Why it is Important to File Workers’ Compensation Claims Promptly
Ensuring that workers’ compensation claims are processed promptly, safely and efficiently benefits both employees and employers.
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Dealing with a workers’ compensation claims is complicated, but critical when work causes a legitimate injury, illness, or disease. Employers need to ensure that workers’ comp claims are processed safely and efficiently. Legal transcription services are available for attorneys and physicians involved in process for documenting primary reports of injury, casualty and liability status reports, financial reports, disability claims, transmittal letters, verification reports, general correspondence, and follow-up notes. Reporting workers’ compensation claims quickly is a best practice that promotes both employee and employer wellbeing. Need to Avoid Delays in Reporting Workers’ Compensation Claims Delays in reporting workers compensation claims can have many detrimental effects. •
Increases claim costs: Acadia Insurance points out that the average cost of a claim that is reported late is higher due to the following reasons: -
Delay in treatment could worsen the employee’s condition and slow down recovery time, preventing return to work and thereby affecting business productivity.
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The investigation of the claim by the insurance company may be impeded as time passes. Witnesses may no longer be available or key evidence may be lost, making it difficult for the insurer to determine compensability.
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Each state has rules on the time limit for reporting workers’ comp claims. Claims submitted after the specified time period may be denied. Many states impose fines if an insured reports a claim late or fails to report a claim. According to insurance industry standards, a claim should be reported within the first 24 hours of occurrence.
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Reporting delays can affect the ability to reject a claim due to the worker being under the influence of drugs or alcohol.
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Late notice can limit the benefits of using managed care initiatives to effectively manage the care of the worker.
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Can affect employee-employer relations: Delay in reporting workers’ comp claim may give employees the impression that the employer is not truly invested in their health and wellbeing. This can lead to loss of trust. Employees handling the work of the injured worker may be disgruntled when they learn that the co-worker’s claim submission was delayed. Moreover, when claims are not reported promptly, it will affect the employee’s interest in returning to work.
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Increases risk of litigation: The potential for litigation when claim resolution is delayed. One of the goals of a workers’ compensation program is to ensure that workers injured on the job get the necessary medical care and income benefits without the uncertainty, delay, and expense of litigation. A study by the Workers Compensation Research Institute (WCRI) found that workers were more likely to seek legal help when they felt threatened. Delays in payment or communications often lead workers to perceive that his or her claim had been denied, although it may be paid later. Swift resolution of the claim is critical for all parties involved and can minimize risk of litigation.
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Supports accident investigation: Acadia Insurance also highlights the importance of reporting all claims, even minor ones promptly, in order to support accident investigation for preventing future losses.
Strategies to Reduce Lags in reporting Employee Injury Claims Here are some tips to build a culture that promotes prompt reporting of workers’ compensation claims: •
Training for employees and supervisors: Both employees, supervisors and managers should be made aware of the importance of timely investigation and prompt reporting of workplace accidents. Companies need to have procedures in place to react to and report such incidents promptly via proper communication channels. Employees should be informed about the proper communication channels to notify the employer of a work-related injury. The supervisors and managers should be knowledgeable about how to collect the vital information from the injured person and how to filling out the Accident Report. Correct reporting should be done within 24 hours of the incident.
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Streamline claims reporting procedures: For timely claims reporting, it is important to have a defined procedure in place. Additional persons should be trained to handle the process in the absence of supervisors or managers. All concerned personnel should be familiar with state rules for “first aid” claims vs. claims subject to reporting.
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Encourage employees to report all claims, even those they do not perceive as serious. The management should reassure employees that they will not face any negative consequences for reporting a claim.
The in-house incident investigation and post-incident drug test should be conducted immediately and the claim should be reported within 3 days of the incident. The longer the lag between the accident and report, the less control the company and their insurer and will have in handling the claim properly. Outsourcing workers compensation transcription tasks to an experienced legal transcription company will ensure accurate and timely documentation of all related reports.
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