Claims Management in Workers' Compensation Cases

HR Resource
September 6, 2013 — 2,539 views  
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Workers’ compensation claims are all too abundant, yet surprisingly, very little appears to be understood on issues involving health practice and occupational safety. Companies involve a diverse variety of work environments with challenges of regulatory compliance. However, despite the variation in circumstances, the same health and safety issues are faced by nearly all of them. 

Reporting an Injury 

In case of workplace injury or illness, both employees and employers are bound by a certain set of obligations that should not be over looked for successful workers’ compensation claims to take place.

Workers must report an illness or injury immediately. They need to seek medical attention and inform the doctor that their injury or illness is workplace related. The employer has to bear the transportation cost to the hospital or the medical referral center. The claim should be reported immediately to a place like WorkSafeBC where the documents can easily be submitted online. 

Workers’ compensation claims rest on having fulfilled a certain set of conditions.  Write in detail about employee's as well as the employer's responsibilities when it comes to reporting an injury. The employers too need to submit form 7, which is the incident and injury report. The report can be submitted online or through fax or mail. Fatalities must be reported immediately.

Referring Employee to Medical Care

It is mandatory to refer employees in case of work place illness or injury for the workers’ compensation claims to take effect. Serious injuries as well as fatalities must be reported immediately. Any incident or accident that kills or threatens a worker with death or causes serious injuries to a worker must be immediately reported. The same procedure is to be followed in cases of unusual events involving explosives and blasting accidents resulting in injury.

Any diving incident causing death or requiring treatment against decompression or injury, leak of dangerous substance, collapse or structural failure, collapse while excavation, failure of construction support or equipment or any other serious mishap should be immediately reported whether there is injury or not.   

Effective workers’ compensation claims strategy must ensure that the scene of accident is not tampered with except to attend to injured person, prevent more death or injuries, and protect property.

Returning an Employee Back to Work

Workers’ compensation claims are based on actual illness or injury/death while on work, yet it is important to rehabilitate the injured workers. It is based on the philosophy that injured workers can perform certain tasks conveniently in course of their recovery. Workers are not only able to maintain their income levels, but also perform meaningful work. There are also several other benefits involved in a return to work program such as quick recovery process, retention of job, maintenance of ties with workers and workplace, and protection of employment.  

The management or the employer also has lots to gain from a successful return to work program. The employers demonstrate that they value their employees. It helps maintain a healthy employer/employee relationship while injured workers return to work in a timely and safe manner. Employees can retain the qualified workers while reducing the cost of replacement and training. Employees become partners in the recovery process.

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