CLAIMS MANAGEMENT
Claims Management In The Workplace :
WHAT EVERY EMPLOYER SHOULD KNOW WHEN AN EMPLOYEE REPORTS AN INJURY
So what do you do when an employee walks in your office and reports that he or she sustained an injury ? Most employers have had it beat into them to call their insurance company , report the injury , and let the insurer handle it . But is that enough ?
In today ’ s economic times , more employers are looking at their mod rates and wondering what they can do to help manage their workers ’ compensation claims and to keep their claim expenses as low as possible to save premium dollars .
This article provides some tips that every employer should implement into their claims management practices that would not only assist a claims adjuster and a workers ’ compensation attorney but also , without question , save the employer and insurer money in the long run .
So , what should you do when an employee reports an injury ? Take the time to sit down with the employee , understanding that your role is to be an investigator who is trying to get as much information from the employee as you can about the injury and document that information . The following is a list of things that you want to keep in mind and put into practice when communicating with the employee :
1 . Document all communications with the employee .
2 . Document the specific physical complaints the employee has and the various body parts he or she feels were injured .
3 . Document the specific employment activities the employee reported to be doing at the time of the injury .
4 . List all potential co-workers and witnesses , and find out from the employee if any of them witnessed the injury .
5 . Use incident reports and require that the employee put down in writing the details of the injury .
6 . Document your observations of the employee over the next couple weeks if he or she continues working .
7 . If using an interpreter to communicate with the employee , document the name of the interpreter , the relationship to the employee , and consistency with the interpreter .
It is extremely important for the employer to document all communications with the employee so that if the matter goes to litigation one year later , your notes are clear and concise as to who said what . It will give you something to review when you are asked to restate what the employee told you at the time of the injury .
With this in mind , if there are co-workers or supervisors that witnessed the alleged injury , confirm with those people what they did or did not see . Again , ask them to write a short note describing what they did or did not see that either supports the employee ’ s claim of an injury or refutes that an injury was sustained . Have the co-worker or supervisor sign and date the note so that when asked one year later , the note can be used to refresh memories of initial observations at the time of the injury .
Under Minnesota Workers ’ Compensation Law , there are a number of defenses available to the employer and insurer to deny primary liability for an alleged injury . Those defenses include but are not
30 | FALL 2016