Every workers’ compensation program should be a goal to ensure that a claim is reported within 24 hours of the event. The significance of this immediate time frame is that studies demonstrate that claims reported early in the process have a better outcome for the employee getting back to work and money spent. Now is the time for claim teams to provide their insured and self-insured employers with tools to enhance their claim reporting processes and educate all interested stakeholders on the process.
Why Timely Reported Claims Reduce Program Costs
Think about an instance you were asked to write down details of an event. When you are asked to report the information concerning an event after it occurs, you have a fresh memory. Specific details are easily recalled. As time goes on, memories fade. Specific details as to what some did or said are not easily recalled. The same holds following a work injury:
- Key details regarding the work injury are recalled. People remember how the event happened and what took place immediately after the incident;
- Evidence is preserved, such as faulty equipment. Slippery surfaces are also documented before the situation is reminded; and
- A complete investigation can take place.
Remember to provide immediate medical care to the injured employee after the unfortunate event.
Essential Issues in Injury Reporting
There are many important items to consider ineffective injury reporting beyond proper education. Claim teams seeking to provide best-in-class services can provide stakeholders the tools to ensure an injury is documented correctly and the necessary reports are completed.
- Provide multiple formats to report an injury. Tools to report an injury can include telephonic means through a dedicated line for an employer, email, or dedicated web or app-based reporting tools. The platform used to report a work injury should be easy to use and accessible for all parties, including the employee.
- Provide intake support for all parties. It is vital to consider all parties do not use English as a primary language. Allowing non-English speaking workforce members the ability to report an injury is needed. It is also essential to have portals accessible 24/7/365 to report an injury on weekends, holidays, and during severe weather.
- Consider injury triage services. All injured employees should receive immediate medical care following a work injury. When the employee does not require emergency medical help, supervisors and managers should have access to telephonic nurse triage services to assess the injury, direct medical care, and assist in gathering information.
It is also essential to treat all injured employees with respect and dignity. Ensure that supervisors and managers understand they should not be judgmental. These employer representatives should also be willing to provide transportation for the employee to receive medical care and follow up the next day with a telephone call or “get better soon” card.
State-specific workers’ compensation forms must be completed correctly and filed promptly with the industrial commission to avoid penalty assessments. These reports can include the First Report of Injury and a report regarding a workplace death or “severe injury or illness.”
Return to Work and Injury Response
Considerations regarding return to work should be a part of every post-injury response. There are countless benefits to every workers’ compensation program when an assigned employer representative can coordinate these efforts with the employee, qualified vocational rehabilitation consultant, and claim team.
- Increased employee morale – people feel valued;
- Drives conversations regarding restrictions and work available for the employee to perform; and
- Increased workplace productivity.
Many employers do not have an appointed contact person for return to work matters. If a claim handler is aware of a client who does not have this procedure in place, it can be used as an opportunity to demonstrate how this position can be influential. It can also improve workplace morale by demonstrating a willingness to place employees above profits.
Now is the time to refocus efforts on educating employers and other interested stakeholders on the importance of timely and proper injury reporting. This requires the claim team to help all interested stakeholders understand the importance of reporting all workplace injuries and illnesses within 24 hours of the event. These steps should also highlight the vital details of injury reporting and understanding the necessity of a return to work effort. When done correctly, there will be an immediate reduction in workers’ compensation program costs
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 the founder & lead trainer of Amaxx Workers’ Comp Training Center, which offers the Certified Master of Workers’ Compensation national designation.
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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.