Streamlining Workers’ Compensation Claims: A Guide for Employers

workers' compensation claims

Ensuring the safety and well-being of employees is not only the ethical thing to do, it is also required by regulatory bodies like the Occupational Health and Safety Administration. However, workplace accidents are unfortunate and can wreak havoc on employees and employers. When an accident does happen, it triggers the process known as workers’ compensation. This system provides medical and financial assistance to employees who experience work-related injuries. As an employer, your role in this process is vital. This article will discuss the intricacies of workers’ compensation claims and the importance of creating a streamlined process. This article will prepare employers to take proactive steps to benefit employees and their organizations’ bottom line.

Understanding Workers’ Compensation

Workers’ compensation is a required insurance program that provides medical and financial benefits to employees who are injured on the job. The most common work-related injuries that lead to workers’ compensation include overexertion, slips and falls, and exposure to harmful substances. It is a no-fault system, meaning it doesn’t matter if the injury was due to employee or employer negligence. 

Workers’ compensation provides numerous benefits to both employees and employers. For employees, it provides necessary financial assistance following an injury, including paying for medical bills and wage replacement. For employers, it provides legal protection and allows them to care for employees after an injury. 

Workers’ compensation, though necessary, can be costly for employers. The national average cost of workers’ comp is $1.19 per $100 of payroll. Additionally, the average cost of a claim in 2019 was $41,353, not including intangible costs like lost productivity and decreased employee morale. Getting employees this money can take a long time due to inefficiencies in the workers’ comp process.

The Employer’s Role in Workers’ Compensation

Employers play a significant role in the workers’ compensation process. From creating a safe workspace to communicating with injured employees to filing claims, employers are responsible for keeping the ball rolling and streamlining this process. 

Creating a Safe Work Environment

One of the most effective ways to simplify workers’ compensation claims is to proactively create a safe work environment. While all injuries cannot be avoided, they can be anticipated, and prevention is always preferable to compensation. Employers can make a secure workspace for employees by establishing safety programs that educate workers on safety practices and hazard identification. This process requires collaboration with employees regarding their experiences on the work floor. In these programs, safety training should be the critical focus. Employees should regularly partake in seminars, discussions, and practice drills that focus on safety in the workplace. This includes training on how to use safety equipment, like PPE, and reporting injuries and accidents when they happen. It is important to note that OSHA requires employers to provide employees with a safe way to report hazards without fear of retribution. 

Prompt Reporting of Workplace Injuries

Creating a safe work environment is the best way to prevent injury, but some accidents will still occur. When they do happen, employers must respond promptly to keep the workers’ compensation process streamlined. Employers should create procedures for employees to report workplace injuries. The reporting procedure should always start with getting medical help for the injured employee, as employee safety and well-being are paramount. Quick treatment, such as that from an onsite care facility, can prevent injuries from worsening, keeping employees safer and reducing workers’ comp costs. Following this, the procedure should include reporting deadlines and what personnel to contact regarding an injury. 

Once an injury has been reported to employers, the employer needs to kickstart the workers’ compensation claims process, including notifying the insurance company and gathering information about the accident. Employers must provide support and guidance for injured employees through the workers’ compensation process and ensure they receive the care they need.

Providing Documentation

The workers’ compensation claims process requires detailed documentation about the workplace accident and the injured employee. This extensive documentation often bogs the process, preventing employees from promptly receiving funds. To avoid this slowdown, employers should create a procedure for gathering and making documentation. This procedure should start following the reported injury. 

The first necessary documentation is the First Report of Injury (FROI). This document initiates the workers’ compensation claim and details the accident and injury. This document must be completed accurately and promptly. Following the injury report, employers should collect statements from witnesses to ensure that the incident is fresh in their minds. These statements can provide critical information for the claims process.

Maintaining comprehensive records of medical treatment received by the injured employee, including treatment plans and follow-up care, is also essential. This information ensures that the insurance company can accurately compensate the injured employee. Employers must maintain close communication with the insurance company throughout the process to ensure they can provide all necessary documentation.

Communication with Employees

Communicating with injured employees throughout the workers’ compensation claims process is crucial for successfully managing these claims. Be sure to keep employees updated on the process, including expected timelines. This level of communication allows employees to maintain awareness of their claims’ status and shows them that their employer is concerned about their recovery and willing to provide support. As the injured employee progresses in their recovery, employers can work with them and their healthcare providers to develop a safe return-to-work plan.

Employers can streamline the process by keeping employee safety a priority and actively engaging in the workers’ compensation claims process, leading to quicker processing times and greater employee satisfaction.

How Can We Help?

Work Health Solutions offers comprehensive healthcare solutions for your medical needs. Our qualified team treats patients and employers alike and always provides top-quality service. We back our quality service with years of experience. We have worked with academic and research institutions, corporate healthcare, Fortune 25 companies, small governments, and local businesses. Reach out today with any questions about how we can assist you!

Work Health Solutions

Work Health Solutions

About Us

Work Health Solutions is dedicated to preserving a safe work environment and improving existing programs and care for local, regional and national organizations.

Share This Post

Facebook
Twitter
LinkedIn
Email

Recent Posts

Speak with an Occupational Health Specialist

If you have questions about Work Health Solution's occupational health services or if you need to purchase bulk medical supplies, such as COVID-19 testing kits, please contact us.

Get in Touch

Dr. Michael Tenison

A series of notable accomplishments distinguish Dr. Michael Tenison’s career in medical operations and healthcare management:

  • Successfully led medical operations at a national healthcare provider, focusing on optimizing healthcare delivery and patient outcomes.
  • Oversaw the regional medical practices in key markets like Oregon and Northern California, ensuring consistent, quality medical care and service delivery.
  • Demonstrated exceptional leadership in building and mentoring a large medical provider team, enhancing team performance and patient care standards.
  • Implemented strategic company policies and protocols, significantly improving center efficiency, clinical quality, and patient experiences.
  • Played a pivotal role in financial planning and identifying growth opportunities for healthcare services, contributing to the organization’s overall success.
  • Served as a primary point of contact for regional employer clients and insurance companies, fostering strong relationships and effective communication.
  • Maintained high medical care and case management standards through diligent supervision, chart audits, and performance metric analysis.

Dr. Matt Feeley

Dr. Matt Feeley is a renowned figure in military aviation medicine, with a robust background in occupational and environmental medicine from the Johns Hopkins Bloomberg School of Public Health. 

  • Former Naval Flight Surgeon, exemplifying his expertise in aerospace medicine and commitment to military health.
  • Served with distinction at NSA Bahrain and HSM-37, earning the COMPACFLT Flight Surgeon of the Year award for exceptional medical service.
  • Supported U.S. Marines VMFA-323 aboard the USS Nimitz, MACG-38, and VMU-3, demonstrating versatility and leadership in diverse medical environments.
  • Broad interests and significant contributions in global health, corporate medicine, and aerospace medicine, highlighting his multidisciplinary approach.
  • Proven track record as a dynamic leader, well-equipped to face the challenges in a fractional medical directorship role with innovative solutions.

Dr. Glen Cheng

A physician-attorney with a dedication to healthcare innovation, informatics, and digital health.

  • Currently spearheads employee health protection and promotion within the VA Pittsburgh Health Care System.
  • Trained in residency at Harvard, achieving board certification as a physician; also a licensed patent attorney with experience as FDA regulatory counsel.
  • Co-founded Acceleromics, a consulting firm providing clinical and regulatory guidance to digital health startups.

Erin Davis

 Chief Clinical Officer at Work Health Solutions, certified in Adult-Gerontology (AGNP-C) and Athletic Training (ATC).

  • Oversees clinical operations and ensures high clinical standards across the company’s national field staff.
  • Former Manager of Clinic Operations and Occupational Health Nurse Practitioner at Stanford University Occupational Health Center (SUOHC).
  • Specialized in treating occupational injuries and illnesses, and provided medical surveillance and travel medicine consults at Stanford and SLAC National Accelerator Lab.
  • Dedicated to sports and occupational injury treatment and prevention.
  • Assistant Clinical Faculty at UCSF, mentoring students in clinical rotations within the Adult Gerontology and Occupational and Environmental Health Program.
  • Holds leadership roles as Treasurer and President Elect of the California El Camino Real Association of Occupational Health Nurses (CECRAOHN), affiliated with the American Association of Occupational Health Nurses (AAOHN).

Dr. Robert Goldsmith

Expert in benefits design and onsite innovation with specialization in the pharmaceutical industry.

  • Previous role as Executive Director for Employee Health at Novartis Services, Inc., leading health services and clinical support.
  • Instrumental in creating an integrated healthcare system at Novartis.
  • Former private practice in internal medicine in Stamford, Connecticut, and Medical Director consultant for GTE Corporation.
  • Transitioned to GE as a Global Medical Director in 2000.
  • Holds a medical degree from Albert Einstein College, an MPH from the University of Connecticut, and completed training at Greenwich Hospital and Yale-New Haven Medical Center.
  • Assistant professor in the Department of Medicine at the Vagelos School of Medicine, Columbia University.
  • Serves as a team physician for high school athletes in Stamford.
  • Published works on occupational health risks, primary prevention, and exercise-induced asthma.