CHECKLIST_HANDLING WORKERS’ COMPENSATION CLAIMS

. The initial period is critical in handling workers’ compensation claims. So you must be sure to:


Immediately

 Administer first aid
 Accompany injured worker to a selected medical provider
 Report incident within company
 Notify family
 Assign responsible person to follow claim


First day

 Report to claim handler outside company (insurance company or third-party administrator)
 Determine, on a preliminary basis, whether the injury is covered by workers’ compensation
 Counsel employee and/or family on claims procedures, available benefits, company’s continuing interest in employee’s welfare, etc.
 Follow up with the employee or family


First week

 Coordinate payment of initial benefits
 Talk to treating physician to learn diagnosis and treatment plan
 Evaluate whether medical rehabilitation is necessary or appropriate
 Develop return-to-work plan
 Contact the injured employee and/or the family and forward mail


First month

 Use a “wellness” approach (cards, phone calls, visits) to continue to reinforce company’s concern
 Consider medical examination by independent physician, if warranted
 Reevaluate treatment plan based on new medical information
 Update return-to-work plan and contact the injured employee and/or the family


Ongoing

 Continually reevaluate treatment plan
 Refer for pain management evaluation of chronic pain, if appropriate
 Maintain contact with the injured employee and/or the family

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CHECKLIST_HANDLING WORKERS’ COMPENSATION CLAIMS