What to keep in mind during a workers’ comp case.
As an employer, you’re expected to follow safety standards set by the Occupational Safety and Health Administration (OSHA) and other related agencies to ensure your business is a safe environment for everyone that works there. But no matter what type of company you run, situations do arise where safety measures fail and an employee sustains a work-related injury or illness.
While you can’t prevent all accidents and injuries from happening, you can control how the workers’ comp case is handled. Prompt action allows all parties – employee, employer, medical providers, and insurer – to focus on providing care and workers’ compensation benefits to the injured employee.
Here are six things to keep in mind when dealing with workers’ comp cases or settlements.
Have a Plan in Place
Be prepared for a possible workplace accident by having a plan in place with procedures to be followed. This will eliminate confusion and facilitate a quick response that will reduce the severity of the injury and the cost of a workers’ compensation claim.
With your risk and response plan you should:
- Create a response plan for different types of accidents
- Educate employees and supervisors on injury/illness reporting requirements
- Ensure your first aid kit is stocked and easily accessible
- Assign a safety officer for jobs that are particularly dangerous
- Maintain emergency contacts
- Post clear procedural guidelines throughout the workplace
Early intervention is important.
As soon as an accident or injury occurs, you need to ensure prompt and efficient care for the employee. If the accident area is dangerous, moved the injured employee away and make sure the other workers stay clear. Evaluate the severity of the injury and the cause of the accident.
Provide first aid for non-emergency situations and coordinate care with pre-arranged medical facilities if the injury requires medical care beyond basic first aid. For major injuries, call 911 and stabilize the injured employee.
Gather Information and Keep Evidence
Write down all the relevant details about the incident so you can communicate them to your claims management professional.
Be sure to write down:
- Who was injured
- How and where the accident happened
- What caused the injury
- The type of medical attention sought
- Employees who witnessed the accident
Take photos of the employee’s injury, even if they say they’re fine. Also, keep evidence of the accident, such as pictures of the scene and equipment involved in the accident.
Report the Injury to Your Workers’ Comp Carrier and File the Claim Form
When it comes to workers’ comp cases, the employer should report the injury to the workers’ comp insurance provider, ideally within 24 hours of the incident. Depending on your carrier’s requirements, you can report the claim via phone, email, or website. You need to provide your employee with a claim form, complete the Employer’s Report of Accident form, and submit all supporting documentation to the workers’ compensation insurance company.
While handling the workers’ comp cases, it’s in your best interest to maintain open communication between your employee, treating physician, manager, and insurance carrier. You’ll need to be responsive to inquiries from all involved parties. Maintaining open communication can help speed up the claims process, allowing the employee to receive the needed care and funds.
Know What to Do If a Claim is Approved or Denied
The workers’ compensation insurance company will either approve or deny the claim. If approved, the insurer will contact you and the injured employee with payment details.
The employee may accept the insurance offer, which may cover the costs of medical bills, lost wages, disability payments, and medicine. Alternatively, the employee may negotiate for a larger or lump sum settlement. The employee may file an appeal through the workers’ comp board if a claim is denied.
You should also know the steps to take if an injury becomes a lawsuit. Keep the lines of communication open and share all relevant information with claims adjusters and attorneys. Try to settle the workers’ comp claim without litigation. Early settlement can prevent a costlier, drawn-out lawsuit.
Have a Return-to-Work Program
When an injured employee is cleared by a medical provider to return to work in a limited capacity, be prepared to offer alternate duty or train your employee on other skills. You can rely on your company’s return-to-work program or use your workers’ comp carrier’s tools for Alternate Duty Employment (ADE). Getting the employee back to work can help minimize downtime and even help speed recovery.
Get the Right PEO to Assist You with Workers’ Comp
Handling workers’ comp insurance can feel overwhelming for a small to mid-sized business owner. But worry not, Vested HR can offer the tools and expertise that you may lack. As a Professional Employer Organization (PEO), we specialize in managing all aspects of worker’s comp insurance.
We can help you find the right policy, improve worker safety, reduce workplace injuries, and take care of all the paperwork. This keeps you focused on your core business tasks, rather than juggling the stress involved with making sure the workers comp is handled correctly and in compliance with the law. Contact us today to get started with a free consultation and to learn more about our PEO services.