What to Do When an Employee is Injured (and How to File a Workers Compensation Claim)
There are many things business owners worry about each day, and employee injuries are at the top of that list. Even in the safest of workplaces, an employee can get injured very easily. You can make yourself crazy trying to create the best environment for your employees, but unfortunately, you can’t prevent every claim (i.e. slips and falls or car accidents).
When an employee gets injured, it can be a blow to your business. It could affect your ability to generate revenue, it could slow productivity and it could even put a significant dent in morale.
It can also create an enormous amount of stress.
“Are they ok? Should we file a workers compensation claim? When will they be back to work?”
Take a deep breath - we’re here for you. Since 1922, we’ve been helping employers manage their employee injuries, and have been answering all the questions and concerns that come up along the way to recovery.
We know you want to make the claim process as quick and as painless as possible - for both you and your business, and equally, the employee. So read on to learn more about what to do if an employee is injured so you are prepared if and when the time comes that you need to file a claim.
It’s important to note, this article pertains only to workers compensation claims, but is not relevant to other types of business insurance claims. Check out this article for more details on how to file a property, auto or liability insurance claim for your business.
Before a Claim Happens
First thing’s first: while it's important to know what to do when an employee is injured, it's even more important to know how to set up your company to be safe before a claim occurs. Here are a few tips to get you started.
Create an open-dialogue culture
In order to protect your business (and your employees), the first thing you need to do is create a culture where your employees are encouraged to give feedback on workplace safety. They should feel comfortable alerting you to any potential unsafe conditions. They should also be encouraged to report any and all injuries, no matter how insignificant they may feel they are.
Implement risk management strategies
Your next best line of defense against a claim is to implement that feedback, and the feedback of your insurance agent and/or insurance company. If you’re unsure of how to create a safe work environment, or of what strategies you should implement, be sure to discuss your concerns with your insurance agent. They can advise you on the strategies to implement to help create a safer, more productive work environment.
Create an emergency plan
Does your company have a written process for what to do in case of an emergency? If not, you probably want to get started on that right away. The plan would detail who injuries should be reported to, and should detail the steps you will take in a variety of situations.
What to do if an Employee is Injured
If your employee needs medical attention, don’t delay. Call 911 or an ambulance to transport them to the hospital. Make sure your employee knows to advise medical professionals that this is a work-related injury. You wouldn’t want them to give their health insurance information out as that could delay the claim process later.
Collect detailed information
If an employee has had an accident while on the job and you think there is even a remote chance you may want to file an insurance claim, you’ll want to collect some details.
You’ll need the name of the employee and some of their employment details, including date of hire, wages/salary, and job position. You’ll also need to know the date of the injury, where it happened and what the injury is. You’ll also want to take notes of any witnesses or any emergency personnel who responded to the incident.
Your insurance carrier will likely need to collect several details on the incident to file a claim, so take notes on everything to make the claims process smoother and to increase your chances of coverage.
File the claim
As an insurance agent, we always advise our clients to report claims to us, so that we can gather all the information, give any advice on next steps, and then report it to the insurance company for handling. But when it comes to workers compensation insurance, we always recommend that the employer report the claim directly to the insurance company first!
You want to report the claim immediately. A delay in reporting could prevent your employee from receiving workers compensation benefits.
Depending on your insurance company, you might be able to file the claim online, or would have to file over the phone. This report is often referred to as the “First Report of Injury”. If you aren’t sure of how to do this, your insurance agent will be able to help.
Over the years, we’ve had many clients ask us whether they should report a workers compensation claim, or just pay for the medical expenses out of pocket. We get it, reporting a claim means that your insurance costs will likely increase. But if you don’t report the claim, and additional injuries or expenses come up, or worse, a lawsuit, you will likely be on the hook for all payments and legal expenses.
Regardless of if you decide to pay the claim, or file it with the insurance company, you should always put the insurance company on notice. Submit the claim to them, and make a note if you have paid anything out of pocket. That way if something does happen, you’ll have a better leg to stand on.
What happens next?
Once you report the claim, your insurance company will assign an adjuster to take over and process the claim. They will reach out to the employee to gather additional details, and may wish to speak to a manager or supervisor at your company to gather more information.
While minor injuries can be resolved quickly, more complex claims can take months to even years to resolve. This will depend on the circumstances surrounding the claim and the extent of the employee’s injuries. In addition, the workers compensation system is governed by the state of Massachusetts, which means there are very specific laws and regulations that must be followed with respect to a claim. This process can be lengthy and can draw the claim out.
Be prepared before the claim
If you do have an employee that is injured, in addition to knowing how to navigate the claims process, you want to be sure your employee is covered. As a business owner, the last thing you would want is to have an injured employee, only to find out that you don’t have adequate or enough insurance.
What you might think is a small claim, could easily turn into several hundreds of thousands of dollars in medical expenses, rehabilitation expenses, and even legal fees.
Your business is changing constantly, and your workers compensation insurance needs to keep up if you want to ensure proper coverage. Check out this article Why You Should Review Your Commercial Insurance Annually to learn about the importance of insurance reviews, and to know what to look out for.