In the manufacturing industry, over 100,000 workers suffer a job-related injury each year. It's important for employers to take proactive measures to prevent workplace injuries in the first place, but if and when accidents do occur, employers must be prepared to handle workers' compensation claims.
By following these tips for claim prevention and handling before and immediately following the first report of injury, manufacturers can capture significant cost savings and prevent workplace injuries from derailing the business.
Document, document, document.
It's impossible to present a strong defense without diligent documentation, and that starts from the moment an accident is reported. When an accident occurs or an employee shows up to work with a visible limp, wound or other injury, you have a duty to inquire and must immediately gather information, report the accident and begin investigation and documentation.
During the initial claim investigation, the employer should consider and document factors such as: Witness statements; the timeliness of the injury report; evidence of a pre-existing condition for that employee; surveillance footage; timing of the accident; whether or not the employee has group health insurance; history of prior claims; and any recent reprimands, warnings or probation for that employee.
Proper documentation of these facts in the first days following an incident is crucial.
Show empathy and support the employee's request to seek medical treatment.
The moment an individual reports a workplace injury, the employer should express care and concern for the injured worker by sending them to a panel physician for evaluation. This will aid in determining whether or not this is a bona fide claim and illustrate the employer's commitment to addressing workplace injuries in a timely and thoughtful manner. If medical treatment is declined, document this, as well.
If an employer fails to show care and concern and the employee feels ignored or distrusted as a result, he or she is more likely to contact a lawyer and the case is more likely to enter litigation. From the time a claim is filed, the employer has 21 days to investigate and a company is not accepting a claim as compensable simply by sending someone to see a panel doctor, so offering medical treatment can only aid in the claims process.
Establish a strong panel of physicians early and follow requirements for posting and explaining the panel.
A panel of physicians lists the authorized treating physicians that have been selected by the employer, preferably with the help from a defense attorney, for purposes of treating injured workers. Panels should be updated, as needed, on a quarterly or semi-annual basis. If the number of physicians on a panel drops below the minimum requirement, which is 6 in Georgia, or details are no longer accurate due to a doctor relocating or retiring, your panel may be invalidated, giving the claimant the right to choose a treating physician.
The panel must be properly posted in a conspicuous location, like the break room or next to the time clock, and explained to the employee, preferably during the hiring and orientation process. When an injury occurs, it's important to explain the purpose of the panel again, requesting the employee sign and date a hard copy to confirm this occurred.
One of the easiest ways a claimant's attorney can sway the direction of a case is by claiming that the posted panel was never explained to the claimant, therefore enabling that worker to select a different doctor outside of the panel. Doctors off the panel are less familiar with the employer and more likely to cooperate with the claimant's attorney, resulting in higher costs for the employer. Taking the steps outlined above will ensure this does not occur.
Have a transitional, light-duty work program in place.
When returning to work is a viable option, work with human resources and/or the claimant's supervisor(s), to identify light-duty jobs that fall within the work restrictions issued by the treating physician. Welcome your panel of physicians to tour your manufacturing plant so they can observe the range of light-duty jobs available. When weekly income benefits are being paid, once a job offer is made on a form called a WC-240, an employee is under an obligation to return to work and attempt the job. Otherwise, benefits are suspended.
While this may not apply to every case, this is generally the best way to mitigate a claim's value. Transitioning injured employees back to work gets them off any income benefits, restores meaningful employment and income, lowers the chances of that employee seeking additional treatment and controls costs, as well as reducing fraudulent claims in the first place. This also shows you care and that this worker is valued – a powerful message to your other employees.
The first 30 to 90 days will make or break a claim. By staying proactive and following these steps, you can reduce costs and get people back to work.
Originally published by Industry Today
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
