8 Things To Learn about Managing Workers’ Compensation Claims

Workers’ compensation can become expensive without proper management. Fraud, for example, can result in the approval of unnecessary claims and their accompanying premium increases. If you take an aggressive approach to denying worker’s compensation claims, however, you risk expensive litigation that might cost more than a fraudulent claim.

After a job-related injury or sickness, the process of workers’ compensation begins. Your insurer works with you and the affected employee to ensure the delivery of an appropriate level of care. Through proper management, you can minimize the cost of a claim while enjoying the security that comes from complying with applicable laws. Learn the following eight things to improve the management of workers’ compensation claims in your company.

1. Prevent injuries

You can take charge of your workers’ compensation premiums by creating a safe workplace. Make sure that your firm complies with all applicable OSHA standards, laws and regulations to prevent the occurrence of all work-related injuries. Another method to reduce the number of injuries in your organization is to conduct pre-employment screenings for applicants who want to fill physically-demanding jobs. Doing so can reduce the severity of injuries and the duration of claims by ensuring that employees can safely perform their duties.

2. Begin with the injury

You and your team should consider a workplace incident as the beginning of a workers’ compensation claim. As a general rule, the delayed reporting of a claim can increase its costs, so your management team needs to know that cost control begins at the time of an injury. To prevent the delay of injury reporting, supervisors and a nurse should be on the scene as quickly as possible to collect information and provide guidance to the worker. Some cases can be treated without any medical attention, and others can be managed without an emergency room visit.

3. Review the facts

Your company can work with your adjuster to prevent workers’ compensation abuse by regularly reviewing the facts surrounding claims. Careful attention to the initial language of a claim, when compared with subsequent reports, can identify fraud and abuse while helping you and your insurer to motivate injured workers to recover. Even when an employee involves a personal injury lawyer, you should pay attention to all the records generated by a claim, especially when an extended claim begins covering conditions that were not directly related to the original workplace incident.

4. Watch for fraud

Make sure that your company has policies and procedures in place to evaluate workers’ compensation claims for fraud. Also, when a workplace injury occurs, you should follow your established rules. Doing so can deter fraud and eliminate unnecessary claims. Examples of potential fraud include employees who file claims for injuries that they incurred as a result of an their personal activities.

Also, some injured employees might exaggerate the extent of their injury in an effort to collect more compensation. Of course, in some claims, no injury at all occurred. Another type of fraud, malingering, can needlessly extend payments and services to employees. As you work with your claims adjuster, look for signs of fraud and promptly report and investigate any related evidence.

5. Monitor recovery

Employees must follow the treatment regimen specified by the doctors that treat them. Failure to comply can result in exacerbated conditions, extended treatment and increased costs. Your firm must, therefore, make sure that a supervisor, manager or nurse monitors the recovery of an injured worker throughout the duration of a claim.

6. Contain drug costs

Compensation for accident at work claims can increase with the use of expensive drugs during recovery. You and your insurer must, therefore, work together to monitor the use of prescription medications in connection with a claim. If the use of an inordinate amount of narcotics and other high-cost drugs is detected during the resolution of a claim, remedial action can be taken before expenses spiral out of control.

7. Accommodate the return

When a claimant returns to work, they can expect their workers’ compensation to soon end. HR professionals and your management team should do everything possible to bring a recovered worker back to work in a timely manner. Doing so can help alleviate problems that can result from social isolation. As part of the process, however, you must consider factors such as the quality of an employee’s relationships at work and the distance between home and work.

8. Manage post-claim costs

Medicare set-asides can be an ongoing source of workers compensation costs. By encouraging employees, during settlement talks, to discontinue using medicine that doesn’t help them, you can reduce the cost of an MSA. You can also reduce the expense associated with other long-term claims by negotiating a settlement.

As an employer, you can avoid the traditional attitude toward workers’ compensation by working together with employees and your insurer to speed up the resolution of claims and minimize costs while providing a satisfactory treatment outcome. As a result of learning the above eight things on managing workers compensation claims, you can look forward to reduced levels of fraud and abuse, minimized treatment costs and the productive reentry of injured workers into the workforce.

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About author

Riya is an inspired writer, passionate about traveling, lifestyle and encouraging startups. With spending her years in business administration, she understands the importance of productivity at work. Riya never stopped finding new ways to create her work productivity. Follow Riya on Twitter.