Employers’ Guide to Managing Compensation Claims

managing compensation claimUsually on The HR Digest, we talk about the direct and indirect form of compensation and its multitude of types ranging from salaries to bonuses. This article is an introduction to employers managing compensation claims cost-effectively and as accurately as possible.

REPORT ALL CLAIMS TO THE INSURER AS QUICKLY AS POSSIBLE

Timely reporting of your workers’ compensation claim will help you equalize the claims process. There’s a reason why one must always report claims in a timely manner. It helps-

Preserve evidence,

Resolve claims in a better way,

Start workers’ medical treatment ASAP,

Identity fraudulent claims more quickly,

Avoid potential penalties/fines for failing to report claims.

In addition, it can help avoid delays in obtaining medical records and delays in compensability decisions. HR reps should have the claimant sign a medical release at the time of the injury.

PROVIDE TRAINING ON INJURY MANAGEMENT

Addressing safety and training concerns are critical to preventing workplace injuries. It’s important that supervisors understand the workers’ compensation process so they know what to do when an injury occurs. The supervisors’ role is to direct employees to –

Appropriate individuals,

Help determine if a claim is valid,

Assess the validity of a potential claim,

Manage work restrictions,

Assist in getting an employee back to work in a timely manner.

Moreover, supervisors need to be given proper training on the cost and impact of workers’ compensation, and be held accountable for preventing injuries.

INCIDENT INVESTIGATION

Managing compensation claims includes regarding each injury as legitimate and investigate it thoroughly. If not immediate, then at the earliest. Incident investigation should including the following:

Obtaining facts about the incident,

Timely investigate the witnesses to determine an appropriate plan of action,

Interviewing the supervisor; by and large has the most knowledge of the job and is nearest to the worker,

Securing the scene of the incident and preserving evidence,

Taking pictures.

Please note: Don't decline a questionable compensation claim promptly. Hold up until the investigation is finished and all facts are in before rashly defying an employee about documenting a fraudulent claim. If you wrongly accuse an employee of faking an injury, you could face a lawsuit.

COMMUNICATE WITH ALL PARTIES

It is imperative to communicate clearly with the employee during a workplace injury case. It’s critical to provide proper understanding of –

Employee’s compensation process,

How to report an injury,

When can the employee expect benefits,

How to return to work,

Whom to contact with questions.

Moreover, stay in touch with the case manager/claim representative, work together to manage the claim and reach the proper resolution of all issues. There should be an agreement on targets for the return to light duty, regular duty, and completion of medical care.

CREATE A RETURN TO WORK PROGRAM

Organizations with far reaching come return to work projects can minimize or wipe out lost-time claims by taking an injured worker back to work sooner. It moreover offers the employee some assistance with feeling that they are valued by the organization. Early indicators of underlying potholes in the safety management system should be corrected before a major incident takes place.

PREVENT EMPLOYEES FROM WORKPLACE INJURIES

The primary approach to keep workers from getting injured on the job is to add to a thorough security program, and routinely prepare employees and supervisors on it. Likewise, think about executing as a wellbeing focused culture and building up either an individual or advisory group accountable for security programs.

Likewise, consistently track and audit your organization's cases history and find a way to reduce the odds.

CHOOSE A QUALITY MANAGEMENT ORGANIZATION

A Managed Care Organization is an alternative approach to deal with workers’ compensation coverage. An MCO can deliver –

Medical care to injured employees,

Manager workers’ compensation claims,

The best MCO can help your organization save thousands of dollars on workers’ compensation claims.

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