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You are here: Home / Assessment & Diagnostics / Three Areas Where Best Practices for the Employer Can Make a Difference

Three Areas Where Best Practices for the Employer Can Make a Difference

August 31, 2011 By //  by Rebecca Shafer, J.D. Leave a Comment

 
We often hear about “best practices” for workers compensation claims-handling by the adjuster. Best practices are guidelines used throughout the insurance industry to provide full benefits to the employees while protecting the insurer and the employer from too much being paid on the claim.
 
 
Best practices for the employers work in a similar manner. The following guidelines are designed to assist the employer in controlling the workers comp claims cost while providing the injured employees with all the benefits to which they are entitled.(WCxKit)
 
 
There are three areas where best practices for the employer can make a significant difference. The areas are:
 
1.     The pre-injury best practices.
2.     The injury best practices.
3.     The claim handling best practices.
 
 
1.  Best Practices Pre-injury
Prior to the time an employee reports an injury, there are many things the employer can do to prevent the claim from ever happening. Among these best practices would be:
 
1.     Have a strong safety program.
2.     Have an awards program that provides recognition and prices to the department that has the best safety record.
3.     Tie management bonuses, raises, and promotions to the safety record.
4.     Train all supervisors/managers on proper procedures for reporting an injury claim.
5.     Include an employee accident brochure outlining what the employee needs to do in the case of an injury in the new hire package.
6.     Post the injury procedure where all employees will see it.
7.     Post state-required posters on workers comp next to the poster reminding all employees that workers comp fraud is a crime and will be prosecuted.
8.     Have a medical provider network in place.
9.     Post the required medical providers (in the states where the employer selects the medical provider) or the recommended medical providers (in the states where the employee can select the doctor) where all employees will know who to treat with in the case of an injury.
10.  Have a written transitional/modified duty program ready for employees who can return to work with restrictions.
 
2.  Best Practices for the Injury Occurrence
For the employer to control cost and to assist the employee, the following best practices are recommended when an injury does occur:
 

1.     Obtain immediate medical assistance for the employee – guide the employee to the appropriate medical facility.

2.     Call the medical facility and advise an accident just occurred, the nature of the accident and the type of injury to allow the facility to be ready immediately upon the arrival of the injured employee.

3.     Advise the medical facility of the light duty jobs you can offer the employee.

4.     Do not allow the macho man to delay treatment of minor injuries – the employee will end up seeking medical care from their family doctor or hospital emergency room, the cost will be higher and the control over when the employee can return to work will be diminished.

5.     Have a goal of returning all injured employees to work within 3 days unless the employee is unable to perform any role for the employer.

6.     Report the claim immediately to the claims office with full details.

7.     Provide all necessary state forms to the claims office or the appropriate department within the state government.

8.     Place on your calendar a weekly reminder to contact the employee until the employee is ready to return to work.

3.  Best Practices Post Injury
The employer needs to continue to manage the work comp process. The best practices for the employer after the injury include:
 

1.       Contact the claims office to confirm receipt of the first report of injury, wage documentation, and any other information that should have been provided to them with the claims report.
2.     Advise the claims adjuster of the employee's prior workers comp claim history, as the approach the adjuster will take on the claim will vary significantly between the employee who has never had an injury and the employee who files his annual summer/hunting season/winter holidays work comp claim.
3.     Make the internal arrangements for the injured employee to return to work on modified duty.
4.     Arrange for the injured employee's supervisor and co-workers to discuss the claim with the adjuster.
5.     Be empathetic with the employee and let the employee know the company cares about the employee.
6.     Maintain regular contact with the employee, either weekly or after each medical visit until the employee is released to return to work.
7.     Coordinate with the employee, the medical provider and the adjuster the employee's return to work.
8.     Monitor the state filings by the adjuster and all claims related paperwork.(WCxKit)  


In summary, the above recommended best practices are not meant to be an all inclusive list of the things the employer can do to control  workers compensation claims. These suggestions and guidelines should be supplemented by other processes the employer has established to handle their workers' compensation claims.


Author Rebecca Shafer
, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
 
 


Our WC Book:
http://www.wcmanual.com
WORK COMP CALCULATOR: http://www.LowerWC.com/calculator.php
MODIFIED DUTY CALCULATOR:  http://www.LowerWC.com/transitional-duty-cost-calculator.php
WC GROUP: http://www.linkedin.com/groups?homeNewMember=&gid=1922050/
SUBSCRIBE: Workers Comp Resource Center Newsletter
 
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
 
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.

Filed Under: Assessment & Diagnostics, Claim Management Tagged With: Best Practices in Workers Comp, Claims Handling, Employer Cost Savings, Injury & Pre-Injury Practices

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