Workers' compensation: 7 best practices for injury case management

By Higginbotham on May 22 , 2019

GettyImages-Workers Comp blog

There’s only one way your business can run on all cylinders, and that’s with every employee at work and functioning at full capacity. Unfortunately, that’s not always possible. Injuries and illnesses happen. And when you have employees off work due to injury, it can put a real strain on your operation and your bottom line.

But what can you do about it? After all, you can’t wave a magic wand and have an injured employee be well and back to work again instantly. The process has to run its course, right?

Yes, but don’t forget that you have a great deal of control over that process. Take control by following these seven best practices:

  1. Foster an environment of safety, trust and mutual respect. A negative work environment is a magnet for workers’ comp claims, and injured workers often aren’t motivated to get back to that environment. That can drag out a claim.

  2. Educate employees. Employees should know what to do if they get injured on the job, including informing their supervisor, seeking proper care, filling out the proper forms and understanding the workers’ compensation process. Educate them now and have fewer headaches down the road.

  3. Take control early. The first 48 hours after an injury is crucial. During that time, you need to get the injured worker proper care; start the paperwork for your HR department and Department of Labor requirements; inform your insurance carrier; and thoroughly investigate the incident while facts are fresh. This is your best chance to take control of claim costs.

  4. Manage medical costs right out of the gate. Medical treatment accounts for almost 60 percent of workers’ compensation costs, so there’s plenty of incentive to be proactive here. You should have systems in place for coordinating nurse case management, conducting utilization reviews and managing pharmacy costs. Encourage your employees to use only in-network providers and pharmacies to help control physician dispensing, drug compounding and overall treatment costs.

  5. Have a robust return-to-work program. Every day an injured worker is off the job is money out of your pocket. Discuss return to work with injured workers early on, and be prepared to accommodate work restrictions to get them back on the job as quickly as possible. Getting them back to work is the best thing for them and your business, and you don’t want to pay indemnity and medical costs any longer than necessary.

  6. Engage early and often. The workers’ comp system is confusing and stressful for injured workers. Lack of communication is one of the most common reasons they hire attorneys, and it’s a big reason so many claims go south. Communicate regularly with the injured worker, the insurance adjuster, medical providers and anyone else involved in the claim to keep everyone focused on the goal of getting the injured worker back on the job.

  7. Choose the right insurance carrier. Whether a claim stays on track and has a positive outcome can depend a great deal on your insurance carrier and adjuster. Make sure your adjuster is knowledgeable and experienced in your industry, understands workers’ compensation claims and is proactive about keeping claims moving along and controlling costs.

Are you in the driver’s seat of your workers’ compensation program? If you need help getting there, contact our workers’ compensation professionals.

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Tags: Risk Management


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