workers compensation

Reporting Workers' Compensation Claims

Workers' compensation laws are often misunderstood because they can vary significantly between states. If a staff member reports an injury and you are unsure about what steps to take, you're not alone.

Regardless of your practice’s geographical location, the first two days after a staff member gets injured on the job are always the most critical.

It is important to act quickly and immediately for legal reasons, but also because studies show that the faster you initiate the workers’ compensation process after an injury, the lower the ultimate cost of your claim. Additionally, waiting more than 48 hours after an incident occurs gives the injured party and witnesses more time to forget crucial details about what happened. It also means your staff members’ recollections may become skewed from opinions of outside parties, such as attorneys and other staff members.

You can help protect your practice and save money by taking the following steps in the 48 hours after a staff member reports an injury.

Refer the Staff Member for Medical Attention

  • If the injury is an emergency, seek immediate care for the staff member. All state workers’ compensation laws allow the staff member to see any doctor in an urgent situation. If the circumstance is not an emergency, refer the staff member to a medical provider within your practice’s network.
  • Never prevent a staff member from getting medical attention, even if you feel the injury is not serious.

Perform an Assessment or Accident Investigation

  • Visit the place where the injury occurred and make notes of the surrounding environment. Speak with staff who witnessed the event or who worked near the incident.
  • Be thorough, and be sure to gather consistent information for all incidents. It is important to begin this investigation within the first 48 hours so details of the accident or injury are fresh in the minds of all staff members.

Immediately Ensure the Injury or Accident Will Not Happen Again

  • After investigating the site, take the necessary steps to ensure the incident won't reoccur. For example, block off any area that is unsafe.

Report the Injury

  • According to the Department of Labor, several reports must be generated when an injury occurs in the workplace. Complete a "First Report of Injury or Occupational Disease" form as required by your state workers’ compensation law. The incident should also be reported to the staff member’s direct supervisor and the provider who saw or treated the staff member.
  • Report the incident objectively—do not skew information gathered from the scene or from witnesses in any way, even if your preliminary instincts tell you the claim is not legitimate.

Inform the Staff Member about Practice Policies on Returning to Work

  • Not only is it crucial to review work restrictions and leave procedures, but it is also imperative that you inform the staff member about the possibility of any transitional duty jobs that would suit their needs during the injury recovery period.

Submit the Workers’ Compensation Claim

  • This is an important step to complete quickly because your insurance provider could give you valuable information about medical care, make timely payments and begin its own investigation into the incident.

In addition to these points, become familiar with the workers’ compensation laws in your state(s) of operation. Your state’s workers’ compensation board can help you become informed about the legal timelines in effect in your state, which may ultimately help save your practice money.

Content from Zywave, Inc.

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