Are You in Control of the Workers Comp Claim Process?

For the smart business owner, properly managing your workers’ compensation claims is good business.

Think about how much time and money can be lost in cases where workers comp cases end up costing companies countless dollars. Not only is money lost, but premiums begin to rise. All told, it is a losing proposition for the business owner.

One of the keys to properly managing the claim process is being more than just a spectator, especially after your employee is sent for medical treatment. The key is to make sure a formulated post-injury process is in place.

Among the ways to go about this include:

Proper reporting – Make sure the claim is reported to the insurance company, TPA (third party administrator) or self-insured claims office right away. Delaying this reporting can ultimately lead to higher premiums for your business;
Do the paperwork – It is also important that the first report of an injury and any other required paperwork is done quickly and effectively. In the event the injury proves severe and the worker will be prevented from returning to his or her job within the waiting period, be sure to provide the claims people with the needed wage detailers in order to properly calculate the indemnity benefits;
Know the history – Make sure you advise the claims office with the details surrounding the individual’s prior history of workers comp claims. Whether the claimant has a history of claims or this is their first goes a long way in how the adjuster approaches the matter;
Review your transitional duty program – This is important in order to track down a job the employee can do within the treating physician’s parameters;
Make available for discussion – Be sure the employee’s supervisor (and co-workers if needed) are available to discuss the accident and injury with the claims adjuster, along with helping the adjuster with the claims investigation as necessary;
Treat the employee properly – Make sure you do not alienate the worker. Treating them fairly should lead to a smoother process;
Keep dialogue flowing – It certainly does not hurt to check in on the employee as they are recovering at home;
Are attorneys involved? – In the event you are reached by an attorney representing the claimant, let the claims adjuster know right away;
Dispute questionable claims – If there is one or more questionable claims, dispute them so as not to give in to something that could cost you unfairly;
Know the past – Be wary of and fight attorneys and/or doctors that have a history of inflated claims, something that could go unchallenged if you don’t stand up to it;
Watch the claims trail – It is also important to monitor the adjuster’s state filings along with any related claim papers;
Keep an eye on workers comp board decisions – Another item to watch is reading the decisions made by the workers comp boards. If something seems amiss, fight it;
Be active – Given there are time limits on disputing decisions, don’t waste time, fight them actively and quickly. This also includes monitor the medical progress reports, making sure appropriate treatment is being dispensed;
Keep the adjuster in the loop – Finally, make sure you contact the adjuster immediately when your employee returns to work.

Having an employee go out due to an injury is never fun, but the process of getting them back to work and not seeing your premiums dramatically rise is something you do have a say in.

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: mstack@reduceyourworkerscomp.com.

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

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