10 Best Practices for Workers’ Compensation Claim Management

By Steve Donovan on Oct 10, 2018
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Whether you are the Head of School for a private school, or a doctor who has opened up your own practice, managing risk in the workplace is a must and should start well before an injury occurs.

According to OSHA, workplace injuries and illnesses cost employers almost $1 billion per week, and that is just for direct costs including workers’ compensation payments, medical expenses, and legal services. Employers also incur indirect costs including hiring and training replacement employees, accident investigation and implementation of corrective measures, lost productivity, repairs of damaged equipment and property, and costs associated with lower employee morale and absenteeism. And even though the number of serious workplace injuries and illnesses fell by 1.5% between 2017 and 2018, their cost increased by 2.9%.

While every measure should be taken to reduce risk, in the unfortunate event an employee gets injured, steps can be taken to minimize employee recovery time and overall claim cost. Axcet’s Steve Donovan, Director of Risk Management, shares his top 10 steps for effective claims management. Donovan has been with Axcet for more than 21 years and is a Certified Risk Manager (CRM).

10 Best Practices for Workers' Compensation Claim Management

  1. Set the Safety Culture

    True claims management starts before an injury even occurs. Management needs to set the safety culture of an organization as a core value and not just a goal or priority. Goals and priorities change. Core values don’t.
    RELATED: Why Every Business Should Build a Positive Safety Culture >>
  2. Document Policies

    Make Sure Your Policies, Procedures and Safety Training are Effective and Well-Documented

  3. Train Supervisors

    Train Supervisors to appropriately respond to injuries, direct injured employees to the appropriate people at the company, assess whether the claim is valid, and determine whether any safety rules were violated.
  4. Complete Reports

    If possible, have the injured employee complete an injury/incident/near-miss report. Make sure the employee is very detailed in describing what they were doing at the time of injury. Also, make sure they are specific about the injuries they have sustained.

    RELATED: 13 Ways To Spot an Employee's Fraudulent Workers' Compensation Claim >>
  5. Medical Care

    Direct injured employees to appropriate and authorized medical providers when possible. The direction of medical care varies by state. Know the rules and regulations of your state regarding the direction of medical care.

    RELATED: Returning to Work After Workers’ Compensation - Tips for the Employer >>
  6. Drug Use

    Follow your company’s post-accident drug testing policy.
  7. Investigate

    Investigate the injury as soon as you can. Speak with witnesses and the employee’s supervisor, take photos of the area where the injury occurred, document everything, and if required, be sure to make the proper OSHA log entries and notifications.
  8. Communicate

    Communicate with the employee, health care provider, and claim representative frequently to let the employee know that you are concerned for their health and that you want to get them better and back to work as soon as possible.
  9. FMLA and ADAAA

    Determine whether the FMLA and/or the ADAAA apply and act accordingly.
  10. Review Past Claims

    Review past claims at your work site to determine the problem areas or issues that need to be addressed. Where do most injuries occur? Why do they occur? Are proper safety procedures followed? What have you done to prevent injuries? If you can prevent the injury, then you prevent the claim. That’s a win. 

Axcet HR Solutions manages human resources, benefits, payroll, risk management, and workers’ compensation insurance for small and medium-sized businesses in the greater Kansas City area. Axcet upholds the highest safety standards and has been recognized by OSHA as a STAR site for eight years. Only companies that demonstrate the very best in occupational safety and health receive this official distinction.

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Written by Steve Donovan

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