Claim Reporting: Guidelines, Warnings, and Tools

This is one of the most critical subjects you will ever try to understand about Workers Compensation. Yet, it is not a subject that screams out to you at the moment of your possible fatal mistake, a mistake all too often made when using employer based logic.

Each state obligates employers to report every injury, which also includes every complaint, every whimper, every rumor, every hint, every expression of pain, in other words everything connected with any conveyed employee wish of seeking or inferring a need for doctors care….no questions asked. To NOT do so is to deny your employee their legal rights at that very moment in time thus setting you up for successful litigation should the employee choose to acquire an attorney.

In the end – employers and supervisors DO NOT have the right to decide what should be reported or not reported when it comes to an employee’ injury or mere complaint, and many times complaints are not obvious or clearly defined. Some states allow for “stress and psychic” claims that have ambiguous dates or time frames and most of these are – trouble heading your way. Some states will make you think you can decide to report or pay a claim directly as if it magically inoculates your future EXP MOD. And if you are one who loves to gamble maybe you will take the bait even if doing so proves to be a costly mistake over time. Beating the house in Vegas is much like beating the system in Work Comp.

The INSURED SOLUTIONS rule is to always promptly report any injury and/or complaint by an employee, other than a band-aide cut and back to work. Complete the paperwork and submit it as a claim and/or mark it as an IRO (Incident Report Only).

The files contained in the Forms Packet or folder we provide all of our clients are to layout the potentially dangerous mine field for YOU the employer if you like to gamble. The system is NOT your friend thus liking or disagreeing with the reporting mandate is not relevant in the end since the state has the final say, we do not.

The more you can do to cover yourself on this subject the fewer claim problems and costly surprises you will have to lament over in the years ahead.

Please carefully review each of the forms/files contained within the packet and accept that only YOU can protect your back pocket when it comes to controlling your claim costs and that Insured Solutions is your ONLY friend in this process.

If you have questions please call me at (229) 207-0664 to discuss them. Do not guess or underestimate the problems that so easily arise because if your call is wrong – we both lose in a big way.

-Steve Petty, Director of Risk Management

StevePettyPhotoCroppedWP Steve Petty joined the Insured Solutions team as Director of Risk Management in 2010. The lessons he has learned from thirty-five years in risk management formed a foundation for what is today a unique Workers’ Compensation program, generating exemplary results for employers.

Contact Steve at, (229) 207-0664.

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