What to Do After a Workers' Comp Injury Has Occurred

By Eric Becker | 01/19/2017

You did everything right: rigorous safety training, an unsafe practice reporting system, proper personal safety equipment, and a culture of safety ingrained in the workforce. But no matter how prepared you were, an accident happened and one of your employees got injured. You know this accident will involve workers’ compensation, but what’s the next step?

The workers’ compensation process can seem messy and confusing, especially if you haven’t had to deal with it very often. There are certain steps to follow throughout the process to ensure that the claim is handled correctly, and that your employee receives proper care to return them to health and work quickly. Every state’s laws and regulations are different, but this article provides an overview of the proper steps to take after a work-related injury.*

1. Notify and Report

Once a work-related injury has occurred, it’s important to inform all key stakeholders involved in the work comp process. The injured employee should immediately notify their employer or direct manager that the injury has occurred. The employer is responsible for documenting the details surrounding the injury, sometimes known as a “Worker’s Report of Injury”. Once the employer has been informed and any required authorization forms have been completed, the employee is ready to visit their healthcare provider. In situations when an employee is unable to complete the proper documentation, his or her supervisor usually must capture as much information about the injury and document them on their behalf.

When at their healthcare provider, the injured employee should complete documentation showing they received initial injury treatment, commonly known as the “First Medical Report of WC Claims”. There are often short, mandatory time periods in which employers must report the claim to their insurer. The healthcare provider will also be submitting the claim to the insurer within days of the initial visit. Once all parties have been informed of the injury and your employee has visited their provider, the treatment plan can begin and the focus will be on returning your employee back to work.

2. Classifying the Injury

Your medical provider will evaluate the injury and then classify it as set forth in your state’s laws and regulations. Some injuries require no time off work. However, in some cases, while the employee can return to work, they will still need to continue treatment until they are completely healthy and healed. Other injury classifications may require limited-duty (able to return to work with limitations on physical activity) or off-duty (not able to work until given clearance from the medical provider). Your insurer will then have a set period of time from the employer’s knowledge date to either accept or deny the claim.

3. Communicating with the Physician

Just because you’ve transitioned your employee’s care to the provider doesn’t mean communication should stop. In a successful workers' compensation program there will be consistent communication between the employer and physician throughout each step of the treatment plan.** A good care provider will inform you with regular updates after each treatment milestone and discuss any issues that may be hindering the return-to-work process. Employers should be able to talk with medical and therapy clinicians to help increase their understanding of and comfort level with return-to-work plans.

Clinical informatics should also be available to employers. Data outcomes can help employers compare themselves to other organizations in the marketplace and determine where they fit in terms of injury and treatment.

4. Communicating with the Employee

It’s important to maintain communication with your employee both during the injury care process and thereafter. Getting injured on-the-job can be a very stressful situation for your employee and it is important for them to know that they have your support. The employee is more likely to return to work quicker if they feel that they are returning to a positive, caring environment.

Both the employer and care provider should communicate the workers’ compensation process to help the injured employee understand the process and reduce any confusion or anxiety.

5. Reintroduction to the Workplace

After your employee has been cleared to return to the workplace, it is important to engage with them to help support their return to work. Be sure to follow-up on the injury with them and ask if there is anything you can do that might help to ease their transition. Your employee might need some extra safety tools to help them feel more comfortable completing their job tasks.

Conclusion

The workers’ compensation process is one that is complex and at times can be daunting. The above steps provide a general overview of dealing with a workers’ compensation claim. The process can either be simpler or more complicated depending on case and situation. Concentra will be there for you throughout each step of the workers’ compensation process. If you would like to learn more about the process or set up your own customized program, click here

*This article is an overview of general workers’ compensation concepts.  It is not legal advice.  Always consult qualified legal counsel regarding workers’ compensation rights and responsibilities.

**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.