Your workers’ compensation policy is mandatory coverage that you need to have in place to protect your business and your employees. When an employee comes to you to report an injury or job-related illness, there are steps you need to take to ensure you file the claim properly and within the permitted time frame. Learn the laws in your state, so you understand the expectations. You should also train your employees on workers’ compensation policies, so they also know how to report an injury. Find out the basic steps to follow to file a claim.
Employee Reports Injury
When an employee comes to you stating they have suffered an injury, you should first instruct them to get medical attention and pursue treatment. If the injury does not require urgent care, they still need to prove that they sought non-emergency treatments before being eligible for benefits.
Employer Provides Necessary Paperwork and Assists Employee
Next, give them the required paperwork and help them to complete it. Collect supporting documentation. Interview any witnesses that saw the injury occur and get a formal statement. Ensure that the doctor contributes a full write-up of the diagnosis, treatment plan, and prognosis.
Employer Files the Report and Supporting Documentation
Fill the report out in as much detail as possible. Compile the medical documents and any other supplemental materials and submit them all together. In some instances, you may also need to file a report with your state’s workers’ compensation board.
Claim Processed and a Determination Made
Now you need to wait for the insurer to make a decision. If they approve the claim, the insurer will notify both you as the employer and the employee. Your employee receives details of the benefits proposed. They can discuss payment details with their lawyer if they have one. The employee decides whether they will accept the initial offer or negotiate for a different amount in a lump sum or a bigger structured settlement.
If the insurer denies the claim, the employee has the right to request a reconsideration. Or, they may choose to file an appeal through the workers’ compensation board in the appropriate state.
Employee Returns to Work
The final step of the claim process brings the employee back to work after they have recovered. Your insurer requires written notice of the expected return date. It is also possible to offer your employee modified duties if they are able to work in some capacity.
Everyone hopes that workers’ compensation claims are rare, but you still need to prepare yourself in case you need to handle such a scenario. Common claims involve slips and falls, broken bones, and carpal tunnel. Take preventative action to keep your work environment free of safety hazards to try and avoid employee injuries.
About InsureMyWorkComp
InsureMyWorkComp is a digital brokerage that helps clients find the right workers’ compensation solution for their business needs. Unlike other online platforms, we will help you to work with an agent who can provide you the right solution for your risk profile. Our staff has over 50 years of workers’ compensation underwriting and sales experience, and we are confident that we will provide you the support that you need. For more information or to get a quote, contact us today at (855) 340-9138.