Not a Lexis+ subscriber? Try it out for free.

Workers' Compensation

Why Every Employer Needs a Post-Injury Response Procedure: How to Keep the Ship on Course

 At the 21st Annual National Workers’ Compensation and Disability Conference®, Rebecca Shafer, JD, president of Amaxx Risk Solutions, Inc., will speak on Legal Triage: Team-Based Early Case Management to Fast-Track Claims.

An employer’s actions in the minutes following a workplace injury have a major impact on the overall outcome of the workers’ compensation claim. Actions mean not only having a post-injury response procedure in place but also training employees on how to follow the process.

A post-accident response can include having someone drive the injured employee to the doctor and sending in a fully complete First Report of Injury and Witness Reports to ensure fewer negative workers’ compensation claim outcomes–and lawsuits.

Here is what happens when an employer either has no injury response procedure or, if there is one, no one knows what it is, and the employee is on her own. Marcia, a bank employee, went into the bank vault where she works to get documents out of a lower drawer. When she stood up, she cracked her head on a drawer carelessly left open by a co-worker above her head.

Marcia returned to her desk feeling disoriented and in pain. One of her co-workers, seeing how “out of it” Marcia was, suggested she go to the emergency room. A few minutes later, Marcia drove herself to the local hospital. Testing showed she had sustained a serious concussion. The emergency department called her family to take her home. By not having a post injury process in place, the employee and the emergency department have decided the course of the injury.

In the following days, Marcia stayed out of work because she was still disoriented, suffering from memory loss and an inability to concentrate. Marcia’s mother, not satisfied with her daughter’s progress, took her to a private neurologist who ordered an MRI and confirmed the serious nature of her injury and advised her to stay home indefinitely. Two weeks after the injury occurred, Marcia files a workers’ compensation claim. The bank had not given Marcia any information about when to file a claim or how to get any benefits she is entitled to if she is injured on the job. They have not required her to participate in transitional duty or speak with the company injury coordinator. The insurance company has not required her to give a recorded statement, nor do they know if there are witnesses to the incident. The employer filed a First Report of Injury two weeks after the incident and left responses blank where they do not know have complete information.

Ms. Shafer discusses in her presentation:

  • The 16 components in a post-injury response procedure, including using nurse triage to assess the injury; getting medical care; reporting the injury; completing key forms; handling medical restrictions; employee communication; return-to-work in a transitional duty position.
  • What information the workers’ comp coordinator gives the carrier/TPA, such as completing the First Report of Injury; a written Employee Report of Injury with a body diagram; prior claims list; job analysis with specific restrictions.
  • A standardized response results in better cost containment and maintains a higher level of employee appreciation for the employer’s immediate post-accident response. When an accident happens, everyone, including the injured worker, knows exactly what to do and how to do it because a written set of procedures ensures uniformity of application and effectiveness in following every claim.
  • Seven documents every employer needs to gather the necessary information for the claims adjuster to determine claim compensability and for the employee, supervisor, and workers’ compensation coordinator to arrange for return to work. Tips are given on communicating these procedures in the workplace.

It’s been proven when employers follow these post-injury procedures, injured employees receive better medical care, claims handling is more efficient, employees return to work sooner, and the experience modification factor is lower, keeping insurance premiums from rising.

Follow the link to learn more about how to reserve your place at the 21st Annual National Workers’ Compensation and Disability Conference® and see a complete listing of conference topics.