Claim Reporting Basics, Part 1

Claims Reporting part 1

When it comes to workers’ compensation, claims reporting is one of the most difficult subjects to try and wrap your head around. But understanding it is vital so that you don’t make a mistake that could end up costing you in the end. Let’s learn a little more about it, shall we?

No matter where you are in the country, every state’s rules are the same: employers must report every on-the-job injury. That might seem pretty straightforward, until you realize what it encompasses: a complaint, a whimper, a rumor, a hint, an expression of pain – anything that could possibly, in any way, result in an employee seeking a doctor’s care.

Why is this an important concept to grasp? Because if you DON’T report the complaint, whimper, etcetera, you’re denying an employee their legal rights (the expressed legal right to receive care by a doctor regardless of employer opinion or interpretation). And if that employee decides to lawyer up, you’ll very much regret not taking action.

But surely employers have the right to decide what should or shouldn’t be reported when it comes to an employee’s injury or complaint … right? Wrong. It all needs to be reported. Always.

Some states allow for “stress and psychic” claims (also referred to as a “mental claim”). If you have no idea what that means, you’re not alone. Some states will make you think you can pay a claim directly. Don’t buy it.

Here at INSURED SOLUTIONS, our rule is to always report any employee injury or complaint right away. Complete the paperwork and submit it as a claim and/or mark it as an IRO (Incident Report Only). Having a paper trail will save you immeasurable headaches down the road. The more you can do to cover yourself, the fewer claim problems and costly surprises you’ll have.

If you have any questions, please call our Risk Manager to discuss them. Do not guess or underestimate the problem, because if you’re wrong, we all lose.

Next week, we expand further on this with : Claim Reporting Basics, Part 2: Reporting of Injuries by the Employer

-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.

Share This Post