The First 24 Hours of a Workers’ Compensation Claim: 6 Steps to Maintaining Safety and Reducing Costs

By: Chrissie Lovold, CWWPC, CPFI, CWCA | National Manager – Workers’ Compensation Advocate, PCF Insurance

Worker’s Compensation (WC) insurance helps your business avoid the direct costs of the injured employee’s medical expenses and lost wages. However, the longer you wait to report an injury, the more expensive that injury is likely to be.

Your response during the first 24 hours post-accident will determine just how much your business will pay in direct medical costs as well as indirect costs including the time it takes to train new employees, accident investigation, lost productivity, and employee morale.

A study by Liberty Mutual found that WC claims reported just four to seven days post-accident were already more likely to be litigated, turn into indemnity claims and cost 9% more than those reported within the first 72 hours. The price tag increased significantly after that.

WC claims reported between 8- and 14-days cost businesses 21% more, a 15 to 21 day lag increases costs by 33% and, finally, those reported a month or more out cost businesses 52% more.[1]

Employers that act within the first 24 hours post incident have the best chance of reducing direct and indirect costs — and more importantly getting their injured worker back on the job faster.

During this short, but critical period, employers can take several steps to secure the best outcome for their business and injured employee:

1. Report the incident within 24 hours. OSHA requires employees to notify them of a fatality within 8 hours and amputation and loss of an eye within 24 hours. Most states set deadlines for reporting injuries as well. Some of these deadlines can be up to 30 days after the incident occurs, often too late for your business. Creating a culture of safety includes learning optimal WC reporting protocol. As a best practice, reach out to your broker or insurer and let them know about every accident on the job as soon as possible, preferably within 24 hours. They will help you determine if it’s a WC claim or not.

TIP: Align your insurance filing with your OSHA filing. This will help ensure the most significantly and costly claims are reported to your broker immediately.

2. Offer medical treatment immediately. Offering immediate medical treatment is important for several reasons. First, it is a vital benefit for the employee. Second, offering immediate medical care can prevent injured employees from seeking more expensive and less effective care later. If the injured employee initially declines medical treatment, documentation on your end is important. Make sure that your offer of treatment and their decline is documented.

TIP: Develop a relationship with a local medical provider or clinic. Doing so will provide you with a trusted source of information every time there’s an injury on the job. If the injury is suspicious or unwitnessed, alert the doctor on the background before they see the patient.

3. Investigate the claim. As the employer, it is your responsibility to report the incident to your workers’ comp insurer. But first, you’ll need to gather all of the appropriate details. Does your workplace have cameras that may have captured the incident? Are there witnesses? Getting witness accounts before too much time has passed adds validity to their statements. Remember, when it comes to WC claims, accurate documentation is your best friend.

TIP: Memories fade and blur quickly. Verify all potential witnesses and interview them within the first 24 hours post-accident.

4. Collect and accommodate work restrictions. When an employee is injured on the job, they have new work restrictions dictating what they can and cannot do due to their injury. Have a few office-related jobs or tasks that can accommodate injured workers while they’re on WC leave. Doing so keeps the worker more engaged and loyal to your business and significantly reduces the chances they’ll take litigation into their own hands. Organizations like ReEmployAbility provide work placement services for injured employees at nonprofit organizations.

TIP: Document each interaction with the injured employee so you can refer to it if necessary in the future. You’d be surprised how often you refer to your notes! 

5. Be the information gateway for the employee. Employers who take an active role in the employee’s claim, introduce them to their WC claims adjuster and keep an open line of communication are more likely to work side-by-side with the employee, reduce the employee’s desire to seek outside counsel. Let employees know what to expect – calls from the examiner and physicians, letters from the carrier, etc. Build trust by becoming their advocate throughout the process.

TIP: Make employee medical care the focus of your aid. This will send a message to your employee that you care about them and want to ensure their optimal recovery.

6. Establish a safety committee review. A safety committee can help enforce and promote your company’s health and safety procedures. This safety committee will aid in providing regulation compliance analysis, but also help further the culture of safety within your organization that encourages employee engagement and awareness.

TIP: Nominate employees from a cross section of your business to build trust from a variety of stakeholders and encourage buy-in from each department.

The 24 hours after an on-the-job-incident are the most critical to reducing injury and WC costs. Make them count.

[1] Liberty Mutual “Workers compensation claim reporting lag study,” February 2021.

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