When a worker suffers an injury or illness from work, their life can change in dramatic ways. They will want to know how they can support themselves and their family, how they can get treatment, and if and when they can return to work. The way you support your employee through this process can have a big impact on their recovery.
Managing a work-related injury starts at policy inception. Make sure these forms are given to your employees at the beginning of your policy:
In addition, provide the New Employee’s Guide to Workers’ Compensation whenever new employees are hired.
Next is managing the claim when you first learn about the injury or illness. There are additional forms and steps you will need to take during that process. When you’re ready, you can File a Claim.
If the claim is accepted, you will work with the employee and the adjuster to ensure the process runs smooth. Once an initial decision to accept or delay the claim is made, please follow these steps with your employees. Note that if the claim is rejected, the injured worker can contact the assigned claims adjuster or their attorney, if represented, to discuss the matter.
Here are three things you can do to ensure good communication:
Make sure to proactively share information. Although it is true that the claims adjuster, employee, and medical providers will communicate with each other, it will still benefit you to share information between each group.
If you receive forms or information from the provider or employee, send them to the adjuster. If the adjuster provides you information about returning to work, share it with your employee. This will ensure everyone has the most up to date information, so they can act quickly to manage the claim.
Please respond to communications timely. A claim can generate a lot of information. It will be sent to you over the phone, in the mail, and digitally. It can be a lot to process, and may seem intimidating at first, but it is important that you review and respond to these communications quickly.
It’s best to educate yourself about the process. This will empower you with the information to reach out, ask questions, and help move the claim process forward.
Use Available Resources
Using State Fund Online is the easiest way to ensure you are effectively managing the claim.
State Fund Online makes staying up to date on claims easy, and facilitates communication between you and the adjuster. It provides access 24 hours a day, seven days a week to claim and adjuster information.
We have developed a number of resources to provide you more information about how claims are managed. This content is helpful for both you and the employee, so feel free to share it with them to help answer their questions.
- Understanding Your Workers’ Compensation Claim – Explains the basics of the claim process and the forms you will need to complete.
- Delayed Claim – A claim may be delayed when more information is needed before we can make a liability decision.
- Understanding Utilization Review and the Independent Medical Review Process – These processes ensure requested medical treatments use standard best practices.
- Beginning Temporary Disability Benefits – Temporary Disability may pay a portion of the workers’ salary while they recover.
- Beginning or Resuming Permanent Disability Benefits – Permanent Disability is a benefit for an injury that will not result in a full recovery.
- Returning to Work – Learn about the process of returning to work, including light duty, modified duty, and what happens if there is no work the injured worker is able to perform.
- About Workers’ Compensation Benefits – Workers’ compensation has several different benefits to support injured workers financially. Learn more about Temporary Disability, Permanent Disability, and Supplemental Job Displacement Benefits.
On Demand Webinars
- Claims Management – This presentation provides an overview of the life of a workers’ compensation claim. It provides valuable understanding into how claims are managed.
- Advanced Claims Topics – Some injuries require more advanced care in the workers’ compensation system than others. We explore topics including the claim resolution process, medical settlements, and more.
Lastly, remember that our customer support staff and your claims adjuster are here to help you. They are dedicated to managing claims to the best possible outcome. If you ever have any questions, never hesitate to contact us.