Tips on Actively Managing Workers’ Compensation Claims

Contributed by Brandon Anderson

Not a week goes by without at least one call from a client asking about what it can and should do about an employee who has been off work due to a work-related injury for one, two or even three or four years.  What often prompts the client to call is the realization that the company has been paying for the injured employee’s portion, as well as the company’s portion, of the employee’s health insurance premium, which can amount to thousands upon thousands of dollars over time. 

In terms of “what can we do,” it always depends on the specific circumstances of the situation.  However, these types of situations always present an opportunity to remind clients that it is criticalthat the company actively manage all open or potential workers’ compensation claims from the very beginning.  Active management ensures that no one loses track of the employee and ends up calling legal counsel to see what can be done about an employee whose status is unknown and has been off work for upwards of four years.  In the spirit of avoiding that conversation, here are some tips for managing workers’ compensation claims:

  • Train all employees on the necessary safety procedures that must be followed in order to ensure a safe work environment.  Be open and communicate with employees about safety concerns.
  • Implement a comprehensive workers’ compensation policy that, amongst other things, requires employees to promptly report all workplace injuries to their supervisors. The policy should also inform supervisors of who they must notify so that the necessary people in the organization are informed of the injury.
  • Develop a relationship with the company’s insurer.  The insurer is going to be (or should be) an expert in “active management,” and will be a great resource.
  • Get to know the local occupational health facility and/or medical providers.  The company should not rely solely on the employee’s medical evaluation from his or her own doctor.  Also, if the company has the ability to provide light-duty or modified work, it is important for the medical facility evaluating the employee’s fitness for duty to know of such options.  The sooner the employee can return to work, even with restrictions, the better.
  • Train supervisors so that (1) they are cognizant of the potential for workplace injuries; (2) they can assist in determining the validity of a potential claim; and (3) as injured workers return to work, they can ensure that any work restrictions are being adhered to and that the employee is capable of safely performing the necessary job duties.
  • Immediately investigate and document all claims—even potential claims.
  • Promptly report all claims to the company’s insurer.  Again, workplace injuries can spiral and minor injuries could turn out to be major.
  • Stay in touch with the employee and ensure that the employee is staying in touch with the adjuster.

The more actively the company manages the claim, the sooner the employee will return to work and the less likely it is that the employee will fall through the cracks.