The 4 Phases of Injury Care
When an injury occurs on the job, prompt medical response offers an important key to a timely resolution and returning an employee back to full function. This begins with a solid implementation of an injury care program as directed by employers, and necessary guidance from medical providers to help return injured employees back to work.
There are four critical phases that an employer must consider during implementation of an injury care program.
Phase I Injury Planning
In order for an employer to be successful when responding to an employee injury, there must be a pre-established injury plan in place before an event occurs. As an employer, you should communicate this plan with employees early on in the orientation process.
With a system already in place, employees will know what to do immediately when an injury occurs, starting communication from the supervisor right through to management and the insurance company. For the best recovery, a chain of events needs to happen immediately for each injury case.
It is important to have an established reporting mechanism in place because it provides the ability to understand lost work time and track lost work days, case duration, and lost productivity time efficiently. Every day that an injured worker isn’t doing what they normally do is an opportunity for worker disengagement and for an injury to become a disability. By having a pre-established injury program in place, you are able to activate the medical response and decrease delays when an injury occurs. A great occupational medicine provider should be able to assist in developing such a program, and assist with planning for injury response before an injury occurs.
Phase II Injury Occurrence
If or when there's an accident in your workplace, the first step you must take is to notify the supervisor at the exact moment the injury occurs, or as soon as possible. The employee must make sure to inform their immediate supervisor of an injury and make sure it has been recorded.
From this point the next step would be to determine the most appropriate care option associated with the injury. As an employer, you must determine where your employee needs to go to for treatment. You must also ensure your employees have authorization for treatment. The injured employee needs to have all the correct paperwork completed in order to receive treatment.
Next, the employer must submit the injury claim to the payor/insurance company so that everything is on record before any sort of treatment even begins.*
Phase III Injury Evaluation
Workplace injuries must be evaluated by a certified physician. The physician is responsible for developing a return-to-work treatment plan specialized to the specific injury. This includes determining the appropriate treatment plan, but also investigating any transitional duty options.
Each step within the injury care process must be communicated to the employee, employer and the payor.** Concentra will provide an Activity Status Sheet after each visit to the injured employee themselves, a copy for their immediate supervisor, and e-mail/faxes to the employer and payor contact.
During the evaluation phase, the medical center where the injured employee is being treated will also submit a payment request to the insurance provider that the employer is currently using.
Phase IV Injury Treatment
Once the injury has been evaluated by a physician, the actual treatment of the injury can begin. The employer and the employee are both responsible for complying with the return-to-work treatment plan in place. Your employee must attend scheduled follow-up appointments and physical therapy (if necessary) until function is restored.
*This document is an overview and does not constitute legal or medical advice. Consult applicable laws and regulations.
**Many states have laws regulating the manner and extent of communication regarding patient care. Concentra strives to provide the fullest communication under applicable laws to maximize employer information while protecting patients’ rights. The communications as described here may be altered to adhere to these laws.