A Step-by-Step Guide for Employers
The workers’ compensation process is a maze of paperwork, deadlines and regulations. But as an employer, knowing the steps to take when an employee gets injured on the job doesn’t just protect your business — it helps you safeguard your most valuable asset: your workforce.
Fortunately, the claims process doesn’t have to be overwhelming.
In this guide, we’ll break down each step of workers’ compensation claims to help employers make sure employees get the support they need while controlling costs and ensuring compliance.
Step 1. Provide Immediate Medical Care for Injured Workers
First and foremost, when a workplace injury occurs, it’s crucial for employees to receive the care they need. Depending on the severity of the injury, this may include medical treatment and a visit to an approved healthcare provider. This timely treatment is critical for preventing injuries from worsening, and it can also lead to faster recovery times.
Some states require employers to provide a list of authorized medical providers. As an employer, it’s essential to familiarize yourself with state requirements and establish partnerships with healthcare providers that specialize in occupational health. By doing so, you can ensure employees receive proper care and that the workers’ compensation process moves forward smoothly.
It’s also important to maintain thorough records of all medical treatments. Keeping track of medical records not only supports each workers’ compensation claims but also helps you stay informed throughout the employee’s recovery.
Step 2. Prioritize Quick Injury Reporting to Avoid Delays
While medical care is a top priority following a workplace injury, the second most important step in managing any workers’ compensation claims is to report the incident immediately. Timely reporting can make a world of difference. For instance, the National Safety Council (NSC) emphasizes that delays in reporting incidents can lead to complications and higher costs, especially as unreported injuries may worsen over time.
To avoid these complications, employers must have clear internal policies that require employees to report injuries immediately. Train your team on how and where to submit injury reports and ensure reporting forms are easily accessible to all employees. Supervisors should also be well-versed in assisting with injury reports to avoid delays.
State guidelines for reporting will vary, so it’s important to know your state requirements and OSHA’s reporting rules, which mandate that employers report certain workplace injuries within specific timeframes. By having a streamlined reporting process, you can avoid penalties and ensure that your employees receive the medical attention they need as quickly as possible.
Step 3. File Claims Correctly to Keep the Process Moving
Filing a workers’ compensation claims involves navigating a complex system of forms, deadlines and regulations. Each state has its own rules, but the core process is generally the same: You’ll need to fill out the necessary paperwork and submit it to your workers’ compensation insurance carrier within a specific timeframe.
According to the National Council on Compensation Insurance (NCCI), workers’ compensation claims cost an average of over $41,000 per claim. However, staying on top of filing procedures and following legal guidelines can prevent delays and minimize unnecessary costs.
As you complete and submit the necessary forms, remember to keep the injured employee informed about the claim process. Open communication ensures that they understand their rights and know what to expect. Additionally, maintaining communication with your insurance carrier helps avoid any missing documentation or misunderstandings that could slow down the claim’s resolution.
Step 4. Conduct an In-Depth Investigation into the Incident
Once the claim has been filed, it’s time to conduct a thorough investigation to determine the root cause of the injury. An in-depth investigation can reveal important details about the incident and highlight any hazards in your workplace that need addressing.
Begin by interviewing the injured employee, any witnesses and supervisors present at the time of the incident. Capture the details of the scene through photographs, videos and reports. OSHA recommends conducting investigations to help identify potential workplace hazards that might lead to similar incidents in the future.
Investigating workplace injuries also provides valuable insights into whether the injury was work-related and offers you the opportunity to correct safety hazards before they cause future injuries. Document the findings and share them with your workers’ compensation carrier, as this information could affect the claim’s resolution.
Step 5. Keep Communication Open Throughout the Claims Process
A successful workers’ compensation claims relies heavily on maintaining clear communication throughout the process. Employers should check in regularly with the injured employee to show support and address any concerns they may have during recovery. This process is key to preventing misunderstandings and ensuring the claim is processed correctly.
Regular updates about the employee’s medical progress and expected return-to-work timeline can also ease their anxiety and keep them connected to the workplace. Additionally, employers should stay in contact with the insurance carrier to ensure that all requested documentation is provided promptly, and that the claim’s status is updated regularly.
Step 6. Help Injured Workers Transition Back With Support
Return-to-work programs are invaluable. In fact, a 10-year study from the Department of Labor found that these programs reduced lost-time claims by 73% and total workers’ compensation costs by 54%.
These programs offer modified duties, reduced hours or other accommodations to allow employees to transition back into the workforce. Employers should work closely with medical providers to ensure any workplace accommodations align with the employee’s physical restrictions. Offering support during this time helps employees feel valued and keeps morale high, fostering a positive work environment.
Step 7. Wrap Up Claims With Final Documentation and Support
Once the employee has fully recovered and returned to work, or if they have reached maximum medical improvement (MMI), it’s time to close the claim. Employers should ensure that all necessary documentation, including final medical reports and insurance confirmations, is complete before officially closing the claim.
Even after the claim is finalized, it’s a good idea to maintain communication with employees who might need long-term support or accommodations. Proper documentation will also be critical for future reference or audits, ensuring your records are up-to-date and complete. Moreover, employers should remain supportive of employees who may have long-term injuries or disabilities, ensuring they continue to receive the accommodations and support they need.
Step 8. Invest in Safety Programs To Prevent Future Injuries
Finally, taking proactive steps to prevent future injuries is the best way to reduce workers’ compensation claims. Regular safety audits, employee wellness programs and hazard assessments all contribute to reducing the risk of accidents.
Investing in workplace safety programs and conducting regular safety audits are effective ways to address these hazards before accidents happen. And by fostering a culture of safety awareness, employers can create an environment where injuries are less likely to occur in the first place.
Outside of a hazard-focused approach to safety, wellness programs can also reduce workplace injuries. Studies show that employees in wellness programs are more likely to report lower stress levels, reduced musculoskeletal disorders and fewer workplace injuries. By promoting employee health and safety, employers can prevent future claims and create a healthier, more productive work environment.
Let FFVA Mutual Help You Streamline Workers’ Compensation claims
As you can see, navigating the workers’ compensation claims process doesn’t have to be overwhelming when you have a clear, structured approach in place. At the same time, taking proactive steps, such as implementing safety programs and return-to-work plans, ensures a safer and more productive work environment.
FFVA Mutual is here to help you every step of the way, offering guidance and resources to help policyholders streamline the claims process, minimize costs and prioritize employee well-being.
Ready to learn more? Contact FFVA Mutual today for more information on how we can support your business and help you build a stronger, safer workplace.
