Part 1 – Employer Role in Managing a Workers Comp Claim

 

As an employer, you often hear the recommendation “stay involved in your workers’ compensation claims.” That is great advice, but way too often it’s where the discussion ends without any explanation as to what “staying involved” means.

The employer’s involvement in the workers’ comp claim begins before the injury occurs and ends when the employee is back at work, fully recovered from the injury. Let’s first look at two phases of employer’s involvement in the workers’ comp claim.

The four phases are:

1. Pre-injury process
2. The injury occurrence
3. The claim process
4. The claim settlement

1. Pre-injury

If you have employees, sooner or later an employee is injured on the job. The following are some suggestions about what you can do prior to the injury occurring that will impact on the outcome of the workers’ comp claim.

• Provide each new hire with an employee accident brochure outlining what the employee should do in case of an accidental injury.
• Have a written transitional duty policy.
• Provide each supervisor within the company a written guide on how they are to report and be involved in workers comp claims.
• Post the injury procedure policy where all employees will see it.
• Have a published returned to work policy.
• Have a strong safety program.
• Have a medical provider network in place through your insurance company or join a medical provider network for self-insureds.
• Prevent fraud by letting all employees know workers comp fraud takes money away from their raises and bonuses.
• Put up posters reminding the employee that workers comp fraud is a crime and will be fully prosecuted.
• Post all the state required notices in a place convenient for all employees to see including workers comp laws, OSHA posters and anything else required in your state.
• Post a list of the required medical providers (where allowed by state statute) or recommended medical facilities (in the states where the employee is allowed to select their own doctor).

2. The Injury Occurrence

Even companies with the strongest safety programs will have some workers comp claims. When an injury occurs, the immediate actions taken by the employee’s supervisor or co-workers have an impact on the outcome of the claim. The employer must require a tight injury process, including:

• Obtain immediate medical assistance for the employee – send the employee to designated doctor or medical facility if statute permits
• Do not permit employee’s with minor injuries or soft-tissue strains to wait to obtain medical assistance – most will end up going to the unapproved hospital emergency room or their own doctor
• While the employee is in-route to the treating physician, advise the treating physician of any temporary jobs you can offer during recovery.
• Advise the treating physician of modifications you can make to the existing job to accommodate any work restrictions the physician gives the employee
• Have a goal of returning to work all employees within 1 to 3 days after the injury unless they are medically unable to perform any role for the employer
  

  FREE DOWNLOAD: “5 Critical Metrics To Measure Workers’ Comp Success”

Phases 3 & 4 covered in:

Part 2 – Employer Role in Managing a Workers Comp Claim

Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .

Contact: [email protected].

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.