Tips on managing workers’ compensation claims

One of the most important phases in the life of a workers’ compensation claim is the very beginning, right when it happens, as time is of the essence.

“It’s important to stay on top of the situation and utilize your resources to explore remain at work options for the injured worker as well as coordinate return to work plans when the employee is able to do so,” says Sean McKelley, assistant vice president of claims at CompManagement. “Working with the Ohio Bureau of Workers’ Compensation (BWC), your Managed Care Organization (MCO) and your Third Party Administrator (TPA) will help you care for your injured worker, modify your workplace to prevent future injuries, and facilitate a safe and early return to work. That will not only control the cost of the claim, but also show the injured worker and other employees that you count on them as valuable contributors to your organization.”

Smart Business spoke with McKelley about simple ways to control costs while assisting injured employees.

What should be done immediately upon learning of a work-related injury?

First and foremost, obtain prompt medical attention for the injured employee with a preferred medical provider in your MCO’s network.

Second, document the injury. Take the time to review the circumstances surrounding the injury. Look at how and where the injury occurred and take the steps necessary to prevent another injury. Take pictures or review security footage. Ask the supervisor and co-workers what they saw or know about the incident and create witness statements. Make sure results of the investigation are documented and complete all required reports such as an incident report, a supervisor’s report and other BWC forms.

What can be done to keep injured workers engaged?

Maintaining good communication with all parties involved in the claim can help to minimize the impact of the claim. Stay in touch with the injured worker while he or she is off work and make sure that he or she understands who the primary contact is at your organization if there are questions about a claim.

Employees who do not hear from their employer often assume the employer does not care about them and may even wonder whether they have a job in the future. A brief call once or twice a week will help maintain their confidence, positive attitude and eagerness to return to work. This averts a prolonged disability absence and helps provide an avenue to discuss salary continuation or a transitional work program, which can have a positive impact on your premium rate.

Why is it important to know the doctors in the area?

Many employers have seen the benefits of establishing a working relationship with medical providers in their area, especially occupational health facilities. As these providers become more familiar with your operation, they are able to better assist with transitional duty programs that may be offered to the injured worker during recovery. A transitional duty program provides alternatives to lost time and allows the employer to keep workers’ compensation disability costs low. Often, with minor modification in job duties or hours scheduled, an employee will be able to return to work following the injury. Sometimes a completely different job position is necessary for the short term, but employers should try to accommodate any physical restrictions. The idea is to return an injured employee to gainful employment activities as soon as possible to avoid the ‘disability trap.’ The BWC also currently offers transitional work grants and an incentive bonus program to qualified employers to assist them with the costs of implementing transitional work programs.

What resources are available?

Use the resources available in Ohio through the BWC, your MCO or your TPA. TPAs are retained by employers to help navigate the BWC system. A TPA is an advocate for the employer. An MCO medically manages an employee’s claim and is a neutral party representing both the interests of the employer and the injured worker so that a safe return to work is possible.

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