Proper Handling for Workers Comp Claims

By August 29, 2018 Uncategorized

Are your employees trained on the proper handling for Workers Comp claims?  The moment an injury occurs, it initiates a sequence of events that can last for weeks or even months. But no matter how prolonged the recovery period, the first 24 hours after an injury are the most crucial.

Your supervisors may already be experienced in the proper handling for Workers Comp claims. Still, a clearly defined injury response plan will help them provide even more effective and consistent responses, and ensure that supervisors and employees know what to expect when someone is injured. The plan will also provide the necessary guidance when experienced supervisors are not immediately available to respond to an accident or injury.

first 24 hours

The First 24 Hours after an Injury are Critical

Injured employees may feel worried about keeping their jobs, worried about their health and confused by company policies. A rapid response plan turns a potentially negative event into a more manageable scenario for you and the employee by addressing their concerns up front, helping them get the care they need and lowering claims costs.

The Flanders Group knows that prompt and thorough action promotes the best outcomes for everyone involved. The lag between when an injury occurs and the reporting of that injury has a significant effect on both the time it takes to close the claim and the final cost of the claim.

A study published by the Hartford Financial Services Group found the following regarding the proper handling for Workers Comp claims:

  • Workers Comp claims reported during the second week after an occurrence had an average settlement value that was 18% higher than that for claims reported during the first week.
  • Waiting until the third or fourth week resulted in claims costs that were about 30% higher.
  • Claims that were not reported until 1 month after the occurrence were typically 45% higher.
  • According to the study, back injuries were particularly sensitive to delayed reporting; waiting just one week to report a back injury typically results in a 40% increase in the ultimate cost of the claim.

Common Reasons for Delayed Claim Reporting

  1. The most common reason for delayed reporting is that the injured party believes the pain will go away. This creates problems, as most injuries that are not addressed immediately take longer to heal.
  2. The second most common reason for delayed reporting is a lack of employee training. Approximately 97% of employees injured on the job do not know what process to follow; in many cases, they will go to their own doctor rather than reporting to their supervisor.
  3. Less common, but certainly prevalent, is the concern that there will be a negative reaction from a supervisor.  This highlights the importance of supervisor training, creating a clear message about immediate reporting, and maintaining a supportive work environment.
  4. Delayed reporting may also be caused by a conflict over a non-injury issue. This occasionally can result in an employee belatedly reporting a real or fabricated injury in order to retaliate for some other grievance against the company or supervisor. Unfortunately, claims of this nature are rarely resolved quickly.

Training and Communication

Since time is so valuable to the process, it is important that training regarding the proper handling of Workers Comp claims  is given in advance so employees won’t be confused about their responsibilities should an injury occur. For supervisors, training allows them to take a more active role in managing the response and to serve as a guide for injured employees. This means quicker reporting times and better health outcomes.

Prompt Medical Treatment

Immediate assessing of the injury and facilitating appropriate and personal treatment is crucial. Determine the type and severity of the injury; ideally, a staff member trained in first aid can assess the severity of the injury and the appropriate action needed. For injuries that usually result in the most lost time and highest claims costs, such as sprains, strains, neck and back injuries, appropriate medical care is most likely a prompt visit to a doctor well versed in evidence-based, occupational health care delivery.

Expedited Return to Work

From the moment an injury is first examined, there should be considerations made as to when the employee will be able to return to his or her duties. Return to Work programs tend to result in better health outcomes and preserve many important benefits, such as health coverage, that are contingent on attendance. Return to Work programs also tend to limit claims costs to medical costs only. Whenever possible, employers should facilitate a return to work in order to minimize indemnity payments, because even small indemnity payments can have an adverse effect on your mod.

Proper handling for Workers Comp claims should be a priority to keep your insurance premium in check.  For more information, contact the Workers Compensation experts at The Flanders Group.  Call 800-462-6435 today!