Claim Reporting – FAQ


Continuing on the subject of CLAIM REPORTING – WARNINGS AND GUIDELINES, we have added an Employer FAQ section.

Do not let a trusted supervisor drop the ball even if they do not realize they are doing it. This may happen more frequently than one might think. Your intention may be to discuss this with your supervisors when you can find the time – but sadly 90% of the time…that time never arrives.


Part Two


When in doubt – Report it as a claim. Conduct the detailed investigation remembering the injured employee needs to fill out their report in great detail using the outlined Who, What, When, Where, Why questions. Give answers without writing down the questions.


Q – Why file a claim if I do not have to or I believe it is a minor injury?

A – 1) To start the clock for you meaning a claim number MUST be assigned. Until that happens, the time clock can run to infinity, which sets you up over the long run. 2) To have a Doctor determine the validity of the report putting it to bed quickly rather than allowing it to linger only to resurface later when facts are vague, conditions change and the employee has skirted a drug test. 3) To send a message that when an employee opens their mouth about any degree of injury the “fun” is only beginning for them.

Q – Won’t this be charged against me and cost me on my MOD?

A – Being penny wise and pound foolish is a trap – do not fall into this trap. The real damage comes if you “guess wrong” and the claim opens up later becoming a genuine nightmare. Remember – you do not have the ability of retracing your tracks or undoing the damage, which leaves the employee in charge on all fronts. Most of these reports will be OPENED with a claim number and then CLOSE in 90-days after any/all bills come in and are paid. If no bills arrive then it goes to $00 on your loss run. You cannot beat the actuarial statistics of 1 claim per year for every 10 employees out working. Of these, 1 in 5 will typically be lost time in some form. Don’t major in minors by trying to beat (nickel and dime) the system because over time it will beat you.

Q – Why can’t I as the employer pay the small first aid or simple Doctor visit claims?

A – Why pay double the cost since carriers apply the state fee schedule for all Work Comp medical services? Why avoid the claim number to start the clock of protection for YOU. Why set yourself up for a small claim to mushroom into a major one that always turns into a very costly one where you have lost all control. Majoring in minors is never a wise decision against a system with unlimited resources and the will power to use them.


Never fall for an employees’ assertion of “I am OK, I am fine, and I can continue working”. Granted a few of these may work out just fine, but those that do not will blow up in your face when all control has been lost and cost containment has become your best—worst option. So take charge of how claims are handled and do not take the expedient way out no matter how tempting it may be at the moment; for in the end…it will cost you dearly.

WARNING: The system knows most employers will take the bait when it comes to ignoring the legalities of Work Comp, which is why they have designed it as they have. What better way to transfer wealth than to use confusion as cover and tacit technicality as the basis for creating confusion?

GUIDELINE : Taking quick action on any potential claim will send the right message to employees, which is — if you choose to go down the road of “I hurt myself” YOU will be the one subject to full scrutiny with no short cuts allowed.