple. 

Sometimes the intentions out weigh the final results.


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## Winchester (Jun 29, 2008)

he's only been there 3 months you say?

A lot of places that is still considered probationary period. Maybe he really needs a job and really likes working for you. So as not to seem like an idiot and incompetent he decided to tough it out and make it in without having to call you and say that he is unable to do his job because he is locked out.

It's just too bad that he got hurt, if he is a good employee hold on to him. At least he's not a slacker. A lot of guys would gladly sit around and smoke until the boss comes back.


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