Planning Leads to Good Workers Compensation Claims Management

Part of any successful workers compensation claims management program is early intervention. Early intervention on all new claims has proven time and again to have a positive impact on the length of both minor and major disabilities and ultimately, the process of a claim payout. Timely recognition by managers and owners and quick reporting of workplace incidents is invaluable to claims management.


In any industry there is a likelihood that an on-the-job injury will occur to one or more employees during their period of employment. The handling of workers comp claims in an expeditious manner enhances the ability of those responsible for the handling of these claims to make prompt contact with the injured worker and prepare them for any medical treatment, if necessary, as well as rehabilitation and an eventual return to work.


Proper claims management will have the following positive affects on a business:


  • Facilitate active case management that impacts payout and early return-to-work planning


  • Provide for the timely delivery of benefits


  • Preserve investigative facts that can affect compensability and/or offset opportunities


  • Enhance the ability to provide appropriate medical management, and


  • Prevent the potential loss of policy or statutory defenses


Be aware of any pre-existing condition


An employee who misses work for a knee injury that is not related to work, then months or years later sustains an injury to the same knee while at work, unfortunately has what is referred to as a pre-existing injury. If the insurance company is notified of the previous problem, it may mean that any permanent disability claim will be lowered because there was a pre-existing problem.


Return-to-Work programs are extremely valuable


Return-to-work programs are essential to the success of a lot of businesses. Claim case managers will contact the employee, employer, and treating physician to determine eligibility for an employee to commence working again. Many return-to-work plans include a diagnosis review, treatment plan, return-to-work strategy, and physician management plan.


A company can benefit by seeking the assistance of an insurer that is committed to actively engaging injured employees in their return-to-work plan. This is an important aspect of any workers compensation claims management program.


photo credit: starbright31 cc