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What are some of the most frequently asked questions regarding workers' compensation claims?

My employee was injured at work, what do I need to do?

Direct the employee to get medical care, and if they refuse medical care, reiterate that it is available to them. Get details from the employee about what happened, what they were doing, when they were injured, and if there were witnesses. Inform your work comp carrier and broker as soon as it is practical to do so that the injury occurred and provide all available details.

Can I just pay the bills and avoid a work comp claim?

Typically, no, not beyond first aid.

My employee did not get medical treatment, should I still file a claim?

The safest answer is yes, you should. A $0.00 claim is unlikely to affect you, but it prepares you and the carrier, should the employee seek treatment later for the injury.

My employee is claiming an injury that is suspicious, should I file a claim?

Yes. Express your concerns to the carrier, and they will likely investigate the matter further. The carrier will deny benefits if the injury appears illegitimate.

When a claim is filed, what information should I prepare?

Make sure that you have as much knowledge as possible about what happened, what body parts were injured, where the injured worker treated, and their employment status. Depending on which state the employee filed their claim in, the adjuster may also need up to 52 weeks of payroll for the employee prior to the date of injury.

My employee got an attorney. Should I be worried?

Not necessarily. Many injured workers are simply unfamiliar with the workers’ compensation process, and hiring an attorney is a way for them to make sure that they are getting treated fairly by the carrier. Your insurance carrier will hire an attorney to represent your interests.

How do I keep my claim costs, and my premium, low?

1. Direct your injured employee to get medical care as soon as you know about the injury. Catching an injury early may prevent it from becoming more serious.
2. Have modified duty available. Keeping an employee on the clock and earning wages keeps them from becoming “de-conditioned,” or reluctant to return to work. This may also keep your claims“medical only,” rather than “time lost” or “indemnity” claims.
3. Stay in contact with injured employees. The more they feel that you care about them, and the more connected they feel to their workplace, the sooner they’re likely to come back to work.
4. If you do not have modified duty available, consider continuing the injured employee’s wages until they can return to work.Even if they are off work, if you continue their wages, the claim will remain a“medical only” claim.

How can I prevent or avoid claims?

Regular safety trainings, as well as a signed training manual from employees, are great ways to increase the safety of your workplace. Keep an eye out for any “high risk” areas, and do what you can to mitigate those hazards, such as loose cords on the floor. Additionally, enforce a drug and alcohol policy, if possible, with signed consent from employees.

If you have any more questions, feel free to email Mike at mcasavant@ellerbrock-norris.com today!

About Mike

Mike previously worked for a large Workers' Compensation carrier, where he handled cases of varying complexity across the country. Mike worked directly with employers to address the needs of current claims, and assisted in educating employers about how to report future claims, as well as avoid them.

Mike currently possesses Workers' Compensation adjuster licenses in Texas, Alabama, Georgia, and New York, and is able to adjust claims in many other states through these licenses.

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