• Washington
  • robinwcc2@gmail.com

While some workplaces may be more dangerous than others, accidents can happen at any workplace despite everyone’s best efforts. This means that you, as an employer, have to be prepared for the worst-case scenario so that in case it happens, you can handle it in a way that hurts neither your company nor the employee in question.

Workers’ compensation insurance or workers’ comp is justone of the insurance policies every business must have. Most places, in fact, enforce this insurance for companies of all sizes, but even if your particular state does not, having it in place can save you from a lot of legal trouble when push comes to shove. Improper management of a worker’s comp will greatly increase the insurance expenses and might result in other damages, such as lost productivity. So, here is what you should know about the steps of managing a workers’ compensation claim.

The extent of workers’ compensation

extent of workers’ compensation

It is important to mention that worker’s compensation might not cover every employee, and what kinds of injuries it covers is also limited. For instance, an injury may be ineligible for compensation if it was sustained in the process of “horseplay.” Accidents that occur during commuting might also not be covered, not to mention injuries that the employee sustains while engaging in illegal activities or under the influence.Therefore, you should be well-informed on the topic and keep your policy up-to-date with your company’s needs.

The process of a workers’ compensation claim

1. The incident takes place

Employees should be trained and taught so that they know what they have to do in case an incident occurs. In case an employee gets ill or injured, they should ideally report it immediately. Different states have different deadlines for this. In case immediate treatment is necessary, they are sent to a healthcare facility. As for non-emergency treatments, your insurance provider may have a network of healthcare providers they can turn to.

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2. Recording the incident

It is not enough to report the incident verbally; it needs to be recorded on paper as soon as possible. This is usually done by the supervisor of the employee in question, but it can also be the employee themselves depending on your local laws. The report records all the basic information about the incident, such as the time and place it occurred as well as the injury that was sustained. You are also obliged to provide the affected employee with all the necessary information about their rights and the details of the compensation claim, too.

3. Filing a compensation claim

The next step is filing the compensation claim. This is done either by the employer or HR. You should collect all the necessary paperwork, including the doctor’s report, and send it to your insurance provider, as well as any other authority that your state requires you to.

4. Investigating the incident

The following step in the process involves the investigation of the incident. The HR department collects interviews from the witnesses and reviews the incident. It’s important to stay vigilant here in order to identify attempts of fraud. An employee may exaggerate an injury or try to present an injury sustained in their free time as a work injury.

5. Recovery

In the meantime, you should monitor how your employee’s recovery is coming along. As already mentioned, treatment may be done at a healthcare provider recommended by your insurance carrier. However, keep in mind that the employee also has the right to seek out another doctor if they feel the need to do so. In case the injury was severe enough to take them away from work, the HR department should keep in contact with them and keep a close eye on their progress. This will ensure that the employee is following the treatment prescribed by the doctor and the recovery period is not prolonged, which would be costlier for your business. In addition, this way, HR will be able to predict when the employee will be able to return and organize operations accordingly.

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6. Settlement

At the next stage, the insurer will either approve or deny the claim that was filed. In case it is approved, employees can either accept the offer or, together with compensation lawyers, negotiate better terms. In either case, you will learn about the payment details. On the other hand, the authorities may also deny the claim. This can happen if they find that further investigation is necessary, for instance. In this case, the employee can request reconsideration or file an appeal, depending on the situation.

7. Return to work

Finally, when the employee has recovered, it is time for them to return to their workplace. In case the injury was not as serious, it is also possible to bring the employee back sooner at a lower duty capacity in order to minimize the negative effects a prolonged absence would involve. In any case, workers should return to work as soon as they are ready to – delaying this process is not recommended. In case the employee sustained an injury that prevents them from working in the same position as before, return to work programs are utilized where employees are trained for other skills for a successful return.

As you can see, the whole process of workers’ compensation costs a lot for a business, especially time- and labor-wise. Therefore, your first priority should always be prevention. If an incident does occur, nevertheless, knowing what steps to take immediately is paramount. The most important thing is helping the injured person get the necessary medical help and recover his health as soon as possible. And, when all are safe and sound, the next priority is managing a probable conflict. It is the employer’s duty to care about his workers and put their benefits first. If it is the employer’s fault, he must accept it and make up for the injured. Maybe they won’t be able to work anymore and they definitely need support for the rest of their lives. Whatever it is, compassion and kindness are the things that give meaning to life.