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Best Practices in Workers Compensation

Effective Claims Handling

Workers' compensation claims can become very expensive when not handled effectively. Following these basic steps may be helpful:

1. Provide initial and periodic employee orientation regarding the reporting of any work -related injuries or illnesses in a timely fashion. Compel employees to promptly report work-related injuries or illnesses.

2. Mandate supervisors to immediately report work-related injuries or illnesses.

3. Implement a supervisor's accident report form.

4. Documentation may provide a basis for further investigating the claim  and contesting a fraudulent claim, and establish third-party liability.

5. Establish communication with the WC carrier. Insist that they
expedite processing of claims, medical treatment, and benefits.

6. Identify the medical clinic; hospital and doctors to whom you will be referring injured employees. Include every conceivable specialty that may be needed, given the work environment, e.g., ophthalmologist, orthopedic, chiropractic, etc. Establish your protocol with each entity so that all matters are handled according to your instructions.

7. Medical treatment must be provided promptly to injured employees. Employers have medical control for the first 30 days, unless the employee previously designated his own personal doctor.

8. Establishing a transitional work program (modified duty). 
The program must be closely monitored.

9. File form 5020 within 24 hours, for every injury other than first aid, with their WC carrier.

10.Additionally, employers are required under LC §6409 to report each injury, which results in lost time or medical treatment beyond first aid to the Cal/OSHA within 8 hours.

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