Legal and Regulatory

Take a Proactive Approach to Workers’ Compensation Claims

Effective workers’ compensation management strategies help contractors to protect employees from risk.
By Greg Larson
March 1, 2022
Topics
Legal and Regulatory

In 2019, the U.S. Bureau of Labor and Statistics reported more than 195,600 injuries in the construction industry, putting it among the top 10 largest contributors of job-related injuries in the private sector. And while many of the impacted businesses likely had careful planning in place, these statistics show incidents and injuries are an everyday risk in construction. Having a consistent, efficient and transparent process to report, investigate, and record incidents can help minimize disruption to a business’s workforce and get employees back on their feet.

Prepare for possible incidents

Keeping employees healthy and safe should be among any business’s top priorities—particularly in construction. It’s critical to create effective workers’ compensation procedures for filing claims for legal compliance and employee welfare. Comprehensive workers’ compensation procedures should effectively:

  • Help ensure the immediate health and safety of any employees involved in an incident;
  • Assign accountability to all operating personnel;
  • Require immediate and thorough reporting of all injuries and incidents—no matter how minor they may seem—to supervisors or management;
  • Ensure the first report of injury is promptly created and communicated to the business’s insurance carrier;
  • Help business leaders choose objective healthcare providers (if applicable for their state) with knowledge of the state’s workers’ compensation laws; and
  • Direct employees—in non-emergency situations—to a designated management team member to receive proper authorization before seeing a doctor.

Respond quickly to incidents and employee injuries

Even minor injuries can lead to significant workers’ compensation claims if they’re ignored or misdiagnosed. Conducting a timely investigation and thoroughly reporting all the necessary details surrounding the incident helps minimize lost work time for the employee, keeps projects on track and reduces the risk of the employee pursuing litigation against the company.

Create a central resource to gather information and conduct consistent investigations. Record the following evidence during each investigation:

  • The names and roles of the injured employees;
  • Any witnesses present;
  • Descriptions and locations of any equipment involved; and
  • Photos of the location.

In the event of a significant injury, do not disturb the area. Keeping the area as is helps the investigator determine any underlying causes that could clarify how and why the incident occurred. Business insurance providers can help train supervisors to conduct effective incident investigations and teach them best practices for reporting a claim, as requirements differ by state.

Maintain clear and consistent communication

Situations involving injured employees can be complex, and often emotionally charged. Maintaining good communication and a sincere commitment to the employee’s well-being and recovery can help facilitate a more seamless return to work.

Immediately following the incident, establish consistent, timely and transparent lines of communication with the injured employee, his or her health care provider and the business insurance provider. Keeping all parties informed and involved from the outset reassures employees of their job security, and helps them feel more confident that they’ll receive the appropriate care and compensation for their injury.

To ensure effective communication, remember to do the following.

  • Contact the injured employee within 24 hours of the incident and maintain weekly contact. Be prepared to answer the employee’s questions about returning to work, and be sensitive to his or her concerns, welfare and personal privacy.
  • Contact the employee’s treating physician within 24 hours to discuss the employee’s status, when they may be able to return to work and any accommodations they may need.
  • Send a detailed job description to the treating physician and business insurance representatives so they’re aware of the job-related activities the injured employee generally performs.
  • Maintain a detailed log of all contact with the treating physician and injured employee to document questions, concerns and progress.
  • If applicable, contact the business insurance representative to initiate a thorough and confidential investigation of any claims of injuries that may not have occurred on the job.

Be proactive about return-to-work programs

Thorough communication is critical. So is providing the employee with a detailed return-to-work plan. Good programs benefit the businesses by reducing lost workdays, minimizing recruiting and training expenses for replacement employees, limiting claim costs and helping avoid litigation. Efficient programs benefit employees too. They can maintain their earning capacity, return to their original roles with minimal restrictions and feel assured that the company is committed to their safety and recovery.

Incidents and employee injuries are unpredictable and require immediate action. Adjusting programs on the fly can lead to confusion and miscommunication. Develop a policy statement that emphasizes the business’s commitment to providing reasonable accommodations for injured employees. Establish clear objectives and a system to monitor results, with specific criteria for employee eligibility and related administrative details.

Facilitate an effective return-to-work plan
Perform a job safety analysis and discuss the employee’s expected physical demands with their treating physician. Consider the following questions.

  • What activities would the employee need to perform?
  • What physical actions are required to complete expected tasks? At what frequency and duration?
  • What is the daily schedule for this role?
  • What equipment would the employee be expected to use?
  • What skills are needed for an employee in this role?

Recommend practical job tasks that align with the injured employee’s restrictions. Prepare an outline of physical requirements necessary to perform the job. Specify the skills, education, experience and critical physical demands required to perform the job successfully. Identify options for temporary work. Early return to work can be a valuable opportunity for cross-training—the injured employee can learn new skills, making them a more valuable employee to the organization in the future.

Effective workers’ compensation management strategies, including planning and good communication, help construction businesses better protect employees from the inherent risks in the industry. Businesses should always consult with their insurance provider, local expert, or attorney to ensure their plans and procedures surrounding workers’ compensation will help meet the requirements for filing a claim and getting an injured employee the proper assistance.

Keep in mind that even the most effective plan is no replacement for a culture that makes employee safety its top priority. Treating workplace injuries with empathy and honoring employees’ needs is the best way to ensure continued productivity and should always be at the foundation of any strong construction business.

by Greg Larson
Greg Larson is the assistant vice president of workers’ compensation claims for Sentry Insurance. Sentry provides property and casualty products to construction businesses. Learn more at sentry.com.

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